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Blue Cross of Northeastern Pennsylvania (BCNEPA) Offers Blue Health Solutions to Help Support Your Care of Our Members

Your patients with BlueCare^® coverage now have access to a unique, state-of-the-art program that helps them better manage and take control of their health: Blue Health Solutions.

Blue Health Solutions is different from traditional utilization management programs that focus solely on the 20% of health care users who account for 80% of health care costs. Instead, Blue Health Solutions uses advanced predictive modeling to identify members who may be at high risk, and helps them before they become high-cost.

This ‘proactive’ versus ‘reactive’ approach is the key to better health for patients, and for controlling rising health care premiums. BCNEPA offers resources that help patients take action and assume accountability for their health, and support the care that you provide to en sure the healthiest outcomes.

Blue Health Solutions program features include:

MyHealth Manager , a series of health, care and lifestyle management programs that are confidential and available to eligible members at no additional cost. Programs available to support your care of our members include: asthma, chronic obstructive pulmonary disease, coronary artery disease, diabetes, depression, heart failure, prenatal care, tobacco cessation, weight management and case management programs for catastrophic cases and for transition of care and intermediate care. You can call 1-866-262-4764, weekdays, 8 a.m. to 8 p.m. for more information. Encourage your patients with BlueCare coverage to call if it would benefit them. For information about the case management programs, please call or refer your patients to call
1-800-346-6149, weekdays, 8 a.m. to 8 p.m.

To view eligiblity requirements to enroll in a MyHealth Manager Program click here.

Once enrolled, a member will receive the following program benefits:

• Phone contact with Care Coordinators who are specially trained registered nurses
• Information on evidenced-based treatments
• Educational mailings regarding the member’s condition and management
• Coordination of care with the member’s doctor, as necessary
• Scheduled calls from program staff, based on assessed risk level

Each program is staffed with registered nurses specializing in that area of care, and who are available weekdays, 8 a.m. to 8 p.m.

Who Is Eligible to Enroll in a MyHealth Manager Program

All groups and direct-pay members except:

• PEBTF
• Security 65
• 65 Special
• Blue Card Host Plan
• HMO Guest Membership

All BCNEPA employees are eligible regardless of coverage or non-coverage.

Referring One of Your Patients to a MyHealth Manager Program

If you have a patient with BlueCare health care coverage who would benefit from any of our MyHealth Manager programs, we encourage you to refer them to the appropriate program or call us directly to enroll them.

To refer eligible patients, call toll free at 1-866-262-4764. *Call Bethann Hoffman at extension 2014 , for Prenatal, Asthma, COPD, and Tobacco Cessation programs, and for Depression, CAD, Heart Failure and Diabetes programs, call Samara Mitkowski at 1-866-262-4764, extension 2033 . You can also complete a Referral Form to any MyHealth Manager Program and fax it to the Health Management Department at 200-8010.

*If you choose to call to refer your patient, please be prepared to provide the information listed on the Referral Form above.

Additional Resources Offered through Blue Health Solutions:

MyHealth Solution is an exciting online resource that helps members better manage their health through a comprehensive health assessment, personal health records file, interactive fitness and nutrition tools, customized learning tools and quizzes, symptom tracker, and more.

MyHealth Coach provides a 24-hour/seven-day-a-week coaching service that helps our members make informed decisions about their health. Members can speak with a registered nurse, dietitian or respiratory therapist on a variety of health topics, from chronic conditions to common health issues. Health Coaches can inform members so they know what questions to ask their doctors at their next visit.

MyHealth Mart offers members discounts on numerous health and health-related services and products, such as fitness classes, nutritional services, massage therapy, yoga, books, DVDs, and much more. Members are encouraged to take advantage of discounts on products and services that can help them achieve an improved level of well-being for mind and body. For a listing of participating vendors, click here or call 1-888-345-3845. If your patients who are BlueCare members would like more information about any of these programs, you can refer them to our website, to the number on the back of their ID card or the specific number listed for each program.