The Clinical Care Report, unless a member chooses to opt out, can now be accessed through the NaviNet? web portal. The Clinical Care Report offers participating physicians a snapshot view of the care that their patients have received based on AmeriHealth-paid medical and prescription drug claims. It is intended for viewing by the following participating health care providers:

• a member's personal or primary care physician;
• a physician who has treated a member in the past year;
• a new physician with whom a member has an upcoming scheduled appointment;
• a physician who is addressing a current emergency medical need.

Information available in the Clinical Care Report

The information populated in our members' Clinical Care Reports is derived from member claims data and includes:

• disease conditions reported in the past two years;
• visits to the emergency room in the past year;
• hospital admissions in the past four years;
• outpatient procedures in the past two years;
• specialists seen in the past two years;
• prescriptions filled in the past six months;
• alerts by condition (i.e., gaps in care), if any;
• lab tests with results (when available);
• diagnostic imaging in the past two years;
• immunizations in the past four years.

This report is not a complete medical record of all services, tests, or products that a member may have received. It does not include data for sensitive health conditions, such as mental/behavioral health, substance abuse, HIV/AIDS, or sexually transmitted diseases; genetic testing; or services for which AmeriHealth did not pay a claim.

How to grant or remove access to the Clinical Care Report

Initially, only the designated Security Officer(s) in your provider office has access to the Clinical Care Report, and he or she can control user access through the User Management transaction on NaviNet. Note: In order for providers to access the Clinical Care Report, a designated Security Officer must enable individual or all users. For detailed instructions on how the designated Security Officer(s) in each provider office can grant or remove individual or group access to the Clinical Care Report, please refer to the article in the July edition of Partners in Health Update .