PC Best Practices
For Wyandotte PC sites, which column is used to verify insurance on the payor grid?
Use the Wyandotte column to verify insurance plans.
Besides Pediatrics, where else can peds patients be seen for PC?
Walk us through the process used to transfer triage patients to the My Care Advice Nurse.
Do not put caller on hold, Use Consult(2 heads) - Mycare_800 - once nurse answers, hit play (resume) merged click transfer to disconnect yourself.
How many messages should be created for a patient calling to request a refill on a specific medication, request to be prescribed a new medication that they saw on tv last week, and request a referral to physical therapy? Which Kaizen options should be used.
3
Medication, Paperwork/Referral
Established patient wants to be seen for test results. What visit type should be used?
Follow up-PC
MD, DO, NP, PA, Residents.
A mom calls to r/s her 3-year-old who has a severe cold and cough. You notice that the patient has UHC Medicaid plan. Can you reschedule the visit? What is the process?
No. We do not schedule non contracted HMO's. We instruct parents to contact their insurance company to find a provider in their network or to switch to a HFH accepting HMO Medicaid. You should also note to the caller by switching, you would need to ensure that the new plan covers any other provider that the child is seeing outside of HFH. Esp. important for those with critical diagnosis.
You're working from home and a patient calls and says their child is choking. You should put the patient on hold and call 911 from Genesys. True or False.
True.
If there are no same day/next day sick visit appointments available for an established patient, what should you do?
Send a high priority message to the clinic for assistance.
Patient over 60 requesting an appointment at E. Jeff Family Med for a physical exam. How do we schedule their appointment in EPIC?
Medicare Wellness visit.
Someone who has graduated medical school and is completing a postgraduate training program.
a Resident
Who should update newborn patient's names when the parents call to schedule their newborn visit?
The clinic when the parent/guardian brings the child to the visit.
You have a patient that is not established with HFH and they are having vision changes. You should transfer them to speak to the My Care Advice Line nurse. True or False?
When should you use Kaizen Messaging?
When sending messages for PC patients
New adult patient calls and wants to be seen by a Dr. Miller at Main for a possible sinus infection. Can they see Dr. Miller for this without establishing?
What days of the week is TB testing scheduled on?
Mon-Wed only.
How many peds patients can be seen together?
2
A HFH patient goes on vacation in Florida and starts to experience an allergic reaction. She contacts her doctor's office for triage. You should contact MYCAL to triage. True or False
False. Patients that are out of state cannot be triaged.
.1cpr
Established patient wants to be seen for a hospital follow up. They were recently admitted into HFH 3 days ago. What visit type would you use?
Follow up - PC
A patient calls and wants paperwork completed, what timeframe do we advise him for paperwork completion?
7-10 business days.
A mom calls to schedule her child an appointment to update her vaccinations but is unsure of when the appointment needs to be scheduled. How should we assist the mom?
Send a message to the clinic for assistance.
Patient calls with chest pain and wants to schedule an appointment. After recognizing that the patient's symptoms should be triaged. You should schedule them and transfer them to speak with the My Care Advice Line nurse. True or False?
False. You should not schedule any appointments before triaging.
smartphrases
A patient had a physical exam at the Ford Rd Internal Medicine center last month and now want to come to the E. Jefferson Family Medicine center for back pain. Are they considered new? What visit type would you use?
sick/injured-PC