FO-005Front Office

Managing POCs/Referral Source Comm/ No Show & Cancellations/ Verification Tasks

Patient Access & Front Office Excellence

Recommended pathEnable / Adoption
Capability status
To be confirmed with PRN
Transformation phase
To be confirmed with PRN
Effort
To be confirmed with PRN

Current State / What We Learned

Observed today, as captured in the corrected assessment.

Managing plans of care (POC) remains a major manual burden, with exceptions and tasking rules needing fine tuning to reduce unnecessary workload. Currently, PSRs must manually complete POC tasks, including resending for physician signatures, even when not required by payer or state rules.

Desired Future State

The target way of working PRN and Raintree are aiming for.

• Patients scheduled out based on Plan of Care during eval check-out

Requirement / Gap

Indhu offered to provide training and documentation on these exemption setups to reduce unnecessary POC tasking.

Raintree Recommended Path

POC Tasking required for replacements plans, wc (exception TX). Liens, cash pay & should not be necessary in these instances. WHY are we creating extra work? Indu shared utility screen for CS to review and potentially remove requirements. Indu did review POC Exemption: Exempt a Plan of Care (POC) from requiring a referring provider's signature and return. This group of options is for accommodating the Medicare regulation that exempts an initial evaluation POC from requiring a referring provider's signature and return, provided a valid prescription (Rx) is on file.

Dependencies / Considerations

Not applicable

Outstanding Questions / Decisions

Not applicable

Evidence

Evidence for this opportunity is still to be confirmed.

Source

Detailed Transformation Assessment (Corrected)