Pod Model Health Coach Role and Responsibilities

The health coach will provide support in the following areas:

  • Track caseload per provider 
    • Generate a list of no-shows 
    • Confirm if consents are signed, if not follow up to get them signed 
    • Patient profile is updated and accurate (including insurance information)
    • Quarterly eligibility checks
    • Confirming OnPatient is activated 
  • PHQ9 completion tracking
  • Internal referrals - If your patient requires the care of a different type of provider, or if you would like to bring in another provider for an assessment or review, the health coach will facilitate this process. For example, if you are a therapist and your patient needs a medication management assessment, the health coach will contact the patient and match them to the appropriate prescriber. 
  • Support discharge/re-engagement  - If a patient is being discharged or has no-showed for two consecutive appointments without any contact, please let the health coach know.  They will engage in one outreach attempt and then let you know the outcome so you can send discharge letters as needed. 
  • Attendance issues - If a patient is having consistent trouble with attending appointments, the health coach can help to reassign the patient or support a new scheduling process.  
  • For prescribers:
    • PCP support: support setting up case conferences as needed
    • EPC workflow support: support with flagging EPC patients and making sure reports are sent to PCP
  • Technical issues support
    • Support patient with app issues
    • Troubleshooting provider issues on DrChrono and OnPatient
  • Initial consultation - The consultation includes the following components: 
    • Completion of an initial PHQ9
    • Brief assessment of presenting problem
    • Review of the Valera model of service delivery
    • Collection of all relevant financial information 
    • Distribution of  consent packet to patient, 
    • Onboarding the patient into the Valera platform, including support through the download of the Valera Health smartphone application

The health coach is not responsible for:

  • Responding to patient chat messages on the Valera Health platform.
  • Ensuring that PracticeChat (see section 'Inter-team Communication’ below) messages are read and responded to between Providers.
  • Reviewing any clinical alerts or assessments in the Valera Health platform.
  • Responding to a crisis or safety concern (see section ‘After Hours Care’ below).
  • Providing periphery clinical care on behalf of you, such as sending ‘release of information’ letters, discharge letters, etc. 

Still need help? Contact Us Contact Us