OPIE Template Patient Process Flow

Transcription

1 Template Process low Intake Process calls to schedule ront Office schedules in Scheduler arrives at Intake office has scheduled? ront Office reviews Scheduler for any openings Time available that day? uture scheduled by ront Office New or Returning? New completes Registration orm & returns to ront Office Does have insurance? ront Office reviews inancial Responsibility with chooses to proceed with care? for time Returning ront Office confirms demographic changes ront Office enters demographic info into & scans in Reg form reviews HIP and signs using digital signature pad reviews Supplier Standards and signs using digital signature pad ront Office scans ID Does have prescription? ront Office contact Referring Physician to get Rx ront Office scans Rx into ront Office verifies insurance & documents in Is insurance current? ront Office reviews inancial Responsibility with chooses to proceed with care? for time Insurance verification data entered in marked as rrived in & shown to room

2 Template Process low Clinical Process Repair Clinician documents findings in, sends ab Order form thru & sends Order f fab Complete Cab Tracking Order in documented in New Device Clinician completes Schedule ppointment orm & sends to Checkout documented in ront Office schedules follow up Stage of clinical process? Evaluation Clinician completes appropriate clinical evaluation form Clinician casts / measures Clinician picks components & sends order to ab Supervisor via Clinician sends cast to ab department Clinician decides on L- codes, adds tes & creates Justifications Intake Office seeks authorization from insurance payer itting Intake completes insurance authorization form in Payer authorizes care? itting Definitive Diagnostic Clinician completes Clinician completes Diagnostic process continues until device fits correctly Mark authorization not approved in Clinician completes Clinician completes Diagnostic process continues until device fits correctly for time Clinician & approve final device Did L-code selection change? Clinician walks to Intake to discuss changes in L-codes inal decisions made on L- codes & updated in OIPE Clinician verifies & selects final L-codes in & prints delivery receipt Clinician reviews care of device & education with & documents in Clinician completes Schedule ppointment orm & prints Education forms Clinician guides to Checkout Clinician completes final tes in OIE after leaves room Checkout gives Education & gets digital signature Checkout gives delivery receipt & gets digital signature Checkout schedules follow up C

3 Template Process low abrication Process ab Work Order in forwarded to Intake Office Intake Office updates ab Work Order w/ Intake Office releases ab Work Order to ab Supervisor Repair Review Repair orm in completed by Clinician & sent to ab Order f fab Complete Cab Tracking Order in documented in New Device documented in Review ab Order orm in completed by Clinician & cast sent to Cast modified by clinician pool per ab Order orm ab Supervisor reviews & batches componentry orders from clinicians D Order f fab Complete Cab Tracking Order in documented in ab Supervisor assigns fab job to technician documented in Technician fabricates device E ab Supervisor verifies device matches ab Order ab Supervisor updates job in ab Tracker to Ready to e it status ab Supervisor assigns job to Intake to schedule appointmen t already scheduled? Intake schedules Intake Office verifies device ready prior to

4 Template Process low Purchasing & Inventory Process D Clinician uses catalogs/inventory to select items for device or supplies Clinician sends items to P&I Shopping Cart ab Supervisor reviews requests from clinicians in Shopping Cart Item in stock? Item needed within 3 days? ab Supervisor adds item to supplier batch order in ab Supervisor places batch orders in on Tues & Thurs end of day ab Supervisor places specific orders in at end of day Ordering from Integrated Supplier? ab Supervisor selects supplier, starts Purchase Order & selects items to order ab Supervisor calls supplier to check availability, update pricing & document sales person ab Supervisor finalizes order in by each item number & finalizes Purchase order Place order by phone or fax? ax ab Supervisor prints Purchase Order from ab Supervisor updates & assigns items in inventory to (where applicable) fab or supply? Supply ab Supervisor selects items in to be ordered ab Supervisor submits order thru & order placed electronically with Integrated Supplier Phone ab Supervisor calls supplier item numbers & confirms shipping date ab Supervisor records final order being placed in ab Supervisor faxes order to supplier & confirms receipt of fax ab Supply ab Supervisor notifies assigned technician that parts on hand Submitted order confirmed in by Integrated Supplier or manually updated by ab Supervisor Items received & item's status updated in ll items on PO received? Partial order retained in Items received & item's status updated in Inventory updated in for received items ab Supervisor updates & assigns items in inventory to (where applicable) or inventory? Inventory Item placed in general inventory in & stocked in storage area Item ready to provide to or fabrication ab Supervisor notifies assigned technician that parts on hand ab fab or supply? Supply E

5 Template illing Process low (May 2012) illing Process C illing Supervisor reviews both the WIP documentation and the Validation tab ( illing: ill Claim Task) to ensure compliance and accuracy for claim submission ll steps correctly completed in? ollow up with clinician or intake admin to get claim documentation C1 Insurance or to pay? Statement of balance due provided to Insurance Claim submitted to insurance payer thru Zirmed in Pending Tasks assigned in illing Daily monitoring of task list in to ensure claim issues are handled in a timely manner Claim issues resolved? ollow up with Insurance payer and provide required documentation. e sure to note any response deadlines Payment received Payment applied in and all adjustments posted Is there a balance due to be paid? Does the have a secondary insurance? Claim status moves to Resolved in and no further task required Process Claim to secondary insurance plan following steps above beginning at C1 Send a statement and follow steps above beginning at C1