IBC has introduced a new approach to
health coaching for our members, called the Primary Health Coach model. The new
Primary Health Coach model gives members a single point of contact for all
issues and concerns related to disease/condition and case management (this
combination is called care management).
The following table describes our
former care management programs and the changes that have been made as a result
of this transition to the Primary Health Coach model:
Program
|
Program
description
|
Former
program
|
Changes for new
model
|
ConnectionsSM Health Management Program
|
Disease/condition management that
offers eligible members 24/7/365 access to a Health Coach by calling 1-800-ASK-BLUE
|
Program was administered by Health
Dialog, an independent company
|
Program is administered by
IBC Health Coaches
|
ConnectionsSM Complex Care Management
Program
|
Supports eligible members who have
one or more of 16 complex, chronic conditions
|
Support was provided by IBC care
management nurses
|
Program name has been discontinued,
but support continues to be provided by IBC Health Coaches
|
Case
management
|
Provides members with extra support
when dealing with an acute illness, chronic condition, or multiple
comorbidities
|
Support was provided by IBC care
management nurses
|
Support continues to be provided by
IBC nurses, who are called Health Coaches
|
Fully insured commercial and Medicare
Advantage HMO and PPO members transition to the new Primary Health Coach model
on May 6, 2013, and IBC members from self-insured groups will transition on
January 1, 2014.
Benefits of a Primary Health
Coach model include:
- The Health
Coach remains consistent as members transition across the health care
continuum. This consistency ensures patient-centered coaching that is
individualized and coordinated.
- The Health
Coach and member can develop a trusted relationship, which fosters higher
levels of member engagement and helps members reach their health goals.
- A Health Coach will
have a 360-degree view of a member?s complete health record using an integrated
nurse dashboard, which puts information at the Health Coach?s fingertips. This
display features information about the member?s condition, prescription drugs,
recent diagnostic or therapeutic activities, and patterns of treatment and
procedures. Such complete data review allows our Health Coaches to have a more
meaningful interaction with a member and improves the customer experience.
What providers need to know
Providers should now refer IBC patients
for disease/condition and case management by submitting an online physician referral form. A link to
this form is also available on NaviNet? Plan
Central in the Administrative Tools & Resources section. Providers who wish
to refer their patients via telephone should call 1-800-ASK-BLUE.
Note:
Providers should no longer call the Provider Support Line (1-866-866-4694) to make patient referrals.
The ConnectionsSM Provider Portal has been discontinued, and
providers will no longer receive the SMART?
Registry. Instead, providers continue to have access to similar information for
their patients through our Clinical Alerts and the Clinical Care Report, both
available on the NaviNet web portal through the Eligibility and Benefits
Inquiry transaction.
Please note that, with the
discontinuation of the SMART Registry, the SMART Registry CD Access Code
transaction will be removed from NaviNet later this year.
What members need to know
Members who currently use the
disease/condition management program and who have a Health Coach under the
current program have been transitioned to a new Health Coach at IBC. These
members were notified of this change by mail and were assigned to a new IBC
Health Coach.
Members should continue to call the
same number (1-800-ASK-BLUE) to reach a Health
Coach. Once they indicate that they would like to speak to a Health Coach,
their call will be routed to a Health Coach at IBC. Members continue to have
24/7/365 access to a Health Coach and online educational tools.
If you or one of your IBC patients has
any questions about this change, please call Customer Service at 1-800-ASK-BLUE.
NaviNet® is a registered trademark of
NaviNet, Inc., an independent company.
SMART® is a registered trademark of Health
Dialog Services Corporation, an independent company.