CCNC Pediatric Care Management in Action
A recent care management scenario shows the value of CCNC to members and CCPN practices. Brittany Keith, RN, BSN, CCM, Care Manager Regions 2, 4, 6 received a referral from a Cary pediatric practice. The member was attending a daycare and due to his behavior, the daycare told the member’s mother that she would have to get him an aide to continue to be enrolled there.
To accomplish this would require both a confirmed diagnosis of autism and assistance in finding an aide, which can be challenging in many cases.
Integrated Care Coordinator Kris Strong, MSSW, LCSW stepped in to help. Kris provided the mom with a list of providers and encouraged her to get on appointment waiting lists. Her son was seen and completed testing, confirming a diagnosis of autism.
As her son is currently on a prepaid health plan (PHP) with limited behavioral health benefits, Kris is now helping the mom get her son identified as having Intellectual and Developmental Disabilities (IDDs) and eligible to transition to a Tailored Plan under Alliance.
This will provide broader coverage that will allow the mom to better meet this member’s comprehensive medical and behavioral needs. CCNC staff will continue to work with the mom in pulling needed services together, helping her navigate this complex health issue successfully.
