Provider Resources

Disease Management

Program Features include (Based on NCQA Disease Management Definition):
  • Uses proactive population identification processes to identify members who may benefit from Disease Management and have (but not limited to) one or more of the following conditions:
    • Congestive Heart Failure
    • Diabetes Mellitus
    • Chronic Obstructive Pulmonary Disease
    • Solid Organ Transplant Candidate or Recipient
  • Utilization of national evidence-based clinical guidelines/algorithms directed toward specific disease states
  • Development of individualized care plan based on member needs and their disease(s)
  • Liaison between the member, family/caregiver and provider to promote a collaborative team approach for continuity of care and access to needed services
  • Continuous patient self-management education, including disease specific information, primary prevention, behavior modification programs, and compliance/surveillance.
  • Ongoing process and outcomes measurement, evaluation and management
  • Ongoing communication with providers regarding patient status
Who Is Eligible?

All Bravo Health members with the above diagnoses are eligible for Disease Management. Members are identified through continuous case finding efforts to including referrals.

Disease Management Provider Rights and Responsibilities:
  • Obtain information about Disease Management programs and services; staff's credentials; and any contractual relationships that exist in Disease Management.
  • Be involved in the development and identification of member treatment plans (as needed) and return the plans to Disease Management team in a timely fashion.
  • Know contact information for the Disease Management team.
  • Receive professional treatment from Bravo Health's Disease Management staff.
  • To communicate complaints regarding Disease Management as outlined in Bravo Health's Provider Complaint and Grievance Procedure.
Hours of Operation

Bravo Health Disease Managers are available from 8:00 AM to 5:00 PM EST; however confidential voicemail is available 24 hours a day.

Contact Information

To enroll a member in Disease Management or speak with a Disease Management team member, please call 1-888-454-0013, extension 336351.