Denver Health Medical Plan, Inc. (DHMP) Case Management Department provides service to our insured members including Denver Health commercial plans, Medicare Select, Medicare Choice, CHP+ and Medicaid Choice. Services are provided in three main categories: Utilization Management (UM) and RN Case Managers, Complex Case Management (CCM) and Episodic Case Management.
Insurance (or payer-based) case management services are necessary when our members have the following situations. Depending on member needs, there are times when case managers from several areas are working together to provide services.
- Acute health care needs, diagnoses, or hospitalizations
- Complex medical issues and co-morbidities
- Complex hospital discharge requirements
- Complex social issues
Our case management staff works with members, families, and health care providers to make sure our members receive the best care possible, in the most cost-effective way, with the best possible outcome. Because we provide case management services in an insurance (payer-based) setting, our focus is on the health and wellness of our members and being a liaison between providers of care.