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Revision Updated: June 9, 2009

1. SNP Select a filter option The o the se Inter The orl i recelving comprehensive quality care in the lease restrictive setting ear Lats Y Add pertinent documents to the document library ELEMENT A Monitoring Members Health Status At least quarterly the organization monitors information on all members health statu facilities Scoring i Internet Gr Windows Me ES calculator 5 Inbox micr wE 31 Screenshot 6C Document Library Add Documents Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA SiGe GO El https ffiss ncqa oarg ROSat 47ShowElements asp StandardID 6764eCategory ShPEProductlineIO 1 amp MultiLineID EJ x O l Fie Edit wiew Favorites Tools Help w i EE E Customize Your Settings pa Survey Tool 20095WPs L X gt gt er 5 7 del Page 06 Tools SETUP SURVEY TOOL PRINT UPLOAD DOCUMENTS SUBMIT SURWEY OL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT STANDARDS ORGANIZATION R 2 HH HESU 5 APPENDICES F x ARTY TIDER amp PROCEDURES amp GUIDELINES ld BACKGROUND Ken AAS Bh Se 4 Document Library Add Edit Microsoft Internet Explorer provided by NCOA New Document Document name SNP Element 1 Document file path GASNPASNP Trainings SNP 3 19 09 xml Use the Browse button to locate the document Document name Document file path Locate d
2. Ge windows Me far SMP Screen coy Survey Tool thy fet 10 19 AM Screenshot 5B ISS tool Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA Ele fx de E https iss r cga org ROSatl aTShowStandard asp Category ShP Fie Edit View Favorites Tools Help e abr EE r e Survey Tool 20095NPsL X j The Health Flan of the Upper ca E Ei Page 0 Tools NCQA a Mie rima cpuctity mprowing h eallh core SETUP SURVEY TOD DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOO UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS Esce tjj POLICIES STANDARDS ORGANIZATION y y p SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES i BACKGROUND j z Sr 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 F G SNP 2 Improving Member Satisfaction Elements A B SNP 3 Clinical Quality Improvements Elements A SNP4 Care Transitions Elements A B C fe 10 15 AM Screenshot 6A Document Library Survey Tool 2009S5MPs Lic 12255 Microsoft Internet Explorer provided by NCQA Ele fx de E https ffiss ncga org ROSat 47CategoryMain asp ProductType license activityID 12255 gt x pl Fie Edit View Favorikes Tools Help r ar 88 F G windows Live Hotmail E
3. e g _ amp etc 13 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 23 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 and Link More Elements if you would like to link this document to more elements f click Save ENREDO RATTEN To link another new document to an element repeat steps a through e 14 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 doc
4. A TLategoryPlain asp ProductType License activityID 1574 File Edit View Favorites Tools Help wr utr e Survey Tool 2006P00c Lic 1574 Engagement Health en Es Page De Tools gt DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURWEY TOD UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS Mei a POLICIES STANDARDS a MIZAT OWN URWEY T TESULTS APPENDICE SLOSS ARV MDE amp PROCEDURES GUIDELINES SURWEY TOOL GROUND RESULTS PPEMDICES GLOSSARY INDE gt Document Verification and Upload Microsoft Internet Explorer provided by NCQA Remowe From Server Document Document File Referenced in Wen Document File Path Upload Name Path Elements Copy to input box Complete SNP G SNPiSNP Element TrainingsiS P 1 measures 1 3 Final 2009 notes ppt Unknown Element GASNMSNFP Trainingeis Yes Verify document file path Supporting Documents from the Organi Document Document File Referenced im eiserne Upload Remove From Name Path Guestion s onda papal ica Complete Sener Ho documents were referenced in this Survey Tool Return to the Survey Tool and reference files in the appropriate sections as needed Return to Survey Tos Upload Documents i Inte 000 K Y gou PNF T j 5 m Upload 34 Screenshot 7C Upload Documents Survey Tool 2008POC Lic 1574 Engagement Health Microsoft Internet Explorer provided by NCQA A le ES Oso Se https
5. Explorer provided by NCQA Sl A All Document Library Link to Element Document name SNP Element 1 Reference pages 1 3 Relevance Level Primary Mi Document file path G SNP SNP Trainings S P measures 1 3 Final 2009 notes ppt Please pick an element to link SNP4 Element A v Ai Save and Link More Elements Cancel and Return to Document Library 3 Make sure to select the element you are linking the document to and save Elements A SNP4 Care Transitions Elements A B C Inte v Inbox windo Micr er SNP Scr wi Docum 33 Screenshot 7A Upload Documents Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA MEJE JS E https iss ncga orgi A DSatjAT Category Main asp ProductT ype LicenseactivityID 12255 a EJ x Pp 5 Fie Edit View Favorites Tools Help A ma nn S o CC CCC we de 38 survey Tool 20095NPS L X The Health Plan of the Upper th gt m ap Page Ch Tools CCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDAR 3 ORGANIZATION l SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDE Y BACKGROUND a Se Upload the organizations documents by selecting the upload documents option ol yey Tool select a tab above me sermorerid
6. Home NCQA Intranet e Survey Tool 2009 X le Eme rSElPSERES TT SETUP SURVEY TOOL DOCUMENT LIBRARY PRIMT UPLOAD DOCUMENTS SUBMIT SURWEY TOOL UTILITIES HOME WHAT S MEW SEARCH HELP amp INSTRUGTIONS LOGOUT POLICIES STANDARDS ORGANIZATION SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES BACKGROUND Zu Click on Survey Tool Document Library tab to EAN M F This section includes all the Structure amp Process measures that are used for evaluation The categories in add and link 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 To enter the Survey Tool select a tab above documents the Structure amp Process measures elements that specify exactly how the Structure 4 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 Y
7. INDEX amp PROCEDURES amp GUIDELIMES BACKGROUND z se Ber Click on the SNP tab to enter the ISS tool 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 by clicking on the PA symbol Inbe ICH 2 Internet
