Accept Linked Contract Patients
New Linked Contract Patient cases are presented to Agencies from an authorizing Payer as Placements. An Agency is free to review the Patient’s case before ultimately deciding whether to accept or reject it. If an Agency accepts a case, all Patient information stored on the Payer’s Professional system transfers to the Enterprise system. The following section covers the review and acceptance of new Linked Contract Patients as well as all correspondence between an Agency and the authorizing Payer for any Linked Contract Patients.
Complete the following steps to accept or deny a Pending Placement.
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From the Pending Placements queue, click the Placement Admission ID link.
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The Patient Info page opens to display Patient information such as General, Demographics, Special Requests and Authorizations. Review the details and scroll to the bottom to proceed.
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There are several Placement options to include: Accept, Request More Time (from the Payer to further review the case), Accept and Print, and Deny (to reject the Placement).
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If accepting the Placement, an Agency Coordinator must be selected from the Coordinator dropdown options.
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If denying the case, select a rejection reason from the dropdown menu.
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Once a Placement is Accepted or Denied, it is cleared from the Pending Placement section.
The Link Communication tab in the Home Module facilitates communication between an Agency and all Payers (Linked Contracts). This is where any data shared between the Professional and Enterprise systems is stored for review. In the Home page, Pending Placements and Notes are seen.
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Sections |
Description |
|---|---|
|
Pending Placements |
New Patient cases are presented to Providers from an authorizing Payer as Placements. Agencies are free to review the Patient’s case before deciding whether to accept or reject it. |
|
Notes |
All miscellaneous communications between an Agency and the Payer pertaining to Linked Contract Patient cases. |
Use the Office(s) and Coordinator fields to sort information under the Home tab.
The Notes section contains all open correspondence between an Agency and Payers. Notes may include information such as Caregiver observations, Patient requests, or any other information pertaining to the Patient’s case.
The Pending Placements section contains new Linked Contract Patient cases sent to an Agency from Linked Payers. The table under the image describes the information seen per line item.
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Sections |
Description |
|---|---|
|
Admission ID |
Patient’s Admission ID |
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Office |
The Office within the Agency where a Patient is assigned. |
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Start/Stop Dates |
Specifies the case’s start and stop dates. |
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Frequency |
Specifies the frequency of service to provide for the Patient. |
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Service Category |
Indicates the service category such as Home Health or Non-Home Health. |
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Service Type |
Indicates the type of service required by the Patient. |
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Request Sent At |
The time the Payer sent the Placement. |
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Status |
Indicates the Status of the case (whether it has been accepted or not). |
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Cut Off Time |
Indicates the date and time when the system will automatically remove the Pending Placement from the queue. The value in the Request Sent At column is highlighted in red text when a Placement is nearing Cut Off Time; signifying immediate action is required.
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Payer Name |
Indicates the Payer sending the Placement. |
