Living With Your Condition Made Easier

AvMed has several programs designed specifically to help Members living with complex medical conditions.

Case Management Program

AvMed’s Case Managers are registered nurses or social workers with extensive clinical experience in many specialties. They collaborate with members and physicians to personalize a patient's suggested treatment plan, and help coordinate the different types of care that most complex cases require. These programs are confidential and are available through your AvMed plan.

Medical Directors support the Case Managers, helping to ensure the use of clinical protocols are proven by medical science. This, in turn, helps bring the best clinical outcomes. AvMed designed this service for members who have experienced a critical event or diagnosis that requires extensive use of resources.

Programs within Case Management Include:

  • Complex Case Management
  • Short-Term Case Management
  • Care Transitions

Questions?

If you think you can benefit from one of our Case Management programs, please contact our Case Management Department at 800-972-8633 (option #3) (TTY 711), Monday-Friday 8 am-5 pm or you may email us at CM@avmed.org.

If you are the member’s caregiver or designated representative, you may also call to request assistance, or to make a referral to one of our programs.

Case Management FAQs

We work with you to:

  • Define your needs and goals
  • Coordinate services with your provider(s), when you give us permission
  • Find new tools to meet your goals
  • Develop an individualized plan
  • Make proactive plans to prevent readmission to the hospital
  • Provide you with health information
There are lots of ways we find members who may benefit from case management programs. Your provider may have told you about a program. If you were in the hospital recently or another program, they might have referred you to a case management program. You may be taking medications, have been diagnosed with or treated for a condition that may improve with the added support provided to you as part of a program. Your health plan may have referred you to a program. You can also refer yourself.
Case Management staff are available Monday through Friday from 8:00 a.m. to 5:00 p.m.by calling 800-972-8633 and choosing option 3;  TTY: <711>; or by emailing CM@avmed.org
You can call the Nurse on Call line at 888-866-5432; TTY: <711> to speak confidentially with a registered nurse about any health concerns or issues. In an emergency, call 911.
Feel free to call us at 800-972-8633, option 3; TTY: <711> Monday through Friday between 8:00 a.m. to 5:00 p.m. to talk about our case management programs.
If you do not want to be in a program now, that is okay. You can join a program in the future if you change your mind. You are able to opt-in and opt-out of any of our case management programs by calling 800-972-8633, option 3; or by sending an email to CM@avmed.org.
You can give us your feedback by calling 800-972-8633, option 3, TTY: <711> Monday through Friday between 8:00 a.m. to 5:00 p.m; or by sending an email to CM@avmed.org.

Each year, Members are also surveyed about satisfaction with this program. If you receive a letter or call regarding your participation in this program, we hope you will take a few minutes to participate.

Transplant Case Management Program

Transplant Case Management is a statewide resource for both members and providers, to assist with identifying, facilitating, and coordinating transplant services with an appropriate transplant center.

Transplant Case Management provides services while you are being considered for a transplant, throughout the process and usually through a year of recovery.

Transplant Case Management FAQs

We work with you to:

  • Define your needs and goals 
  • Coordinate services with your provider(s), when you give us permission
  • Provide transplant authorizations
  • Develop an individualized plan
  • Ensure you are accessing transplant services at an appropriate facility
  • Provide education on transplant services
There are several ways a member may be identified for the Transplant Case Management program. Most referrals are received directly from the transplant facility and/or your physician. You may have been referred as a result of a recent hospitalization, where you were identified as needing transplant services. You may have referred yourself. 
Case Management staff are available Monday through Friday from 8:00 a.m. to 5:00 p.m. by calling 1-800-972-8633 and choosing option 3; TTY: <711>; or by emailing CM@avmed.org. 
You can call the Nurse on Call line at 1-888-866-5432; TTY: <711> to speak confidentially with a registered nurse about any health concerns or issues. In an emergency, call 911.
Feel free to call us at 1-800-972-8633, option 3; TTY: <711> Monday through Friday between 8:00 a.m. to 5:00 p.m. to talk about our Transplant Case Management Program. 
If you do not want to be in a program now, that is okay. You can join a program in the future if you change your mind. You are able to opt-in and opt-out of any of the Transplant Case Program by calling 1-800-972-8633, option 3, or by sending an email to CM@avmed.org.
You can give us your feedback by calling 1-800-972-8633, option 3; TTY: <711> Monday through Friday between 8:00 a.m. to 5:00 p.m; or by sending an email to CM@avmed.org.

