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Chronic Care Management Program

At UT Health East Texas, we believe that managing chronic care needs should be a convenient and simple process. That’s why we have partnered with CareHarmony to offer a Chronic Care Management program for Medicare patients living with two or more chronic conditions. Chronic Care Management is a care coordination program designed by Medicare to help you better manage your chronic conditions, receive support and access care, even from the comfort of your home. UT Health East Texas recommends all qualifying patients to enroll in this program.

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Care Coordination Service

Our care coordination service is designed to help you take care of you! Through participation in the program, you will receive monthly phone calls from a dedicated Care Coordinator in between your scheduled appointments with your provider.

During the monthly call, your Care Coordinator will provide the following services:

  • Assist in scheduling appointments, lab tests or other tests
  • Explain how and when to take your medications
  • Coordinate any home health or medical equipment needs
  • Connect you with health education resources, services and programs
  • Identify available community resources
  • Coordinate follow-up care after you leave the hospital
  • Access other support services you may need to stay well

There is also a 24/7 Care Coordinator phone line to help answer any questions you may have. To use the help line, call 903-747-4294.

Cost and Coverage

This service is covered by Medicare and is subject to your annual deductible and coinsurance (usually 20%). If you have a secondary or supplemental insurance plan, your coinsurance may be covered. Please call your insurance representative for more information.

Contact Us

To enroll in the program or for questions, please call 903-747-4294.

Find out more about CareHarmony here.

A chronic condition is an ongoing, long-lasting health condition, which will require continual management and treatment. Left untreated, a chronic condition can hinder independence and negatively impact health. Examples of chronic conditions include asthma, diabetes, arthritis, high blood pressure and heart disease.

Chronic Care Management extends your care outside of the four walls of your provider's practice to help you maintain the best possible health. You will be matched with a dedicated Care Coordinator and have access to help 24/7. A treatment plan (care pathway) will be created to plan for your ongoing care and better address all your health-related issues. Your Care Coordinator will help you navigate the healthcare system, including scheduling appointments, refilling medications and answering lingering questions. Your Care Coordinator acts as an extension of your provider and helps monitor and adjust your care accordingly.

Call 903-747-4294 to enroll and learn how you can benefit from the program.

To be eligible for the Chronic Care Management program, you must be a Medicare beneficiary and have two or more chronic conditions that are expected to last at least 12 months, or until the end of life. If you are unsure if your conditions qualify, contact your healthcare provider for more information.

Managing and coordinating care can be especially difficult if you suffer from multiple chronic conditions. For every medication you take, it’s important to know how it reacts with other medications and for every provider you see, there are test results and/or health information that need to be shared. Proper coordination of care helps your providers receive pertinent information regarding your condition and better care for your needs.

Chronic Care Management helps you not only achieve good health, but also maintain it. The program also focuses on things such as helping you keep on top of preventive care and helping you locate specialists, valuable healthcare resources and community services.

Most Medicare patients have secondary insurance, which often covers Chronic Care Management program copays. In instances where this isn't the case, the program may be subject to a modest copy (usually 20%), as well as your deductible. It is best to review exactly what your insurance plan covers.

Yes. The same rules that protect your medical information in your provider’s practice apply here as well. Your information is and will always be secure using the latest certified information technology and following all HIPAA guidelines.

With Chronic Care Management, there is no long-term commitment. You may opt out any time by calling 903-747-4294. Unenrollment will take effect at the end of the current month.