By The Numbers
What is the birthday of BHCP?
7/1/18
What does BEST stand for?
Boston Emergency Services
How do we avoid conflicts of interest when making LTSS referrals?
Offer the member choices and be sure to include referrals to outside agencies
How many times per year must our members have a physical/wellness visit with their PCP?
1
What disqualifies members from having BHCP?
No MassHealth, MassHealth Limited, Partial SafetyNet, no ACO/ACCS, SCO, PACE, One Care
Name at least 3 ways you maximize safety while doing outreach?
get as much history as possible, work with other providers, safety screening, double up, check out with supervisors, follow your gut, make sure phone is charged, aware of environment, etc.
How many days do we have to reach out to each member once assigned?
30
What do ACO and MCO stand for?
Accountable Care Organization/Managed Care Organization
Name 3 steps you should take when a member is discharged from hospital
notify care team, get d/c summary, send d/c summary to care team as appropriate, complete f2f follow up within 3 days, assist RN with med rec, confirm follow up w/appropriate doctors, document event, review care plan and revise if necessary
After an inpatient stay, we have how many days to follow up with an in-person visit?
3
When do we use the COVID-19 modifier in our work?
When billing for a service normally required to be Face to Face, but currently being done by telephone due to COVID risk--with permission from MassHealth.
Name at least 2 people/places you would report safety concerns to.
supervisor, teammates, care team, team meeting, Ping Pong, Risk Review
All new enrollees assigned to RCP after 11/1/18 have how many months to complete a signed PCTP
3 Months
What does CSU stand for? Or CCS?
What does this service offer?
Crisis Stabilization Unit
Unlocked, diversionary program staffed by nurses and mental health workers for psychiatric crisis stabilization
Name 3 reasons to connect with ACCS about a member's care
care planning, incidents, hospitalizations, ED visits, referrals made, goals met
If a member takes anti-psychotic medications, what test do they need, how often, and why?
A1C, annually, diabetes screening
Name 5 possible Care Team Members
PCP, Psychiatrist, therapist, guardian, Specialist, VNA, Family member, Peer Support, ACCS, DMH/DDS
What are some ways we stay safe from COVID?
hygiene, masks, distance, no gathering, meet outside, bring disposable pens, gloves, cleaning/disinfecting, screening questions before visits and every call, staff screening, stay home if sick and report
On average the life span of a person with serious mental illness is X years shorter than the general public.
25 years shorter.
Bonus Q. Possible reasons?
What does ACCS stand for? What is it?
Adult Community Clinical Services
DMH service for outreach and support for adults with serious mental health conditions.
Name 3 steps to take when you learn a member is in the hospital
Event log, notify care team, reach out to hospital to leave contact info and request to be part of treatment/discharge planning, activity notes, update Ping Pong notes, send current med list
After an ED Visit, we have how many days to follow up by phone or in person?
7
Name 3 steps you should take when receiving a signed care plan back from PCP
event log, CP complete Activity Note, upload to ehana, Update annual review dates on member page, give member copy for signature, send to care team
What are the forums we have to review member cases with increased risk or incidents?
Medical Peer Review, Special Clinical Review, Continuing Care Risk Review, Res Risk meetings, team meetings
How many ACO/MCOs do we (Riverside) have contracts with?
14
What does MAT stand for? & When is it most often used?
Medication Assisted Treatment
Used in addictions treatment (Suboxone, Methodone)
Where would you get medication lists when you are completing an initial or annual CHA? First choice and other options.
MAP orders, VNA, PCP, Psychiatrist, Member, ACCS, Pharmacy--Always cite your source!
How many days do we have to complete a Care PLan in order to meet Quality Standards?
122
What three reasons we would enter an event log?
hospital admissions/discharge, ED admission/discharge, Care Plan statuses, PCP or Specialist Visits, Labwork or other testing
What kind of plan do you create with your member in case they have emergencies after hours? Give example of important pieces to the plan.
Crisis Plan-risk history, stressors, supports, coping skills, actions for crisis like calling 911, calling BEST, reaching out to support.