HealthCare Partners is pleased to offer a Case Management program that offers support to help our members meet their individual health needs. The case management program is a free service provided by HealthCare Partners Nevada in collaboration with your Primary Care Physician (PCP). Your case manager will work with you and your doctor to make sure that you understand your illness and can follow the treatment plan that your doctor recommends.
Services we offer you:
- Coordination of your health care
- Development of an agreed upon treatment plan with your primary care physician
- Information on available community resources
- RN monitoring and ongoing assessment of your care needs
- Assistance to promote quality, cost effective outcomes
- Provide health education dependent on your individual needs
To be Eligible for Case Management programs:
- You may request a referral from your Primary Care Physician on your next visit
- You may self-refer by calling the Case Management Department directly or your Health Plan
- The Case Management Department may review your medical record and call you about enrollment
What you can expect:
- A Registered Nurse Case Manager will be available to you at no charge
- You will receive regular telephone calls from the case manager to assist you with your health questions
- The case manager will assist you with urgent Primary Care Physician (PCP) appointments
- You will receive health education materials and tips on how to follow your doctor's instructions
- You will be provided with information on community and national resources
- Assistance in dealing and working with your Health Plan
Cost:No cost to members of participating Health Plans
Complex Case Management
What is complex case management?Complex case management is the process of coordinating care for members who are identified as having significant medical care needs that may be acute or chronic in nature. Complex case management also involves the proactive management of anticipated medical situations. The process encompasses care coordination, anticipatory guidance, targeted education and support in behavioral changes. Licensed, registered nurses, under the direction of a HCPNV Medical Director, perform complex case management.
How are at risk members identified and what is encompassed in their care?Members with potentially complex cases and needs are identified through various mechanisms including referrals from other health care workers, self referrals and claims analysis. Coordination and maximization of benefits with the Health Plan/Payor and providers is required throughout episodes of illness and continuum of care. This service also includes assisting with the transition of new members into a plan or assisting members with other care, if necessary, when benefits end or upon termination of providers. Complex case managers develop plans of care, based on patients' needs, in conjunction with patients and their families, physicians, or ancillary providers. Episodic issues requiring coordination, support and education are also addressed through this department.
Members who also participate in Disease Management programs will receive applicable educational materials, in addition to any case management services they may need.
For more information or to refer a member to the HCPNV Case Management Program, contact the Case Management Department at 702-479-4800.