Support Beyond the Medical Visit
We help your patients navigate healthcare, appointments, community resources, and everyday challenges through Enhanced Care Management and Community Supports services.
Why Refer a Member to Us?
Improved Care Coordination
We help your patients manage appointments and medication education, ensuring they never miss important health appointments, labs, or ordered exams. Our team also completes monthly screenings for HEDIS measures and health gaps to help members stay up to date with annual exams, preventive care, and age-related screenings.
Reduced ER Visits
Our team helps prevent avoidable hospital stays by connecting members to medical care, community resources, and wellness support early. We also help members understand their assigned urgent care, contact the nurse advice line, and schedule telehealth appointments when needed.
Resource Navigation
We help connect members to community resources such as food programs, transportation, wellness services, benefits assistance, and other support programs that can improve their overall health and quality of life.
Application Assistance
We help members complete applications and paperwork for services such as IHSS, CalFresh, Medi-Cal renewals, DMV forms and appointments, and other community support programs they may qualify for.
Mental Health and Chronic Health Management
We screen members for mental health needs and help connect them to counseling, behavioral health, and other mental health support services. Our team also provides personalized education for chronic conditions such as diabetes, heart disease, cancer, and high blood pressure to help members better understand and manage their health.
Monthly IDT & Provider Updates
We offer monthly IDT meetings and share monthly member progress updates so everyone stays on the same page. Our team also includes a nurse practitioner who helps support clinical guidance, health education, and coordination of care for complex members.
Refer a Medi-Cal Member
We are a HIPAA-compliant community support team. Please provide the member's information below so we can begin their care coordination journey.