Authorization
What identifiers can be used to locate patients in Epic?
What is name, DOB, address, phone number, insurance ID and SSN.
If a request letter is addressed to one location, but the authorization form lists several locations, where do you log it to?
What is the location that is on the request letter.
Your request letter is the directions from the requester.
Your authorization form gives you permission needed to release from the sites listed.
Who releases continuing care requests for Radiology FILMS/RECORDINGS?
This is split by where the request for radiology films lands at.
If Medical records receive the request, then Franciscan ROI team will send.
If radiology dept receives, then radiology will send.
Where can you find a list of request types processed in house by Franciscan?
What is Franciscan SharePoint ROI Chapter 12 "When to release"
What form should be used when you need your timesheet fixed?
Timesheet correct form
If an authorization form is signed by someone other than patient and they are over the age of consent, what document do you need to process the request?
What is:
Documentation that says why they are able to sign for the patient.
Health Care Representative/Power of Attorney
Guardianship
Estate Papers
WE are logging COC/Provider request what delivery method should this be logged as?
What is Onsite Delivery.
These requests should be faxed through epic, when we can.
What is the number of pages Franciscan has asked us to limit for faxing through epic?
What is 50 pages.
Where do Request for Amendments, Release Restrictions, Accounting of Disclosure, and Revocation of Authorization go?
Privacy officer.
If it is a printed request, then we will send to HIMROIleadership email and they will forward.
If patient is at an onsite location, please provide the name and phone number of the privacy officer.
(Some sites have business cards.)
How many times a day should you check your action list?
At least twice a day!
What records require special permission to release?
What is HIV test results, mental health, Genetic and substance use disorder.
What types of requests gets logged to Payer Reviews location?
All Risk adjustments, HEDIS, EDV.
These request types are processed in house by MRO audit team.
Who releases Quality of care/Grievances requests?
Franciscan ROI team processes these internally.
What do you do with request that has any LEGAL flag in Epic?
What is notate request Franciscan to process, forward request documents to himroileadership email and close in Exchange Manager.
What do you get two of every year and expires at the end of the year?
What is Floating Holidays.
What information is required for an authorization to be valid?
What is:
Patient name/2nd identifier
Record description/dates
Recipient name/address
Purpose
Expiration date/event
Revocation/Re-disclosure statement
condition treatment, payment, statement
Signature/date
What is the default DOB to use in Exchange Manager if none is given?
What is 1/1/1900
If you receive a request for CMS 1500, UB or any other type of Insurance claim forms what should you do?
Make a billing component in Exchange manager, then place the request on hold for Franciscan billing.
Who releases unencrypted email, CD/DVD/UB requests?
What is Franciscan internal ROI team.
What are the functions of the ? and # icons in the top-right corner of the Exchange Manager?
Look up a request by:
? = MRO Release/Status ID
#= MRN number
What are the various release methods on a Franciscan authorization?
What is paper, MyChart, fax, email, CD/DVD, USB, OTHER (given to Franciscan)
When should the Required by Date be filled in?
What is when logging a subpoena or payment integrity audit? 25 days from the date of request.
Who releases Cardiology images/recordings?
Franciscan cardiology department, which you can find on the ROI Resource list.
What requests type should NEVER have an issue letter or NRS added without management approval.
What is a payment integrity Audit.
What two holidays are recognized by MRO but not by our client?
What is Martin Luther King Day & Day after Thanksgiving.