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CASE MANAGEMENT
Highly trained Registered Nurses serve as patient advocates, collaborating with patients and providers to attain the most cost-effective treatment and maintain quality of care.
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Focusing on acute and life-threatening diagnoses such as:
Cancer
Premature delivery
Organ transplants
Cardiac issues
UTILIZATION MANAGEMENT
Independent medical reviews ensure medical necessity and enhance care quality.
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Adding value by:
Reducing healthcare costs
Achieving medical care compliance
Minimizing hospital and ER visits
Screening members for other HealthWatch services
Download Utilization Management Program Consumer Rights and Responsibilities [PDF, 319KB]
Download Download Utilization Management Notification Form [PDF, 244KB]
DISEASE MANAGEMENT
Promote health and control costs through education on chronic conditions, goal setting and patient-specific provider coordination for improved medical knowledge, fewer ER visits and lower costs.
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Multidisciplinary, multilingual Care Coaches led by a Medical Director include:
Registered Nurses
Dietitians
Respiratory Therapists
Exercise Physiologists
Diabetes Educators
Obstetric Nurses
Mental Health Professionals
Download Disease Management Participant Rights and Responsibilities [PDF, 78KB]
Download Physician Rights and Responsibilities 2016 [PDF, 419KB]
ADDITIONAL SERVICES
GPA NURSE NAVIGATORSM
A patient concierge program, designed to help members maximize their benefit plans with step-by-step guidance through the healthcare system.
Each team includes:
Registered Nurses
Multilingual Medical Support Specialists
Benefit Specialists
Physician Advisor
BEWELLSM
A customized wellness program offering your workforce interactive tools to promote improved health habits and increased engagement.
BeWellSM offers:
Certified Wellness Experts
Tailored Program Design
Communications to Suit Your Population
Best-In-Class Management Reporting
Integrated Biometric Screenings
Custom Wellness Portal & Mobile App
Innovative Healthy Me & More Coaching Program delivering online education using varied media sources, accountability, community support, and motivation to achieve goals
LIFESTYLE COACHING
A lifestyle coaching program for individuals who want to achieve a healthier lifestyle and prevent future health problems. Participants work with a Specialized Care Coach telephonically receiving one-on-one support, motivation and accountability to reach their health goals.
Lifestyle Coaching Programs include:
Back Pain
High Blood Pressure
High Cholesterol
Stress Management
Tobacco Cessation
Weight Management