Check out this short roundtable discussion with our team to learn how and why they do their important work.
Putting members first
when they need it most.
That’s why we’re here.
Healthcare can feel complicated, confusing, and even a little scary. That’s why our Medical Management team takes our members by the hand to ensure they understand their options and receive the care they deserve. It’s meaningful work from a uniquely talented team.
“I’m speechless and almost in disbelief. This is incredible, we are over the moon grateful for all you’ve done. Thank you, thank you, thank you!!!
Going beyond traditional care management
Better outcomes, timely assistance, caring guidance and even a helpful nudge. It’s all part of the concierge services available to our members.
- Member Services
We are the go-to contact for our members, no matter where they are on their health journey.
From finding a primary care doctor to making postop appointments, we are there in moments
- Single point of contact
- Preferred provider referrals
- 24/7/365 help line
- Coordination of services
- Our 71%-member engagement rate is more than 2x the industry average
- Utilization and Case Management
We provide resources, education, and a review of members’ cases when there is a chronic or
complex condition requiring case or disease management. Our team goes the extra mile for
- Utilization review completed by highly trained nurses and physicians
- Provide education and resources
- Medical necessity reviews
- Precertification needs
- Trigger Reporting
Even if members don’t know to reach out, we ensure that no one is left behind. All utilization
review, treatment requiring precertification, high dollar drugs, 50% specific deductible, and ER
visits trigger an internal review process to assess potential risk, member need and cost
- Early identification of potential large claims
- Review for alternative care options
- Early identification of steerage opportunities
- Member contact with each Emergency Room visit
Care management programs
Whether it’s a chronic illness or a new pregnancy, we’re here to help members navigate through their healthcare journey. Our member engagement rates lead to better outcomes and reduced risk and costs.
We help members manage chronic conditions like diabetes, hypertension, and high cholesterol by providing education, diet, and exercise tips. We can even provide referrals to providers and order medical supplies for our members.
HealthEZ’s team of health care professionals believe that partnership and realistic support are the keys to lasting change.
HealthEZ works with a program called Livongo which helps members stay on top of their health.
Through this partnership, HealthEZ members can get connected devices, personalized guidance, on-demand coaching, an easy-to-use app, and more for help managing:
HealthEZ offers maternity support by providing education and resources to promote a healthy pregnancy through post-partum. Expectant parents receive:
Dedicated single point of contact throughout the pregnancy journey
Referrals to internal programs for additional support
Tips to stay happy and healthy during and up to six months after pregnancy
health is what drives us.
At HealthEZ, we believe nothing is more important than the health of
our members. Our Medical Management team is driven to make a
positive difference in their lives.