Software
A picture is worth a thousand words.
What is 'Spotlight'?
The health plan decides whether to add this on to the IOA program for their providers, to promote a more comprehensive assessment of the patient and improve the quality of IOA submissions.
What is CGAP?
Communicating next steps is a component of this Core Competency.
What is 'Get the best possible outcome from every visit'?
The CGAP acronym meaning.
What is Comprehensive Gap Assessment Program?
Conditions that were diagnosed in previous years or alerted by clinical indicators are part of the IOA Program.
What is 'Risk' or 'Suspect'?
A platform used to provision providers for using Practice Assist.
What is 'Prospective User and Management Authorization- PUMA'?
A program that addresses Risk and Quality gaps for providers, and supports better patient outcomes.
What is the 'In Office Assessment Program (IOA)'?
Providing direction, guidance, provider focus and clinical quality improvement through HEDIS guidelines is part of this Core Competency.
What is 'Plan every provider visit to include the elements of the Great Field Visit'?
The CPG acronym meaning.
What is Care Priority Groups?
This is the process of providers returning the completed IOA and required documentation back to Optum.
What is Submission?
A platform containing a Work Queue, Engagement Planner, and your Book of Business.
What is 'Field Assist'?
One of the UHC program expansions that started in 2026, where the Provider Performance Team manages Risk only.
What is 'MCAIP IOA'
What is 'MA-IPi IOA'.
Assessing provider groups current workflow and any barriers to working the IOA program is part of this Core Competency.
What is 'Create added value to the provider relationship'?
The TIN acronym meaning.
What is Tax ID Number?
These measures are supported by providers being alerted to gaps in care where screenings weren't completed that are appropriate for the patient.
What is 'Quality'?
A platform that provides practical access to data. Feeds off other portals to conglomerate information in one place.
What is 'Optum Assessment Insights- OAI'?
One of the two parts of CGAP.
What is 'Gap Assessment Threshold (GA) or Documentation Verification (DV)'?
Developing knowledge on coding intensity, clinical quality initiatives, and proper documentation and coding for chronic conditions is part of this Core Competency.
What is 'Master professional knowledge'?
The HSD acronym meaning.
What is Health Systems Director?
A system used by CMS to categorize and group medical diagnoses that risk adjust.
What is 'Hierarchical Conditions Categories- HCC'?
HCAs submit provider's questions here via email, related to payment, rejections, missing submissions, ASF/W9 submissions, CGAP, and program rules.
What is ICAP?
(Intake, Coding Abstraction & Payment Team)
The process of the IOA being transmitted out to the provider.
What is Deployment?
Confidently delivering the appropriate message and creating dialogue with compelling content and resources is part of this Core Competency.
What is 'Grow strategic partnership through provider-focused dialogue'?
The HEDIS acronym meaning.
What is Healthcare Effectiveness Data and Information Set?
A healthcare model focusing on quality, patient experience, outcomes, provider performance, efficiency and cost reduction.
What is 'Value-Based Care- VBC'?