Case Management Services

 
At Home Physicians Group, we are dedicated to ensuring smooth and effective transitions of care for patients in post-acute settings. Our comprehensive case management services prioritize quality care, clear communication, and seamless coordination.
  • Our Team:
    • Knowledgeable professionals, including Doctors, ARNPs, LPNs, and Social Workers.
    • Expertise in facilitating transitions and supporting patients’ return to their Primary Care Provider (PCP) services.
  • Our Commitment to Communication:
    • Assistance with all necessary communication between healthcare providers, hospitals, SNFs, PCPs, and health plans.
    • A streamlined direct admission process for both acute and post-acute settings.
  • Direct Admission Goals:
    • Smooth, Safe Transitions: Focused on patient safety and minimizing disruptions.
    • Avoid Hospitalizations: Whenever possible, prevent unnecessary hospital admissions.
    • Key Processes:
      • Completion of required forms such as 3008 and PASRR documentation.
      • Regular status updates to PCPs and health plans.
      • Coordination to transition patients back to PCP services efficiently.
  • Benefits of On-Site Case Management:
    • Improved patient care through hands-on, efficient oversight.
    • Cost savings for healthcare providers and plans.
    • Clear and consistent communication to ensure the best outcomes.
“On-site, hands-on, efficient case management results in better patient care and increased cost savings.”