Provider Program Referral
The Health Plan has a variety of clinical programs conducted by professional staff to help you achieve your patient care goals.
There are Health, Wellness and Prevention Programs to provide education, support and resources to member who may require assistance with improving nutrition, achieving a healthy weight, increasing physical activity, managing stress, identifying and addressing depressive symptoms, tobacco cessation or facilitating access to community based organizations to address health determinants (SDOH) such as homelessness, lack of food or transportation.
Pregnancy Care Programs are available to both high and low risk members, as well as to members who may want to discuss family planning or birth control options.
Chronic Disease Management Programs are available and aimed at helping to educate members and reinforce provider treatment plans for members learning to live with and manage diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease with or without comorbid depression.
Medical/Behavioral Health Case Management Programs are here to bridge gaps between moderate to high-risk members and providers. Program goals include increasing member understanding of disease or condition, managing/controlling symptoms, adherence to medication regimens, removing any barriers to care and helping members gain control of their health and achieve optimum function.
Further explanation of The Health Plan Care/Case Navigation Program can be found in the Provider Procedural Manual, Section 7.