ACO's
ACO is the acronym for
What is Accountable Care Organization?
A face to face care coordination activity is
What is Care Coordination Direct?
A meeting scheduled between member and care coordinator after an inpatient level of care
What is Follow up after discharge
BHCP is the acronym for
What is Behavioral Health Community Partners?
Who should we inform of member disenrollment's?
What/who is ACO and PCP?
Where would you go to look up ACO contact information?
What/Where is JIVE?
This billable note can be completed after video conferencing services
What is Outreach or Care coordination telehealth?
A Member with 15+ ED visits and or 4+ IP visits
What is MVP
Enrollee becomes age 65, obtains Medicare A&B, lose MassHealth or loses their ACO.
What is ineligible for BHCP services?
Stopping by a known address for outreach or to drop off a HTR letter is considered.
What is a cold visit?
Community Care Cooperative is also known as
What is C3?
This billable note is completed after care coordinator contacts the ACO for additional services/resources/
What is RFS: Referral to ACO for flex services?
This qualifying activity is entered when a care coordinator speaks to someone at the Hospital during an ED or IP visit.
What is support for transition of care?
How many number of days are we allotted from assignment to engagement?
What is 122 days?
Bay Cove has EHR (Electronic Health record) access for members to which three ACO's
What are C3, MGB and Tufts CHA?
SouthCoast
Community Alliance
Signature
Care Alliance
Beth Israel Lahey (BILH)
East Boston Neighborhood Health Center (EBNHC)
What is Wellsense?
This billable activity note is completed after a member is discussed by CC with at least two or more external care team members.
What is CTM: Care team meeting?
Documentation requested that provides aftercare/follow up appointments, updated medication list, current problem list, diagnosis and more.
What is the discharge summary?
How many days are we contractually allotted from assignment to completion of comp assessment?
What is 90 days?
When outreach is unsuccessful what health care technology platform would you check for additional phone numbers and addresses
What is Point click (formerly collective medical)?
Do not request demographic information directly from pcp sites under this ACO.
What is MGB
Status change after the completion of a comp assessment note, Development of care plan note, Comp Assessment Complete note, SDOH complete note, Care Plan Complete note.
What is Engaged status?
An RN calls or meets directly with member to identify any confusion or discrepancies in medication regimen
What is Med Review
Bay Cove
Vinfen
Mistic Valley Elder Services (MVES)
JRI
What are the CCP agencies?
Found at the bottom of the members main page are these three eHana flags/affiliations necessary to know for outreach
What are DMH, DDS and EOEA (Executive office of Elder Affairs)?