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2010 ISS TOOLKIT For the Assessment of Special Needs Plans

1. SNP 2 Improving Member Satisfaction Elements A B SNP 3 Clinical Quality Improvements Elements A SNP4 Care Transitions Elements A B C 6 Inbox Microsoft gt Internet Explorer Windows Media Pl SNP Screen Shots Er 10 15 AM 34 Screenshot 7A ISS Tool S amp P Measure C Survey Tool 201705NPs Lic 1783 8 A Windows Internet Explorer provided by Comcast Ge e no nao Fiz sdt View Brworitez Toole Help y Favorites ny HE Survey Tool 20 105NP5 Lic 1783 Engagement Health th BS mm Page Safety Tool Ge SNPA Care Transitions If you did not set up your tool by selecting the correct survey type under evaluation options you will not see the Yes or No options as shown on the left Returning Surveys The organization manages the process of care ransitions identifies problems that could SNP 4 amp 6 only cause transitions and where possible prevents unplanned transitions Initial Surveys it AAA SNP 1 6 The organization makes a special efor to coordinace care when members move from one setting to another u such as wher they are discharged from a hospital Without coordination such transitions often result in pecr quality care and nsks to patient safety ELEMENT A Managing Transitions Clear Data The organization lacilitates safe transitions by eit
2. Completeness Check Support Text Notes Use the link below to view a single page with data from all elem rights View all Evaluations click here to view your evaluation comments from all elements e View all Comments click here to view all your organizations comments to the preliminary results from all elements Note If your organization has not completed this stage in the survey process or this step is not applicable to your survey process you will be unable to access this data See your Policies and Procedures for more details on survey stages Attach Document E Inbox Micr 2 3 Internet O Windows Me a SNP Screen Ley 2 Microsof E a 10 05 AM Screenshot 11B Utilities Completeness Check Completeness Check Windows Internet Explorer provided by Comcast Cerne termes s Check The following elements for the evaluation option you selected are incomplate Please check your data entry to ensure these elements are complate R Dements That Are Mot Complete Completeness check E gt os Elements that are not complete will appear Lalo thie window 2002 2008 by Natianal Committee for Quality Assurance Patent Pending Use ef this Web sfefapplicadon constiites acceptance of the License Agreement and Privacy Poly E Documenti Microsof 42 Screenshot 12A Submit Setup Survey Tool Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer
3. Mir E hes si e lin pite real ATS I geachgr ound a5p 0rgbGCategor vil 15581 00u0 Alas E e E View Favorites Tos Help w Favorites ES Organization Background 20105PS Lic 1783 Engag NCQA 20 YEARS rela T a SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS Suh SURVEY TOOL UTILITIES HOWE y a E SEARCH HELP amp ai INS TARLETON POLICIES STANDARDS SAvET TO Y t RESULTS PFENDIGE aa HE o SURVEYTOO Ba ESULTS APPENDICES GLOSSARY INDEX Please complete the fields below for your SNP DAGAMNIZATION NFORMATIOM Organization Information Please include the following information for identification and verification purposes Organization Name SNP Beneit Package Name Names of Affiliated SNP Plans Organization H Number CMS contract number SNP Benefit Package Plan ID SNP Type fe dual chronic Institutional if Chnonic what conditions are covered Attache Model of Care E t Please include the organization name 2 SNP Benefit Package Mame Internet 7 Hooft Gutlock gt Gitrocken pp Log Tock t Sandra El Documnentl f OF pe anization Ear kground 201 OSNPs Lie 1 783 f ngapement Health Windows Internet Explorer prov ded bw Comecast Wew Favorites Tools Help El Organization Background 20105MP5 Lic 1783 Engag Er E Di dm Poger safety Too O 4 Please include a
4. Return to Results Index SUMMARIZED E DETAILED RESULTS RECOMMENDATIONS 2010 SNP Structure amp Process 2010 Mote Ary elements that are incomplete are scored at 0 00 To view the Survey Tool click on the link to the nght of the Standard you wish to view To return directly to this page from the Survey Tool use the Back button on your browser Scroll down to view all of your results SNP1 Complex Case Management pee es Element A Element B Element C Element D Element E Element F Element G Done l o n internet Start Mcosoft Oute Cire Yen pp App Results Detad 201 U Screen Shet Log In 48 49 VO 1D PR WN e ISS Documentation Tips Maintain documents on a shared drive Consider creating folders for each standards category Establish a system for version control Name documents clearly your audience is both internal staff and surveyors Avoid characters such as ampersand 4 or apostrophe Avoid duplicate names Use common file types such as doc Word documents xls Excel documents ppt Power Point pdf Adobe PDF gft tif jpg Do not send exe executables Documents that you dont have electronically can be scanned and converted to PDF GIF TIF or JPG Dont scan everything this creates large files that may be challenging for you to upload and for the surveyors to open Consider including only relevant pages of a lar
5. 28 Screenshot 3A Help amp Instructions Welcome Microsoft Internet Explorer provided by NCQA GO el https fiss ncga org RDSat ATwWelcomedccred asp ka 4 Live Search File Edit View Favorites Tools Help ki Page Ct Tools Welcome x E Windows Live Hotmail E Home NCQA Intranet E Help Microsoft Internet Explorer provided by NCQA Help 1 WHATS NEW HELP amp INSTRUCTIONS LOGOUT We look forward to helping you understand and use the Interactive Survey System and all our programs and services Below is a list of helpful links and contact information LL le area Interactive Survey System User Resources j Help amp Instructions tab Instructions can assist you in navigating the ISS tool Instructions for the Standards and Guidelines and Survey Tool click here for instructions on navigating in the Standards and Guidelines and Survey Tool setting up the Survey Tool o view Inactive projects using the Survey Tool for evaluation document management and submitting the Survey Tool for survey User Manuals l lamar mamada Arm ETETE coed im Ardahani Anrabhati E OME Dimara de el hence far once arald tre Please select one to view CVO 2004 CVO 2006 CVO 2007 CVO a 2 Internet Gb Windows M E Calculator E Inbox Micr Ly 2 Microsof 29 Screenshot 4A Survey Tool Survey Tool 20095NPs Lic 12255 Micros
6. large documents should be sent singly Start with small documents before moving to those with more bulk 4 Copy your documents from your network to your hard drive and upload from there This will significantly increase the likelihood of a successful submission Note you do not have to change the ST references to the document location if you do this 5 Upload during off peak hours The Internet and your network both have rush hours too traffic moves more slowly when everyone s on the information superhighway Plan accordingly 57
7. RDSat 4TShowStandard asp Category SNP v amp s 1x Live Search File Edit View Favorites Tools Help f gt gt JE te survey Tool 20095NPs Lic 12255 ar Ej dea Page iG Tools ull NCQA SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S NEW SEARCH HELP amp INSTRUCTIONS Lo co ti POLICIES STANDARDS ORGANIZATION RVEY TOOL Y amp PROCEDURES 2 GUIDELINES su T BACKGROUND RESULTS APPENDICES GLOSSAR INDEX gt Document Library Microsoft Internet Explorer provided by NCQA Ea bx Filtering by doc type in view by document Using the drop down box below you may filter the list of documents to view only those in one or more document types To select a document type highlight the document type To select more than one document type hold down the Ctrl button on your keyboard while you select multiple document types Apply Filter Link documents to relevant elements Select a filter option 1 SNP Element 1 Remove From Library File Path G PT DateAttached a Edit File Path Is linked to the following elements Link to New Element When you link a document to the Survey Tool during your readiness evaluation it is for your orqanization s internal Elements A SNP4 Care Transitions a et Elements A my Docum Screenshot SE Document Library
8. activityID 1574 File Edit View Favorites Tools Help ar dr e Survey Tool 2008POC Lic 1574 Engagement Health NCQA al SETUP SURVEY TOOL r E ONS LOGOUT Document Verification and Upload Microsoft Internet Explorer provided by NCQA E a O x Document File Referenced in Weny Document File Path Upload Path Elements Copy to input box Complete SNP GASNP SNP Unknown Element sd Browse Yes Element Trainings S P 1 measures 1 3 Final 2009 notes ppt You will see a Yes confirmation for a successful Supporting Documents from the Organization Background Section Very Document File Path Copy bo imput box Upload Complete Document File Referenced in Path Gueston Document Name Ho documents were ra enced in this Survey Tool Return to the Survey Tool and refere files in the appropriate sections as Returnto Survey Tool to Returnto Survey Tool Tool Upload Documents Upload Documents e Click Upload A start Be 3 Inte Inbox O windo Daumen ts E Upload mob gt E Screenshot 9D Additional Example https iss ncqga dies eo Rigel 1 amp retMse Document Verification and Upload Microsoft Internet Explorer E le x EZ o addendum to G laddendum to SNP5 Element C enaddendum te Updates Yes F Updates Updates xls draft training G draft training SNP G draft trainin
9. conformidad Destaque oraciones o reas de clave en sus documentos para llamar la atenci n del agrimensor a esa rea Inserta un hiperenlace si es necesario para demostrar conformidad por o copiar la url https iss ncgqa org RDSat ATLogin asp o por utilizar la funci n de Insert de Word o Excel Etiquete el concepto y documentos finales para distinguir entre ellos S lo someta versiones finales de documentos NCQA no considerar documentos en versi n borrador Utilice la caracter stica de la fecha en pies de p gina para seguir la ltima vez que usted actualiz el documento el documento se puede actualizar cada vez que se abre con cambios o no 53 51 32 53 54 55 56 57 58 Los documentos ligados pueden ser redactados pero recuerdan que eso puede cambiar n meros de referencia Los documentos cargados esos ya transferidos a servidores de NCQA no pueden ser redactados Antes de sumisi n si usted necesita redactar un documento cargado al servidor de NCQA usted debe quitar el documento redactar y descarga lo Despu s de sumisi n usted no pueda redactar documentos cargados 54 55 NCQA easuring g qual lity ln mproving las salth care INTERACTIVE INTERACTIVE SURVEY SYSTEM ss Quick Tips Uploading Documents NCQA s Interactive Survey System is designed to make the process of transferring your survey documentation to NCQA easy and secure But depending on factors such as th
