Overview:

Telligen's Case Managers coordinate treatment plans and engage directly with your members and their families to coach, educate and empower them and their providers to take the complexity, fear and cost out of complex care.

Programs:

• Catastrophic
• Oncology
• Transplants
• End Stage Renal
• Infertility

Success Story:

A 56-year-old member was diagnosed with Lymphoma. Telligen's Case Management team became involved. During chemotherapy and radiation therapy, multiple health issues arose. The cancer returned and an inpatient stay left her so weak her family could no longer care for her at home. The family contacted the benefit office and asked for assistance.

The benefit office contacted the case manager as the decline happened over the weekend. The case manager was in contact with the patient's family and a skilled facility, and negotiated a rate for the care as the facility was out of the PPO network. Within hours, the member was on her way to the skilled facility and the family was thrilled.

The family stated: "I hope you know how much we appreciate that we can count on you!" The negotiations saved the patient's family and the insurance company over $500 per day.

Return On Investment:

For every dollar spent in the case management program, four dollars are saved.