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Questions and Answers
In the EPIC system, what action should be taken if a patient's chart indicates 'Patient not enrolled' in Strive?
In the EPIC system, what action should be taken if a patient's chart indicates 'Patient not enrolled' in Strive?
- Upload Summary of Benefits and Availity Member Summary
- Send an inbasket to Kimberly McPeak & Kelly Haukland (correct)
- Update the wellness plan
- Mark the case as outreach
What should be done if the second outreach call is unsuccessful?
What should be done if the second outreach call is unsuccessful?
- Send an inbasket to Kimberly McPeak & Kelly Haukland
- Upload Summary of Benefits and Availity Member Summary
- Document in task and check 'FINAL ATTEMPT' box (correct)
- Update the wellness plan
What triggers the autogeneration of a UTR letter task?
What triggers the autogeneration of a UTR letter task?
- Uploading Summary of Benefits and Availity Member Summary
- Marking the final attempt on the second outreach call (correct)
- Updating the wellness plan
- Sending an inbasket to specific individuals
Which system should contain the information 'Patient enrolled in Strive' under Care Coordination?
Which system should contain the information 'Patient enrolled in Strive' under Care Coordination?
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When should a second intake task be autogenerated?
When should a second intake task be autogenerated?
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Study Notes
Intake Process Overview
- All intakes should begin immediately or within two days.
- Use resources from OneNote and specifically work with LCM case files.
- Read the enrollment note prior to starting the intake.
Intake Scripts and Resources
- Ensure the Intake Script & Resources (version 10.2023) are accessible.
- Reference Patient Call Scripting in Canopy for OSH or EPIC for Loyola to confirm patient hospitalization status.
Checking External EHR
- In Canopy, look for documents labeled "IP Review."
- In EPIC, utilize Chart Review to check for any ED or Admissions Notes related to the patient.
Initial Patient Contact
- First contact with the patient should be based on their preference.
- Complete two verifiers and fill out the HC Intake Form.
- Determine if a referral to RD/SW is necessary based on Social Determinants of Health (SDOH).
- Conduct a consent conversation and verify nephrologist and primary care provider (PCP) information.
Escalation Protocol
- If required, escalate any concerns or unusual findings during the intake.
Post-Intake Actions
- Once intake is deemed successful, complete an assessment and switch the case to active status.
- Send a request to RNCM for "CHART REVIEW" regarding the "LCM INITIAL" from the unscheduled visit tab.
Risk Assessment Guidelines
- For low-medium risk patients, schedule follow-up within 2-3 weeks from the receipt of the intake task.
- For high-risk patients, a follow-up should occur within one week.
Creating Additional Tasks
- Generate additional tasks for:
- Consents that were mailed, emailed, or completed during intake.
- Any community resources referred to during intake.
- Additional information provided by the patient that could not be documented.
- Verified provider contact if escalations were necessary.
- Any form of follow-up required after the intake process.
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