Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Tel: Pager: 6707

Size: px

Start display at page:

Download "Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Email: agardner@mah.harvard.edu Tel: 617-441-1625 Pager: 6707"

Janis Campbell
8 years ago
Views:

1 Support: Andrew Gardner Clinical Data manager Mount Auburn Hospital Tel: Pager: 6707

2 Mount Auburn Hospital Case Management Department PROCESS STEP See page... Concurrent Review PROCESS STEP See page... Support Services Log in, Menus 1 Choosing the Patient 9 Worklist 2. 3 General Tab 10 General Tab 4 Series User Fields Tab 11 Diagnosis/Procedure Tab Payer Tab Referral Tab Comments Tab Episode User Fields Tab General Tab - Basic Certification History Certification Avoidable Days Series User Fields Tab 8 Avoidable Days Entry 14 Case Management System Overview Concurrent Review Entry: Enter or view information about ongoing patient care, including reason for review, severity and intensity criteria, level of care, diagnoses and procedures, payer information, and physician advisor review Concurrent Review History: View the results of previous reviews, such as review date, severity and intensity, and comments Certification Entry: Enter or review payer certification information for an encounter Track payer update requests Avoidable/Denied Days Entry: Track the review process of outside agencies regarding actions, appeals, denials, or financial implications for each occurrence of avoidable/denied days. You can also track the in-house process of assigning avoidable days (variance days) to a physician or department. Support Services Entry: Enter or review information on support services and agencies arranged for a patient following discharge Enter patient discharge information. Support Services History: View a summary which includes the date, service type, case worker, agency, and comments of previous support services related to the selected encounter.

Certification Avoidable Days 12 13 Series User Fields Tab 8 Avoidable Days Entry 14 Case Management System Overview Concurrent Review Entry: Enter or view information about ongoing patient care,

3 MIDAS Case Management Login, Menus Page 1

4 MIDAS Case Management Worklist Page 2

5 MIDAS Case Management Worklist Page 3 Condense or expand the Patient Header Open the Patient Explorer Additional patient information

6 MIDAS Case Management Concurrent Review Page 4 Shortcut! General Tab Review by: Enter your name here or press, enter a few letters and press Level of Care: Skip Review Location: System will default to current location Severity: Choose Met or Not Met (Type N or M and lookup ) Intensity: Choose Met, Not Met or NA (Type N or M and lookup ) Prioritize: Check only if you want review flagged on worklist Reason: Skip Status: Choose COMPLETE if you have finished for the day with this review. Choose PENDING if you need to re-visit this review during your shift. Next Review: Use T + 1, 2, 3, depending on the next date to be reviewed. The patient will not re-appear on your worklist until the next review date.

Choose Met or Not Met (Type N or M and lookup ) Intensity: Choose Met, Not Met or NA (Type N or M and lookup ) Prioritize: Check only if you want review flagged on worklist

7 MIDAS Case Management Concurrent Review Page 5 Diagnosis/Procedure Tab Admission review : Skip HCM Diagnosis: Enter the diagnosis determined during the initial review (or chief complaint) HCM Procedure: Enter any procedures performed during the stay Diagnostic Category: Skip DRG: Skip Payer Tab Skip Informational only

the initial review (or chief complaint) HCM Procedure: Enter any procedures

8 MIDAS Case Management Concurrent Review Page 6 Referral Tab PA Date: Date case referred to EHR. Can use T + 1, 2, 3 for date Referral reason: Choose appropriate reason case referred to EHR PA Name: Choose EHR,Referral Disposition This is filled in with EHR determination when referral is returned Comments: Right click with mouse to enter additional information required by EHR. Choose Add Template to be prompted for required information. Comments Referral Tab Skip

EHR,Referral Disposition This is filled in with EHR determination when referral is returned Comments: Right click

9 MIDAS Case Management Concurrent Review Page 7 Episode Referral User Fields Tab Tab Review Type: Choose the type of review Case Management Progress Note: Document the patient Update (including Interqual criteria for IS and SI) and the Plan Payer update: Document the patient Update and Plan for the Payer Update report. Note that this field will be sent to the payer!

