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The referral request form below allows members to receive assessment from our care management staff. We offer the following services:

  • Regence Case Management involves needs assessment, coordination of resources and creation of flexible, cost-effective options for members to facilitate quality care and individualized treatment plans. All case management staff are registered nurses or clinical social workers.
  • Regence Disease Management supports members who have chronic health conditions such as heart disease and diabetes. Registered nurses and other health care professionals provide 24/7 access for questions about conditions and treatment.
  • The Health Coach program provides one-on-one support for members to set and reach goals for a healthier lifestyle. Participants receive personalized support and educational resources for health issues.
  • The BabyWiseSM Maternity Management program provides a nurse advice line, available toll-free, 24 hours a day, 7 days a week. Many members' benefits include BabyWise at no additional cost. Call our department during business hours to verify patient eligibility at 1 (888) 569-2229.

All information provided is confidential and will not affect members' health benefits. Care management staff will respond to urgent requests by the end of the next business day or, if the request is not urgent, within three business days.

Care management referral request form

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Person being referred for care management

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Person making referral

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How should we contact this person?

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