What is Case Management?
Case Management means getting extra support in taking care of your health. It is a program for members with complex or chronic medical conditions that are hard to manage. We offer this program free of charge. A case manager will be dedicated to helping you get the care you need.
A case manager’s role is to identify alternative care options and educate members about the resources available to them. They will work with your doctors and health care providers to help you get the most out of your health care. They figure out what kind of care is best for you and support you through treatment. Case managers make sure you understand your health plan benefits and help you adjust your care plan as needed.
Members can be referred to Case Management in the following ways:
Case management is most beneficial to members who have chronic, complex or more than one medical condition such as diabetes, depression, COPD and other illnesses. You must be referred to case management services. Here are some ways you can be referred:
- Members may refer themselves
- Caregivers can also refer a member
- Clinic referral coordinator
- Primary care practitioner or clinic staff
- Specialist practitioner
- Discharge planner referral
- Customer Service, Population Health and/or Transition Management departments
- Medical (Utilization) Management program referral
- High-risk reports at the plan level
If you are referring yourself to a case management program, please fill out the Case Management Referral Form.
If you are not sure if case management is right for you, contact the case management department to learn more. You can reach them at 1-866-418-7003 (TTY Relay: 7-1-1) from 8:00 a.m. to 5:00 p.m., Monday through Friday. You can also email them at firstname.lastname@example.org. For all other questions, please contact Customer Service.