Blue Cross MN



[pic]

Blue Plus New Care Coordinator Checklist

| |This checklist is a training tool for new Care Coordinators. Refer to the MSHO and MSC+ Care Coordination Guidelines for |

| |complete details. |

| |Review the following links: |

|Care Coordinator Tools | |

| |Blue Plus Care Coordinator Website (see below) |

| |Community Based Services Manual (CBSM) |

| |DHS |

| |MHCP Provider Manual |

| |Prepaid MHCP Manual |

| | (to search DHS enrolled providers) |

| |My Prime (MSHO formulary) |

| | |

| |MHCP Supplies and Equipment Coverage Guide |

| |EW Rate Limits |

| |BlueRide Portal (LogistiCare portal for Care Coordinators to schedule and review rides) |

| |DHS Training for MMIS |

| | |

| |Review the following links in the Care Coordinator website to ensure Care Coordinator understands where to find Blue Plus |

|Care Coordinator Website |Care Coordination Resources: |

| | |

| |Manual and Reference Guides: these sections include guidelines, forms, letters and resource information. |

| |MSHO |

| |MSC+ |

| |Post Discharge Resources for SecureBlue MSHO |

| |SecureBlue MSHO Supplemental Benefits |

| |STAR Program Information and Resources |

| |Communication: this is where Communiques are posted. |

| |Training: to view previous Care Coordinator trainings/webinars |

| |Resource Management: view Blue Plus resources, Primary Care Network Listing, MSHO Enrollment Resources, and other helpful |

| |links |

| |Amerigroup: Information on accessing the Amerigroup systems including manuals, trainings, and resources. |

| |BlueRide – LogistiCare: BlueRide phone number and links to LogistiCare resources. |

| |Find a Doctor link: link to Find a Doctor tool on Blue Cross Blue Shield of MN website |

| |Contact Us: Key contacts for frequently contacted departments |

| |SecureBlue MyPrime Rx Formulary: link to find covered Rx drugs (MSHO only) |

| | |

| | |

|Tasks |Complete the Following Tasks: |

| | |

| |Read Care Coordination Guidelines as applicable to each Care Coordinator |

| |MSHO & MSC+ Community Care Coordination Guidelines |

| |MSHO & MSC+ Nursing Home Care Coordination Guidelines |

| |Notify Partner Relations Team requesting access to Amerigroup systems. Include name, e-mail address, phone |

| |Get set up with Availity and complete ICR training, if applicable. (see below) |

| |Review MSHO and MSC+ product differences using resources under the SecureBlue MSHO Enrollment Resources link |

| |Review supplemental benefits available to MSHO members |

| |Read Amerigroup Manuals including: |

| |CareCompass-Member360 Manual |

| |ICR Manual |

| |Review current DHS MCO Audit Protocol (on the Care Coordination Audits page under the Resources link) |

| |Review 6.02.02 Instructions for the Collaborative Care Plan |

| |Review 6.22.01 Transition Log Instructions |

| |Complete the following trainings found on the Care Coordination portal under Training: |

|Trainings | |

| |Complete Blue Plus Model of Care Training or review most recent Fall Training slides. Complete Attendance Sheet and maintain |

| |in new care coordinator’s records. |

| | |

| |Complete Blue Plus 101 Training module |

| | |

| |Review any other applicable trainings |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download