Disease Management: Health Coach Jeopardy

Compliance

100

Staff must tell the member that the call is _______ for quality purposes. This is a federal law for every call!

recorded

200

When leaving a voicemail, the Health Coach will never include their... 

credential

300

The member must always tell us this info before we discuss any Protected Health Information.

Their first/last name and date of birth

400

This person has permission to speak on the member's behalf, and the member CANNOT speak for themselves.

Designee

500

When speaking with a member's caregiver, the caregiver has to tell us their own....

first/last name and relationship to the member

Initial Health Assessment

100

The name of the activity (task) in the DM Region queue that represents the Initial Health Assessment.

Complete Referral

200

After we submit an assessment, we must ______ it to the health coaching case. 

Assign

300

If the adult member's sponsor offers Weight Management coaching, calculate the member's _____ during the Initial Health Assessment to check for WM eligibility. 

BMI

400

If the member enrolls in coaching, then this is the "Decision" we will choose on the 'edit referral' screen. 

Meets Criteria to Proceed

500

A member is unsure of or does not believe they have a qualifying diagnosis. Choose this 'Agreed Upon Intervention'.

refused program

Clinical Coaching Calls

100

The name of the activity (task) that represents the Baseline assessment.

Complete Chronic Conditions Addendum Assessment

200

The member has to go suddenly, partway through a Baseline. You save the assessment form. Set the 'due date' of the 'contact member about chronic conditions addendum assessment' forward how many day/days?

one  (next day)

300

Member doesn't answer for follow-up call. Edit the 'due date' of the 'Work on Intervention' task out how many day/days in the future?

7 (one week out)

400

This is where you will document the number of days missed of work/school due to the member's condition.

Key Metrics

500

At the conclusion of a Baseline or follow-up call, you will do this to the case.

Edit 

(As needed: case owner, case status, next scheduled follow-up, monitoring/contact frequency)

Care Plan

100

Every Care Plan will include one behavior-related and one program-related _________.

Problem and Goal (both are correct answers)

200

These are sub-elements of a goal.

Intervention and Barrier

300

While editing the Care Plan, we choose a selection in this drop-down ONLY if the goal is met at 100%. 

Outcome

400

Health Coaches use this type of note structure for the Care Plan note. 

DIPSS

(Data-Intervention-Plan-Specialty Referrals-Stratification)

500

This must be updated when first creating a new care plan, because it can never be changed after submission

name of care plan (replace 'New Care Plan' with appropriate condition, e.g. Diabetes)

Miscellaneous

100

Health Coaches should do this before providing advice or education.

1-Find out what the member already knows 

2-Ask permission to share advice/education

200

In Correspondence, send this type of 'UTR' letter after the third unsuccessful attempt to reach member for an Initial Health Assessment.

DM Pre-Enrollment UTR (adult/peds)

300

Member doesn't answer for their Baseline call after two attempts on the day it it scheduled. Edit the 'due date' of the 'Complete Chronic Conditions Addendum' task out how many day/days in the future?

7 (one week out)

**this will be the first of three fresh outreach attempts

400

At the conclusion of a Baseline, we create these two activities (tasks) and assign them to the 'DM Referral' queue.

1-Send member letter (description: please send [English/Spanish] Diabetes enrollment kit)

2-Follow-up with primary care (description: please send medical information form to Dr. Jeckyll)

500

Always double-check this area for accuracy before leaving the member's chart. 

The 'Member Tasks' screen.