EASY
Client is 17 years old.
Closed Reason: Program Fit - Age/ Gender
Sub Closed-Category: Facility does not offer child/ adolescent programming
A female patient calls in seeking IP treatment, but due to her specific trauma, wants a female only facility.
Closed Reason: Program Fit - Age/ Gender.
Closed Sub-Category: Needs gender specific facility.
Patient no showed their admission.
Closed Reason: No Response to calls/ emails.
Closed Sub-Category: No show and no response to calls.
Patient calls in seeking IP at LCG. Abusing alcohol but is also on methadone. This patient also has chronic COPD and is prescribed 4L of continuous oxygen daily.
Closed Reason: Program Fit - Acuity/ Capability.
Closed Sub-Category: Clinical - Medical Fit.
A patient is seeking immediate admission with us. However, their insurance requires we obtain a pre-authorization via fax prior to being admitted with us. This process takes anywhere from 3-7 business days. While waiting on the fax to come through, patient admits elsewhere due to worsening symptoms and the severity of their situation.
Closed Reason: Non-Emergency Patient: Financial - Commerical Insurance Dependent.
Closed Sub-Category: Will not precert/ limited precert.
*Went Elsewhere Non-Acadia Facilty seems like it could also fit this situation, HOWEVER, the only reason this patient would not have admitted with us was because their INS WOULD NOT precert without that authorization. We had availability, this road block comes from an insurance issue. Not anything on the facility end.
Client calls in for MRC but is currently dosing methadone.
Closed: Program Fit - Acuity/ Capability
Closed Sub-Category: Clinical - Medical Fit
*cross refer to LCG :)
Client calls on MRC line with a dual Medicare/ Medicaid policy.
Closed Reason: Non-Emergency Patient: Financial - Public Funding Dependent.
Closed Sub-Category: Medicare/ Medicaid.
*let's cross refer to LCG :)
Patient is on methadone but seeking immediate admission for treatment. Using benzos and alcohol daily (requires detox bed) but Galax building is full.
Closed Reason: No Capacity/ Staffing Limitations.
Closed Sub-Category: No capacity/ bed.
Client has not used in 6 months due to incarceration. Denies any usage while in jail. Covered by a MCO VA Medicaid plan.
Closed Reason: Non Emergency Patient: Financial - Public Funding Dependent
Closed Sub-Category: Payor Guidelines not followed.
You have been working with a caseworker on a referral, but they call and let you know the patient is being placed elsewhere/ admitting elsewhere.
Closed Reason: Unable to Enter Treatment
Closed Sub-Category: Referral Rescinded (By Payor or Referent).
Patient is seeking immediate admission for MRC, but we are currently on a WL. Has Cigna so LCG is not an option.
Closed Reason: Went Elsewhere: Non-Acadia Facility.
Sub-Closed Category: First Available.
Patient calls in for MRC IOP but cannot participate in evening groups due to work.
Closed Reason: Program Fit - Doesn't Meet Client Needs/ Preferences.
Closed Sub-Category: Schedule (Evenings, etc.)
Patient is looking to specifically admit to a dual diagnosis facility, but both of our programs are only primary substance abuse.
Closed Reason: Program Fit - Doesn't Meet Client Preferences/ Needs.
Closed Sub-Category: Clinical track.
Client has not used any substances in the last month (at home, not in a facility, hospital or jail) and has a commercial insurance policy.
Closed Reason: Not Emergency Patient: Financial - Commerical Insurance Dependent
Closed Sub-Category: Will not precert/ limited precert.
Patient is calling in seeking a 7-10 day detox.
Closed Reason: Program Fit - Doesn't Meet Client Preferences/ Needs.
Closed Sub-Category: Other.
Patient calls in seeking treatment. You start the admissions process, but they state they are getting another call and will call back. We call 3 days in a row with no successful contact.
Closed Reason: No Response to Calls/ Emails.
Closed Sub-Category: Stopped returning facility calls.
Patient was seeking a bed to bed transfer from jail, but instead of an approved bond, was sentenced to serve 2 years.
Closed Reason: Unable to Enter Treatment.
Closed Sub-Category: Legal.
Mom calls in for her son seeking IP treatment. She provides a cell phone number to reach him, but it comes back out of service. Because we cannot reach patient directly we call Mom for over 3 days with no response.
Closed Reason: No response to Calls/Emails.
Closed Sub-Category: Stopped returning facility calls.
*If you thought "No/Wrong contact information" as an answer... totally understand. Per Breeze, we should not be using "No/Wrong contact information" unless there is literally nothing (no phone, email, emergency contact, nothing) because our closed INQ reports will not list that INQ as a potential follow up in the future.
Patient is seeking IP but has a commercial Kaiser Permanente policy.
Closed Reason: Non-Emergency Patient: Financial - Commerical Insurance Dependent.
Closed Sub-Category: Payor Guidelines Not Followed.
*Kaiser limits their clients to Kaiser specific facilities. If needing a referral recommend they call their INS directly.
Patient is being referred to a MAT program/ regimen by current provider/ therapist/ program.
Closed Reason: Program Fit - Level of Care
Closed Sub- Category: Suboxone doctor/prescription.
A patient you currently have scheduled, calls the day of their admission attempting to cancel. When asked why, they state "I am not ready to commit to treatment or recovery." Overcoming objections not successful.
Closed Reason: Seeking Treatment Information/ Refusal.
Closed Sub-Category: Client refused or changed mind about treatment.
A patient seeking care with LCG is informed they will not be dosed until the day after their admission. This patient is not comfortable with that and chooses to find another facility.
Closed Reason: Program Fit - Doesn't Meet Client Preferences/Needs.
Sub Closed-Reason: Clinical Track.
Patient calls in stating their PO/ court system is STRONGLY recommending they admit to a long term facility, due to their history and chronic relapses. 6 -12 months at least.
Closed Reason: Program Fit - Level of Care.
Closed Sub-Category: Long term treatment.
Patient calls in from VA Beach on a NOVA pick up day. They state they HAVE to admit today and cannot wait until the next Tuesday or Friday to admit. They are forced to look into other facilities.
Closed Reason: Program Fit - Geographic.
Closed Sub-Category: Facility unable to provide transport.
Patient calls in to start admissions process. They are reporting active SI, HI, AVH, Paranoia. Has had 12+ suicide attempts in the last 24 months and one of them was in an IP Psych Hospital. Struggles with daily self harm. You as the AC make the decision to not send for review, as we cannot give them the care they need, and advise the caller to seek help at a local ER and ask for their assistance referring them to a facility that would best fit their needs.
Closed Reason: Program Fit - Acuity/ Capability.
Closed Sub-Category: Clinical- Psychosis.