The Disease Management (DM) department provides services for Healthy Blue members. These services are based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.
Additionally, DM offers the Healthy Families program, which is a six-month program for members ages 7-17 designed to assist families in obtaining a healthier lifestyle. This program provides families with fitness and healthy behavior coaching, written nutrition information, and online and community resources. To receive additional information or enroll in the Healthy Families program, call us at 1-844-421-5661
The mission of the DM department is to improve the health and quality of life for members by encouraging self-care efforts, coordinating health care education and providing interventions along the continuum of care.
Our programs feature:
DM objectives are to:
Members are eligible if they have been diagnosed with one of the above conditions and are identified through continuous case finding efforts, claims mining and referrals.
The Healthy Blue DM department and programs do not advertise, market or promote specific products or services to members or providers.
The DM department and programs do not have any financial ownership arrangements with anyone who advertises, markets or provides the goods and services we offer.
As a valued provider who could use some help in following up with patients, you can refer your asthma, bipolar disorder, CAD, CHF, COPD, diabetes, HIV/AIDS, hypertension, MDD for adult and child/adolescent, schizophrenia, and SUD. In addition, refer patients who could benefit from additional education or care management.
To assist in managing patients, DM requests your input for patient treatment plans. DM information and the most up-to-date Clinical Practice Guidelines (CPGs) are provided to assist you in creating an individual plan of care.
Providers can access Patient360 to obtain feedback on their patients regarding their care plans and condition management while enrolled in a DM program.
You have additional rights and responsibilities, such as the right to:
These rights and responsibilities are available to you in written format upon request to DM by calling 1-888-830-4300.
The CPGs are available to providers on our secure provider website (login is required). They can also be requested at any time.
DM case managers are registered nurses who are available from 8:30 a.m. to 5:30 p.m. CT, Monday through Friday. Confidential voicemail and the Care on Call line are available 24/7.
Please call 1-888-830-4300 to reach a DM case manager. Your patients can also get information about DM programs and services by calling 1-888-830-4300.
DM case managers are licensed nurses and are available from 8:30 a.m. to 5:30 p.m. local time, Monday through Friday. Confidential voicemail is available 24 hours a day. Care on Call is available 24/7 for our members.
Please call 1-888-830-4300 to reach a DM case manager. Your patients can also get information about DM program services by calling 1-888-830-4300.