10. e Setup each ISS tool by selecting the correct survey type returning or initial meme AO NM Elements A G No Yes 2 Improving Member Satisfaction 3 Clinical Quality Improvements AA Elements A D Yes Yes Aemet ao O es Elements A C No Yes 6 Coordination with Medicare amp Medicaid Coverage Yes Yes Elements A E The column labeled Returning Surveys includes the reporting requirements for SNPs that were assessed in 2009 The Initial Surveys column contains the reporting requirements for new SNPs that have not reported before Only SNP benefit packages that were operational in 2009 and renewed in 2010 are required to report e Each SNP survey tool has a 1 4 person user license Your organization s ISS administrator this is the person who was sent the tool originally can give three other individuals access to each of your survey tools e Do not push the Submit Survey Tool button unless your survey tool is complete and you are ready for NCQA surveyors to start the survey process e You must attach documentation to demonstrate performance for all factors and elements e When preparing for a survey please review the S amp P measures FAQs any policy clarifications and training materials NCQA releases updating or clarifying the requirements since FAQs and policy clarifications are effective upon release unless noted otherwise Plan to highlight sections in your documents that contain evidence for the individual factor
11. is used to evaluate organizations and individuals The Survey Tool allows you to evaluate yourself just as we will but at your own pace You may score yourself attach the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and identified with the PA symbol You may view a glossary definition at any time by clicking on the symbol te start E 5 Inbox Micr 2 Internet Gb Windows Me SNF Screen Ed Survey Tool a Ey D 10 19 AM Screenshot 6B ISS tool Survey Tool 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA JS https fiss ncga org RDSat ATShowStandard asp Category 5MP wt 2 x hel Fie Edit View Favorites Tools Help ve a EE e Survey Tool 20095MPs L X The Health Plan of the Upper SETUP SURVE DD DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURWEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS POLICIES STANDARDS DRAGANIZA TIM E SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES BACKGROUND penne etc ie Special Needs Plans This category includes the following Standards You are now in SNP 1 Complex Case Management the ISS Tool Elements A B C D E E G
12. necessary to demonstrate how your organization meets the measures as well as any cover page that identifies the document and if applicable provides its date If you reference a document multiple times you may place the entire document in the document library and reference different pages and paragraphs throughout your assessment 17 If you wish to stop using the Survey Tool click on the Log Out button located on the Navigation Bar You should log out even if you only plan a short break This will properly notify the system that you are done with your session If you do not log out the Survey Tool will time out after 30 minutes of inactivity Submitting the Survey Tool Start of the SNP Evaluation Process Upon completion of your readiness evaluation you will submit the Survey Tool on or before June 30 2010 Be aware that After you submit the Survey Tool you will not be able to change data in the Survey Tool or submit additional materials through the Survey Tool The Survey Tool is final upon submission An independent external surveyor will access the Survey Tool and will perform the assessment A Plan Comment Period will take place between the second and third levels of internal review in which plans may provide information to clarify issues raised from documentation originally submitted The turn around time for the plan comment period is short therefore plans must respond quickly and provide appropriate docum
13. provided by NCQA MEE de E https iss ncga org RDSatl4TShowStandard asprCategory ShP w EJ X p File Edit View Favorites Tools Help a survey Tool 20095MPs Lic 12255 dm Fok Page Of Tools DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS ac a Ep POLICIES STANDARDS ORGANIZATION SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES BACKGROUND z E is When you are ready to submit your ISS tool click Setup Survey Tool followed by select evaluation options This category includes the following Standards SNP 1 Complex Case Management Elements A B C D E F G SNP 2 Improving Member Satisfaction Elements A B SNP 3 Clinical Quality Improvements Elements 4 SNP4 Care Transitions Elements A B C le 4 11 PM Screenshot 12B Submit Select Survey Type Evaluation Option PM Surrey Tool Anda intenet Explorer provided by Lomcast FR erie Asa ga amp demon sd A Trae vation ono ia mp a zi A Select Evaluation pbons E TIA MEHU EVALUATION OPTICAS SAT SAA Toe IA A RGG Instructions To conduct a readmess evaluation and undergo suney you musi select from the evaluation options below For additional information on selecting evaluation options chick on the msiructions link above To select evaluation options for readiness v
14. the above statement Click I Agree Care bee Screenshot 13E View Results continued Survey Tool 20105NPs Lic 1783 Engagement Health Windows Internet Explorer provided by Comcast GO E monogenean e AE trx gt Fe Edt Vew Fiv iies Took Hep iy Favorites oh HE Survey Tool 10105MPs Lic 1783 Engagement Health z CI Wh Page Safety Toos NCQA 2U YEARS PRINT 2010 SNP Structure amp Process 2010 Select an evaluation option for which to view results Click on your Evaluation Name None Option Initial or Returning Fealnation Option DER 7 Survey Standards Year 2010 Valid Dates Hot Available 2002 2008 by Nabonal Committee for Quality Assurance Patent Pending fies Ae btn Aa SAA Samet AAA RA AA Ar ieee Asses ae Bie A Dalene Start Microsoft Gulo Orks endop App Survey Tool 2010 Docurmentl Moros 5 Soeen Shot Log en ta Screenshot 13F View Results continued Results Detail Z010SNPs Lic 1783 Engagement Health Windows Internet Explorer provided by Comcast Fie Edt View Favorites Teee Kee 8 u DFB ar Favorites de ME Results Detal 2010508 Lic 1733 Engagement Health ka CI m Page Tools Mr ar ARA APS Ps POLICIES STANDARDS AUS ORGANIZATION EE eee pe SURREY TOCH z RESU APPENDICES GLOSSAR INDEX EPROCEDLURES 7 T TI WET Pe BACK OROUND RESULTS hi
15. to provide updates on members health Evidence of coverage This list is not all inclusive Job descriptions Briefing materials Checklists Scripts Education materials Brochures Information prepared for members experiencing transitions Evidence of coverage Benefit summaries Marketing materials Instructional materials Provider directory Provider manuals Newsletters 13 Management reports Key indicator reports Redacted reports daily monthly Redacted reports that show predictive modeling Reports on overall rates of admission Report showing aggregate analysis Summary reports of analysis System output giving information Meeting minutes Documentation of actions that the SNP has taken Written notification of scheduled meeting with state or state acknowledgement of receipt Reports on access indicators Actual reports required 14 NCQA suring quality Impro ving health care 2010 ISS Toolkit Guidelines for a Successful Evaluation of a Special Needs Plan SNP Against the 2010 Structure amp Process Measures Welcome to the Structure amp Process Measures survey process The guidelines and resources contained in this section will help you prepare for your organization s survey and maximize the efficiency of your preparation time SNP Survey Process Readiness NCQA s Web based Survey Tool for the Evaluation of a Special Evaluation Needs Plan allows your organization to perfo
16. 6B 6C 6D and 6E Element 6B Factor 2 is not applicable N A for SNPs that are not contractually responsible for adjudication of Medicaid claims Element 6C is not applicable N A for Chronic and Institutional SNPs Not applicable for Dual eligible SNPs in states that do not or refuse to enter into agreement Element 6D is not applicable N A for Chronic and Institutional SNPs with fewer than 5 dual eligible members Element 6E is not applicable N A for Chronic and Institutional SNPs with fewer than 5 dual eligible members Returning Surveys SNPs that previously submitted S amp P measures in 2008 and or 2009 Initial Surveys 1 submission for SNPs operational as of 1 1 09 and renewed in 2010 Element D Administrative Coordination for Chronic Condition amp Institutional BP lt Element E Service Coordination 10 NCQA Measuring quality Improving health care 2010 ISS Toolkit Data Sources by Element SNP 1 Complex Care Management OO Element B Element D Documented processes SNP 2 Improving Member Satisfaction TTV SNP 3 Clinical Quality Improvements SNP 4 Care Transitions Element D for factors 1 and 4 Documented processes AND Reports Element D for factors 2 and 3 Documented processes AND Reports OR Materials SNP 5 Institutional SNP Relationship with Facility Element A Documented processes AND reports OR materials Element B Documented processes AND rep
17. CIES STANDARDS A ORGANIZATION p SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES i BACKGROUND z de Click on Document Library tab to add and link documents Survey Tool To enter the Survey Tool select a tab above This section includes all the Structure amp Process measures that are used for evaluation The categories in the tabs above organize the Structure amp Process measures Each category includes information about the Structure amp Process measures necessary to understand the survey process This information includes the Structure amp Process measures elements that specify exactly how the Structure amp Process measures are evaluated and scored specific scoring rules for each element the data source needed to document the scoring the scope of review for each element and additional explanation and examples This dynamic Survey Tool is used to evaluate organizations and individuals The Survey Tool allows you to evaluate yourself just as we will but at your own pace You may score yourself attach the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and identified with the FA symbol You may view a glossary definition at any time b
