New Members
The initial care management outreach must occur within __________ of the referral to care coordination.
What is two business days?
This document must be fully completed (without blanks) within 14 days of the member's consent to care coordination.
What is the crisis safety plan?
The care plan must be fully completed with no blanks. If a section does not apply or no need is identified ______________ should be entered.
What is N/A or None?
The care plan must be shared with ___________.
What is the child and family team?
A visit event should be completed and signed every __________ for each member?
What is Visit event?
In dynamo, the care coordination referral date can be found on the episode page labeled as _________.
What is "date entered"?
This document must be completed within 1 business day of the comprehensive assessment supplement (or if a CAS is not required, within 30 days of consent).
What is the NCQA assessment summary?
The care plan must be completed within _______ of completion.
What is 1 business day?
If the PCP is on the child and family team __________ must also be sent with the care plan letter.
What is the provider welcome letter?
If I refer a member to a community resource, I should document this in the CRD (community resource directory). I should follow up with the member within 30 days to ________.
What is close the loop?
New members are outreached a minimum of _____________ times within ___________ days of the member referral date.
What is 5 times within 30 calendar days?
The purpose of the NCQA assessment summary is to summarize and draw conclusions based on the initial member assessments demonstrating a link or golden thread from assessment to this document.
What is the Child and Family centered care plan?
On the care plan, a ___________ is required for all services being received by the member in the event the service cannot be received?
What is "back up plan"?
Documentation must be entered into dynamo the same day as the activity or within _____________ after the activity unless otherwise noted by contractual, NCQA, or federal timeframes.
What is two business days?
In order to ensure HIPAA compliance all of my notes should include __________________.
What is the name of who I spoke with, the number I called or how I contacted them, and what information I verified (Name, DOB, Zipcode etc).
This assessment must be started and members must be asked for the information under the ________________ tab at a minimum as a part of the outreach process.
What is health care equity (HCE) and education tab?
These sections of the member episode must be completed and reviewed/updated as appropriate.
What are vulnerable Member, Primary Diagnosis Code, ICM Special Interest Subgroup and ICM Conditions/Dx of Interest?
If a condition is listed on the care plan, a condition specific assessment must be started within _________ and completed within _______________.
What is started within 30 days of the episode date and completed within 60 days of the episode date?
The care plan should be reviewed every 90 days during a child and family team meeting and this should be documented in a _______________ note.
What is interdisciplinary note?
The number 1 missed question on the new audit tool is ___________________.
What is #9, ICM conditions?
9. Were the following reviewed and/or updated on the Episode page Vulnerable Member, as applicable, Primary Diagnosis Code, ICM Special Interest Subgroup and ICM Conditions/Dx of Interest?
This event should be completed with the initial member contact and controls the care coordination status listed on the members episode page.
What is "consent event"?
If the member is prescribed medication, the med V2 events must be entered and include the following four details:
What are name of medication, dose, frequency, and reason?
The care plan goals must be:
1.
2.
3.
What are numbered by priority, individualized to the member, and be measurable (have target dates).
After completing the New member outreach process, the job aid I should refer to next is the ___________.
What is the Limited care management assessment for non-LTSS job aid?
If I am looking for a standard operating procedure (SOP AKA job aid) and I cannot find it the OhioRISE SOP library, I should ______________.
What is look in the corporate SOP Library (AKA Medicaid care manage SOP)?