Our care managers help make health care easier and less overwhelming for our members. They work with our members to help them understand the types of services we offer and how to participate in their own care. Your patients may already be working with one of our care managers. If not or if they need help contacting their care manager, please have them call Member Services .
Our care managers may call members if:
- Care management might help the member.
- They’ve just gotten out of the hospital and need help with follow-up visits to other doctors.
- They’re going to the emergency room (ER) often for nonurgent care that could be handled by their health care 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.
Care managers can also help with:
- Setting up health care services for the member.
- Getting referrals and prior authorizations.
- Checking a member’s plan of care.
From time to time, members may have questions about calls they receive from one of our care managers. When we call, a nurse or social worker will:
- Always identify themselves with their name, title and position.
- Tell the member about the services we offer.
- Talk to the member about their health and how they’re handling different parts of their life.
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 and pharmacy overview