Health Management Programs. Members have access to resources that support personal health management including online tools, print materials and programs or services to help enhance quality of life in three areas: staying healthy, preventing illness and living with a chronic condition. We help you reach optimum health through educational tools (such as those available on the myPRES Member Portal), Preventive Health Guidelines (such as Mammography and childhood immunizations) as well as with disease management for conditions such as Asthma, Coronary Artery Disease , Diabetes, and/or Hypertension. If you would like more information about these services visit xxxxx://xxx/xxx.xxx/tools-resources/member/Pages/default.aspx. Members can also call our Presbyterian Customer Service Center at (000) 000-0000 or 1-855-923- 7528, Monday through Friday, from 7 a.m. to 6 p.m. Hearing impaired users may call TTY 711. Messaging therapy offers members age 14 and older behavioral health coaching with licensed behavioral therapists via text, video or audio messaging at a time and place that is convenient for them. Go to xxxxx://xxx.xxxxxxxxx.xxx/php to access the program. This interactive software offers an alternative to traditional mental health and substance use disorder care by providing access to tools and resources that are easy to use, confidential and available 24/7. Go to xxxx://xxx.xxxxxxxxxxxxxxxx.xxx/php. Create an account and answer a few questions to gain access to the Health Better Services available to you. You have the protection of Assist America’s global emergency travel assistance services 24 hours a day, 365 days a year. This unique program immediately connects you to services when experiencing a medical emergency while traveling 100 miles or more away from a permanent residence or in another country. First, download the free Assist America Mobile App, then log in with reference number 01-AAPXI-10071. For questions, contact Assist America’s Operations Center at 0-000-000-0000 (or +0-000-000-0000 outside of the USA).
Health Management Programs. BCBSNC shall make available to the Plan Administrator and Plan Sponsor a health and wellness program which is designed to promote healthy behaviors of Employees.
Health Management Programs. In an effort to improve access, quality, and continuity of care for MCP members, each MCP must:
i. Establish a primary care provider (PCP) for each member and encourage the member to have an ongoing relationship with the PCP. For this requirement, a primary care provider as defined in OAC: 5101: 3-26-01 serves as the ongoing source of primary and preventive care; assists with coordination of care as appropriate for the member’s health care needs; recommends referrals to specialists for the member; triages the member appropriately; notifies the MCP of a member who may benefit from care management services; and participates in development of the Care Management care treatment plan. The MCP must ensure the primary care provider agrees to perform the
ii. Provide education and outreach to each member to emphasize the importance of disease prevention and health/wellness promotion. The MCP must encourage and enable the member to make informed decisions about accessing and utilizing health care services appropriately.
iii. Direct and monitor coordination of care efforts for each member for medical services delivered across the continuum of care. The MCP should incorporate the requirements in Sections 3 c, d, and e in its overall strategy for care coordination.
iv. Develop and implement a strategy to identify members who display risk factors for developing a disease and/or who over-/under-utilize health care services, and would benefit from targeted outreach or education. For this requirement, the MCP must implement mechanisms to identify such members and should include the following information sources: administrative data review (e.g., pharmacy claims, emergency department claims, or inpatient hospital admissions), provider/self referrals, telephone interviews, home visits, referrals resulting from internal MCP operations, and data as reported by the MCEC during membership selection. Should the MCP identify members characterized as having an increased risk for developing a disease or who inappropriately utilize health care services, the MCP must offer education and outreach initiatives (e.g., educational mailing) designed to mitigate the risk factors, and prevent the member from requiring more progressive interventions, such as care management services.
Health Management Programs. Members have access to resources that support personal health management including online tools, print materials and programs or services to help enhance quality of life in three areas: staying healthy, preventing illness and living with a chronic condition. We help you reach optimum health through educational tools (such as those available on the myPRES Member Portal), Preventive Health Guidelines (such as Mammography and childhood immunizations) as well as with disease management for conditions such as Asthma, Coronary Artery Disease, Diabetes, and/or Hypertension. If you would like more information about these services, visit xxxxx://xxx.xxx.xxx/tools-resources/member/Pages/default.aspx. Members can also call our Presbyterian Customer Service Center at (000) 000-0000 or 1-855-923- 7528, Monday through Friday from 7 a.m. to 6 p.m. Hearing impaired users may call TTY 711. Messaging therapy offers members age 14 and older behavioral health coaching with licensed behavioral therapists via text, video or audio messaging at a time and place that is convenient for them. Go to xxxxx://xxx.xxxxxxxxx.xxx/php to access the program. This interactive software offers an alternative to traditional mental health and substance use disorder care by providing access to tools and resources that are easy to use, confidential and available 24/7. Go to xxxx://xxx.xxxxxxxxxxxxxxxx.xxx/php. Create an account and answer a few questions to gain access to the Health Better Services available to you.
