Flagging
This is the place on your case where you can find your flags and a description of when they should be used
What is beneath the SIU summary and before the search boxes?
Where to find the specialties and amount of facilities you are calling on the case
What is under Tasks in the OD System, occasionally on your report? When in doubt, ask TL.
The amount of times a facility is called before using multiple attempts verbiage
What is twice with at least one hour between the calls and then once more before submitting the case?
When do my calls count towards production
When the case is fully turned in and proofed
The first thing that you should do after downloading your case
What is save it to my medical searches folder?
DAILY DOUBLE: The placement of the 1 and 4 flags on your case, the placement of the 2 and 3 flags on you case, and the placement of the 5 flags on your case
What is goes behind the date they apply to, behind the facility name that they apply to, and behind the alias verbiage?
Two instances that do not count for your calls
When to use alias verbiage
What is when the report provides alias verbiage and you get hits and blank profiles and when the alias isn't on the report but they are found under an alias?
A good number for production
What is 0 or a negative number which means I did the required amount of work for each hour I worked that week?
What to do before you start calling on your report but after downloading and saving it
Check the objectives on OD System to find additonal information and check over claimant information
With this information, what flag do I use: I have 2 hits under the Physician Search and an additional hit under the Physician Search from a prescriber
What is the pink 2 flag, because there are 3 hits under the Physician Search?
The phone number formatted for the faiclity is out of service-what do you do?
What is google the address/facility name to try an find an alternate phone number?
What verbiage is used in this instance: A Hospital says the Claimant was seen there in 2019
What is 2019, partial date verbiage, contact name, fax number, Note to proofer share/don't share?
A good percentage for hits
13.50% or higher, which means for that the amount of hits I got in relation to the amount of calls I turned in was high
The time to let your TL know you need help on your case
By 2pm (3pm at latest) so that the case can be split up and called
The difference between flagging for a TRAveler's case and a Non-TRAveler's case
TRA adds up the number of hits with flags, Non-TRA counts adds up the number of flags
The next steps after getting a prescribing/referring physician
What is google the number/name given, find out which specialty they are, and add them to the report?
What verbiage is used in this instance: I call a prescribing doctor but they won't release any information including fax number
What is the prescribing doctor verbiage, no contact name verbiage if they don't tell me their name, and I google the facility to find a fax/email or use the address for a mailing address?
DAILY DOUBLE: What counts as a REDO?
How I know what case is due that day
It's in my group chat's tasks each morning or I could ask my TL
With this information, what flag is used: I have two hits for orthopedics and 1 hit for a separate chiropractic search, all 3 locations are in the same state and less than 10mi from the claimant's address.
No flag can be used with this information
The contact asks you why you don't ask the claimant and why you're calling their facility-what do you say?
We're doing a radius search on behalf of their insurance company trying to verify service dates
What verbiage(s) do you use in this instance: You have 3 diagnostic facilities with the same phone number and, when you call the number, they give you one date of service for the first location.
Put the date of service at the first location, blank profile for the second location, and no records for the third location
Do the math: If I turn in a 20 facilities in the morning and 30 facilities by 5pm, will I hit production?
No that would only be a 5/day when you need 5.33/day at minimum.
Order of operations before turning in cases
Call multiple attempt and line not in service facilities one more time, remove highlights and check font color/size/type, check flags and SIU summary, check for fax number/contact name/Note to proofer, make sure all verbiage is correct, make sure name and report date is on report, upload case, complete tasks on case and in group chat