Does anyone know how the monitored status is as far as NCQA compliance? Seems to me that with none of those members having surveys performed they would be out of compliance?
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We were told that the only ones NCQA is concerned with in the HCCP program (not SNP) is the high severity members. None of the others are reviewed by NCQA.
Right. Our team was instructed to move chronic utc’ers, members with invalid contact info, members on the verge of declination - anyone who isn’t getting anything out of our calls or who are avoiding calls, etc......
Members with high referral scores scores are also being moved to monitored status as well
I don't think so since they are lower quadrant