Care Management

You'll hear it often from Nippon Life Benefits: We believe in treating our customers with honor, respect, and dignity. Care Management is just another way we show it.

Nippon Life Benefits offers:  Utilization Management, Case Management, and Disease Management solutions. These targeted solutions help pinpoint "at-risk" employees - or those who need extra help. Our care management solutions are supported by:

  • Evidence-based decisions - ensuring employees receive the right care at the right time.
  • Integration and technology - cohesive systems that help identify (and support) as many employees as possible.
  • Targeted outreach to employees - direct contact with employees who have complex medical needs.

Utilization Management

We offer a confidential telephone service staffed by professionals trained in the insurance field.  These professionals can access employees' coverage information through our computer network and are able to provide:

  • Benefit Advice
  • Hospital preadmission authorization for non-emergency stays

Authorization for:

  • Hospital stay extensions
  • Emergencies

Case Management

We have Case Managers on staff who can offer early risk identification, assessment, monitoring, reporting and outcome measurement.

"Active Health" Integrated Medical Management

Participants in the Aetna Signature Administratorssm network can take advantage of the "Active Health" Integrated Medical Management program. Solutions include:

  • Pre-admission authorization
  • Large case management
  • Utilization management

Large Case Management/Utilization Management services include:

  • Management of complex illnesses and injuries that require intensive nurse management
  • Ensuring that members receive appropriate health care services at the right time, for the right length of time and in the right clinical setting.
  • On-going utilization management applied to all inpatient and select outpatient services planning
  • Improving the quality of care received by members by taking a proactive approach to intake and discharge planning protocols.

YourCare Health and Wellness Management

YourCare Health and Wellness Management

YourCare Health and Wellness Management

It's a fact: Most medical costs incurred are for chronic diseases. When employees are able to properly manage these conditions, it helps employers control future health care costs.

At Nippon Life Benefits, we believe in minimizing medical plan costs by maximizing the health of every employee. That's why we offer YourCare Health and Wellness Management*, a program providing everything from customized preventive health reminders to one-on-one clinic and lifestyle coaching. Through claims, health risk assessments, and health screening data, YourCare assists employees in making appropriate, cost-effective use of their benefits.

*YourCare Health and Wellness Management is available for groups with 100+ employees.