MedCareOne

Our Services

MedCareOne is a comprehensive care management service designed to help members navigate their healthcare options. 

Case Management

MedCareOne nurses work directly with patients, their families, and physicians to coordinate cost-effective, quality care. MedCareOne promote optimal outcomes for patients with catastrophic or chronic conditions. Our team of nurses help ensure that our members are getting the appropriate services for each condition. 

Utilization Review

MedCareOne’s team works diligently to confirm that the suggested procedure is medically necessary. The Utilization Review team works closely with the Utilization Review team to follow up and ensure that the member is having success during their treatment. 

Renewal Process

MedCareOne’s team provides a complete and comprehensive review for potential high-dollar claimants. They communicate directly with the stop-loss underwriters and clinical review team.   

Negotiations

MedCareOne’s team works thoroughly to review in and out-of-network claims to find resolutions and savings for high dollar claims. MedCareOne is able to assist members with Single Case Agreements to prevent any balance billings.