The Disease Management (DM) department offers services for Anthem Blue Cross and Blue Shield Medicaid (Anthem) members. These services are based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.
DM services include:
The mission of the DM department is to improve the health and quality of life for Anthem members by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.
Our programs feature the following:
DM aims to:
Members diagnosed with the above conditions and identified through continuous case finding efforts, claims mining and referrals are eligible for Disease Management services.
Maximize your time
As a valued provider who could use some help in following up with patients, you can refer your patients with asthma, bipolar disorder, CAD, CHF, COPD, diabetes, HIV/AIDS, hypertension, MDD in adult and child/adolescent, schizophrenia, or SUD. In addition, refer patients who could benefit from additional education or care management.
Get help with treatment plans
In order to assist in managing patients, DM requests your input for patient treatment plans. DM information and the most up-to-date Clinical Practice Guidelines (CPGs) are provided to assist you in creating an individualized plan of care.
Receive feedback on your patients
Providers can access Patient360 to obtain feedback on their patients regarding their care plans and condition management while enrolled in DM programs.
Hours of operation
DM case managers are registered nurses who are available from 8:30 a.m. to 5:30 p.m., local time, Monday through Friday. Confidential voicemail and the member Care on Call line are always available.
Please call 1-888-830-4300 to reach a DM case manager. Your patients can get information about DM program services by visiting https://mss.anthem.com/ky/home.html or calling 1-888-830-4300.
Provider rights and responsibilities
You have additional rights and responsibilities such as the right to:
These rights and responsibilities are available to you in written format upon request to DM by calling 1-888-830-4300.
The CPGs for the above-outlined chronic conditions are available on our secure provider website (login is required). CPGs can also be requested at any time.
The Anthem DM department and our DM programs do not advertise, market or promote specific products or services to members or providers.
The Anthem DM department and our DM programs do not have any financial ownership arrangements with anyone who advertises, markets or provides the goods and services we offer.
Please call 888-830-4300 to reach a DM Case Manager.
Your patients can get information about DM program services by visiting www.anthem.com or calling 888-830-4300.
As a valued provider who could use some help in following up with patients,...Read More you can refer your patients with asthma, bipolar disorder, CAD, CHF, COPD, diabetes, HIV/AIDS, hypertension, MDD, schizophrenia and substance use disorder who could benefit from education or care management to DM. Read Less
In order to assist in managing patients, DM requests your input for ...Read More patient treatment plans. Disease management information and the most up-to-date clinical practice guidelines are provided to assist you in creating individualized plans of care. Read Less
Providers receive feedback on members enrolled in disease management...Read More programs through member status letters, care plans and telephonic communications. Feedback includes assessments of how well the condition is being managed, adherence to treatment plans, patient goals, and psychosocial and safety issues while enrolled in a disease management program. Feedback is provided weekly, monthly, quarterly, annually or as needed based on the severity of the member’s condition. Read Less