Complex Case Management
Dedicated support for serious diagnoses
A personal case manager to coordinate care and advocate for you through complex health journeys
Why does complex case management matter?
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Serious diagnoses throw patients into a fragmented healthcare system. Multiple specialists, conflicting opinions, overwhelming information, and critical decisions—all while dealing with the emotional weight of illness. A dedicated case manager brings order to chaos.
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See where your benefit plan is leaking
Find out what gaps exist — and what you can do without changing your plan.
We'll show you where money is leaking, risks are growing, and what you can fix within your current structure. No pressure to change brokers, carriers, or benefit design. Just clarity.
- Gap analysis based on your actual plan structure
- Clear findings you can share with your broker
- Recommendations that layer on — no disruption required
Dedicated Case Manager
One person who knows your entire situation, coordinates all aspects of your care, and serves as your consistent advocate. Not a hotline or rotating staff—your case manager.
Multi-Provider Coordination
Complex conditions involve multiple specialists. Your case manager ensures they communicate, coordinates appointments, and prevents the fragmentation that undermines care quality.
Treatment Navigation
Help understanding treatment options, facilitating second opinions, and making informed decisions. We ensure you have the information needed to participate fully in your care.
Continuous Advocacy
Ongoing support throughout your health journey—handling insurance issues, coordinating logistics, and advocating for your needs at every step.
What is Complex Case Management?
Complex Case Management is intensive, personalized support for employees facing serious health conditions that require coordination across multiple providers and settings.
When someone receives a cancer diagnosis, needs major surgery, or faces a complicated chronic condition, they shouldn't have to coordinate their own care while dealing with illness. A case manager handles coordination, advocacy, and logistics so the patient can focus on healing.
This is relationship-based support—one dedicated professional who learns your situation thoroughly and supports you throughout your health journey.
Why Do Complex Cases Require Dedicated Management?
Most employers renew their health plans year after year without questioning the underlying assumptions. Brokers present options, carriers set rates, and leadership approves budgets based on incomplete information.
The result? Companies overpay for benefits employees don't use while missing coverage gaps that create real risk. They accept premium increases as inevitable rather than addressable. They lack visibility into where their money actually goes.
A Healthcare Risk Assessment changes that. It gives you the data and insight to make informed decisions, negotiate from a position of strength, and take control of one of your largest operating expenses.
How It Works
Complex case management provides intensive support from diagnosis through recovery.
Initial Assessment
When a complex case is identified, we conduct a thorough assessment—understanding diagnosis, treatment plan, providers involved, patient concerns, and support needs.
Case Manager Assignment
A case manager with relevant experience is assigned to the case. They become the patient's dedicated point of contact throughout their health journey.
Active Coordination
The case manager coordinates appointments, facilitates provider communication, handles insurance issues, and manages logistics. They're proactively involved, not just reactive.
Ongoing Support
Support continues through treatment, recovery, and beyond. The case manager monitors progress, adjusts coordination as needs change, and remains available throughout.
When Is Complex Case Management Needed?
Complex case management is appropriate for:
• New cancer diagnoses
• Major cardiovascular events (heart attack, stroke)
• Transplant evaluation and management
• Complex surgeries with extended recovery
• Multiple simultaneous serious conditions
• Rare diseases requiring specialized expertise
• Any diagnosis requiring care from multiple specialists
If you're unsure whether your situation qualifies, contact us—we'd rather provide support that turns out to be unnecessary than miss someone who needs help.
Where Does Complex Case Management Operate?
Case management operates across all care settings:
• Hospitals—advocating during admissions and coordinating discharges
• Specialist offices—facilitating communication and coordination
• Home settings—ensuring post-discharge success
• Centers of excellence—coordinating care at distant facilities
• Rehabilitation facilities—managing transitions
Your case manager follows you wherever care takes you.
Who Receives Complex Case Management?
Employees and their covered dependents facing serious health situations:
• Those with new major diagnoses
• Employees managing complex treatment plans
• Anyone whose care involves multiple specialists
• Patients preparing for or recovering from major surgery
• Those whose conditions aren't improving with routine care
• Family members facing serious illness
See What Our Customers Are Saying
"What could have been data driven, was soon a conversation. Over 3 years with the best coaches, listeners, advisors you could ask for. If Monique didn't have an answer readily, she would note it, research it, and then update you on the answer. Always a positive meeting. Highly recommend!"
— Sue D.
“Our Medical Insurance Premiums were Out of Control! Thanks to Weltrio and their amazing team of healthcare experts, Weltrio is my single most-profitable cost center!”
— Cayuse CEO
Everything You Need to Know
At Weltrio, we are a medically trained team that works with HR and benefits partners at companies of all sizes to improve healthcare quality, reduce risk exposure, and optimize costs. We work within your existing plan structure—providing employers with clarity, trust, and transparency at every step. Whether you're upgrading your benefits plan or building from scratch, we've got you covered.
Is this the same as telemedicine?
No. Clinical support provides guidance and triage, not diagnosis or treatment. We help employees decide when and where to seek care.How many nurses will be assigned to our company?
Assignment depends on your company size and typical utilization. Smaller companies may share a primary nurse with backup coverage. Larger organizations get dedicated teams. Either way, employees experience consistent relationships with clinical professionals who know them.Who answers calls in the middle of the night?
Board-certified nurses from your Weltrio clinical team. We staff night shifts with experienced nurses who have full access to your company's benefits information and employee interaction history. It's not an outsourced answering service.What protocols do nurses use for triage?
Our nurses use evidence-based clinical decision support protocols developed from emergency medicine and primary care best practices. These protocols are regularly updated based on current medical guidelines and are customized for telephone/virtual assessment settings.How much does an unnecessary ER visit actually cost?
Average ER visits cost $2,200 or more—even for minor issues. Add lab work, imaging, or specialist consultation and costs climb quickly. The same conditions treated at urgent care typically cost $150-300, and telehealth visits run $50-75.
