Loren was having a normal day when something went amiss. She was rushed to the emergency room with chest pains and later found that she had experienced a coronary occlusion. What surprised her was that she had always been in good health, was fairly young and did not have a history of cardiac problems. After being discharged, Loren’s husband, concerned for her welfare, called Blue Cross to better understand their treatment options. The customer service representative who took their call addressed their benefit issues and referred them to the Care Consultant Team. They were in need of answers from a qualified professional to help them understand what they were facing.
Enter Chris Carlee, a registered nurse and a member of the Chronic Condition Management Team at Blue Cross. This team of specialized nurses assists members in understanding and managing their rare and/or chronic conditions, such as asthma, cardiovascular disease, diabetes, multiple sclerosis and lupus.
Chris’s main responsibility is serving as a point of contact for members with a cardiovascular condition and assisting them in their journey to better health. Loren’s tests during hospitalization revealed that additional outpatient diagnostic testing was needed to confirm possible causes.
Stressed and worried, Chris’s help was a godsend to the couple in getting the tests approved and scheduled. Chris personally called the specialist offices and imaging review vendor to facilitate the review process. Her diligence helped to get the tests scheduled and approved. Loren says, “Everybody thinks of Blue Cross as an insurance company. But my experience showed me that there were other purposes and ways I could get help from my insurance. Not only did Chris help me with getting the tests scheduled, she also gave me information about my benefit plan and education about signs and symptoms to watch out for.”
Chris says she was happy to help. “My goal was to be a calming voice to help her manage her stress and concern about her condition, while helping her navigate the healthcare system”. Part of that navigation involved helping Loren understand her benefits, coordinating services amongst multiple providers, providing Loren with community resources, telephonic education and health coaching on self-management tools/resources. Chris collaborated with co-workers, managers, social workers, and other BCBSF departments to help meet Loren’s healthcare needs.
Chris and Loren have one goal in telling their story – they hope that other Blue Cross members in similar situations will take advantage of the multiple services at Blue Cross to help manage their condition better. “I hope that members will reach out for help when they have questions about their health condition or when they need assistance in navigating the health care system. Just call Blue Cross Customer Service,” says Chris, “the phone number on your ID card, and explain the situation. Members can be assured that they will be referred to the care program that best suits their specific needs.”
Ultimately, Chris is glad she was able to assist Loren through this difficult process. “She is a joy to work with and her positive attitude is an inspiration to me.”
Have a story to tell us about a positive experience you had with BCBSF? Email us at socialmedia@bcbsfl.com. For more information on the Care Consultant Team, refer to www.bcbsfl.com.
No comments:
Post a Comment