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In-home assessments of high-risk members

May 1, 2013

AmeriHealth has partnered with Inovalon, Inc. to conduct face-to-face assessments of high-risk Medicare Advantage HMO members. This outreach initiative began in 2012 and will continue throughout 2013. The purpose of these assessments is to gather member-specific documentation and provide the member?s primary care physician (PCP) with accurate health information to help support ongoing patient care. Members are contacted by telephone or letter to schedule an appointment. Assessments are completed by a nurse practitioner from Inovalon in the member?s residence, whether in their own home or the skilled nursing facility in which the member resides. During the assessment, the nurse practitioner uses ePASS[]?[], a decision-support tool that is prepopulated with the member?s medical history. It also addresses specific questions targeting gaps in documentation, assessment, and quality improvement. Each assessment is completed electronically and then shared with the member?s PCP as well as AmeriHealth. If you or your AmeriHealth patients have any questions about these assessments, please call Customer Service at []1-800-275-2583[].

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