18. Favores Took Hep Zu je Favorites le e Results Legal Agreement 30 MSNS Lic 1783 Enga HD Co ome Per i are final once submitted to NGGA The organization may only use the repons and numeric results from the readiness evaluation for internal business purposes to examine review and otherwise analyze its business operations and may not use disclose represent or otherwise communicate these reports or numeric resulis to amy third party for any other purpose The organization may nal represent that il is NOOA Accredited based on reports or numenc resuls No individual or entity may purchase a license to use the Survey Tool from NCOLA or use it regardless of the source lo evaluate another organization against NCOA SNP structure and process measures This prohibition does not appi to individuals of entities that are assisting the organization with its readiness evaluation and preparation for an NCOA Survey The organization may not use the Survey Tool to evaluate another organization against NCOA SNP structure and process measures except as pan of its own internal preparation for an NCOA Survey including specifically evaluating a debegate s performance in order to conduct oversight as required by NOGA OF Siruchure and process measures The organization may not allow a hurd party to use the Survey Tool it has licensed to evaluate another organization against NCOA SNP structure and process Measures have read and understand
19. Link Document to Element gt Survey Tool 2009SNPs Lic 1708 Engagement Health Microsoft Internet Explorer provided by NCQA File Edit View Favorites Tools Help El https fiss ncga org demositelrdsat4T5howElements asp StandardIL a keai A Live Search gt w a survey Tool 20095NPs Lic 1708 Engagement Health en Eis cm S gt Page z e Tools https fiss ncga org orderBy document Document Library Link to Element Microsoft bi A Link Document to Element SURVEY Instructions Document Library Link to Element Documentname 2009 SNP Training Sessions Reference pages Relevance Level Document file path H gt Multi Department Efforts SNP Assessment Phase II SNP Training 2009 SNP Training Sessions doc Please pick an element to link SP Elementa 4 save and Link More Elements j Cancel and Return to Document Libra Make sure to select the element you are linking the document to and Micro 2 Internet w 3 Microsoft Lest w UL a 11 51 AM save 38 Screenshot 9A Upload Documents Survey Tool 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA do https fiss ncga org RDSat ATCategoryMain asp ProductType LicensetractivibyID 12255 he EJ kedi x Live search Live Search Y ss Fie Edit wiew Favorites Tools Help x abr 88 lhe E survey Tool 20095NPsL X The Health Plan of the Upper DOCUME
20. NCQA Measuring quality Improving health care 2010 ISS TOOLKIT For the Assessment of Special Needs Plans SNPs Against the Structure and Process Measures Prepared by the SNP Team Brett Kay Casandra Monroe Sandra Jones Melanie Bujanda Romero Priyanka Oberoi Contact SNP ncqa org VI VII VII SNP Reporting Key Messages English SNP Reporting Key Messages Spanish Reporting Requirements for SNP Type Element Data Sources by Element Examples of Data Sources Guidelines for a Successful Evaluation of a Special Needs Plan SNP Against the 2010 Structure amp Process Measures Steps and Screenshots for Key Activities ISS Documentation Tips English ISS Documentation Tips Spanish ISS Quick Tips for Uploading Documents 11 13 15 22 24 48 50 53 56 NCQA Measurin g qua ry Improving health care 2010 ISS Toolkit SNP Reporting Key Messages The following key messages are important and should be used to guide you through your organization s readiness evaluation and the ISS tool submission process e If your organization has more than one Special Needs Plan SNP benefit package you must submit a separate survey tool for every SNP benefit package Use the name of the SNP H number and plan ID to identify the correct survey tool e Prepare to submit ISS tool s early to avoid internet traffic delays but do not submit your ISS tool s later than June 30
21. NT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDAR 3 ORGANIZATION SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX 2 PROCEDURES amp GUIDE gt E BACKGROUND Upload your documents by selecting the upload documents option urvey Tool select a tab above ool Tssermormcludes all the Structure amp Process measures that are used for evaluation The categories in the tabs above organize the Structure amp Process measures Each category includes information about the Structure amp Process measures necessary to understand the survey process This information includes the Structure amp Process measures elements that specify exactly how the Structure amp Process measures are evaluated and scored specific scoring rules for each element the data source needed to document the scoring the scope of review for each element and additional explanation and examples This dynamic Survey Tool is used to evaluate organizations and individuals The Survey Tool allows you to evaluate yourself just as we will but at your own pace You may score yourself attach the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and id
22. P tiene 1 4 licencia de usuario de persona El administrador de ISS esta es la persona que le fue enviado el instrumento originalmente puede dar acceso al instrumento de inspecci n a tres individuos e No presione la tecla de Somete Instrumento de Inspecci n a menos que su instrumento de inspecci n sea completo y usted est listo para agrimensores de NCQA comiencen el proceso de inspecci n e Usted debe conectar documentaci n para demostrar desempe o para todos los factores y elementos e Cuando est n preparando una encuesta por favor repasen las medidas de S amp P preguntas frecuentes y cualquier comunicados de prensa de NCQA clarificando las p lizas y poniendo al corriente los requisitos desde que las clarificaciones de p liza de preguntas frecuentes son efectivos desde el momento del los comunicados de prensa a menos que se indique e Destacar secciones en sus documentos que contienen evidencia para los factores y elementos individuales esto nos ayudar a evaluar su desempe o e No incluya ning n s mbolo es decir amp en el t tulo de los documentos de guardar e Si tiene un pregunta sobre el contenido de S amp P o reportes de SNP el modo preferible de comunicaci n es por escrito atrav s del sistema de Policy Clarificaction Support PCS http app04 ncga org pcs web asp TIL ClientLogin asp e Usted puede contactar el equipo de SNP enviando un correo electr nico a SNP ncqa org Informaci n de Contacto del E
23. QA that the SNP Assessment is complete and your results are available log on to NCQA s ISS hittps iss ncga org RDSat ATLogin asp with your original User ID and password screenshot 13A If you cannot remember your password but still have your User ID click on the hypertext on the log in page that says If you have forgotten your Password enter your User ID above and click here Your password will then be emailed to you Once on the main ISS home page please select the Survey and Results tab for each survey tool which should have a project number listed directly below it screenshot 13B Open the survey tool s click the results tab agree to the statement regarding results and click on the red link for the evaluation option this will provide the score for each element screenshots 13C 13F You should also go directly into the survey tool and view each element If your tool has elements with scores less than 100 click the Support Text Notes tab at the bottom of the element for an explanation of the score 26 Screenshot 1A Change Password Welcome Mozilla Firefox File Edit View History Bookmarks Tools Help a v e a A i http stagend01 ncga org development rdsgafrdsat ATWelcome ccred asp lt 2 or X Google LA Most Visited Getting Started Dj Latest Headlines Do you want Firefox to remember this password HOME WHAT S NEW HELP lt INSTRUCTIONS LOGOUT Interactive Survey Sys
24. adiness evaluation As you assess your performance with each factor and element be sure to 1 Preload your document library with essential documents that demonstrate performance against the measures 2 Evaluate each element and attach the appropriate document s that demonstrates performance by linking it to an existing library document or if necessary attach a new document by clicking the Link a New Document button Each factor and element must have supporting documentation If possible limit supporting documentation to no more than three documents per requirement Once you have linked the documents you must also upload them to NCQA s secure server For detailed instructions please refer to the section titled Steps and Screenshots for Key Activities which starts on page 25 be sure to view screenshots 9A 9D and ISS Quick Tips for Uploading on page 56 of this guide In addition you may wish to view the Uploading Documents in ISS demo within the ISS Tool by selecting Help and Instructions on the dark blue tool bar scroll down to ISS Demonstrations click on Uploading Documents in ISS 3 After entering a data in an element save it before moving on by clicking the Save button the Next Standard or Previous Standard button 4 For each supporting document listed you must e identify the page number containing the information that supports the factor or element as specified in the Survey Tool e attach only pages and sections
25. aluation check the box for the product s m the Selec for Resdiness Evaluation column To select evaluation options te submit for survey check the box for the options in the Select to Sibrmit for Survey columna Click the appropriate survey type in the Select to Submit for Survey section and save You may revise these selections at any time during your readiness evaluation an 2 en Select to Suber for initial 5 HKriurning Sureey close thas window 2002 2009 b Nabonal Commitios for Quality Assurande Palen Pending Lise of this Web ste applicaion consttuies acceptance ofthe License Agreement and mac Policy Done i MB internet fa Kinn gt Screenshot 12C Submit Survey Tool 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA Ge https fiss ncga org RDSat ATCategoryMain asp ProductType LicensetactivityID 12255 File Edit View Favorites Tools Help ve ok survey Tool 20095MPs Lic 12255 i K fm Page E Tools SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDARDS RGANIZATION SURVEY TOW RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES _ ACKGROUND iio Next click on Submit Survey Tool To enter the Survey Tool select a tab above This section includes all the Structure amp Process measures that are
