Anthem case manager

[MRG]

Anthem called me today asking if I wanted a case manager assigned to me. The gal explained it was free, included in my premiums. She spent all her time reading from a script with all the buzzwords, improved communication, better support me, monthly calls with my team.... but nothing about how this would benefit me. I asked several times "how does this add value to me?" and was told monthly calls.

We parted ways without me having a case manager assigned and just as confused. I do believe that Anthem has their, not my, best interests in mind and this is a way to collect information.

So does anyone have a case manager or experience with a case manager from Anthem? Am I being overly cautious?

 

[Go-NoGo]

Case managers are typically assigned to patients who have chronic conditions that cause them to "utilize" the system greater than the average person, they would call you on a frequent basis to make sure you are taking your medications and following protocol for your treatment. It does lead to better outcomes for patients who are unable to do so on their own - and of course lower "utilization" for the insurance company by preventing costly hospital visits.

They may even offer helpful advice for your particular case - you will have to decide if the intrusion into your private life is worth it.

 

[Carpediem]

We have Anthem and my wife will be having a TKR in October. When she called Anthem about something related to the surgery, she somehow ended up getting assigned a 'Patient Advocate' - probably the same thing as a 'Case Manager'. What a total waste of time (it didn't cost anything). They seem to call DW about every 2-3 weeks to see if she has any questions. That might all sound great but at best the information they provide is nothing we could get ourselves via Google. Plus, whenever DW asks them a medical type question, they tell her she would need to talk to the Anthem Nurseline about that.

Btw, the 'Patient Advocate' actually works for an entirely separate organization that is somehow affiliated with Anthem. That might be the situation with the 'Case Manager' too.

 

[MRG]

Btw, the 'Patient Advocate' actually works for an entirely separate organization that is somehow affiliated with Anthem. That might be the situation with the 'Case Manager' too.

Thanks.

Anthem and many insurance companies use third partys to do the work they don't want to. I was around similar situations at Megacorp, they were a third party in financial services.

I had a great experience with another Anthem third party today, their new prior authorization provider. They were to take over prior authorizations effective 7/1/19. Apparently they are having major problems and can't fulfill their obligations. I was told for July prior authorizations are not necessary. Not sure how broad this is.

 

[Clone]

And we wonder about the security of personal information. The same person that is calling this week representing anthem was selling storm windows a month ago and time-shares the month before that.

 

[GravitySucks]

I had an Anthem nurse that used to call every couple of weeks when DW was sick. She was reassuring. Is rate it as an overall good experience and would agree to it again.

 

[fh2000]

When I had lung surgery last year, I was assigned a Case Manager who was an RN before. She called to check on me few times after surgery. I think it is reassuring that someone who is little more knowledgeable than DW can go thru a few routine and answer few questions. After I told her I was fine and no need to have more calls, she stopped.

I think it is a positive experience so I wouldn't mind having a Case Manager in the future, except I am with a different insurance company now and not sure this is Anthem specific or not.