May 20, 2016
Bridgeview reports,enhancements, and changes to the HRA audit
There are now two new reports available that are generating out of the Bridgeview tool.
The Daily Add report: This is generated when a member enrolls into Blue Plus after capitation and DHS decides to retroactively enroll the member back to the beginning of the current month.This is a new member who was processed after both the New CAP and Full Detail reports were run. You will receive an email if there are any members like these and be directed to log into Bridgeview to access this report. In the past, these members were added to your next month’s full detail, now we have the ability to notify you of them sooner. Please treat these as new enrollees for the month and follow the Guidelines for seeing these members within 30 or 60 days of notification as applicable. If these members are assigned to you in error, please report the discrepancy no later than 15 daysfrom notification to .
Note: the Daily Add report is found in the Enrollment Reports section of Bridgeview. You may log in at any time and download this or other enrollment reports you need to review.
Delegate Assessment Performance report:This report summarizes all of the HRA dates and information you have put into the Bridgeview system, to report on how well you are doing as a Delegate in terms of timely HRAs, percentage of refusals, assigning CCs, etc. This report is generated quarterly and should be used as a tool to help you support Care Coordinators in their efforts to see members within required timelines. The accuracy of this report is directly associated with the completeness of data entered into Bridgeview. If assessments are not entered, this will directly affect your percentages. Please make sure assigned staff are doing the required data entry into the Bridgeview system.
Enhancements: Starting in June, there will be additional enhancements to Bridgeview, which allows Care Coordinators to request an assessment be edited or deleted within the Bridgeview system. This request will be processed at Blue Plus and the requested change may be made in the system if approved.
The Bridgeview User Guide will be updated to include specific instructions on how to complete these actions.
HRA Audit: This month there are changes to the HRA audit that many of you are familiar with. In order to improve the correct documentation of HRA dates in the Bridgeview system, you will receive a request via email to provide documentation of specific HRA dates. We have enhanced the audit process to include both MSHO and MSC+ member files. We will now be auditing 100% of any assessments completed on the 1st of the month (as this appears to be the enrollment date) as well as any Unable to Reach members on a monthly basis. The date entered into Bridgeview must be the date the member assessment was completed or the date the Unable to Contact Letter was sent. This is also the date entered as the activity date in MMIS for members who reside in the community. For members new to SecureBlue(MSHO) or MSC+, the assessment date is the date the assessment was completed, not the date the member enrolled in the health plan (unless this is the date the assessment was actually completed).Since this is our first review of data in Bridgeview, we will be auditing all Delegates against data in Bridgeview from January to current.
If you have questions about any of these changes or updates, please contact your Partner Relations Consultant.
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