IBR MCA Provider Packet Instructions

Questions and Answers

What is the first step in assembling and sending a Provider Packet?

Sort the tasks by due date

Click on My Tasks tab

Access the Client Matrix

You can view tasks assigned to your team by clicking on the My Tasks tab.

False

What action should you take after selecting a PROVIDER_PACKET task?

Click the reassign task icon

To sort the tasks by due date, click on the ______ column.

Due Date Signup and view all the answers

What option allows you to see tasks that are assigned to other people/entities?

Assigned Tasks tab Signup and view all the answers

What should you type in the User First Name Last Name field to find the correct task?

Fac Signup and view all the answers

The effective date of the instructions for assembling and sending a Provider Packet is 4/3/2023.

True Signup and view all the answers

Match the steps to assemble and send a Provider Packet with their corresponding actions:

Step 1 = Access the Claims screen Step 2 = Click Tasks to view tasks Step 3 = Sort by Due Date Step 4 = Select the task assigned to you Signup and view all the answers

What should you do if the Forensic Review Report (Provider) is not found in the ClinicalPoint Documents tab?

Email EQN MCASUPS and EQN MCA Leads. Signup and view all the answers

If the Client Matrix indicates a Provider Packet is required, you should always find the Forensic Review Report (Provider) in the ClinicalPoint Documents tab.

False Signup and view all the answers

What format should the file be saved as when creating a Provider Packet?

Patient Last Name, Patient First Name – Provider Packet Signup and view all the answers

In ClinicalPoint, the documents should be saved as “Patient Last Name, Patient First Name – ______ Name.”

Exhibit Signup and view all the answers

What is the first action to take when you cannot find the Uniform Bill in OnBase?

Access the Documents and Communications tab in ClinicalPoint. Signup and view all the answers

Match the following actions with their corresponding conditions:

Yes, Package Sent to Facility Date exists = Proceed to the next step. No, Package Sent to Facility Date does not exist = Skip to Step 15. Communications tab shows sent due to corrected claim = Proceed to resend the ProPac. Communications tab shows sent due to duplicate task = Click Finish in the Tasks tab. Signup and view all the answers

What should be done if the provider information on reports does not match with the UB and Provider Matrix?

Contact the Lead for corrections. Signup and view all the answers

You can access the Uniform Bill (UB) directly from the Claim Review tab in ClinicalPoint.

False Signup and view all the answers

Study Notes

IBR MCA – Provider Packets Overview

Document outlines procedures for assembling and sending Provider Packets (ProPacs) within ClinicalPoint.
Effective date: 4/3/2023; scheduled annual review: 10/15/2023.

Accessing and Navigating ClinicalPoint

Log in using username or email and password.
Access the Tasks screen via the "Tasks" button.
Use "My Tasks" for individual tasks and "POD Tasks" for team tasks.

Steps for Assembling a Provider Packet

Filters available for tasks: Assigned Tasks, Task Type (select PROVIDER_PACKET), and search by Facility Packet Queue.
Sort tasks by due date to prioritize older tasks.
Reassign tasks if necessary by selecting the contact from the dropdown.

Claim and Document Review Process

Open the claim using the 6-digit Claim ID in ClinicalPoint.
Use the Client Matrix to check for the need to send a Provider Packet or Provider Report.
Action steps vary based on whether a Forensic Review Report is available.
Retrieve documentation from ClinicalPoint; if unavailable, check OnBase.

Saving and Checking Documentation

Save documents in the MCA Work Folder using a specific naming convention: “Patient Last Name, Patient First Name – Exhibit Name.”
Always check for the Uniform Bill (UB) in OnBase; if not found, look in ClinicalPoint’s Documents and Communications tab.

Provider Information Verification

Ensure provider information on all reports matches with the UB and Provider Matrix.
Contact Lead for corrections if discrepancies are found in provider information.

Finalizing and Sending the Provider Packet

Check Claim Summary under the Review tab to see if the packet has been sent.
Use the Communications tab to understand why the packet was sent.
Follow specific steps based on the reason for packet transmission, including resending procedures as needed.

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Description

This quiz focuses on the procedures for assembling and sending a Provider Packet (ProPac) in ClinicalPoint. It provides detailed instructions as outlined in the document effective from April 3, 2023, and includes essential terminology and revision history. Test your understanding of these important procedures.