8. amp P H Training Patient Participation Rates doc SNP 1 Element B Browse Yes m SNP 1 Element A Supporting Documents from the Organization Background Section er nn Tem ae Referenced in Verify Document File Path Upload Remove Question s Copy to input box Complete From Server QuickTips_Uploads0414 H Communications amp Marketing Education Programs internal 2008 Programs SNPs QuickTips_Uploads0414 doc Return to Survey Tool Upload Documents Remove Documents close this window I Start ed 9 Cabinet Microsoft Dutlook d RE SNP ISS Demo Link Survey Tool 2008SNPs https iss ncqa_org 2 Ea La a lt O V2 2 19 PM 35 Screenshot 8A Logout Welcome Mozilla Firefox File Edit View History Bookmarks Tools Help a E gt e AF http stagendO1 ncga org dewelopmentirdsgafrdsat ATwWelcome ccred asp LY r Gl Google Most Visited E Getting Started Latest Headlines 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 13 Flease select one to use Administrative Functions Always logout when you EX E EEE a nenn 2010 SNP Structure Process 2010 comp your ISS tool for mromero License 14623 Inactive Projects 2009 SNP Structure amp Process 2009 comp Click on the Inactive Projec
9. ccred asp v q 911 Live Search Pr File Edit View Favorites Tools Help gt Pr x Re E welcome Mr deb y Page Of Tools NCQA 20 YEARS HOME WHAT S NEW HELP amp INSTRUCTIONS LOGOUT Interactive Survey System o Your organization has licensed the following Web Administration The ISS tool gives based publications Click on the link below to enter the administrative area you the option to Please select one to use e Administrative Functions change your Se Le password 2011 SNP Structure amp Process 2011 comp for mromero License 20009 Inactive Projects 2010 SNP Structure amp Process 2010 com Click on the Inactive Projects link listed below to view inactive projects for mromero License 17478 2009 SNP Structure amp Process 2009 comp for mromero Lioense 12255 2008 Special Needs Plans comp for mromero License 11590 e Inactive Projects Surveys amp Results We have conducted or are conducting the following surveys Min ln un do omo A Local intranet E 100 E Office Communicator 4 Microsoft Office 2 Microsoft Office 2011 Screenshots NCQA gt Home Micr Welcome Microsoft El ES gm LS Screenshot 1B Change Password Change PSW 20085NPs Microsoft Internet Explorer provided by NCQA go Attps iss ncga org ROSat 4 7pdatelserPassword asp uk 1 File Edit View Favorites Tools Help car abr e Chan
10. 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 Evidence of coverage documents Instructional materials distributed to members or responsible parties on where to reapply for Medicaid 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 look back period 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 Insti
11. doc Word xls Excel ppt Power Point pdf Adobe PDP 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 paginas mas importantes de los documentos con una cubra pagina Considere convertir los documentos finales de Word y Excel a el formato PDF o 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 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 ss ncga org RDSat ATLogin asp o por utilizar la funci n de Insert de Word o Excel Etiquete el borrador y la copia final para distinguir entre ellos Utilice la caracter stica de la fecha en pies de pagina para seguir la ltima vez que usted actualiz el documento el documento se puede actualizar cada vez que se abre con cambios o no Utilice la caracter stica de la fecha al final de la p gina para asegurar la ltima vez que hizo cambios al documento 4 YANN UN a Los documentos ligados pueden ser reda
12. ffiss ncga org demosite rdsat 47CategoryMain asp ProducktT ype License activitvID 1574 wt El Live Seach ss Ps oj Fie Edit View Favorites Tools Help gt we abr survey Tool 2008POC Lic 1574 Engagement Health a E de Page Tools RUCTIONS LOGOULU Document Verification and Upload Microsoft Internet Explorer provided by NCQA ll x Document Document File Referenced im Venty Document File Path Upload Hame Path Elements Copy to input box Complete SNP GASNP SNP Unknown Element Element Trainings S P 1 measures 1 3 Final 2009 notes ppt You will see a Yes confirmation for a successful upload Supporting Documents from the Organization Background Section j i Harz di Verify Document Document File Referenced in File Path Upload Path Ques thom Copy to input box Complete Ho documents were referenced in this Survey Tool Return to the Survey Tool and reference files in the appropriate sections as needed Remowe Do Return to Survey Tool Upload Documents Click upload documents O Inbox Ze windo la Micr er SMP Scr m Upload Screenshot 7D Additional Example https iss_ncqa_org nextStagelID 1 Document Verification and Upload Microsoft Internet Explorer provided by NCQA PES Upload Reminder Please remember to upload completed documents from your document library to the ISS perio
13. 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 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 You can also add documents to the library without linking them to a specific element This feature allows you to load your documents 14 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 NC
14. 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 transition and arrange services Reports detailing an analysis of admissions and ER visits which indicates how the SNP works to reduce unplanned transitions Elements C and E require documented processes and reports For Elements C and E 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 December 2010 CMS Comprehensive Report 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 19 Reports such as MDS or materials of how member health status data is collected Job
15. page of NCQA s Web site http www ncga org snp 17 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 Process measures The list is not intended to 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 they must contain the date and time to meet the intent for factor 2 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 dem
