Clinical Review
Therapy service descriptions that require Clinical Review approvals
What is Physical, Occupational, and Speech Therapy
An assessment that is filled out when the participant communicates, they are not going to an appointment.
What is a Visit verification assessment
What is the email address for the transportation team
cltransportationrequest
If you clock in 1 minute after your start time this is considered
What is late
What do we use to schedule Optometry appointments
What is NVA
These therapy visits are the only ones that you can schedule for
What are evaluations
An assessment that is filled out when there is a PCP change
What is a Call Center contact assessment
When Centerlight is notified of an appointment within less than three business days it is called
What is a late add on
If you are calling out sick you must notify management (Time duration)
What is an hour before
What company do we use to schedule dental appointments
What is Liberty dental
What is the name of the form that is needed from the doctors office to send to Clinical Review for them to review the request
What is a PARF (Prior authorization request form)
What is the scheduling team processing assessment
What company do we use for transportation
What is CTG
You are to log in to this system right after you log into workday
What is agent Max
The referrals for Optometry, Periodontist/ Oral Surgeon/ Endodontist has to be given to the office by this source
Who is the participant
Clinical Review can make one of these four decisions when it comes to their requests
What is an approval, denial, partial denial, and dismissal.
An assessment that is filled out to document if the participant utilizes a wheelchair for transportation
What is a transportation assessment
If the participant requires a C leg (second appointment) for the day what should be sent and who should approve it
What is an email and who is the Care Manager
When you take a break this system has to be updated to reflect this
What is Agent Max
What are the specialties that we can send to Urban Health Care and which sites do they cover. Also what is the process to refer cases to Urban Health
What is Nephrologist, Allergist, Neurologist, Cardiologist. What is 99th St and Wallerstein. What is send the cases to MGMT to process.
We email Clinical Review for the following reasons
What is to extend the end date of an authorization to cover a scheduled appointment. What is to update the location of the facility approved.
An assessment that is filled out if you are on the phone with the participant and they request an increase in PCA hours
What is an SDR
What are the four things you should look out for when taking care of late add on appointments
You always require a MD note
What is on the third sick day and the day before and after a holiday
Who can assist in communicating appointment details to the participant if you are unable to contact them.
Who is the CM (Care Manager), CHN (Community Health Nurse), and the Participants site