Anyone do CM for insurance companies?

  1. Anyone out there do telephonic CM for insurance companies? I'm just curious what your job entails. I currently work for a very small company that contracts with larger TPAs to do their UR and CM. At times it seems very haphazzard in how we obtain referrals for CM and making contact with the patient's after they discharge home is nearly impossible at times. The TPAs don't seem to understand what we do because they continually ask for updates on people we have never heard of based soley on a claim they've received and nothing on the any needs the patient might have. Just curious how other companies do it....especially the bigger ones like Cigna, BCBS, and Humana.
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    About hnrnccm

    Joined: Aug '11; Posts: 2