fbpx ua
Web-Site-InteriorPage-Graphics-provider-news

Tsis txhob nco qhov hloov tshiab. Sau npe kom tau txais xov xwm Alliance tus kws kho mob.

Tus Muab Kev Digest | Qhov teeb meem 11

Tus neeg muab kev pabcuam Icon

Phau Ntawv Qhia Tus Muab Kev Pab Tshiab Pib Pib Lub Ib Hlis Tim 1, 2023

Koj tuaj yeem nrhiav tau peb Phau Ntawv Qhia Kev Kho Mob tshiab thiab cov npe ntawm cov cai tshiab thiab so haujlwm ntawm peb lub vev xaib.

Kev hloov pauv rau Lub Ib Hlis 2023 Phau Ntawv Qhia Tus Muab Kev Pabcuam suav nrog ntxiv ntawm:

  • Txoj Cai 300-4180-Kev cob qhia thiab kev them nqi rau kev soj ntsuam cov kev tsis zoo thaum yau (Section 3. Lub luag haujlwm ntawm tus kws kho mob thawj zaug).
  • Txoj Cai 300-4035-Cov Neeg Ua Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Zej Zog (Section 6. Alliance Covered Benefits and Services).
  • Electronic Visit Verification Overview, cov ntaub ntawv hais txog cov txheej txheem suav nrog cov kev cai thiab tsis suav nrog (Tshooj 10. Cov lus thov).
  • Txoj Cai 300-4175-Txhim Kho Kev Tswj Xyuas Kev Tiv Thaiv Cov Ntaub Ntawv, thiab Txoj Cai 300-4185-Lub Zej Zog Txhawb Nqa Cov Ntaub Ntawv (Nqe 11. Kev Pabcuam Saib Xyuas Kev Kho Mob).

Yog tias koj muaj lus nug txog qhov hloov tshiab, thov hu rau Alliance Provider Services ntawm 831-430-5504.

Cov kev coj ua zoo tshaj plaws rau kev txhawb nqa CBI thiab kev ua tau zoo

Raws li kev txheeb xyuas thawj zaug ntawm Q2 Care-Based Incentive (CBI) cov ntaub ntawv, ntau tus kws kho mob poob qis dua 50th feem pua ntawm ib lossis ntau qhov kev ntsuas kev saib xyuas zoo. Yog tias kev ua haujlwm tsis zoo hauv cov kev ntsuas, cov kws kho mob muaj feem pheej hmoo tau txais kev hloov pauv nyiaj CBI (uas tuaj yeem yog kev them me me lossis tsis muaj CBI them rau xyoo 2022).

Hauv Q2, kev ntsuas nrog cov neeg muab kev pabcuam siab tshaj plaws hauv qab 50th feem pua suav nrog:

  1. Kev Ntsuas BMI: Cov Me Nyuam thiab Cov Hluas.
  2. Mob ntshav qab zib HbA1c Tsis Zoo Tswj> 9.0%.
  3. Cervical Cancer Screening (Pap and HPV screening and hysterectomies).

Nco tseg: Thaum kuaj mob qog noj ntshav mis thiab kev ntsuam xyuas kev nyuaj siab yog kev ntsuas kev saib xyuas zoo, lawv tsis suav nrog hauv kev them nyiaj hloov pauv.

Tsis tas li ntawd, ntau tus neeg muab kev pabcuam tau poob qis dua 50th feem pua rau kev ntsuas menyuam yaus.

Txhawm rau txhim kho kev ntsuas kev ua tau zoo, peb pab neeg txhim kho kev ua tau zoo pom zoo:

  • Kev tshuaj xyuas niaj hnub ntawm cov ntawv ceeb toom zoo txhua hli los ntsuas qhov tsis sib xws hauv kev saib xyuas.
  • Kev mob siab rau kev siv cov ntaub ntawv xa tawm (DST).
  • Yog tias tsim nyog, tsom rau kev teem sijhawm rau cov neeg mob rau kev pabcuam tiv thaiv ua ntej xyoo xaus.

Nkag mus rau cov ntaub ntawv nrog DST

Cov kev ntsuas uas feem ntau poob qis dua 50th Cov feem pua yuav yog vim cov ntaub ntawv tsis sib xws, uas tuaj yeem kho tau siv Cov Ntaub Ntawv Xa Khoom (DST).

DST muaj nyob rau hauv Alliance's Kws Kho Mob Lub Chaw Tswj Xyuas Tswvcuab Cov Ntaub Ntawv nyob rau hauv "Cov ntaub ntawv xa tawm."

