HRS
QUALITY
GOALS
PROTOCOLS
MISCELLANEOUS
100
The 5 elements of the DPP that must be completed within 14 days of enrollment
What are the Condition Manager, Medications, Self-Monitoring Orders, Self-Monitoring Results, and Medical History
100
This must be verified on all incoming and outbound calls
What is HIPAA
100
The nurse should obtain and collaborate on one action step for this goal on the initial call
What is the Overall Health Goal
100
The callback is set for 2 days in this situation
What is leaving a message
100
All nurses must get permission from their MML or Manager prior to utilizing this aux code
What is case management
200
Provides claims information, care history, diagnoses, future risk information, etc on the member
What is Impact Pro
200
Associates must properly identify themselves, plus provide these three things when leaving a message for a member
What are the toll-free program telephone number, hours of operation, and program name
200
These are identified and addressed when working with the member to resolve a health concern or issues
What are barriers
200
If the provider indicates that the member is not his or her patient, the nurse must complete this document, as a breach of protected health information has occurred
What is a risk report
200
This performance metric centers on member facing activities such as talk time, after call work, case management, and available time
What is occupancy
300
When the nurse addresses the member's behavioral health status, it is documented here
What is the VIP note
300
Must be completed on initial health support if a low core condition exists
What is the management assessment
300
Once a noncompliance issue has been met, the nurse will need to do this
What is close the goal
300
Must be completed upon enrollment into the program (within 30 days of engagement for Complex Care if unable to complete on initial), annually, and prior to graduation (unless completed within 30 days of graduation)
What is the SF-8
300
Manager approval must be given prior to creating a social work consult for this client group
Who is Gateway
400
The nurse must call the physician's office to verify severity for this condition upon initial assessment
What is COPD
400
What the nurse should do to include goals and IIPs for follow up in the call summary/wrap
What is flag the item
400
HMC approved abbreviations can be found at this location on the 411 site
What is Associate Education - Clinical Program Support - Clinical Program Abbreviation List
400
This dialer will automatically send an outbound call to a nurse when enough associates are available
What is the progressive dialer
500
The client profile and benefits matrix can be accessed these two ways
What are through the links on the case information page of HRS or the 411 site (websites and resources)
500
Four key elements of health behavior change that are an important part of the nurse's conversation with the member
What are open-ended questions, affirmations, reflection, and summarization
500
SMART goals and action steps are these 5 things
What are Specific, Measurable, Achievable, Realistic, and Time Framed
500
In addition to completing the rounds prep form for Condition Care or Complex Care rounds, the nurse must complete this documentation as well in the HRS case
What is a consult for the Medical Director under the Individualized Intervention Plan
500
This dialer will list the campaigns available and allow the nurse to decide whether to accept an outbound call to make or reject it; can be accessed by clicking the arrow on the navigation bar in GAD
What is the preview dialer