Our Case Management program is designed to work in collaboration with you, your patient and additional specialists to create action plans that best support patient needs.
Patients who are referred to case management work closely with our clinical teams to review health needs and goals to assure that they receive needed services in an efficient, timely and cost-effective manner.
Members will be connected to both clinical and non-clinical resources, such as Pharmacy Support Services, Social Work and Behavioral Health resources, and Community Resources that support playing an active role in the self-management of their health care needs and goals.
HCP provides this program to your patients as a no-cost, value added service. When they sign up, they will receive one-on-one guidance to help with day-to-day health care questions and needs. HCP wants to ensure that the most appropriate level of care and services are received, enabling members to take full advantage of the benefits available to them through their health plans.
Case managers can provide the following assistance directly to your patients:
- Teach patients about their condition
- Guide them in making a treatment plan
- Help them get medications and care
- Set up referrals and doctor visits
- Arrange transportation
- Access all members of their health care team
- Nurse on call, 24/7
Suggested Referral Criteria
- Medically complex patients with one or more poorly controlled chronic medical conditions
- Frequent preventable Emergency Department visits
- Takes more than 10 medications
- Unstable housing or other social determinants of health
- Difficulty accessing health care services
- Lack of support in home or community
- Poor understanding of disease and/or treatment (low health literacy, labeled “non-compliant”)
- Provider is unable to contact the patient
- Patient is not engaged in own care
- Language or other social barriers
- Newly diagnosed chronic conditions
If you would like to refer a patient for a Case Management evaluation, download and complete the Case Management referral form and FAX to (516) 941-2145 or email CMRef@hcpipa.com.
We will review your request and contact you with updates as soon as they become available.