Going Beyond the Call: Helping a Member When It Mattered Most

Going Beyond the Call: Helping a Member When It Mattered Most

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A Member’s Story

At Home Care Delivered (HCD), every order represents a real person. Many of the members we serve are managing chronic health conditions, caring for loved ones, or working to maintain their independence at home. That’s why our team approaches every conversation with compassion and care, treating each member the way we would treat our own family.

Recently, one of our Customer Care Representatives, Daniel, was making a routine monthly call to a 97-year-old member in New Jersey to help her reorder her medical supplies. It was a conversation like the many our team has every day — checking in, making sure she had what she needed, and ensuring her supplies would arrive on time.

But during the call, Daniel sensed something wasn’t right.

There was something in her voice, in her answers, that alerted Daniel that she seemed to be in physical distress. Rather than rushing through the call, Daniel took a moment to check in with her and asked how she was feeling. As he listened, he grew increasingly concerned that she was experiencing a health issue.

Daniel immediately went into action.

Knowing the member lived in a senior living community and that it was after normal business hours so he wouldn’t be able to get an employee on the phone, Daniel kept the woman on the phone while alerting his supervisor. Together, they attempted to contact the members’ alternate emergency contact — but quickly realized the number was no longer in service.

Without hesitation, the team shifted their focus to getting her help through emergency services.

Connecting to emergency services from a workplace call system — especially in another state — isn’t always straightforward. While Daniel stayed on the phone reassuring the member that help was on the way, his supervisor worked to locate and connect with the correct EMS team in her area.

Within minutes they were able to reach the appropriate 911 dispatch center and coordinate assistance. Daniel remained on the phone with the member, calmly talking with her and assuring her that emergency services were on the way.

Moments later, EMS reported they were just moments away from reaching her.

This wasn’t part of a script. It wasn’t something anyone trained specifically for. It was simply a team member recognizing someone needed help — and stepping up to make sure they were okay.

At Home Care Delivered, caring for our members means more than delivering the right products. It means listening, responding, and being there when it matters most.

Because when someone trusts us with their care, we believe they deserve to be treated just like family.

Allowable Amounts and Coverage Expertise

Allowable Amounts and Coverage Expertise

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Incontinence Awareness: Allowable Amounts and Coverage Expertise

Incontinence affects more than 25 million adults in the United States, and national studies show that nearly half of adult women and a significant percentage of men experience some degree of urinary leakage. Access to the right products plays an important role in maintaining comfort, dignity, skin health, and quality of life.

For Health Plan Case Managers, understanding plan-specific allowable amounts and coverage requirements is essential. These guidelines determine the types, sizes, and quantities of incontinence supplies members can receive through their insurance. When coverage requirements and member needs are aligned, members are more likely to receive the right product from the start, reducing delays, denials, and product changes.

What Are Allowable Amounts for Incontinence Supplies?

Allowable amounts refer to the maximum quantity and type of incontinence products that a health plan will cover for a member within a specific time period, typically monthly.

These limits help ensure appropriate utilization of supplies while supporting member needs. However, coverage guidelines can vary between health plans, including:

  • Maximum monthly product quantities
  • Approved product types (briefs, pull-ons, underpads, liners)
  • Documentation or diagnosis requirements
  • Physician order or medical necessity criteria

Because of these variations, accurate product matching and coverage expertise are critical to avoid delays and ensure members receive the supplies they need.

Why Coverage Expertise Matters for Case Managers

Navigating coverage guidelines can take valuable time away from member care coordination. When allowable amounts, product types, or documentation requirements are unclear, referrals can be delayed or require resubmission.

Working with a partner that understands health plan coverage requirements for insurance-covered medical supplies helps Case Managers streamline this process. That’s where your Account Executive and the HCD team help to support you.

Our coverage expertise helps ensure:

  • Referrals are submitted with complete and accurate documentation
  • Members receive products that meet both clinical needs and plan guidelines
  • Orders move forward without unnecessary delays or denials
  • Case Managers spend less time navigating coverage rules

How HCD Supports Case Managers and Members

At Home Care Delivered (HCD), we specialize in supporting Health Plan Case Managers, physicians, and members through deep knowledge of insurance coverage rules for medical supplies.

Our team works collaboratively to ensure members receive the right products, in the right quantities, at the right time.

We support Case Managers by helping to get a personalized product solution specific to each member’s specific needs.

Our trained specialists understand your health plans’ coverage requirements, and work closely with the physician to provide products that best support each member. The product solution is based on coverage requirements, member needs, body type, and condition severity, helping improve comfort and effectiveness.

 

Our team:

  • Align coverage requirements with member needs
    We review plan-specific allowable amounts to ensure recommended products meet both clinical and coverage criteria.
  • Provide product sampling when needed
    When fit, comfort, or preferences require testing, members can try different options to identify the best solution.
  • Simplify referrals and documentation
    Our team understands plan requirements and works to ensure referrals and documentation are complete and compliant, reducing back-and-forth communication.

Partnering with Experts in Insurance-Covered Medical Supplies

By combining coverage expertise, product knowledge, and member-centered support, Home Care Delivered helps ensure incontinence supplies are accurate, effective, and fully covered whenever possible.

For Health Plan Case Managers, this partnership helps simplify referrals, reduce administrative complexity, and ensure members receive the supplies they need to manage their condition confidently at home.

