Condition Management Program
Recognizing that the physician-patient relationship is at the heart of patient care, the condition management program is designed to help providers and their patients manage chronic conditions, support the providers’ relationships with their patients, and do the following:
- Enhance the provider’s ability to provide integrated care for their patients
- Provide members with evidence-based information so they can understand their diagnoses and their health care options, while actively participating in health care decisions with you
- Promote integration of care among members and their family, physicians, Registered Nurse Health Coach (Health Coach), social workers, and community resources
Health Coaches offer condition management to all eligible members. Health Coaches help members work effectively with their physicians to make “shared decisions” that are right for them.
The best way to refer a patient for health coaching is to complete the physician referral form. Providers can also call 1-800-313-8628 to make a patient referral. Eligible members can speak with a Health Coach 24 hours a day, 7 days a week, by calling 1-800-ASK-BLUE.
Independence Blue Cross members who are covered through fully-insured employer groups are automatically considered eligible for the condition management. Members covered through certain self-insured employer groups may not be eligible for the program. Members can call Customer Service at 1-800-ASK-BLUE to verify their eligibility.
Provider rights and responsibilities
Our condition management program values the importance of the physician-patient relationship and is designed to enhance evidence-based care. The program is based on open and collaborative communication among the provider, his or her patient, and the Health Coach. We ask all participating providers to review their rights and responsibilities.