Our Disease Management (DM) program is based on a system of coordinated care management interventions and communications designed to assist physicians and other health care professionals manage members with chronic conditions.
The mission of the DM program is to improve the health and quality of life for the members served by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.
Disease Management aims to:
Our disease management programs do not advertise, market or promote specific products or services to members or providers.
Disease management invites your input for patient treatment plans. We provide you with DM information and the most up to date Clinical Practice Guidelines (CPG) to assist you in creating an individual plan of care. CPGs are available on the secure provider website (log in required). CPGs can be requested at any time.
The Clinical Practice Guidelines (CPGs) for the chronic conditions outlined above are also available on Availity*. CPGs can be requested at any time.
Providers can access Patient360 via Availity to obtain feedback regarding their patients’ care plans and condition management while enrolled in DM programs.
How can I refer a member to DM?
To refer a member, fax a completed Disease Management Referral Form to 1-888-762-3199 or send via Availity.
Please call 1-888-830-4300 to reach a DM team member. Our DM case managers are licensed nurses.
Your patients can get information about DM program services for members on the UniCare Health Plan of West Virginia, Inc. (UniCare) website or by calling 1-888-830-4300.
Our DM case managers are available 8:30 a.m. to 5:30 p.m. local time.
Confidential voicemail is available 24 hours a day. The Nurse Helpline is also available for our members 24 hours a day, 7 days a week.
You have the right to information about UniCare, including:
You also have the right to:
These rights and responsibilities are available to you in written format upon request to DM by calling 1-888-830-4300.
* Availity, LLC is an independent company providing administrative support services on behalf of UniCare Health Plan of West Virginia, Inc.