Case Management
Our case managers help make health care easier and less overwhelming for our members. They work with members to help them understand the types of services we offer and how to participate in their own care.
As a specialty plan, Clear Health Alliance (CHA) assigns every member a case manager or care coordinator to assist them. If your patient needs help contacting their case manager, please have them contact Member Services at 1-855-459-1566.
Our members may receive a call from their case manager if:
- They have just gotten out of the hospital and need help with follow-up visits to other doctors.
- They are going to the emergency room (ER) often for non-urgent care that could be handled by you (their provider).
- They call our 24-hour Nurse HelpLine and need more follow-up for ongoing care.
- They have serious physical problems and need more help managing their health.
- They have behavioral health problems and need more help working with all of their doctors.
- The case manager or you, as their provider, think case management might help the member.
Case managers can also help with:
- Setting up health care services.
- Getting referrals and prior authorizations.
- Checking the plan of care.
From time to time, members may have questions about calls they receive from one of our case managers. When we call, a nurse or social worker will:
- Always identify themselves with their name, title and position with CHA.
- Tell the member about the services we offer.
- Talk to the member about their health and how they are handling different parts of their life.