Care Conference Sample Clauses

Care Conference. Lead Care Coordinator - $300.00 per adult Attributed Life Per Year Paid once per year to the TIN of an eligible Participant or Preferred Provider who establishes a Lead Care Coordinator relationship and completes a qualifying Care Conference with the adult Attributed Life. The $300.00 per adult Attributed Life Per Year is paid in the month following documentation of the Care Conference in Care Navigator or other mutually agreed upon care coordination software.

Care Conference. Care Team - $150.00 per adult Attributed Life Per Year Paid once per year to the TIN of an eligible Participant or Preferred Provider who participates in the Care Team and completes a Care Conference with the adult Attributed Life. The $150.00 per adult Attributed Life Per Year is paid in the month following documentation of the qualifying Care Conference in Care Navigator or other mutually agreed upon care coordination software. Review/Oversight by OneCare This Model is supported by predicted rates of patient engagement in care coordination and will be monitored for outliers. If 20% or more of a Participant’s or Practice Participant’s High or Very High Risk Attributed Lives, as identified by OneCare, are actively Care Managed, OneCare may initiate a quality assurance review. Participants and Preferred Providers assigned to that Health Service Area may be required to participate in that review. The quality assurance review may result in corrective action, which may include a corrective action plan or other remedies such as repayment. Exhibit A3