Participants

What Services Are Provided?

Case Management

Our Case Management program provides support and/or information that you may need to meet your health care goals. Our Case Management team also provides the education and support you may need to follow the treatment plan ordered by your physician – such as medications, special diets, exercise programs, or follow-up appointments. Once enrolled in the program, you have access to a wide variety of web-based health education information that you can read at your convenience and then discuss with your assigned primary case manager. This case manager will be your point of contact when you need additional assistance in meeting your health care goals as long as you remain eligible to receive benefits under the health plan. This program is voluntary and available to everyone. You may self-refer to this program by calling us at 800-634-4832.

Care Navigation

When behavioral health matters arise, it is common to be confused about what to do. You may not know who to talk to, what questions to ask, or where to go for help. Kepro provides you with a dedicated health advocate who can help you better understand your health plan and reduce your out-of-pocket costs. Our Care Navigation Team is here to assist you with accessing the right care at the right time. Our team will also help with understanding your treatment plan, and assist in coordinating resources to meet you, and your family’s needs.

Utilization Management

We are excited to be working with you and supporting you in meeting your health care goals. Our multifaceted programs are designed to work collaboratively with you and your healthcare providers to empower you to make informed decisions about your health and health care. We keep our focus on you and your evolving needs as we assist you in your healthcare journey.

Through our utilization management program, our nurses and customer support staff:

  • Work with you and your providers to make sure you receive quality care that is most appropriate for your health condition.

  • Work with you and your providers to make sure services are delivered at the most appropriate, safe level of care meaning that you are not admitted to the hospital when the services could be delivered in your physician’s office or in your home by a home health agency.

  • Assist you with finding network providers in your area who can deliver safe, quality of care. Using network providers maximizes your health plan benefits and limits your out-of-pocket expenses.

  • Assist you with managing and maximizing your health plan benefits.

 

Contact Us

We can be reached Monday – Friday 8:00 am to 8:00 pm EST at 800-634-4832.