Assessments
First assessment completed by the dietitian
What is the MedAdvantage Dietitian Initial Assessment?
ROI stands for ---
What is return on investment?
Specific, measurable, attainable, relevant, time bound.
What are SMART goals?
Tool used to record member and provider calls.
What is the MA Outreach Template?
The link in the workflow with the information on the alert you receive when your member goes to the ER.
What is the link for the resource document on CareAdvance alerts?
TAT to complete ongoing assessments
What is same day?
Jimmy wants $2 for a tomato plant. Fred sells Jimmy's plant for $4. Fred receives a percentage of return on his investment.
What is 100%?
- Diagnosis / - Barrier / - Disease / - Diet
What you add after the case name to specify case type?
Documenting member's preferred outreach method
Where is the custom case field within the case property screen (participation method)?
TAT for first unsuccessful follow up call.
What is 15 days?
Assessment pathway used when the nurse has an IDStrat indicator of Poly Chronic
What is complex case management pathway?
"Action taken" drop down under clinical risk tab
What is the area to document what is done for gaps in care in agent workspace?
Purpose of the case provider field
What is the ability to filter cases by facility name?
Letter for second unsuccessful attempt
What is the Intro letter?
The case manager needs information from the social worker.
What is the collaboration process?
Pathway used when no care plan is needed and a member has a specific need or barrier.
What is the connection pathway?
To show case management value
Why is ROI important?
Care plan goals prioritization and progression
What is evaluated on every member call?
Prior level of function, current level of function, home status, diagnosis, condition
What are things addressed during a discharge planning call?
Case types I work after completing urgent and high referral tasks.
What is IDStrat case type? or What is IDStrat?
Assessment completed within 30 days of a successful follow up call
What is the ongoing assessment?
Red, yellow, and green dots in the gaps in care section.
What is the compliance indicator?
Barriers, Progression toward goal, and interventions to meet barriers
What elements should be addressed in care plan member note?
Provider intro letter is sent.
What is an unsuccessful provider outreach by the CM?
TAT for urgent, high, medium, and low case priority.
What are 1, 2, 5, 7 business days?