BlueCross BlueShield Member Story

BlueCross BlueShield of Illinois Coordinates Across States To Get Critical Infant The Care She Needs

During July 2022, Niah, a one-year-old member from Naperville, IL, with a history of complex heart conditions such as congenital malformations, hypertrophic cardiomyopathy, and cardiac arrhythmia required a lifesaving surgical procedure. Due to Niah's complex condition, she, and her family needed to travel to Boston, MA so that Niah could receive her surgery.

Realizing that Niah's surgery was so specialized it could only be done at Boston Children's Hospital, the BCCHP care coordination team quickly sprang into action. Niah's care coordinator worked diligently with her interdisciplinary care team to execute a single case agreement (SCA) with Boston Children's Hospital so that she could have the surgery.

Going above and beyond, her care coordinator also sought financial assistance on behalf of Niah's family through BCCHP's Social Determinants of Health Fund (SDOH) – a fund designed to provide members with funding for basic needs, allowing members to focus on their health goals and subsequently improving the overall health of Blue Cross and Blue Shield of Illinois communities. Niah was then successfully airlifted via an air lift ambulance to Boston Children’s Hospital – all arranged by her BCCHP care coordinator.

With the help of the SDOH funds for travel and lodging, Niah’s family was able to be with her in Boston for her surgery. To ensure that Niah and her families' needs were met, Niah's care coordinator called every day, even on weekends. Niah’s surgery was successful! She is back in the Chicagoland area and is currently recovering with heart arrythmias and G-tube placement at Lurie's Children Hospital. She is doing well post-surgery.

*Names changed to protect privacy