Worklist Management
S
What denotes Observation status on the Midas worklist
Bed Request
What is to be used for Admit date if available
Patient Care Overview:
Plan of care review
Individualization and Mutuality
Discharge needs Assessment
What is the IPM
Not met Admit reviews
Mandatory escalation to a Physician Advisor
Admit and DCP within 24 hours of admit all payers
What is the UM standard
*
What denotes a new open
Critical level of care not met
Intermediate level of care not met
MCFFS Acute Level of Care Not met
What is documentation of over utilization
Separate notes:
Initial
Update
Final
What is the DCP documentation process
Grant Access
What is the final step to an EHR escalation
Escalation of all not met admit reviews to PA
What is the standard for escalation
EPIC access not granted
What is HCM EHR Awaiting more information
Care date
LOC
Series User Filed
Comments
IQ
Status
What are the 6 steps for success
Care Plan closed
New note same day-addendum
What are the allowed DCP documentation variances
Not met continued stay due to no SNF bed
What is non-clinical escalation
Observation reviews daily
What is the standard review frequency for Observation reviews
HCM PA/Supervisor Escalation
IM Letter
HCM EHR Awaiting more information
HCM EHR Final Disposition Sent
What worklist activity lines are automatically deleted from worklist on discharged patients
Responder criteria
What validates clinical readiness for discharge
.ACM Initial
.ACM Update
.ACM Final
What are the standard smartphrases
Change disposition to "No Response" by end of work day
What is the Internal IPA documentation Process
Continued stays reviews every other day all payers
What is the standard review frequency for continued stay reveiws
OBV
IP
CS
New Admits
What are daily priorities
Certification Inquiry module, 3 days
What is pre-auth
Asking all patients for preference for all post acute providers
Including preference in geographical referral; 30 miles
Including Sutter Affiliates, if no preference in geographical referral
Providing SNF/HH list/identifying ins covered options
What is Patient Choice
PA states "Does not demonstrate medical necessity"
facilitate discharge
What is process for cases no longer meeting medical necessity for hospitalization
Day before discharge review
What is the Commercial payers review requirement