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.
Provider tools and resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Provider manual and guides
- Training Academy
- Pharmacy information
- Electronic Data Interchange (EDI)