Our Disease Management (DM) 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.
DM services include:
- A holistic, member-centered approach to DM focusing on the needs of the member.
- Motivational interviewing techniques used in conjunction with member self-empowerment.
- DM programs for:
- Bipolar disorder
- Coronary artery disease
- Congestive heart failure
- Chronic obstructive pulmonary disease
- Major depressive disorder in adults and children/adolescents
- Substance use disorder
Our programs feature:
- Proactive population identification processes.
- Evidence based national practice guidelines.
- Collaborative practice models to include physician and support-service providers in treatment planning for members.
- Continuous patient self-management education including primary prevention, coaching related to healthy behaviors and compliance/surveillance, and case management for high-risk members.
- Process and outcomes measurement as well as evaluation and management.
- Ongoing communication with providers regarding patient status.
How to use DM services
Maximize your time
As a valued provider, you can refer patients who could benefit from education or care management.
Get help with treatment plans
In order to assist in managing patients, we request your input for patient treatment plans. We provide DM information and the most up-to-date Clinical Practice Guidelines to help you create an individualized plan of care.
Receive feedback on your patients
Providers can access Patient360 to receive feedback on members enrolled in disease management programs. Patient360 is an independent company that provides a clinical data registry on behalf of BlueChoice HealthPlan.
Hours of operation
Our case managers (licensed nurses) are available from 8:30 a.m.–5:30 p.m. ET, Monday–Friday. Confidential voicemail is available 24 hours a day. The 24/7 NurseLine is also available for our members.
Call 888-830-4300 to reach one of our case managers. Your patients can find information about DM program services on our member website or by calling 888-830-4300.
Provider Tools & Resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview