Documentation
The type of encounter used to document a face-to-face contact
Social Work Encounter
The three people required to sign the plan of care
Member, Care Manager, and Supervisor
CMP
Care Management Partners
This form must be signed and dated by the member and list all participating partners to confirm enrollment
DOH 5055 Health Home Patient Information Sharing Consent
The status of a member before they have enrolled
Outreach
The monthly documentation of this three-letter acronym assesses the member's risk for housing, incarceration, and hospitalizations
HML
This questionnaire that measures for symptoms of depression is found in the mental health domain of the comprehensive assessment
PHQ-9
HARP
Health and Recovery Plans
This form notifies the member of their enrollment and provides them with the Health Home's information
DOH 5234 Notice of Determination for Enrollment
The amount of business days that a care management service should be provided after a ED or Hospital discharge
Two days
The note template designed to document the progress of goals and interventions provided during a visit with the member
Care Standard Note
This area of the medical chart contains member diagnoses and is where care management goals are added
Problem List
TCM
Transitional Care Management
This letter gets sent to the member upon discharge and has two different variations
Disenrollment Letter (Voluntary and Involuntary)
This billable service is conducted when a member has been unable to be located for at least one month
Diligent Search
The Chief Complaint when documenting an unsuccessful contact with the member
Attempted Enrolled Service
This domain of the comprehensive assessment screens for independence level of activities of daily living
Independent Living
CEST
Continued Eligibility for Services Tool
This form notifies the member of their disenrollment from the Health Home and must be sent 10 days prior to case closure
DOH 5235 Notice of Determination for Disenrollment
This eligibility criteria that corresponds with a code is required to be documented within 28 days of enrollment in the Assignment Note
Initial Appropriateness
The primary service documented in the service summary when completing a comprehensive assessment or care plan
Comprehensive Care Management
Care Management goals should reflect the SMART framework. This refers to the "S" in SMART Goal
Specific
Assisted Outpatient Treatment
This letter is sent to the member upon enrollment to inform them of care manager, CMA, and HH information
Welcome Letter
The HH reviews monthly process metrics for Service Provision, Face to Face, Care Plans, Assessments, and Consents. This percentage is this network goal for the Consent on File monthly metric
100%