Documentation System
Community Solutions (CS) providers must use a documentation system or process that supports the integration of physical, behavioral, social service, and administrative data and information from other entities. This includes the health plan, Enhanced Care Management (ECM), CS, and other county and community-based providers to support the management, maintenance, and sharing of member information that can be shared with other providers and organizations involved in each member’s care.
Documentation systems may include certified electronic health record (EHR) technology or other tools that can support the documentation of:
- Member’s enrollment into CS.
- Member’s authorization/approval to release information to other providers and anyone involved in the member's care plan.
- Collecting social determinants of health (SDOH) data based on ICD-10-CM.
- Member’s individualized CS assessments and goals/goal attainment status.
- Tracking and coordinating CS referrals to available community resources and following up to ensure services were rendered (closed-loop system).
- Information from other sources to identify member needs.
Documentation systems also need to be able to:
- Support the sharing of the member’s assessment, individualized plan and other required data to Health Net, as requested.
- Assist with data sharing and reporting to Health Net as requested.
- Support and track the CS services provided to the member to enable CS providers to appropriately submit claims to Health Net.
A care management documentation system is not required to be a certified EHR technology and it may include systems that are securely managed and hosted by third parties, including Health Net’s partners.