JLN Process - Assign beneficiary to a Primary Care Provider (PCP) or primary care unit
Process Group
Beneficiary Management
Objective
Assign beneficiary to participating PCPs or primary health units based on rules (i.e., geography, load of beneficiary).
Allow beneficiary to select PCP or primary health units from available list.
Input
beneficiary identifier
Census
Benefit class
Physical proximity (e.g. work or home)
List of available providers
Family relationships
Maximum number of beneficiaries to which a provider can attend
Output
Provider capitation list
Provider roster
Notification of primary provider
Task Set
Measurable Outcomes
Providers receives beneficiary list/roster
Beneficiary receives notification of primary provider
Accurate list of beneficiary and selected/ assigned PCP or primary care unit
Task Flow Diagram
Sources