Frequently Asked Questions

FAQs For Participants

• Do I need to have an email account to access the Sustainable Health Questionnaire tool?

No, not anymore!

To use the SHQ from your home, you do need an email address. But if your doctor uses the SHQ, his or her office can create your account even though you don’t have email or internet at home. But in that situation you’ll have to complete the SHQ when you’re at your doctor’s office.

• How do I select my doctor or health professional so that they can see my questionnaire and report?

Log-in, and click on the Select Providers button on your Dashboard.

Click on the type of provider you wish to add (primary care, specialist or health mentor).

Using the Search tool, look for them by name or practice name.

Click the box on their row to choose your provider’s practice.

Click the Save button.

• Do I have to select a doctor or health professional?

No, you can use the SHQ by yourself, but it’s meant to be shared with someone who can work with you to figure out a plan for how you can stay healthy.

• Can I un-select my doctor or health professional?

Yes, you can do that and use the SHQ by yourself (for free), or you can select another provider who is in our system.

• What happens if I un-select my doctor or health professional?
Your data stays in the system, so you can continue to access it (for free). The only difference will be that the provider(s) you un-select will no longer be able to access your data. Note: your provider, as part of his or her duties during the time that you allowed them to access your data, may have saved a copy of your data as part of your medical record.

FAQs For Practitioners

• Why is the display not working right on the new system?

If you are having trouble accessing content or if the text on the page looks funny, you likely need to refresh the cache in your browser. This problem arose for prior users with the update on 4/30/2014, as there is new content not identical to the old site, and your browser is trying to substitute the wrong content. Every system clears the cache a little differently. Access the browsing history or cache and reset it (usually is done by clicking on the "clear" button).

• How do I find a patient on the My Patients page?

By default, providers are taken to the My Patients page, where all their participating patients are organized in alphabetical order. The Search tool, located at the top of this page, allows you to search by the patient’s name, email address, or date of birth. Enter some of this information and then either press the return key, or click on the Search button.

• Why is my patient not showing up on the My Patient’s page?

If the patient you are looking for is not on this list, but you know they’ve done the questionnaire, they have not properly selected you or your practice as their provider. They need to log-in to their account and select you as a primary care, specialist or health mentor type of provider.

• Can I see my patient's answers to individual questions?

Yes, from the “My Patients” page.

Find the patient you are looking for using the search filter.

Click on the patient, to see a list of questionnaires that they have worked on.

Scroll to the questionnaire that you want to see.

Click on the button labeled “View Responses” to see the questions and their answers.

• How do we enter the SHQ report into an EMR?

It is easiest to use the “Print and Save” button. Save the report as a PDF file, which can then be imported into the EMR.

Alternatively, you can print 2 paper copies when you print it for your patient, and then scan your copy into the EMR. For some EMR’s, this may be the easier solution. Consult your EMR vendor for advice. PCPs who don't have an EMR should just put a paper copy in the patient’s chart.

• Do I need to have an email account to access the Sustainable Health Questionnaire tool?

Yes, all providers and their office staff must have unique email addresses to log onto our website. If someone doesn’t have a work email address or doesn't want to use his or her personal email address, you can set up a free account with services such as Gmail, Hotmail, or Yahoo.

We STRONGLY discourage multiple staff using one person’s log-in to access your practice’s patients. Each person should log-in separately, because our system tracks usage of the system, and some automated functions uses access data in order to operate properly.

• What if I am seeing a patient who elected another provider or midlevel in the practice, as their provider?

Everyone in a practice is able to see all SHQs from all patients who have elected your practice as their provider.

• Can we have a patient take the SHQ more than once a year?

Yes, patients can re-take the SHQ at any time.

We do not, however, recommend taking the SHQ more often than semi-annually. Our preferred frequency is annually. Providers should be aware that most payers only cover one annual wellness visit per year, though some plans may cover a few additional wellness follow-up visits.

• Why does a patient who has few lifestyle risk factors, get a high-risk score?

This is an extremely good question, and the answer is not easy to understand because of the epidemiological view provided by health risk assessment tools (including the SHQ). Our best advice is to use the Overall Risk Score as a “lifestyle meter” and use the Framingham Score for cardiovascular risk.

Population data is extremely useful, but it categorizes people into subgroups. In truth, it’s not known exactly what happens to risk in the group of people who are overweight, sedentary, hypertensive, hypercholesterolemic and pre-diabetic, once they start taking their medications, exercising and eating better. Moreover, it’s unclear what differences there are between the folks who improve things by lifestyle, those who improve it by taking medications, and those who do it by bariatric surgery. Existing data imply that reducing weight, becoming more active, getting cholesterol in control, etc., does not reduce risk down to the level of persons who were always at low risk. But this kind of evaluation of risk assessments and interventions has never been studied.

Thus, if a patient has a health history with disease, they are scored according to the risk assigned to that group in the population in terms of risk for this disease. Even if their lifestyle is very healthy and there are no other risk factors, existing disease will put them at a higher risk and based on population statistics. This can be hard to remember when you are assessing this individual, or if they have used medications to improve their profiles.

