Care management

Our care managers may call a patient if:

• They or you, their health care provider, thinks care management might help the patient.
• They have just gotten out of the hospital and need help with follow-up visits to other doctors.
• They are going to the emergency room (ER) often for non-urgent care that could be handled by you, their health care provider.
• They call our 24/7 NurseLine and need more follow-up for ongoing care.
• They have serious physical problems and need more help managing their health.
• They have behavioral health problems and need more help working with all of their doctors.

Care managers can also help with:

• Setting up health care services for the patient.
• Getting referrals and prior authorizations.
• Checking a patient’s plan of care.

From time to time, patients may have questions about calls they receive from one of our care managers, licensed clinicians, or outreach care specialists. When we call, a nurse or social worker will:

• Always identify themselves with their name, title and position with Highmark Blue Cross Blue Shield of Western New York.
• Tell the patient about the services we offer.
• Talk to the patient about their health and how they’re handling different parts of their life.