Our health care management (HCM) team comprised of nurses, social workers, and medical management specialists, help make health care easier, and less overwhelming, for our members. They work with our members 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 HCM team members. If not, or if they need help contacting their HCM team member, please have them call
Our HCM team may call our members if:
- They or you, their health care provider, think care management might help the member.
- 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 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.
Our HCM team 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 HCM team. When we call, a nurse, social worker, or Medical Management Specialist will:
- Always identify themselves with their name, title and position with Amerigroup Community Care.
- Tell the member about the services we offer.
- Talk to the member about their health and how they are handling different parts of their life.