16. to enter the tool Click on the Help and Instructions tab for complete instructions or a Users Manual screenshot On Navigation Bar click Organization Background tab and complete screenshot 4A 10 Click Survey Tool to return to SNP page screenshot 5A Top Navigation Bar includes ISS functions Blue Navigation Bar includes contents of the S amp P measures 11 Click the SNP Tab Select the Measure or Element to begin readiness evaluation screenshot 12 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 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 Tip Ensure that document titles do not contain any special characters or symbols
17. C SNPs Yes Yes Elements A C I SNPs only Yes Yes 6 Coordination with Medicare amp Medicaid Coverage Yes Yes Elements A F e f 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 February 28 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 Measuring quality Improving health care SNP Mensajes de Clave para Reportar ISS 2011 Los siguientes mensajes de clave son importantes y deben ser utilizados durante la evaluaci n de su organizaci n y la sumisi n del ins
18. Functions C RAR 2011 SNP Structure amp Process 2011 comp for mromero A Inactive Projects Click on the Inactive Projects link listed below to view inactive projects Select the 2011 SNP Structure a amp Process link to enter the ISS A Lioense 12255 2008 Special Needs Plans comp for mromero License 11590 Surveys Results We have conducted or are conducting the following surveys 7 0 Local intranet E 100 AS Min 4 un do omo NCQA gt Home Micr Welcome Microsoft 2 Microsoft Office 2011 Screenshots E Office Communicator 4 Microsoft Office 27 Screenshot 3A Help amp Instructions Welcome Microsoft Internet Explorer provided by NCQA GO B https ifiss ncga org RDSat ATwWelcomedccred asp ka ri 6d ES Live Search File Edit View Favorites Tools Help w oa 33 Windows Live Hotmail E Home NCQA Intranet Welcome x fry E del i Page O Tools NCQA Mar dria ua Help Microsoft Internet Explorer provided by NCOA Pi g it g hein ca Pe 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 ive area Interactive Survey System User Resources Help amp Instructions tab Instructions can assist you in navigating t
19. NCQA Measuring quality Improving health care 2011 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 Anthony Davis Nidhi Dalwadi Priyanka Oberoi Chris Dillon Contact SNP ncqa org Vi VII VIII SNP Reporting Key Messages English SNP Reporting Key Messages Spanish Reporting Requirements by SNP Type Element Data Sources by Element Examples of Data Sources Guidelines for a Successful Evaluation of a Special Needs Plan SNP Against the 2011 Structure amp Process Measures Steps and Screenshots for Key Activities ISS Documentation Tips English ISS Documentation Tips Spanish ISS Quick Tips for Uploading Documents 10 12 14 21 23 42 44 47 90 NCQA Measuring quality Improving health care 2011 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 All SNPs operational as of January 1 2010 that renewed for 2011 are required to report SNP 1 through 6 in the S amp P Measures for the February 2011 Assessment GememsAcGe AS os Elements A G Yes Yes 2 Improving Member Satisfaction 3 Clinical Quality Improvements AAA Elements A F Yes Yes EomentA
20. PPENDICES GLOSSARY INDE amp PROCEDURES amp GUIDELINES BACK GROUND ORGANIZATION INFORMATION Completeness Check Microsoft Internet Explorer provided by NCQA Completeness Check The following elements for the evaluation option s you selected are incomplete Please check your data entry to ensure these elements are complete Elements That Are Not Complete Completeness check Elements that are not 4 complete will appear Attach Document m fe Inbox Micr i Internet Ge vindows Me es SMP Screen EN Microsof a er E 10 09 AM 37 Screenshot 10A Submit Survey Tool 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA amp HA 42 https fiss ncgqa org RDSat A TCategoryMblain asp ProductType License activityID 12255 Fie Edit View Favorites Tools Help de ot survey Tool 2009SNPs Lic 12255 SETUP SURVEY e PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS LOGOUT ORGANIZAT OM BACKGROUND DOCUMENT LIBRARY RESULTS APPENDICES GLOSSARY INDEX When your organization is ready to submit click on the Submit Survey Tool Survey Tool Lith 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 catego
21. QA 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 February 28 2011 submission date For instructions on attaching linking and uploading documents please refer to page 23 and 24 of the section titled Steps and Screenshots for 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 6D 6E linking documents and uploading documents Tips and helpful information for uploading documents can be found on page 50 of this guide in the section titled SS 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
22. SNP Structure amp Process 2011 Click Results Welcome to the Interactive Survey System The information in the following sections includes e the complete Structure 4 Process measures e information about how your organization will be evaluated against the Structure 4 Process measures e policies and procedures We designed the system to facilitate understanding of our Structure amp Process measures and the evaluation process The Help and Instructions section above directs users to assistance Policies and Procedures This section provides an overview of the survey option you have selected it describes the goals and principles that guide our approach to evaluation and provides a high level summary of areas addressed by the Structure amp Process measures The Policies and Procedures describe e eligibility criteria evaluation options the interactive survey process e the structure of the Standards and Guidelines and the Survey Tool e how we report survey results and obligations of organizations and individuals undergoing a survey Standards and Guidelines This section allows you to open or download printable versions of publications v ET U ER AEE S E NE Y E EA E D 5 ENE E EEE V ee EI E E E EEE NN TIBET E 100 start Office Communic T Guidelines for a Change Passwor Screen Shot 114 2 Microsoft Offi 2011 Screenshots Internet Expl 7 Sl lt JA K n Re 12 25 PM XP Screenshot 11D Vi
