What are topics that can be searched in healthwise?
100
Updated on each call to assess progress
What are goals?
100
OARS is an acronym for this.
What is open ended questions, affirmations, reflections, summary?
100
These steps are done at the beginning of each call.
What is verify HIPPA and call recording disclosure?
200
____ is defined as the action that causes harmonious functioning of various parts to bring about effective results.
What is coordination?
200
Go to teaching tab and click on healthwise knowledge base
How to get to healthwise in HRS?
200
Member will lose 10# by 12/15/15 by walking 2 miles each day starting on 10/16/15.
What is a smart goal?
200
Pre-contemplation, contemplation, preparation, action, maintenance, relapse and termination
What are the stages of change?
200
A time to ensure the member has met all of their goals and is ready to maintain their success on their own.
What is a closure call?
300
Collaborative process in which a CM considers options and services required to meet an individual's health needs with quality, cost effective outcomes during an entire episode of illness or course of treatments
What is case management?
300
Talking points and links to healthwise can be found here.
What is the HIP?
300
A referral to a health professional (SW, dietician, pharmacist) is documented this way in HRS
What is a consult?
300
Elicit, provide, elicit
What is the most effective way of teaching and providing education to members?
300
One of the goals of post-discharge calls.
What is readmission prevention?
400
URAQ and NCQA
What are the accreditation bodies for case management?
400
Check your symptoms and emergencies
What is the section in healthwise used by nurseline only?
400
The two steps to take when setting up a BH referral.
What is create the referral and open up a BH case?
400
Reflection of member's ability to change their behavior
What is importance and confidence questions?
400
MMH+ (or Member 360), PBM (Pharmacy benefit manager), call wrap note, impact pro
What is pre-call work?
500
Case selection, assessment, planning, implementation, monitoring, evaluation
What are the components of the CM process?
500
Assess understanding of the implications of their condition(s) health need
What is the intervention in the goals section where you may find links to healthwise?
500
SMART is an acronym for this.
What is specific, measurable, attainable, realistic, timely?
500
Nurse CM steps to take when a member is in contemplation.
What is find motivation for member, pro/con list, determine reasons for change and barriers to change.
500
4 areas to be completed during a pre-admission or a post--discharge call.
What are medication, trigger, questionnaire and care plan?