diabetes DM program General member Multi, Decimal. Multi, Unknown Unknown education (e.g., From 0 to newsletters) 100000000000. 1: HMO, 1: Low, 2: PPO, 2: Medium, 3: 3: High risk, Intervention 4: No not offered stratification General care Multi, Decimal. Multi, Unknown Unknown From 0 to based on 100000000000. 1: HMO, 1: Low, condition alone 2: PPO, 2: Medium, (e.g., personalized 3: 3: High risk, letter) Intervention 4: No not offered stratification Member-specific Multi, Decimal. Multi, Unknown Unknown reminders for due From 0 to or overdue 100000000000. clinical/diagnostic 1: HMO, 1: Low, 2: PPO, 2: Medium, maintenance 3: 3: High risk, services Intervention 4: No Answer not offered stratification reminders” only if it involves reminders that are independent of the live outbound telephonic program (Documentation needed) Member-specific Multi, Decimal. Multi, Unknown Unknown reminders for From 0 to medication events 100000000000. (e.g., level of use, 1: HMO, 1: Low, 2: PPO, 2: Medium, failure to refill) 3: 3: High risk, Answer Intervention 4: No not offered stratification reminders” only if it involves reminders that are independent of the live outbound telephonic
diabetes DM program General member education (e.g., newsletters) Multi, 1: HMO, 2: PPO, 3: Intervention not offered Decimal. From 0 to 100000000000. Multi, 1: Low, 2: Medium, 3: High risk, 4: No stratification Unknown Unknown General care based on condition alone (e.g., personalized letter) Multi, 1: HMO, 2: PPO, 3: Intervention not offered Decimal. From 0 to 100000000000. Multi, 1: Low, 2: Medium, 3: High risk, 4: No stratification Unknown Unknown Member-specific reminders for due or overdue clinical/diagnostic maintenance services Answer reminders” only if it involves reminders that are independent of the live outbound telephonic program (Documentation needed) Multi, 1: HMO, 2: PPO, 3: Intervention not offered Decimal. From 0 to 100000000000. Multi, 1: Low, 2: Medium, 3: High risk, 4: No stratification Unknown Unknown Member-specific reminders for medication events (e.g., level of use, failure to refill) Answer reminders” only if it involves reminders that are independent of the live outbound telephonic Multi, 1: HMO, 2: PPO, 3: Intervention not offered Decimal. From 0 to 100000000000. Multi, 1: Low, 2: Medium, 3: High risk, 4: No stratification Unknown Unknown
Qualified%20Health%20Plan%20Certification%20Application%20Fourth%20Quarter%202017%20Smal....docx