For Providers

Information for Providers:

As a Community Care of NC Network Provider, you have access to network care managers. RN Care Managers will function as a liaison and resource for patients, healthcare providers, and community partners. Services care managers are able to provide you and your patients:

Care Managers Enhance Patient Knowledge of:

• Benefits of using Medical Home
• Consequences of “No show” appointments
• After hours PCP availability
• Effective use of Medicaid benefits
• Effective use of healthcare resources
• Your “Plan of Care” for them
• Disease management “self-care”
• Medication education
• Post appointment or hospital visit follow up
• Appropriate use of ED
• Monitor “Yearly Visit Limit”
• Transportation choices
• Coordinate specialist referrals
• Home and Social Assessment

Care Managers Focus On:

• Pharmacy Utilization/Medication Reconciliation
• Disease prevention, disease management, and health promotion.
• Inpatient / Post Hospital Transition Care Coordination
• Integrating behavioral health & physical health care
• Referral Coordination
• Use of Care Management Information System (CMIS) and Informatics Center (IC) in coordination of patient care

Care Manages will also:

• Assist with implementation of Community Care of NC Disease Management Initiatives in provider offices by:
• Training office staff on new disease management initiatives
• Helping offices develop processes for disease management to assure optimal patient outcomes
• Train office staff on how to refer to care managers
• Supporting the integration of behavioral health into primary care
• Assisting with interpretation of annual quality improvement audit results