Administración de cuidados integrados
If you have a serious health problem, you may join our Integrated Care Management program. You will work with case managers who are trained in integrated care management. They help you and your doctors meet your needs. They also help you plan so that you can receive the right services at the right time. Call the Customer Service number on your Member ID card to reach a case manager.
Quality Improvement Program
Our Quality Improvement (QI) program helps us to be sure that our services meet high standards for safety and quality. Every year we do our best to improve. As part of the QI program, the Plan helps you take care of your health and get the best service. The QI program looks at ways to better members:
- Access to doctors
We always look for ways to better our services. Our goals are to:
- Make sure that we use good ways to check our services
- Have staff to help the quality improvement process
- Focus on important quality problems
- Be aware of our members’ culture and language needs
- Make sure that we meet state and federal laws
- Meet all requirements of health care accreditation
All doctors and staff must keep all information private. We look at the QI program every year to be sure it meets guidelines. The results help us make the work plan for next year. Please see the Contact Us section at the bottom of the page for any questions.
Financial Compensation – Providers Make the Decisions
We do not pay more money to doctors for deciding if you do or don't need care. We only pay doctors for the care you get.
Doctors and health care companies are creating new technologies. This can be anything from a new test to a new machine. The Plan has processes on how to look and judge new devices. When we find out about new devices, we look over the new information. We may also ask experts for their views. Aetna Better Health matches the information with known standards. We base our decisions on making sure you have the right care.