MHS now offers to its Providers Care Gap Alerts.

Care Gap alerts are available through the Provider Portal to assist Providers by notifying them of specific care that a patient may need based on a member’s eligibility and most recent claims data. 

The alert will notify providers of immunizations, screenings, lab tests or other interventions the patient may need based on established clinic guidelines for a given condition or immunization/developmental screening protocols. This will occur when a member’s claim data does not show he or she has received the health services indicated.

Current Care Gap* alerts are available for:

• Diabetes (HbA1c, LDL)
• Physical exams (CORE members)
• Health Checks (Children, under 20 years old)

*Additional alert enhancements will be added throughout 2010, featuring other care needs.

We are pleased to offer this service to our Providers to support an awareness of potentially needed patient care.

For any questions regarding Care Gap alerts, please contact the Provider Inquiry Line at (800) 222-9831.