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Case Management

For ProvidersCase Management


Case Management

Our Case Management Program is included in as an added benefit for our members. The program is completely voluntary. Your patient may opt in or out at any time.

Case Management Program provides:

  • Coordination to bridge gaps in care for needed treatment, services and/or equipment
  • Empowerment towards self-management of chronic diseases/conditions
  • Specialized management options based on diagnoses, medications, and health status including pregnancy and behavioral health
  • Guidance and advice on the healthcare system and patient benefits
  • Assistance with coordination of referrals and authorizations
  • Referrals to community resources to alleviate social determinant of health barriers

Referring a patient to Case Management:

All Health Plan members with current coverage are eligible to participate in the Case Management Program. Anyone can refer a member to Case Management, including providers. Members may even self-refer to Case Management by calling the number on the back of their insurance card and asking to speak with a member of our team.

Referrals can be made by completing the attached referral form and emailing to: or by calling Customer Service and asking for Case Management.

What to expect after referring to Case Management:

A member of the Case Management team will call your patient within four (4) days, offer Case Management and attempt to complete a comprehensive health assessment. Any needs or opportunities for assistance identified during the assessment will be utilized to develop an individualized plan of care with your patient. Our staff will continue to work with you and your patient until the goals are met and no new needs are identified, the member’s coverage terminates, the member remains unreachable, or they decline to continue.