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.