Security Health Plan has programs available that are above and beyond the normal benefit to help improve member health. Security Health Plan identifies members, using established criteria and assessment tools, who may benefit from these programs. Not all members are eligible for these programs. If a member is selected to participate, they must also be willing to participate in Security Health Plan’s Case Management program. These programs are available at no extra charge to the member.
Referring members: As a provider, you may refer a member whom you think would benefit from any of the programs listed below to Security Health Plan. Please call our provider assistance line (PAL) at 1-800-548-1224 and ask to speak to a care manager.
Below is a brief summary of the program available to Family Health Center members.
- Nurse On-Call program Required criteria: Not homebound; in need of one home visit to assess for home maintenance management, safety, psychosocial/behavioral health needs; and member must give verbal consent to Security Health Plan Care Manager Reimbursable code: 99600
- 24-hour Nurse Line (1-800-549-3174). Family Health Center has a phone line, staffed by registered nurses, available to members 24 hours a day, 7 days a week. The nurses servicing the phone line are specially trained in triage and are ready to discuss health-related questions and concerns. The nurses use guidelines approved by physicians to advise members as to what type of care they may need: self-care, physician appointment, urgent care or emergency care. The nurses offer advice. The final decision regarding type of care is always the choice of the member.
- Nurse navigator. A nurse navigator is a registered nurse, supported by medical directors, who works across the health care system to help members receive the right care at the right time. A nurse navigator can assist members in managing their health care resources and act proactively on their behalf. The goal is to enhance the quality of care members receive by helping them navigate through a complex health care system.
- Member advocate. Security Health Plan has an advocate on staff to assist members. The advocate is the member’s contact in the event of a formal grievance, but is primarily available to help answer questions and solve problems that may prevent a grievance from becoming necessary. It is the advocate’s job to assure member access to care and quality of care, and to help the member overcome barriers he or she might encounter within Security Health Plan or the provider network. The advocate is responsible for ensuring members receive culturally sensitive care. The advocate is available to any Family Health Center member. Providers may call the advocate for assistance with any Family Health Center members.