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Kidney Quest is a comprehensive program that encompasses all clinical and cost containment issues related to the treatment of chronic renal disease. Strategic Health Development Corporation is committed to maximizing savings in this high risk and high cost arena while simultaneously striving to optimize patient care and treatment.

Cost Containment Features

  • Prospective or retrospective provider contract and claim evaluation

  • Prospective/potential savings profile report

  • Additional savings achieved (net of existing PPO discounts)

  • Transplant network discounts

Clinical Features

  • Patient care assessment/disease management

  • Full spectrum care coordination by experienced RN’s with extensive renal and transplant care management expertise

  • Provider evaluation

  • Co-morbidity evaluation and identification

  • Comprehensive case plans and goals

  • Compliance monitoring

  • Cost avoidance

  • Alternative care and solutions

  • Specialty Nephrology physician review, if required

In an effort to expand client participation and promote early identification of potential patients and savings, the Kidney Quest program encompasses 4 levels of medical and cost containment management.

 

Level 1: Pre-Dialysis

  • Identification and assessment of all chronic renal failure, diabetes, and hypertension patients/cases (including claim history, data mining & pre-cert reviews) and extensive patient education regarding disease process

Level 2: Dialysis (hemo & peritoneal)

  • Evaluation of provider claims, renegotiation of terms (including all pharmaceutical and self-administered meds), confirmation and education of patient regarding Medicare eligibility

Level 3: Transplant Care Management

  • Coordination of pre-transplant phase, assurance of medical appropriateness per complete medical review, and comprehensive Care Management from admission to discharge

Level 4: Post Transplant Management

  • Coordination of all post-transplant care (including medication, physician follow-up, compliance with protocols, patient education and return-to-work goal attainment)

 

Patients may be enrolled in the Kidney Quest program at any level. Transplant Network Contract Access Fees are WAIVED for cases enrolled in all levels of the Kidney Quest program. Transplant Network Contract Access Fee will be charged for patients enrolled in Level III and IV only.