TrustCare Advantage is a set of medical management services that helps employers and employees better manage their health plan benefits and completes a comprehensive healthcare package. These services also help ensure members receive appropriate care, while keeping claim costs in check. Certain benefits may be optional for employers choosing custom plan designs.   Care Management/Pre-certification. The Trustmark Group Insurance Care Management program is a comprehensive service to help control medical costs. It works by reviewing healthcare treatment plans at critical points in the treatment process, including appropriate hospital admissions and lengths of stay. The care management program requires pre-certification for all inpatient admissions to make sure each member receives appropriate care. Pre-certification is also required for acute and sub-acute rehabilitation, skilled nursing facilities, behavioral health residential treatments, hospice and home healthcare services. A specially trained medical management team evaluates both the proposed course of treatment and the patient's individual needs. All evaluations are conducted by healthcare professionals and are based on national medically accepted guidelines. Proposed admissions are reviewed for medical necessity and length of hospital stays. Most cases are certified for treatment within several minutes. If a treatment plan varies significantly from established medically accepted guidelines, the case is referred to a second level of review by a specialist. A decision on certification in these cases is typically made within 72 hours. This pre-certification process reduces the need for costly second surgical opinion programs. Emergency Admissions must be communicated within 48 hours or the next business day. If pre-certification is not obtained when it's required, the member may be required to pay a penalty. Condition Management Trustmark has teamed with Matria Healthcare, the largest independent provider of condition management services, to offer a comprehensive range of customizable programs that successfully manage some of the most expensive and debilitating chronic conditions: diabetes, cardiovascular diseases, and respiratory diseases such as asthma. Our objective is to facilitate compassionate and effective care management. Case Management. Case Management is a patient-centered process that coordinates and monitors major health services by intervening soon after the onset of a serious illness or medical problem. Case managers coordinate complex treatments in difficult situations such as premature birth or an organ transplant, always keeping the patient's wishes and needs at the forefront. By collaborating with patients and their medical team, full-time nurses serve as case managers and work closely with the patient, physician and family to coordinate appropriate, cost-effective care in concert with the patient's wishes from diagnosis to post-discharge. Our goal is to promote the most effective care, the best use of available benefits and to provide cost savings for the member and employer alike. MaternaLink®. MaternaLink is a maternity wellness program that encourages prenatal care and helps mothers-to-be take an active role in getting infants off to a healthy start. The program provides expectant moms with educational materials and resources about pregnancy, childbirth and baby care. The program is completely voluntary, confidential and available at no additional cost to members. To find out more information on MateternaLink Program click on the following link www.MaternaLink.com/trustmark Fraud Protection. Trustmark’s Special Investigation Unit, The Sentinel Group, investigates suspected fraud and claim abuse in health, life, dental and disability insurance. Our proactive stance against fraud helps us control premium cost, possibly saving you and your members money. The Cash Reward Program. This program encourages employees to monitor their medical expenses. If an insured detects and resolves an overcharge on a hospital or a physician's bill, he or she can receive a cash reward equal to 20% of the amount overcharged, up to a maximum of $500. The overcharge must be for an expense for which insurance benefits were payable. There is no limit to how many times an insured can collect.