INSURANCE CASE MANAGEMENT
\ɪnʃˈʊ͡əɹəns kˈe͡ɪs mˈanɪd͡ʒmənt], \ɪnʃˈʊəɹəns kˈeɪs mˈanɪdʒmənt], \ɪ_n_ʃ_ˈʊə_ɹ_ə_n_s k_ˈeɪ_s m_ˈa_n_ɪ_dʒ_m_ə_n_t]\
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Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.
By DataStellar Co., Ltd
