Specialty Care

Specialty care at AvMed focuses on high-risk obstetrics, oncology and transplant. Registered nurses in these specialties assist and work closely with members and their medical team to provide the best possible outcomes.

Healthy Expectations

The Healthy Expectations program focuses on pregnant members and those members experiencing high-risk pregnancies. All pregnant members receive a complimentary educational packet that provides tips and guidance during all stages of the pregnancy. A pregnancy survey included in the packet should be filled out and returned to the Healthy Expectations program for enrollment. Pregnant members should call AvMed Member Services at the toll-free number listed on the back of their AvMed ID card to receive the educational package. Members identified by their obstetrician as high-risk will be assigned a maternity nurse Care Coordinator who will provide health surveys, counseling, and coordination of services throughout the member’s pregnancy and post partum period. Members who have been identified as high-risk can also self-refer themselves to the Healthy Expectations program by calling Member Services. All counseling and educational activities are customized to the member’s high-risk condition and unique pregnancy needs.

Oncology

The Oncology Care Management program provides individualized attention to oncology patients with a variety of cancers. The goal of the program is to work collaboratively with providers, provider’s staff and support systems within communities, utilizing standards set by the National Comprehensive Cancer Network. The program follows our members from initial diagnosis, assuring treatment and beyond treatment to ensure continuity with a professional registered nurse specializing in oncology. Our approach is holistic, providing sensitive and caring support while implementing knowledge and professionalism in the field of cancer care. Our Oncology Care Management program also has experience and professional affiliations with the Oncology Nurses Society, which allows for the dissemination of the most up-to-date cancer care information to its members in an effort to inform and empower the member. The oncology care manager communicates with providers as an advocate for its members and family support systems to improve quality and enhance life.

Transplant

The Transplant Care Management program is a statewide resource for both members and providers to assist with identifying, facilitating, and coordinating transplant services with an appropriate Transplant center. All members referred for transplant consideration are enrolled in this program as soon as they are identified. Transplant benefits are determined and contracting issues are addressed. This program provides medical review and authorizations for services, and assistance with claims issues is given as needed. Enrollment in this program continues as long as the member is being considered for transplant, throughout the transplant process until the member is successfully transplanted and stable (usually 1 year after transplant), and requiring no further specific interventions.