We encourage you to take an active role in seeking information
about the hospital(s) at which your physician or specialist has
admitting privileges. It is important to verify information
before you are admitted such as:
- Hospital's accreditation status
(when did the hospital receive the most recent accreditation by a hospital
review board)
- Does the hospital have any information regarding consumer
satisfaction
- What is the hospital's experience in providing treatment
for conditions similar to yours
- Have your family or friends been treated at the hospital
and if so, what was their experience
By obtaining answers to these and other important quality concerns,
you can make sure that the hospital care you receive is right
for you. Please call our Customer Service Department for assistance
in verifying hospital information.
To increase your primary care physician's involvement in the
decision-making process, many of our physicians will work within
a hospital and physician network to manage your care. In these
arrangements, your primary care physician's hospital and physician
network will make decisions regarding your care instead of Care
Choices HMO.
To help ensure that you receive quality care, all hospital stays
and some outpatient procedures require prior approval, except
in the case of an emergency. The approval process may involve
Care Choices HMO or your physician's network.
If your primary care physician:
- Recommends certain procedures - your physician will review
your treatment plan with a Care Choices HMO Case Manager (a
registered nurse) or your physician's network and get approval
- Decides that you should be admitted to a hospital, your physician
will arrange for you to go to a Care Choices HMO hospital
- Decides you need services which are not available at a Care
Choices HMO hospital, your physician will arrange for you to
go to another hospital after getting prior approval from the
Care Choices HMO Medical Director or the Medical Director from
your physician's network
While you are in the hospital, the Care Choices HMO Case Managers
or your physician's hospital and physician network will work
with your physician to keep track of your care. They will make
sure you receive appropriate treatment and coordinate any follow-up
care you may need.
Manage My Care