26. and Link More Elements if you would like to link this document to more elements f click Save To link another new document to an element repeat steps a through e To upload documents You may also wish to refer to Quick Tips for Uploading Documents a From the Survey Tool page click Upload Documents b the Documents verification and upload window will appear maximize window c scroll down to view documents d Under the Supporting Documents for the Survey Tool header you will see the Document Name Document File Path Referenced in Elements Verify Document Path Upload Complete and Remove from Server fields e complete the Verify Document Path field by Browsing to document file path recommended or by copying and pasting it f after browsing select the file path and open it from the file look in menu g click Upload Document h The page will refresh Yes will appear under Upload Complete and file path will move if the upload is successful i You must verify the path and upload each document j Please upload documents periodically in batches To remove documents a Select the checkbox under the Remove document from server field b click Remove Documents from Server button at the bottom of page c click OK in the dialogue box No will appear if removal is successful d click return to Survey Tool when you have completed uploading the documents Tip Always logout when you are finished workin
27. andards e You are an existing user and have elected to change your password Password Criteria New passwords must be at least 8 characters in length and must also have 3 of the 4 following characteristics Atleast one uppercase character Atleast one lowercase character Atleast one numerical character Atleast one symbol i e amp etc Enter Your User ID and New Password Below New Password Sd SRA Password Cancel Home HICE Change PS fc Inbox Micr i Windows Me a Microsof Lt by 12 06 PM 21 Screenshot 2A Welcome License Welcome Windows Internet Explorer provided by Comcast EI EI hetes iawneqmorgitencaterduatiATWwelcomenceredans O Ma Bc Fie Eat Wew Favorites Tools Help de Favorites E Gl Ei mm Pages Safety Tode Me oy NCQA Se 20 YEARS HOILE WHATS MEW HELFA INSTRINCTIONS LOGOUT Interactive Survey System on l Your organization has licensed the following WWeb Administration based publications Cleck on the link below to enter the adruntistratree area Please select one lo use Lisaras 1733 200 Inactive Projects Select the 2010 SNP Structure amp Cleck on the Inactrwe Projects link listed below to view inactre projects Process license link to enter the ISS tool Inactivo Projects following surveys Please select one lo vigi Ea 3 Internet Explorer Ea Y 20110 Toolkit Sandra s Ca Document Microsof
28. awer this is optional and nat requited 33 Screenshot 6A Enter Survey Tool Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA Efe ex de 2 https fiss ncga org RDsar ATCategoryMain asp ProductType license activityID 12255 a File Edit View Favorites Tools Help FE II E ee gt We adr es survey Tool 20095MPs L x j The Health Plan of the Upper B ae Page 6 Tools Pecera Fy SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDARDS ORGANIZATION 3 En l E SUN LESULTS APPENDICES GLOSSARY DEX ers ES Apia SURVEY TOOL en RESULTS PPENDICES GLOSSARY INDE Survey Tool To enter the Survey Tool select a tab above This section includes all the Structure amp Process measures that are used for evaluation The categories in the tabs above organize the Structure amp Process measures Each category includes information about the Structure amp Process measures necessary to understand the survey process This information includes the Structure amp Process measures elements that specify exactly how the Structure Process measures are evaluated and scored specific scoring rules for each element the data source needed to document the scoring the scope of review for each element and additional explanation and examples This dynamic Survey Tool
29. be all inclusive or prescriptive Measure Documents SPECIAL NEEDS PLANS Policies and procedures for identifying members for complex case management Specific criteria used to identify members eligible for complex case management program Scripts or protocols with evidence based guidelines and automated documentation of contacts Policies or reports that demonstrate frequency with which SNPs systematically identify eligible members for case management Case management procedures Sample case management reports For Element C screenshots are required considered reports For Element E scripts for in person phone conversations are required For Factor 3 the SNP must submit documentation to support its claim for not applicable N A based on the requirement to provide case management to all members opt in opt out Provider manuals training brochures information on organization s website used to inform and educate practitioners Reports demonstrating an evaluation of member complaint and appeal data including how the population was identified sampling methodology and collection of valid data 19 Report showing an organization s analysis of CAHPS results and opportunities for improvement it identified if used Reports demonstrating identification of opportunities for improvement Organizations with no members at the start of the look back period may select not applicable N A however you must provide informati
30. cable Standards You may revise your choices any time prior to submitting the Survey Tool Upload Documents You may begin uploading your documents to our server at any time Prior to submitting your Survey Tool for review you will have to have uploaded all your documents to the server This function allows you to do that when convenient such as once you know the document is final and will not be changing Click on the Select Evaluation Options link on The categories in information about the ormation includes Submit Survey Tool To formally begin the survey process you uated and scored must submit an application for survey that includes the license number for your Survey Tool We will work with you to confirm your application and set a submission date for the Survey Tool and any documentation Your survey commences when you submit the Survey Tool at which point we consider any documentation attached to be final The Policies and Procedures provide complete details of the application and survey processes ey Tool allows you to h the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and identified with the PA symbol You may view a glossary definition at any time by cl
31. e Projects link listed below to view inactive projects for mromero License 12255 e Inactive Projects 2008 Special Needs Plans comp for mromero License 11590 Surveys amp Results We have conducted or are conducting the following surveys Please select one to view 2004 CVO 2007 CVO v Done ES Inbox Microso f 2010 Screenshots Welcome Mozil Ti Logout 104 Co EJ M og 41 Screenshot 11A Utilities Completeness Check Organization Background 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA a T rT File Edit View Favorites Tools Help we e Eu oo N ig quality 6 Organization Background X The Health Plan of the Upper 2 SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURWEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT ORGANIZATION ici iia SURVEY TOOL RESULTS GENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES BACK GROUND Utilities Tab ORGANIZATION INFORMATION Survey Tool Utilities Microsoft Internet Explorer provided by NCQA Survey Tool Utilities After you are The following utilities are available to help you review data in yo finished completing the tool please click Completeness Check e Use the link below to check for any incomplete elements for thd ON the Utilities tab and check your ISS tool completeness
32. e size of those documents the speed of your server and network conditions the upload process may take several hours The following facts tips and guidelines will help make sure that your documentation makes it to NCQA on time and with a minimum of hassle e Upload early Upload often It s never too early to upload completed documents Uploading documents is not the same thing as submitting the Survey Tool ST and starting your S amp P assessment You can visit the upload screen as often as you wish before hitting the Submit Final Survey Tool button If a document you have already uploaded to the ISS server needs to be updated or replaced no problem Simply resend the updated document with the same file name The ST will only use the latest version you can add or delete documents from the ISS server before you submit e Document bulk will affect your upload times Bulk is NCQA s term for the total size in kilobytes of all your organization s supporting documents For example ten 200 kilobyte documents have the same bulk as one 2 megabyte document Your upload times will be determined in large part by your document bulk e Your network and server capability will affect upload times too Every network is different yours may be extremely fast allowing you to upload several documents at once without concern But if that s not the case you might consider uploading during off peak hours e Your Privacy is Paramo
33. entation upon NCQA s request SNPs with questions regarding plan comment requests should contact a member of the SNP Team immediately for clarification since it is extremely important for you to submit appropriate responses to these requests NCQA will then conduct a final review of any clarifying information the plan provides along with the surveyor s assessment and finalize the survey results Please Note This is the only opportunity Plans will have to address outstanding issues for scores less than 100 percent 18 NCQA Resources Online Support NCQA s SNP Web page http www ncga org snp contains a wealth of information that includes recent news from NCQA the Policy Clarification Support PCS system policy Clarifications and updates and slides and audio recordings of SNP trainings PCS Send any questions about interpretation of the Structure amp Process measures through the PCS system on the NCQA Web site at http app04 ncqa org pcs web asp TIL_ClientLogin asp FAQs FAQs are available on the SNP page of NCQA s Web site http www ncga org snp Recommended Supporting Documents Ensure that your documents policies procedures reports and materials address all aspects of each element The following is a list of documents recommended to attach as evidence of performance so the NCQA surveyor may complete the evaluation of your SNP plan against the Structure amp Process measures The list is not intended to