Thov nco ntsoov tias koj siv DST xa cov ntaub ntawv los ntawm EHR thiab cov ntaub ntawv sau tseg. Cov ntaub ntawv xa los ntawm DST tuaj yeem pab koj lub tsev kho mob txhim kho kev ua raws li CBI thiab Healthcare Effectiveness Data and Information Set (HEDIS) ntsuas.

Teem caij cov me nyuam rau kev pab tiv thaiv

Tseem muaj sijhawm teem sijhawm teem sijhawm rau menyuam yaus thiab lwm yam kev pabcuam tiv thaiv ua ntej lub xyoo kaw. Txhawm rau kom koj lub tsev kho mob tsis poob qis dua 50th feem pua ntawm kev ntsuas menyuam yaus, nws yog ib qho tseem ceeb uas cov menyuam yaus txuas nrog koj qhov kev coj ua tau los rau hauv cov kev pabcuam uas xav tau hauv kev sib raug zoo nrog Bright Futures lub sijhawm teem caij nyoog.

Yog tias koj muaj lus nug txog kev rub cov npe cov tswv cuab tsis ua raws, thov hu rau koj Tus Neeg Muab Kev Sib Raug Zoo ntawm 800-700-3874, ext. 5504 ib.

Xov tooj cua hloov tshiab

Lub Alliance tau ceeb toom rau cov kws kho mob tias Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau hloov kho qee qhov Medi-Cal cov nyiaj them rov qab rau cov xov tooj cua (muaj txiaj ntsig Lub Ib Hlis 1, 2022).

Raws li Senate Bill 853 (Tshooj 717, Statutes of 2010), DHCS tau hloov kho Medi-Cal cov nqi them rov qab rau cov kev pabcuam hluav taws xob kom lawv tsis pub tshaj 80 feem pua ntawm cov nqi Medicare sib xws. Cov kev hloov kho hluav taws xob rov them nqi rov qab muaj nyob rau ntawm Nplooj ntawv Medi-Cal Rates.

Lub Alliance tau ua raws li cov lus hais saum toj no cov kev hloov pauv rau cov lus thov nrog cov hnub ua haujlwm rau lossis tom qab Lub Kaum Hli 1, 2022. Cov kev hloov pauv yuav raug ua ntxiv.

Tsis muaj qhov yuav tsum tau ua ntawm koj feem. Cov ntaub ntawv ntxiv txog cov kev hloov kho no tuaj yeem nrhiav tau ntawm Medi-Cal lub vev xaib.

Yog xav paub ntxiv, thov saib tshooj 5 ntawm lub Lub Yim Hli 2022 Medi-Cal Hloov Kho Cov Ntawv Tshaj Tawm.

Ua tsaug rau koj txoj kev koom tes!

Nyob twj ywm rau hnub tim ntawm ECM/CS kev cob qhia

Txhawm rau nkag mus rau cov kev cob qhia tshiab kawg ntawm Kev Tswj Xyuas Kev Kho Mob thiab Kev Txhawb Zej Zog (ECM/CS), mus saib peb Webinars thiab Training page thiab lim cov ntawv qhia zaub mov rau "ECM-Community Supports." Koj tseem tuaj yeem nkag mus rau cov lus teb rau cov lus nug ECM / CS ntawm peb tus muab kev pabcuam ECM/CS nplooj ntawv.

Kev cob qhia tshiab muaj: Smart Referrals (Monterey County)

Qhov kev cob qhia no yog rau Monterey County Alliance cov kws kho mob uas muab lossis tau txais kev xa mus rau Kev Tswj Xyuas Kev Kho Mob thiab Kev Txhawb Zej Zog (ECM/CS).

Nyuam qhuav pib lub hlis no, peb tau txais kev cob qhia txog Smart Referrals hauv kev koom tes nrog United Way Monterey County. Qhov kev cob qhia muab cov ntsiab lus ntawm Smart Referral Software thiab Smart Referral Network, suav nrog:

  • Lub network ua haujlwm li cas thiab cov txiaj ntsig nws muab rau cov tswv cuab.
  • Ib daim ntawv teev cov koom haum koom nrog.
  • Smart Referral Network kev cia siab rau kev xa mus, teb rau kev xa mus thiab xa cov ntaub ntawv xa mus rau Alliance.

Koj tuaj yeem saib qhov kev cob qhia ntawm peb lub vev xaib. Yog tias koj muaj lus nug txog Kev Tswj Xyuas Kev Txhim Kho lossis Kev Pabcuam Hauv Zej Zog, thov mus saib hauv ECM nplooj ntawv ntawm peb lub vev xaib los yog hu rau Alliance ECM pab neeg ntawm [email protected].