New Member Care Alert coming to web-DENIS eligibility screens

In an ongoing effort to provide you with resources to help you care for Blues patients, web-DENIS users will notice new Member Care Alert buttons on the web-DENIS eligibility screens in July.

The new alert buttons will be color-coded to help you identify patient needs quickly. Here are the three colors you may see and what they will mean:

	Red — This member has an open diagnosis gap or treatment opportunity that requires action.
	Green — This member has a pending or closed diagnosis gap or treatment opportunity. No action is required.
	Gray — This member doesn’t have a diagnosis gap or treatment opportunity at this time. No action is required.

A diagnosis gap is a suspected or historical condition that has not been documented and coded in the current calendar year or that has not been confirmed as not applicable to the member.

A treatment opportunity is a preventive service or treatment needed by the member, measured according to Healthcare Effectiveness Data and Information Set quality indicators.

The new Member Care Alert button will appear on the initial web-DENIS contract eligibility screen in a new column to the right.

The alerts will also appear on the individual member’s eligibility screen.

If you are a Blue Care Network primary care physician or a BCBSM Medicare Advantage PPO provider with access to Health e-Blue^SM, clicking on one of these alert buttons will take you to Health e-Blue, where you may search for patient diagnosis gaps and treatment opportunities by clicking on the Diagnosis Evaluation panel or the Treatment Opportunities panel.

The new Member Care Alert button will appear for BCN commercial and Medicare Advantage patients and BCBSM Medicare Advantage patients covered under the following products: BCBSM Medicare Advantage PPO, BCNA, BCN commercial fully insured, BCN commercial self-funded, BCN65.

Over the coming months, watch for more enhancements to these screens that will bring even more functionality for efficiently closing diagnosis gaps and treatment opportunities.

If you are a primary care office and need access to Health e-Blue, register online today. Please contact your provider consultant if you need assistance.