INcontrol Care Management
As a health care provider you spend most of your day advising patients on taking care of their health and keeping medical conditions in check. But what happens when the appointment is over?
The MDwise INcontrol program is here to reinforce the messages you provide in the office. INcontrol is a care and disease management program, specially designed for patients with chronic conditions and special health care needs.
As a health care provider we welcome you to refer your MDwise patients to the INcontrol program. You can do so by calling MDwise customer service or by using the online care management referral form on the myMDwise provider portal.
Members are eligible to participate if they have any health condition such as:
- Attention Deficit Hyperactivity Disorder
- Asthma
- Congestive Heart Failure
- Chronic Kidney Disease
- Chronic Obstructive Pulmonary Disease
- Coronary Artery Disease
- Hypertension
- Depression
- Diabetes
- Autism Spectrum Disorder
- Post-Traumatic Stress Disorder
- Pregnancy
- Sickle Cell Disease
Your patients will have a case or care manager assigned to them to provide services including assisting the member with transportation needs, counseling on appropriate ER usage, connecting members to social and behavioral health services and counseling on taking medications appropriately.
The MDwise INcontrol program is designed with the primary medical provider in mind. Our care managers routinely contact members to assess their adherence with the treatments you prescribed. If your patients become non-adherant we will keep you informed, especially if they are at risk for hospitalization.
MDwise INcontrol also offers additional easy-to-understand patient materials about specific medical conditions. The materials stress the importance of following the specific treatment plan of their primary medical provider.
Case Management/Disease Management Referral Form
View the Care Management Territory Map
Provider Overview for Right Choices Program
A care management program for people who need help using their health care benefits.
The Right Choices Program is a MDwise care management program for people who need help using their health care benefits. Members in the Right Choices Program receive quality health care because each member has a team to help manage their care.
Integrated care is a hallmark of MDwise’s approach to improving the health status of our members and lowering total health care costs. MDwise has developed a comprehensive behavioral health network that allows members to receive the right care in one place for both primary and behavioral health care.
Some of your MDwise patients may need extra guidance for making appropriate health care decisions. For those patients, MDwise offers the Right Choices Program.
The Right Choices program is available for Hoosier Healthwise and HIP members. Members are enrolled in the Right Choices program for two years. After two years, the member undergoes a review to determine whether the member would benefit from continuing in the program.
In the Right Choices program, members are assigned or “locked-in” to one primary medical provider (PMP), one pharmacy and one hospital. To receive health care outside of the assigned providers, the PMP is required to submit a referral. If a member goes outside of their assigned providers for care they will be liable for charges, except for self-referral services such as behavioral health or for true emergencies.
Members in the Right Choices program will be assigned a care manager to provide additional education.
If you believe one of your patients would benefit from participating in the Right Choices Program, you can make a referral by contacting MDwise customer service. The member’s case will be researched prior to being assigned to the Right Choices Program. If one of your patients is assigned to the Right Choices Program, you will be alerted in a letter from FSSA.
For more information see the Right Choices Program manual at IndianaMedicaid.com and MDwise Right Choices Program information for members.