HRA
What should you choose as your contact type if you spoke with an AOR.
CM Authorize Representative
If member declined for ED Visit Assistance, what should you do to the referral?
Close the referral as Declined>Yes?Refused/Declined Assistance.
If member declines completing the HRA, what should you use as contact outcome?
Refused
If member was scheduled for an ED Visit after the due date, what should you choose as Program/Care Plan Outcome?
Appointment Scheduled (Outside Timeframe)
An important tool for understanding what is most important to member and member's health.
HRA
If member was UTC for 1st attempt, when should you enter the next attempt?
Next business day
What should HC/HN do after completing an HRA for DSNP member?
Send an email to Kari
If member was referred to Christiana Care TOC and has open TOC Referral, what should you do?
Escalate to Kari.
If member's care plan is UTC/Refused and member completed the outreach, what should the HC/HN ask/offer?
Ask/Offer CM Engagement.
If member expires, what should you do aside from closing the referral as Member Deceased?
Create a Deceased Member Alert and HR Issue