23. You will use it to verify you are viewing the correct final survey tool results once NCQA finalizes the scoring and notifies you of the results 17 Reviewing your results after NCQA completes the assessment After you receive notification from NCQA that the SNP Assessment is complete and your results are available log on to NCQA s ISS https iss ncga org RDSat ATLogin asp with your original User ID and password screenshot 11A 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 24 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 11B Open the survey tool s click the results tab agree to the statement regarding results and click on the red link for Special Needs Plans this will provide the score for each element 11F 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 25 Screenshot 1A Change Password Welcome Microsoft Internet Explorer provided by NCQA GO Y https fiss ncga org RDSat ATWelcome
24. ain documents on a shared drive Consider creating folders for each Structure and Process measure Establish a system for version control Name documents clearly your audience is both internal staff and surveyors Avoid characters such as ampersand 4 apostrophe or semicolon Avoid duplicate names Use common file types such as doc Word documents xls Excel documents ppt Power Point odf Adobe PDF gft tif pg Do not send exe executables Documents that you dont have electronically can be scanned and converted to PDF GIF TIF or JPG Don t 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 large document with a copy of the document cover page on top Consider converting your final Word or Excel documents to PDF format or making them 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 httos iss ncga org RDSat ATLogin asp or by using the Insert function of Word or Excel 44 Label drafts and final documents carefully to be able to distinguish
25. another organization against NCQA SNP structure and process measures have read and understand the above statement 41 Screenshot 11E View Results continued Survey Tool 2011SNPs Lic 20009 UnitedHealthcare Insurance Company Washington Microsoft Internet Explorer provided by NCQ Sai EY v E https fiss ncga org RDSat available asp Y 4 x Live Search I Y File Edit View Favorites Tools Help gt gt xx amp sunvey Tool 201 15NPs Lic 20009 UnitedHealthcare a E deb i Page Of Tools NCQA 20 YEARS PRINT HOME WHAT S NEW SEARCH HELP 4 INSTRUCTIONS LOGOUT Click on the Special Needs 2011 SNP Structure Process 2011 Plans link Select an evaluation option for which to view results Name SNP Structure amp Process 21 for mromero Evaluation Option Special Needs Plans Standards Year 2011 Valid Dates Not Available Footer on some results pages 2002 2010 by National Committee for Quality Assurance Patent Pending Use ofthis Web site application constitutes acceptance ofthe License Agreement and Privacy Policy K Done Loo Localintranet 100 E Office Communic T Guidelines for a Ty Change Passwor TY Screen Shot 114 2 Microsoft Offi 2011 Screenshots Internet Expl H 7 RAILS G s Y 12 26PM Screenshot 11F View Results continued Results Detail 2011SNPs Lic 20009 UnitedHealthcare Ins
26. between them 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 pal On the File menu click Page Setup and then click the Layout tab 2 If you re adding line numbers to part of a document 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 45 46 ODN BW NY RAR RRA RAR RWW WWWWWWWWNNNNNNHNHNNDNKH PRB BB Be ee COoNSISSURODT OO NIAUROD A SO OIAUUFROD AT SO NA RUND O0 Consejos para los documentos de ISS Mantenga documentos en un camino compartido Considere carpetas para cada medida de los estandares de S amp P Establezca un sistema para el control de version Establezca un nombre claramente para el documento su audiencia es ambos internos personal y agrimensores Evite caracteres como el signo amp el ap strofo o punto y coma Evite nombres de duplicado Utilice archivos comunes como
27. completing the worksheet include a copy of it in the document library and link itto SNP 3 Element A 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 15 appear on the next screen They provide all the information necessary to successfully navigate and complete the tool and complete your readiness 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 lf possible limit supporting documentation to no more than three documents per element 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 24 be sure to view screenshots 7A 7D 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 selectin
28. ct true w EJ s x e File Edit wiew Favorites Tools Help ai EN Page r EF Tools r ur abr le Interactive Survey System Login Interactive Survey System PLEASE LOG IN You must use your UserID SNP 2011 License 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 of the License Agreement and Privacy Policy e Local intranet 100 dE Inbox Microsoft 2 Blackboard Acade Interactive Surve T Documenti Micr Ei REB W 10 51 AM 39 Screenshot 11B Log in to view your results continued Welcome Microsoft Internet Explorer provided by NCQA Go v E https fiss ncqa org RDSat ATWelcomeAccred asp v 4 tr x Live Search File Edit View Favorites Tools Help w e Welcome Mr dh i Page Tools 2 Your organization has licensed the following Web ministration based publications Click on the link below to enter the administrative area Please select one to use e Administrative Functions EC 2011 SNP Structure amp Process 2011 comp for mromero E eee Inactive Projects 2010 SNP Structure amp Process 2010 com Click on the Inactive Proje
29. ctados 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 48 49 Measuring quality Improving health care INTERACTIVE INTERACTIVE SURVEY SYSTEM Seaver system 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 the 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 y
