1. Question: What is condition management?
Answer: SISC introduced condition management in the fall of 2007. It helps people with specific conditions manage the condition and stay as healthy as possible. Although the name of the program will vary depending on your plan administrator (ConditionCare for Anthem Blue Cross; Health Management Program for Blue Shield), the program works in essentially the same manner for both. Condition management nurses who are knowledgeable about the condition will work over the telephone with plan participants who are living with asthma, diabetes, heart failure (HF), coronary artery disease (CAD), or chronic pulmonary obstructive disease (COPD).
This voluntary, confidential program extends--but does not replace--your relationship with your doctor. It is offered at no additional cost to plan participants who are diagnosed with any of the above conditions.
2. Question: I was recently diagnosed with diabetes. How will I know if I’m eligible for condition management?
Answer: Your medical claims will alert your health plan administrator (Anthem Blue Cross or Blue Shield) of your condition. Shortly afterward, a representative from your health plan administrator will call to invite you to participate in the condition management program for diabetes. If you choose to participate, you will be given a number to call to set up an initial telephone meeting with a nurse who is knowledgeable about diabetes.
3. Question: How much will it cost me to be in the condition management program?
Answer: Nothing. The cost of the condition management program is covered by SISC.
4. Question: What will happen to my medical coverage if I don't participate in condition management?
Answer: Nothing. Participation in condition management is completely voluntary. Condition management can be a valuable addition to the care your doctor already provides; and many doctors are pleased when their patients participate in supplemental care programs like this. So, if you're invited to participate, we ask that you seriously consider it. However, you are never under any obligation to participate.
5. Question: Can my spouse and children participate in the condition management program?
Answer: If your spouse or domestic partner is covered under a SISC medical plan and has been diagnosed with asthma, diabetes, heart failure (HF), coronary artery disease (CAD), or chronic obstructive pulmonary disease (COPD), he or she can participate in condition management.
Some pediatric asthma and pediatric diabetes programs are available for covered dependent children.
6. Question: Will my doctor be involved with my condition management program?
Answer: The condition management nurse will notify your doctor about your participation in the condition management program. Condition management nurses don’t replace your doctor; they will work with your doctor to develop your individual goals. The condition management nurse may ask your doctor to complete a questionnaire to help ensure they are aware of your doctor’s treatment plan for you.