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Home Health Intake Workflow Procedure Steps to Take:

Intake – Referral Process:

1. Is the referral from an outside source or internal (Riverside)?

a. Internal Referral

i. Within Referral/Authorization workqueue 7697 HH – Incoming Referral:

1. Single Click the patient

2. Select INTAKE

a. Start intake process a outlined below

NOTE: Once the referral is started the patient remove of the Incoming Referral workqueue and will

move 7671 HH – Intake Incomplete workqueue.

b. Outside Referral

i. Select Transcribe Order

ii. Search for the patient

1. LastName,FirstName & Date of Birth

a. Click on Find Patient

b. Is the patient found?

c. Yes – Move to step XX

d. No – Enter full LastName, First Name, Date of birth, SS # and sex – Click

on NEW

e. Select NEW on the Encounter Selection form

f. Confirm the Date

g. Enter the Provider

h. Confirm the Department

i. Click Accept

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i. From the Transcribe Order Activity, Select ADD ORDER

j. Search for Amb Referral Home (REF34)

k. Select Ambulatory referral to Home Health

l. Click Accept

m. Confirm and/or change fields

i. Class - Incoming Referral

ii. By Provider - Enter the provider

iii. Referred by location – Enter where the referral is coming from

iv. Status change to Normal

v. Under Comments, highlight and delete information

n. Click Accept

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o. Select DX Association

p. Search for Diagnosis by description or by ICD 10

q. Select the correct code

r. Click Accept

s. Enter additional Diagnosis, if necessary

t. Associate the diagnosis

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u. Click Accept

v. Select Sign Orders

w. Under Order Mode, select the proper selection for transcribing the order

x. Enter the ordering provider. If the provider is an external provider, enter

“Provider, External”

y. Enter the Authorizing Provider

z. Close the Transcribe Order Activity

c. The referral will move to the Referral/Authorization workqueue 7697 HH – Incoming Referral

i. Single Click the patient

ii. Select INTAKE

1. Start intake process a outlined below

NOTE: Once the referral is started, the patient remove of the Incoming Referral workqueue and will

move 7671 HH – Intake Incomplete workqueue.

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Intake – Intake Process:

1. Confirm correct patient demographics within the Interactive FaceSheet

a. Under Additional Information:

b. ID cards, Photo IDs, additional registration documents can be reviewed.

c. Preferred Pharmacy can be updated and/or changed

d. Under Episode of Care, select the form with the patients name

i. Under the Episode name: Remove all but the patients name

ii. Under Admission source: Select the correct source (where is the patient coming from?)

iii. Under Event History: Enter HH Ready for Ins Ver – this sends for Insurance Verification

(Referral/Authorization workqueue 8035 – HH – Insurance Verification Process

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iv. Under Event History: Enter Start of Care Date

e. Under Episode Info 2 – enter any additional providers

f. Select the Caregiver/Religion form

i. Enter the caregiver. If the caregiver is on the “Contact” list from the interactive facesheet,

use the more button and select pull info

1. Select “Other Relationship”

2. Select “All Information”

g. Move to the Referral Information form

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i. Select the Enter Referral hyperlink

ii. the referral is not attached

1. On the referral Action screen, right click and select assign

2. Upon assigning, a black check mark will show as indicator of assignment

iii. Double click on the referral

iv. If the “Referred By” has not been enter or

1. Confirm the “Class” shows incoming for external referrals.

2. Under the “Referred By” place a check mark in the “Override referred by and to

restrictions”

3. Enter or update the Location/POS

v. Select Questionnaire

1. Enter Yes or No under the disciplines needed

2. Click Accept

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vi. Close out of the Referral Action Activity

vii. Under the Face to Face Attestation, click on Create

viii. For Transcribed Orders:

1. Select Mark as Already Signed

2. Enter the Physician

3. Encounter Date & Signed Date

4. Accept

ix. Internal Referrals

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1. Select Mark as Already Signed

