SIP Notes
list the 5 W's of the Summary section
Who:
What:
Where:
hoW:
Why :
members tier 1-3 without the telehealth option requires...
( In person) face to face at least once a quarter.
who is required to be part of all life plan meetings?
member and advocate/representative
All new enrollment members require what in the first month ? list all in order..
1. Initial contact within the first 5 days ( must document )
2. schedule in-person visit ( must be scheduled for the first 60 days)
3. Obtain CCO checklist within 30 days of enrollment.
what is CAS/CANS
CAN: Child and adolescent needs and strength.
CAS: Coordinated Assessment system (members 18 and older)
what should care managers NOT use in the Summary section?
"monthly check-in" or "Quarterly Face to Face"
Members tier 1-3 with telehealth option requires...
at minimum telehealth per quarter.. but requires a in person visit once every 6 months or twice a year.
the life plan requires a minimum of ___ POMS and ___ Goals.
2 Poms and 3 Goals
What is the requirement within the second month of the new enrollment process..
schedule and complete path assessment /DDP2 / schedule CAS/Cans Assessment and complete face to face in person if not completed within the first month.
Can you use the results from CAS/CANs to add in the life plan / assessments ? True or false
True
Impact section includes the 3 I's ...
2. Impact describes how the member responded to the Care Manager's action or activity.
3. Impact describes the members level of satisfaction with cm services , provider and community services.
Tier 4 ( fewer) in person option visits require...
at minimum telehealth or in-person visit once a quarter. requires in-person visit twice a year.
To finalize the life plan cm must obtain ...
member/ guardian approval
new enrollment process within 90 days of enrollment ...
Initial life plan held and finalized.
Do you need a CAS/CANs to complete the new SART ( Service authorization Request Tool) ? True or False
True
wat does not apply to the impact section?
DDP-2 , LCED Redetermination or contact with providers.
Member says they always meet via telephone to conduct the annual life plan ? ( true or false)
False
To mark the life plan as acknowledged and agreed
all members who took part of meeting should provide some type of written agreement , signature page /email approval.
how to document the CAS/CAN in Core using new SIP drop down ?
Use drop-down only : CAS/CANs Assessment - Assistance/Communication/Review.
Core Service: Comprehensive Care Management ( CCM)
Plan section includes ?
1. Document the plan to move forward with goals.
2. Document follow-up actions taken by the care manager, member, and family.
3.Include referrals to community resources.
If a member is sick and doesnt want to move the semi life plan meeting and wishes to meet virtually but doesnt have the telehealth option, what should the cm do ?
CM can reschedule the meeting to add the telehealth option ONLY in person when the member feels better.
If member is unable to approve their life plan and there is no representative what should CM do ?
reach out to the ACA/NY Member Representative Committee.