Case management
Our case managers help make health care easier, and less overwhelming, for our members. They work with members to help them understand the types of services we offer and how to participate in their own care.
Your patients may already be working with one of our case managers. If not, or if they need help contacting their case manager, have them call Member Services .
Our case managers may call our members if:
- They or you, their health care provider, thinks case management might help the member.
- They’ve just gotten out of the hospital and need help with follow-up visits to other doctors.
- They’re 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-hour Nurse HelpLine 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.
Case managers can also help with:
- Setting up health care services for the member.
- Getting referrals and prior authorizations.
- Checking a member’s plan of care.
From time to time, members may have questions about calls they receive from one of our case managers. When we call, a nurse or social worker will:
- Always identify themselves with their name, title and position with Summit Community Care.
- Tell the member about the services we offer.
- Talk to the member about their health and how they’re handling different parts of their life.