Case management

Complex case management

MercyCare Health Plans complex case management program is a collaborative process of assessment, planning, facilitation and advocacy for options and services that meet your health needs. We offer members open communication and resources to promote cost effective outcomes. 

The case manager nurse evaluates criteria such as diagnosis, complications, cost, current status, prognosis, and situational and functional analysis to identify potential members suitable for effective case management intervention. 

If you would like to be assessed for this service, please call (800) 895-2421.

Disease case management

MercyCare Health Plans has a team dedicated to improving your quality of care. Our registered nurses on this team are involved in ways to help you prevent illness and improve your health*.

Some of the ways that we do this include:

  • Helping members with specific problems or questions they might have about their disease or their benefits as they relate to their disease.
  • Working with your physician to help coordinate your care.
  • Providing physicians with the most current treatment guidelines.

To learn more about an available program, simply click on the program title.

Diabetes program

Chronic kidney disease

Asthma program

*Members may opt out of the disease management programs at any time.