Member Review and Intervention Program (MRIP)
The Member Review and Intervention Program (MRIP) is a Community Health Plan (CHP) program designed to generalize WAC 388-501-0135 Patient Review & Restriction (PRR) Coordination (PRC) guidelines to the overall CHP membership and to outline how CHP will meet its Healthy Options contractual requirements in relation to the Health and Recovery Services Administration's (HRSA) PRR PRC Program.
Services to be provided by CHP include:
- Review of billing to capture excess utilization
- Notification of Primary Care Providers (PCP)s of patients with excess utilization
- Interventions with patients warning them of undesirable trends and offering alternatives
- Restriction of patients to one provider, one pharmacy, and one hospital (if necessary)
- Consultations by specialists (pain control, behavioral health, substance abuse) for cases of concern, as requested by PCP
How to make a referral/contact names and numbers