EBMS • CLCorePrograms

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CareLink Core Programs:

Coordinated Care (UR)
Statistics demonstrate patients who have received education—prior to and following a planned hospital stay—experience better outcomes. Our CareLink nurses provide our members with support prior to a scheduled hospital inpatient admission and following discharge. The nurse interaction encourages patient compliance with their physician’s established plan of care, and also provides the patient with education and emotional support during a time of illness. Variations from the normal expected recovery are identified and addressed by the nurse.

Case Management
Identification of potential candidates for case management historically has been dependent on hospital admissions or incurred large claims. Quite often the case is so advanced by the time of identification, that opportunities for case management are limited. However, with EBMS’ seamless integration of Coordinated Care (UR) and Case Management with claims processing, we’ve been able to show better cost savings for our clients.

A quality case management program lies in the early detection of serious medical conditions.

Early Detection

EBMS’ proprietary claims processing system uniquely integrates medical and pharmacy claims information, which allows our nurses to identify potential large cases based on the ICD-9 (diagnosis) code associated with the patient’s claims. By identifying potential large claims through this process, our nurses have been successful in becoming involved with cases early on, which has lead to significant savings for both the patient and the plan sponsor.

Flexible Benefit Plans Designed for Your Group’s Needs

EBMS offers employers the unique ability to customize benefits around the specific needs of their employees. A Senior Benefit Consultant and team of professionals will work closely with employers and their broker to determine the appropriate programs and investment needed to maintain and improve their employees’ health. Our goal is to ensure your investment will result in lower claims costs, with improved employee attendance, productivity, and morale, which leads to improved employee satisfaction.