Clinical operations & governance
Who actually performs the work?
Every responsibility in a care-management program needs an owner. Kare and your organization settle these assignments during scoping—and document them before the first patient enrolls.
Responsibility model
Responsibilities established during scoping.
Assignments vary by organization and program. The table lists what is decided—not a default answer.
| Responsibility | What is decided | Owner |
|---|---|---|
| Patient identification | Criteria and final eligibility decisions | Kare, provider, or shared—agreed per program |
| Enrollment & consent | Who explains the program and records consent | Kare, provider, or shared—agreed per program |
| Device deployment | Where applicable: supply, setup, replacement | Kare, provider, or shared—agreed per program |
| Education | Program, device, and self-management education | Kare, provider, or shared—agreed per program |
| Outreach | Cadence, channel, and whose name is used | Kare, provider, or shared—agreed per program |
| Monitoring & review | Hours, parameters, and reviewer credentials | Kare, provider, or shared—agreed per program |
| Care planning | Creation and updates under provider direction | Kare, provider, or shared—agreed per program |
| Escalation | Thresholds, pathways, and after-hours handling | Kare, provider, or shared—agreed per program |
| Provider communication | Format, cadence, and delivery channel | Kare, provider, or shared—agreed per program |
| Documentation | Where records live and who creates them | Kare, provider, or shared—agreed per program |
| Coding | Code selection and review | Kare, provider, or shared—agreed per program |
| Claims & billing | Submission, follow-up, and patient statements | Kare, provider, or shared—agreed per program |
| Reporting | Measures, format, and cadence | Kare, provider, or shared—agreed per program |
Clinical decision boundaries
Diagnosis, treatment changes, and medical decision-making remain with the treating provider.
Monitoring hours & after-hours
Hours of review and after-hours arrangements are defined in writing. Programs are not emergency services.
Escalation pathways
Thresholds and routes are agreed with each practice, including who receives escalations and how quickly.
Define your responsibility model with Kare.
Start with a conversation about your team, patients, and programs.