Case Management
With our voluntary Case Management program, we want to give you the power to effectively manage your own healthcare. At the same time, we want to support all your values and preferences.
As a participant in the Case Management program,
you have a personal nurse who will work with the
providers who are involved in treating you. Your nurse
will help ensure that you receive care smoothly and
seamlessly and be a resource to help you make
healthcare decisions.
Through this program, we may often:
- Help you coordinate your healthcare services.
- Serve as an advocate for your healthcare needs.
- Give you educational materials and information
about community-based resources, and
- Promote a healthy lifestyle. We will help you set
positive healthcare goals and will coach you to
reach them.
Why is Case Management Good for You?
Case Management helps you become a true partner in your healthcare and not just a
receiver of services.
The Case Management Nurse is a resource for information about treatment options.
Your Case Management Nurse will tailor assistance and information to what is important
to you and your health.
What Should I Expect?
You may have already spoken to a Blue Cross nurse. If you haven't. one will contact you
(and a family member, if you wish). Your nurse will review your situation fully and ask
about your current needs. This information is confidential. We will not release it to anyone
without your permission.
After the review, your nurse will contact members of your treatment team to see if they
need help with authorizing or coordinating your treatment. For example. many patients
need home health or physical therapy after they leave the hospital.
Your nurse will help you anticipate and plan for future health needs. The length of your
Case Management service depends on your individual case and your own goals.
Benefits to You
Our state-of-the-art Disease Management
programs center on you and your preferences.
By
working with one of our Disease Managers, you
will receive:
- Personal, confidential support and attention
- Preventive and wellness care reminders
- I mproved and up-to-date self-management
techniques and support
- Nurse coaching support in areas in which
you want to make changes
- Support for health decisions and
conversations with caregivers and
healthcare providers
What If You Don't Agree with a Decision
If you do not agree with a Case Management
decision, you or your caregivers have the right to
file a complaint or ask for an appeal.
Just write to us at:
Blue Cross and Blue Shield of louisiana
Customer Service Unit
P.O. Box 98045
Baton Rouge, LA 70898·9045
Or call us at:
1·800·599·2583
8 a.m. to 5 p.m.
Monday through Friday
How Do I Contact a Nurse?
Call 1-800-363-9159 and choose Option 1 or
call 225.295.3307, extension 1068, and choose
Option 1. You will be connected to the Disease
Management Unit.
-
A Disease Management specialist will
process your referral.
- After being assigned to a Disease Manager,
you may be asked some questions to assess
your individual needs.
- If you can benefit from our Disease
Management services, a Disease Manager
will provide you with support and
encouragement.
Together, you and your Disease Manager will make
plans to maintain or improve your condition and
overall health.
