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Success Story: Assisting Member with Breast Cancer Treatment Options

Patient: a 63 year old female Diagnosis: The member has a diagnosis of stage I (T1bN0)invasive ductal carcinoma of the upper outer quadrant of the right breast. Medical History: The member had breast implants more than 20 years ago, and actually her cancer helped discover that the right implant was leaking.  She underwent removal of her implants and lumpectomy [...]

2016-08-03T23:33:47+00:00 August 3rd, 2016|Solutions for Better Health, Success Stories|

Success Story: CPAP Needed for Obstructive Sleep Apnea

Patient Medical History: The member has a history of Obstructive Sleep Apnea.  MCM Intervention: The member's doctor office was not helpful in getting DME for his OSA and left the task of finding a DME provider up to him. The member had difficulty and found a pharmacy that did not supply CPAPs. Our Case Management team spoke with the patient to direct [...]

2016-06-29T21:47:05+00:00 June 29th, 2016|Recent News, Success Stories|

Success Story: Patient Averts Progression of Disease

Patient Diagnosis: The member has a diagnosis of diabetes and atrial fibrillation. Medical History: The member has a history of diabetes and atrial fibrillation.  MCM Intervention: Since enrolling in the diabetes program the member has been receiving education and surveillance on proper diet including snacks. The member was experiencing low blood sugar in the morning. In [...]

2016-05-28T21:15:10+00:00 May 28th, 2016|Recent News, Success Stories|

Success Story: Case Manager Expedites Precert to Avoid Delays in Treatment

Patient Diagnosis: The member is diagnosed with B cell Lymphoma. Medical History: The patient had been suffering from TIA-like episodes for the past few years that had become more frequent and he was starting to have decreased mentation and ability to communicate. He had been shuffled from one doctor to another without a diagnosis, until he was [...]

2016-05-26T21:40:38+00:00 May 26th, 2016|Recent News, Success Stories|

Success Story: Case Manager Assists in Acute Inpatient Rehab

Patient Diagnosis: The member met the medical necessity for a continued stay in Acute Inpatient Rehab. Medical History: The patient was progressing and needed more time as an inpatient. MCM Intervention: The MCM Case Manager contacted the fund office and received clarification regarding Acute Inpatient Rehabilitation benefits. The family and case manager were both informed shortly thereafter that they were still [...]

2016-05-03T15:51:31+00:00 May 2nd, 2016|Recent News, Success Stories|

Success Story: Case Manager Assists Parents of a Member with Lifelong Care Needs

Patient: 20 y/o male Diagnosis: The member has a history of premature birth, cerebral palsy, and is visually impaired. Medical History: The member's parents have had challenges with lifelong care and getting equipment needed while conserving resources. MCM Intervention: Overall, this is a family working hard and giving everything they have to their child. Our [...]

2016-04-06T14:36:29+00:00 April 5th, 2016|Recent News, Success Stories|