Clinical Model
What is a Care Ally?
This Curana team member is often the first point of contact for members and cordinates care needs.
To qualify for an I-SNP, a member must reside in this type of facility for 90 days or longer.
What is a skilled nursing facility? (SNF)
These Curana employee referral source often has a great impact on enrollment opportunities.
Who are the Care Ally and APP.
This is one major advantage of an I-SNP over Original Medicare for eligible residents.
What is coordinated care?
Before discussing plan enrollment, MBCs must have this documented.
What is Scope of Appointment? (SOA)
The three pillars of the Model of Care are Primary Care, Care Coordination, and
What is Behavioral Health?
This government program can help lower premiums.
What is Medicaid.
Building strong relationships with this facility leadership team drives access and referrals.
Who are the interdisciplinary team members?
Members have access to this type of annual visit that helps identify health risks and care needs.
What is an Annual Wellness Visit?
This federally regulated period limits marketing activities before an enrollment election.
What is the 48-hour SOA rule?
Members receive healthcare services directly in this location.
What is the skilled nursing facility?
This enrollment period allows qualified institutionalized individuals to make monthly election changes.
What is the institutionalized Special Enrollment Period? (ISEP)
This monthly habit helps MBC's identify new opportunities and discharge risks.
What is conducting facility census reviews?
This benefit helps members receive products that they would not otherwise receive.
What is OTC Benefit?
MBC's should never complete this portion of an enrollment application on behalf of a beneficiary.
What is the beneficiary attestation/signature section?
This assessment helps identify member needs and drives the individualized care plan.
What is the Health Risk Assessment (HRA)
A beneficiary must have both Medicare Parts A and this other part to enroll in an I-SNP.
what is Medicare Part B?
A successful presentation should focus on member outcomes and this Curana value proposition.
What is bringing care directly to the resident?
This benefit helps members receive visits from a healthcare professional to play cards, visit, or accompany to appointments.
What is companion care?
This organization oversees Medicare Advantage plan compliance.
What is CMS?
This document outlines goals, interventions, and coordination activities for an I-SNP member
What is a Care Plan?
True or False: A beneficiary living at home can enroll in an I-SNP designed exclusively for SNF residents
What is false?
The most successful MBCs consistently partner with these two groups inside their facilities.
Who are Care Allies and facility staff?
The primary goal of an I-SNP is improving health outcomes while reducing these avoidable events.
What are hospitalizations and ER visits?
TRUE or FALSE: An MBC may offer cash or gifts over CMS - approved limits to encourage enrollment.
What is FALSE?