Managing your chronic conditions is a vital part of staying health and our Health Services Team helps you stay on track. When you seek medical services, Health Services looks at your health risks, needs, and goals and then puts together an action plan specifically for you. Our Health Services programs support the relationship between you and your providers, and tracks how well the care plan is working by using clinical and evidence-based guidelines.
Health Management Programs
Case Management advocates for the member and helps coordinate care between several different providers. They also make sure members can access other resources that are available to them.
➔ Read more about Case Management.
Health coaching is available to members who have been diagnosed with asthma, COPD, diabetes, or heart failure.
➔ Read more about Health Coaching.
Utilization Management is a review process that makes sure you are getting appropriate care.
➔ Read more about Utilization Management
Patient Review and Coordination Program
The Patient Review and Coordination Program helps make sure services are being used safely.
➔ Read more about the Patient Review and Coordination (PRC) program.
Ensuring Continuity of Care
It’s important to maintain your general level of health and care. If you experience times where you are unable to get reliable care or have trouble accessing basic needs, our team can help connect you to the necessary resources. We make sure there are no interruptions in the care you receive or with the prescription medications you take. We can refer you to additional resources to address your whole health needs. These can include:
- Care Managers
- Transportation and Interpreter Services
- Patient Review and Coordination (PRC) program, for enrollees who meet the criteria identified in WAC 182-501-0135
- Dental services
- Health Homes
- Regional Support Networks for mental health services
- Substance Use Disorder services
- Aging and Disability Services, including home and community based services
- Skilled nursing facilities and community-based residential programs