2. Enter Physician

3. Enter the Encounter date and Signed date

4. Review the face to face information

5. Accept

x. Under Referral instructions, enter your intake note

h. Move to Referral Info 2 form

i. Enter Labs, Infusion companies, DME or other agencies

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i. Move to the Assessment Info form

i. Answer M0102 – typically, select NA. By selecting NA M0104 will populate with the date

of referral. This date can be changed, if necessary.

ii. Select the appropriate Number of Previous Consecutive Episodes. M0110 Episode Timing

will populate based on the number of episodes.

iii. Select the correct answer for M0140. Race can be found on the interactive facesheet. By

selecting the demographics hyperlink, the race field can be reviewed.

j. Move to the Inpatient Stay Information form

i. Complete M01000

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k. Move to the Home Care Diagnosis

i. Diagnosis can be entered by ICD-10 code or entering the description.

l. Move to Financial and Authorization form

i. This form is completed after Benefits/Authorization is completed

ii. Select the correct Payment Source

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iii. NOTE: No Authorization information is placed on this screen

m. Move to the Care Team Information

i. Enter the patients address, where are service being rendered? If home address, select Pull

Info. If the address is different from home, enter the address (Free Text)

ii. Enter any Directions or precautions for the clinician.

n. Move to the Place of Service form

i. Select Update

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ii. If the Place of Service is the patients home care address from the Care Team form, pull

department and address by selecting the Pull buttons.

iii. Click Accept

o. Click on Finish. The account will be sent for benefits to complete their steps.

Intake – Benefits Completed

1. From the Referral/Authorization workqueue 7671 HH – Intake Incomplete workqueue.

a. Double click to enter the workqueue

b. Single click on the patient

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c. Select INTAKE

i. Select the correct encounter

ii. Move to the Financial and Authorization form

1. Enter the correct financial payer source

iii. Verify all information is correct

iv. Move to the Care Team Information form

1. Select Intake Complete

Benefit Verification:

1. Accounts needing verification will be located within workqueue 8035 – HH – Insurance Verification

Process

a. Double click to open the workqueue

b. SINGLE click to highlight the patient

c. Select INTAKE

d. On the Interactive FaceSheet, verify the patient’s information is correct and complete.

i. Once completed, select the Verify button on the checklist

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e. Move to Home Care Account form

i. Review Guarantor acct type: Personal Family/ Workers Comp / TPL

ii. Select Create Recurring Series

iii. Select Next or the Coverage Info form

1. Add or Remove coverages, as necessary

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f. Move to the Care Team Information form

i. Enter the Attending provider

ii. Enter the Team assignment

2. Select Auth/Cert Button

a. From the Auth/Cert activity, select Service Level Auths

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i. Select the Coverage link

1. Enter the authorization information obtained for all necessary disciplines

2. Click accept

b. From the Auth/Cert activity, select notes to enter any necessary notes from your investigation.

Benefits – AOB Process 3. From the Auth/Cert activity, select notes

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a. Under type, search for AOB or click the magnify glass (F5) to select HH Assignment of

Benefits Note (AOB)

b. Click Accept

c. Upon accepting the HH Assignment of Benefits Note, the system will auto generate the AOB

form.

i. Confirm the Insurance Company is correct

ii.

iii. Using F2 enter all the remaining data, as appropriate

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iv. As the information is populated, some boxes will be a drop down box. Double click to

select the correct response.

v. Once completed and verified for accuracy, select Accept Note.

d. Copy the AOB note completely. (This can be done by selecting all the data, right click and

select copy)

e. Select the InBasket Button

f. Select New Message

i. Select the Scheduler Homehealth Pool

ii. Enter the Subject: AOB for XX (Patient Name)

iii. Search for the Patients record

iv. Paste the AOB form. (Right click within the box and select paste)

v. Select Send

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a. Move to the form with the patients name under Episode of Care

vi. Under Event History

1. Enter the date

2. Add HH Ins Verification Complete

3. Entered by