Event Type
RV
Patients who've been seen within 6 months of their last visit for the same problem with the same DR/PA.
YELLOW SLOT
What must a patient have had in the last 12 months to see EBS
Any patient without an MRI or CT scan in the past 12 months MUST be scheduled with KR.
imaging
needs to be documented where the imaging was done and the type of imaging. If the patient can't remember the name of the facility, please document that they were advised to call us back with that info or obtain the imaging for their appointment
What is a perfect Greeting
Use the appropriate greeting
start speaking within 5 seconds of the start of the call
What does QA stand for
Quality Assurance
Established (Same)
Patients coming in for the same problem and seeing the same DR/PA.
MUST be between 6 months and 3 years since their last visit for the same problem.
YELLOW SLOT
MMB & SPS require what before switching teams of providers
A record Review
Dr. Arthur Valadie and new patients
Dr. Arthur Valadie will no longer be accepting new patients, as he will be retiring at the end of this year. A note has been added to his schedule as a reminder. ARV will see the new pt’s that are already scheduled but please do not add any more new pt’s to his schedule.
Dr. Richard Puzzitiello will be taking over care for Dr. Arthur Valadie’s patients. If a new patient calls to schedule with Dr. Arthur Valadie, please inform them that he is no longer taking new patients due to his upcoming retirement and that he recommends scheduling with Dr. Richard Puzzitiello who is taking over his patient’s.
If the patient declines, please schedule with their provider of choice.
How to show clear comprehension of the issue
In our willingness to assist statement.
Sounding confident and knowledgeable on reason for call.
Not repeating information
Steps to prevent insurance error
Verify complete member ID number even if it has remained the same
Check insurance list
Ask if pt is primary card holder
Verify spelling is correct
Established
(New)
Established Coastal patients with new problems.
Patients coming in for the same problem but seeing a new DR/PA.
Any problem that the patient hasn’t been seen for in the last 3 years
GREEN SLOT
Patients calling for Ribs
We do not treat Ribs
What Department is Dr. Richard Puzzitiello
Dr. Puzzitiello is a Sports Medicine Physician treating knees, shoulders and elbows.
What are 3 different things we must do at least once on every call.
Willingness to assist statement
Address caller by name once
Say please and thank you
What part of the spine is Lumbar
Lower back
Post Op
Patients in the global post-op period (within 90 days after their surgery).
All appointments within global post op period
Schedule post-ops with the PA.
YELLOW SLOT
Surgery in the Last 90-days with a non-Coastal Dr
All doctors would require a records review
Children with a hand FX
require us to get approval before scheduling kids with fractures. If the fracture involves the growth plate, then we would end up referring to All Children’s
transfer calls to 3290 for patients under 16 years old that have a fracture of the hand, wrist, or elbow
exhaust all procedural options to handle the patients request/concern
Exhaust all options to assist patient request or concern if there is something we cant do what is it we can do.
Test RV Appt notes must include
the type of test as well as the date and location of the test in the details box.
PHOSP- Consult Vs PHOSP- Surgical
Patients admitted to the hospital and were seen by a Coastal provider.
Must be scheduled with a provider who treats their problem.
GREEN SLOT
Surgical
Patients who had emergency surgery by a Coastal Doctor and need to follow up with Coastal.
C4H may only schedule if follow-up instructions were left in the patient’s chart.
If NO follow-up instructions were left on the chart, submit an urgent appointment request
Scheduled with the PA '
Will have an alert in the chart letting you know with whom and when to schedule with. If not transfer to coastal call center
GREEN SLOT
If you are unsure transfer to 3290
Spine COA
A patient who has an internal referral from another Coastal provider to see a spine specialist.
GREEN SLOT or ORANGE SLOT
EMG Scheduling
an office visit with LBO is required prior to her doing an EMG if the testing was not ordered by a doctor from Coastal.
5 types of Auto fails
refrain from giving any medical advice or treatment options
Handle the call without using Inappropriate remarks, yelling, cursing.
start speaking within 15 seconds
handle the call without discussing medical history, or verify all patient information first
have less then 5 minutes of disconnect time
R Stephen Otte requires pt's with New elbow injury's to be scheduled with RSO or AN
PA Amanda Notely