CareNet: Care Management Services

CareNet staff are members of and active in local and National Case Manager Societies including Case Manager Society of South Texas, and Case Manager Society of America.

We work with all Insurance and Managed Care Organizations including Humana, Healthnet Federal Services and Aetna.

CareNet is a clinical and management partner for managed care organizations selecting alternate delivery systems. Quality of care management and sincere patient advocacy are the hallmarks of CareNet. Our care managers are tenured in working with network management systems and have changed behavior by moving care into the alternate site environment. CareNet, the network manager, provides value to managed care organizations and other payors. Below are CareNet’s attributes and essential components:

		A Network of Carefully Selected Providers
CareNet delivers home care services through a network of providers selected for their strength and reputation in the local marketplace. A unique network of the most qualified providers is selected to meet the alternate site care needs for each payor partner. Currently our networks consist of nursing, infusion therapy, respiratory therapy and durable medical equipment providers. The network concept allows CareNet to expand its offering of services as the need arises to secure new contracts. Each provider is credentialed by utilizing an all-inclusive standards data set.
	A Comprehensive Clinical Management and Information System
CareNet goes well beyond coordination of referrals. Care Managers work with the payor’s clinical staff and physicians to assure that appropriate and timely home care services are provided at the optimum level of intensity and duration. Our clinical managers have the expertise and experience to assess the appropriateness of care-acuity, duration, necessity and site of care. Under capitated agreements this capability is vital to contract management. Additionally, CareNet has developed an information system with integrated capabilities to manage home care services and utilization. Some of the current reporting capabilities includes: patient status, cost and utilization by patient and by diagnosis, physician utilization, and outcomes at discharge based on therapy type and diagnosis. Monitoring and measuring results helps payors meet HEDIS and NCQA requirements: and thus makes CareNet a strong provider in the managed care industry.
Local Management
CareNet will provide an on-site clinical liaison to assist in in-patient utilization review and coordinate all alternate site services. This allows the payor to maximize current case management and utilization review team effectiveness. The liaison works with physicians in the payor’s network to assist in realigning practice patterns and utilization behavior. Local market presence and availability are key components to CareNet’s commitment to its payor organizations.
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CareNet Staff

Gretchen Matteson,RN, BSN, CCM- Care Manager

Gretchen graduated from TWU nursing school and worked in a clinical setting for 8 years. She then moved in to UR/Case Management for the following 10 years. She has 6 years experience working Case Management for Home Care and Infusion Therapy. Gretchen works full time at ensuring patient benefits and coverage, getting authorizations and working with Case Managers within the Insurance Companies.

Elaine Jackson, RN, Vice President- CareNet

Elaine graduated with her nursing degree from University of Arkansas. She worked as a clinical nurse in the hospital setting for 8 years in ICU and CCU. She has been in case management in Home Health and Home Infusion for the last 12 years. Elaine is responsible for CareNet operations overseeing all functions of patient benefits, authorizations, and negotiation of charges and Coordination of services.