Menu

HealthQuest Disease Management Program

HealthPlus HealthQuest Disease Management works to support primary care physicians by providing reports based on member claims information that suggest intervention opportunities. Patient education materials for use in your office can be found on our website at http://healthplusmi.kramesonline.com/ . In addition, disease-specific videos can be found on our website at /DMVideos.aspx .

Referrals to the disease management programs are accepted from PCPs, medical directors, specialists, ancillary providers, members and plan staff. For questions about referrals to the HealthQuest Disease Management Program, please call (800) 345-9956, extension 8050.

Eligibility  

The Disease Management Program is available to eligible members of the HealthPlus Commercial, Medicare Advantage, and PPO lines of business.

HealthPlus members are identified as eligible for participation in HealthQuest Disease Management programs through medical and pharmacy claims analysis, referrals using claims criteria, or referral sources without continuous enrollment requirements.

Enrollment and participation in HealthPlus HealthQuest disease management program is automatic after HealthPlus identifies a member’s eligibility from claims and other sources. Members may enroll in or opt out of the program by calling (800) 345-9956, ext. 3246, or by e-mail at dismgmt@healthplus.org. The member will be asked to provide their name, telephone number, and HealthPlus ID number, and must request to opt out of theHealthQuest Disease Management Program.

The HealthQuest Disease Management Program targets the following diseases:

Asthma  

Diabetes  

Cardiovascular disease  

Heart failure  

Chronic Obstructive Pulmonary Disease (COPD)  

 

HealthPlus works with patients identified as suffering from these diseases to provide the following:

  • Introductory welcome packet and phone call
  • Disease-specific health care reminders
  • Telephone calls to select members to assess needs for education and self care
  • Mailings of disease-specific educational materials at least four times per year
  • Telephone and mail reminders for disease-specific standards of care and missing services
  • HealthPlus Web site education, information and links to other health information sources
  • Case management for complex care needs
  • Disease-specific newsletters
  • Community seminars

HealthPlus members who test positive in a review of health related behaviors and screening for possible depression require further evaluation to determine if they are depressed. The member is advised to discuss the results of this screening with the primary care physician (PCP) and/or a mental health practitioner. HealthPlus will send the member's PCP a letter indicating the need for follow-up with a Behavioral Health service provider.

For more information about the HealthPlus Disease Management programs, please contact the Disease Management Department at (800) 345-9956, extension 2246, or by email at dismgmt@healthplus.org .