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Together with CCP PO Box 1997 MS 6280 Milwaukee, WI 532011997 Toll free: 18442014672 togetherCCHP.org Case and Disease Management Referral Form Our Case Management and Disease Management programs
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How to fill out case and disease management

01
To fill out case and disease management, follow the steps below:
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Begin by gathering all relevant information about the case or disease you are managing.
03
Create a comprehensive case or disease management plan, outlining the goals, objectives, and strategies for managing the case or disease.
04
Collect and analyze data related to the case or disease, including medical records, laboratory results, and patient history.
05
Develop a treatment plan based on the collected data and established goals and objectives.
06
Implement the treatment plan, monitoring the progress of the case or disease management regularly.
07
Make any necessary adjustments to the treatment plan based on the patient's response and feedback.
08
Continuously evaluate the effectiveness of the case or disease management plan and make improvements as needed.
09
Keep detailed records of all actions taken, including medications prescribed, treatments administered, and follow-up appointments.
10
Regularly communicate and collaborate with other healthcare professionals involved in the case or disease management to ensure coordinated care.
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Provide education and support to the patient and their family, empowering them to actively participate in the case or disease management process.

Who needs case and disease management?

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Case and disease management is beneficial for various individuals, including:
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- Patients with chronic diseases such as diabetes, heart disease, or cancer, who require ongoing monitoring and treatment.
03
- Individuals with complex medical conditions or multiple comorbidities that require comprehensive coordination of care.
04
- Patients transitioning from one healthcare setting to another, such as from a hospital to a rehabilitation facility.
05
- Elderly individuals who may have multiple age-related health issues and require assistance in managing their overall wellbeing.
06
- Individuals with behavioral health conditions, such as substance abuse or mental health disorders, who need specialized case management support.
07
- Individuals at high risk for certain diseases or conditions, such as genetic predispositions or occupational exposures.
08
- Patients with limited access to healthcare resources or who face socioeconomic barriers to receiving appropriate care.
09
- Caregivers or family members of individuals with chronic or complex health conditions, who may need guidance and support in managing their loved one's care.
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Case and disease management is a coordinated approach to healthcare that involves multiple services and healthcare providers to ensure optimal care for individuals with complex medical conditions.
Healthcare providers, insurance companies, or employers may be required to file case and disease management depending on the specific regulations and requirements of the healthcare system or organization.
Case and disease management forms may vary depending on the organization or healthcare system, but typically require information such as patient demographics, medical history, treatment plans, and outcomes.
The purpose of case and disease management is to improve patient outcomes, quality of care, and cost-effectiveness by coordinating healthcare services and resources.
Information that must be reported on case and disease management forms may include patient identification, medical history, treatment plans, healthcare provider information, and outcomes.
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