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Case management

For your patients with serious illness, BCBSND offers a case management program to help them understand options available and to achieve their optimal health and functional capability. This program is available at no additional cost to qualifying members.

Care coordinators—registered nurses and licensed social workers—recognize the emotional impacts of serious illness and are trained in:

  • Motivational interviewing
  • Crucial conversations
  • Case management and utilization management

Assessments

Case management often includes voluntary assessments including:

  • Comprehensive health screening
  • Screening for depression and anxiety
  • Assessment of Member’s Health Engagement
  • Medication reconciliation

Interventions

Care coordination interventions include:

  • Goal setting with members to achieve optimal health outcomes
  • Motivational interviewing to assess barriers to change
  • Assessment of member engagement into their health
  • Providing education regarding health risks and needs assessment
  • Collaboration/referral to Patient Centered Medical Home/primary care provider
  • Transition of care planning for complex cases
  • Coordination of local, regional and nationwide health care services
  • Ongoing case management for especially complex and chronic cases
  • Referrals to disease management professionals for rare and complex disease management
  • Assisting members in making informed health care decisions
  • Connecting the members to the right resources within BCBSND to help them understand their benefits

Case management referrals

A member or their authorized representative must consent and agree to participate in the case management program. Enrollment is voluntary, at no additional cost to the member.

Case management referrals can be initiated by:

  • The member/patient
  • The member's authorized representative
  • A health care provider

To initiate a referral to case management, contact BCBSND at 800-336-2488.