Depending on their benefit plans, some members have additional resources available to help them better manage chronic conditions. The ConditionCare program is designed to help participants’ improve their health and enhance their well-being. The program is based on nationally recognized clinical guidelines and serves as an excellent adjunct to physician care.
The ConditionCare program helps members better understand and control certain medical conditions like:
A team of nurses with added support from other health professionals – such as dietitians, pharmacists and health educators – work with members to help them understand their condition(s), their physician’s orders and how to become a better self-manager of their condition. Members are stratified into three different risk levels.
Nurse coaches encourage participants to follow their physician’s plan of care; not to offer separate medical advice. In order to help ensure that our service complements the physician’s instructions, we collaborate with the treating physician to understand the member’s plan of care and educate the member on options for their treatment plan. Providers may receive a quarterly report for patients who are currently enrolled in the program including the member’s current educational goals.
If you would like to refer a patient into the program, download this referral form
and fax it back to the number provided. Depending on their benefit structure, some members may not be eligible for this program. If you have any questions or comments about the program or would like to check a member’s eligibility for the program, call toll free 877-681-6694
. You may also use this number to refer a patient into the program if you do not have access to a fax machine. Our nurses are available Monday-Friday, 8:30 a.m. to 9 p.m. CST, and Saturday, 9 a.m. to 7:30 p.m. CST.