Routine/SCIS Assessment Encounter – Care Management Assessment of Services Prior to Initial Call: Review Care Management Assessment of Services Review UAS Comprehensive Assessment Report Review Fall Risk Assessment Review Electronic Persons Centered Service Plan (ePCSP) Routine/SCIS Encounter Call During Call: Review any comments on Care Management Assessment of Services left by FA with member ***** When done reviewing with member change status to “CM Review Complete” ***** Review ePCSP with member (Care Plan, Authorizations, Risks and any Recommendations) ***** When done reviewing with member change status to “CM Review Complete” ***** Review Medications List with member (Reconciliation) Create & Complete Fall Prevention Form Review Authorizations with member Create & Complete an Activity Log (Summary of education) Activity Type: Inbound or Outbound call Activity Detail: Care Management of Services Create & Complete Activity Log Activity Type: Inbound or Outbound call Activity Detail: MD Contact Create & Complete & Fax Health Maintenance Form Activity Type: Outbound Call Activity Detail: Care Plan Development/Update/Oversight (Covid-19 Education & Safety Plan Template provide) Routine Note Routine Note summary Example: CM contacted member at 347-777-1111 at 4:29pm to discuss Routine UAS-NY assessment, POC and FA recommendations for member to look into going to SDC due to member reporting wanting to meet new people. Mbr agreed to POC and continuation of services and at the moment does not want to go to SDC. CM re-educated member on covered vs. non-covered MLTC CPHL Services. Care plan Updated to reflect most recent UAS. Fall prevention program was conducted and reviewed with member. CM ensured member has contact numbers for CM & CPHL and re-educated member to contact CM in case of any changes in member’s condition and/or in case of ER visit, hospitalization and/or fall. Member verbalized understanding with all provided education. CM re-educated member on how to obtain services such as transportation, dental-Health Plex 1-800-468-9868, optometry-VSP 1-800-877-7195, and audiology-Hear USA 1-800-700-3277 as well as phone numbers for further assistance. CM reached out to PCP Dr Mark George at 718-999-9999 and spoke with secretary Maria to obtain fax number to fax over Health Maintenance form. Maria provided CM with fax number of 718-456-7890. Remember a Routine/SCIS replaces the Monthly Encounter Assessment
