Med&PA's
how much is our bridge supply
7 days maximum
ESA letter process
Obtain HIPAA review to assure it is valid.
PLEASE FIND OUT WHAT TYPE OF ANIMAL
ONLY 1 ANIMAL per letter
No more then 2 letters per patient
Upload to patients file and add to spreadsheet.
Due to ESA letter coming with payment, please be sure to add it as a medical record $25 appointment on the providers schedule for the day the request came in.
Be sure to obtain approval for ESA by the provider.
Send patient save reply for pending letters and forms that informs them of our processing time 7-10 business days.
Line 8 refers to
This is the section that tells us who we are able to communicate with.
The first and last name must be listed.
We will not accept “Therapist” “doctor” “school” “work” etc. as a valid designee.
One HIPAA release per recipient
For example, if the patient would like us to communicate with their mom and dad, we will need an individual HIPAA for mom and an additional HIPAA for dad.
Jury Duty process
HIPAA is required, can be done under a patient status verification letter and requires provider approval
How to respond to this scenario: patient" hello im calling because i need to speak with my provider for a refill of medication"
"Hello thank you for calling Mindful Care, Can i get your name and DOB?"
Find out if they have a scheduled appointment, or had, or need.
If they require appointment, please sent to PX to schedule.
If they had appointment, verify medication was sent
If they have an appointment within 7 days and are out of medication, send bridge.
what is our bridge refill policy
must be within the past month or they require same day appointment and appointment must be on file within 7 days before we can send over bridge request.
Always posting in designated chat, never individual provider unless specific case.
Bridges are a one-time courtesy unless appointment has been cancelled or reschedule because of Mindful Care
What is required of a bariatric surgery letter
Can be done after psychiatric evaluation and requires HIPAA for the Bariatric surgeon. If current patient, requires Bari appointment and approval from provider and HIPAA
Line 9(a) refers to
Entire medical record allows for the use of or the release of the entire record.
Patient can also choose specific date ranges to use on letters or release information.
What requires HIPAA
LITERALLY EVERYTHING
besides appointment confirmation letters
How to respond to this scenario: Patient" hello, my provider said he would fill out disability forms and i wanted to know where to send them."
" Hello, thank you for reaching out. Unfortunately, mindful care does not sign off on disability forms as it is against our policy. but we can provide you with a copy of your medical records after hipaa has been submitted."
NEW YORK RX
EXCEPT UHC COMMUNITY PLAN--PLEASE USE THEIR BIN,PCN GRPID
Letters we do
Treatment Summary
Bariatric Surgery Letter/Spinal Stimulator Surgery
Discharge Letter
Medical Records
Patient Status Verification
ESA
Work/School Accommodation
Work/School Excuse Note (up to two weeks ONLY (within 6 month period))
Return to Work/School Letter
504
Appointment Confirmation (can be handled same day)
Jury Duty Excuse (put on patient status verification letter and add in additional information)
Accutane Approval (appointment confirmation or patient status verification and add in additional information)
Line 9(b) refers to
This section allows us to discuss health information.
Please be sure it says Mindful Care and not the individual provider.
Make sure the third blank matches the person listed in section #8.
Why is line 8 necessary
We are not to send documents directly to patients to avoid events like them altering our letters. We can send them a copy AFTER we have directly sent the letter already to the facility.
Care Collaboration
Do not bother the provider until we have obtained HIPAA
Use the excel sheet to keep track
Care collab times are to be done during providers admin time (exceptions may be made if necessary)
12 hour providers have a set care collab time
After date and time is approved with both providers, send an email to MC provider, book it on their schedule and document in excel
PCA can handle care collabs- if times do not work and providers are okay with it, conduct the collab call
Care collaboration for parents with minors is not allowed. The parent must verbalize their concerns at the next appointment with the provider. Mindful care policy for minors in appointments is that they are not allowed to be seen without a parent present. This is their time to bring up their concerns.
For adults. If the provider agrees and feels as if there might be a benefit to a care collaboration, it can be done. we need provider approval first.
when a provider is out, who do we send a refill request to, OUTSIDE OF THE STATE OF NEW YORK
@everyone-- the next available provider in the state designated rx chat
Therapy letters that we do
The only Letters LMSW or LCSW are able to supply their patients are the following:
Appointment confirmation letter (After 1 visit) * this is not an excuse letter
Therapy treatment summary letter (After 3 visits)
Emotional support animal letter (After 3 visits)
Therapy department does not fill out Outside forms under any circumstance
All letters besides the Appointment confirmation letter require HIPAA form on file that can be found on our website and it takes 7-10 business days.
Please do not give patients the impression that they will receive any documentation the same day
If a hipaa is signed by someone other then the patient
if they are a minor, and it is a parent, it is ok.
For adults, they are not valid. must be filled and signed by the patient
New provider change
This is the responsibility of PX team to fill out the provider change form. PCA is to, after approval, add a flag in the patients chart indicating change has been approved and the date. ex Provider change approval--new provider Ctada--9/9/2023
If denied, please try to obtain reason as to why to further explain to px and patient
Add a flag indicating that request has been denied with date
Higher Level of Care referral
Provider puts in request via PCA special request
Add the patient’s information and referral info to the excel sheet under the “HLC referrals” tab- you will use this to keep track
Research resources and proper insurance for requested programs
Email patient the saved reply: “PHP/IOP Referral Email (PCA Use Only)” edit and add the resources requested
Document in excel that resources were sent with the date and the helpscout email #
Follow up on the request up to three times
You should be following up via email and phone
This request should be completed from start to finish within 2 weeks
If you have followed up 3 times with no response from the patient
Notify the provider and document in the communications with dates sent and explain that there was no response
Once you receive a consent form
Upload the consent form to dr chrono under documents and label it
Write the PHP/IOP Referral Letter via share point
Download and label it
You will need to contact the program for their intake coordinator’s information
Find out program requirements ie. Most recent note, eval and referral letter
Get the proper email or fax number for referrals for the program
Once you have that information, download the requirements and use PDF filler to make one complete document ie. Referral letter, recent note
Send the document to the appropriate fax or email given to you by the coordinator
Document this in the excel, move the patients info from the pending section to the completed section on the excel
What do you do when the insurance information is not found on covermymeds
reach out to PCA leads for Pverify to confirm insurance address or call insurance to verify
Letters process
When the request comes in, check HIPAA consent form and make sure it is okay, make sure patient has met the visit requirement.
Add to the letters/forms excel sheet
Upload HIPAA and label it (For example: HIPAA for__________ tx summary request)
Ask provider if they approve of request
Respond to the patient with the pre-saved reply Administrative: letters/forms received/ processing
Update list with provider approval
In 7-10 days write letter, upload to chart (label it), and send the document
Update the excel sheet
Patient claiming power of attorney
We need a copy
The language MUST allow for them to have complete authorization over the patients file.
PCAs Must review the language.
what to do if Emergency room provider call
if a patient is in the emergency room (HIPAA is not require) Please find out why they are there, we are to obtain information as to who the patient is, the emergency room they are in, the name and phone number of the person calling and a call back number to them provide to the provider for a call back
Medical record process
When the request comes in, check HIPAA consent form and make sure it is okay.
Add to the medical records excel sheet
Upload HIPAA and label it (For example: HIPAA for__________ and make sure all notes are locked
Respond to the patient with the pre-saved reply PCA: Medical Record Processing
Make sure the release person is the email or fax we have, if not ask for that information from the patient
If it is an outside person such as a lawyer, insurance company, etc.tag billing “@billing please send medical record invoice and move to ANYONE AND BILLING BOX