SAVINGS
A good Cost Management Program will help to preserve the benefit plan’s assets. CARE Network’s average return on investment indicates the following range of savings to our clients for every dollar spent:
| Utilization Management (Inpatient and Outpatient) | $ 1.50 - $ 4.50 |
| Case Management | $ 5.00 - $ 17.00 |
Variables such as demographics, overall health of the workforce, and the existence of a Preferred Provider Organization (PPO) could impact the above savings. Having a Cost Management Program may also produce additional, unmeasurable savings via a sentinel phenomenon, which are not represented above.
QUALITY
Our Total Quality Management (TQM) program is incorporated into every aspect of our services. Continuous improvement is achieved through open, ongoing communication, allowing CARE Network to gather internal data and external data (including client satisfaction) which are then compared to nationally accepted standards of care. We use this information to measure our performance and guide us in improving the quality of our service.
ACCESSIBILITY
Our staff is available from 8:00 a.m. to 5:00 p.m. EST, Monday through Friday, and 8:30 a.m. to 5:00 p.m. EST, weekends and holidays, via a toll-free telephone number. After business hours, a confidential voice mail system may be used to leave pertinent information. Our staff promptly responds to all voice mail during the next business day.
ACCREDITATION
The American Accreditation Health Care Commission, Inc. (AAHCC), formerly the Utilization Review Accreditation Commission (URAC), was established to encourage efficient and effective utilization review processes and to promote continued evaluation and improvement in utilization management services. AAHCC’s Board of Directors includes representatives from the American Medical Association, the American Hospital Association, the American Nurses Association, the American Psychiatric Association, the National Association of Insurance Commissioners, the National Association of Manufacturers, the International UAW Union, and the American Managed Care and Review Association.
Our program received this much-sought-after accreditation in 1994. This accreditation is a testament to CARE Network’s meeting the highest level of credentialing in the industry. The CARE Network Medical Cost Management product is licensed in all states that require licensing of utilization management companies.
VALUE
CARE Network brings value by demonstrating a return on investment, appropriate use of health care dollars and services, continuous monitoring of quality, and delivery of specialized services through case management to those patients who need it most.
COMPREHENSIVE SERVICES OFFERED
CARE Network delivers comprehensive services through a professional staff of physicians and registered nurses who are highly qualified in managed care issues, such as quality assurance standards and cost management measures. Comprehensive services include, but are not limited to, the following:
- Utilization Management of Inpatient Admissions
- Outpatient Utilization Management
- Case Management
- Maternal Newborn Program
- Disease Management Program
- Point-of-Service Program
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