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Care coordination

Our Care Coordinators aim to bridge the gaps that occur when patients move from one setting of care to another. We want to ensure you receive personalized care – whether you are getting care from one of our providers or a specialist outside our organization – and that you are kept informed along the way.

Care coordination services

  • Patient advocacy – ensuring proper care is delivered
  • Providing access to financial assistance programs including Charity Care, utility and housing services, and medication assistance
  • Overseeing safe, effective, and patient-centered care transitions from one service to the next.
  • Identify needed services and refer as appropriate
  • Assist patients in navigating the healthcare system seamlessly and as stress-free as possible
  • Provide education to patients and families with chronic conditions to promote healthy behaviors in all populations across our services area.
  • Prevent service duplication
  • Facilitate the Welcome to Medicare/Annual Wellness Visits
  • Develop care plans for patients
  • Process and track all referrals

Please fax all referrals and consults to 509.725.0327.

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