Care Management

The purpose of the Care Management Department at Community Health Network Of Connecticut is to coordinate, direct and monitor the quality and cost effectiveness of health care resource utilization. The Utilization Management Program implements comprehensive processes to monitor and control the utilization of health care resources. Utilization Management assists in ensuring that services are available in a timely manner, provided in appropriate settings, and that services are planned, individualized and evaluated for effectiveness. Utilization Management also serves to ensure care is safe, accessible and efficient.

Components of the Care Management Department include

Referral Management
Preadmission review, concurrent review, discharge planning, retrospective review.
Case management
Verify eligibility, benefits coverage and physician/hospital contract status
Identify and route members into specific Disease Management Programs

The Process Improvement Teams will meet quarterly to evaluate current processes and make recommendations for improvements.

Referral Form [PDF] (31 KB)

Prior Authorization Process Letter - June, 2009 [PDF] (152 KB)

Bariatric Surgery Requeset Form [PDF] (131 KB)

DME Requeset Form [PDF] (135 KB)

Donor Requeset Form [PDF] (174 KB)

Genetic Testing Request Form [PDF] (163 KB)

Home Care Intake Form [PDF] (134 KB)

Home Care Intake Form (Private Duty Nursing) [PDF] (130 KB)

Hospice Intake Form [PDF] (116 KB)

Out of Network / Out Of State Referral Authorization Request Form [PDF] (219 KB)

Out of State Lab / Radiology Request Form [PDF] (100 KB)