To refer yourself to case management, please fill out the Case Management Referral Form. Learn More If you are not sure if case management is right for you, contact our Case Management department to learn more: 1-866-418-7004 (TTY Relay: 711) from 8:00 a.m. to 5:00 p.m., Monday through Friday, or by email to [email protected].
Full Answer
Is the case management program right for You?
If the answer is yes, the Case Management program may be right for you. The Case Management team is made of nurses, health coaches, pharmacists, and other staff who work behind the scenes to help customers, like you, manage their health conditions. These services are available at no cost to you, and anyone can apply.
Is the Cigna case management program right for You?
If the answer is yes, the Cigna Case Management program may be right for you. The Case Management team is made of nurses, health coaches, pharmacists, and other staff who work behind the scenes to help customers, like you, manage their health conditions. These services are available at no cost to you, and anyone can apply.
How do I get help with Medicare enrollment?
Need help with Medicare enrollment? Call a licensed agent at 1-855-335-1407 (TTY: 711) , 7 days a week, 8 AM to 8 PM. Aetna members have access to contact information and resources specific to their plans. This material is for informational purposes only and is not medical advice.
How much does PAF case management cost?
PAF Case Management is free for patients and families living with a serious or chronic health condition. To get services, a patient must be in, just starting or just ending treatment for a serious health condition. To get services, a patients, caregiver, or healthcare provider asks for our help.
How do I set up chronic care management?
Chronic Care Management (CCM): How to Implement Your ProgramStep 1: Develop a Plan and Form Your Care Team.Step 2: Identify and Recruit Eligible Patients.Step 3: Enroll Patients.Step 4: Deliver CCM and Engage Patients.Step 5: Coding, Billing, and Reimbursement.Care Coordination Software To Help You Manage CCM.
Does Medicare cover CCM?
CCM is covered under Medicare Part B. This means that Medicare will pay 80 percent of the cost of service. You'll be responsible for a coinsurance payment of 20 percent.
What is Medicare management?
Medicare care managed care plans are an optional coverage choice for people with Medicare. Managed care plans take the place of your original Medicare coverage. Original Medicare is made up of Part A (hospital insurance) and Part B (medical insurance). Plans are offered by private companies overseen by Medicare.
What is the difference between case management and care management?
Care Management focuses on the patient's actual care and helps them transition between treatments and stages of care effectively. Case management encompasses the entire rehabilitation and recovery process. It deals with every aspect of the process and creates one clear path to better health.
What conditions are considered chronic by CMS?
CMS IDENTIFIES 15 CHRONIC CONDITIONS FOR MEDICAREChronic alcohol and other drug dependence.Certain autoimmune disorders.Cancer excluding pre-cancer conditions.Certain cardiovascular disorders.Chronic heart failure.Dementia.Diabetes mellitus.End-stage liver disease.More items...•
What is considered chronic care management?
Chronic care management is a specific care management service that provides coverage for patients with two or more chronic conditions for a continuous relationship with their care team. Under CCM, the patient's care team can bill for time spent managing the patients' conditions.
Which of the following is a requirement to bill for chronic care management?
Requirements: Two or more chronic conditions expected to last at least 12 months (or until the death of the patient) Patient consent (verbal or signed) Personalized care plan in a certified EHR and a copy provided to patient.
What is a care management visit?
Transitional care management is designed to last 30 days. It involves a medical professional engaging in one face-to-face visit with the patient and then additional non face-to-face meetings (such as by telephone or a video call, as is the case with telemedicine).
What is the difference between Medicare and managed care?
Medicare managed care plans are alternative options to Medicare Part A and Part B. If you have heard of a Medicare Advantage plan, you have heard of Medicare managed care plans; they are the same. Most managed care plans provide additional benefits for services that Original Medicare does not include.
Which healthcare provider would be considered a case manager?
The healthcare case management team may include unlicensed assistive personnel (e.g., a medical assistant), other licensed healthcare professionals (such as a pharmacist), and the client's primary care providers.
What does a case manager do?
The case manager will advocate for the client and consider all aspects of their life, enabling and promoting opportunities and inclusion. They will work closely with the client, their family and/or support network. Case Managers provide the clinical support and expertise for those going through a litigation claim.
What do case managers in healthcare do?
A case manager at a hospital is a professional who handles the hospital's discharge planning, as well as its utilization reviews. Discharge plans are important because they can help determine the type of treatment patients can receive, and how often they receive it for their ailments after they leave the hospital.