Don't panic, it's Strategic
Med Adh task start?
January 30 and February 2
What are Rural CCA's?
Just has Depression and Obesity
Which plan quality supplemental file will be submitted this month?
UHC
If you start work at 7am, but are sick and will not be in you must notify your manager by what time?
6 AM via text or phone call (1 hour before start of your shift)
Self-evaluations are due when?
Today Jan 9 by 6PM
We are going to grow our Midlands ACO lives by
15K
Do Patient that are "Not on Plan or CMS file" Get CCA's?
YES
What are the 4 Gaps we are needing to chase for Humana?
BCS, COL, CBP, and SPC
What are Proxy Gaps?
Blanket quality measures to get ahead of the chase
What do you need to communicate to your Market Manager when you are calling out for your shift or putting in for the future PTO?
If scheduled: Request is submitted in ADP and coverage is communicated in request or via email.
If Unscheduled: Sick or Non-sick
CCA coverage
Clinic notification
When is the last day to reconcile CCA's for 2025?
Jan 15th
If a patient is scheduled and in the clinic but leaves before the provider sees them. How would you disposition the CCA?
You will cancel it as No-Show/Canceled/Rescheduled
What measure is focused on Centene, Aetna, and Wellcare Tier 1 Priorities
HBD- A1C
What is the only way OM ICD10 Codes get captured?
Claim Submission
An absence not approved a head of time is classified as what?
Unscheduled absence
Which Payer's Tier 1 focus includes BCS, SPC, CBP and A1C?
Aetna
Same-Day CCA's for patients with ____Prior-year visits are turned off.
6+
What are the Tier 1 Payers for Arkansas?
Centene, Aetna and Wellcare
What issues does the Patient Experience piece touch on?
Balance, exercise, Lab work, bladder control and feeling down
What is the RED list?
People that Failed Med Adh the past year.
With Centene, what was the GOAL for CBP?
83% 4 Star
Manually Smoothing CCA's should only be done in extreme cases and must be dispositioned as what?
"Provider did not Return"
Humana falls under which Tier Level for Arkansas
Tier 2
What is the avenue to send additional data to MA Payors?
Supplemental File
How many of those ACO lives are targeted specifically in the Midlands region?
15,000