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Nurse case manager helps find formula replacement

Every day, Arkansas Blue Cross and Blue Shield’s nurse case managers are the friendly voice on the other end of the phone. The reason for the calls could range from needing help finding medical equipment to learning more about a recent diagnosis. The nurse case managers help members work through the complicated world of doctors, hospitals and health insurance.

As a case manager, Amy Rorex often goes above and beyond to provide crucial help.

In March 2022, Rorex received a request from Chance and Kirby Smith from Bono, Arkansas. Their son, 8-year-old Koen, suffers from a chronic disease that makes it difficult for him to swallow. Because Koen cannot eat like most kids, he needs a specific type of formula. Faced with a medical challenge, the couple contacted Rorex for help.

Seeking support

“This formula was his only source of nutrition, and he couldn’t eat anything else,” Rorex explained. Because the formula was recalled, his parents struggled to find a replacement. They used about a can a day, and their supply was dwindling fast.

“When the only thing your child can eat is taken away, you can imagine what that does to a parent,” said Kirby Smith.

A plea from parents

“When his parents called us, nobody knew at that point how they would get more,” Rorex said. “The uncertainty on when or if the formula would be available was extremely stressful for them. I am sure they felt very helpless.”

As a case manager, Rorex set to work to untangle the complicated knot of finding an acceptable replacement, an available supply of it, and a way to have the new costs covered, that was agreeable to all involved. Rorex began working the phones and kept Koen’s parents updated, continually verifying the supply of formula on hand.

Determined to help

“She put a lot of work into doing what is best for Koen,” Smith said. “You should see the emails we had from that time. Amy did not take ‘no’ for an answer. It was her compassion that guided us through the process.”

Eventually, the formula recall crisis eased, and through it all, Koen did not go without nutrition.

Celebrating the success

The Smiths recently held a party to celebrate Koen’s journey, inviting those involved in his success. The party’s menu included chicken and green beans – the two safe foods Koen can now eat. Rorex was given a “best of the best” award at the celebration in appreciation of her dedication to Koen.

As a case manager, Rorex regularly addresses all kinds of members’ issues and concerns, but her work with Koen and his parents is not one she will forget anytime soon.

Happy to help

“I already knew Koen had an excellent team of doctors, a pharmacist and a dietitian working with us here at Arkansas Blue Cross, but hearing about each person’s impact in Koen’s journey made it clear the right people were brought together to fight for him. I am very blessed to have been a piece of this puzzle.”

How Case Management Supports Whole Person Health

Nurse case managers can help you

If you or someone you care about is facing a health issue, it can be overwhelming. This is where a nurse case manager comes in. They’ll be an advocate for you.

Our case managers are experienced registered nurses who work directly with members to ensure they receive the medical care they need as efficiently as possible. They reach out to members after surgery, find medical equipment and support services, and help them learn to care for themselves. They work closely with members’ families and medical care providers to address each health issue from every angle.

Our RN case managers are here to help you navigate the stresses of challenging health situations. Simply call the customer service number on the back of your member ID card.

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