MHS has several programs to improve the health of our members. We do this through education and personal help from MHS staff. This is referred to as case management. The goal of this service is to add to the quality of your care and help you to improve your health.

Case management is part of your health benefits and is provided to you at no cost. MHS pays for this service. You may be selected for these services in a variety of ways:

• Your doctor may enroll you
• We may call you after reviewing your medical information
• You or your care giver may call and ask to help

Your case manager will help you work toward better health using the following methods:

• Frequent contact with members, family and health providers
• Member assessment and evaluation
• Care planning and setting short and long term goals
• Coordination of services to provide necessary and efficient care

A case manager is a resource person:

• To answer questions about treatment.
• To help you meet your health needs by using knowledge of the health care system
• To help you consider your options and choices
• To work with you to develop a plan of care for home health services, if needed.
  • These might include such things as nursing services, medical equipment, and physical therapies.
• To help with referrals for treatment at health care facilities
• To act as your link to MHS
• To identify covered benefits and help with referrals to specialists
• To help to plan your transition out of the hospital.
  • This helps to reduce the stress of the often complex health care system

Confidentiality:

The information obtained through our case management process is confidential. It is shared only when needed to plan your care and to properly pay your claims.

Ethics:

MHS provides case management services in an ethical manner based on CCMC and CMSA’s Statement on Ethics and Standards of Practice.  Upon your request, information on MHS policies and standards regarding its ethical framework for case management, are available to: staff, members, consumers, contractors and clients.

Please contact us at (888) 713-6180 to request to speak with the MHS Compliance Officer.