CAMS
Why would you document EAP information in CAMS?
To create an eap auth or to close an existing eap.
When do we document?
Documentation is required any time correspondence is sent to an external party.
When do you send out a behavioral case note?
When you quote higher levels of care, change forms, and escalated issues.
What do you put in the notes of your template documents?
Always remember to include any relevant details that are not captured in the prepopulated fields of our templates.
What do we use Flup numbers for?
In CAMS, when updating Case Admin. Details in the case notes tab.
When you document in Sharepoint, when should you check back to see if the changes were updated?
One week
When would you fill out a HCP availability template?
When a provider wants to notify a patient when they are available and seeing new patients.
Receiving a faxed claim or document?
Sharepoint
When do we not use CAMS?
When we have an authorization that starts with letters like IP, we use Trucare.
How do we change demographic information about a provider?
Provider change form in PMRS.
What do we use the Provider Referral template for?
For providing a list of providers in the member's zip code that are specific to the member's needs.
Where do we document provider change forms once we have filled them out in PMRS?
Sharepoint
You're in CAMS quoting a higher level benefit, what do you do after the call?
Document that you gave information and gave out the IOP form/NAT number for authorizations.
When do we send a REGIS?
When there is a discrepancy issue with eligibility, registration, customer level, benefit inquiry, and benefit load.
Why do we fill out the Callback Case note template?
If we give the provider wrong information and need to call them back.
What happens if an authorization expires with visits leftover?
A new auth can be opened for the remaining number of sessions. A comment needs to be added to the original auth indicating how many visits should be paid.
When creating a new case (new auth), what must you complete during the call?
Complete the authorization tab and save it.
When do we send a escalated REGIS?
When the member needs to be verified before a visit that is upcoming within 48 hours.
What are the two types of EAP templates and what are they used for?
EAP Authorization Case note: To send details of a new or existing EAP authorization to a caller, through fax or email. A case note must be entered whenever a copy of the letter is sent.
EAP case closure: When you are closing an existing EAP authorization.
What does CAMS stand for?
Care Advocacy Management System