Health Management Programs - Chapter 12, 2020 UnitedHealthcare Administrative Guide

Health Management Programs

We offer case and disease management programs to support your treatment plans. They also assist members in managing their conditions. By using medical, pharmacy, and behavioral health claims data, we can identify members who are high-risk and a good fit for our programs. A referral from a health risk assessment, the NurseLine, or a member/ caregiver can also help identify these high-risk members.

You can refer these members to the appropriate program by calling the number on the member’s health care ID card. Participation in these programs is voluntary. Upon referral, we assess members for the appropriate level of care for their individual needs. The programs vary based on the member’s benefit plan.