Case Management

Case management is a support service offered to eligible PrimeWest Health members and refers to the coordination of health services on behalf of a member. PrimeWest Health contracts case management to the 13 PrimeWest Health county Public Health and Human Services agencies (visit our Service Area page for more information about the 13 counties). Case managers play an important role in our members' health; they may be nurses or social workers and may accompany members to their health care provider appointments. They can also assist members with the following:

• Arranging for, getting, and coordinating assessments, tests, and health and continuing care services
• Developing and updating member care plans
• Communicating with a variety of agencies and people
• Disease management programs
• Other services as outlined in member care plans

Case managers are automatically assigned to members age 65 and over and to members enrolled in Prime Health Complete (HMO SNP), one of our programs for people with disabilities. However, members always have the right to refuse case management. To find out if a member has case management or to contact his/her county case manager, call the Provider Contact Center at 1-866-431-0802 (toll free).

Do you know a member who would benefit from case management services? If so, please complete the Care Coordination/Case Management Referral Form and submit it via fax to 1-320-335-5301. Thank you for the referral!