Form completion
Once form is complete, what status does it go into?
Pending quality control
What is a reprocess?
Status form is put in when a change/correction needs to be made to the form or request itself.
Once DE is complete, what status does request go into?
FMLA pending
If pt has reached cap fee, do we charge for a STAT?
Yes
Does pt name go on every page?
Pt name needs to only go in the spots it requests it.
When do we charge for a reprocess?
Any info that needs to be updated like RTW changed, restrictions added or changed
Can we list a third party under billing?
Billing must always be the pt info. If needed we can always send an invoice to a third party.
Do we delete forms uploaded on a request?
No, never delete forms, change the document to a support doc and add new forms needed.
How do we handle a refund?
Once approved, send email with Invoice number, RQID, pt name and reason we need to refund.
If question on form doesn't pertain to pt then we can just leave it blank
No, every spot needs a response or NA
When do we NOT charge for a reprocess?
- OB
- a mistake we made on the form
- Pt has reached cap fee
-state form
What must be in the request note box when doing DE?
Number of forms, auth/ no auth, state form, note if form is for caregiver or spouse
If pt name in EMR says John R Smith but forms say John Smith, how are we going to enter name for DE?
John R Smith. MR must match EMR and add a note
What is considered a STAT?
Pt needing forms by EOD but can't always guarantee it by EOD. Turn around 1-2 days.
How do we avoid nitro notes on a form?
Print from Nitro
Explains the steps we take for a reprocess we charge for
Make a new request, leave notes with previous RQID, amended with date, auth/ no auth, upload amended form as record
If pt name on forms says John Smith but in EMR it says pt name is Pinky Smith, which name are we going to enter for DE?
Pinky Smith and add a note on request. Name MUST match EMR, especially important for Athena Run.
Do we charge a STAT fee on State forms?
No, for state forms we are unable to charge any type of fee
Once form is completed, reach out to facility for signature noting that forms are a STAT or mark urgent. Then reach out to a lead for QC to be completed and temp signed
Can we add info that pt gives us that is not in the chart?
No, any info not in pt's chart must be approved by MD first.
Do we make a new RQID for reprocesses that we do NOT charge for?
No, form will be amended on same RQID
Explain what info is put into SpeeDE
When should we amend a form vs request a new form from pt?
Anything under a year can be updated. Over a year request new form.
Who can provide an auth?
Pt only and auth must be signed and dated