Care Coordinator a provider-based clinician or other trained individual who is employed or contracted by the Contractor or an Enrollee’s PCP. The Care Coordinator is accountable for providing care coordination activities, which include assuring appropriate referrals and timely two-way transmission of useful patient information; obtaining reliable and timely information about services other than those provided by the PCP; participating in the Enrollee’s Comprehensive Assessment, if any; and supporting safe transitions in care for Enrollees moving between settings in accordance with the Contractor’s Transitional Care Management program. The Care Coordinator may serve on one or more care teams, coordinates and facilitates meetings, and other activities of those care teams.
Care Coordinator. 2.5.4.4.1. The Contractor must establish its own written qualifications for a Care Coordinator. The Contractor is responsible for the appropriate training for the Care Coordinator and verifying that the training or any certifications remain current. The Contractor must have policies in place to address non-compliance with training by the Care Coordinators. The Care Coordinator must:
Care Coordinator. The individual who has primary responsibility for performance of care coordination activities for a TennCare Covered Person receiving Long-Term Services and Supports as specified in this Appendix and meets the qualifications specified in the CRA.
Care Coordinator. An individual who is responsible for managing all activities performed by the Interdisciplinary Care Team (ICT) for Enrollees who are not receiving long-term services and supports (LTSS) and are otherwise not identified as being at high-risk.
Care Coordinator. An employee or delegated subcontractor of the Demonstration Plan who provides Care Management, and together with an Enrollee and care team, establishes a Care Plan for the Enrollee and, through interaction with network Providers, ensures the Enrollee receives necessary services.
Care Coordinator. Wrap OC Provider Agency staff, responsible for facilitating the Wrap OC Child and Family Team (Wrap CFT) meetings and guiding the evolution of a Plan of Care (POC) to ensure that it’s family-centered and effective in safely transitioning and/or maintaining Participant to the least-restrictive family setting with minimal reliance on formal support systems.
Care Coordinator. An individual within a Provider organization who facilitates Care Coordination for patients.
Care Coordinator. The Contractor must establish its own written qualifications for a Care Coordinator. The Contractor is responsible for the appropriate training for the Care Coordinator and verifying that the training or any certifications remain current. The Contractor must have policies in place to address non-compliance with training by the Care Coordinators. The Care Coordinator must: Act as the single point of contact for an Enrollee to the Contractor and the ICT; Be a provider-based clinician or other trained professional; or Be an individual employed or contracted by the Contractor or the Enrollee’s Primary Care Provider who is trained in providing care coordination to persons with disabilities;
Care Coordinator. An employee or delegated subcontractor of the Demonstration Plan who provides Care Management, and together with an Enrollee and care team, establishes a Care Plan for the Enrollee and, through interaction with network providers, ensures the Enrollee receives necessary services. Care Management - Services that assist Enrollees in gaining access to needed services, including medical, social, educational and other services, regardless of the funding source for the services. Care Management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services (both Medicare and Medicaid) required to meet an Enrollee’s needs across the continuum of care.
Care Coordinator. An individual within a provider organization who facilitates Care Coordi- nation for patients. Care Coordinator Fee — A fixed amount paid by a Blue Cross and/or Blue Shield Licensee to providers periodically for Care Coordination under a Value-Based Program. Close Relative — the spouse, Domestic Partner, children, brothers, sisters, or parents of a Member. Coinsurance — the percentage amount that a Member is required to pay for Covered Services after meeting any applicable Deductible. Continuous Nursing Services — Nursing care provided on a continuous hourly basis, rather than intermittent home visits for Insureds enrolled in a Hospice Program. Continuous home care can be provided by a registered or licensed vocational nurse, but is only available for brief periods of cri- sis and only as necessary to maintain the termi- xxxxx ill patient at home. Copayment — the specific dollar amount that a Member is required to pay for Covered Services after meeting any applicable Deductible. Cosmetic Surgery — surgery that is performed to alter or reshape normal structures of the body to improve appearance. Covered Services (Benefits) — those Medically Necessary services and supplies which a Member is entitled to receive pursuant to the terms of the Group Health Service Contract.
