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October 2013
Web-DENIS enhancements enable physicians to identify patient gaps in care
- Diagnosis gap: A suspected or historical condition that hasn’t been documented and coded in the current calendar year or hasn’t been confirmed as not applicable to the member.
- Treatment opportunity: A preventive service or treatment needed by the member, measured according to Healthcare Effectiveness Data and Information Set quality indicators.
To help identify gaps in patient care, we have enhanced web-DENIS. Now, when physicians or health care professionals click on a member care alert, they’ll be brought to a page in web-DENIS that will display a printable list of diagnosis gaps and treatment opportunities by patient.
Primary care physicians
When you click on a diagnosis gap or treatment opportunity on the list, you’ll be brought to the Health e-BlueSM home page, if you have access. Once in Health e-Blue, if the patient is in your panel, you may navigate to the Diagnosis Evaluation panel or Treatment Opportunities by Condition/Measure panel to close patient gaps.
If you don’t have access to Health e-Blue, download an application from bcbsm.com.
Specialists and other health care providers
If you aren’t eligible for access to Health e-Blue, you can still close patient gaps by providing the service and billing for that service on a claim. Check our website for a list of provider types who are eligible for access.
New member gap details screen
The Member Care Alert buttons will appear for BCN commercial and Medicare Advantage patients and BCBSM Medicare Advantage patients covered under the following products: BCBSM Medicare Plus Blue PPOSM, BCN AdvantageSM and BCN commercial. Diagnosis gaps will only be available for Medicare Advantage patients.
See the previous article about the new member care alert buttons in the July edition of The Record. The color-coded buttons were added to the web-DENIS member eligibility screen in July to quickly assist physicians in identifying patient needs.
The alert buttons are color-coded as follows:
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- Red: This member has an open diagnosis gap or treatment opportunity that requires action.
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MemberCareAlert |
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- Green: This member has a pending or closed diagnosis gap or treatment opportunity. No action is required
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MemberCareAlert |
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- Gray: This member doesn’t have a diagnosis gap or treatment opportunity at this time. No action is required.
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MemberCareAlert |
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If you have questions regarding these enhancements, please contact your BCBSM provider consultant or BCN provider affairs representative.
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