Case Management
Cost effectively coordinate quality care for even your most complex cases
TruCare Case Management allows you to easily coordinate care for members with the most complex health needs. Reduce costs while improving health outcomes through streamlined workflow and business
processes. This module operates seamlessly with the TruCare Disease Management, TruCare Home and Community Services, and TruCare Utilization Management modules, establishing a single platform you can utilize across your entire population.
Case and Program Enrollment – Effectively track member programs and case artifacts in one place. The power of enrolling members in cases and programs both within the TruCare Case Management workflow as well as outside of the workflow guarantees organizational processes are upheld.
Assessment & Referral Management – Easily identify high-risk, high-cost members for case management by leveraging internal and external patient data from multiple referral channels. Swiftly determine which programs and resources will be most beneficial to the member utilizing structured and configurable initial, general, and specialty assessments.
Care Planning –Better assess a member’s health status by simultaneously viewing co-morbidities within the template-based, configurable care planning tool. Allow clinical users to quickly individualize care plans for member-specific conditions, while driving program consistency. Ensure ongoing adherence to care plans and correct deviations from treatment protocols.
Task Management – Readily view required tasks in order of priority through a single shared platform showing user and member information as well as input of other care team members’ tasks, which automatically populate. Proactively identify missed tasks and gaps in care with your care team per your standard operating procedures to expedite appropriate interventions.
Documentation & Letter Generation – Documentation is effortless with structured notes that meet individual organization
requirements which are available throughout the case management workflow. Users can easily configure, customize, and generate accurate, comprehensive, and relevant template-driven letters; for both internal and external audiences.
Third Party Integration – Web services allow for the efficient exchange and integrate real-time data with eligibility criteria, claims and pharmacy data, predictive models, third-party HRAs / vendors and lab systems, resulting in a true member centric health record. Multiple document formats are supported in faxing through both inbound web services and outbound fax.