Symptoms
60 M: Pt is requesting to be seen in office. Had had a cold/sore throat, ear pain and cough for ~ 2 weeks, it will not go away.
What is:
MA- Schedule an appointment
Reason: Typical respiratory illness symptoms
68M: Is there anything you can prescribe to help with this issue if so please send in prescription to Optum thank you
What is:
MA call or send message- respond to patient asking what issue he is having
If this is a new issue, schedule an appointment with PCP
50 F: I am having ear pain for the month. can I get a referral to see ENT?
What is:
MA to call and schedule appointment. In primary care, we are a good start to almost all medical conditions to initiate workup. Depending on results, we can refer to specialty if appropriate.
Following up on my question around the Anion Gap test results. They have been lower than recommended, and seem to continue to drop. What should I do?
**Message sent 4 days AFTER MD resulted labs as "normal/stable", no further action is required. Recheck in 1 year. Pt has MyChart and saw results.
What is:
Route to RN - cover additional questions (even though PCP noted "normal/stable, no further action required.
Reason: Pt needs further explanation, easier for RN/MD to provide.
11 y/o F- MOC messaging - my daughters school is requiring this general appraisal form to be filled out ASAP. Please have provider fill out and let me know when its ready to be picked up.
** patients last WCC was over a year ago**
MA- call MOC and advise her that patient needs to be seen for her annual exam (WCC) so we can fill out form with current/accurate information. Schedule patient for a WCC.
Bonus: What if we've seen patient within the last year?
55 M: I came back from a Wedding out of town, and started having a stuffy head, sore throat and cough Saturday night. I tested Sunday Negative for Covid, but today (2 days later) I am testing positive. Now what? Can I get some medicine for anti-covid?
What is:
MA to SCHEDULE A VIRTUAL VISIT with provider, OR recommend NAVV visit. You can also route to RN to facilitate this, however not necessary.
39 F: I am needing a refill on my thyroid medication. I can't remember the dose at the moment, whatever is on file. Send to Walgreen's on Colorado Blvd.
You review the chart and see the patient has not been seen in 1.5 years. That is the last time TSH with reflex was checked.
What is:
MA to follow medication refill guidelines. Last time lab was checked? Last appointment in clinic?
Refill for 30 days and schedule appointment. Notify pt.
40 F: I got an order for an ultrasound. I have been waiting to schedule for a month. Touchstone is saying they don't have the order. What is going on?
What is:
Review the order in Epic, make sure it is ordered correctly:
Bonus: If pt has emailed or called several times or has been waiting a while, please take the extra step to call imaging facility to confirm receipt, then notify pt.
55 F: Pt needs appointment from her Emergency Department visit on 9/8/23 for ascites. Needs a GI referral from her PCP.
What is:
MA call patient to schedule an office visit or can route to PSR.
Bonus: when do we schedule TCM?
88 F: Daughter (MPOA) is requesting FMLA paper work to be filled out by patients PCP so that the daughter can stay home and help.
MA- Call daughter and schedule appointment for patient to see PCP to discuss. Advise daughter that she needs to be present at appointment to fill out forms accurately.
36 F: I have been having burning with urination for a few days and going more frequently. I have had UTIs in the past and know what they feel like. Can I get a prescription sent?
What is:
Schedule appointment, Co-visit, NAVV
68 F: Pt wanting call back regarding her side effects since starting her medication for vertigo. Pt has been having hot flashes, nausea, light headedness and sees spots. Pt feels her head is swollen, and her head itches. Should she stop the medication immediately, or stop gradually little by little?
What is:
Route to RN.
Reason: Symptom, side effect or reaction to medication question
45 M: I have completed 4 weeks of PT for my knee but I am still having pain. Please order an MRI for further assess - I would rather not have to come in for an appointment if I can avoid it.
What is:
MA advise patient to schedule an appointment for reassessment as appropriate document is necessary for insurance to consider covering imaging.
45 M: MyChart message: I am just wanting to check in in to see if we will be appealing the denial of my Ozempic?
Review chart. Send to EPA team if it has not been initiated.
Real example: Often there has been a response by EPA team or Katy Estes, but we are not taking the time to read.
