Caring for your family and you It’s not always easy to navigate your way through the health care system. But if you or a family member have a chronic health condition or a complex need, that's where our Care Management Team comes in. Working together, our team can help you find the services you need and ensure your questions and concerns are addressed. Personal support when you need it most If you have a complex condition, you may be identified for free case management. Through case management, you’ll be connected with a registered nurse who serves as your resource. Your case manager works with you, your health care provider and other members of your health care team to establish the best plan of care for you. Enrollment in case management is based on: diagnosis acute injury referral by your health care provider. You can also request case management services yourself by following the link below. This doesn’t mean you’ll receive additional benefits. And it doesn’t change your plan's benefit rules. But your case manager will work with network providers to meet your needs using available resources so you get quality cost-effective care. Sign up or learn more about complex case management. Sign Up for complex case management
You can expect services you receive to be appropriate and of high quality. Our Utilization Management team makes sure of it. Team members review the appropriateness of medical services before and after they are provided. This helps us ensure you receive services and supplies that are medically appropriate and necessary. Our service review includes: Inpatient hospital admissions Skilled nursing facility and rehabilitation care Home health care services Hospice care Behavioral health outpatient care Dean also identifies and evaluates your health care needs following discharge from a hospital and directs you to specific outpatient providers when needed. Find out more about our Quality efforts and programs. We're here to help For more information about our Care Management programs, contact our Customer Care Center at (800) 279-1301.