AdviCare |
Regence has partnered with American Healthways to work with patients, their families and their physicians to offer education, coordination and continuing support to members with specific chronic diseases or health conditions. |
| Case Management |
Regence Case Managers are experienced registered nurses and social workers who will provide one on one support and guidance for any disease or health condition. This complimentary service to our members will provide educational material, support, guidance and a personalized advocate to help navigate the health care system. |
| Clinical Practice Guidelines |
Regence supports the use of practice guidelines to assist in determinations of the clinical appropriateness of treatment services. The practice guidelines describe generally accepted practices and were developed by nationally recognized organizations. |
| Medical Pre-authorization |
Pre-authorization is a prospective determination performed by licensed health-care professionals. The intent is to determine the medical necessity and appropriateness of the proposed treatment, level of care assessment and appropriate treatment setting.
Investigational services and supplies
Charges for investigational services and supplies are denied as provider write-offs unless the patient agrees in writing prior to receiving services to be financially responsible for the charges. View services and supplies currently considered investigational.
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| Pharmacy Prior Authorization |
Pharmacy prior authorization information and forms are located on the RegenceRx Web site. |
