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Programs

 

24-Hour Nurse Helpline and Health Information Library

Experienced registered nurses are available via a toll-free telephone number, 24 hours a day, 7 days a week. Using advanced clinical criteria, this program provides health information and education to patients and their families, and assures the most effective patient cost management by avoiding over-utilization of unnecessary settings. Health care counseling and telephone triage assess health status and provide immediate health information, steering patients to the appropriate level of care, which may include self-care instructions.

Wellness and Health Coaching

Programs uti-lize the latest coaching and patient engagement strate-gies to promote the best outcomes. Health coaches work one-on-one with patients to develop care plans that address all aspects of their disease and wellness ini-tiatives including smoking cessation, obesity manage-ment and stress management. Health Risk Assessments are offered online, telephonically and by mail.

Independent Physician Review and Consulting

Physicians in a broad range of medical specialties provide expert clinical decision making support on a prospective or retrospective basis, meeting all regulatory requirements and timeframes for appeals and external reviews.

Claims Cost Management

Conducted by experienced nurses, hospital bill audits fee negotiation and DRG Validation assure clients that claims payment is both cost-effective and clinically appropriate. Clients receive effective claims cost containment with measurable results and quick turnaround.

Disability Case Management

Claims review and case management intervention by AMM's registered nurses and physicians facilitates a patient's return-to-work when clinically appropriate. AMM communicates directly with the employee, physician, worksite contact, and claims payer to assure appropriate length of disabil-ity certification and claims payment. AMM also works with the treating physician to identify potential partial return to work options and modifications.

24-Hour Referral

Operating 24 hours a day, 7 days a week, experienced and knowledgeable customer service professionals direct plan participants to customized hospital and physician networks.