34. entified with the FA symbol You may view a glossary definition at any time by clicking on the FA symbol w E E Inbox micr Internet Windows Me SNP Screen Ch Survey Tool O A 11 10 AM Screenshot 9B Upload Document https iss ncgqa ore nextStageID 1fretMsp Document Verification and Upload Microsoft Internet Explorer A A SERA Suey PO PI Remowe From Server Referenced in Very Document File Path Upload ea Elements Copy to input box Complete 2009 SNP H Multi Department SNP4 Element A HAMuti Department Effort Yes Training Efforts SNP Sessions Assessment Phase INSNF Training 2009 SNP Training Sessions doc Verify document file path Supporting Documents from the Organization Background Section Document Document File Referenced in haters Pre aa Upil ee ee Name Path Duestiond s Copy lo input box Complete Server No documents were referenced in this Survey Tool Return to the Survey Tool and reference files in the appropriate sections as needed Return to Survey Tool Upload Documents J Remowe Documents fe Inbox Micro F gt gt Internet E93 Microsoft F E l 12 10 PM 39 Screenshot 9C Upload Documents Survey Tool 2008POC Li Lic 1374 Engagement Health Microsoft Internet Explorer provided by NCQA Geo el https jiss ncqa org demosite rdsat 47 CategoryMain asp ProductT ype License
35. ernet Explorer provided by NCQA BAA ge https fiss ncga org RD5at ATLogin asprRedirect true b 4a s E Liv ej File Edit wiew Favorites Tools Help Y abr E Interactive Survey System Login en ve 5 g gt Page r it Tools k NA Interactive Survey System You must use your SNP 2010 License PLEASE LOG IN Password ID to log in and view your results If you have forgotten your Password enter your User ID above and click here to continue To purchase a license to access this system click here for details 2002 2009 by National Committee for Quality Assurance Patent Pending Use ofthis Web site application constitutes acceptance ofthe License Agreement and Privacy ME e Local intranet 100 at Inbox Microsoft Blackboard Acade Interactive Surve Tt Documenti Micr El x a Be 10 51 AM 45 Screenshot 13B Log in to view your results continued Welcome Mozilla Firefox File Edit View History Bookmarks Tools Help v E A A O http stagendO1 ncga org development rdsgafrdsat ATWelcome ccred asp v7 2 eN Google P 8 Most Visited ge Getting Started y Latest Headlines a Do you want Firefox to remember this password Never for This Site 8 A HOME WHAT S NEW HELP amp INSTRUCTIONS LOGOUT Interactive Survey System Your organization has licensed the following Administration Web based publications Click on the
36. g email dod ai Yes El e mail e mail doc Element A Medical G Medical SNPS Element B GAMedical Certification of Yes Certification Certification of of Health Health Care C Care Provider doc Provider Supporting Documents from the Organization Background Section Very Document File Path Copy to input box Upload Remove From Complete Serner Document File Referenced im Path Question s No documents were referenced in this Survey Tool Return to the Survey Tool and reference files in the appropriate sections as needed Return to Surrey Tool Upload Documents close this window w sa Start C AE E Inbox Micro a 3 Microsoft Dzintenet EA A 40 Screenshot 10A Logout Welcome Mozilla Firefox File Edit un v e X A O http Istagendol ncqa orgidevelopmentirdsqajr sal ATWelcomeAccred asp LY r Googl LB Most Visited Getting Started A Latest Headlines a a View History Bookmarks Tools Help HOME WHAT S NEW HELP amp INSTRUCTIONS LOGOUT Interactive Survey System Your organization has licensed the following Administration Web based publications Click on the link below to enter the administrative area Please select one to use e Administrative Functions Always logout when you CC eee ee 2010 ct rocess 2010 co your ISS tool for mromero License 14623 Inactive Projects 2009 SNP Structure amp Process 2009 comp Click on the Inactiv
37. g on your ISS tool screenshot 10A 16 17 Perform a completeness check before you submit your survey tool To check completeness a Click Survey Tool followed by Utilities b Select the Completeness check link c Review the Evaluation Option selections d double check each element and complete all that are listed as incomplete To submit survey tool s After you have confirmed all information in the survey tool is accurate and you are ready to submit a Click on Set up the Survey Tool followed by Select Evaluation Options b Mark the checkbox for your survey type under Select to Submit for Survey and save c click on the Submit Survey Tool link on the Top Navigation Bar d confirm that you are ready to submit your final Survey Tool This is the last chance you have to cancel the final submission of your Survey Tool e Click ok to submit your Survey Tool for survey Once submitted you will receive a confirmation and have access to a read only copy of your submitted Survey Tool screenshot 12D Please note once you have successfully submitted you will receive a project number for that survey tool on the completed submission page Please save this number You will use it to verify you 25 18 are viewing the correct final survey tool results once NCQA finalizes the scoring and notifies you of the results Reviewing your results after NCQA completes the assessment After you receive notification from NC
38. ge document with a copy of the document cover page on top Consider making your final Word or Excel documents read only to ensure no changes will be made Try using legal line numbering as on the left of this page to identify areas that demonstrate compliance remember this may change your pagination Highlight key sentences or areas of your documents to call the surveyor s attention to that area Insert a hyperlink if necessary to demonstrate compliance by either copying the url https iss ncga org RDSat ATLogin asp or by using the Insert function of Word or Excel 50 Label drafts and final documents carefully to be able to distinguish between them Only submit final versions of documents NCQA will not consider drafts Use the date feature in footers to keep track of last time you updated the document note that it defaults to updating every time you open the document whether you made changes or not Linked documents can be edited but remember that may change page reference numbers Uploaded documents those already transferred to NCQA servers cannot be edited Prior to submission if you need to edit a document uploaded to the NCQA server you must remove edit and re upload it After submission you may not edit uploaded documents Directions for legal line numbering in Word pad On the File menu click Page Setup and then click the Layout tab 2 If you re adding line numbers to part of a doc
39. her conducting or assigning to providers the following tasks and manitaring system performance Yes 1 For planned transitions from members usual seting of care to the hospital and 5 transitions from the hospital to he next setting Wdentifying that a planned transition is going to happen 2 For planned and unplanned transitions from members usual setting of care to O 3 the hospital and transitions Irom the hospital to he next setting sharing the sending setting s care plan with the receiving setting within one business day of notification of the transition 2 For planned and unplanned transitions from any setting to eny other setting D notifying the patent s usual practitioner of the transition within a specified timeframe 4 For all transitions conducting an analysis of the organization s aggregate oO performance on the above aspects ol managing transitions at least annually Scoring 35 Screenshot 8A Document Library Survey Tool 7009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA E T El https iss ncga oro RDSat 0 TCategoryMain asp ProductType license lcactivityID 1 2255 gt o Fie Edit View Favorites Tools Help ur hr 88 r G Windows Live Hotmail E Home NCQA Intranet e Survey Tool 2009 X E Customer Self Service DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLI
40. icking on the PA symbol K Q Window win Obi Lv Docume 30 Screenshot 4C Select Survey Type Evaluation Option fe Survey Tool Windows Internet Explorer provided by Lomcast heise hoc nee org idemocitajrdsa CA Manet val borProduict ean Sekci Evaluation Opbons SE TUE MEHI PALMA TEM GF Tice UPLOAD GOGE BAT SUES TOOL Instrucbons To conduct a readmess evaluation and undergo turay you must select from the evaluation options below For additional informatson on selecting evaluation options click on the mstructions link above To select evaluatron options for resdiness evaluation check the box for the product s in the Select for Readiness Evaluation column Ta select evaluation options to submit for survey check the box for the options in the Select to Submit for Survey column Select your survey type fe selections at any time during your readiness evaluation Save _ Select fos Evaluation pis Reacdinma Evaluation You may select any one of the followigg evaluation options ect bo Submit for Survey close thas window 2002 2008 by National Commitiee for Quality Assurance Pa eni Pending Use of this Web site applicaton consttuies acceptance of the License Agreement and Preg Follow 31 Screenshot 5A Organization Background Organization Background ZO 10SNPs Lic 1783 Engagement Health Windows Internet Explorer provided by Comcast E m E
41. link below to enter the administrative area a Please select one to use e Administrative Functions e Change User Password 2010 SNP Structure amp Process 2010 comp for mromero License 14623 2009 SNP Structure amp Process 2009 comp for mromero DO NOT click here license 1s displayed Click on the Inactive Projects link License 12255 e Inactive Projects 2008 Special Needs Plans comp for mromero License 11590 CLICK HERE The SNP tool Surveys 8 Results located under Survey amp We have conducted or are conducting the p buda lt lt Results to view your FINAL results Please select one to view Done f JE gt Inbox Microso f 2010 Screenshots pa Change Passwo gt Welcome Mozil EJ i dop 46 Screenshot 13C View Results Results Legal Agreement 20105NPs Lic 1783 Engagement Health Windows Internet Explorer provided by Comcast E ES geo e https iss naga ang demosite rdsat scoring asp amp a e x 3 Songe Fis Edit vu Favorites Tese Help iy Favorites g E Results Legal Agreement 20105NPs Lic 1783 Engag BO m ir Page Safety Tools del NCQA 20 YEARS ria yo PRINT HOME iaa REY POLICIES STANDARDS 2 ORGANIZATION a Sue SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX A PROCEDURES GUIDELINES BACKGROUND da ze 2010 SNP Structure amp Process 2010 Reports and numeric resul
