Humana At Home-Star Member Talking Points
|
|
- Henry Strickland
- 6 years ago
- Views:
Transcription
1 At Home-Star Member Talking Points What are the CMS Medicare Star Ratings? The Center for Medicare & Medicaid Services (CMS) is a federal agency that oversees Medicare & Medicaid, and is part of the Department of Health & Human Services. CMS developed the Medicare Star Ratings to help consumers compare health plans and providers based on quality and performance, and to reward top-performing health plans. The Medicare Plan Finder (MPF) tool ( allows consumers to search for health plans in their geographic area and compare cost-estimates and coverage information. CMS rates the relative quality of service and care provided by MAOs based upon a five-star rating scale that utilizes the contract level data. There are 44 unique quality measures are included in the Medicare Part C and D Star Ratings, including success in providing preventive services, managing chronic illness, access to care, Healthcare Effectiveness Data and Information Set (HEDIS ) measures, the Consumer Assessment of Healthcare Providers and Systems (CAHPS ) survey, and responsiveness. The Medicare Star Ratings helps Medicare members compare Medicare Advantage (MA) plans, helps educate consumers on quality, and makes quality data more transparent and comparable between plans. CAHPS Survey Details What are the surveys? Consumer Assessment of Healthcare Providers and Systems (CAHPS ) surveys ask consumers and patients to report on and evaluate their experiences with health care. These surveys cover topics that are important to consumers and focus on aspects of quality that consumers are best qualified to assess, such as the communication skills of providers and ease of access to health care services. The survey is sponsored by CMS, and National Committee for Quality Assurance (NCQA) is responsible for recruiting, training, certifying, and providing quality oversight to survey vendors who collect data for this survey. CAHPS measurements include Getting Appointments & Care Quickly, Getting Needed Care without Delay, Customer Service, Coordination of Care, Getting Needed Rx Drugs, Flu Vaccine, & Overall Rating of Health Care Quality, Health Plan, Drug Plan, etc. Why it is important for members to take the survey? The purpose of this survey is to learn more from a member s perspective about the care they have received and use these data to provide information about the quality of healthcare services to Medicare members. Important aspects of the member s experience with healthcare and prescription drug plan services are collected through this survey. The data from the survey compares consumer experiences of health care and prescription drug plan services. By participating in this survey, the member helps Medicare to improve its health-care services. Who is eligible to receive the survey? Members who have been continuously enrolled in their Medicare Advantage Organization (MAO example, is a MAO) for a six-month period are eligible. When will selected members receive survey and how they may receive it? Consumer Assessment of Health Plans Survey (CAHPS ) surveys is conducted during the early spring of each year. Members are selected at random. For 2015, pre-notification letters were mailed to selected members on March 4. The surveys & cover letters were mailed to selected members March 11 through March 15. Surveys must be received at the return address or completed via phone no later than June 5. What is the deadline for completing the survey? The deadline for returning the surveys by mail and completing the survey by phone is Friday, June 5, However, it is best if members can complete and return the surveys within two weeks of receiving. What can I say or not say about survey? is allowed to notify members that they may be asked to participate in CAHPS Survey. However, certain types of communication (either oral, written, or in the survey materials, e.g., cover letters and telephone scripts) are not permitted, because they may introduce bias in the survey results. It is very important that survey vendors conducting the MA & PDP CAHPS Survey and plans participating in the survey initiative (), must NOT attempt to influence or encourage members to
2 At Home-Star Member Talking Points answer survey questions in a particular way. For instance, survey vendors, contracts, or their agents are not allowed to: Attempt to influence or encourage members to answer survey questions in a particular way Imply that the plan, its personnel, or agents will be rewarded or gain benefits for positive feedback from members by asking the member to choose certain responses or indicate that the plan is hoping for a given response Offer incentives of any kind for participation in the survey Show or provide the MA & PDP CAHPS Survey or cover letters to members prior to the administration of the survey Indicate that the health or drug plan s goal is for all members to rate them a 10, Definitely yes, or Always Click on the links from CMS for examples of surveys and the letters being sent to members. Please note that these documents are for your viewing only, and should NOT be shown to members due to the regulations set forth by CMS. - CAHPS: - HOS: HOS Survey Details What are the surveys? The Health Outcomes Survey (HOS) is the first patient-reported outcomes measure used in Medicare managed care. The goal of the HOS program is to determine how well each health plan is able to maintain or improve the health and wellbeing of its members over time. The Medicare HOS program gathers valid and reliable clinically meaningful data that have many uses, such as targeting quality improvement activities and resources; monitoring health plan performance and rewarding top-performing health plans; helping beneficiaries make informed health care choices; and advancing the science of functional health outcomes measurement. Managed care plans with Medicare Advantage (MA) contracts must participate. Each spring, a random sample of Medicare members is surveyed from each Medicare Advantage Organization (MAO) that has a minimum of 500 enrollees. Members are asked questions about improving and maintaining mental and physical health. Surveys are administered to a different baseline cohort each year. Two years later, the baseline respondents are surveyed again for the follow-up measurements. HOS is administered by DSS Research on behalf of. Members can complete the survey by completing the paper survey that is mailed or by phone interview. Why it is important for members to take the survey? HOS results are a very important part of CMS quality improvement activities. The survey ensures that medical care paid for under the Medicare program meets professionally recognized standards of health care and assesses the quality of health plans. By participating, the member helps Medicare improve its health care services, as well as the quality of health plans. Who is eligible to receive the survey? For surveys taken between , members were required to be continuously enrolled in their MAO for a six-month period for inclusion in the baseline sample; however, that requirement is waived for surveys with data collection in 2009 or after. Prior to 2009, members with End Stage Renal Disease (ESRD) were excluded as well. When will selected members receive survey and how they may receive it? There is standard protocol for each annual round of HOS data collection, data management, and reporting results. Medicare HOS baseline is completed between April and June each year. The follow up is completed in May-July of each year.
