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This authorization form is needed to release this information before sharing a members information with other individuals or organizations.
What is Protected Health Information?
Completed with a newly enrolled member.
What is an Initial Comprehensive Assessment?
Resource used to give members a variety of educational material to improve health outcomes.
What is Krames material?
Initial Comprehensive Assessment & F2F.
What is 75 days?
One visit every 365 days.
What is Monitoring.
Referral completed when a member has needs that cannot be met by ICM Case Management.
What is a HENS Referral?
Discharged to home after an acute hospital stay.
What is a Post Discharge Questionnaire?
Must be addressed between September and March and this event must be created annually.
What is a Flu Event?
Post Discharge Assessment.
What is 2 days?
Completed prior to contacting a member.
What is a Member File Review?
Completed when there is a health/welfare risk with an SRSP Member.
What is an Incident Report?
Completed after specific conditions/diagnoses are identified.
What are Condition Specific Assessments?
This plan should be discussed at each physician visit and updated as needed & the form includes a green, yellow and red zones that are up for discussion.
What is a COPD Action Plan?
Interval Assessment for Medium Member.
What is 180 days?
Gives the "big picture" in the Care Plan.
What is a Member Story?
Investigation intake form completed when there is any suspected provider service issue that has a potential to impact the level of care being provided to the member.
What is a Potential Quality of Care Concern?
"I've moved! Come & check out my new place!" -Aetna Member
What is an Environmental-Safety Assessment?
"I want to quit smoking." -Aetna Member
What is the Ohio Tobacco Quit Line (1-800-QUIT NOW)?
Core 2.1 (Opt In)
What is 75 days.
Opt out member's can call this to become a duals member.
What is the Medicaid Consumer Hotline?
Completed when a potential risk to the member's health, safety, or welfare is identified.
What is a Health & Safety Action Plan?
Specific to High & Intensive Member.
What is a Care Plan Interview (CPI)?
What is an Over the Counter Card?
High Member F2F visit Schedule.
What is 90 days?
The process of comparing a patient's medication orders to all of the medications that the patient has been taking.
What is Medication Reconciliation?