Assessments
Is the assessment that is used to close COA Star Gaps.
What is the Clinical Indicator?
A high priority task that requires one attempt on days 10 & 18.
What is a Post Hospital Call task?
CN notifies consumer “Call may be recorded for quality and training purposes.”
What is the call disclaimer?
Platform used to identify open star gaps.
What is Nerve 2.0?
A benefit & program that must be introduced on every initial call and/or when triggered by the member. For example, "I'm looking of ways to get healthier."
What is Renew Active & Get Moving Challenge?
Is due within 90 days of plan enrollment then every 365 days.
What is the HRA/RSA?
Requires 1 attempt – within 5-10 business days.
What is a Resource Follow Up task?
First and Last name, Validate member’s subscriber, Medicare, or member ID and one of the following: Full address or Full date of birth, or Full phone number or
What is HIPAA authentication Option 1?
The tab used to document Health Screenings such as: OMW, BCS, EED & COL STAR Gaps.
What is the Health Maintenance tab in Pathway?
The main JA in Resource1 that contains most Care Navigation Processes?
What is the CN 2.0 JA?
Needs to be completed every 6 months.
What is the SDoH Assessment?
Requires 3 attempts – follow UTR process after 3rd attempt if unable to reach member.
What is an initial or biannual call?
First and Last name, Validate member’s full date of birth and one of the following: Member’s subscriber, Medicare or member ID or Full address or Full phone number
What is HIPAA authentication Option 2?
Star measure that is asked during the months beginning of August through ending of April.
What is the Annual Flu Vaccine?
The campaign that focuses on an overdue assessment.
What is the Urgent dialer (HRA) campaign?
Will be tasked from the PREE team as a follow-up task.
What is the OAH ER Follow-Up Assessment?
High Priority task that requires 3 attempts that MUST be completed in 7 business days to meet Model of Care.
What is a ER Task?
Member must verify HIPAA prior to handing the phone to the custodian.
What is Verbal (for this call only)?
Star gaps to be closed by completing assessments.
What is the HRA/RSA, COASFA/COAPS, & FMC STAR Gaps?
The platform that houses Model of Care requirements processes and JAs for Optum at Home.
What is Resource1?
The assessment that requires permission prior to completing.
What is the HRA/RSA 2024?
1 telephonic attempt needed within 24-48 business hours.
What is Return Voice Mails?
Partial prompting is not allowed when verifying HIPAA. Meaning you can not assist the member in validating their information.
What is Trouble verifying HIPAA?
The two star gaps that detect early cancer.
What is the COL & BCS star gaps?
The dialer/campaign that allows you to preview your tasks prior to calling out to your member.
What is the Care Navigator dialer?