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What is Case Management?
A medical illness or
unexpected injury can quickly create
stress and confusion. We hope your clients will
never be confronted with a serious medical problem,
but if they are, a Case Manager can help.
Case
Managers are experienced, licensed health care
professionals who provide support and guidance.
In addition to our Case Managers assisting our
members with existing medical conditions,
our proactive team of Case Managers can help
with early intervention options for future medical
issues. Our Case
Managers make sure your client's needs
come first by:
- Answering questions and providing information about
the member's condition, illness or injury.
- Serving as a member advocate by helping navigate
the health care system.
- Working with the member's doctor and supporting
treatment plans.
How members are identified for Case Management
Members are identified and referred through a number of sources. Referrals may come from one of our internal Regence departments, from the member themselves, from the member's family, physician, or other professional provider.
Regence Case Managers can:
- Help members and their providers navigate the health care system.
- Act as a liaison and refer to available community, commercial and/or social services.
- Provide assistance in coordination between all services provided by Regence BlueCross BlueShield of Oregon.
What is the Case Management Process?
A Case Manager reviews the member's health status
and treatment plan. A care plan is developed based
on the individual's needs, social support system, provider
involvement, as well as policy benefits. The Case Manager
helps the member explore all available treatment
options and coordinates efforts to facilitate
care where appropriate.
Who is eligible for Case Management?
Case Management is available to all
members, from birth through the golden years, who may
have complex or chronic medical conditions or events.
Case Managers can also assist members who have a potential
for future medical conditions.
Who To Contact
If you have a client who would benefit from Case
Management, please call 1 (866) 543-5765. You may
also complete our online Case
Management Referral Request.
Program Availability
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