Solutions
Treatment
Opusone Treatment solutions include Case Management, Medical Peer Review & Second Opinion as well as Nurse Consultation Services.
The Opusone Treatment solutions proactively ensure you and your members have convenient access to a variety of trustworthy professionals, so you can make the best decisions for each case.
Behavioral / Mental Health
Our team’s deep understanding Behavioral Health ensures your patients are treated with compassion and dignity:
- High levels of education in addition to industry-recognized specialized certifications
- Services are also sub-specialized within the team to provide high impact clinical expertise for your members
- When indicated, access board-certified specialists actively practicing in the indicated behavioral health field
- COVID-19 educational/inquiry services
Specialized Case Management
Case Management can be challenging. Hines proudly offers one of the most comprehensive services on the market:
- Pro-actively working with patients, their families, and their physicians, to coordinate the delivery of cost-effective quality care
- Can be bundled with Hines’ UM services or implemented as a standalone solution
- Specialty Complex Case Management, including oncology, transplant, renal/dialysis, high risk obstetrics, neonatal, and behavioral health
- Chronic Condition Management including, Hepatitis C, Crohn’s, Hemophilia, MS and other large dollar or complex diagnoses
- Specialty Pharmacy Management
- Transplant Management
- Upfront Negotiations
Nurse Consultation Services
Hines’ Nurse Consultation Services provide you with professional evaluation for both medical and cost-related issues:
- Review of claims or requests for medically necessary services or cost effectiveness, as requested by payer
- When requested, onsite evaluations
Upfront Negotiations
To ensure the right terms are established early on for each case, our seasoned team of dedicated negotiators are involved upfront, allowing you to focus on your members’ needs:
- Skilled team of 40 professional full-time negotiators
- Early involvement during treatment to establish case specific payment terms
Hines & Associates, Inc. is a nationwide, independent leader in personalized managed health care, focusing on what's important to you—comprehensive services with the program excellence and cost containment that you demand.
© Hines & Associates, Inc. 2021
A member of the Global Excel Family
