Care Management

Sometimes navigating your way through the health care system can be challenging. That's where the Prevea360 Care Management Team comes in.

If you have been diagnosed with a chronic health condition or have a complex health care need, the following services are available to ensure your needs are met and all your questions and concerns are addressed.
 

All for a Healthier You
Our Living Healthy program is designed to help you, our members, get answers to questions about your chronic health problem and offer support to help manage chronic health needs.

Along with your health care providers, the Living Healthy program supports member self-management through:
  • Telephonic counseling
  • Care reminders
  • Education
  • Long-term patient advocacy and support

Support When You Need it Most
You may be identified for Case Management based on a diagnosis, acute injury or from a referral by your health care provider.

You also have the option to request Case Management services yourself.

Case Management is free of charge and provides you with a registered nurse who serves as your resource during a time where health care may be intense or confusing. Your Case Manager will work with you, your health care provider and other members of the health care team as needed to establish the best plan of care for you.

Case Management does not provide additional benefits or change your plan's benefit rules; however, the case manager will work with Prevea providers to meet your needs using available resources with the goal of delivering quality cost-effective care.
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Focusing on Quality Care
The Utilization Management team reviews the appropriateness of medical services that you receive before and after they are rendered. This allows us to ensure you are receiving services and supplies that are medically appropriate and necessary. The review of services includes:
  • Inpatient hospital admissions
  • Skilled nursing facility and rehabilitation care
  • Home health care services
  • Hospice care
  • Behavioral health outpatient care
In addition, the Prevea360 Care management team identifies and evaluates your health care needs following discharge from a hospital and directs you to specific outpatient providers when needed.
Contact Us
Care Management Services
If you are interested in any of Prevea360 Health Plan's Care Management services, call 877.230.7571.
Care Management Specialists are available to take your call Monday through Friday from 8:00 a.m. to 4:30 p.m.