Ageless - AUTUMN 2022

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The Case for Case Management The healthcare system can be confusing and complex. Dealing with a new diagnosis of a chronic illness, facing surgery, or multiple conditions can be overwhelming. That’s where Arkansas Blue Cross and Blue Shield case managers can help. A case manager is your advocate, on your side, to help you. Case managers can work with Benefits of having a case manager: your doctors to help develop a plan. They can also find doctors and clinics and help make appointments. They can ask questions you might not know to ask or are afraid to. Case managers are registered nurses and certified case managers, which means they have the experience and knowledge needed to help you. Have better communication with your doctors and other providers. Get the proper healthcare. Help you see the right providers at the right time in the right place, guiding you through the healthcare system. Make better decisions by understanding your condition and your benefits. Get the information you need to make decisions about your treatment options and insurance coverage. Stay healthy through preventive care. Your case manager can share ways for you to stay healthy and avoid illness when possible. They can also connect you with a social worker to help find local resources if you need help with transportation, food, housing, utilities and more. 4 Ageless AUTUMN 2022
Is case management available for you? Medicare Advantage PFFS Most of our members have case management available if needed. There is a good chance you qualify if you have: Medicare HMO Medicare PPO For Case Management programs and information, call 800-285-6682. A Passionate Advocate “She needed an advocate and guidance,” said Ashley Stormes, an Arkansas Blue Cross and Blue Shield social worker, about a recent member case that came to her attention. Sheila’s needs were brought to Stormes by Ann Furlow, a Registered Nurse case manager for Blue Cross and Blue Shield. “This patient came to my attention after calling customer service needing resources,” said Furlow. “Sheila had been case-managed in the past by one of my co-workers, so she was aware of the assistance the case management program could provide.” Sheila had been recently diagnosed with stage three rectal cancer and needed to receive six weeks of daily chemotherapy and radiation treatments at the University of Arkansas Medical Sciences’ Winthrop P. Rockefeller Cancer Institute. The problem? Living two hours away from UAMS, Sheila could not drive or get transportation to Little Rock. She also dealt with multiple mental health issues that made making the necessary arrangements for the needed care impossible. This is where Arkansas Blue Cross stepped in. Stormes set on an extensive search for a place for the member to stay while going back and forth from UAMS for cancer treatments. One of the hurdles Stormes had to clear was keeping the temporary housing affordable. “After many calls and what felt like daily changes, I found an apartment complex called The Goodness Village of Little Rock,” said Stormes. “They offer very clean and assessable apartments for people and families going through medical struggles. It’s located close to UAMS. The cost is very, very minimal compared to other options. As a case manager, we can impact change and hopefully improve the outcome of the member’s healthcare experience. – Ashley Stormes Arkansas Blue Cross and Blue Shield social worker And, in this case, the rate was able to be covered by UAMS.” The story has a happy ending. Sheila got her chemotherapy and radiation treatments and, according to Stormes, is currently “stable.” “The most satisfying thing about being a case manager is meeting so many different members and their care teams,” said Furlow. “I love that as a case manager, along with my team of social workers, we can impact change and hopefully improve the outcome of the member’s healthcare experience.” Ageless AUTUMN 2022 5
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Ageless - AUTUMN 2022

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