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Proposed enhancements in the call center process to improve accuracy in determining eligibility, enrollment, and behavioral health category for each caller. The Crisis Specialist will ask specific questions and input responses into the system for automatic categorization. This process aims to simplify selection and improve reporting flexibility.
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Eligibility, Enrollment & Behavioral Health Category OverviewCall Center Current Process: Crisis Specialist subjectively selects from 40 different funding type from a drop down box in Claimtrak. • Proposed Process Enhancements: • Incorporate a series of questions in the EHR to populate most accurate depiction of eligibility, enrollment and behavioral health category (BHC) for each caller. • Actions • Crisis Specialist asks a series of questions and enters responses into the EHR to automatically derive callers eligibility, enrollment and behavioral health category (BHC) • Keep eligibility, enrollment, and behavioral health category as separate fields in the EHR • Allow more flexibility in reporting • Un-complicates selection process Business Intelligence
Eligibility, Enrollment & Behavioral Health Category FlowchartCall Center Did the caller provide you with their first name, last name, DOB? - Eligibility - Enrollment - Behavioral Health Category (BHC) Default to Unknown 1 No 2 3 Yes Is person eligible for AHCCCS? Check for AHCCCS Eligibility and EOC Look up in AHCCCS System TXIX or NTXIX 1 Is person in EOC with Maricopa County RBHA? What is their BHC? C/A Yes 3 2 GMH/SA No Default to GMH/SA Is the person 18 years or older? Yes SMI Default to C/A No Business Intelligence
