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 county Public Health and Human Services agencies where we serve Minnesota Health Care Programs participants (visit our Service Area page for more information about these 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 ages 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. Members who refuse case management are offered the opportunity to work with a PrimeWest Health care coordinator. While the member may also refuse care coordination, their care coordinator is available if they have questions or need assistance in the future.  

To find out if a member has case management or to find a member’s county case manager or PrimeWest Health care coordinator, call the Provider Contact Center at 1-866-431-0802 (toll free).

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

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Updated_09/25/2024