Group Health programs generally don’t have adjusters like other insurance programs. They most often have claims processors, which for the most part, have no one to ensure the care a patient receives is timely, effective, and coordinated with all treating providers. Most cases move forward with no coordination, resulting in them taking on a life of their own, wasting a lot of precious time and money.

The ultimate goal of the nurse case manager is to assist the patient in returning to optimal health as soon as possible. This is why their role can be so important in reducing costs associated with hospital stays, surgeries, and a number of chronic illnesses. They ensure specialty referrals are made promptly, that the patient understands the treating provider’s instructions, and orders for prescription drugs are followed correctly to enhance recovery times  — and that saves money for everyone!

MediReview has a professionally trained team of registered nurses who are Certified Case Managers. Collectively, MediReview has managed thousands of cases over the past 30 years of service. There are numerous tools used by our nurse case managers, perhaps the most valuable, is their knowledge of the healthcare system, what questions to ask, and how to move someone through it quickly and effectively!