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

HiRes_MANPatient 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 hospitalized while on vacation in South Carolina. The patient’s wife was our main contact as the patient’s condition did not allow him to be a full participant, however, the patient was on speaker phone for our first contact. The patient’s wife was exhausted and desperate to get her husband the treatment that he needed. We happened to intervene when they were finally going to get to see a neuro-oncologist and devise a treatment plan. 

MCM Intervention: The MCM Case Manager was able to expedite the reception of the clinical so that the patient’s chemotherapy precerted in a timely manner, and not cause any further delays in his treatment.