Our Condition Care (CNDC) team is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions. CNDC services include a holistic, member-centric care management approach that allows case managers to focus on multiple needs of members. Our Condition Care programs include:
- Bipolar disorder
- Chronic Obstructive Pulmonary Disorder (COPD)
- Congestive Heart Failure (CHF)
- Coronary Artery Disease (CAD)
- Major depressive disorder–adult and child/adolescent
- Substance Abuse disorder
In addition to our 12 condition-specific Condition Care programs, our approach also allows us to assist members with smoking cessation and weight management education.
The mission of the CNDC department is to improve the health and quality of life for our members served by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.
CNDC aims to:
- Address gaps in care
- Improve the understanding of disease processes
- Improve the quality of life for members
- Support network provider relationships with members
- Increase network provider awareness of Condition Care programs
- Reduce acute episodes requiring emergent or inpatient care.
Our programs feature:
- Proactive population identification processes
- Evidence-based national practice guidelines
- Collaborative practice models to include physician and support service providers in treatment planning for members
- Continuous patient self-management education, including primary prevention, coaching related to healthy behaviors and compliance/monitoring, and case/care management for high-risk members
- Ongoing communication with primary and ancillary providers regarding patient status
Nine of our CNDC programs are National Committee for Quality Assurance-accredited and incorporate outreach, education, care coordination and follow-up to improve treatment compliance and enhance self-care.
Who is eligible?
Members diagnosed with the above conditions are eligible for CNDC services.
Our CNDC programs do not advertise, market or promote specific products or services to members or providers.
Our CNDC programs do not have any financial ownership arrangements with anyone who advertises, markets or provides the goods and services we offer.
What are the benefits of collaborating with Condition Care?
Maximize your time
If you have patients with one or more of the conditions listed above; who could benefit from additional education or care management, we encourage you to refer them to Condition Care.
Collaborative treatment plans
We provide you with Condition Care information and the most up-to-date clinical practice guidelines to assist you in creating an individual plan of care.
Receive feedback on your patients
Providers can access Patient360 via Availity to obtain feedback on their patients regarding their care plans and condition management while enrolled in CNDC programs.
Hours of operation
CNDC case managers are available by calling 1-888-830-4300 from 8:30 a.m. to 5:30 p.m. Pacific time, Monday through Friday. Confidential voicemail and the Nurse Helpline are always available 24 hours a day.