3 At Home-Star Member Talking Points What can I say or not say about survey? See following attachments from CMS for examples of surveys and the letters being sent to members. Please note that these documents are for your viewing only, and should NOT be shown to members due to the regulations set forth by CMS. Refer to previous section under CAHPS for more detailed CMS guidelines. Additional Member General Questions and Answers When members have more detailed questions put them in contact with the survey vendor, DSS. They are experts on this topic. Phone numbers to DSS are listed at end of this document. Possible Member General Question Concerns about privacy. Who will see my answers? What happens to my answers? Will I get junk mail if I answer? Answer The information you provide is protected by the Privacy Act and will not be shared with anyone other than by authorized persons at the Center for Medicare & Medicaid Services (CMS) and DSS Research. Your answers are kept confidential and will only be seen by authorized persons at the Center for Medicare & Medicaid Services (CMS) and DSS Research. No, you will not get any junk mail. Your name and address will be kept absolutely confidential. Who is DSS Research? Will my answers affect my benefits? Where do I put my name and address on the survey? I just completed a survey a few months ago. Why am I getting this again? I have misplaced my survey; can you please send me another one? I received a postcard reminding me to take a survey, but I did not receive the survey. Can you please send me another one? Can I take the survey online instead of the one I received in the mail? DSS Research is a CMS certified vendor that is conducting the CAHPS & HOS Surveys on behalf of. DSS can assist you with completing the survey and/or answering any questions you may have. No. Your answers will not affect your benefits in any way. You should not write your name and address on the survey. Each survey has been assigned an identification number that allows us to keep track of which respondents have returned a completed survey. However, the last page of the survey may contain a few optional questions to assist us with contacting you two years from now. You may have received a Medicare Satisfaction Survey. This is a different Medicare survey that asks about health outcomes. DSS Research can send you another survey or you can complete the survey by phone with DSS. (See below for phone numbers.)
4 At Home-Star Member Talking Points I need a copy of the survey in a different language. What languages are available, and how do I get a copy in my language? What if I need a language other than English, Spanish, or Chinese? I do not have a health plan. Member is unable to complete the survey (in a nursing home, dementia, very frail, etc.) I am concerned that if I answer questions on behalf of that I am violating HIPAA. I have been advised not to give out my personal information over the phone. I am on the DO Not Call List. Is DSS Research supposed to be calling me? What if I do not want to answer some of the questions? The Medicare Health Outcomes Survey is also available in English, Spanish, & Chinese. A copy of the Medicare Health Outcomes Survey can be requested by contacting DSS Research at the phone numbers listed below in this document. If a member is requesting the survey in a language other than English, Spanish, or Chinese: At this time, the Medicare Health Outcomes Survey is not currently translated into [insert language]. If you have difficulty reading English, you can either complete the survey by phone or have someone who knows about your health, such as a family member, relative, friend, or professional caregiver complete the survey for you as a proxy. [If the member states he/she has Medicare, then ask him/her to complete the questions based on his/her Medicare enrollment. Members may have someone who knows about your health, such as a family member, relative, friend, or professional caregiver complete the survey for you as a proxy. HIPAA permits covered entities to disclose protected health information or PHI for the purpose treatment, payment, or health care operations. Because CMS will use information collected by the HOS for health-care operations to monitor health plan performance, the disclosure of this information to CMS is permitted. I understand your concern but hope you will consider participating. This is a very important survey that is sponsored by CMS. Your participation will help CMS monitor and improve the quality of care provided under the Medicare program. To verify the legitimacy and/or to find out more about this survey you can call Medicare at MEDICARE ( ). The Do Not Call List prohibits sales and telemarketing calls. DSS Research is calling on behalf of your health plan. DSS will not try to sell you anything or ask for any money. I can understand your concern, but this is a very important survey. You can skip any question you do not want to answer and move on to the next question.