47 M - I have been struggling getting myself back to my "norm". I would like to extend my STD to 4 more weeks out. This will allow me to get in with therapy and tweak any medications as appropriate. Please fill out form ASAP and submit to my employer as I cant go without pay.
MA- schedule patient for either a virtual/in-person visit. Explain to the patient that our provider needs to assess and have supportive documentation that justifies the request.
3 yo M: Mom calling, Child has been pulling on right ear and fever of 101F. He is more fussy. What can I give him?
What is:
Route to RN for triage, schedule appt, co-visit
60 F: Can you send in a Rx for Depression / Anxiety? I am feeling myself spiral mentally into depression, and I need to focus better. Sleeping poorly. I do not want to have weight gain from medications, which will compound my depression.
What is:
Route to RN.
Reason: Active Symptom or question. RN will triage and schedule with provider.
What if pt was having SI and RN not in clinic?
65 M: My GI doctor wants labs done and told me to go to my PCP. Please see attached lab orders. Let me know when orders are in so I can make an appointment.
What is:
MA respond to patient letting them know that we are unable to draw needed labs in clinic as our providers would need to order under their name. Advise patient to go to PSC for needed labs.
Bonus: if patient gives push back or if weve done a simple PSA for pt before, queue lab and route to provider
55 F: I have met with the bariatric surgeon and need clearance to proceed with surgery. Please have the provider sign this form that clears me so I can get scheduled ASAP.
What is:
MA - either MA or PSR to call patient to schedule them for an appointment (preferably PCP). Clearance requires an exam by the provider.
77 y/o M- Patient dropped off Handicap parking privileges' application for PCP to fill out and sign. Patient is now back 3 days later requesting to pick up the form.
What is:
MA- review patients chart for any documentation of status of form. Go to designated MA for that PCP. Review folder. if not in folder, speak with MA to check on status. (please see work flow inside each folder)
62 F: MyChart message -
I have been having chest tightness in the middle of my chest since yesterday. I think it is indigestion. Can you have the doctor call me to talk about what to do?
What is:
Route to RN. Trigger word and should have warm hand off
40 M: MyChart message -
Hi, this is just an FYI....I had trouble waking up during the middle of the night from what my mom says. She called 911 and they gave me glucagon cause my blood sugar was 35. EMS told us to make sure I ate with my insulin. Wanted you guys to know what happened.
(Next day): So it happened again, I took my insulin at lunchtime with food. At 4pm I had trouble waking up and could not stand. Blood Sugar was 44. Maybe we need to adjust the insulin?
What is:
Route to RN/MD.
Reason: Trigger Word (low blood sugar) AND Active Symptom Question. **This is an emergent routing issue** so make sure you notify RN/MD with high priority.
68 F - I called the rheumatology office that you referred me to and they told me they are out-of-network with my insurance. Please place a new referral to a provider that takes my insurance.
What is:
MA: Due to patient not being able to see initial provider we referred pt to, message patient back and let them know that we are sending their request to our referrals team to redirect referral to a different provider.
Bonus: IF pt has already seen the provider and just wants a second opinion- what do we do?
57 F - I had tweaked my neck back in August and started seeing my physical therapist. Therapy has been helping a ton. For me to continue with receiving treatment, I need a letter from my PCP indicating that the therapy has been helpful and that it would benefit me to continue for another 4-7 weeks. Please have the provider fax this letter to 303-447-1242.
MA- review chart. Have we seen this patient for this issue and if so, how long has it been since initial visit? Before writing an note requesting additional therapies - patient needs to follow up with PCP so documentation can be made on progress. Have patient schedule an appointment.
35 M- I need this biometric form filled out for my work so I can get a discount on my annual premium for my insurance. This is due ASAP. please complete and send back to my employer.
** patients last physical and biometric labs were done 6 months ago - not by PCP**
What is:
MA- review patients chart - which provider preformed physical exam 6 months ago. This form needs to be signed by the examining provider. MA to fill out forms as best as possible and place form in appropriate inbox for signature.
Bonus: What if patient requests to get labs done prior to physical exam?