ensuring members understand their benefits, and providing members ongoing support through case management, as needed. Contact UMP Customer Service for more information. Care management Regence care management supports the unique needs of members with chronic, serious, or sudden illness or injury and prioritizes those needs by providing personalized services that enhance well-being. Care management teams can help with: • Advocating for members and their support systems and improving care through close collaboration with providers. • Assisting members as they navigate the health care system, including helping members find preferred providers and facilities, and supporting members transitioning to different levels of care. • Educating members about their care options, benefits, and coverage, as well as helping members make educated decisions regarding their health care. • Supporting members with coordination of care needs. We offer a single-nurse model dedicated to delivering personalized and holistic medical and behavioral health support to each member and their family. Once a member is engaged in the care management program, they may be assigned a case manager who is a licensed social worker or registered nurse. Regence case managers work closely with a member and their providers to help meet treatment plan goals and improve a member’s overall health. How to get started Providers may refer members, and Regence also proactively reaches out to members most likely to benefit from care management support. Members can also self-refer by calling Regence at 1-866-543- 5765 (TRS: 711) for information about care management services. What’s next Once a member is identified for care management, the designated case manager calls the member. The Regence case manager will attempt at least three calls and will send a letter to the member. The member can respond to the letter if they wish to engage with a case manager. Providers are sent a letter or contacted by phone when their patient is enrolled in care management. Care management newsletters Newsletters are sent once per year with an option to opt into care management to all members with a new diagnosis of depression, anxiety, a painful condition, or adult/pediatric cancer. Condition-specific newsletters are sent twice per year with an option to opt into care management to all members diagnosed with coronary artery disease (CAD), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), asthma, or diabetes. Case management as a condition of coverage An HCA or plan medical director may review medical records and determine that your use of certain services is potentially harmful, excessive, or medically inappropriate. Based on this determination, the plan may require you to participate in and comply with a case management plan as a condition of continued benefit payment. Chiropractic physician services See the “Spinal and extremity manipulations” benefit. 2024 UMP Classic (PEBB) Certificate of Coverage 43