5 At Home-Star Member Talking Points I have not been to the doctor. I have not used my plan yet. My is deceased. What should I do with the questionnaire? Even if you have not been to the doctor and/or used the plan, it is still important to answer the questions. You may skip the questions that do not apply to you. I m very sorry to hear that. Please discard the questionnaire. If you let DSS Research know, they can make sure that we don t contact you again. (See below for phone number) Additional Member CAHPS Questions and Answers Possible Member CAHPS Question I do not have a lot of time, how long will it take me to complete the survey? I am very busy. I do not have time. Answer We know your time is limited and very important. The average time needed to complete the survey is about minutes depending on the type of plan you have (MA, PDP, etc.) You can complete the survey at a time that is convenient for you. If you wish to complete the survey by phone, you can even do so in the evening or on a weekend if you prefer. Additional Member HOS Questions and Answers Because the HOS survey follows a group of members for two years there are other questions members in year two of survey may have. In addition, the survey time-frames are different compared to CAHPS. Possible Member HOS Question I do not remember participating before. I already completed the survey two years ago. Why do I have to do it again? My health has not changed. Why do I have to take the survey again? Will I have to take this survey every two years? I do not have a lot of time, how long will it take me to complete the survey? I am very busy. I do not have time. Answer We asked you some general questions about our health and well-being. Because the survey was fairly short, and it was two years ago, many people do not remember participating. When you start answering questions, you may find that you remember some of the questions as the questions are the same. The survey is designed to measure the health and wellbeing of Medicare beneficiaries over time. By comparing the answers you give now with the answers you gave two years ago, we can determine whether your health plan is keeping its members as healthy as possible. No, because this survey is done only twice with each respondent; however, it is possible that you will be selected for a new survey in the future. The paper survey takes about 15 minutes to complete, and the phone interview takes about 20 minutes to complete.
6 At Home-Star Member Talking Points Members with questions should contact DSS Research, if they have additional concerns and would like to contact CMS or NCQA, a representative from DSS can provide them with appropriate phone number. CAHPS & HOS Phone Numbers DSS Research Contact Line DSS Research Phone Number: English DSS Research Phone Number: Spanish Medicare CAHPS (English) Medicare HOS ext ext Commercial and Medicaid , ext (English) , ext CAHPS QHP (877) , ext (877) , ext. 8024
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
More informationPATH Program. Getting Started Guide
PATH Program Getting Started Guide We have a BIG opportunity. Together, we can empower and encourage people to take an active role in their health. Preventive health care services help people find and
More informationQuality Assurance Guidelines Version 2
CAHPS for Physician Quality Reporting System (PQRS) Survey Quality Assurance Guidelines Version 2 July 2016 CAHPS for Physician Quality Reporting System (PQRS) Survey Quality Assurance Guidelines Version
More informationMedicare Advantage Star Ratings
Medicare Advantage Star Ratings December 2017 The Star Rating System measures how well Medicare Advantage (MA) and its prescription drug plans perform for consumers. As an integrated health system, Presbyterian
More informationQuality Assurance Guidelines Version 1.0
CAHPS for Physician Quality Reporting System (PQRS) Survey Quality Assurance Guidelines Version 1.0 July 2015 CAHPS for Physician Quality Reporting System (PQRS) Survey Quality Assurance Guidelines Version
More informationThe Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
More informationPharmacy Quality Measures. Presentation Developed for the Academy of Managed Care Pharmacy Updated: February 2013
Pharmacy Quality Measures Presentation Developed for the Academy of Managed Care Pharmacy Updated: February 2013 Objectives Explain the purpose of quality measures and how they are developed Identify quality
More informationFriday Health Plans of Colorado
QUALITY OVERVIEW Health Plans of Colorado (formerly Colorado Choice Health Plans) Serving Colorado for over 4 years, Health Plans utilizes a community-focused model. We work hand in hand with local providers
More informationFALLON TOTAL CARE. Enrollee Information
Enrollee Information FALLON TOTAL CARE- Current Edition 12/2012 2 The following section provides an overview on FTC enrollee rights and responsibilities, appeals and grievances and resources available
More informationPassport Advantage Provider Manual Section 8.0 Quality Improvement
Passport Advantage Provider Manual Section 8.0 Quality Improvement Table of Contents 8.1 Quality Improvement Program 8.2 Clinical Practice Guidelines 8.3 Star s 8.4 Quality of Care Concerns 8.3 Practitioner
More informationQUALITY IMPROVEMENT. Molina Healthcare has defined the following goals for the QI Program:
QUALITY IMPROVEMENT Molina Healthcare maintains an active Quality Improvement (QI) Program. The QI program provides structure and key processes to carry out our ongoing commitment to improvement of care
More informationOklahoma Health Care Authority. ECHO Adult Behavioral Health Survey For SoonerCare Choice
Oklahoma Health Care Authority ECHO Adult Behavioral Health Survey For SoonerCare Choice Executive Summary and Technical Specifications Report for Report Submitted June 2009 Submitted by: APS Healthcare
More informationKaiser Permanente QUALITY OVERVIEW OVERALL RATING : 3.4 COMPANY AT A GLANCE. Company Statistics. Accreditation Exchange Product
QUALITY OVERVIEW Permanente As the state s largest nonprofit health plan, Permanente is committed to improving the health of our members and our state as a whole. Permanente is made up of: Foundation Hospitals
More informationNotice of Privacy Practices for Protected Health Information (PHI)
Notice of Privacy Practices for Protected Health Information (PHI) Dermatology Associates of Colorado, PC THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
More informationAn Introduction to the HIPAA Privacy Rule. Prepared for
An Introduction to the HIPAA Privacy Rule Prepared for January 2005 An Introduction to the HIPAA Privacy Rule Prepared for Covering Kids & Families National Program Office Southern Institute on Children
More informationMinimum Business Requirements To Administer the CAHPS Hospice Survey
A survey vendor must meet ALL of the Minimum Business Requirements at the time the CAHPS 1 Hospice Survey Participation Form is received. In addition, subcontractors performing major CAHPS Hospice Survey
More informationCancer Hospital Workgroup
Cancer Hospital Workgroup William G. Lehrman, PhD Centers for Medicare & Medicaid Services (CMS) August 28, 2014 2:00 3:00 PM ET Agenda Roll Call PCHQR Program Updates HCAHPS Updates 2 PPS-Exempt Cancer
More informationCancer Hospital Workgroup. Agenda. PPS-Exempt Cancer Hospital Quality Reporting Program. Roll Call PCHQR Program Updates HCAHPS Updates
Cancer Hospital Workgroup William G. Lehrman, PhD Centers for Medicare & Medicaid Services (CMS) August 28, 2014 2:00 3:00 PM ET Agenda Roll Call PCHQR Program Updates HCAHPS Updates 2 PPS-Exempt Cancer
More informationQuality Management Report 2018 Q1
Quality Management Report 2018 Q1 Care Wisconsin Participates in Many Quality Initiatives Across the State and Federal Levels These activities include: Centers for Medicare & Medicaid Services (CMS) Department
More informationSTANDARD ADMINISTRATIVE PROCEDURE
STANDARD ADMINISTRATIVE PROCEDURE 16.99.99.M0.21 Patient Request to Amend Personal Health Information Approved October 27, 2014 Next scheduled review: October 27, 2019 SAP Statement This procedure applies
More informationGreenwood Connections Notice of Privacy Practice
Note: This notice describes how healthcare information about you may be used and disclosed and how you can get access to this information. Please read it carefully. This Notice is effective April 1, 2003
More informationMedicare: 2017 Model of Care Training 4/13/2017
Medicare: 2017 Model of Care Training Training Objectives This course will describe how MHS Health Wisconsin Medicare Advantage and its contracted providers work together to successfully deliver the Model
More informationSpecial Needs Plan Model of Care Chinese Community Health Plan
Special Needs Plan Model of Care 2017 2017 Chinese Community Health Plan Elements of CCHP SNP Model of Care Special Needs Plan (SNP) Goals CCHP Dual Eligible SNP Enrollment & Eligibility Vulnerable Beneficiaries
More informationIntroduction to the Home Health Care CAHPS Survey Webinar Training Session. Session I. January 2018
Introduction to the Home Health Care CAHPS Survey Webinar Training Session Session I January 2018 Session I 2 Introduction to the Home Health Care CAHPS Survey Welcome This training session will cover
More informationJuly 21, General Conditions and Instructions to Offerors for. Consumer Assessment of Health Providers and Systems ( CAHPS ) Surveys
July 21, 2017 Notice of Request for Proposals General Conditions and Instructions to Offerors for Consumer Assessment of Health Providers and Systems ( CAHPS ) Surveys Alameda Alliance for Health 1240
More informationINFORMED CONSENT DOCUMENT. Project Title: The Contraceptive Choice Center: an innovative health services delivery and payment model
INFORMED CONSENT DOCUMENT Project Title: The Contraceptive Choice Center: an innovative health services delivery and payment model Principal Investigator: Research Team Contact: Tessa Madden Linda Buchanan
More informationCAPITAL SURGEONS GROUP, PLLC
CAPITAL SURGEONS GROUP, PLLC NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
More informationPayment: We are permitted to use and disclose your health information to receive payment for our services. For example, we may:
Your Rx Pharmacy Notice of our privacy practices THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
More informationHumana Physician Quality Rewards Program 2014
Humana Physician Quality Rewards Program 2014 Medicare Glen Champlin MSO Director March 28, 2014 1430ALL0114-B What is CMS Stars and Why Should Providers Be Concerned? CMS Program of Quality & Performance
More informationAssessing the Quality of California Dual Eligible Demonstration Health Plans
M A Y 2 0 1 2 Assessing the Quality of California Dual Eligible Demonstration Health Plans T A B L E O F C O N T E N T S Overview... 1 Introduction... 2 Table 1: Plan Rating Overview... Summary of Quality
More informationWelcome to LifeWorks NW.
Welcome to LifeWorks NW. Everyone needs help at times, and we are glad to be here to provide support for you. We would like your time with us to be the best possible. Asking for help with an addiction
More informationColorado Choice Health Plans
Quality Overview Health Plans Accreditation Exchange Product Accrediting Organization: Accreditation Status: URAC Health Plan Accreditation (Marketplace ) Full Full: Organization demonstrates full compliance
More informationQuality Management Report 2017 Q4
Quality Management Report 2017 Q4 Care Wisconsin Participates in Many Quality Initiatives Across the State and Federal Levels. These activities include: CMS DHS DHS & CMS HEDIS Member Satisfaction (CAHPS
More informationImportant RMHP Pharmacy Change for 2016
Fall 2015 Provider Edition Important RMHP Pharmacy Change for 2016 In an effort to control increasing medication costs, RMHP will begin using MedImpact s High Performance pharmacy network beginning January
More informationCompliance Program And Code of Conduct. United Regional Health Care System
Compliance Program And Code of Conduct United Regional Health Care System TABLE OF CONTENTS Page MESSAGE FROM OUR PRESIDENT... 1 COMPLIANCE PROGRAM... 2 Program Structure...2 Management s Responsibilities
More informationNEW BRIGHTON CARE CENTER
NEW BRIGHTON CARE CENTER 805 6 th Ave NW, New Brighton, MN 55112 NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS
More informationQUALITY IMPROVEMENT PROGRAM
QUALITY IMPROVEMENT PROGRAM QI PROGRAM PURPOSE The Physicians Plus Quality Improvement Program is member-centric. It is designed to deliver safe and effective medical and behavioral healthcare, at the
More informationSeptember 3, Dear Provider:
September 3, 2014 Dear Provider: As a contractor with Centers for Medicare & Medicaid Services (CMS), Arkansas Blue Cross and Blue Shield are required by the regulations to develop and maintain a compliance
More informationPATIENT GRIEVANCE & COMPLAINT GUIDELINES
ESRD NETWORK 18 PATIENT GRIEVANCE & COMPLAINT GUIDELINES This material was prepared by The Southern California Renal Disease Council, Inc. under contract #HHSM-500-2006-NW018C with the Centers for Medicare
More informationMedicare: 2018 Model of Care Training
Medicare: 2018 Model of Care Training Training Objectives This course will describe how Centene and its contracted providers work together to successfully deliver the duals Model of Care (MOC) program.
More informationGuide to Accessing Quality Health Care Spring 2017
Guide to Accessing Quality Health Care Spring 2017 MolinaHealthcare.com 5771749DM0217 MyMolina MyMolina is a secure web portal that lets you manage your own health from your computer. MyMolina.com is easy
More informationMyHealth. results with your doctor. Talk High. to him or her about how often 3. Eat foods low in saturated 140/90 or higher
2016 MyHealth Quarter 3 Anthem Blue Cross Cal MediConnect Plan What is blood pressure? Blood pressure is the amount of force it takes for your heart to push blood through your body. When your blood pressure
More informationNote: Accredited is the highest rating an exchange product can have for 2015.
Quality Overview Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product can have for 215.