30. cts link listed below to view inactive projects for mromero License 17478 ez lo Proiects 2009 SNP Structure amp Process 2009 comp lt for mromero lt A License 12255 ul DO NOT click here license s displayed 2008 Special Needs Plans comp for mromero License 11590 I We have conducted or are conducting the CLICK HERE The SNP tool following surveys located under Survey amp Results to view your FINAL results Please select one to view CVO 2004 CVO 2006 CVO 2007 CVO v ANANN IA Done 7 Local intranet 100 start E Office Communi pa Guidelines for a pa Change Passwo pa Screen Shot 11 2 Microsoft Of 2011 Screenshots Internet Exp 2 gt e e W JA JR 12 23 PM 40 Screenshot 11C View your final results Interactive Survey System Index Page 2011SNPs Lic 20009 UnitedHealthcare Insurance Company Microsoft Internet Explorer p Jer Go v El https fiss ncga org RDsat ATMain asp ProductType LicensesProductID 280t activityID 20009 q e x Live Search File Edit view Favorites Tools Help fp dy y cp Page Of Tools 2 Y ar Interactive Survey System Index Page 20115NPsL NCQA 20 YEARS PRINT HOME WHAT S NEW SEARCH HELP amp INSTRUCTIONS POLICIES STANDARDS ORGANIZATION SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES s BACKGROUND r 2011
31. cumented processes AND reports OR materials Element B Documented processes AND reports OR materials Element C Documented processes AND reports 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 for each factor Documented processes AND reports OR materials Element F Documented processes AND reports If you would like examples of documented processes reports or materials please refer to the Data Sources Examples document or the Guidelines for a Successful Evaluation of a Special Needs Plan SNP Against the 2011 Structure amp Process Measures document SNPs must provide the required data sources to demonstrate performance specific to each factor For example for SNP 4 Element A factor 1 the SNP must provide documented processes AND reports materials For factor 2 the SNP must provide documented process AND reports materials This applies to each element in SNP 4 l O 11 NCQA Measuring quality Improving health care 2011 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 mat
32. dically Uploading completed documents periodically will help avoid any issues with potentially lengthy last minute uploads as your submission deadline approaches Moreover uploading documents periodically will give you an opportunity to familiarize yourself with the process Please see the instructions for more information Uploaded documents remain inaccessible to surveyors until you have submitted your Survey Tool Supporting Documents from the Survey Tool Document Library Referenced in Verify Document File Path Upload Document Name Document File Path zes A Complete HEDIS 101 description H Communications amp Marketing Education Programs internal 2008 SNP 2 Element B Browse No Programs SNPs HEDIS 101 description doc make up session H Communications amp Marketing Education Programs lnternal 2008 SNP 2 Element A Browse ecommerce new Programs SNPs make up session ecommerce new seminar request xls No seminar request participant list for 3 11 H Communications amp Marketing Education Programs internal 2008 SNP 3 Element A Browse No Programs SNPs participant list for 3 11 doc S amp P measures H Communications amp Marketing Education Programs internal 2008 Unknown Element Browse No Final0401 Programs SNPs S amp P measures Final0401 ppt FINAL SNP S amp P H Multi Department Efforts SNP AssessmentiISS Demo FINAL SNP S amp P SNP 1 Element A Browse Yes o Measures 3 20 08 Measures 3 20 08 pdf SNP 1A P
33. edidas 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 NCQA Measuring quality Improving health care i 2011 ISS Toolkit Reporting Requirements by SNP Type Element Measure SNP 1 Complex Case Management Element A Identifying Members for Case Management Element B Access to Case Management Element C Case Management Systems Element D Frequency of Member Identification 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 4 Care Transitions Element A Managing Transitions Element B Supporting Members Through Transitions Element C Analyzing Performance Element D Identifying Unplanned Transitions Element E Analyzing Transitions gt Element F Reducing Transitions Measure SNP 5 Institutional SNP Relationship With Facility Element A Monitoring Members Health Status Not for Chronic Duals Element B Monitoring Chang
34. eeds Plan SNP Against the 2011 Structure amp Process Measures Welcome to the Structure amp Process Measures survey process The guidelines and resources contained in this document will help you prepare for your organization s survey and maximize the efficiency of your preparation time SNP Survey Process Readiness Evaluation Evaluation by NCQA NCQA s Web based Survey Tool for the Evaluation of a Special Needs Plan allows your organization to perform 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 The NCQA survey process begins with the submission of the Survey Tool which is final upon receipt by NCQA All Survey Tools are due to NCQA no later than February 28 2011 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
35. erials or content is what the organization provides to its members and practitioners Documented Process 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 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 12 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 13 NC quality Improving health care Guidelines for a Successful Evaluation of a Special N
36. es 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 by clicking on the FA symbol 8 Inbox Micr Internet Gr Windows Me fr SNP Screen wi Survey Tool Screenshot 7B Upload Document Survey Tool 2008POC Lie 1574 Engagement Health Microsoft Internet Explorer provided by MCOA Ge heal el https iss ncga org demosite rdsat
