Our Disease Management team is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.
Disease Management services include:
In addition, we assist with the management of prenatal cases in high-risk populations.
Our programs feature:
Our disease management programs do not advertise, market or promote specific products or services to members or providers.
Our disease management programs do not have any financial ownership arrangements with anyone who advertises, markets, or provides the goods and services we offer.
*Programs offered are subject to change.
As a valued provider who could use some help in following up with patients, you can refer patients with asthma, bipolar disorder, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, diabetes, HIV/AIDS, hypertension, major depressive disorder or schizophrenia who could benefit from education and care management.
In order to assist in managing patients, we request your input for patient treatment plans. Disease management information and the most up-to-date Clinical Practice Guidelines are provided to assist you in creating an individualized plan of care.
Providers receive feedback on members enrolled in disease management programs via member status letters, care plans and telephonic communications. Feedback includes assessment of how well the condition is being managed, adherence to treatment plans, patient goals, and psychosocial and safety issues while enrolled in a disease management program. Feedback is provided weekly, monthly, quarterly, annually or as needed based on the severity of the member’s condition.
Our case managers — who are licensed nurses and social workers — are available from 8:30 a.m. to 5:30 p.m. local time, Monday through Friday. Confidential voicemail is available 24 hours a day. The Nurse HelpLine is available 24/7 for our members.
Please call 1-888-830-4300 to reach one of our case managers. Your patients can get information about Disease Management program services by calling 1-888-830-4300.