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Employee Benefits Services

Nurse Case Management
 

NURSE CASE MANAGEMENT:
EMPLOYEE BENEFITS SERVICES

IPMG Employee Benefits Services (EBS) offers an internal medical case management program that offers several services that are customizable to meet the specific needs of the client with the focus on the Right Result. IPMG Case Management Program incorporates industry standards and utilizes evidenced-based medicine guidelines in their daily practice of case management to improve the quality of care while saving medical costs. 

The services provided include:

Triage

IPMG Case Management offers an integrated service that evaluates high cost cases and trigger diagnoses to determine the need and appropriate level of assignment to case management through early identification in the utilization review and claims processes.

Case Management

When members have a serious illness, IPMG Case Management can work with them, their family, and their doctor to coordinate a plan to meet their needs. The cost savings is facilitated through network steerage, medical necessity reviews, coordination of services, evaluation of cost effective treatment options, discharge planning, patient education, and negotiations.

Behavioral Health Case Management

IPMG Case management offers specialized expertise in the areas of alcoholism, drug addiction, chemical dependency, mental health, and eating disorders.

Oncology Specialty Case Management

IPMG Case Management offers specialized expertise in the area of oncology.

Medical File Reviews

IPMG Case Management utilizes evidence based medicine criteria to address the medical necessity of services that are outside of the utilization review process.

Medical Bill Review Assistance

IPMG EBS has onsite Registered Nurses that are utilized for resources by the claims payment staff. The referrals are received directly from the claims payment staff with large claims identified and reviewed by the multi-specialty Large Claims Review Team.

Out of Network Discounts and Negotiations

IPMG Case Management assists clients in cost containment by offering our out of network negotiation services with a multi-specialty team approach.

Employee Health Management

IPMG Case Management is a key team member of the Health Management Resources Team that is a multidisciplinary team approach to promote employee good health with cost reduction realized in medical and disability dollars through identification of “at-risk” employees. Case management works with patients with chronic conditions to reduce the risk of further complications.

Utilization Review

IPMG EBS partners with select vendors to provide utilization review services specific to the clients’ Health Plan. IPMG offers partners that are URAC accredited Utilization Management programs that are designed to positively impact claims costs and provide savings to the claim.

Specialty Drug Program Review

IPMG Case Management offers specialty drug review that facilitates early identification of cost savings opportunities with early triggers to case management.

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