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Eligibility, Enrollment & Behavioral Health Category Overview Call Center

Eligibility, Enrollment & Behavioral Health Category Overview Call Center. Current Process : Crisis Specialist subjectively selects from 40 different funding type from a drop down box in Claimtrak . . Proposed Process Enhancements:

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Eligibility, Enrollment & Behavioral Health Category Overview Call Center

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  1. Eligibility, Enrollment & Behavioral Health Category OverviewCall Center Current Process: Crisis Specialist subjectively selects from 40 different funding type from a drop down box in Claimtrak. • Proposed Process Enhancements: • Incorporate a series of questions in the EHR to populate most accurate depiction of eligibility, enrollment and behavioral health category (BHC) for each caller. • Actions • Crisis Specialist asks a series of questions and enters responses into the EHR to automatically derive callers eligibility, enrollment and behavioral health category (BHC) • Keep eligibility, enrollment, and behavioral health category as separate fields in the EHR • Allow more flexibility in reporting • Un-complicates selection process Business Intelligence

  2. Eligibility, Enrollment & Behavioral Health Category FlowchartCall Center Did the caller provide you with their first name, last name, DOB? - Eligibility - Enrollment - Behavioral Health Category (BHC) Default to Unknown 1 No 2 3 Yes Is person eligible for AHCCCS? Check for AHCCCS Eligibility and EOC Look up in AHCCCS System TXIX or NTXIX 1 Is person in EOC with Maricopa County RBHA? What is their BHC? C/A Yes 3 2 GMH/SA No Default to GMH/SA Is the person 18 years or older? Yes SMI Default to C/A No Business Intelligence

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