42. materials brochures and benefit summaries Contracts or agreements with the state Medicaid agency MOU MOA or letter legislation regulation indicating a refusal or inability to act from the state procedures for administering Medicaid benefits written notification of a scheduled meeting with state to discuss contracting within the past 12 months and acknowledgment of receipt of instructional materials from state on how to administer Medicaid benefits Job descriptions procedures and scripts used by staff that assist members with information on Medicare and Medicaid eligibility benefits and claims Policies and procedures for arranging services for members along with provider directories provider manuals Reports on accessibility of Medicare and Medicaid practitioners and providers Elements 6A 6B and 6C are not applicable N A for Chronic condition and Institutional benefit packages 21 Element 6B Factor 2 is not applicable N A for SNPs that are not contractually obligated to adjudicate Medicaid claims Element 6D is not applicable N A for all Dual Eligible SNPs and Chronic and Institutional SNPs with fewer than 5 dual eligible members however Chronic and Institutional SNPs must provide information to support the N A claim and NCQA will verify with enrollment data from CMS Element 6E is not applicable N A for Chronic condition and Institutional SNPs with fewer than 5 dual eligible members are not required to re
43. n and arrange services Reports detailing an analysis of admissions and ER visits which indicates how the SNP works to reduce unplanned transitions For Factor 4 of Element D SNPs with no members at the start of the look back period may select not applicable N A however you must provide information to support the N A claim and NCQA will verify with the April 2010 CMS SNP Comprehensive Report 20 Policies and procedures that demonstrate how the SNP receives updates from facilities on members care and monitors their health Procedures delineating how the organization and facilities respond to changes in members health status and triggering events Contracts or agreements with facilities covering their reporting responsibilities Reports such as MDS or materials that show how the SNP collects member health status data Job descriptions of staff that visit members and reports they provide on changes in members health status Briefing materials distributed by facilities Elements 5A 5B and 5C are not applicable N A for Chronic condition and Dual eligible benefit packages Policies and procedures that demonstrate how the SNP coordinates Medicaid and Medicare benefits and services Procedures and reports used to determine Medicaid eligibility and changes in members Medicaid eligibility Instructional materials distributed to members or responsible parties on where to reapply for Medicaid Sample marketing
44. ny additional market names plan names or other ways in which this SNP is referred to in the organization s documentation You may attach additional documentation for this response ff so desired h 5 Please inlcude the mames of affliated SNP plans that operate under the same corporate structure parent organization You may attach additional documentation for this question 6 SMP Type i dual chronic institutional 7 this is a Chronic care SNP please include the diseases or conditions covered by this benefi package you may attach additional documentation to respond to this question p gt Microsoft Dirtiook PE ri en Ape Log F Organization Badagr Y 20 10 Toolkit Sandra pa 32 Screenshot 5A Organization Background continued Organization Background SEAT 1783 1 ngapcment Healih iro interret Enplor cr pl ovided by Comcast e o A E Organization Background 20 ISNPS Lie 1733 Engag if thes is a Chronic care SNP please include the diseases or conditions covered by this benefi package you may attach additional documentation to respond to this question a E Pisase attach the SNP Model of Care The organization can attach additional documents Organizations may attach information o materials about the SNP benefit package that provide additional background imomatan h
45. o add documents to the library without linking them to a specific element This feature allows you to load your documents so that they are available in a list of previously linked documents that you can access when you need to link a document to an element during your readiness evaluation NCQA limits the types of documents you may send see the list of Recommended Supporting Documents at the end of these guidelines NCQA encourages you to submit only documents pages or sections necessary to demonstrate how your organization meets the measures Preparing your documentation for submission in ISS requires you to follow several steps The Toolkit contains written instructions and screenshots to walk you through each process You must 1 add your documents to the Document Library 2 link the documents to the appropriate element s and 3 upload the documents to NCQA s secure server It is important to note that adding documents to the Document Library and uploading documents to NCQA s secure server are separate and distinct processes When you have added your documents to the Document Library AND linked them to appropriate elements you should begin to upload the documents in batches to the NCQA secure server thus avoiding possible delays that could occur around the June 30 submission date For instructions on attaching linking and uploading documents please refer to page 24 and 25 of the section titled Steps and Screenshots fo
46. oft Internet Explorer provided by NCQA Go E e https iss ncga org RDSat ATCategoryMain asp ProductTypes license amp activityID 12255 v a 4 x Live Search File Edit View Favorites Tools Help we de Windows Live Hotmail Nor amp Home NCQA Intranet amp Survey Tool 20095NPs L X tar E deb y Page Oj Tools hecim DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S NEW SEARCH HELP amp INSTRUCTIONS ES AS ORGANIZATION S 1 t th S t S DOL BACKGROUND RESULTS APPENDICES GLOSSARY INDEX elect the Setup Survey Tool to select the SNP s correct evaluation option SETUP SURVEY TOO Survey Tool Mm To enter the Survey Tool select a tab above This section includes all the Structure amp Process measures that are used for evaluation The categories in the tabs above organize the Structure amp Process measures Each category includes information about the Structure amp Process measures necessary to understand the survey process This information includes the Structure amp Process measures elements that specify exactly how the Structure amp Process measures are evaluated and scored specific scoring rules for each element the data source needed to document the scoring the scope of review for each element and additional explanation and examples This dynamic Survey Tool is used to evaluate organizations and individuals The Survey T
47. on to support the N A claim and NCQA will verify with the April 2010 CMS SNP Comprehensive Report Reports that demonstrate the SNP identified at least three meaningful clinical issues and the SNP selected three clinical measures that are relevant to its membership SS tool supplemental worksheet Organizations with no members at the start of the look back period may select not applicable N A however you must provide information to support the N A claim and NCQA will verify with the April 2010 CMS SNP Comprehensive Report Documented processes AND reports are required for each factor in SNP 4 Elements A B and C Policies and procedures detailing the organization s process for identifying and managing planned unplanned transitions between care settings which include timeframes for specified activities Procedures with specified timeframes that demonstrate how the SNP notifies the member s usual practitioner of a transition how the SNP communicates changes in members conditions to member and or responsible party and how the SNP educates member and or responsible party regarding the transition process Reports demonstrating aggregate analysis of performance managing transition tasks Policies and procedures for reporting by contracted entities Reports on daily admissions or staff notification of transitions Policies and procedures for case managers or other staff to contact members at risk for a transitio
48. ool Submission Your Survey Tool has been submitted Thank you Submission Completed Thank you for submitting the Survey Tool ta NCQA and for participating in the MCGA survey process A copy of your assessment and documentation has been succegstully transterred tq gt cords A project number for the survey The project number for this survey is 9606 is assigned What Happens Hext When you next log in to the Interactive Survey System a section titled NWCOA Survey and Results appears on the Welcome page The NCOA Survey and Results section includes a read only copy of the assessment and a listing of documents you have submitted including the project number assigned above For details on the stages of the survey process and how to access the Survey Tool during the process please see the Policies and Procedures for the applicable accreditation certification or recognition program Your original version of the Survey Tool remains available to you to continue the ongoing process of quality improvement We look forward to working with you in the coming weeks If you have any questions regarding the survey process please contact your assigned NOGA contact directly or MCGA Customer Suppor at Doo 25 505 or customersupport nega org Thank you again for participating in the NCQA survey process Please click here to continue 44 Screenshot 13A Log in to view your results gt Interactive Survey System Login Microsoft Int
49. ool allows you to evaluate yourself just as we will but at your own pace You may score yourself attach the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and identified with the FA symbol You may view a glossary definition at any time by clicking on the FA symbol lt Q Window AT OA Gy Docume fm SNP Scr p s 1 41PM Screenshot 4B Setup Survey Tool Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA https fiss ncga org RDSat ATCategoryMain asp ProductType licensetzactivityID 12255 File Edit View Favorites Tools Help ve bi 88 2 Windows Live Hotmail E Home NCQA Intranet E Survey Tool 2009SNPs L X SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S NEW SEARCH HELP amp INSTRUCTIONS oc o tjg nn wri Or azamam mm Arie A REIT A Is ee GLOSSARY INDEX Survey Tool Microsoft Internet Explorer provided by NCQA Setup Survey Tool SETUP MENU EVALUATION OPTIONS UPLOAD DOCS SUBMIT SURVEY TOOL el valuation Options In this section you select the evaluation products you wish to use The Survey Tool will reflect your selection and will automatically include the appli
