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For Providers

For Providers

Information For Providers

As a Community Care of North Carolina 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 are listed below:

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 use
• Scheduling post appointment or hospital visit follow up
• Appropriate use of ED
• Transportation choices
 

Care managers focus on:

• Pharmacy utilization/medication reconciliation
• Disease prevention, disease management, and health promotion.
• Inpatient/post-hospital transitional care coordination
• Integrating behavioral health & physical health care
• Referral Coordination
• Home and Social Assessment
• Coordinate specialist referrals
• Use of Care Management Information System (CMIS) and Informatics Center (IC) in coordination of patient care

• Monitor “Yearly Visit Limit"

Care managers will also:

• Assist with implementation of CCNC 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
• Support the integration of behavioral health into primary care
• Assist with interpretation of annual quality improvement audit results