Care coordination resources

• Training Manual (PDF)
• Community Based Services Manual 
• Minnesota Health Care Programs Manual

• Advance Directive Planning (PDF)
• Assessment Schedule Policy (PDF)
• Audit (PDF)
• Behavioral Health Home Coordination (PDF)
• Benefit Inquiry Exception Request (PDF)
• Care Coordination Operations - CC Ratios (PDF)
• Care Coordination Delegation Oversight (PDF)
• Case Management Accountability (SNBC, SNBC Enhanced) (PDF)
• Choice of Primary Care Provider (PDF)
• Collaboration with Tribal Case Managers (PDF)
• Coordination with Certified Community Behavioral Health Clinics (PDF)
• Denial, Termination or Reduction (DTR) – (PDF)
• Evaluation of Care Coordinator's Performance (PDF)
• Home Care Policy (PDF)
• IDT Process for Delegates (PDF)
• Interdisciplinary Care Team (PDF)
• Most Vulnerable Beneficiaries Identification (PDF)
• Pre-Admission Screening Process for All Products (PDF)
• Provider and Vendor Concern Reporting
• Range of Choice (PDF)
• SNBC and Enhanced Members Turning 65 (PDF)
• Telephonic Assessment Policy (MSC+, SNBC, SNBC Enhanced) (PDF)
• Transfer Responsibilities (PDF)
• Transitions of Care (PDF)
• Unable to Reach/Refusing Member (PDF)

• 2023 Medica Additional Benefits (PDF)
• Bridging (PDF)
• Durable Medical Equipment (PDF)
• FOODRx with Second Harvest Heartland (MSHO, ISNBC Supplemental Benefit) (PDF)
• Gloves (PDF)
• Hospice (PDF)
• Housing Stabilization Services (PDF)
• Incontinence Products (PDF)
• Nutritional Products (PDF)
• One Pass Fitness Program (MSHO, ISNBC Supplemental Benefit) (PDF)
• Reemo^TM Smartwatch Programs (PDF)

• Notification of Care Transition Fax (DOC)
• Transition of Care Policy (PDF)
• Transition Log  (DOC)
• Transition Log Instructions (PDF)
• Transition of Care Hospital Readmission Prevention Resource Guide (PDF)

DTR

• DTR Form (PDF)
  • Form Directions (PDF)
• Frequently Asked Questions (PDF)
• Denial, Termination or Reduction Policy (DTR) (PDF)

Benefit Exceptions

• Benefit Exception Inquiry (BEI) – (DOC)
  • Form Instructions (PDF)
• Benefit Inquiry Exception Request Policy (PDF)

• Care Coordinator Contact Info Update letter (DOC)
• Change of Care Coordinator letter (DOC)
• Documents letter (DOC)
• Due for Dental Visit letter (DOC)
• Eligibility Renewal Reminder letter (DOC)
• Member Refusal letter (DOC)
• On-going No Contact letter (DOC)
• Post-Visit letter (DOC)
• Welcome Letter (DOC)
• PCP Letter (DOC)
• PCP Letter-Unable to Reach or Refusing (DOC)
• Post-ER Visit dental letter (DOC)

Assessment and Care Plan

• Assessment Checklist (DOC)
• Care Plan - Version 3 (DOC)
• Care Plan Instructions (PDF)
• Medica Leave-Behind Document (Revised 9/2023) (PDF)
• Medication List Form (DOC)
• Medication Safe Disposal Handout (PDF)
• Medication Safe Disposal Handout Instructions (PDF)
• Member Engagement Questionnaire (PDF) 
• Transfer Member Health Risk Assessment (DOC)
• Unable to Contact/Refusal Care Plan (PDF)
• Member Signature Page (DOC)

Referrals

• Claims Referral Guidelines (PDF)
• Referral Request Form (DOC)

Institutional

• Nursing Home Checklist for SNBC and SNBC Enhanced (DOC)
• Nursing Facility Chart Coverage Guide (PDF)

Miscellaneous

• Home Care At a Glance Grid (PDF)
• Bridging Client Checklist (PDF)
• Bridging Shopping Preference Form (PDF)
• Bridging Referral Form (DOC)
• 2024 Medica CC HRA Completion Report (XLS)
  
• Submit a Care Coordinator Concern
•  I-SNBC Disenrollment Form
•  I-SNBC Cancellation Form 

Health Improvement Programs

• Complex Case Management/Health Support Referral Form (PDF)
• Tobacco Cessation Program
• SNBC Delta Dental Services (PDF)
• When and Where to Get Care (PDF)
• Tips for Good Oral Health Tip Sheet (PDF)

Contacts and Group Numbers

• Care Coordination Product Group Numbers for Special Needs Plans and MSC+ (PDF)
• Care Coordination Support Specialists Team Contact List (PDF)
• Contact Numbers for Key Staff in Medica Care Coordination Products (PDF)
• County, Care System and Agency Contact Numbers (PDF)
• Contracted PCA and Home Care Services (HCS) (XLS)