Care Bridge Sample Clauses

Care Bridge. The Care Coordination framework for Michigan’s integrated care program. Through the Care Bridge, the members of an Enrollee’s Integrated Care Team (ICT) facilitate formal and informal services and supports in an Enrollee’s person-centered care plan. The Care Bridge includes an electronic Care Coordination platform which will support an Integrated Care Bridge Record to facilitate timely and effective information flow between the members of the ICT.
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Care Bridge. The care coordination framework for Michigan’s integrated care program. Through the Care Bridge, the members of an enrollee’s care and supports team facilitate formal and informal services and supports in an enrollee’s person-centered care plan. The Care Bridge includes an electronic Care Coordination platform which will support an Integrated Care Bridge Record to facilitate timely and effective information flow between the members of the care and supports team. Care Coordination – A process used by a person or team to assist enrollees in accessing Medicare and Medicaid services, as well as social, educational, and other support services, regardless of the funding source for the services. It is characterized by advocacy, communication, and resource management to promote quality, cost effectiveness and positive outcomes.
Sample 1
Care Bridge. The Care Bridge is the care coordination framework for the Demonstration. Through the Care Bridge, the members of the enrollee’s care and supports team facilitate access to formal and informal services and supports identified in the enrollee’s Individual Integrated Care and Supports Plan (IISCP) developed through a person-centered planning process. The Care Bridge includes an electronic Care Coordination platform which will support an Integrated Care Bridge Record to facilitate timely and effective information flow between the members of the care and supports team. The Care Bridge requirements are based on the following:  The ICO is responsible to provide care coordination services to the enrollee in accordance with the enrollee’s individual preferences as determined through the person-centered planning process.  Care coordination services will provide for:  A person-centered, outcome-based approach, consistent with the CMS model of care (MOC) and Medicare and Medicaid requirements and guidance.  The opportunity for the enrollee to choose arrangements that support self-determination.   Appropriate access and sharing of information. Enrollees and treating providers will have access to all the information in the Integrated Care Bridge Record (ICBR). It is the Enrollee’s right to determine the appropriate involvement of other members of the ICT in accordance with applicable privacy standards.  Medication review and reconciliation.
Sample 1
Care Bridge. The Care Coordination framework for Michigan’s integrated care program. Through the Care Bridge, the members of an Enrollee’s Integrated Care Team (ICT) facilitate formal and informal services and supports in an Enrollee’s person-centered care plan. The Care Bridge includes an electronic Care Coordination platform which will support an Integrated Care Bridge Record to facilitate timely and effective information flow between the members of the ICT. CareConnect360 - A web portal to support care coordination of Enrollees’ physical health and behavioral health conditions. The portal provides Integrated Care Organizations (ICOs) and Prepaid Inpatient Health Plans (PIHPs) access to Medicaid and limited Medicare Claims information in the MDHHS Data Warehouse related to both physical and behavioral health care. Due to federal confidentiality requirements, Substance Use Disorder information is not included in the Claim data. Care Coordination – A process used by a person or team to assist Enrollees in accessing Medicare and Medicaid services, as well as social, educational, and other support services, regardless of the funding source for the services. It is characterized by advocacy, communication, and resource management to promote quality, cost effectiveness and positive outcomes.
Sample 1

Related to Care Bridge

  • Care Management The Contractor’s protocol for referring members to care management shall be reviewed by OMPP and shall be based on identification through the health needs screening or when the claims history suggests need for intervention. In addition to population-based disease management educational materials and reminders, these members should receive more intensive services. Members with newly diagnosed conditions, increasing health services or emergency services utilization, evidence of pharmacy non-compliance for chronic conditions and identification of special health care needs should be strongly considered for case management. Care management services include direct consumer contacts in order to assist members with scheduling, location of specialists and specialty services, transportation needs, 24-Hour Nurse Line, general preventive (e.g. mammography) and disease specific reminders (e.g. Xxx X0X), pharmacy refill reminders, tobacco cessation and education regarding use of primary care and emergency services. The Contractor shall make every effort to contact members in care management telephonically. Materials should also be delivered through postal and electronic direct-to-consumer contacts, as well as web-based education materials inclusive of clinical practice guidelines. Materials shall be developed at the fifth grade reading level. All members with the conditions of interest shall receive materials no less than quarterly. The Contractor shall document the number of persons with conditions of interest, outbound telephone calls, telephone contacts, category of intervention, intervention delivered, mailings and website hits. Care management shall be coordinated with the Right Choices Program for members qualifying for the Right Choices Program. However, the Right Choices Program is not a replacement for care management.

  • Teacher Professional Growth Plan 9.1.1 Teacher Professional Growth Plans will consider but will not be required to include the School Division’s goals.

  • Hospice g. Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.

  • Healthcare Section 1. Bargaining unit employees with one (1) year or more of service will be provided coverage for the duration of this contract through the “Full Coverage” Team Care Plan (“Team Care MM200”), which includes dental, vision, life, short term disability, medical and prescription drug benefits. Prior to January 1, 2020, bargaining unit employees with less than one (1) year of service will be provided coverage through the “Medical Only” plan. On January 1, 2020, all bargaining unit employees enrolled in the Medical Only plan shall be enrolled in the Full Coverage plan, and the Medical Only plan will eliminated. The rates for 2019 and a further description of the plan and rates are referenced

  • Professional Growth Program There shall be a Professional Growth Program in place for all classified employees. Professional Growth is an organized activity designed to improve performance of employees in the classified service and to provide training for employees to gain new skills and abilities, to broaden their opportunity for promotion, to engage in study and related activities designed to retain and extend the high standards of the classified employee.

  • Childcare 8.1. One third credit shall be given where a teacher resigns or takes leave from the New Zealand teaching service in order to care for her/his own children provided that the teacher was a certificated teacher (or equivalent) at the time of resigning or taking leave, otherwise no credit will be given.

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • Professional Growth Plan A written plan, self-directed or jointly developed between the teacher and evaluator, designed for the sole purpose of continuing teacher growth focused on areas identified in the teacher’s observations and/or evaluation. The approved form for the Professional Growth Plan is found at Ohio ES.

  • Management of Company 5.1.1 The Members, within the authority granted by the Act and the terms of this Agreement shall have the complete power and authority to manage and operate the Company and make all decisions affecting its business and affairs.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

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