Care Management
Care Management facilitates improved health outcomes and wellness for Consumers Life members. We focus on ensuring and facilitating the delivery of medically necessary, high quality, cost-effective healthcare services in the most appropriate setting. In addition we strive to provide information and tools to our constituents that will empower members, support providers and manage healthcare trends for our employer groups.
Available Resources
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2008 Prior Approval List
List of services that require prior approval.
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Clinical Quality
Consumers Life recognizes the adoption and utilization of clinical practice guidelines that have been developed by our network providers as one way of achieving better health for our members.
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Discharge Planning
Convenient discharge instructions for patients, families and all individuals and organizations responsible for providing continuing care.
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Medical Necessity Criteria
Criteria utilized for medically necessary determinations.
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Corporate Medical Policies
Consumers Life’s guidelines for determining coverage criteria for specific practices, procedures, equipment and services.
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Patient Safety
Consumers Life works to educate our members and work with you to improve the safety of all hospitalized patients through the implementation of programs and initiatives.
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Rx Benefit Management
Consumers Life’s guide to prescription formulary, pharmaceutical education, prior authorization, clinical services and home delivery practices.