Assessments
Assessment completed by the SW for copay assist
What is the Resource pathway?
ROI stands for ---
What is return on investment?
What are specific, measurable, attainable, relevant, and time bound?
The purpose of the MA Outreach Template
What is to record member and provider calls (and partners)?
TAT for follow up on an ADT ER alert.
What is 5 business days?
Assessment to use for initial outreach when you do not reach the member
What is there is no assessment, MA Outreach Template?
If Emma wants $2 for her soap and Bella sells it for $5, Bella gets a return on investment that equals ___.
What is 150%?
Can be added to the case name to specify case type
What is (- Diagnosis / - Barrier / - Disease / - Diet)?
A member is in telephonic CM program and onboards to the CareTN app. The participation method is updated to ___
What is Hybrid - Telephonic?
Member is not reached on the second attempt. A task will be set for 7 calendar days for ___
What is case closure?
Assessment used when you have successfully completed a follow up call.
What is ongoing assessment?
The area to document what is done for gaps in care.
What is the "Action taken" drop down under clinical risk tab in agent workspace?
The field that allows a CM to filter by facility name.
What is the case provider field?
Letter for follow up second unsuccessful attempt
What is the welcome letter?
The way that a social worker sends a referral to the dietitian.
What is create a referral task?
Pathway used when no care plan is needed and a member has a specific need or barrier.
What is the connection pathway?
The importance of ROI is ____
What is to show the value case management?
(Show the great work you already do)
The part of the care plan goal that is evaluated on member calls
What is the prioritization and progression of the goal?
Things that are assessed during a discharge planning call
What is the prior level of function, current level of function, home status, diagnosis, condition?
The case source that you choose if the member is in a specific queue that shows at the bottom of CM Case Builder.
What is IDStrat?
Resource document used for information on MHP Referrals.
What is the Collaboration - Referral - UM Route information document?
The compliance indicator has 3 colors: red, yellow, and green. The yellow means a gap is due in ___ months.
What is within the next (1) month?
The areas to address in the care plan member notes are ___, ___, & ___.
What are the barriers, progression toward goal, and interventions to meet barriers?
Nurse CM has an unsuccessful outreach to the provider. CM leaves a vm. ____ is sent.
What is a provider intro letter?
1, 2, 5, 7 business days is ___
What is the TAT for urgent, high, medium, and low case priority?