Again, our bottom line advice: use the Overall Risk Score as an estimate of lifestyle, and use the Framingham score more as a measure of biometrics (blood pressure, cholesterol, etc.).

• What age range is the SHQ designed for?

The SHQ is not valid in persons under age 18. The Framingham score is only valid for persons aged 30-74 years.

• If we can't access the SHQ to review it with the patient during the annual wellness exam (e.g. there is a system issue and it can't be accessed during the visit), what do we do?

This process decision up to the practice. You could either reschedule or proceed with the visit. For the CPHL plan, if you proceed with the examination part of the visit and reschedule the patient to review the SHQ at a later date, Aetna will waive the co-pay for both visits, even if there are two different dates of service. For the CPHL plan, the SHQ is not mandatory but is strongly encouraged.

FAQ’s for Practice Managers

• Do practice managers have administrative access to the Sustainable Health Questionnaire (SHQ)?

Yes, but it is limited.

It is the practice manager’s responsibility to create, modify and delete staff. Sustainable Health Systems has no way of knowing about personnel changes in your practice, so it is the practice manager’s responsibility to keep this information up-to-date.

• Can we have 2 people in the practice designated as “practice Managers” in the SHQ?

Yes. It is good to have a “back-up” person with practice manager access.

• Can office managers add a provider in the SHQ?

Yes. Practice managers can do this under the “My Practice” panel of the Dashboard screen. To the right of the “My Practice” section, click the “Edit Practice” button. Then click the “Add Practitioner” button.

• Can office managers view a SHQ patient questionnaire?

Yes. Everyone who works in your practice and is entered into our system can see all questionnaires. On the “My Dashboard” page, click “View Patients”. Find the correct patient and in the far right column click on “View Questionnaire”. This shows you the patient’s questionnaire results. Also, you can view answers to all the questions by clicking on the “View Responses” button.

• Who can create or delete staff in each practice?

Only those who have practice manager status can create or delete office staff.

• Who can edit the data on the actual patient’s SHQ questionnaire?

Everyone in the practice can edit the data (specifically so the biometrics can be completed) as long as they have signed in to the system.   

Are we to load mid level providers in this system?

Yes. The SHQ is set up for practice managers to do this. Any provider can see any patient in the practice regardless of whether the patient selected them as their provider for follow up preventive visits and routine sick care.

Should we send welcome email letters to patients, inviting them to complete the SHQ?

Absolutely! Some plans will expect PCP offices to send welcome letters to plan beneficiaries. Our system is designed for you to upload invitations that are specific for each plan.

• Should a PCP access the SHQ during the annual wellness visit with a patient, or should the patient bring a printed copy of their Report Page to the visit?

Our recommendation is that the PCP should not expect the patient to bring a paper copy, but should log-in using a kiosk or laptop computer, and review the SHQ while on-line. In real-time, the provider can enter recommendations that the patient can then access from home. This approach requires some forethought in order to maintain eye-contact and good bedside manner.

Should the PCP’s make use of the interactive portion of the SHQ to make notes and record patient goals during the visit and print this out to provide the patient with at the end of the visit?

Absolutely! Giving your patient something personalized to take home is a great idea.

• How do we bill the annual wellness exam?

For some plans, an annual wellness visit is bill the age-appropriate preventive evaluation and management code. If you choose to see the patient for preventive counseling only and do not perform an exam, these plans require a preventive counseling visit to use codes 99401-99404, depending on the length of visit. No co-payment is charged for these codes.

• How do we bill for using the SHQ?

For health plans that include a covered benefit for reviewing a health risk assessement tool, the review of the SHQ should be billed using CPT code 99420. This generally needs to be performed on the same date as the annual wellness exam and billed on the same claim submission.

• How do we bill the “New patient routine preventive exam?”

For a new patient routine preventive exam, the CPT codes are 99382-99387. These codes may not be a covered benefit under some plans.

• What if we can’t complete a billable visit due to reasons such as not having current labs available?

This is a process decision up to your practice. You can reschedule the visit or can proceed with the visit. If you proceed with such a “partial” visit, confirm with the health plan administrator so that the patient’s co-pay and deductible will be waived for both visits.

FAQ’s for the Cornell Program for Healthy Living (CPHL)

• How do we bill for the CPHL “New patient routine preventive exam?”

For a new patient routine preventive exam 99382-99387 AND, on the same claim submission, bill for the SHQ/Pediatric Risk Assessment interpretation. The Risk Assessment Review CPT code is 99420. No co-payment is charged for this exam.

• How do we bill the CPHL annual wellness visit?

For an annual visit, bill the age-appropriate preventive evaluation and management code. If you choose to see the patient for preventive counseling only and do not perform an exam, bill a Preventive Counseling Visit using codes 99401- 99404, depending on the length of visit. No co-payment is charged for these preventive counseling visits.

• How do we bill lab tests related to the CPHL annual exam?

Lab tests ordered for the purpose of the CPHL annual wellness exam should have the primary diagnosis of V70.0.