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Disease Management
ADVANTAGE Care Select works with providers to ensure that members eligible
for Disease Management services receive additional support to manage their condition.
We are another resource for members to get questions answered, provide additional
assessments and offer educational articles and information. Our goal is to help
our members manage their disease for increased quality of life and fewer severe
medical issues.
Chronic Conditions Covered
» Asthma
» Diabetes (DM)
» Congestive Heart Failure (CHF) or Coronary Artery Disease (CAD)
» Hypertension (HTN)
» Chronic Kidney Disease (CKD) without Dialysis
» Severe Mental Illness (SMI)
» Serious Emotional Disturbance (SED)
» Depression
Disease Planning
Disease Management plans assist members in understanding their chronic conditions,
set goals, and achieve self-selected outcomes through education, counseling, and
on-going support. Members with multiple chronic conditions might have unique health
needs that are incorporated in to the Disease Management plan. Disease Management
plans are prepared with members (and their families, if appropriate) based on clinical
guidelines.
Disease Management plans can be fairly basic or more involved depending on member
needs. The simplest of them might contain:
» documentation of a member’s stratification level
» the condition(s) for which the member should receive DM
» the schedule of DM interventions for those conditions,
» contact information for the member’s PMP.
Members will receive monthly phone calls from ADVANTAGE Disease Management staff
reinforcing key elements of chronic Disease Management and treatment. These conversations
shall encourage members to follow the Disease Management plan by addressing any
identified barriers and referring members to additional community resources when
appropriate.
Member education materials are also provided by mail or electronically.
Patient Referral & Questions
You or your office staff can call Disease Management at 1-866-311-3101 to refer
an ADVANTAGE Care Select member that would benefit from the Disease Management
program or for general questions.
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