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The Practitioner Connection
Volume XXVI, 2nd Quarter

The right help at the right time!

GAPS IN CARE FOR BIPOLAR DISORDER

A clinical program is now in place to address medication compliance for those participants who may have Bipolar Disorder. Participants are identified through claims diagnoses and prescribed medication classes. When identified, participants are encouraged to be compliant with their medication, communicate with their prescriber and engage in supportive therapy through an educational mailing.

Simultaneously, a Medication Refill Adherence Rate (MRA) is calculated, based on dosage and amount prescribed, counting expected days the participant would have taken the medication. If the rate is below 80%, the prescriber will receive a list of those patients on a monthly basis. If on monthly runs of the MRA, a participant is still below 80%, they will be contacted by an Outpatient Case Manager for assessment and follow up.

The Prescriber Clinical Guideline and tools are available on www.cignabehavioral.com, as well as the participant flier, inclusive of a mood monitoring chart.

Other Featured Articles:

KEY FINDINGS OF THE QUALITY AND UTILIZATION MANAGEMENT PROGRAM

AUTISM AND OTHER PERVASIVE DEVELOPMENTAL DISORDERS

EAP SUBSTANCE ABUSE ASSESSMENT AND MANAGEMENT REFERRALS

PREVENTIVE HEALTH PROGRAMS

PROVIDER SATISFACTION SURVEY

CLAIM OFFSETTING PROCESS

MEDICAL MANAGEMENT PROGRAM

 

 

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