Welcome to the Viewing and Submitting Care Gaps training video!

In the provider portal, users with the appropriate role access can:

1. View member care gaps

2. Submit member care gaps for closure

3. View and download a care gaps report for all members

Viewing Member Care Gaps

There are a couple of different ways to view member care gaps. Users can either:

• Search for individual members or multiple members via the My Patients Search, or

• They can run a care gaps report showing open care gaps for all members

A report listing open care gaps for all members is accessible via the Care Management area in the main navigation. Select Care Gaps Report to access the page. The same report is also available in the My Practice area by selecting Reports.

To generate the report, the user needs to enter a provider ID. If the provider ID isn’t known, users can look it up via the provider lookup tool.

Please note, there may be a delay if the number of results is large.

Once the report loads, results can be sorted using the column headers or filtered using the Filter Results option. Users may also download and save or print a copy of the report.

My Patients Search

An easy way to identify members with open care gaps is by navigating to My Patients and searching for members.

All users can search for an individual member or up to ten members at a time.

PCPs can also search by provider ID and quickly view which members have open care gaps.

After executing a search, members with open care gaps are easily identifiable by an icon in the Care Gaps column. When hovering over the icon, users will see a message that the “Member has open care gaps.”

Users can expand each result to view more information about the member. In this view, a snapshot of open care gaps is displayed. Selecting View All will take users to the Care Gap Services screen for that member. This screen is where users can select which care gaps they’d like to submit for closure. More information about submitting care gaps will be covered later in this training module.

There are two other ways to access the Care Gap Services screen from the My Patients search. After searching a member:

• Users can choose Submit Care Gaps from the Select Action menu.

• Or users can choose View Details from the Select Action menu. This goes to the member profile screen, from which users can access the care gaps services page by selecting the Details link in the Care Gaps Services box.

Submitting a Care Gap

Now we’ll move to submitting a care gap for closure.

Once the Care Gap Services screen is reached through any of the ways just described, users will first see the member’s demographic and contact information. Scrolling down, they can view a list of all the member’s open care gaps, and select which ones to submit for closure.

Users can sort the list using the column headers or filter using the Filter Results option. Also, a report can be downloaded in the file format of their choosing.

If a previous care gap submission has failed, the reason displays in the Failure Reason column.

Users can choose one or multiple care gaps to submit for closure, or they can select all by checking the box atop the Care Gap Services column. After making selections, users should click the Submit Care Gaps button.

This takes users to the care gap submission screen.

The submitting provider information displays but can be changed by using the Choose a Provider tool. Please note that a specialty must be selected and is required for submission.

If the rendering provider is the same at the submitting provider, users can select the Same Provider Details checkbox and the information will prepopulate.

Users then need to complete the Care Gap Service section of the form by entering all required fields, which include date of service, place of service, care gap service, and results. Supporting documentation can be uploaded using the Select File button.

When submitting multiple care gaps for closure, if users want to use the same attachment for more than one care gap, they can do so by selecting the Use Previous Attachment checkbox. This enables the user to only have to upload an attachment once for multiple care gaps. Please note that one attachment per care gap is required for submission.

After completing the form, users should click the Submit button. If any of the required fields were missed, the form will not be submitted and the user will be alerted as to what information is missing.

Upon submission, the care gap is suppressed and will no longer appear in the portal. If the submission for some reason fails review and is rejected, it will reappear as an open care gap with the failure reason visible to the user.

Another way to view care gaps is via the Visit Checklist feature. When searching My Patients use the Select Action menu and select View Visit Checklist.

Visit checklists are designed to help providers know what to address with members during their office visits, thus ensuring a quality visit for both parties. More information about this is covered in the Visit Checklist training module.

After selecting View Visit Checklist, users can scroll down the page and view open care gaps for that member in the last 90 days.

Users can then select the Go To Submit Visit Checklist option and when they scroll down they can click on Select Open Care Gaps to Submit and users can then complete the form to submit care gaps for closure.