Referral Portal: Evolved for Case Managers

Referral Portal: Evolved for Case Managers

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Core Features of the Referral Portal

With a secure login, Case Managers can:

  • Submit referrals quickly through an intuitive, easy-to-complete online form
  • Track order status in real time, so you always know where each referral stands
  • Access previously submitted referrals, giving you a full history at your fingertips
  • Use built-in tools like NPI Lookup and ICD-10 code search, ensuring accurate submissions the first time

These features are built to simplify workflows, reduce administrative burden, and help Case Managers focus on member care, not paperwork.

New Functionality & Enhancements

Based on feedback from Case Managers, we’ve added several improvements:

  • Streamlined navigation and a more intuitive form layout
  • Increased overall speed of the tool
  • Enhanced visibility of order progress
  • Quick access to member and provider information to reduce back-and-forth communication

Looking ahead, in Q2 2026, we will roll out enhanced reporting features, providing actionable insights to help Case Managers manage referrals efficiently and prioritize high-need members.

Try a Quick Test Run

Already have a log in or want one?
Log in today and experience the value of the HCD Referral Portal. Fast, efficient, and easy to use.
Hcd.com/myaccount

Not ready to log in yet?
You can experience the Referral Portal without an account by using our quick form at HCD.com/refer. While full tracking features aren’t available in this test mode, it’s a fast way to see how simple submitting a referral can be.

See It in Action
Watch our quick video demo that highlights core features, new functionality, and upcoming enhancements:

How the Portal Supports Case Managers

The Referral Portal and our Health Plan Case Manager Sales Account Team are more than a team and a tool — they are extensions of your team. By reducing administrative burden, giving you visibility into every referral, and providing helpful tools and resources, the portal and our specialized team help support you in your role:

  • Submit accurate referrals faster
  • Track member orders without extra follow-up
  • Prioritize high-need members with upcoming tagging features
  • Focus more time on member care and less on paperwork
  • Effective and efficient communication, expert knowledge and expertise

 

The Referral Portal continues to evolve based on your input. Built specifically for Health Plan Case Managers and their members, it’s designed to streamline workflows, improve referral accuracy, and enhance the member experience. Stay tuned for more updates in Q2 2026.

Libre 3 Introduces Libre Assist – Helping Members Understand the Impact of Food

Libre 3 Introduces Libre Assist – Helping Members Understand the Impact of Food

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Helping Members Understand the Impact of Food

Libre Assist simplifies the process of connecting food choices with glucose patterns. With just a quick photo of their meal, members can gain a better understanding of how their food may affect their glucose levels.

The process is simple:

  • Snap
    Members take a photo of their meal using the Libre app.
  • Predict
    Libre Assist analyzes the food and provides an estimate of how it may impact glucose levels.
  • Know
    Members can view potential glucose trends and use that information to make more informed dietary decisions.

For individuals managing diabetes, this added insight can help support healthier eating habits and better glucose control over time.

Continued Benefits of the Libre 3 CGM

In addition to the new Libre Assist feature, the Libre 3 CGM continues to provide several benefits that help members manage diabetes more effectively that are common attributes of typical CGM device functionality.

The system offers minute-to-minute glucose readings, allowing members and their care teams to better understand glucose patterns throughout the day. The sensor is small, comfortable, and painless to apply, and can be worn for up to 15 days.

Readings are sent directly to a smartphone, making it easy for members to monitor glucose levels discreetly without routine finger sticks.

These features allow many members to manage their diabetes more confidently and with fewer daily disruptions.

Understanding Coverage Requirements

Coverage for Continuous Glucose Monitors varies by insurance plan, but many plans follow clinical guidelines similar to those established by Traditional Medicare.

Traditional Medicare (Red, White, and Blue)

Members typically must:

  • Be diagnosed with Type 1 or Type 2 diabetes
  • Administer insulin at least once per day
  • Have visited their physician within the past six months regarding diabetes management

Members experiencing documented hypoglycemia may also qualify under special circumstances.

If you have a member who may fall into this category, your HCD Health Plan Account Executive can help review eligibility requirements.

Medicaid and Commercial Plans

Coverage requirements may vary by plan, though many follow similar clinical criteria. Our team works closely with our Health Plan Case Managers and providers to review documentation and help determine whether members may qualify.

If you have questions about eligibility for one of your members, we’re always happy to help.

What This Means for Health Plan Case Managers

Tools like Libre Assist can help your members better understand how their daily habits affect their diabetes management. When members have greater insight into how food impacts glucose levels, they are often better equipped to make informed choices that support long-term health outcomes.

For Case Managers, this can mean:

  • Better member engagement with diabetes management
  • Improved understanding of glucose trends
  • More informed discussions between members and their care teams

Features like Libre Assist help support a more proactive approach to managing diabetes, which can contribute to improved member outcomes over time.

How Home Care Delivered Supports Your Members

At Home Care Delivered, we work closely with Health Plan Case Managers, providers, and members to ensure individuals receive the medical supplies they need — while meeting coverage and documentation requirements.

Our team helps simplify the process by:

  • Being experts in coverage requirements
  • Coordinating with physician offices for documentation
  • Ensuring members receive the correct supplies based on their individual needs

If you have a member who may benefit from a Continuous Glucose Monitor or have questions about eligibility requirements, our team is always available to help. You can reach out to your individual HCD Account Rep or refer via any of these avenues:

Submit your referral:

libre assist
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