Care coordination resources
Medica DUAL Solution® (HMO D-DNP) (MSHO)
Letters, tools, and forms
- Air Conditioner PCP Support letter
- Care Coordinator Contact Info Update letter
- Care Plan Change letter
- Change of Care Coordinator letter
- Documents letter
- Eligibility Renewal Reminder letter
- Member Refusal letter
- On-going No Contact letter
- Post-Visit letter
- Post-Visit Institutional Letter
- Welcome Letter
- PCP Letter (Updated 10.2022)
- PCP Letter-Unable to Reach or Refusing
- Provider Signature Care Plan Cover Letter
- Provider Signature Care Plan Summary Letter
- Provider Signature Care Plan Sharing Requirements
- Provider Signature Requirements Frequently Asked Questions
Assessment and Support Plan
- Assessment Checklist
- Medica Leave-Behind Document (Revised 9/2023)
- Medica Transitional HRA Form
- Medica Transitional HRA Flow Chart
- Medica Transitional HRA Job Aid 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
Institutional
- Institutional Member Assessment
- Nursing Home Checklist for MSHO and MSC+
- Nursing Facility Chart Coverage Guide
Referrals
Miscellaneous
- Date of Death Report Template
- Home Care At a Glance Grid
- Bridging Client Checklist
- Bridging Shopping Preference Form
- Bridging Referral Form
- 2024 DHS MMIS Capitation Dates
- Submit a Care Coordinator Concern
- MBH Case Consultation form
- MSHO D-SNP Cancellation Form
- MSHO Disenrollment Form
- Referral form for MBH MSHO Case Management
- SBAR for Interdisciplinary Team Case Consult
Guidelines, policies, and manuals
- Advance Directive Planning
- Assessment Schedule
- Audit
- Behavioral Health Home Coordination
- Benefit Inquiry Exception Request
- Care Coordination Accountability
- Care Coordination Operations - CC Ratios
- Care Coordination Delegation Oversight
- Choice of Primary Care Provider
- Collaboration with Tribal Case Managers
- Conversion Rate Request Process
- 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
- Remote Assessment
- Transitional Member Responsibilities
- Transitions of Care
- Unable to Reach/Refusing Member
- 2024 Medica Additional Benefits
- Condition-based Health Education with CHW Solutions
- FOODRx with Second Harvest Heartland
- Healthy Savings Fresh Produce Program
- Memory Fitness Program
- One Pass Fitness Program
- Over-The-Counter (OTC) Allowance Program
- Reemo Smartwatch Programs
- Re-Admission Prevention
- Utility Assistance Allowance Program
- Web-Based Education Program Cell-ED