Prior to any planned hospitalization
Within 24 hours of an emergency admission to a hospital
As soon as you know you are pregnant
Health Care Strategies
"Your Care Counselor Services"
What is the Care Counselor Service?
The Care Counselor Service is an additional feature of your Benefit Plan. The Service is designed to provide you & your family with information & assistance regarding medical decisions and care. Your Care Counselor is a medical professional who has received additional training to provide you with personalized information to identify & assist you in understanding options available to you through the medical community.
When do I need to call the Care Counselor?
In order to maximize the benefits available through your Plan, you or your Physician must call the toll-free Care Counselor number found on your Benefit Plan ID Card.
CALL 800-582-1535
|
Prior to any planned hospitalization
| Within 24 hours of an emergency admission to a hospital
| As soon as you know you are pregnant |
Check your Plan Booklet to determine if a call is required for Selected Therapies, Specialized Testing or Outpatient Surgery.
When you speak with your Care Counselor, you will be provided a CASE REFERENCE NUMBER". You should make a note of your Case Number, Care Counselor's Name & Extension (you can dial it directly the next time you need to speak with them).
Will the Care Counselor tell me how much will be covered for tests, hospitalization or surgical procedures?
The Care Counselor can not answer questions concerning eligibility or benefits. For information on coverage, refer to your Benefit Plan booklet of contact your Claims Payor.
How do I reach my Care Counselor?
Simply dial the toll free number:
800-582-1535
The Care counselor Service is available 24 hours a day, seven days a week.
What information will I need to provide?
When you call...your Care counselor will ask for:
|
Your Name
| Employer
| Phone Number
| Employee's Social Security Number
| Name & Phone Number of your Doctor & Hospital |
If your Care counselor is assisting another participant, you may choose to leave a message indicating the convenient time for a return call. Your call will be returned as soon as possible.
All information provided to your Care Counselor is treated confidentially.
Medical Information HELPline
What if YOU had questions about...
|
where you could obtain medical treatment or service?
| what new medical technologies are developing?
| details on a particular diagnosis or procedure?
| safe use of prescriptions or over the counter medications? |
To help you answer questions like these and maneuver more comfortably through the often confusing medical care system, our benefit plan provides a special service. your Medical information Helpline
The Medical Information HELPline provides toll-free access to valuable heath care information. Calls answered by our staff of professional Registered Nurses, responding to your questions and offering information over the phone. In addition, printed and electronic materials are available on a variety of health related topics.
The service can be reached 24 hours a day, 7-days a week. Calls placed during the regular business day receive immediate information.
Inquires requiring further investigation, late-night or weekend calls sometimes require additional research.
So the next time you
face a question about medical care, side-effect, treatment choices or simply
need information about how to locate a qualified health care provider, call... Medical
Information Helpline at: 1-800-582-1535
press "9" to transfer directly to the
HELPline nurses.
Case Managers
|
Advocate on behalf of individuals & families
| Provide confidential education & specific teaching to facilitate recovery & improve quality of life.
| Focus on teaching patients how to navigate the healthcare system & access quality medical care.
| Support patients & treating physicians to improve health outcomes, while limiting out-of-pocket costs to patients
| Assist individuals in accessing "Centers of Medical Excellence" for treatment of illness or injury when appropriate
| Collaborate, facilitate & coordinate health care services based upon the personalized needs of the patient & family. |