Preventive Care Compliance Program

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Preventive Care Compliance Program 2017-06-29T23:08:51+00:00

Program Objectives

  • Educate members about age and gender appropriate preventive tests and care
  • Monitor member compliance for participating in various preventive test and care over the period of a calendar year.
  • Member will be notified via letter, the month of their birthday, that they should receive specific, age appropriate preventive tests or care within the next calendar year.
  • If the tests or care are not completed within six months, member will be notified via letter and reminded to obtain the appropriate preventive tests or care.
  • MCM will provide an annual report to client that will measure program compliance by procedure.

Letters to Member

  • Initial Educational Letter will be sent to the member during the month of their birthday.
    • Letter will explain that the member is entitled to have one or more gender and age appropriate tests or care during the next calendar year.
    • Letter will stress the importance of receiving the recommended tests or care.
  • MCM will track for member compliance in obtaining recommended preventive care or testing.
  • MCM will send a reminder letter to the member if they did not receive the recommended tests or care with in six months of the initial letter.
  • In the case of minor dependents the letter will be sent to the parents or legal guardians.

Recommended Preventive Care Tests and Care

  • The following procedures will be tracked
    • Colon cancer screening:  age 50 and older
    • Glaucoma screen:  age 65 and older
    • PSA or DRE:  males age 50 and older
    • Breast Cancer Screening:  women between ages 40-69
    • Chlamydia Screening: women ages 16-25
    • Child Physical Exam:  age 3-7
    • Child Physical Exam:  age 8-12
    • Child Physical Exam:  age 13-21

Reporting

  • MCM will issue an annual report in January of each year that will report compliance results by procedure and age group