Use the Clinical Care Report to improve coordination of care

The Clinical Care Report (CCR) was introduced in 2011 to promote better coordination of health care for our members and physicians. Unless a member has opted out, this tool is accessible through the Eligibility and Benefits Inquiry transaction and offers participating physicians a snapshot view of care that their patients have received based on IBC-paid medical and prescription drug claims, including the following:

• disease conditions reported in the past two years;
• emergency room visits in the past year;
• hospital admissions in the past four years;
• outpatient procedures in the past two years;
• specialists seen in the past two years;
• prescriptions filled in the past six months;
• lab tests with results (when available);
• diagnostic imaging in the past two years;
• immunizations in the past four years.

The Clinical Care Report is intended for viewing by a member’s personal or primary care physician, a new physician with whom a member has an upcoming scheduled appointment, or a physician who is addressing a current emergency medical need.

Initially, only the designated Security Officer(s) in each provider office has access to the Clinical Care Report, and he or she can control user access through the User Management transaction on NaviNet. Please refer to the April edition of Partners in Health Update^SM for detailed instructions on how to enable or disable user access.