Case Management

Case management services are a standard of care in healthcare today used to better meet patients' needs and improve their treatment by attempting to coordinate the full continuum of care. Onicol achieves this by coordinating the full range of case management services. We provide telephonic, onsite or web-based case management services as part of Onicol's Medical Management and Pharmacy Management programs across settings and specialties. This is a fully integrated component of Onicol's Protocols, Pathways and Systems. Each requested service, prescribed medication, or collected outcome can trigger an episode for case management intervention. Ultimately the full integration of Medical, Pharmacy and Claims enable Onicol to monitor a patient's progress through the treatment plan and react to the smallest yet important clinical information that is provided by patients, providers and staff. Each request and entered outcome trigger a risk assessment algorithm and, if any data point is abnormal, or is identified as a risk factor or change in protocol then the patient's case is immediately triaged and a case manager will take the appropriate next steps. This comprehensive program is designed to empower well-trained, experienced Case Managers resulting in improved outcomes and lower costs. This is achieved when Case Managers:

  • Each handle a low volume of patients that are carefully screened by our systems
  • Insure patients fully understand their condition and how they can improve the outcome of their own care
  • Carefully coordinate a patient's medical and pharmaceutical services
  • Are also responsible for prior authorization and utilization management for a members treatment giving them unparalleled insight into the patient's record