What is Managed Care? - It is a means of providing health care services within a defined network of health care providers who are given the responsibility to manage and provide quality, cost effective health care to their patients.

In healthcare today, there are often many choices when selecting health care coverage. Among the many managed care plans offering different types of coverage plans are products such as Health Maintenance Organization (HMO), Point of Service (POS), and Preferred Provider Organization (PPO). Understanding all the differences and making the best choice for you and your family can be challenging.

Recognizing this, Partners in Internal Medicine offers a service of trained representatives to help patients understand the requirements, cost differences and benefits of their specific managed care plan. The Managed Care Representatives serve as a liaison between you, your primary care physician, and your health plan. They assist in simplifying your efforts to meet your managed care needs.

Services Available

• Processing of referrals and authorizations for specialty services
• Education and assistance with benefit interpretation for managed care plans
• Assistance with general health plan inquiries
• Explanation of managed care guidelines specific to your health plan

Obtaining Service & Assistance

• You have access to the Managed Care Representatives by calling the office in which you see your primary care physician.
  
  Ann Arbor           734-994-7446
  Canton                734-981-3300
  
  
• The telephone service hours are Monday, Tuesday, Thursday, and Friday, 8:00am to 12:00pm, and 1:00pm to 4:50pm, and Wednesday, 9:00am to 12:00pm and 1:00pm to 4:50pm.

Referrals & Authorizations

Your primary care physician can assist you through the health care system by assessing your healthcare needs and referring you to the appropriate specialist. Managed care plans require that you obtain a referral and/or authorization prior to seeking specialty services. Therefore, it is important to obtain the proper referral/authorization before your appointment. Our Managed Care Representatives are here to help guide you through this process.

In Office Referral Process - Referrals may be obtained at the time of your appointment with your primary care physician

• Your physician will initiate the referral to a specialist
• The managed care representative will process your referral within five (5) business days of your request
• The referral is forwarded to the specialists office via fax, mail or by electronic online processing
• A copy of the your referral authorization will be filed in your electronic medical record

Expediting Your Call - Having the following information ready when you call will expedite the Managed Care Representatives’ ability to assist you:

• Your name
• Daytime telephone number
• Name of your insurance carrier, contract number, and group number (if applicable)
• Primary Care Physician’s name
• Reason for call

Additional Referral Visits - You can contact our Managed Care Representatives via e-mail or phone.

• The Managed Care Representative will process the referral upon approval from your primary care physician.
• The referral is then forwarded to the specialists office via fax or by online processing.

Remember our Managed Care Representatives are available to assist you with your health plan questions and concerns.