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Utilization Management PDF Print E-mail
A medical services solution with benefits for your employees and your bottom line

The Utilization Management Program monitors, evaluates and manages the costs and quality of healthcare services delivered to customers of Community Health Partners. A local staff consisting of a medical director and a team of registered and licensed practical nurses review inpatient and outpatient procedures and services to determine medical necessity and cost-efficiency.

Program components include:

  • Pre-admission and admission review.
  • Concurrent hospital stay review.
  • Case Management and Disease Management (SmartChoice).
  • Referral authorization for a specialist or out-of network care.
  • Outpatient service and ambulatory review.

For more information on Utilization Management and other medical services solutions from Community Health Partners, call 239.659.7770

Click the link below to fill out the Pre-certification request form and fax to 239.659.7785. Please make sure to attach supporting clinical information. 

Pre-cert Form - NCH Healthcare System 

Pre-Cert Form - CC Gov't, CC Schools, CC Sheriffs

Pre-Cert Form - Naples Gold Network

CCHC 2010Formulary Impact

 

Health Tips

Accept personal responsibility for what you eat. No one forces you to eat anything.
 

Testimonials

To Whom It May Concern:

I just wanted to express my appreciation to CHP, my school district, and Dietician, Ashley, in providing such a terrific service as the "SmartChoice" program.  It emphasized personal responsibility, accurate supportive dietary information, and a healthy environment for me to learn about nutrition, weight control, and good food options.  I would recommend it to anyone looking to make some good personal health choices for themselves.

Thank you.

 

"I went to the nutritionist with the thought that I would lose some weight and get off my medications within one year.  Within 6 weeks I have lost 17 pounds, am off my diabetic medication and my blood pressure is down to 100/80.  I feel like I have a new life.  I don't crave the foods I used to crave and don't feel like I am being deprived.  For the first time in my life I feel like "I can do this."  Thank you so much!

Anonymous

 

"I just wanted to express my appreciation to CHP.  My school district and dietician Ashley, in providing such a terrific service as the "SmartChoice" Program.  It emphased personal responsibility, accurate, supportive dietary information and a health enviironment for me to learn about nutrition, weight control and good food options.  I would recommend it to anyone looking to make some good personal health choices for themselves. "

Thank you.

-Anonymous

 

 

"I have struggled with my weight for the past ten years, losing a few pounds and regaining the weight.  Although I work out at the Wellness Center five days a week, weight management continues to be a problem for me.  As I've gotten older, maintaining a healthy weight, blood pressure and glucose levels have become increasingly more difficult.  Although I ate what I thought was a healthy diet, I continued to struggle.

I first learned of the Smart Choice program through my employer and decided to give it a try.  I met with Ashley Wheeler, a SmartChoice dietitian.  Together, we reviewed my eating habits.  She was able to point out mistakes that I was making.  She identified the high salt content is some of my favorite foods such as prepared tomato sauce, canned soups, pickles, and canned beans.  She taught me to read the nutrition labels and be mindful of foods with high salt, and sugar content.  She instructed me on portion size, health snacks, increasing water intake, and an appropriate mix of fruits, vegetables, healthy fats, whole grains, good carbohydrates, and protein.  Ashley answered many questions and provided support.

In just a few weeks, I've lost five pounds and lowered my blood pressure 10 points.  I have more energy and feel great.  I've learned so much through the SmartChoice program.  I've made changes in my diet that I will continue for a life time.  The SmartChoice program is working for me."

-Anonymous

 

"During a routine physical in August 2006, my doctor informed me that I was at risk for a range of health problems including hypertension, heart disease, and diabetes.  I had reached the point where I knew I needed to lose weight and change my lifestyle for myself and family.  My employer directed me to the SmartChoice program to educate and assist me in developing a long-term healthy lifestyle change.  Through the assistance of Licensed Dietitian, Morgan Rouleau, I have lost over 80 pounts, lowered my blood pressure within normal limits, reduced my cholesterol and been taken off prescription medications.  I am looking forward to my continued partnership with SmartChoice as I work toward attaining my ultimate health goals."

-Annoymous 


 

"I learned about SmartChoice through an in-service training.  I felt that I needed to make a lifestyle change with my eating habits and exercise.  I signed up and met with Morgan Rouleau.  She has taught me how to pick out healthy foods and alternatives to not so healthy foods.  By changing my diet and starting an exercise program I am hoping to add some years to my life and live healthier.  Not only has Morgan taught my wife and I how to eat better, but also she has taught us valuable information on topics such as high blood pressure, cholesterol, different types of fats, and the importance of a high fiber diet.  I would recommend this program to anybody that wants to get into a healthier lifestyle but doesn't quite know where to start.  Thanks Morgan!"

Robert Cruz


 
"In March of this year, I was part of a contest at my workplace, The District School Board of Collier County. It was a "Biggest Loser" contest. The object was to lose the largest percentage of weight. I was completing against several others and was determined to win. The "Smartest Choice" I made was to pick up the phone, the first day of the contest, and call Morgan Rouleau. She talked to me about the "SmartChoice" program and gave me a 1300 calorie a day eating plan. I found that I never was hungry and the weight just fell off. Morgan called me on a regular basis and offered me support and continued to feed me information to help me achieve my goal. I did win the contest but more important, I lost 7% of my body weight!

Thanks again for your help!"

Linda Haslinger
 

"I started out at 150 + pounds and with my cholesterol starting to rise and borderline diabetes and high blood pressure I needed a change. I started exercising at Wellness but every time I convinced myself I needed to diet I would just binge even more.

I met Morgan at the NCH benefits fair and she informed me of this great program. A short visit with Morgan and Carolyn I went away with information enough for a lifetime change. I was told that on this diet I would not be hungry, why most starvation diets don't work. Being a non believer I started out on the plan. I started loosing inches and pounds every week. At first Morgan would contact me frequently and I would share my joy at reducing my body fat and pounds.

After a few short months I found I was not counting calories but just watching what I ate. I learned which foods were better for me, what foods were free to eat without too much moderation, how to cheat once in awhile with 1 cookie instead of about 20, and how to choose foods in a restaurant that will still keep me on track. Four months later at a weight of 133, I have reduced my blood pressure, gone from a dress size 12 to a size 8, improved my appearance and most of all FEEL BETTER. The smart choice program teaches you to eat healthier so you can feel better about yourself."

Rickie Zarb


 

 

 
"I learned to eat a little protein and associated fat with my 15g fruit snack to stretch out the sugar digestion which provides safety and hunger prevention for a longer time.

I learned to eat 2 tsp of olive oil with my supper (on salads) to provide longer hunger prevention and prevent snacking after supper.

I learned to eat fruit with lunch to stretch out my sugar digestion. Doing these things and following the diet plan provided by Morgan Rouleau, I have been losing a pound a week and am not hungry.

Bravo SmartChoice."

Jim Goodman
 

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Contact Details

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239.659.7700

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