50. orts OR materials Element C Documented processes AND materials SNP 6 Coordination of Medicare and Medicaid Coverage materials materials Element C Documented processes OR reports OR materials Element D Documented processes AND MAY PROVIDE reports OR materials Element E Documented processes AND reports OR materials If you would like examples of documented processes reports or materials please refer to the Examples of Data Sources document found on page 13 or the Guidelines for a Successful Evaluation of a Special Needs Plan SNP Against the 2010 Structure Process Measures document which starts on page 15 l 12 NCQA Measurinc g quality Improving wh salt care 2010 ISS Toolkit Examples of Data Sources Documented Process A documented process includes policies and procedures process flow charts protocols and other mechanisms that describe the SNPs actual process it uses Reports Reports are aggregated sources of evidence of action or compliance with an element Materials Prepared materials or content that the organization provides to its members and practitioners Policies and procedures with timeframes where appropriate Procedures for arranging services Procedures for ordering services from providers Contracts or agreements especially for facilities responsibilities with institutional SNPs and administering Medicaid benefits to dual eligibles Procedures for network facilities
51. port however you must provide information to support the N A claim and NCQA will verify with enrollment data from CMS For security reasons including the protection of the data and documents you send to us we limit the types of documents you may send The permitted file tyoes are CSV DOC GIF JPG MPP PDF PPT RTF TIF TXT VSD and XLS We cannot accept files in other formats Please note that most other formats can be converted to GIF TIF or JPG via scanner or to PDF using Adobe Acrobat Please do not attach documents to ISS that contain Protected Health Information PHI 22 23 2010 SNP ISS Toolkit Steps and Screenshots for Key Activities This section of the toolkit summarizes and illustrates steps and information organizations can use to perform certain activities in their ISS survey tools It provides a quick reference for logging into survey tools changing passwords adding documents to the library uploading documents to your server and conducting completeness checks Please consult the Interactive Survey System User s Manual in ISS for complete instructions and details on all ISS survey tool functions Getting started NCQA gives the Administrator for each SNP a temporary user ID and password which prompts the user to change the password the first time it is used Administrators should store their password in a safe place since they can grant up to 3 additional users access to the organization s
52. quipo de SNP Brett Kay kay ncga org Casandra Monroe monroe ncga org Sandra Jones jones ncqga org Melanie Bujanda Romero romero ncqa org Priyanka Oberoi oberoi ncga org 2010 ISS Toolkit Reporting Requirements by SNP Type Element Element E Providing Members With Information Element F Case Management Process Element G Informing and Educating Practitioners Measure SNP 2 Improving Member Satisfaction Element A Assessment of Member Satisfaction Y Element B Opportunities for Improvement Y Measure SNP 3 Clinical Quality Improvements Element A Relevance to Members Measure SNP 1 Complex Case Management lt lt lt lt lt lt lt lt Measure SNP 4 Care Transitions Y Y Element C Identifying Unplanned Transitions Y a Y Measure SNP 5 Institutional SNP Relationship With Facility Y Not for Chronic Duals Element B Monitoring Changes in Members Health Status Y Not for Chronic Duals Element C Maintaining Members Health Status ON Element C Maintaining Members Health Status Y Not for Chronic Duals Measure SNP 6 Coordination of Medicare and Medicaid Coverage Y Not for Chronic Institutional Element B Administrative Coordination for Dual Eligible BP Y Y Element C Relationship With State Medicaid Agency for Dual Eligible BP Y SEE EXCEPTIONS Y SEE EXCEPTIONS EXCEPTIONS SNPs must provide documentation for any of the following NA scores allowed in Elements
53. r Key Activities This document walks you through each activity and directs you to several screenshots which illustrate the steps you need to follow such as attaching documents and 8D 8E linking documents and uploading documents Tips and helpful information for uploading documents can be found on page 56 of this guide in the section titled ISS Quick Tips for Uploading In addition you may wish to view a demo within the ISS Tool on Uploading Documents in ISS to do so select Help and Instructions on the dark blue tool bar scroll down to ISS Demonstrations and click on Uploading Documents in ISS Utilizing the available resources and following each of these steps are essential for successful preparation of your documentation for the submission process 3 Download the Supplemental Worksheet for SNP 3A by clicking the Supplemental Worksheet link at the bottom of Element A Review the instructions and enter the requested data as directed documenting your performance After completing the worksheet include a copy of it in the document library and link itto SNP 3 Element A 16 Completing the Survey Tool Print out and use the instructions in the Survey Tool which you can access by clicking the Help button on the Navigation Bar on the opening screen The Structure Process Survey Tool instructions appear on the next screen They provide all the information necessary to successfully navigate and complete the tool and complete your re
54. ring 100 80 50 20 0 3 Internet Gb Windows Me S Calculator O Inbox Micr 36 Screenshot 8C Document Library Add Documents Survey Tool Z20095NPs Lic 1706 Engagement Health Microsoft Internet Explorer provided by NCQA File Edit Wem Favorites Tools Help El https ss ncga orghdemosite rdsat AT5howElements asp 5tandardIL 4 x Tr abr e Survey Tool 2009SMPs Lic 1708 Engagement Health en T NCQ 3 Guia Peg health ce up New Document SURVEY TOOL sla Document name 2009 SNP Training Sessions amp PROCE Document file path SNP Training 2009 SNP Training Sessions doc Use the Browse button to locate the document Document name Z gt Z O0 Locate documents by browsing Document file path fnd them More information Use the Browse button to locate the document included 1n the ISS steps Document name Document file path Bros Use the Browse button to locate the document gt save Saveand Attach More and Attach More Cancel a Return to Document Library https iss ncga ore referrer A DocumentLib aspidocLibAdd newtorde fe Inbox Micra gt 2 Internet a 2 Microsoft Screenshot 8D Document Library Link Documents 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA Survey Tool Go X le https iss ncqa org
55. rm a readiness evaluation at its own pace before submitting data to NCQA You may assess your program s operations and evaluate your performance against the Structure amp Process Measures During the readiness evaluation stage NCQA does not view your information therefore you can use the tool to its full capacity and evaluate your organization in a variety of ways Evaluation The NCQA survey process begins with the submission of the Survey by NCQA Tool which is final upon receipt by NCQA All Survey Tools are due to NCQA no later than June 30 2010 If you have specific questions about your preparation contact Customer Service at 888 275 7585 8 30 a m 5 00 p m Eastern Time or via e mail at customersupport ncqa org Preparing for the Readiness Evaluation 1 To facilitate the process you may find it helpful to keep documents that you link to the Survey Tool in a single directory shared by all your users This will facilitate multiple users working on the Survey Tool You can modify move or rename a linked document since it is not final until you submit it to NCQA for the evaluation If you move or rename documents be sure to update the links in the Survey Tool before your final submission 2 The Document Library includes a list of all documents linked to your Survey Tool From here you can link unlink or edit documents for any element Refer to the instructions under the Help tab for detailed information 15 You can als
56. s and elements this will help us assess your performance Do not include any symbols i e in the title of the documents when saving them If you have any S amp P content or SNP reporting questions the preferable mode of communication is in writing through the Policy Clarification Support PCS system http app04 ncga org pcs web asp TIL ClientLogin asp You can contact the SNP team by e mailing us at SNP ncqa org SNP Team Contact Information Brett Kay kay ncga org Casandra Monroe monroe ncga org Sandra Jones jones ncga org Melanie Bujanda Romero romero ncqa org Priyanka Oberoi oberoi ncga org NCQA Aeasuring quali dl oroving th eis care SNP Mensajes de Clave para Reportar ISS 2010 Los siguientes mensajes de clave son importantes y deben ser utilizados durante la evaluacion de su organizaci n y la sumisi n del instrumento de ISS e Si su organizaci n tiene m s de un paquete de beneficio de Special Needs Plan SNP usted tiene que presentar un instrumento de inspecci n separado para cada paquete de beneficio de SNP Use el nombre de SNP H numero e ID de el plan para identificar el instrumento de inspecci n correcto e Presente el instrumento s de ISS temprano para evitar demoras de tr fico de internet pero no presente su instrumento s de ISS despu s del 30 de Junio e Establezca cada instrumento de ISS por seleccionar el tipo de SNP correcto e Cada instrumento de la inspecci n de SN
