Case management

Our case managers help make healthcare easier and less overwhelming for our enrollees. Case managers work with enrollees to help them understand the types of services we offer to them 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, please have them contact Enrollee Services .

Our case managers may call our enrollees if:

• They or you, their health care provider, think case management might help the enrollee
• 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
• 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 their doctors

Case managers can also help with:

• Setting up health care services for the enrollee
• Getting referrals and prior authorizations
• Checking an enrollee’s plan of care

From time to time, enrollees 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 Amerigroup District of Columbia, Inc
• Tell the enrollee about the services we offer
• Talk to the enrollee about their health and how they are handling different parts of their life