Horizon Case Management FAQs

A Nurse Case Manager is a registered nurse (RN) with specialized training in case management. They work with patients, families, healthcare providers, and insurance companies to ensure patients receive appropriate care and support.

A Certified Case Manager is a healthcare professional, typically a registered nurse (RN), who has obtained certification as a case manager. CCM certification signifies that the individual has met specific education, experience, and examination requirements in the field of case management. Our case managers either have a CCM certificate or work directly under a Certified Case Manager.

You might need Nurse Case Management Services if you have a complex medical condition, require ongoing care coordination, or you’re navigating a challenging healthcare system. It can help you access the proper care, resources, and support. Other specific reasons could be you have been in a car accident, struck pedestrian or bicyclist, injured worker, or struggling with Acute or Chronic Health conditions such as Traumatic Brain Injury and Spinal Cord Injury.

Nurse Case Management can benefit you by providing personalized care plans, optimizing treatment options, reducing hospital admissions, coordinating transportation services to get you to and from doctor’s appointments, arranging home care services, arranging service providers that will accept your insurance, and helping you access the right care, resources, and support.

No, Nurse Case Management can be beneficial for various medical conditions, from chronic illnesses to post-surgery recovery and even preventative care. It’s not limited to serious conditions.

Yes, our Nurse Case Managers work with individuals involved in Motor Vehicle Accidents or Motor Vehicle Collisions.

Yes, our Nurse Case Managers work with individuals injured in their workplace or work vehicle.

Yes, our Nurse Case Managers can help you with job placements, job description modification, finding employment, or setting you up in a vocational therapy program for a smooth transition.

You can access a Nurse Case Management Services by calling us at 855-487-6626 and inquire for services as a new client. You can also complete our online inquiry form, and a member of our team will contact you. Sometimes a doctor may refer you to a Nurse Case Manager.

During the initial assessment, the Nurse Case Manager will gather information about your medical history, current condition, and treatment goals. They will also discuss your preferences and concerns to create a customized care plan.

A thorough assessment could take about 1-2 hours, depending on your medical history and the level of medical treatment you require.

Assessments can be completed in person at your place of residence, our office, via video chat, or telephonically.

Yes, Nurse Case Managers are bound by strict confidentiality rules and will protect your personal health information in accordance with HIPAA regulations. During onboarding, you will sign a HIPAA authorization form allowing us to Advocate and coordinate your medical care on your behalf. Our case managers will only discuss your medical care with the service providers you are treating or anyone you specifically grant us permission to speak with.

The frequency of interactions with your Nurse Case Manager will depend on your specific needs, preferences, and the stage of your care. Initially, interactions may be more frequent and decrease as your condition stabilizes.

Yes, Nurse Case Managers often assist with insurance claims, billing questions, and coordinating coverage for necessary medical services. If you have any outstanding unpaid medical bills we can assist with getting those paid or working with your legal representative to ensure they have unpaid medical bills.

Yes, Nurse Case Management services are covered 100% by auto insurance, Michigan Assigned Claims Plan, and workmen’s compensation plans. We accept all plans. Some insurance plans may have limitations on coverage, but we can look into what those limitations are for you if there are any.

We do not accept Medicare or Medicaid for Nurse Case Management Services, but we can provide a list of companies that do accept Medicare or Medicaid. You can also check with your specific provider and your insurance plan to allocate companies that do. Sometimes, Medicare and Medicaid do not always cover the service if you do not meet the criteria for their services. Our Private Pay Services could be an option in that case scenario.

Yes, we do. If you or your loved one need assistance with Nurse Case Management Services, we can provide our services as private pay to assist you with navigating our complex healthcare system. We do have clients that pay out of pocket for our services. Cost depends on the individualized care plan, level of coordination required, and amount of hours of assistance required per week/month. We cater to individuals who have very busy schedules and cannot manage their loved one’s day-to-day medical care and requirements on their own.

In some cases, you can request a specific Nurse Case Manager, especially if you have a preference for someone on our team. However, availability may vary.

You have the right to discuss your concerns and preferences with your Nurse Case Manager. It’s important to have open communication and work collaboratively to make decisions about your care. If you are still experiencing difficulties, request to speak to the Director of Case Management to find the best resolution.

Yes, in some cases, you may request a different Nurse Case Manager within the company if you are not satisfied with the service. Discuss your concerns with your Nurse Case Manager and request to be re-assigned.

The duration of Nurse Case Management varies depending on your healthcare needs. It can be short-term for acute conditions or long-term for chronic illnesses.

We do understand that life circumstances can interfere with your ability to attend appointments. We just ask that you be aware and communicate any scheduling conflicts in advance. Reoccurring incidences of no communication with your Nurse Case Manager regarding cancellations or rescheduling appointments could lead to being discharged from our services.