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Medical Management Programs

• Utilization Management
• Case Management
• Medical Claim Review
• Healthy Pregnancy
• Disease Management
• Nurse Support Services

Disease Management

Participation in our disease management program is completely voluntary.

We identify potential candidates for the program using medical and prescription drug claims information and then contact candidates and ask them to participate. If they volunteer, they receive:

• A welcome kit and a call from the program to discuss medical history, lifestyle behaviors and current disease state
• Follow-up calls to monitor health and provide support for the physician's treatment plan
• Toll-free access to a program nurse

We help enrolled plan members learn about their conditions, make informed health care decisions, stay healthy and avoid unnecessary medical costs.