Member Outreach Cadence
Call that happens approximately every 6 months.
What is a biannual call?
The 4 risk levels we see in the PW banner.
What is stable, emerging, rising, highest?
HIPAA option that includes: first & last name, DOB, and either full address, phone number, or member ID number.
What is option 2?
On every call this must be stated at the beginning of the call prior to call purpose & introduction of the program.
What is the call disclaimer & HIPAA authentication?
The CN conducts a conference call with the member to the PCP to make an appointment, go over any open star gaps & update PCP information in their communication note and PW.
What is a Member with a PCP and no appointment in the last 12 months?
Follow-up within 5 to 10 business days. Variance to this timeframe may be driven by resource response expectations.
What is a Resources follow up call?
The 2 risk levels that members may have Landmark Health involved in their care.
What is rising & highest risk levels?
HIPAA option that includes: first & last name, member ID number and either full address, phone number, or DOB.
What is option 1?
A UHC benefit that must be stated that provides free gym memberships & fitness programs.
What is renew active?
CN attempts to find PCP using resources on WeRally and attempts to call the Dr's office to make an appointment to establish care w/a Dr.
What is members without a PCP?
Call in which all risk levels contacted in less than 2 weeks for an initial attempt. (including members with newly assigned risk level.)
What is Initial outreach (new members only)?
Risk levels that members qualify for an OAH Clinician (RN, BHCM, RNCM) & CNs are expected to complete all Initial Call components.
What is emerging risk level?
Is the primary platform that Care Navigators can confirm if an AR or POA is on file.
What is Maestro?
The call component that summarizes the call and CNs will provide their name w/ph# & ext and provides what the next steps are.
What is the call closing?
The 2 platforms that CN will need to update PCP information.
What is GPS & PW?