Disease Management

Behavioral Health and Substance Use

To support your behavioral health treatment recommendations and plans of care, CareFirst provides several programs to help meet the specific needs of your patients, including:

  • CareFirst’s appointment team
    • Representatives who help patients find the right behavioral health provider for their situation and location, schedules the appointment and follows-up after the appointment.
    • Members should call 1-800-245-7013.
  • Behavioral Health and Substance Use Disorder Program
    • For patients with conditions like depression, autism spectrum disorder, or anxiety, this program provides one-on-one support through a specialty-trained and licensed behavioral health care coordinator.

      Learn more about the program.
    • For patients struggling specifically with addiction or substance use, CareFirst offers trusted providers within outpatient addiction recovery centers who can provide treatment and care options, support groups, and education.

      Learn more about the Substance Use Disorder Program.

Support is available today. Call CareFirst at 1-800-245-7013.

Diabetes

CareFirst offers a free, comprehensive disease management program for members with diabetes. This confidential, voluntary program:

  • provides routine updates to keep physicians informed about patients' progress and adherence to the plan of care
  • reinforce the physician's plan of care
  • is administered by Healthways, Inc.

Enrolled members:

  • can access a nurse by phone 24 hours a day, 7 days a week
  • are assigned a nurse care manager
  • receive educational materials, including condition-specific workbooks, action plans and newsletters.

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the Diabetes Management Program at (800) 783-4582.

Heart Disease

CareFirst offers a free, comprehensive disease management program for members who have or are at risk for congestive heart failure (CHF) and coronary artery disease (CAD). This confidential, voluntary program:

  • provides routine updates to keep physicians informed about patients' progress and adherence to the plan of care 
  • takes note of the high rate of heart disease among persons with diabetes 
  • reinforces the physician's plan of care 
  • is administered by Healthways, Inc. 

Eligible members:

  • can reach a nurse by phone 24 hours a day 
  • are assigned a nurse care manager (if greater disease severity exists) 
  • receive educational materials, including condition-specific workbooks, action plans and newsletters. 

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the CHF/CAD management program at (800) 783-4582.

CareFirst supports the American Heart Association Clinical Guidelines. You may obtain a copy of these guidelines at www.americanheart.org

Oncology

CareFirst's cancer management program seeks to ensure the best possible outcomes for members with cancer.

Enrolled members are assigned to an experienced oncology Care Manager, who:

  • monitors their progress in conjunction with the physician's plan of care 
  • provides educational and emotional support 
  • is available by calling (888) 264-8648 Monday - Friday from 8:30 a.m. to 4:30 p.m. 

Providers may refer a member to the oncology program by calling (888) 264-8648.

Respiratory Diseases

CareFirst offers free, comprehensive disease management programs for members with asthma and chronic obstructive pulmonary disease (COPD). These confidential, voluntary programs:

  • help members learn how to self-manage their condition
  • reinforce the physician's plan of care
  • are administered by Healthways, Inc.

Enrolled members:

  • can access a nurse by phone 24 hours a day, 7 days a week
  • are assigned a nurse care manager, if disease is severe
  • receive educational materials, including condition-specific workbooks, action plans and newsletters.

To obtain more information, refer a patient or if you are a member and want to self-refer, please call the Asthma Management Program at (800) 783-4582.