Documentation
You fax care plan to PCP. What must be documented to close the loop?
Note indicating care plan was completed, fax was sent, attachment of fax, and confirmation was recorded.
What two items are tied to the 30-day enrollment timeline?
Health Assessment and ROI
You receive a new ECM client. How many hours/days do you have to initiate contact?
24-48hrs
T/F: You can't update monthly care plans without the client's consent.
False
What PoF am I? A member with 3 or more unplanned hospital or ER visits in the past 6 months is eligible under which PoF?
PoF 2
How many minutes should accompany an HNA note [complete] on Kipu?
120 min
What must happen after the Care Plan is completed?
Share with the PCP
You attempt outreach three times with no response. What is the next workflow step?
Try other contact methods (wellness check, call hospital, etc.)
T/F: A care plan update is only required when there is a major change in the client's condition.
False
Member lost Medical coverage, what do you do?
1) Inform manager 2) guide client to reinstate online or in-person 3) obtain new consent form (after reinstating)
To qualify for billing, ECM services and activities must total at least ____ min per month
135 min
How many interventions should you include for each goal?
minimum 1
You upload a note with a referral and notify the receiving provider, but do not receive confirmation. Is the workflow complete?
No - confirmation and outcome documentation are missing.
T/F: If a goal is client-driven but unrealistic, it should be documented as written. For example, "Client will attend all medical appointments."
False. Goals must be achievable; unrealistic goals require reframing.
A client should have a follow up PCP appointment after an ADT alert. Within how many days should this be scheduled?
7
Subject lines contain what three elements?
1)Outcome of contact
2) Label modality
3) Next action/steps
How many required Core Services are included in ECM?
Seven
How many days should the care plan be initiated after completing the health assessment?
5 days
T/F: Use the ECM status "Declined" if the client declines services and wants to be disenrolled.
False. We would disenroll the client and thus you should select "excluded."
PoF1 & 2
Give an example of a progress note that does not need to follow the closed-loop method of documenting?
Adding/Attachment of program guidelines
Within how many hours must a client be contacted after an ADT alert is received?
Within 24 hours (1 business day)
A client is inpatient and gets discharged. What should be completed within 24hrs of discharge?
Post-discharge assessment
T/F: You arrive to meet the client, but they are a no-show. Can you bill for this?
True
Naming convention of consent form OR care plan OR HNA?
Consent: OPTIN_CIN_FL_ILLUM_20260108
HNA : ASMT_[CIN]_[MBR Initials]_ILLUM_[YYYYMMDD]
Care Plan: CP_[CIN]_[MBR Initials]_ILLUM_[YYYYMMDD]