Catastrophic Care
Catastrophic Care Management
The costliest part of health care today evolves around the catastrophic cases. Management of this segment of the industry makes a major impact on risk factors and losses for any given insurer or benefit plan. PMR’s staff works directly with the participant and claims payors to determine when these catastrophic care patterns may evolve. When a catastrophic case is identified through a unique early warning system, PMR’s staff begins immediate disease management control staying in constant contact with the patient. This may involve everything from counseling to advising the patient how to control their problem to extensive reviews of medical files to determine how best to cope with the problem from a care standpoint. Routinely these cases are subject to utilizing the care of facilities that specialize in their type of care. A few examples could be heart hospitals, transplant centers, or burn centers. PMR negotiates with all of these providers on behalf of the claims payor.
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