Care Coordinator definition
Examples of Care Coordinator in a sentence
The following defined terms only apply to the BlueCard section only: • Care Coordinator Fee is a fixed amount paid by us to providers periodically for Care Coordination under a Value-Based Program.
A Clinical Care Manager may serve in the role of an Enrollee’s Care Coordinator when appropriate to meet the Enrollee’s needs.
If you receive covered healthcare services under a Value-Based Program inside a Host Blue’s service area, you will not be responsible for paying any of the Provider Incentives, risk-sharing, and/or Care Coordinator Fees that are a part of such an arrangement, except when a Host Blue passes these fees to us through average pricing or fee schedule adjustments.
A Clinical Care Manager may serve as an Enrollee’s Care Coordinator when the Enrollee requires or would benefit from Care Coordination from an individual with advanced or specialized expertise.
See Section 2.6.1 for detailed requirements, qualifications, and responsibilities of a Care Coordinator.