Proven high-quality and cost-effective Managed Care system, using a variety of managed care tools, including:
- Capitation
- Discounted fee for service
- Preferred provider networks
- Utilization management
- Pre-certification
- Retrospective review
- Case management
Services We Offer
- On-site health services (medical, dental and mental) that meet national accreditation standards.
- Off-site health services through negotiated contracts with community medical resources (out-patient specialty, emergency room and inpatient care)
Levels of Care Provided
- Medically Mandatory
Care essential to life and health, and without treatment, rapid deterioration is expected. - Medically Necessary
Care not immediately life-threatening, but without treatment, the patient's health could not be maintained without significant risk.
Access to Care Standards
- Initial comprehensive evaluation within 7 days.
- Sick-call visits within 48 hours (weekdays) to 72 hours (weekends)
- Expedited specialty care within 30 days.
- Routine specialty care within 180 days.