More informationLutheran Brethren Homes, Inc. NOTICE OF PRIVACY PRACTICES
Lutheran Brethren Homes, Inc. [dba LB Homes] and Affiliates: Lutheran Brethren Retirement Services, Inc. [dba LB Alcott Manor / dba Lutheran Brethren Home Care / dba LB Broen Home / dba LB Short Stay];
More informationOklahoma Surgicare NOTICE OF PRIVACY PRACTICES. Effective Date: 02/17/2010
Oklahoma Surgicare NOTICE OF PRIVACY PRACTICES Effective Date: 02/17/2010 THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
More informationMCS Model of Care For Special Needs Plans (SNP) Annual training for delegated entities and facilities
2018 MCS Model of Care For Special Needs Plans (SNP) Annual training for delegated entities and facilities Quality Department CAN_2790318S CMS Requirements The Centers of Medicare & Medicaid Services (CMS)
More informationHIPAA in DPH. HIPAA in the Division of Public Health. February 19, February 19, 2003 Division of Public Health 1
HIPAA in the Division of Public Health February 19, 2003 February 19, 2003 Division of Public Health 1 Handouts HIPAA Definitions AG Advisory Opinion - Definition of Health Plan DPH Coverage Determination
More informationNOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. WHY ARE YOU GETTING
More informationNotice of HIPAA Privacy Practices Updates
Notice of HIPAA Privacy Practices Updates The following is a summary of the updates to the privacy notice for Meridian Hospitals Corporation, Meridian Home Care Services, Inc., Meridian Nursing & Rehabilitation,
More informationPrivacy Rio Grande Valley HIE Policy: P1. Last date Revised/Updated 02/18/2016
Privacy Rio Grande Valley HIE Policy: P1 Effective Date 01/15/2014 Last date Revised/Updated 02/18/2016 Date Board Approved: 02/18/2016 Subject: Authorization to Use and/or Disclose Protected Health Information
More information08/06/2015. Special Needs Plans. SNP Legislative History Highlights
National Training Program RO V & RO VII St. Louis, August 10-11, 2015 Special Needs Plans Medicare SNPs are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people
More informationWelcome to Health Net
Welcome to Health Net When it comes to Medicare coverage, the right choice depends on your health, your budget and your lifestyle. Health Net makes choosing quality, cost-effective health care coverage
More informationPatient Registration Form Pediatrics
Patient Registration Form Pediatrics For Office Use Only: Visit Date: Initials: PATIENT INFORMATION Preferred Language: English Spanish Other: Patient s Last Name First Middle Initial Date of Birth Sex
More informationCompliance Program Updated August 2017
Compliance Program Updated August 2017 Table of Contents Section I. Purpose of the Compliance Program... 3 Section II. Elements of an Effective Compliance Program... 4 A. Written Policies and Procedures...
More informationNotice of Privacy Practices
River Valley Chiropractic LLC Notice of Privacy Practices Effective 9/2014; Revised 9/2014 If you have any questions about this notice, please contact the River Valley Chiropractic Privacy Officer at 308-534-5840.
More informationWhat is HIPAA? Purpose. Health Insurance Portability and Accountability Act of 1996
Patient Privacy and HIPAA/HITECH What is HIPAA? Health Insurance Portability and Accountability Act of 1996 Implemented in 2003 Title II Administrative Simplification It s a federal law HIPAA is mandatory,
More informationYALE UNIVERSITY THE RESEARCHERS GUIDE TO HIPAA. Health Insurance Portability and Accountability Act of 1996
YALE UNIVERSITY THE RESEARCHERS GUIDE TO HIPAA Health Insurance Portability and Accountability Act of 1996 Handbook Table of Contents I. Introduction What is HIPAA? What is PHI? What is a Covered Entity
More informationphysicians, nurses, and technicians and other Facility personnel for review and learning purposes. We may also combine the medical information we
WESTMINSTER CANTERBURY - RICHMOND NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
More informationTHE MONTEFIORE ACO CODE OF CONDUCT
THE MONTEFIORE ACO CODE OF CONDUCT 2017 Approved by the Board of Directors on March 10, 2017 Our Commitment to Compliance As a central part of its Compliance Program, the Bronx Accountable Healthcare Network
More informationHIPAA 201: Student Self-Learning Module & Test
HIPAA 201: Student Self-Learning Module & Test Information: This self-learning module meets the HIPAA 201 competency for Students. This requirement must be met once (it is not an annual requirement). Instructions:
More informationINFORMED CONSENT FOR TREATMENT
INFORMED CONSENT FOR TREATMENT I (name of patient), agree and consent to participate in behavioral health care services offered and provided at/by Children s Respite Care Center, a behavioral health care
More informationREVISED NOTICE OF PRIVACY PRACTICES ORIGINAL DATE: JANUARY 1, 2003 REVISED: JANUARY 16, 2014 REVISED: NOVEMBER 27, 2017 PLEASE REVIEW IT CAREFULLY
REVISED NOTICE OF PRIVACY PRACTICES ORIGINAL DATE: JANUARY 1, 2003 REVISED: JANUARY 16, 2014 REVISED: NOVEMBER 27, 2017 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED
More informationNational Policy Library Document
Page 1 of 5 National Policy Library Document Policy Name: Medicare Compliance: Compliance Officer and Compliance Committee Policy No.: HR328-133757 Policy Author: Author Title: Author Department: Sheryl
More informationCHRONIC CARE MANAGEMENT TOOL KIT What Practices Need to Do to Implement and Bill CCM Codes
CHRONIC CARE MANAGEMENT TOOL KIT What Practices Need to Do to Implement and Bill CCM Codes Understanding CCM Chronic Care Management (CCM) is defined as the non-face-to-face services provided to Medicare
More informationObjectives. By the end of this educational encounter, the clinician will be able to:
Resident s Rights WWW.RN.ORG Reviewed May, 2016, Expires May, 2018 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2016 RN.ORG, S.A., RN.ORG, LLC By Melissa
More informationNotice of. Privacy Practices. Dartmouth-Hitchcock Affiliated Covered Entity
Notice of Privacy Practices Dartmouth-Hitchcock Affiliated Covered Entity This Notice describes how medical information about you may be used and disclosed and how you can get access to this information.
