Posted June 03, 2020 by Charles A. Zonfa, MD, FACOG | Chief Medical Officer and Vice President, Network Development and Contracting
SummaCare understands a fragmented approach to health care can make it difficult for members to achieve an optimal level of wellness and function. That’s why we offer care management services to fully respond to all of our members’ health needs. Our care managers are on the frontlines to help improve patient experience and the quality of care our members receive.
SummaCare care managers are registered nurses who develop a team approach between you, your family members and providers while planning, coordinating, monitoring and evaluating your care plan.
They work closely with you to ensure you receive necessary health services in a timely manner and can assist with transitions between hospital and home or other care settings.
In addition, our care managers will educate you and your providers regarding your insurance benefits, community resources and alternative treatment and service options.
If you’re diagnosed with a complex health issue, a SummaCare care manager will be assigned to you to monitor your clinical care to ensure your health needs are fully met.
Learn more about our care management services and how we’re helping patients and families every day navigate the healthcare system and obtain the information they need to make informed health decisions.
Short-Term Care Management
Care management services may be short-term for members who are transitioning home after a hospital stay, or when a member is new to our plan and needs help finding new doctors within our network.
Complex Care Management
Care management services may be long-term for members with catastrophic or highly complex problems. If you have complex needs, SummaCare care managers will assist in understanding your condition and will coordinate arrangements for complicated plans of care.
The SummaCare care manager stays in touch with doctors and other caregivers and provides assistance with finding needed care within the plan network.
Transitional Care Management
In the event a SummaCare member reaches the plan limits on certain types of care, a SummaCare care manager is available to help you find other resources.
Pediatric-to-Adult Care Care Management
A care manager is available to help SummaCare members arrange for adult care during a transition from child/adolescent needs to adulthood. Our provider search is also available to help find a new provider for someone entering adulthood.
All of our members are eligible for care management. For more information about SummaCare’s Care Management Program, please call <330.996.8931> or <877.888.1164>.