Teams
Manages members under the SDOH program
Who is the Social Work Team?
Monetary Reward if completed within 45 days of CCP enrollment
What is the Health Snapshot?
Limited to 2500 kids per year
What is the Swim Lesson Voucher?
Platform used to send and receive CRMs
What is Epic?
ER visit criteria
What is three (3) or more emergency room (ER) visits within the last 30 days?
Manages pregnant members up to one year post-partum
Who is the Maternity (OB) Team?
$25 reward for follow-up visit with a behavioral health provider within seven (7) days after a hospital discharge for a behavioral health diagnosis.
What is the Behavioral Health Follow-Up?
Must be member for at least 90 days to pre-qualify and has a lifetime benefit limit
How does a member get the $250 housing benefit?
Topic used to assist with locating in-network providers when we have been unsuccessful
What is Find a Provider?
Initial assessment timeline
What is started in 30 days and completed with 60 days?
Manages members with PDN and/ or PPEC.
What is the MEP Team?
Annual exam by a doctor at 15 months ($50), Age 2 – 11 ($10), and Age 12 – 19 ($20).
What are the Well-Child Exams?
One 12 mile one way and 25 miles round trip/ per month
What is the monthly non-medical transportation benefit?
Topic used when a member or provider leaves you a google review?
What is Positive Experience?
Initial outreach frequency
What is weekly?
Manages members under the Obesity Program
Who is the FHK Team?
$50 reward for a member with diabetes: Diabetes Monitoring
What is complete an annual diabetic monitoring including a:Special blood test for sugar level (A1c),
Urine test (eGFR and urine albumin-creatinine ratio), &
Dilated eye exam?
Our members may have a co-pay if enrolled in these two LOBs.
What are FHK and 22Health?
Which topic is used to verify coverage?
What is COB?
Start of look-back period
What is September 2026?
Provides medical care coordination to both adults and pediatric members.
What is the Adult/ Peds Team?
$50 reward for completing a six (6) month Obesity Management program, including: Two (2) PCP visits, & Three (3) visits with a Registered Dietician in combination with Care Management.
What is the Obesity Management reward?
$50 per month, per household
What is the MMA OTC benefit?
Topics are used to request a new PCP or ID card
What are PCP change and ID Card Request CRMs?
Inpatient admissions criteria
What is three (3) or more hospital admissions within six (6) months?