How is your pregnancy going?
What has been going well in your pregnancy and what has been challenging?
How do you start a CNA?
I have some things I'm needing to update here for your Medicaid, is this still your correct address...etc.
Are SMART goals written in third or first person?
SMART goals and My Actions are in first person "I will..." Care Coordination Actions are in third person "the care coordinator..." Strengths and Barriers are in third person "The member..."
Was the CC's response up to par?
I can't figure out my breastpump form...
Send to Leyla, let them know with any breastpump issues that Leyla will reach out (we will send her an email) to help get that taken care of. *we never want to tell them it's been having problems or not working, we want to be solution oriented*
Are you taking your medications?
Walk me through your current medications and how that's been going for you.
If you call a patient, what will you put as the assessment method?
In-Person ALWAYS
What information do we need for each medication being taken by a patient?
Medication name, dosage, frequency, start date, and end date.
I have been bleeding recently during pregnancy, is that normal?
Let her know YOU will reach out to her provider and have them call... we cannot diagnose. Was the CC response up to par?
I'd really love a carseat and baby supplies...
Finity helps up to 6 months postpartum with a postpartum package. Value added services also can track points that they can spend in an online catelog.
Have you been to your OB appointments?
What has your provider discussed with you at your recent visits?
How many of the PHQ 2/9 questions do we ask?
ALL OF THEM!!
How would I word an unsuccessful contact in general communications?
Date, reason for calling, and next steps. EX. 06/12/2026- I attempted to call the member for our quarterly contact and left my name and callback number. I will reach out again next week. (you can add more detail if needed.)
I don't really have anything I need or any goals...
Was the CC's response up to par?
When would we send someone Delfina information?
Pregnant/postpartum, if they need DME, to have specific health information reach their provider, for pregnancy do and don't questions, activities, meals, exercises, and tracking. ONLY for Rio Pecos patients.
How was your delivery?
What was your delivery experience like, and how has your recovery been since then?
What if someone asks why we are doing this?
This is required annually by your insurance, it's just a few questions and we will be quick! Then continue forward.
The ORIGINAL CCP date, the very first one ever made.
*Hangs up* - what's the next step?
Try calling back, shooting a text, you can always email going forward or try their emergency contact in a week or so if there is no response.
A patient had diabetes (Type 1, 2, or Gestational) what resources do we have for them?
Food is Medicine - Describe.
Do you want to quit vaping/smoking?
Have you thought about making any changes to your tobacco or nicotine use, and if so, what does that look like for you?
What do you do as soon as you finish a CNA?
Send an email to Sam/Julia with a copy to the leaders so that they may look the CNA over and change/add any relevant information.
If a member has not been contacted for a postpartum touchpoint, can we use their in-office visit as that HEDIS date?
YES!
I'm not really interested in this program.
Educate on what we do, that we are covered under their insurance, here for support, ask if they want us to reach out every few months instead... opt out blurb information on Master Doc. Was the CC's response up to par?
How to mention the Doula Program?
Was the CC's response up to par? We will fill out the form and send to who?