| Medical
Case Management
By serving as a professional collaborator with -- and liaison between --
health care providers, medical equipment providers and insurance claims
staff there are many opportunities for a medical case manager to improve
quality, outcome and lifestyle for patients while also controlling costs.
Global Medical Management, Inc. takes a proactive approach to case management.
Medical episodes are monitored to prevent unnecessary treatments and duplication
of services. Medical monitoring ensures and confirms the appropriateness of the
treatment plans being proposed. Medical case managers are able to coordinate
and review projected treatment plans with attending physicians. If the proposed
treatment does not meet established criteria the case is forwarded to a peer
review physician for evaluation. The peer review physician communicates directly
with the attending physician and the plan is mutually discussed, clarified and
modified in order for it to meet eligibility criteria.
GMMI has 24-hour access to our Medical Department and Medical Director.
For purposes of peer reviews and / or treatment denials we have access to
medical doctors of the following specialties; Cardiology, Dermatology,
Endocrinology, Gastroenterology, General Surgery, Hematology & Oncology,
Infectious Disease, Internal Medicine, Neonatology, Nephrology, Neurology,
Obstetrics & Gynecology, Ophthalmology, Orthopaedics, Podiatry and Psychiatry.
Procedures for Medical
Case Management
The client, with assistance from GMMI, determines which cases will benefit from
medical case management. Medical case management begins whenever GMMI becomes
aware of a case that meets the client’s predetermined criteria or is notified
by the client of the need to begin managing a particular case. Qualified and
experienced medical professionals under the overall supervision of Dr. Wayne Lee,
Medical Director, perform the medical case management services.
GMMI can manage all aspects of a case, from the onset of an illness or injury
through its resolution (returned to previous level of wellness/repatriation). Our
proactive methods to containing costs yield substantial savings by preventing unnecessary
services being rendered; monitoring the treatment proposed by the attending physician,
and diligently monitoring cases where the patient and the client might be better served by repatriation.
Medical Services:
GMMI’s Medical Director Dr.
Lee provides GMMI with 24 hour physician coverage. Dr. Lee is
currently the Chief of Emergency Medicine of the North Broward
Hospital District. Dr.
Lee is able to provide us consulting physicians for any specialty.
Contact Us for more
information on Medical Case Management and:
Pre-Certification
Utilization review
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