Epic
Where would you go in Epic to locate a HIPAA form?
Appts>Registration>Documents (or Media)
What is a filing order?
What is:
Which payors are billed when the patient has more than one insurance coverage.
Only when all search options have been exhausted (must probe first)
With things changing so often, what is the best KA to keep up with the overall guide to your calls?
Quality companion Guide
Which 2 identifiers are mandatory to verify a patient's account
What is:
First and last name
DOB
If you look up a chart in Epic and it only has the MRN number, where can you go to find the E#?
What is:
Appt registration page
What is a referral?
What is:
A formal request from a provider for a patient to receive another medical service.
When patient calls in with multiple symptoms/concerns, how do we identify which callflow to use?
What is:
Use the one MOST pressing to the patient (if you are unsure, probe to find out)
What is the name of the KA we would utilize to locate information such as fax numbers, addresses, pool names and landmarks?
What is:
Practice information KA
True or False:
Clinical and branching questions must be asked verbatim.
What is:
True
(The only ones that do not have to be asked verbatim are going to appear in parenthesis, but still need to be documented appropriately)
Where can you go to locate a date and time a refill was sent in for a patient?
What is:
Chart>Medications>click on the Medication and go to where you see the pharmacy date/time and it will show.
What is a contact payor?
What is:
Usually this error happens when our RTE does not have this insurance and we must add it as "generic" plan.
What is the time period in which an appt should NOT be rescheduled, but instead should be CANCELLED and then book a new appt?
What is:
If the patient is calling within 3 hours of their appt time.
What is the name of the KA that you would utilize if you need assistance with a callflow?
Call flow selection KA
List 2 reasons you would receive an auto-fail on a call
What is:
-Missed red flag word
-HIPAA violation
-Call Avoidance
-Giving clinical advice
-Falsifying information
-Use of wrong patient's chart
-Foul Language/Cursing
What is a guarantor?
What is:
The person responsible for medical bills
At what point should an Existing condition/follow up script be used?
What is:
ONLY when the patient has seen THIS PCP for this exact issue in the past, and is following up on the condition AND if there are NO NEW or WORSENING SYMPTOMS.
*Note-if new symptoms use that call flow instead.
If you cannot find the KA you are looking for, what is a great way to find a list of all the KA's and narrow it down alphebetically?
What is:
In Salesforce, click the arrow drop down>Knowledge>Click the dropdown next to "Recently viewed"> Change to published articles> Use the arrow at the top to sort alphabetically
What does quality look for in order to get all the points for insurance verification?
What is:
Verbally verifying insurance, and manually ensuring insurance is verified (swivel to epic and attempt to resolve if not)
Where do you go to set a pharmacy preference for a patient?
What is:
Click on Chart>Pt name>Clinical info
What are two ways to add coverage?
What is:
Type the insurance name or add coverage
What is important to look for when scheduling for an ED/Urgent care follow up?
What is:
Any CURRENT or WORSENING Red flag words (appears on the screen right after selecting ED follow up.
*Those are a NT call, and missing that would result in a auto-fail!
According to the Labs, injections, and Test Scheduling KA, we would cold transfer all patients who are wanting to schedule or cancel tests/imaging to the test scheduling line in that market except which market?
What is:
Irvine/Paducah Kentucky market
(we would WT these to the practice)
Name 3 options Quality looks for when they say "Did SE exhaust ALL options" if appt is NOT booked?
What is:
Selecting additional dates/times
Selecting other providers
Adjusting the date range
Offer Virtualist/walk in appts