Service Coordination

Service coordination means specialized care management services performed by a licensed, certified and/or experienced person called a service coordinator. This included but is not limited to:

Identifying a member’s needs through an assessment.
Documenting how to meet the member’s needs in a care plan.
Arranging for delivery of the needed services.
Establishing a relationship with the member and acting as an advocate for the member in coordinating care.
Coordinating different types of services.
Making sure the member has a PCP.

A service coordinator works as a team with the member and the PCP to arrange all services the member needs to receive, including services from specialists and behavioral health providers (if needed). A service coordinator helps ensure that all of the member’s health care needs are met.

The EPH Service Coordinator will coordinate and collaborate with providers to ensure members have access to medical, social, and education services related to their health condition, health risk, or high-risk (pregnancy) condition. EPH Service Coordinators are available to assist with coordination of services such as, but not limited to:

Referrals to medical/mental/behavioral services.
Referrals to covered benefits and services such as WIC, OT, PT, and ST.
Access to educational services related to the Member’s health condition.
Dental services for members.
SSI referrals.

To reach an El Paso Health Service Coordinator you may contact 1-833-742-3127.

Role of the STAR+PLUS Service Coordinator

Service Coordination is a special program offered by El Paso Health to help members manage their health, long-term and behavioral health care needs. All STAR+PLUS EPH Members are assigned a Service Coordinator and not just the Members in the Nursing Facility. EPH will ensure that each STAR+PLUS Member has a qualified PCP who is responsible for overall clinical direction and, in conjunction with the Service Coordinator, serves as a central point of integration and coordination of Covered Services, including primary, Acute Care, Long-term Services and Supports, and Behavioral Health Services.

The Service Coordinator will work as a team with the PCP to coordinate all STAR+PLUS Covered Services and any applicable Non-capitated Services. All Care coordinator staff members can assist with basic inquires. If additional follow up is needed, the assigned Service Coordinator will contact the provider or member within 24 hours.

We provide a single identified person as a service coordinator to all El Paso Health STAR+PLUS members, not limited to level 1, 2, and 3. The member will be notified by letter of the name and direct telephone number of their assigned personal service coordinator.