Palliative Care/Serious Illness Support is a comprehensive set of benefits and supports available to members and their caregivers who are living with serious illness. Our vision is that every person living with serious illness will experience personalized care that is consistent with their values, goals and preference; caregivers will feel included, honored and supported.
Our clinical team will help support providers who are looking for ways to better address the needs of their patients living with serious illness and who may benefit from specialty palliative care.
Our member benefit covers:
- Adult and pediatric palliative care case management: Assistance with care coordination and benefit navigation with nurses through telephonic support.
- Home health medical: Assistance with activities of daily living
- Psychosocial support: Through our expanded home health benefit, members are eligible to receive individual, family and marriage counseling in the home.
- Caregiver support: Our teams work with the member's and caregivers.
Goals of care/advance care planning (ACP) conversations: Provider reimbursement for conducting and documenting goals of care conversations with their BridgeSpan patients.
Verify your patients' eligibility and benefits using Availity Essentials.
Tips for talking to your patients about palliative care and advance care planning
The Serious Illness Messaging Toolkit includes tips for how to talk about serious illness using evidence-based research.
It includes quick guides for having conversations about these topics:
We reimburse providers for the following services:
- CPT 99497 or 99498 (advance care planning)
- CPT 99509 (Home visit for assistance with activities of daily living and personal care)
CPT 99510 (Home visit for individual, family or marriage counseling)
- Palliative Care (Administrative #136) reimbursement policy
- Incident To Services (Administrative #136) reimbursement policy
- Expanded telehealth claim submission guidelines
- Virtual Care (Administrative #132) reimbursement policy
Our care management supports the unique needs of members with acute, chronic and major illness episodes or severe illness conditions. The mission of care management is to prioritize the needs of our members by providing personalized, equitable services that enhance their wellbeing.
We offer a single-nurse model dedicated to delivering personalized and holistic medical and behavioral health support to each member and their family. Case managers are experienced registered nurses and social workers. Our case managers work closely with providers to help our members improve their health and meet the goals of their providers' treatment plans.
Case managers can:
- Explain what your loved one’s health plan covers and translate health insurance jargon
- Help find in-network providers, get pre-authorization for services, schedule appointments and coordinate care
Connect you to free or low-cost community resources, like support groups
Learn more about our Care Management program.
- CaringInfo (National Hospice and Palliative Care Organization)
- Center to Advance Palliative Care (CAPC)
- Making Choices® Planning in Advance for Future Healthcare Choices, created in partnership with Respecting Choices:
- Palliative care BridgeSpan member webpage
