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A Clinical Tool for MHCP Recipient Care Coordination

MN–ITS Interactive Heath Information Request (HIR). Minnesota Health Care Programs (MHCP) Minnesota Department of Human Services. A Clinical Tool for MHCP Recipient Care Coordination. HIR Provider Access.

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A Clinical Tool for MHCP Recipient Care Coordination

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  1. MN–ITS InteractiveHeath Information Request (HIR) Minnesota Health Care Programs (MHCP) Minnesota Department of Human Services A Clinical Tool for MHCP Recipient Care Coordination

  2. HIR Provider Access Access is limited to individual clinicians within the following MHCP-enrolled provider organizations: • Primary care clinics • Hospitals • Pharmacies

  3. HIR Eligible Clinicians Access must be restricted within the organization to the following clinical providers: • Clinical nurse specialists • Nurse midwives • Nurse practitioners • Pharmacists • Physician assistants • Physicians

  4. HIR History Response HIR enables clinicians to retrieve: • A three-year history of paid MHCP fee-for-service (FFS) and managed care organization (MCO) claims for emergency room and inpatient hospital services • A one-year medication and compound drugs history based on paid and to-be-paid MHCP FFS claims for pharmacy services

  5. HIR Limitations The HIR captures information from claims submitted. Claims history will be incomplete: • If the recipient was not enrolled with MHCP for the full three years • Sought care outside of the MHCP FFS or MCO network • A MHCP provider has not yet submitted their claims

  6. Login to MN–ITS

  7. Health Information Request (HIR)

  8. HIR Home

  9. Subscriber ID

  10. Emergency Department History

  11. Emergency DepartmentDetails Record 1

  12. Emergency DepartmentDetails Multiple Records

  13. Select Inpatient

  14. Inpatient History

  15. Select Pharmacy

  16. Pharmacy History

  17. MN–ITS Home PageLogout

  18. Care Coordination: Pharmacy • Simplify medication plans and look for pharmacy gaps • Are there medications we weren’t aware of? • Are they getting filled in a timely fashion? • How many different pharmacies are they using? • Is the dosage as prescribed and being filled? • What antibiotics have worked/not worked in the past?

  19. Care Coordination: Transitions • Checks ER & Hospital utilization of their patients each month • Improve transitions, avoid re-hospitalizations • Educate patients on need to communicate with HCH; how we can help; etc. • Strengthens relationship with Care Coordinator

  20. MN–ITS InteractiveHeath Information Request (HIR) Questions? Minnesota Health Care Programs (MHCP) Minnesota Department of Human Services Provider Relations - 2011

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