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Why Do You Need a Case Manager?

When you or a loved one experience a health issue, you need an advocate- a case manager- to effectively navigate the world of doctors, hospitals, and health insurance on your behalf.

There are many reasons you may need a nurse case manager:

  • You may be leaving the hospital after surgery.
  • You may have diabetes and have trouble regulating your blood sugar.
  • You may be caring for a child with uncontrolled asthma.
  • You may need help finding medical equipment.
  • You may have learned you have a frightening illness you don’t know much about.

The reasons are endless, but the answer is the same.

Nurse case managers are here to help

Our registered nurses (RNs) work directly with members to ensure they get needed medical care as efficiently as possible. They keep the lines of communication open with physicians, make sure members completely understand the instructions for medications and help with any billing or claims issues.

Our case managers assist members in getting help for their specific needs, ranging from pregnancy to heart disease. They also work with their families and medical care providers to address each health issue from every angle.

If you struggle with a health condition, Arkansas Blue Cross and Blue Shield’s case managers are ready to answer questions about your condition, help develop a plan, tach self-care techniques, and connect you to support services.

Our entire team of RN case managers, dedicated to this very purpose, are ready to help you and your family navigate the stresses of challenging health situations. But they can’t share that help unless they are aware you need it, so your first step is to call the customer service number on the back of your member ID card.

Case management helps Joe with diabetes supplies

Joe Killion, an Arkansas Blue Cross and Blue Shield member in Tennessee, has type 1 diabetes. He has used a continuous glucose monitoring system for five years, but recently his supplier stopped accepting his insurance for his sensors.

Joe tried to get his supplies elsewhere but was unsuccessful. That’s when he turned to Arkansas Blue Cross and RN case manager Kathy Hendon for help.

“It involved several calls and working with his doctor, but, after many phone calls and emails, we finally found a vendor who would provide his sensors,” Kathy said.

“If Kathy would not have stepped in, I would not have received them,” said Joe, whose blood glucose levels quickly improved after receiving the sensors.

“It was a pleasure to work with Mr. Killion,” Kathy said. “I’m always happy to assist members with their healthcare needs.”

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