Providers
Health Management Operations
A Helpful Resource
At iCare, we make our resources available to our network physicians, to help them provide quality care for their patients. We actively coordinate member care, which benefits providers when treating difficult cases. Our Health Management Operations department conducts care coordination through a multi-disciplinary model of care management. We consider the physician to be part of the multidisciplinary team. We recognize that in order to treat complex populations, we have to address social and behavioral health issues in order to treat medical conditions. Other disciplines that are part of the iCare team include: Behavioral Health experts, RN Case Managers, Pharmacy staff as well as Care Managers and Care Coordinators with varied educational and work experience backgrounds.
Some of the elements involved in iCare's Health Management Operations approach to care management involves the following:
- Conduct a comprehensive assessment to identify members’ medical, behavioral and social needs.
- Create a dynamic care plan with the member that addresses and prioritizes their needs and goals.
- Monitor member progress toward goals.
- Identify resources to meet member needs.
- Coordinate service provision with providers and members.
- Assist members with accessing services.
- Work with members to promote behavioral change and self empowerment to achieve improved quality of life.
- Monitor hospital experiences for treatment progress and appropriate discharge planning.
- Coordinate provision of appropriate care following acute care experiences.
- Facilitate provision of services along the continuum of care needs.
- Engage members in health promotion through education about resource utilization, disease management and self care.
- Monitor service provision for quality of care.
- Implement quality improvement initiatives.
Ultimately, the iCare process helps ensure patient compliance with treatment plans, a challenge when working with special needs populations. Besides serving as a resource for both members and providers, we are there to support physicians who need help with challenging cases. The support system for providers is multi-disciplinary, which includes pharmacy, behavioral health, translation services, as well as member data.
We can facilitate the use of alternative delivery options for the provider to use when treating challenging cases. Since we follow members on a continuous basis, we can advise the provider as to whether treatments have been tried and if they have been successful. By providing this level of collaboration and resources, iCare lends providers another mechanism to "nudge" members into compliance with their treatment plan.
With iCare, providers have extra tools to ensure something as simple as more members attending appointments, or as complex as providing multi-disciplinary support in a comprehensive treatment plan.
Provider Resources
PDF Resources
Listing of CMS approved iCare Medicare publications, Medicaid publications, third-party preventive health brochures.
- Abridged Formulary/iCare Medicare Plan 2012
- Abridged Formulary/iCare Partnership 2012
- Annual Notice of Change (ANOC)/iCare Medicare Plan 2012
- Annual Notice of Change (ANOC)/iCare Partnership 2012
- Anti-Smoking Quit Line (English)
- Anti-Smoking Quit Line (Spanish)
- Caregiver Background Check Policy
- Claim Form LTC Professional Services - Trizetto
- Claim Form LTC Residential Services - Trizetto
- CMS Appointment of Representative Form
- Comprehensive Formulary/iCare Medicare Plan 2012
- Comprehensive Formulary/iCare Partnership 2012
- Direct Mail Postcard/2012 Additional Benefits/iCare Medicare Plan
- Direct Mail Postcard/2012 OTC/iCare Medicare Plan
- Direct Mail Postcard/2012 Walgreens/iCare Medicare Plan
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Partnership 2012
- FCP Provider Reference Manual
- First Tier, Downstream and Related Entities Fraud
- Formulary Change Notice (iCare Medicare Plan)
- Formulary Change Notice (iCare Partnership)
- Limited English Proficiency Policy/Procedures
- LIS Premium Summary Sheet 2012
- Member Handbook/BadgerCare Plus Core Plan
- Member Handbook/iCare Medicaid SSI
- Member Newsletter Summer/Fall 2011/iCare BadgerCare Plus
- Member Recertification Reminder/BadgerCare Plus Core
- Part D Coverage Determination Request Form
- Part D Prior Authorization Criteria/iCare Medicare Plan 2012
- Part D Prior Authorization Criteria/iCare Partnership 2012
- Part D Redetermination Request Form
- Pharmacy Listing/iCare Medicare Plan 2012
- Pharmacy Listing/iCare Partnership 2012
- Power of Attorney brochure
- Privacy Statement
- Program Brochure/Hmong/iCare Medicaid SSI
- Program Brochure/iCare BadgerCare Plus
- Program Brochure/iCare Medicaid SSI
- Program Brochure/iCare Partnership
- Program Brochure/Spanish/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Partnership
- Provider Directory/iCare BadgerCare Plus-Medicaid SSI
- Provider Directory/Pharmacy Directory/iCare Medicare Plan 2011
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Expansion Counties 2012
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Original Counties 2012
- Provider Reference Manual 2012
- Provider/Pharmacy Directory - iCare Partnership 2011
- Recertification Reminder (flyer)/BadgerCare Plus
- Report to the Community
- Self-Directed Supports Program Overview/iCare Partnership
- Step Therapy Prescription Drug Criteria/iCare Medicare Plan 2012
- Step Therapy Prescription Drug Criteria/iCare Partnership 2012
- Summary of Benefits/iCare Medicare Plan 2012
- Summary of Benefits/iCare Partnership 2012
- Transition Process
- Value to the Family
Call 1-800-777-4376 (TTY: 1-800-947-3529), from 8:00 a.m to 8:00 p.m.,
7 days-a-week, for further information about iCare.
