Documentation
Do not duplicate documentation nor complete another full eviNote template when a previous one was completed, instead, you should only document this.
What is any relevant new/additional clinical?
This metrics component describes the average number of cases you work per hour.
What is Actions Per Hour (APH)?
When trying to determine the reason or rule out, the best place to start your fax/upload review, would be in the assessment and plan of this document.
What is the most recent office visit?
Following your greeting, HIPAA verification, basic check (status, priority, health plan, etc), and journal review, the 1st piece of clinical you want to obtain is this.
What is the reason or rule out for the study?
When approving a written case, your only documentation should be this.
What is the GL?
Note: Also document any health plan variance, if applicable.
You should utilize this program for quick templates and shortcuts to decrease documentation/ case processing time.
What is eviNotes?
Work your written cases between calls, in a separate one of these.
What is a CDP or ISAAC portal?
Note: Don't use your Finesse (which will have your incoming calls) window for your written work, as it may cause interruption/ loss of work.
Most outpatient visit notes are written in SOAP format, which stands for this.
What is Subjective, Objective, Assessment, and Plan?
You have the rule out for the study and now need to determine what additional clinical information should be collected, thus the next best step to take would be this.
What is open the appropriate/associated GL?
If you are looking for symptoms, they will most likely be found in this section of the office visit note.
What are the History of Present Illness (HPI) or Review of Systems (ROS)?
What you document should be pertinent to this?
What is the GL?
Note: Always let your guideline be your guide.
If working written between calls and the fax has over 10 pages (excluding cover sheets, non-clinical info, etc), you should take this action.
What is reject the case?
Note: See CEG-“Process Change Button” (IO/CDP)/ “Rejecting Cases” (ISAAC) for exceptions.
DO NOT read the attached clinical like a book, instead, use one of these reading techniques to quickly find the pertinent information.
What are skimming and or scanning?
Note: Skimming-looking only for the general or main ideas; Scanning-looking only for a specific fact or piece of information without reading everything.
The clinical information you collect should be specific to this.
What is the GL?
Note: Always let your guideline be your guide.
Physical examination, labs, and diagnostic tests are examples of this type of information.
What is objective information?
You can decrease your imaging documentation by documenting/ or asking for this section of the imaging report.
What is the the impression?
True or False: You should complete calls as a priority, work written between calls when calls become slower or queues become lower, and NOT complete written cases during your after call/ wrap up.
What is true?
If multiple attachments are present, open all attachments at the same time, close out those reviewed by a prior CR, and close out any attachments that are this.
What is duplicate?
In collecting your GL based clinical, you should FIRST collect any clinical that will quickly gain you this.
What is approval?
Social history, family history, past medical history, and symptoms are all examples of this type of information.
What is subjective information?
Use these eviCore approved shortened forms of written words/phrases to decrease keystrokes and case processing time.
What are abbreviations?
Your case counter shows that you worked 60 cases today. Today you worked from 7a-3:30p with no meetings or training sessions, and thus have determined your APH for today to be.....
What is 8?
Note: 60 actions or cases divided by 7.5 hours (lunch is not counted/ considered non-productive time) will tell you how many actions per hour you achieved.
For a more efficient review of the clinical, use this version of the attached fax/upload, and take advantage of the highlighter, copy and paste, and or search functions.
What is the OCR?
Pay attention to the information you're collecting, because once you have enough information to approve the case, you should STOP doing this…..AND do this.
What is STOP collecting/ or reviewing for further clinical AND approve the case?
When reviewing duplicate attached clinical or clinical not related to the request, simply do this.
What is document the facts?
Ex: “Duplicate Fax received on 3-12-18 at 1:09PM” or “Additional fax received with no new clinical related to current request”