Each year, Members are also surveyed about satisfaction with this program. If you receive a letter or call regarding your participation in this program, we hope you will take a few minutes to participate. 

Contact AvMed Case Management

There is no cost for any AvMed Case Management and the programs are confidential.

Want to learn more?

800-972-8633, select option #3.

8am-5pm Monday-Friday.

 

Skilled Nursing Facility Program

The AvMed Skilled Nursing/Acute Rehabilitation Transition Program works closely with Members during and after admission to a skilled nursing facility (SNF) or Acute Inpatient Rehabilitation. Our skilled nurses can help you transition to life at home after your discharge.

Skilled Nursing Facility/Acute Rehabilitation Transition staff are available Monday through Friday from 8am-5pm by calling Member Support at 800-477-8768, TTY: <711>, or by emailing utilization.management@avmed.org.

Skilled Nursing Facility FAQs

We work with you to:

  • Define your needs and goals
  • Coordinate services with your provider(s), when you give us permission
  • Find new tools to meet your goals
  • Develop an individualized plan
  • Make proactive plans to prevent readmission to the hospital
  • Provide you with health information
All Members who are admitted to a Skilled Nursing Facility (SNF) or Acute Inpatient Rehabilitation Facility are eligible to participate in the transition program. Your provider may have told you about the program. There is no cost for enrollment.
Skilled Nursing Facility/Acute Rehabilitation Transition staff are available Monday through Friday from 8 am to 5 pm by calling Member Support at 800-882-8633 (TTY 711), or by emailing utilization.management@avmed.org.
You can call the Nurse on Call line at 888-866-5432; TTY: <711> to speak confidentially with a registered nurse about any health concerns or issues. In an emergency, call 911. 
Feel free to call us through our Member Support team Monday through Friday, 8 am to 5 pm at 800-882-8633 (TTY 711), or by emailing utilization.management@avmed.org to talk about our transition program.
If you do not want to be in a program now, that is okay. You can join a program in the future if you change your mind. You are able to opt-in and opt-out of any of our case management programs by calling 800-972-8633, option 3; or email CM@avmed.org.

Skilled Nursing: Call 800-882-8633, TTY: <711>, or email utilization.management@avmed.org.

You can give us your feedback by calling Member Support at 800-882-8633, TTY: <711>, or email utilization.management@avmed.org. 

Each year, Members are also surveyed about satisfaction with this program. If you receive a letter or call regarding your participation in this program, we hope you will take a few minutes to participate.

Healthy Expectations Program

The Healthy Expectations Program provides you with additional support, assistance with coordination of benefits and regular phone contact with our OB team. The program is designed to assist high risk maternity Members. There is no cost for the program and it is confidential.

Contact AvMed Case Management at 800-972-8633 select option #2 for Healthy Expectations. We are available 8:00am to 5:00pm, Monday through Friday.  

Healthy Expectations FAQs

We work with you to:

  • Define your needs and goals
  • Coordinate services with your provider(s), when you give us permission
  • Provide education on pregnancy topics
  • Develop an individualized plan
  • Make proactive plans for a healthy pregnancy and baby
There are lots of ways we find members who may benefit from the Healthy Expectations Program. Your provider may have told you about the program. If you were in the hospital recently due to a pregnancy issue, they might have referred you to the program. Your health plan may have referred you to the program. You can also refer yourself. 
Case Management staff are available Monday through Friday from 8:00 a.m. to 5:00 p.m. by calling 1-800-972-8633 and choosing option 2;  TTY: <711>; or by emailing CM@avmed.org
You can call the Nurse on Call line at 1-888-866-5432; TTY: <711> to speak confidentially with a registered nurse about any health concerns or issues. In an emergency, call 911.
Feel free to call us at 1-800-972-8633, option 2; TTY: <711> Monday through Friday between 8:00 a.m. to 5:00 p.m. to talk about our Healthy Expectations Program. 
If you do not want to be in a program now, that is okay. You can join a program in the future if you change your mind. You are able to opt-in and opt-out of any of the Healthy Expectations program by calling 1-800-972-8633, option 2, or by sending an email to CM@avmed.org.
Monday through Friday between 8:00am to 5:00pm; or by sending an email to CM@avmed.org.

Each year, Members are also surveyed about satisfaction with this program. If you receive a letter or call regarding your participation in this program, we hope you will take a few minutes to participate.