Our Disease Management team is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing the chronic conditions of Healthy Blue members.
The mission of the Disease Management team is to improve the health and quality of life for Healthy Blue members by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.
Nine of our disease management programs are National Committee for Quality Assurance accredited and incorporate outreach, education, care coordination, and follow-up to improve treatment compliance and enhance self-care.
Members diagnosed with the above conditions and identified through continuous case finding efforts, claims mining and referrals are eligible for disease management services.
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.
Note: Programs offered are subject to change.
You can refer patients with asthma, bipolar disorder, CAD, CHF, COPD, diabetes, HIV/AIDS, hypertension, MDD in adult and child/adolescent, schizophrenia, or SUD. In addition, refer patients who may benefit from additional education or care management.
As we work with patients, we would like 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 individual plan of care.
Providers can access Patient360 to obtain feedback on their patients regarding their care plans and condition management while enrolled in disease management programs.
Please call 1-888-830-4300 to reach a care manager. Your patients can get information about disease management program services by visiting our member website or by calling 1-888-830-4300.
Hours of operation
Disease management care managers are available from 8:30 a.m. to 5:30 p.m. ET, Monday through Friday. Confidential voicemail and the Nurse Helpline are always available 24/7.
You have additional rights and responsibilities such as the right to:
These rights and responsibilities are available to you in written format upon request to disease management by calling 1-888-830-4300.
The Clinical Practice Guidelines (CPGs) for the chronic conditions outlined above are available on Availity our secure provider website. CPGs can also be requested at any time.