Dean Health Plan Cares For You
Sometimes navigating your way through the health care system can be challenging. That’s where the Dean Health Plan (DHP) Care Management Team comes in. If you are diagnosed with a chronic health condition or have a complex health care need, DHP provides the following services to ensure your needs are met and all your questions and concerns are addressed.
All for a Healthier You
DHP offers Disease Management programs that are designed to help members get answers to questions about their disease and offers support to help manage chronic health needs. Along with your health care providers, the DHP Disease Management team specializes in supporting patient self-management through telephonic counseling, care reminders, referrals, and long-term patient advocacy and support.
Support When You Need It Most
A member may be identified for Case Management based upon a diagnosis, acute injury, or from a referral by a health care provider. You also have the option to request Case Management services. Case Management is complimentary and provides you with a registered nurse who serves as your resource during a time when health care may be intense or confusing. Your Case Manager will work together with you, the health care provider, and other members of the health care team as needed to establish the best plan of care for you. Case Management does not provide additional benefits or change your plan’s benefit rules; however, the Case Manager will work with DHP network providers to meet your needs using available resources with the goal of delivering quality care.
Focusing on Quality Care
The DHP Utilization Management (UM)* team uses pre-admission certification, prior authorization, concurrent reviews, and discharge planning to review the appropriateness of medical services that our members receive before and after services are rendered. These tools allow UM to ensure members are receiving services and supplies that are medically appropriate for the member and necessary for the condition being treated. The review of services includes inpatient hospital admissions, skilled nursing facility and rehabilitation care, home health care services, hospice care, and behavioral health outpatient care. In addition, UM identifies and evaluates a patient’s health care needs following discharge from a hospital and assists members with post-hospital care.
For more information on the DHP Care Management services visit deancare.com or call the DHP Customer Care Center at 800-279-1301.
*Dean Health Plan assumes that no one involved in the decision-making process benefits from denying treatment. We do not specifically reward practitioners or other individuals conducting utilization reviews for issuing denials for coverage of services. Furthermore, financial incentives are not provided to UM decision-makers, nor do we encourage decisions which may result in underutilization.