- What could help you feel your best?
Living with a chronic illness can be hard, especially if you feel like you’re going it alone. Healthy Blue has a DMCCU designed to give you a choice and a voice in how you care for your health.
- How could the Disease Management (DM) Program help me?
Registered nurses, also called DM case managers, work with you one-on-one over the phone. They share knowledge and resources to help you learn to better manage your condition and improve your quality of life. They also help you understand your condition and create a plan so you can take control of your care.
- How do I know if I’m eligible for the DM Program?
Take a look at the list below. If you can answer “yes” to any of these questions, you may be eligible for the DM Program.
I am living with:
- A behavioral health condition such as depression, schizophrenia, bipolar disorder or substance use disorder
- A heart condition, including congestive heart failure (CHF), coronary artery disease (CAD) or hypertension, also called high blood pressure
- A lung condition like asthma or chronic obstructive pulmonary disease (COPD)
You may also be eligible for weight management services.
- If I take part in the DM Program, what will I get?
- A case manager who will work with you one-on-one to help you manage your health
- Assistance to make sure you have the health equipment you need
- Information on the most up-to-date treatment for your condition
- Any recommended screenings for other conditions
- Help coordinating care between your primary care physician (PCP) and any specialists
- Contact information for local caregivers
- What other ways could a DM case manager help me?
He or she:
- Monitors your progress with the health condition you’re being treated for
- Gives your providers information on the latest treatment options for your condition
- Provides your doctors with updates on your health
- Listens to your ideas on ways we can help you
- Asks for your feedback to make the DM Program even better
- How do I take part in the DM Program?
There are two ways you can get started in the DM Program.
- Call 1-888-830-4300 (TTY 711) and an experienced DM representative will be happy to help you.
- Email your name and phone number to firstname.lastname@example.org.
Please be aware that emails exchanged over the internet are usually safe from unauthorized interference, but there is some risk third parties may access these emails without your permission or without you knowing. By sending your information by email, you acknowledge the email might be accessed by an unauthorized third party.
- How do I reach my case manager?
You can call your case manager toll free at 1-888-830-4300 (TTY 711). Office hours are 8:30 a.m. to 5:30 p.m., Monday through Friday. You can also leave a private message for your case manager 24 hours a day.
- How do I reach other health care resources?
- If you have routine health questions, call your PCP.
- If you have a life-threatening emergency, call 911 or go to the nearest emergency room.
- For questions about your health any time, call the 24-hour Nurseline at 1-866-577-9710 (TTY 1-800-368-4424)
- What are my rights and responsibilities as part of the DM Program?
As a member enrolled in the DM Program, you have the right to:
- Get details about your plan, including:
- Programs and services provided on behalf of Healthy Blue
- Our staff and staff qualifications
- Any contractual relationships
- Opt out of DM services at any time
- Know who your case manager is, and know how to request a change
- Get support from us to make health care choices with your providers
- Be told about all disease management-related treatment options mentioned in clinical guidelines, even if a treatment is not covered. And you have the right to discuss options with treating providers.
- Have your personal data and medical information kept confidential.
- Know who has access to your information and know the procedures we use to ensure security, privacy and confidentiality
- Be treated politely and with respect by our staff
- File a complaint to Healthy Blue and receive guidance on how to use the complaint process, as well know our standards of timeliness for responding to and resolving issues of quality and complaints
- Get information that is clear and easy to understand
- Formulate advance directives
- Access medical records in accordance with applicable state and federal laws, including the ability to request the record be amended and corrected
- Refuse treatment
- Be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation, in accordance with federal regulations
- Receive services that are appropriate and are not denied or reduced solely because of diagnosis, type of illness, or medical condition
- Have honest talks with your doctors about the right treatment for your condition, in spite of the cost or your benefit coverage
As a member enrolled in the DM program, you have a responsibility to:
- Follow the plan of care you and your case manage agree on
- Provide us with information needed to carry out our services
- Tell us and your provider if you decide to leave the program
- Get details about your plan, including:
- ¡A la Unidad Central de Atención Médica Integral (DMCCU) más que nada le importa usted!
For a written version of your DM rights and responsibilities or information on this website, please print this page or call your case manager.
DM does not market products or services from outside companies to our members. We do not own or profit from outside companies on the goods and services we offer.