Pop Health/NHN/CommunityHealth & SW
This clinic was the first to have a population health coach.
What is Lakeside?
Per HEDIS guidelines, a diabetic patient must have a dilated eye exam every 2 years, unless they have this condition, then it must be every year.
What is Retinopathy?
The program that CHP uses for care coordination and health data analytics.
What is Innovaccer?
The 4 geographic areas (Omaha, Lincoln, Grand Island, & Kearney) that make up the CHP network are referred to as this.
What are chapters?
According to NCQA, all diabetics should be on this type of medication to help prevent heart disease by lowering LDL cholesterol levels.
What are statins?
When putting in a referral for social work, this information is necessary to include.
What are specific details on the reason for the referral?
The rating system used by CMS to measure the quality of health and drug services received by consumers enrolled in Medicare Advantage plans.
What is STARS?
The number (within 5) of dashboards in Innovaccer
What is 57?
Also known as a preferred drug list or PDL, this is a list of prescription drugs that are covered by a health insurance plan at the highest level.
What is a formulary?
The CHP employed health coaches have completed over 6,000 protocols of this type of outreach.
What are care gaps?
The average HCC score of a Medicare beneficiary.
What is 1.0?
The number of patients stored in the Innovaccer database (within 500k).
What is 2,516,255?
The review and verification process that all CHP network providers have to complete prior to being enrolled and active in the CHP network.
What is Credentialing?
The newest coordinator for the Prescription Assistance Program. (first name will suffice)
Who is Kath/Kathy/Kathleen Peterson?
The nursing home that was just recently added to the Nursing Home Network's coverage.
What is Millard Good Samaritan?
In the HEDIS measure, Combo-2, these 3 immunizations must be completed by a child's 13th birthday in order to be compliant.
What are Tdap, Meningococcal, and HPV?
The name of the consultant group that assists our data & analytics team in optimizing our data and programs.
What is CATCH Intelligence?
The cadence in which our credentialing team sends payers the full roster of our participating providers.
What is quarterly?
The amount that the Prescription Assistance Program saved our patients in 2023 (within $1 million).
What is $15 million?
What is $280?
Last year, CMS used "Version 24" of the HCC list to calculate Risk Adjustment Factors or RAF's for Medicare patients. This year they are using a combination of "Version 24" and this Version as a hybrid.
What is "Version 28"?
The version of Microsoft Excel that had the Hall of Tortured Souls in it.
What is Microsoft Excel 95?
The CHP document that lists all of the payer plans that providers can access via their CHP agreement.
What is the Exhibit 1.1 document?
According to the FDA, this type of biologic medication must be made from the same types of sources, and have the same treatment risks and benefits as the original biologic medication and are usually lower cost than the original.
What is a biosimilar?