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Protocols
Know Your Team
Behavioral Health
Engagement
Navigation
100
The background and scope of this protocol supports the Nurse Coach's initial call with the member. Early engagement support from the HE team, for DM, non FEP CXC and provides the NC with the focused opportunity to address member health goals and provide the appropriate related teaching.
What is PR 280
100
This person came in with the second class of HE's and succeeded Aisha Williams in her position.
Who is Belinda Doleman
100
This is a nationally recognized survey employing measures representing basic dimensions relevant to an adult's functional status and well being. Not performed on individuals less than 18years of age.
What is the SF-8?
100
This service is available when speaking to members who do not use English as their primary language.
What is Cyracom/language line?
100
It is here that an HE can quickly view a member's condition and program.
What is member summary?
200
The background and scope of this protocol provides the associate with the process to obtain and document applicable non member permissions.
What is PR 120?
200
This person was the 2nd manager to be hired onto the HE team.
Who is Luke Pittman
200
In reading the questions for the PHQ2 associates are to read the questions in this fashion.
What is verbatim?
200
This 5 letter acronym stands for what requires the company to verify the identity of members in order to disclose PHI. Give the formal name of the acronym.
What is the Health Insurance Portability and Accountability Act?
200
The Questionnaire Center can be found in either of these 3 sections in HRS.
What is 1. clinical info 2. quick links 3. sitemap
300
The backbround and scope of this protocol reads "The SF-8 is a tool used to gain understanding of an adult's functional status and emotional well-being. The score, calculated after the member answers the questions, guides the NC to create a SW consult if unable to address the member's needs.
What is PR 185?
300
This person is a Staff VP for HMC Ops Special Services for the HE Team to whom HE Director Maureen Hughes reports.
Who is Nichola Denney?
300
If an HE is unsure if a mbr's vendor is internal or external the HE is to treat the case as though the vendor is this.
What is an internal vendor?
300
Should a member not want to add anyone to their non member permissions the HE must still complete this documentation action.
What is verification?
300
This tab in HRS can be used to see all tabs and their drop downs in one screen.
What is sitemap?
400
The background and scope of this protocol was created as a guideline for the associate to follow to create a BH referral that will auto-generate a BH goal within the care plan within HRS.
What is PR 309?
400
This person is an EVP w CHS reporting to Angela Braly for the HE Team.
Who is Harlan Levine?
400
When setting BH Referral this piece of information should be added to the comments section when dealing with an external vs internal vendor.
What is the External Vendor's Contact Information?
400
Per PR 130, when updating provider information the associate is to ask for these 3 items about the health care provider.
What is 1. Provider's first and last name 2. city/state 3. phone number
400
When a CC member has a low risk core condition preventing them from participating the HE would follow this basic 2 step navigation path to update risk levels.
What is 1. Questionnaire Center 2. Management Assessment
500
PR 502 speaks this process.
What is warm transferring members to programs and/or health care professionals?
500
Although we do not want to compete nor come near their over 4 hour time frame, this HE holds the record for longest mbr engagement call.
Who is Nicole Barker?
500
When setting a Behavioral Health Referral the next action due date is set to this date.
What is the next business day?
500
The motivational interviewing used during engagements has its origin in this field.
What is alcohol abuse?
500
If a case in HRS is mistakingly opened it is considered this contact type.
What is Not Applicable?