Services

Clinical Resource Partners

  • Dialysis Networks and Negotiations
  • Oncology Specialists and Services
  • Neonatal Clinical Management
  • Congenital Heart Networks and Management
  • Access to Multiple Transplant Networks – Centers of Excellence/Medical Advisory
  • Specialty Pharmacy Services/Medical Necessity Reviews/Treatment Protocol
  • Experimental and Investigational Plan Language Wording Assistance

Physician Advisory

  • Medical Necessity Reviews for Pharmacy
  • Medical Necessity Reviews for Treatment Protocols
  • Level of Care Review
  • Experimental and Investigational Medical Advisory Reviews

Financial Review

  • Independent Negotiation Services
  • Hospital Bill Reviews for Costs/Appropriateness/Level of Care
  • Forensic Hospital Claims Review
  • Dialysis Networks and Discounting

Educational Offerings

  • Quarterly web-based seminars
  • Continuing Education Units
  • On-site Programs


Sample Topics include:

  • Anomalies and cardiac disease of newborns
  • Pharmacy Management/Service Delivery Options
  • Oncology Treatment
  • CHF management
  • Dialysis overview: Coverage and maximizing cost efficiencies
  • Documenting Case Management Success: Cost Benefit Analysis Reports
  • Home Dialysis
  • Reinsurance: The Case Manager’s next layer of support
  • Sub-acute care and current trends in managed care
  • Training claims personnel to identify claimants in need of special care
  • Transplant management for case management and claims personnel

 

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190 West Germantown Pike, Suite 200
East Norriton, PA 19401
Tel: 610.940.9000
Fax: 610.940.9022