CCN’s clinical management services facilitate the utilization of cost-effective services and promote optimal outcomes through channeling to network providers, identifying potentially unnecessary services and recommending treatment alternatives.

Our services include:

• Early medical assessment—This progressive approach to medical management includes medical necessity review, non-network negotiations and channeling. Our early medical assessment services offer all of the advantages of typical utilization review programs, as well as early identification of case management and increased collaborative and education opportunities with providers.
• Utilization review—Our standard inpatient hospital review includes preadmission, concurrent and retrospective review, helping to identify unnecessary, costly inpatient hospital admissions and reduce cost while promoting quality care through channeling. We also offer outpatient review for clients who want to identify procedures that have historically been at risk for lack of medical necessity.
• Case management—Case management services include screening, referral and intervention. Our experienced case managers get involved early and coordinate medical care across multiple providers and caregivers, with the goal of achieving optimal outcomes and reducing costs.

All of our clinical management activities are supported by an in-house staff of Medical Directors and consultants. For clients interested in a comprehensive clinical management program, our utilization review and case management products may be combined with our early medical assessment program.