The first thing you do with a new member.
What is reach out immediately to member and providers.
Organization you can call together to make insurance changes.
Masshealth (ACO or any provider also acceptable)
Length of time member is unreachable before switching to weekly calls.
What is 90 Days?
The number of days to follow up on an events.
What is 7? (10 also acceptable)
The number of days to get a CP signed
90 Days
The system you should check MONTHLY for updates and collaboration.
What is CCBC ehana?
A form you complete annually for medical transportation.
What is a PT1
How long members are kept after becoming unreachable (at minimum).
6 months
The number of times FUD should be attempted within a week (if unreachable).
3
The number of languages spoken on our team.
Four
A 3rd party program used to obtain additional demographic information. Also used to track events.
What is Point Click Care (PCC)? (CMT also acceptable answer)
Which of the following is NOT an ACO we work with? BMC, Tufts, CCC, or BOSCO.
BOSCO
True or False: When a member is unreachable it is not acceptable to search PCC for new contact information.
FALSE. Do all the searching!
The __________ is responsible for Medical FUD follow up and the ___________ is responsible for Behavioral Health FUD follow up.
RN, CC
Phrase Ashley says often (too much) when getting off the phone.
The length of time a member has until their case is closed if they decline.
What is three months?
The most helpful resource with medical related concerns.
Who is the RN?
Members may go to this team if they are unreachable for too long.
ICC
True or False: FUDs are to be completed after a substance use rehab stay.
True! You may need to create an event for it.
The day we need to be in the office.
THURSDAY!
The month a member goes to ICC if they are unreachable.
What is the fourth month?
A highly recommended Care Coordination practice/phrase to ensure successful work between mbr and CC.
Do WITH not do FOR
Two major searches to make when a person becomes unreachable.
What is an obituary and local DOCs (Department of Corrections)
The number of ED visits a member must have to have a “Decrease ED utilization goal.”
10
The name of the VP for BHCP.
Who is Jonathan Marcus?