Health Risk Assessment (HRA). 4.4.2.1 The CONTRACTOR shall conduct the HSD standardized Health Risk Assessment (HRA) on all Members who are: (i) newly enrolled in Centennial Care; (ii) who are not in CCL2 or CCL3 and who have a change in health condition that requires a higher level of care, and (iii) all Members transitioning from another MCO where the client’s CC Level assigned by the transferring MCO is Unable to Reach (CCL0-UTR), Refused Care Coordination (CCL4- RCC) or Difficult to Engage (CCL5-DTE) or for whom there is no prior CC span, or a prior CC span has expired, per HSD guidelines and processes. The HRA is conducted for the purpose of: (i) introducing the CONTRACTOR to the Member; (ii) obtaining basic health and demographic information about the Member; and (iii) confirming the need for a CNA. If, after attempting to conduct an HRA, the CONTRACTOR determines the Member, transitioning from another MCO, is CCL0, CCL4 or CCL5, the CONTRACTOR is required to conduct a Data Mining Review (DMR).
Appears in 5 contracts
Samples: Agreement, Agreement, Care Services Agreement Professional Services Contract
