Care coordination resources
Medica AccessAbility Solution® (SNBC)
- 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)
- 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)
- 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-ER Visit Dental letter (DOC)
- Post-Visit letter (DOC)
- Welcome Letter (DOC)
- PCP Letter (DOC) (Updated 10.2022)
Assessment and Care Plan
- Assessment Checklist (DOC)
- Care Plan - Version 3 (DOC)
- Care Plan Instructions (PDF)
- Medica Care Coordinator Leave-Behind Document (PDF)
- Medication List Form (DOC)
- Self-Report Health Risk Assessment (PDF)
- Transfer Member Health Risk Assessment (DOC)
- Member Signature Page (DOC)
- Unable to Reach Refusal Care Plan (PDF)
- Medication Safe Disposal Handout (PDF)
- Medication Safe Disposal Handout Instructions (PDF)
Referrals
Institutional
Miscellaneous
- Home Care At a Glance Grid (PDF)
- Bridging Client Checklist (PDF)
- Bridging Shopping Preference Form (PDF)
- Bridging Referral Form (DOC)
- 2023 Medica CC HRA Completion Report (XLS)
- Submit a Care Coordinator Concern
Health Improvement Programs
- Complex Case Management/Health Support Referral Form (PDF)
- Tobacco Cessation Program
- When and Where to Get Care (PDF)
- Tips for Good Oral Health Tip Sheet (PDF)
- SNBC Delta Dental Services (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 Health Agency List (XLS)