The following information and resources are offered to provide support to physicians, other health care professionals and their staff:
| Case Management |
Asuris Northwest Health Case
Managers Case Managers are experienced registered
nurses and social workers who will provide one
on one support and guidance for any disease or
health condition. |
| Clinical Practice Guidelines |
Asuris Northwest Health supports
the use of nationally recognized practice guidelines
to assist in determinations of the clinical appropriateness
of treatment services. |
| Disease Management |
Disease management programs offer
both early intervention and long-term management
of chronic conditions such as diabetes, cardiac
and respiratory conditions. Asuris currently
offers two disease management programs:
|
| Medical Pre-authorization |
Pre-authorization is a prospective determination performed by licensed health-care professionals. The intent is to determine the medical necessity and appropriateness of the proposed treatment, level of care assessment and appropriate treatment setting.
Investigational services and supplies
Pre-authorization for investigational services and supplies is required. Charges
for investigational services and supplies are
denied as provider write-offs unless the patient
agrees in writing prior to receiving services
to be financially responsible for the charges.
View services and supplies currently considered
investigational at http://blue.regence.com/trgmedpol/investigationalServices/index.html |
| Pharmacy Prior Authorization |
Pharmacy prior authorization information
and forms are located on the RegenceRx® Web
site. |
| Special Beginnings® |
The Special Beginnings® prenatal
program is used to provide education and support
pregnant women, at any risk level, to decrease the
number of premature deliveries and low birth weight
infants. |
