SMP Hawaii Individual Interaction Report
Individual interactions are conversations you have with anyone about SMP-related topics. Conversations must be less than 15 minutes or less, and are recorded cumulatively throughout the month.
Month of: *
Your answer
Team Member Name: *
Your answer
Date *
MM
/
DD
/
YYYY
How many different individuals did you speak with during the month?
Your answer
Your Zip Code: *
Your answer
Please record all interactions that take place during the current month. Include time spent conversing with anyone about a topic related to the SMP Mission. Record the total time spent under the topic headings below by clicking on the appropriate amount of time. Round to the closest 15-minute interval.
Remember that any conversation about SMP-related topics LONGER than 15-minutes is considered "counseling", and the COUNSELING REPORT should be used instead. You may submit more than one Individual Interaction Report during the month if needed, but a single form with cumulative totals is preferred.
Consumer Protection
Durable Medical Equipment (DME)
Employer Health Plan
General Fraud, Errors and Abuse
Home Health Care
Hospice
Medicaid
Medical Identity Theft
Medicare Advantage
Medicare Part A and B
Medicare Part D
Medigap or Supplemental Insurance
New Medicare Cards ( Without SSNs)
SMP Program Information
SMP Volunteer Recruitment
Social Security
TRICARE
Veterans Health Benefits (VA)
Other
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