MSHO/SecureBlue Care Coordinator Checklist
Community Well (CW) and Elderly Waiver (EW) Members
This checklist is an outline of the care coordination responsibilities. Refer to the MSHO/SecureBlue Care Coordination Guidelines for specific details.Timeframe / Task
Day 1 / SecureBlue Enrollment information received Date:
Notified of any enrollment errors by the 15th of the month
Within 10 days / Notified member of Care Coordinator assigned within 10 days of new assignment or change in care coordinator Date:
Care Coordinator assignment entered into Bridgeview
Within
30 Days ofnotification of enrollment; on or after the enrollment date. / Welcome letter (8.22 Intro to Member) sent and/or phone call made to member Date:
Discussed supplemental benefits using 6.26 Explanation of SupplementalBenefits
A Health Risk Assessment (HRA) completedwithin 30 days of notification of enrollment; on or after the enrollment date
- Long Term Care Consultation (LTCC)/MnCHOICEScompleted (face-to-face visit) if member is on EW and has not had an LTCC in the 365 days prior to enrollment
- 6.28 Transitional HRA if member has had LTCC/MnCHOICES in the 365 days prior to enrollment
- Completed 6.17 ICF/DD and HCBS Waiver HRAand Care Plan Supplement for members with a disability case manager
LTC Screening Document entered in MMIS by cutoff dates for EWor within 45 days for CW
Confirmed correct Primary Care Clinicand update in Bridgeview as needed
For new enrollees receiving home care approved prior to enrollment, obtain copy of prior auth from previous county or MCO and fax with form 6.04.03 as soon as possible
Within
30 Days of HRA / 6.02.01Collaborative Care Plan developed and a copy in member’s file
6.02.03 Blue Plus Member Rights given to member
Assessment, Refusal, or Unable to Reach data entered into Bridgeview by the 10th of the following month
EW members require two face-to-face visits per year and additional contact as needed
CW members (non-waivered) require one face-to-face visit and one 6 month phone contact peryear at minimum
Care Coordinator is required to facilitate an annual physician/provider visit for primary and preventive care.
Within
90 Days* / 8.28 Intro to Doctor letter sent to Primary Care Physician (PCP), or for clinic delegates,
notification to PCP documented per clinic process Date:
8.29 Care Plan Summary letter sent to primary care physician Date:
Within
6 Months* / Face-to-face visit with EW member; reviewed goals and status/effectiveness of careplan
Phone call to CW (non-waivered) member; reviewedmember goals and status/effectiveness of
care plan
Within 365 days of previous assessment / HRA (LTCC) reassessment completed
Discussed supplemental benefits using 6.26 Explanation of SupplementalBenefits
Screening Document entered in MMIS one day prior to enrollment cut-off date
Re-assessment, Refusal, or Unable to Reach data entered into Bridgeview by the 10th of the following month
6.02.01 Collaborative Care Plan updated, copy to member and member rights given to member
8.29 Care Plan Summary letter or a copy of the care plan sent to PCP Date:
Ongoing / Follow process for notification/authorization of state plan home care services and PCA servicesComplete 6.22 Transitions of Care log for members moving from one care setting to anotherCommunicate with Primary Care Clinic as member’s health status dictates Notify Blue Plus of changes in care coordination via Bridgeview
Notify Blue Plus of transfers in care coordination delegation to another agency
Document 6.12 Updated 040117
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