Clinical Review
Therapy service descriptions that require Clinical Review approvals
What is Physical, Occupational, and Speech Therapy
An assessment that is filled out when the participant communicates, they are not going to an appointment.
What is a Visit verification assessment
We send an email to transportation when these occur
What is a late add on, time change, address change
If you clock in 1 minute after your start time this is considered
What is late
What do we use to schedule Optometry appointments
What is NVA
These therapy visits are the only ones that you can schedule for
What are evaluations
An assessment that is filled out when there is a PCP change
What is a Call Center contact assessment
When Centerlight is notified of an appointment within less than three business days it is called
What is a late add on
If you are calling out sick you must notify management (Time duration)
What is an hour before
What company do we use to schedule dental appointments
What is Liberty dental
What is the name of the form that is needed from the doctors office to send to Clinical Review for them to review the request
What is a PARF (Prior authorization request form)
An assessment that is filled out when a call is made but there is no answer from the provider or the participant.
What is an MPA contact note
What company do we use for transportation
What is CTG
You are to log in to this system right after you log into workday
What is agent Max
The referrals for Optometry, Periodontist/ Oral Surgeon/ Endodontist has to be given to the office by this source
Who is the participant
Clinical Review has these documents attached to their authorizations
What is approval, denial, partial denial letters. What is the Clinical documentation (PARF)
An assessment that is filled out to document if the participant utilizes a wheelchair
What is a transportation assessment
If the participant requires a C leg (second appointment) what should be sent and who should approve it
What is an email and who is the Care Manager
When you take a break this system has to be updated to reflect this
What is Agent Max
Who do you contact if your agent Max/ Care Compass/ Okta is down
What is Atlantic Support
We only email Clinical Review for the following reasons
What is to extend the end date of an authorization to cover a scheduled appointment. What is to change a providers name on the auth that is PAR
An assessment that is filled out when the participant states transportation is no longer needed for their appointment.
What is the visit verification assessment
This mode of transportation entails the driver to perform door to door service
What is ambulatory
You always require a MD note
What is on the third sick day and the day before and after a holiday
Who can assist in communicating appointment details to the participant if you are unable to contact them.
Who is the CM (Care Manager), CHN (Community Health Nurse), and the Participants site