All members have access to Care Coordination services. Care Coordinationis how your MCO coordinates your health care needs, whether you are in the hospital or at home. This is for members with long-term, complex, or behavioral health needs. Care Coordination works with you, your family, and your providers. The goal is to keep you out of the hospital or emergency room unless you really need it. If you are in a hospital, skilled nursing facility, or rehabilitation center, a Care Coordinator will work with the staff to help make your discharge successful.
Some members need extra help managing their health care; some members do not need any help.That is why there are three Levels of Care Coordination.
Every Centennial Care member is asked to complete a Health Risk Assessment (HRA) once each year. Your HRA will help your managed care organization (MCO) find out about your health care needs and how we can help you stay healthy or get Care Coordination if you need it. If you have medical and/or behavioral health conditions or long-term care needs that require a higher level of Care Coordination you will receive a Comprehensive Needs Assessment (CNA). The CNA will be completed at your home by a Care Coordination.
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Care Coordination helps Centennial Care members get access to the care you need. Once you join a Centennial Care Plan, you will be contacted and asked simple questions about your health and will work with you to assess your healthcare needs. A care coordinator is made available to you as your main point of contact to coordinate the care and services you may need (such as medical, behavioral health, long term care, prescriptions, medical equipment, and others).
Centennial Care includes long-term services that may be provided in a member’s home, a residential setting, or in an institution, such as a nursing facility.
To speak to someone about long-term services and supports or to find additional resources in your area.
You have a voice. Each member of Centennial Care has the right to file a grievance when you are unhappy with your managed care plan or provider.