More informationSUBJECT: PATIENT RIGHTS AND RESPONSIBILITIES REFERENCE # PAGE: 1 DEPARTMENT: AMBULATORY SURGERY OF: 5 EFFECTIVE:
PAGE: 1 PURPOSE: To ensure all Center for Pain Management staff and contract staff shall observe these patients rights. POLICY: The Center for Pain Management has adopted the Statement of Patient Rights,
More informationNOTICE OF PRIVACY PRACTICES Occupations, Inc. 15 Fortune Road West Middletown, NY 10941
NOTICE OF PRIVACY PRACTICES Occupations, Inc. 15 Fortune Road West Middletown, NY 10941 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
More informationDelegation Oversight 2016 Audit Tool Credentialing and Recredentialing
Att CRE - 216 Delegation Oversight 216 Audit Tool Review Date: A B C D E F 1 2 C3 R3 4 5 N/A N/A 6 7 8 9 N/A N/A AUDIT RESULTS CREDENTIALING ASSESSMENT ELEMENT COMPLIANCE SCORE CARD Medi-Cal Elements Medi-Cal
More informationA Guide to Accessing Quality Health Care
A Guide to Accessing Quality Health Care Spring 2015 MolinaHealthcare.com 37894DM0115 Molina Healthcare s Quality Improvement Plan and Program Your health care is important to us. We want to hear how we
More informationNational Policy Library Document
Page 1 of 11 National Policy Library Document Policy Name: Medicare Compliance: Compliance Officer and Compliance Committee Policy No.: HR328-133757 Policy Author: Author Title: Author Department: Sheryl
More informationNational Policy Library Document
Page 1 of 11 National Policy Library Document Policy Name: Medicare Programs: Compliance Element VII Prompt Response to Detected Offenses Policy No.: EJ44-83932 Policy Author: Author Title: Author Department:
More informationHospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) MBQIP Educational Session One Phase Two, January 2013
Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) MBQIP Educational Session One Phase Two, January 2013 Overview HCAHPS (Hospital Consumer Assessment of Healthcare Providers and
More informationCATARACT AND LASER CENTER, LLC
CATARACT AND LASER CENTER, LLC Patient Information Date: Patient Name: M F Address: Street City State Zip Home Phone: Work Phone: Cell Phone: E-Mail : Referred by: Medical Doctor: Who is your regular eye
More information2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP), Chronic Special Needs Plan ESRD (CSNP ESRD) & Model of Care (MOC) Overview
2018 Medicare Advantage Dual Eligible Special Needs Plan (DSNP), Chronic Special Needs Plan ESRD (CSNP ESRD) & Model of Care (MOC) Overview Medicare Advantage (MA) Program Part C Medicare Advantage Medicare
More informationQuality Standards and Practice Principles for Senior Care Pharmacists
Quality Standards and for Senior Care Pharmacists Preamble The purpose of this document is to complement the current practice and professional standards of the American Society of Consultant Pharmacists
More informationLong-Term Services and Supports Study Committee: Person-Centered Medicaid Managed Care
Long-Term Services and Supports Study Committee: Person-Centered Medicaid Managed Care Barbara R. Sears, Director Ohio Department of Medicaid July 12, 2018 1 Health Care System Choices Fee-for-Service
More informationHCAHPS Quality Assurance Guidelines V6.0 Summary of Updates and Emphasis
This document is a reference tool that highlights the major changes from the HCAHPS Quality Assurance Guidelines V5.0 to V6.0. This document is not a substitute for reviewing the HCAHPS Quality Assurance
More informationSANTA RITA CARE CENTER Notice of Information Practices
SANTA RITA CARE CENTER Notice of Information Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
More informationAnthem BlueCross and BlueShield
Quality Overview BlueCross and BlueShield Accreditation Exchange Product Accrediting Organization: Accreditation Status: NCQA Health Plan Accreditation (Commercial HMO) Accredited Accreditation Commercial
More informationHEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT INSTRUCTIONS Read through this presentation. Submit completed post test to the Portage County MRC Coordinator. Estimated completion time: 1 hour Learning
More informationNOTICE OF PRIVACY PRACTICES
Effective 10-9-2013 This notice of privacy practices describes how Family Chiropractic Health Care manages and protects your personal information. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
More informationThe HIPAA privacy rule and long-term care : a quick guide for researchers
Scripps Gerontology Center Scripps Gerontology Center Publications Miami University Year 2005 The HIPAA privacy rule and long-term care : a quick guide for researchers Jane Straker Patricia Faust Miami
More informationNewsBrief. Network. MyQuest Offers Online Lab Results. Best Practices for Doctor-Patient Experience. Role of PCPs in AOD Dependence
Network NewsBrief A publication for AvMed Providers and Staff Spring 2018 MyQuest Offers Online Lab Results Best Practices for Doctor-Patient Experience Role of PCPs in AOD Dependence TABLE OF CONTENTS
More informationIt defines basic terms and lists basic principles that all LSUHSC-NO faculty, staff, residents and students must understand and follow.