37. es in Members Health Status Not for Chronic Duals Not for Chronic Duals Element C Maintaining Members Health Status Measure SNP 6 Coordination of Medicare and Medicaid Coverage Element A Coordination of Benefits for Dual Eligible Members Element B Administrative Coordination for Dual Eligible BP Element C Relationship With State Medicaid Agency for Dual Eligible BP Not for Chronic Institutional Element D Administrative Coordination for Chronic Condition amp Institutional BP Y Not For Duals SEE EXCEPTIONS Element E Service Coordination Y Applies to all SNP types SEE EXCEPTIONS Element F Network Adequacy Assessment Yr Applies to all SNP types SEE EXCEPTIONS EXCEPTIONS 1 Not applicable N A for a SNP that does not have any members at the start of the look back period NCQA will verify enrollment data with the December 2010 CMS Comprehensive Report Not applicable N A for Chronic and Institutional SNPs with fewer than 5 dual eligible members Not for Chronic Institutional Not for Chronic Institutional gt gt 8 NCQA Measuring quality Improving health care 2011 ISS Toolkit Data Sources by Element SNP 1 Complex Care Management MINA Element A materials Element C materials SNP 2 Improving Member Satisfaction gt O SNP 3 Clinical Quality Improvements gt gt O _SNP 4 Care Transitions O SNP 5 Institutional SNP Relationship with Facility Element A Do
38. ew Results continued Resuits Lepal Agreement OTOSHPS Lia 1783 Engagement Health Windows internet Explor provided by Lomcast DO gt Y mmnnter x ry OKJR E MD DI dm Page Safety gt Tools are final once submitted to N QA 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 icense to use the Survey Tool from NCOA or use it regardiess 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 NCQA Survey The organization may not use the Survey Tool to evaluate another organization against NCQA SNP structure and process measures except as part of its own internal preparation for an NCQA Survey including specifically evaluating a delegate s performance in order to conduct oversight as required by NCQA SNP structure and process measures The organization may not allow a third party to use the Survey Tool it has licensed to evaluate
39. 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 levels of 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 documentation upon NCQA s request SNP contacts 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 NCQA Resources Online Support NCQA s SNP Web page hitp 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
40. g 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 element save it before moving on by clicking the Save button or the Next 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 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 lf 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 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 16 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 February 28 2011 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
41. ge PS 20085MPs Change User Password You have been brought to this page for one of the following reasons e ou 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 standards You are an existing user and have elected to change your password Password Criteria New passwords must be at least 6 characters in length and must also have 3 of the 4 following characteristics At least one uppercase character At least one lowercase character At least one numerical character At least one symbol i e amp etc Enter Your User ID and New Password Below User ID Eee IN Password Sawe Update Cancel Home MEQ Change PS 6 Inbox Micr T windows Me 2 Microsof y ay E 12 06 PM 26 Screenshot 2A Welcome License Welcome Microsoft Internet Explorer provided by NCQA GO Y https fiss ncga org RDSat ATwWelcomeAccred asp v q 4 X Live Search Dj File Edit View Favorites Tools Help we Re welcome fp deb Page O Tools WHAT S NEW HELP amp INSTRUCTIONS LOGOUT F 20 YEARS HOME Interactive Survey System a j Administration Your organization has licensed the following Web based publications Click on the link below to enter the administrative area Please select one to use e Administrative
42. he 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 to view inactive projects using the Survey Tool for evaluation document management and submitting the Survey Tool for survey User Manuals llenar manuals ara maranda in Adakham Aernkhath DME Mirerlanda finan far OF De uel van Please select one to view CVO 2004 CVO 2006 CVO 2007 CVO Is 2 Internet gt T Windows M E Calculator fe Inbox Micr W gt Microsof y Er 1 15 PM 28 Screenshot 4A Organization Background Organization Background 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA JS e El https jiss ncga oro RDSar A TShowCrgBackground asp OrgBGCategoryID 1308 ProductType license jactivityID 12 Y EN File Edit wiew Favorites Tools Help w e ES gt organization Background X The Health Plan of the Upper ca E ah Page Ob Tools SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT pS STANDARDS survey Too PM RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES BACKGROUND ORGANIZATION INFORMATION Please write a short description of the SNP Organization Information 1 Please include the organizati
43. k you for submitting the Survey Tool to NGOA and for participating in the NCOA survey process A copy of your assessment and documentation has been successfully transferred to MCGA Please print this screen for your records The project number for this survey is 9606 A project number for the What Happens Next when you next log in to the Interactive Survey System a section titled Welcome page The NMCOA 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 survey 1S assigned For details on the stages of the survey process and howto 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 Wee look forward to working with you in the coming weeks If you have any questions regarding the survey process please contact your assigned NCQA contact directly or WCOA Customer Support at 866 275 7565 or customersuppontcencga org Thank you again for participating in the NCG s survey process Please click here to continue 38 Screenshot 11A Log in to view your results aces Interactive Survey 5ystem Login Microsoft Internet Explorer provided by NCOA de 2 https fiss ncga org RDSat ATLogin asp R edire
