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Case Managers

What A Case Manager Does

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Wikipedia defines a Case Manager for a health insurer's functions as follows:

  • Check benefits available;
  • Negotiate rates with providers who are not part of the plan's network;
  • Recommend coverage exceptions where appropriate;
  • Coordinate referrals to specialists;
  • Arrange for special services;
  • Coordinate insured services with any available community services; and

Coordinate claims with other benefit plans.


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