Case Management

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Prevea360 Health Plan cares for you

Navigating your way through the health care system can be confusing. That's why Prevea360 Health Plan offers you a Case Management team to help guide you.

Our team ensures your needs are met and all your questions and concerns are addressed. If you are diagnosed with a chronic health condition or have a complex health care need, take advantage of these services—offered free of charge.

Support when you need it most

Our Case Management program provides a registered nurse who serves as your resource during a time where health care may be complex and/or confusing. Your case manager will work with you, your doctor and other members of the health care team as needed to establish the best plan of care for you.

Program participants are identified by referrals from your doctor or based upon diagnosis or acute injury. You can also request Case Management services by directly contacting Dean Health Plan Member Services at 1-877-232-7566 (TTY: 711).

Focused on appropriate care

The Utilization Management team reviews the appropriateness of certain medical services before you receive the service. This allows us to ensure you are receiving services and supplies that are medically appropriate and necessary. This step is called “prior authorization.”

To determine if a medical service requires prior authorization, contact Prevea360 Health Plan Member Services at 1-877-232-7566 (TTY: 711) or refer to your Evidence of Coverage document.

If it is required, work with your doctor to submit the request. Your doctor can refer to the Dean Health Plan Medical Management site for more information.

Once your request has been processed, you and your doctor will be notified via mail.

Managing your medications

Like many Prevea360 Health Plan members, you might be taking multiple medications prescribed by more than one doctor.

Prevea360 Medicare Advantage offers a Medication Therapy Management program that allows you to discuss your medications one-on-one with a pharmacist.

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