Member Search
Search for member by member name or MLTC below.Red - Inactive within MLTC
Blue - Inactive Member
Search Results
| Name | MLTC | Arrow ID | Arrow ID1 |
|---|---|---|---|
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Search For Member Above |
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Team Information
| Role | Name | Contact |
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Key Family and Friends
Contact information for Family and Friends of the member will be listed here.| Name | Phone # | Relationship |
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Add Family Or Friend
Assign Team Member
Assigning for role:
Search by name:| Name | Contact |
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Member History
Table only displays Positive Alerts.
All Issues List
| Issue | Began | Closed |
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Medicaid ID:
Gender:
Plan ID:
Language/Culture:
MLTC:
Special Program:
LHCSA Team:
Date of Birth:
First Admission Date:
SOC Date:
Phone Number:
Phone Type:
Phone Number:
Phone Type:
Phone Number:
Phone Type:
| Name | Specialty | Phone # |
|---|
Add Doctor/Urgent Care/Pharmacy/Lab
| Diagnosis | Current | PAH Category | Option |
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Add Diagnosis
| Vaccine Name | Vaccine Date | Type |
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Add Vaccine
| Name | Started | Ended | Runs Out | Refills | Dose | Frequency | Route | Diagnosis | Prescribing Dr. | |
|---|---|---|---|---|---|---|---|---|---|---|
| No Medication Listed | ||||||||||
Medication Info Verification
Add/Edit Medication
If a medication is temporary, please put in an End Date when it will be finished, leave Runs Out blank, and put in zero refills
| Special Program | Current | Option |
|---|
Add Special Program
Member Address
Street 1:
Street 2:
City:
State:
Zip: