Care coordination resources
Medica AccessAbility Solution® Enhanced (HMO D-SNP)
- Advance Directive Planning
- Assessment Schedule
- Audit
- Behavioral Health Home Coordination
- Benefit Inquiry Exception Request
- Care Coordination Operations - CC Ratios
- Care Coordination Delegation Oversight
- Case Management Accountability (SNBC, SNBC Enhanced)
- Choice of Primary Care Provider
- Collaboration with Tribal Case Managers
- Coordination with Certified Community Behavioral Health Clinics
- Denial, Termination or Reduction (DTR)
- Evaluation of Care Coordinator's Performance
- Home Care
- IDT Process for Delegates
- Interdisciplinary Care Team
- Most Vulnerable Beneficiaries Identification
- Pre-Admission Screening Process
- Provider and Vendor Concern Reporting
- Range of Choice
- SNBC and I-SNBC Members Turning 65
- Remote Assessment
- Transfer Responsibilities
- Transitions of Care
- Unable to Reach/Refusing Member
- Air Conditioner PCP Support letter
- Care Coordinator Contact Info Update letter
- Change of Care Coordinator letter
- Documents letter
- Due for Dental Visit letter
- Eligibility Renewal Reminder letter
- Member Refusal letter
- On-going No Contact letter
- Post-Visit letter
- Welcome Letter
- PCP Letter
- PCP Letter-Unable to Reach or Refusing
- Post-ER Visit dental letter
Assessment and Care Plan
- Assessment Checklist
- Care Plan - Version 3
- Care Plan Instructions
- Medica Leave-Behind Document (Revised 9/2023)
- Medication List Form
- Medication Safe Disposal Handout
- Medication Safe Disposal Handout Instructions
- Member Engagement Questionnaire
- Transfer Member Health Risk Assessment
- Unable to Contact/Refusal Care Plan
- Member Signature Page
Referrals
Institutional
- Nursing Home Checklist for SNBC and SNBC Enhanced
- Nursing Facility Chart Coverage Guide SNBC Enhanced
Miscellaneous
- Home Care At a Glance Grid
- Bridging Client Checklist
- Bridging Shopping Preference Form
- Bridging Referral Form
- 2024 Medica CC HRA Completion Report
- Submit a Care Coordinator Concern
- I-SNBC Disenrollment Form
- I-SNBC Cancellation Form
- SBAR for Interdisciplinary Team Case Consult
Health Improvement Programs
- Complex Case Management/Health Support Referral Form
- Tobacco Cessation Program SNBC Delta Dental Services
- When and Where to Get Care
- Tips for Good Oral Health Tip Sheet
Contacts and Group Numbers
- Provide A Ride Transportation Directory
- Provide a Ride Transportation Out of Network Request
- Provide A Ride Transportation Authorization Form for over 30 60 Mile Rule
- Provide A Ride Transportation Request Form
- Provide A Ride Transport Request Process Over 30 60 Mile
- Certification of need form CON special transportation