44. ld down the Ctr button on your keyboard while you select multiple document types Select a filter option ERAN Apply Filter CE E Link documents to relevant a elements Sort by Document Standard File Path Date Attached 1 SNP Element 1 Fil Path GASNPISNP Traininasts P measures 1 3 Final 2009 notes ppt DateAtached 4 3 2009 le 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 organizations internal Elements A SNP4 Care Transitions Elements A B C Inte O Inbox O windo 2 Micr Mr SNP Scr mi Docum 32 Screenshot 6E Document Library Link Document to Element Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA Go v https fiss ncqa org RDSat ATShowStandard asp Category SNP v Y x Live Search 2 Ir File Edit View Favorites Tools Help a gt we xi survey Tool 2009SNPs Lic 12255 Mr deb y Page Cf Tools AA gt Measuring quo y moroving health core SETUP SURVEY TO DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDARDS ORGANIZATION R RESULT APPENDICES LOSSARY INDEX amp PROCEDURES amp GUIDELINES Br un BACKGROUND SO E ia Document Library Link to Element Microsoft Internet
45. led out all the portions of your 2011 Structure amp Process Measures Survey Tool The Completeness Check can be found under the Utilities section 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 large documents should be sent singly Start with small documents before moving to those with more bulk 50 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 51
46. ner or to PDF using Adobe Acrobat Please do not send documents that contain Protected Health Information PHI 21 22 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 nteractive 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 survey tools y A U N 5 6 9 Go to https iss ncga 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 o ears see full instructions in User Manual Select the ie survey tool by clicking on 2011 SNP S amp P link
47. ocuments by browsing Use the Browse button to locate the document i s A to find them More information Docu me R included in the ISS steps Document file path bree Use the Browse button to locate the document 2 save and Attach More j Cancel and Return to Document Librar At leas faciliti Scoring Click here to begin start fc E 3 Internet o Windows Me E Calculator fc Inbox Micr W Microsoft 7 rl a m 4 51 PM Screenshot 6D Document Library Link Documents Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA MEJE Ey E https fiss ncgqa org ROSatATShowsStandard asprECategory SMP w EJ ESA Pp Fie Edit View Favorites Tools Help uE ope survey Tool 20095MPs Lic 12255 3 A A Pe ir ing que ary A s SETUP SURVEY TOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S MEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDARDS ORGANIZAT HOM pe SURVEY TOOL RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES E i BACKGROUND z Se Document Library Microsoft Internet Explorer provided by NCOA 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 o document types To select a document type highlight the document type To select more than type ho
48. on name and SNP benefit package name NCQA Health Plan of Washington D C was established in 1990 As a federally qualified ae and state certified 50 1 ch 4 not for profit HMO our goal is to provide high quality comprehensive and cost effective health care to residents of Washington D C Virgina and Maryland The NCQA Health Plan is Washington D C first and largest HMO Our extensive provider network includes nearly 4 000 physicians 63 hospitals and a national network of more than 52 000 pharmacies 2 Please include the organization H number CMS Medicare Advantage contract number The organization can attach additional documents A 3 Please include SNP benefit package Plan ID Save Update Attach Document 8 Inbox Micr i Internet G Windows Me fr SNP Screen wt Documenti 29 Screenshot 5A Enter Survey Tool Survey Tool 7009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA MEE de ka E https fiss ncgqa org ROSat A TCategoryMmMain asp ProductType license amp activibyID 127255 wt ry ty gt iP l Fie Edit View Favorites Tools Help we he 58 7 je Survey Tool 20095MPs L X The Health Plan of the Upper di Se EF Page 0 Tools SETUP SURVEY e DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S MEW SEARCH HELP amp INSTRUCTIONS LOGOLFT POLICIES STANDARDS ORGANIZATION SURVEY TOOL RESULTS APPENDICES GLOSSARY
49. onstrating an evaluation of member complaint and appeal data including how the population was identified sampling methodology and collection of valid data 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 information to support the N A claim and NCQA will verify with the December 2010 CMS Comprehensive Report 18 SNP 4 Please note that two data sources e g documented processes and reports materials are required for each factor of every element in SNP 4 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 ISS 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 December 2010 CMS Comprehensive Report 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
50. ou 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 Paramount 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 e 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 fil
51. ou 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 PA symbol w Window ES calculator fe Inbox Gy survey far SNP Scr Screenshot 6B Document Library Browse Documents Survey Tool 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA GO E https fiss ncga org RDSar ATShowElements asp S5tandardiD 67648Categorv SMPeProductLinelD 18JyuoltiLinelD A ESA O File Edik view Favorites Tools Help we abr 88 a E Customize Your Settings le Survey Tool 20095MPs L X En EN deh Page O Tools DOCUMENT LIBRARY PRIMT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHAT S MEW SEARCH HELP E INSTRUCTIONS Mac a Ej OLICIES STANDARDS ORGANIZATION POLICIES STANDARDS SURWEY TOOL RG dial M a RESULTS APPENDICES GLOSSARY INDEX amp PROCEDURES amp GUIDELINES ACKGR See Document Library Microsoft Internet Explorer provided by NCOA EEE 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
52. ry 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 exacthy 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 clickina on the PA symbol 5 inbo zin Wind E z mi EB calcu EJ micro Final Jy ge 4 58 PM Screenshot 10B Submit Confirmation Confirmation of Completed Survey Tool Submission Microsoft Internet Explorer Survey Tool Submission Confirmation SETUP MENUO FRODUCT LINESFRODUCT COMPETE STs ee Confirmation of Completed Survey Tool Submission Your Survey Tool has been submitted Thank you Submission LOMP P Than