57. s for the Measures and Elements assigned to that survey You can add a document in ISS directly from an element or by going into the Document Library however the following instructions are for adding documents from the Document Library To add documents a click Document Library b click Add Document to the Library a form appears that contains fields you must complete entitled Document name and Document file path c use the Browse button to launch a file look in prompt of your local drives d locate the document and select it using the Open button located on the file look in prompt e scroll over the name of the document only not the entire path f copy and paste the name of the 24 14 15 document into the Document name field g click Save or Save and attach more documents Tip We recommend that you browse to the document since the name and file path must match exactly and typing this information could introduce typing errors UE Tip Ensure that document titles do not contain any special characters or symbols e g _ amp etc Remember to link documents to the appropriate element s in the Document library Linking a document to an element a Click Link to New Element to link documents b enter the page number s in Reference Pages c select the Relevance level from the available options d select the element to which you want to link the document to e click Save or click Save
58. survey tools 4 A W N 5 10 11 12 13 Go to https iss ncqa org you may want to bookmark this page Enter the user ID and password passwords are case sensitive Click log in Accept the license agreement access is not permitted if you do not accept Welcome page picture of Peggy O Kane Administrators may manage users via Administrative Functions or Change User Password see full instructions in User Manual Select the appropriate survey tool by clicking on 2010 SNP S amp P link to enter the tool screenshot 2A Click on the Help and Instructions tab for complete instructions or a Users Manual screenshot You must set up your survey tool by selecting the appropriate survey type for the SNP before you can work in ISS Setting up your survey tool a Click Set up Survey Tool screenshot 4A b Click Select Evaluation Options c Select Initial or Returning Survey d Select for Readiness Evaluation e click Save f close window to return to SNP page On Navigation Bar click Organization Background tab and complete screenshot 5A Click Survey Tool to return to SNP page screenshot 6A Top Navigation Bar includes ISS functions Blue Navigation Bar includes contents of the S amp P measures Click the SNP Tab Select the Measure or Element to begin readiness evaluation screenshot Tip If you have selected the appropriate survey type you will be allowed to populate answer
59. tem Your organization has licensed the following Administration Web based publications Click on the link below to enter the administrative area A i The ISS tool gives Please select one to use e Administrative Functions you the option to Change User Password SY ett E change your 2010 SNP Structure amp Process 2010 comp password for mromero t E License 14623 Inactive Projects 2009 SNP Structure amp Process 2009 comp Click on the Inactive Projects link listed below to view inactive projects for mromero License 12255 e Inactive Projects 2008 Special Needs Plans comp for mromero License 11590 Surveys amp Results We have conducted or are conducting the following surveys Please select one to view Done fs Inbox Microso f 2010 Screenshots jw Change Passwo gt Welcome Mozil Ed m Jod Screenshot 1B Change Password Change PSW 20085NPs Microsoft Internet Explorer provided by NCQA MENE Ge el https fiss ncoga org RDSat AT UpdatellserPassword asprut 1 ae amp EB x ej Fie Edit View Favorites Tools Help wa lt br amp Change PS Z008SMPs er r d ok Page E Tools 2 Change User Password You have been brought to this page for one of the following reasons You are a new user and all new users are required to change their password upon initial login You are an existing user but your password does not meet current security st
60. ts generated or othe i are final once submitted to NCQA Click Results The organization may only use the reports and numeric results from the readiness evaluation for internal business purposes to examine review and otherwise analyze its business operations and may not use disclose represent or otherwise communicate these reports or numeric results to any third party for any other purpose The organization may not represent that it is NCQA Accredited based on reports or numeric results No individual or entity may purchase a license to use the Survey Tool from NCOA or use it regardless of the source to evaluate another organization against NCQA SNP structure and process measures This prohibition does not apply to individuals or entities that are assisting the organization with its readiness evaluation and preparation for an NCOA Survey The organization may not use the Survey Tool to evaluate another organization against NCOA SNP structure and process measures except as part of its own intemal preparation for an NCQA Survey including specifically evaluating a delegate s performance in order to conduct oversight as required by NCQA MaTosoft Outioak Citrix XenApp Log gt Results Legal Agree E Documentl Micros A Screen Shot Log In Screenshot 13D View Results continued Results nn al Apreement Zu 105HNPs Lic 1783 Engaperment Health Windows Internet LEHOTEH proridod Dy Lomas OIEA ENDECAR Fle Edit View
61. ument click Selected text in the Apply to box Click Line Numbers 4 Select the Add line numbering check box and then select the options you want 99 51 52 OO 1D URL WN e DW NON NNO WN NON e e qa BF a A NA hUYDND O OOo Jana E YD O 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Consejos para los documentos de ISS Mantenga documentos en un camino compartido Considere carpetas para cada medida de los est ndares Establezca un sistema para el control de versi n Establezca un nombre claramente para el documento su audiencia es ambos internos personal y agrimensores Evite caracteres como el signo amp o el ap strofo Evite nombres de duplicado Utilice archivos comunes como doc Word xls Excel ppt Power Point pdf Adobe PDF gft tif jpg No envie exe Executables Documentos que no tienen electr nicamente pueden ser escaneados y convertidos en PDF GIF TIF o JPG No debe escanear todo esto causa que los documentos sean muy grandes y puede ser un reto para que usted cargue y para que el agrimensor abra el documento Considere incluir las p ginas m s importantes de los documentos con una cubra p gina Considere hacer los documentos finales de Word y Excel S lo Lea para asegurar que ningunos cambios ser n hechos Intente numerar el documento como a la izquierda de esta p gina para identificar reas que demuestran
62. unt It s in the License Agreement NCQA stores documents on a dedicated high security server only accessible to our IT staff for maintenance Surveyors are prohibited from seeing documents until you submit you final ST and the assessment starts The Document Upload option will be added to the main navigation bar If you re already using the ISS you know that the document upload link is found under Submit Survey Tool on the black navigation bar The Upload Documents option can also be found on the main navigation bar saving users a click when it s time to upload documents e Be certain you re set to go before you submit your final ST Prior to submitting your Survey Tool use the Completeness Check to be sure you ve filled out all the portions of your Survey Tool the Structure and Process Measures call for The Completeness Check can be found under the Utilities section THE ISS MAKES managing the survey process easier from start to o 99 finish Kathy Barfoot National Manager of Accreditation UnitedHealthcare S6 ISS Upload Guidelines 1 Test the process It s critical to confirm that your documents will be received by NCQA The test will give you an idea of how quickly your documents will upload 2 Start early Send documents when they are complete Don t wait until your submission date 3 Send documents in bunches NCQA recommends uploading documents in groups of 2 to 5
63. used for evaluation The categories in the tabs above organize the Structure Process measures Each category includes information about the Structure Process measures necessary to understand the survey process This information includes the Structure amp Process measures elements that specify exactly how the Structure amp Process measures are evaluated and scored specific scoring rules for each element the data source needed to document the scoring the scope of review for each element and additional explanation and examples This dynamic Survey Tool is used to evaluate organizations and individuals The Survey Tool allows you to evaluate yourself just as we will but at your own pace You may score yourself attach the necessary documentation and make comments Following your readiness evaluation you must submit the Survey Tool to begin the formal evaluation process You may access a complete glossary of terms by selecting Glossary on the menu Key terms in the Glossary are highlighted and identified with the FA symbol You may view a glossary definition at any time 4 bw clicking on the PA symbol 6 Inbo A Ge Wind cu 2M 7 E Calcu ES Micro m Ay I 4 55 PM Screenshot 12D Submit Confirmation Confirmation of Completed Survey Tool Submission Microsoft Internet Explorer Survey Tool Submission Confirmation SETUP MENU PRODUCT LINEFRODUCT COMPLETE eT wee Confirmation of Completed Survey T
64. y clicking on the PA symbol ti oe Se wi e F Calculator fe Inbox Gy survey far SNP Scr File Edit Wiew Favorites Tools Help we a s8 E Customize Your Settings e Survey Tool 20095MPs L X i ha rien 1 Cu han monn banat ro i SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS Kelceli nn FOLIGIES STANDARDS ORGANIZAT HOM 7 ES i a w E PROCEDURES 2 GUIDELINES SURVEY TOL BACKGROUND RESULTS APPENDICES GLOSSARY IMIDE gt Document Library Microsoft Internet Explorer provided by NCQA Filtering by doc type in view by document Using the drop down box below you may filter the list of documents to view only those in one or more document types To select a document type highlight the document type To select more than one document type hold down the Ctrl button on your keyboard while you select multiple document types SNP z Select a filter option Fineas The o 3 the se Inter Sort by Document Standard File Path Date Attached Add Document to the Library The ork recelving comprehensive quality care in the lease restrictive setting ELEMENT A Monitoring Members Health Status Add pertinent documents to the document library At least quarterly the organization monitors information on all members health status fro facilities I dem Sco

2010 ISS TOOLKIT For the Assessment of Special Needs Plans

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