Office of Compliance Programs Revised: July 18, 2017 HIPAA Privacy HIPAA Privacy Workforce Training The Health Insurance Portability & Accountability Act (HIPAA) requires that the University train all
More informationIRB 101. Rachel Langhofer Joan Rankin Shapiro Research Administration UA College of Medicine - Phoenix
IRB 101 Rachel Langhofer Joan Rankin Shapiro Research Administration UA College of Medicine - Phoenix Contents Brief discussion of regulations IRB Structure Levels of Approval Informed Consent HIPAA/HITECH
More informationComplete Senior Care Enrollment Agreement
Complete Senior Care Enrollment Agreement I have received the Enrollment Handbook and a copy of the Provider Network and have had the opportunity to ask questions. Name: Address: (First) (Middle) (Last)
More informationHealthy Kids Connecticut. Insuring All The Children
Healthy Kids Connecticut Insuring All The Children Goals & Objectives Provide affordable and accessible health care to the 71,000 uninsured children Eliminate waste in the system Develop better ways to
More informationQUALITY IMPROVEMENT PROGRAM
QUALITY IMPROVEMENT PROGRAM EmblemHealth s mission is to create healthier futures for our customers and communities. We will do this by providing members with a broad range of benefits and conscientious
More informationUnderstand the current status of OAS CAHPS related to
August 25, 2017 Kathy Wilson, RN, MHA, LHRM Vice President, Quality AmSurg Objectives Understand the current status of OAS CAHPS related to the ASC Quality Reporting Program Describe the potential benefits
More informationI want to participate in the CMTM pharmacy network. How do I get started?
Pharmacy FAQ for CMTM 07-18-06 What is Community MTM (CMTM)? Community MTM is a Web-based communications service that allows pharmacists to conduct, document, and bill for a variety of sponsors patient
More informationNOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES This notice describes how Pine Creek Medical Center may use and disclose your medical information, and how you may access this information. Please read through and review it
More informationHealth Choice Compliance Program Subcontractor Reporting Guide
Health Choice Compliance Program Subcontractor Reporting Guide Last Revised: June 2017 1 Reporting Guide Table of Contents 1. Purpose of this Guide (page 3) 2. Reportable Compliance Events (page 4) 3.
More informationFairfax Surgical Center. Statement of Patient Rights and Responsibility
Fairfax Surgical Center Statement of Patient Rights and Responsibility PATIENT RIGHTS The Fairfax Surgical Center (ASC) respects the dignity and pride of each individual we serve. Every patient has the
More informationHIPAA PRIVACY TRAINING
HIPAA PRIVACY TRAINING HIPAA Privacy Training Objective Present a general overview of HIPAA and define important terms Understand the purpose of HIPAA and the Privacy Rule Understand the term Protected
More information2017 Blue Cross Medicare Advantage (PPO) SM Provider Manual
2017 Blue Cross Medicare Advantage (PPO) SM Provider Manual A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
More informationAnthem BlueCross and BlueShield HMO
Quality Overview BlueCross and BlueShield Accreditation Exchange Product Accrediting Organization: NCQA (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product
More informationIf you have any questions about this notice, please contact the SSHS Privacy Officer at:
Notice of Privacy Practices 0 Effective Date: April 14, 2003 Revision Date: July 15, 2016 South Shore Health System ( SSHS ) is an integrated health care delivery system. For a list of entities which comprise
More informationNotice of Privacy Practices
Notice of Privacy Practices, pg. 1 of 5 Notice of Privacy Practices CATHOLIC CHARITIES OF THE ROMAN CATHOLIC DIOCESE OF SYRACUSE, NY This notice describes the privacy practices of Catholic Charities of
More informationWELCOME. Payment will be expected at the time of service. Please remember our 24 hour cancellation notice.
WELCOME Those of us at Crossroads Counseling want to thank you for choosing to work with us and we want to make your time with us as productive as possible. In order to expedite the intake process, please
More information