Navigating the healthcare system can often feel complicated and overwhelming. At Anthem Blue Cross and Blue Shield (Anthem), we understand this, and that’s why we offer the Anthem Care Management Program. Our dedicated care managers are here to simplify your healthcare journey, making it easier for you to understand and actively participate in your own well-being. They act as a personal guide, connecting you with the resources and support available under your Anthem plan.
If you haven’t already connected with one of our care managers, or if you need assistance reaching yours, please don’t hesitate to contact Member Services. We encourage you to explore how this program can be a valuable asset in managing your health.
How Anthem Care Managers Proactively Support Your Health Journey
Anthem care managers may reach out to members in various situations where personalized support can make a significant difference. These proactive calls are designed to offer assistance and ensure members receive the right care at the right time. You might receive a call from one of our care managers if:
- Care Management is Recommended: If you or your healthcare provider believe that care management services could be beneficial for your health needs.
- Post-Hospital Discharge Support: Following a hospital stay, care managers can help coordinate necessary follow-up appointments and ensure a smooth transition back home.
- Frequent Emergency Room Visits: If you find yourself frequently visiting the emergency room for non-urgent health concerns that could be effectively addressed by your primary healthcare provider, our care managers can help connect you with appropriate resources.
- 24/7 Nurseline Follow-Up: If you’ve contacted our 24/7 Nurseline and require ongoing support and guidance for your health concerns, a care manager can provide dedicated follow-up.
- Complex Health Conditions: For members managing serious physical health challenges, care managers offer extra support in navigating treatment plans and managing overall well-being.
- Behavioral Health Support: If you are facing behavioral health issues, care managers can assist in coordinating care between your various healthcare providers and accessing relevant support systems.
Comprehensive Assistance Offered by Care Managers
Our care managers are equipped to provide a wide range of support services, all tailored to your individual needs and healthcare plan. They can assist you with:
- Setting Up Healthcare Services: Navigating the process of arranging necessary healthcare appointments and services.
- Referrals and Prior Authorizations: Streamlining the often-complex processes of obtaining referrals and prior authorizations for medical services.
- Understanding Your Plan of Care: Providing clear explanations and support in understanding your personalized healthcare plan and treatment options.
What to Expect When You Hear From an Anthem Care Manager
We understand that receiving unexpected calls about healthcare can sometimes raise questions. When an Anthem care manager contacts you, rest assured that they will always:
- Clearly Identify Themselves: Introduce themselves by name, title (Nurse or Social Worker), and clearly state their affiliation with Anthem Blue Cross and Blue Shield.
- Explain Available Services: Provide a clear and concise explanation of the Anthem Care Management Program and the services available to you.
- Discuss Your Health Needs Respectfully: Engage in a confidential and respectful conversation about your health and well-being, focusing on how they can best support you in managing different aspects of your life and health.
The Anthem Care Management Program is dedicated to empowering you to take control of your healthcare journey. By providing personalized support and guidance, we aim to make healthcare less confusing and more manageable, ensuring you have the resources you need to live a healthier life.
