A Message from
MESSA’s Health Care Resources Department
November , 2013
More about MESSA’s Medical Case Management Program
Last week we shared basic information about MESSA’s Medical Case Management (MCM) program. In this newsletter we want to give you a deeper look at key aspects of how the program serves members who qualify. If you’d like additional information, just call the MESSA MCM office at 800.441.4626. Questions are always welcome.
MESSA members can enroll in MCM by calling 800-441-4626. Nurse Coordinators are available 8 a.m. to 5 p.m., Monday through Friday, to answer questions related to MCM and enrollment.
Q: How does a member enroll in MCM?
A: Enrollment starts with a phone call to the MESSA MCM office. A MESSA Nurse Coordinator will talk with the member about MCM and answer questions. If the situation is appropriate for MCM and the member wants to enroll, the member can give her or his verbal consent immediately.
Once a member enrolls, MESSA’s Nurse Coordinator will contact a field case manager from our network of trusted case management organizations that serve the area where the member lives. The case manager will contact the member (or their representative) within one business day to schedule an initial evaluation visit. If the member is hospitalized, the field case manager will even go to the hospital to meet the member and review medical records.
Both the field case manager and our MESSA Nurse Coordinator continue to work with the member as long as needed. Confidentiality of the patient’s protected health information is always maintained.
Q: What if a member changes their mind about MCM after they’ve enrolled, or they believe MCM is no longer helpful to them?
A: Enrollment in the MCM program is voluntary and members can cancel their enrollment at any time by informing their field case manager or contacting MESSA’s MCM office. The overall goal of MCM is to assist the member and his or her family by providing support, advocacy, and care coordination until the patient is able to resume some level of self-sufficiency in managing their health care. Some patients may achieve self-sufficiency more quickly than others, depending on their individual situation.
Q: How much does MCM cost the member?
A: The services and personalized support provided by MESSA’s Nurse Coordinator and the field case manager are provided at no charge to members. MESSA’s MCM program and the services it provides are a member benefit included in all MESSA’s health plans (except LMS).
Q: What type of serious illnesses and catastrophic injuries qualify a member for MCM support through MESSA?
A: Examples of catastrophic injuries that qualify for MCM services and support include (but are not limited to) head injury, spinal cord injury, amputation, severe burns, and multiple fractures. MESSA’s MCM support often proves to be a valuable benefit for patients battling cancer, ALS, MS, Huntington’s Disease, Muscular Dystrophy, Ventilator-dependence, stroke and others.
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