Cytokine release syndrome (CRS) is a condition that occurs when the immune system overreacts to an infection or immunotherapy drugs. This can lead to a range of symptoms, including fever, nausea, fatigue, and body aches. As an expert in the healthcare field, I have seen firsthand the impact of CRS on patients and the importance of prompt treatment. At Optum, our team of clinical consultants and customer service professionals work together to help patients, case managers, and doctors make informed decisions about cancer care. We understand the complexities of CRS and are dedicated to providing support and guidance to those affected by this condition. One of the ways we assist patients is by identifying healthcare providers who have experience in treating CRS and can meet the specific needs of each individual.
We also provide detailed information about the condition to help patients better understand their diagnosis and treatment options. For healthcare providers participating in our CRS program, we require prompt responses to inquiries related to billing within two business days. We also ensure that our toll-free number and the number for our CRS advisor's office are easily accessible for participants and staff members. Treatment for CRS may include monitoring and laboratory tests, as well as specific medications to reduce the immune response. It is crucial for patients to use all available personal health benefits, such as health insurance or Medicare, before utilizing funds from the CRS program for services. In cases where a patient has comparable benefits, we require providers to bill those benefits before billing the CRS program. This ensures that patients receive the best possible care while also managing costs effectively. When it comes to childhood cancer, there are two immunotherapies that are most commonly associated with CRS: blinatumomab and tisagenlecleucel.
These treatments can be highly effective, but it is essential to closely monitor patients for any signs of CRS and provide prompt treatment if necessary. It's important to note that the CRS program does not cover personal items such as television rentals, phone calls, gourmet meals, cribs, or guest trays. Our focus is on providing necessary medical care and support to patients, and we work closely with providers to ensure that all services are appropriately documented and billed. For patients with a traumatic brain injury (TBI) or traumatic spinal cord injury (TSCI), we offer bundles of services through our CRS program. These services are designed to help individuals manage their condition and improve their quality of life. As part of our commitment to transparency and patient education, we recommend that providers give patients a copy of our CRS brochure. This brochure provides detailed information about the services we offer and how they can benefit patients. Any home modifications approved by the CRS program must undergo a thorough evaluation and receive professional recommendations before being approved and purchased.
This ensures that all modifications are necessary and appropriate for the patient's needs. For providers offering residential or non-residential services for traumatic brain injuries, we require the use of the Mayo-Portland Adaptability Inventory (MPAI) for all CRS participants. This tool helps us track progress and make adjustments to treatment plans as needed. Prior to providing outpatient therapy services, providers must recommend to the CRS program the specific type of service, frequency, and duration necessary for the patient to achieve the desired results outlined in their treatment plan. This helps us ensure that patients receive the most effective care possible. If a CRS participant has a substance abuse disability and there are any observations or evidence of alcohol or drug use, providers must immediately inform the CRS counselor. This allows us to address any potential issues and provide appropriate support to the patient. Finally, it is crucial for providers to clearly communicate their admission policy and procedures in writing, including any requirements, to CRS counselors as requested.
This helps us ensure that all patients receive the care they need in a timely and efficient manner.
