Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Understand
Understand how important it is to communicate regularly with your patients’ medical and behavioral health practitioners.
Your contact helps share clinical information for thorough treatment and continuity of care. It’s especially important:
- When patients have coexisting health problems
- When medications are prescribed
- If you have medical concerns
Ask your patients about their social determinants of health (SDoH) challenges
Doing so can improve quality, support patients in overcoming health barriers and improve their clinical outcomes.
We aim to reduce health disparities related to social risk as we help our members achieve optimal health outcomes. We’ll do this by working proactively and collaboratively with value-based providers to help them identify and address social risk factors that impact member health. We’re also enhancing reporting for 2021 to help providers better identify their “at-risk” patients.
Medicare Advantage collaboration reporting (PDF) — changes coming Q1 2021
Commercial value-based-care reporting (PDF) — changes coming Q1 2021
Resources for Living for Medicare Advantage (PDF)
PRAPARE®: Protocol for responding to and assessing patient risks and experiences
The purpose of the guide above is to educate people about a documentation tool. The specific diagnosis and codes included should not replace clinical criteria necessary to diagnose a condition.
Talk
Talk with your patients about how coordinated care can lead to better results. Ask for their okay for you to communicate with their other treating providers.
Working together can mean reduced costs and better results, including:
- Lower mortality
- Higher satisfaction
- Lower readmission rates
Ask your patients to sign a release form
Ask your patients to sign an authorization to release information. Other treating providers need to know about diagnoses, treatment plan summaries, medications, referrals and consultation availability.
Forms
Physician communication form (PDF)
(for specialists to communicate with primary care physicians)
Related links
Find forms for claims, payment, billing, Medicare, pharmacy and more.