53. th data from all elements to which you have access finished ae I ma Pag 1 Y completing the l l 2 View all Evaluations click here to view your evaluation comments from all elements E tool please click egens View all Comments click here to view all your organization s comments to the preliminary on the Utilities results from all elements Note If your organization has not completed this stage in the t b d h k survey process or this step is not applicable to your survey process you will be unable to ab and enec access this data See your Policies and Procedures for more details on survey stages your ISS tool completeness Attach Document sg start gt E 6 Inbox Micr 3 Internet 0 Windows Me fr SMP Screen E 2 Microsof s fc ey D 10 05 AM Screenshot 9B Utilities Completeness Check Organization Background 2009SNPs Lic 12255 Microsoft Internet Explorer provided by NCQA sa Ge https iss ncga org ROSat ATShowDrgBackground asp OrgBGCategoryIb 1308ProductType licensetactivibyID 12 W amp x Ez E Fie Edit View Favorites Tools Help we fr BS Organization Background X j The Health Plan of the Upper deb Page Cb Tools NCQA SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS MEW SEARCH HELP amp INSTRUCTIONS LOGOUT cw E A h JAJ H F F 5 A en an SURWEY TOOL ae RESULTS A
54. trumento de ISS e SNPs operacional el 1 de enero del 2010 renovado en el 2011 son requeridos a reportar las medidas SNP 1 al 6 de S amp P para la evaluaci n en Febrero 2011 1 Complex Case Management 2 Improving Member Satisfaction 3 Clinical Quality Improvements 4 Care Transitions 5 Institutional SNP Relationship with Facility 6 Coordination with Medicare amp Medicaid Coverage e Si su organizaci n tiene mas de un paquete de beneficio de Special Needs Plan SNP usted tiene que presentar un instrumento de inspecci n separado para cada ch z 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 28 de Febrero e Cada instrumento de la inspecci n de SNP 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 m
55. ts link listed below to view inactive projects for mromero Inactive Projects License 12255 4 2008 Special Needs Plans comp for mromero License 11590 4 Surveys amp Results We have conducted or are conducting the following surveys Please select one to view 2004 CVO 2006 CVO 2007 CVO Gu Inbox Microso fr 2010 Screenshots Welcome Mozil T Logout 104 Co 36 Screenshot 9A Utilities Completeness Check Organization Background 20095NPs Lic 12255 Microsoft Internet Explorer provided by NCQA hi alme File Edit View Favorites Tools Help a B om r gt Page r Tools r JE hr ls e Organization Background X The Health Plan of the Upper a habs ayi ra SETUP SURVEY TOOL DOCUMENT LIBRARY PRINT UPLOAD DOCUMENTS SUBMIT SURVEY TOOL UTILITIES HOME WHATS NEW SEARCH HELP amp INSTRUCTIONS LOGOUT POLICIES STANDARDS E ORGANIZATION a me er PROCEDURES GUIDELINES SURVEY TOOL BACKGROUND aka Ge Serie ce ORGANIZATION INFORMATION Utilities Tab Survey Tool Utilities Microsoft Internet Explorer provided by NCQA AE Survey Tool Utilities The following utilities are available to help you review data in your Survey Tool Completeness Check Use the link below to check for any incomplete elements for the evaluation option s you selected Completeness Check After you are Support Text Notes ape Use the link below to view a single page wi
56. tutional benefit packages An organization that does not have a contract with the state to adjudicate Medicaid claims can meet the intent of Element 6B factor 2 by providing a documented process that shows it helps members understand the states adjudication of claims submitted by providers 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 documentation to support the N A claim and NCQA will verify with enrollment data from CMS 20 An analysis for Element 6F may contain data from July 2010 to February 2011 a year full of data is not required due to the change in submission date SNPs that only submit analysis of data generated before 6 30 10 will not meet the intent Elements 6E and 6F are not applicable N A for Chronic condition and Institutional SNPs with fewer than 5 dual eligible members are not required to report however you must provide documentation 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 scan
57. ument 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 working on your ISS tool screenshot 8A 15 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 16 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 the Submit Survey Tool link on the Top Navigation Bar and b 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 c 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 10B 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
58. urance Company Washington Microsoft Internet Explorer provided by acia Go y https fiss ncqa org RDSat resultsCatElemLev asp ProgramID 3308ProductLinelD 1 ALA tr 1 Live search gt File Edit View Favorites Tools Help Mr dh i Page Cf Tools 2 ww Results Detail 20115NPs Lic 20009 UnitedHealthcar ra ES STANDARDS Survey Too ORGANIZATION PESTS APPENDICES GLOSSARY amp PROCEDURES amp GUIDELINES BACKGROUND Return to Results Index SUMMARIZED amp DETAILED RESULTS RECOMMENDATIONS MW 2011 SNP Structure amp Process 2011 Note Any elements that are incomplete are scored at 0 00 To view the Survey Tool click on the link to the right of the Standard you wish to view To return directly to this page from the Survey Tool use the Back button on your browser i PERCENTAGES View SNP1 Complex Case Management o ee Tool Scroll down to view Element A 0 00 Element B all of your results Element C 0 00 Element D 0 00 Element E 0 00 Element F 0 00 Element G ND9 Imnravina Mamhar Satiefartinn PERCENTAGES View Mi Done B Local intranet Qio amp Office Communic T Guidelines for a T Change Passwor TY Screen Shot 114 2 Microsoft Offi 2011 Screenshots Internet Expl 2 Rls Gi wed 12 28 PM 42 43 OO 0D NK ALNE ISS Documentation Tips Maint

Revision Updated: June 9, 2009

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