Medi-Cal
What is the Assistance Line ext for Lake side for Medi-Cal?
28074
What should patient be advised when trying to schedule a New Patient appointment without a medical need?
Patients without specific medical needs should not be scheduled for the sole purpose of establishing care with a new provider unless specifically requested by the patient. Patients should be informed that visits to establish care without a medical need are not required and may not be covered by insurance.
What age restriction does Dr. Patricia Tansey have listed on her Preference Page?
She does not see patient's ages 19 and older
After verifying patient, opening up chart, identifying provider preference page, what other resource should we open on every call?
Do we send a Staff message or a Telephone Encounter for Auburn/North New Patient for TOC patient?
Staff Message
Which Medi-Cal County Plans is considered as New Patient after 2 years of not being seen in Primary?
Health Plan of San Mateo and Santa Clara Family Health Plan
What is the difference between Video Visit for 12 and older verses 11 and younger?
12 and older must have their own MHO account, 11 and under can be seen via parent's proxy access.
What symptom type does Dr. Silen Bun have listed as Do Not Book on her preference page?
What is considered a 3rd identifier if address and phone number is not available?
MRN, Insurance ID #, Driver's License, (Last 4 of SSN if listed in EHR and last resort), e-mail if on file, if a provider referral information/facility, and if Pharmacy script information
Transfer to NPR
After verifying assignment with Medi-Cal what should we include in the appointment notes after verification?
"Today's Date, Insurance name verified, Reference #"
What should be included in our notes for a Complex Visit Pre-op appointment?
Pre-op - Type of Surgery, Name of Surgeon, Date of Surgery, if EKG is needed (Remind patient to bring paperwork) List symptoms.
How is Dr. Nindya Burhan's WCC age group schedule different on her Preference page from the Well Child Check Grid/other Peds providers?
Okay to schedule up to 36 months WCC
How do we determine if patient is established?
Check patient's office visit history have they been seen in Primary care in the last 3 years
20 year old patient wanting a new provider in Aptos what action should we take?
Warm Transfer to the Santa Cruz line
If Medi-Cal is NOT assigned what is our next step?
Advise patient to contact their insurance and document chart using .udoc
What visit type is a Hospital Follow up? What should be included in the appointment notes?
TCM visit Type - Hospital Name, Discharge Date,Reason.
Where can we find if a provider does a Meet and Greet?
When verifying patient's address what part of the address do you need to obtain to be considered fully verified?
Confirm full address St, Dr, Ave, Apt #
Which Division do we NOT update the PCP in EPIC for TOC?
GSD
What are the acronyms for Medi-Cal?
CCAH=Central California Alliance for
Health
SCFHP=Santa Clara Family Health Plan
HPSM=Health Plan of San Mateo
CCHP= Contra Costa Health Plan
SFHP= San Francisco Health Plan
NEMS= North East Medical Services
HPSJ= Health Plan of San Joaquin
Medi-cal FFS= Straight Medi-cal Fee For
Service
What visit type should be used for Auburn Peds TB Skin test verses Antioch Long Tree Way Peds TB skin test?
Care team - Auburn
Injection - Antioch
Which provider does Dr. Heidi Schmit request in her special notes who her patient should see for acute or preventative care when she is not available?
NP Jordan Matthews
15 year old patient scheduled to discuss bullying at school with provider. Parent calls in to ask what is the appointment for, can we relay this information?
No- due to mental health ROI
What division is okay to schedule with NP or PA if PCP is not available for TOC?
GSD