(including Interqual criteria for IS and SI) and the Plan Payer update: Document the

10 MIDAS Case Management Concurrent Review Page 8 Series Referral User Fields Tab Tab Admission Assessment Tab Complete patient admission assessment Hold down key to make multiple selections from menu If Readmission <30 days is Yes also complete Readmission Assessment Tab Risk Assessment Tab Complete patient risk assessment Check all chronic illnesses that apply Readmission Assessment Tab Complete if patient is a 30-day acute care readmission Patient Referral Tab Complete if patient is being referred to social work Complete if patient is a candidate for Hospital Inpatient Core Measures AMI, CHF or PNA

patient risk assessment Check all chronic illnesses that apply Readmission Assessment Tab Complete if patient is a 30-day acute care readmission

11 MIDAS Case Management Support Services Page 9 Choosing Referral the Tab patient

12 MIDAS Case Management Support Services Page 10 General, Referral Comments Tab Tabs GENERAL TAB Date Entered Enter the current date Case Worker Enter the name of the Case Manager who owns the patient. Case Hrs Skip Frequency Skip Time Skip Worklist Date Automatically fills with the current date Type Enter the type of Service needed by the patient (one Type at a time) Service Enter services the patient needs for that service Type; select additional Services, if needed. Referral Status Choose until the case has been placed and then update to or. Note: this must be set for referral to appear on your worklist Payer Information enters automatically. Completed Do not mark this box with setting up this service. NOTE: you must check this box for the case to be removed from your worklist Agency you can enter the agency you want to refer to in this field Fields below Agency are not used. COMMENTS TAB Record notes on the active referral Use Save or Save and Add to create the next referral inquiry for support service entries

patient needs for that service Type; select additional Services, if needed. Referral Status Choose until the case has been placed and then update to or.

13 MIDAS Case Management Support Services Page 11 Referral Tab Series User Fields (for discharge placement) Document the final placement and discharge disposition of patient Discharge Disposition: Choose the placement/ setting Discharge Placement: Choose the agency Discharge Plan: Record notes to add to the discharge placement report for the medical record NOTE: If the patient did not have any support services a new support entry will need to be created and the Type field completed on the General Tab to record the Discharge Disposition on the Series User Tab. If you would like to see all the referrals have been made on a patient without entering any information, you can go to Support Services History

medical record NOTE: If the patient did not have any support services a new support entry will need to be created and the Type field completed on the General Tab to record the

14 MIDAS Case Management Certification Entry Page 12 Choosing the Referral patient Tab See Page 9 General Referral Tab Tab - Basic Payer: Information only. Shows principal and secondary payers Payer Status: CM Admin will record Authorization No. (if not interfaced), Service Start and Service End dates and Type.

only. Shows principal and secondary payers Payer Status: CM Admin will record

15 MIDAS Case Management Certification Entry Page 13 General Referral Tab - Certifications Tab Service: Skip Date: Enter the date the updated is complete or sent Case Manager Time: Skip Submit By: Enter name of Case Manager who sent request Case Manager Submit to: Name of clinical reviewer for Payer HCM Admin Company: Name of payer being requested HCM Admin Phone, Fax: Where request should be sent HCM Admin Certification History Comments: Notes pertinent to request Case manager and HCM Admin

Manager Submit to: Name of clinical reviewer for Payer HCM Admin Company: Name of payer being requested HCM Admin Phone,

16 MIDAS Case Management Avoidable Days Entry Page 14 Choosing the Referral patient Tab See Page 9 Avoidable/Denied Referral Tab Days Entry Type: Choose from drop-down list Start date: Enter the date of admission End date: Enter if applicable Entered by: Enter your name Amount: Skip Cause: Choose from drop-down list Days: Enter number of days at risk

Start date: Enter the date of admission End date: Enter if applicable Entered by: Enter

How To Print An Encounter Form In Acedo

How To Print An Encounter Form In Acedo Encounter Forms 70 Royal Little Drive Providence, RI 02904 Copyright 2002-2013 Optum. All rights reserved. Updated: 3/8/13 Table of Contents 1 Encounter Form Setup...1 1.1 Overview...1 1.2 Building an