Member Clinical Summary

What if you could see all of the following, for each of your patients, in one report?

  • Demographic information (member and PCP).
  • Medications.
  • Office visits.
  • Chronic conditions.
  • ER visits.
  • Observation stays.
  • Inpatient admissions.
  • Imaging services received.
  • Available lab data.
  • EPSDT and immunization services (for pediatric patients).
  • Patient-specific critical screening services (based on diagnosis compared to clinical recommendations).
  • Plan Care Manager name and contact number (when applicable).
  • Member restriction Information (if member is “locked-in” to a PCP or pharmacy).

How much time could this save you?

It’s all in the Member Clinical Summary

The Member Clinical Summary is a virtual snapshot of a patient’s clinical data and demographic information in a user-friendly format.

Practitioners, hospitals, and ancillary providers can view and print relevant facts about a First Choice member’s health care in a single report—one that is timely, easy-to-access, accurate, and complete. Having this valuable information at hand presents a tremendous opportunity for improving both quality and continuity of care.

The Member Clinical Summary Report is readily available through NaviNet as a printable PDF and as a downloadable CCD formatted file.

If you are not registered with NaviNet, visit their site and follow the simple steps to enroll.

How to access the Member Clinical Summary

The Member Clinical Summary is available through NaviNet, our secure provider portal. Your NaviNet Security Officer must first enable access to these reports for your office and then grant security access to individual users.

If you do not know who your office’s NaviNet Security Officer is, you can find out by signing in to NaviNet and clicking Welcome at the top right of the screen. Next, click My Account, and then select My Security. The name of the NaviNet Security Officer for your office will be displayed. Ask your Security Officer to enable your access to this valuable report.

Once you have been granted access, you can retrieve the Member Clinical Summary report from the Eligibility and Benefits Inquiry Details screen, the Referral Inquiry Details screen, or by selecting Report Inquiry > Member Clinical Summary Reports from Plan Central.

Security Officers can grant access to the Member Clinical Summary by following the steps below.

  1. On the NaviNet toolbar, select Administration and then click Manage Office Permissions.
  2. Click the Enable button to the right of Member Clinical Summary Reports to enable office access to this report.
  3. Once office access is enabled, you can manage individual user access. On the NaviNet toolbar, select Administration and then click Manage User Permissions.
  4. On the User Search screen, select the user whose permissions you would like to change and click Edit Access.
  5. On the Transaction Management for User screen, click Enable next to Member Clinical Summary Reports to enable the user to access the report.

Note: State and federal health privacy laws preclude the inclusion of information related to any behavioral health, HIV-related, and/or drug and alcohol addiction medications and treatments in this clinical summary.

Providers