Back Office-General Quick Reference Guide. Enter a Home Health Referral

Transcription

1 Back Office-General Quick Reference Guide Enter a Home Health Referral

2 Table of Contents Enter a Referral... 3 Common Buttons & Icons... 3 Enter a New Referral... 4 Document Basic Info... 5 Document Demographics... 5 Document Referral Source... 6 Document Payor Sources... 7 Document Physicians... 7 Document Diagnoses... 8 Document Scheduling... 8 Document Clinical Information... 9 Add Coordination Notes Print Patient Information Complete the Referral Process Pending Referral Page 2

3 Enter a Referral The first step to enter any new patient into Homecare Homebase is to create a referral in R2. Referrals can come in many different ways, including from a physician or a facility. The referral contains all of a patient s information, including their demographics, payor information, primary physician, history and physical information, and diagnoses. After a new referral is added, tasks are triggered in the Workflow Console to verify payor information, schedule visits, and more. Common Buttons & Icons New Referral button Save & Continue button Add Contact button Apply Selection button Add Payor Source button Assign Protocols button F2F Encounter button Add button Workflow Console button Edit/View Referral Intake button Medications button Select button Page 3

4 Add Allergy button Add Case Manager button Add Team Member button Set Team Member to Case Manager button Add Other Facility button Add Vaccination button Coordination Notes button Print Patient Info button Save & Close button Close button Pushpin icon Enter a New Referral The referral is divided into several tabs. As you complete your documentation, the tab color and top completion bar indicate the percentage of required fields completed. From the Clinical Manager tab of the Home screen: 1. Click New Referral. 2. Click the Service Line drop-down arrow; then click the appropriate service line. Note: If you are transitioning an existing patient from your legacy system into HCHB before go live, select the Transition the Patient into HCHB Software option. Otherwise, keep the default New Referral option. 3. Click OK. Page 4

5 Document Basic Info From a new, blank referral: 1. Complete the appropriate information in the Basic Info tab. Note: You must select the assigned branch for additional fields to activate. After you enter the branch, team, last name, and first name, a medical record number is automatically assigned and the remaining tabs in the referral become available for documentation. 2. Click Save & Continue to navigate to the next tab. Note: Click Save & Continue to save the information and move to the next tab. Click Save & Close to save your information and close the referral, which will trigger a new task in the Workflow Console reminding you to complete the referral later. If you save the Referral as Pending, document a Pending Reason on the Patient Information tab. Document Demographics The Demographics tab includes basic demographics, election of benefits, service location, contacts, and claim addresses. From the Demographics tab of a new referral: 1. Complete the appropriate information on the Demographics tab. Note: Fields with a red asterisk are required by the application in order to complete the referral. Your agency may require you to document additional information. The bar at the top shows the percentage of required fields you have completed. 2. If the patient is a Hospice patient, complete the Election of Benefits. Refer to the Election of Benefits section of your quick reference guide for more information. 3. Scroll down to the Add Service Location section of the Demographics tab. Note: The service location indicates where care will be delivered to the patient, such as their home address or facility. 4. Complete the Service Location information. Note: When you enter the ZIP code and press Tab, the city, state, county, and CBSA number automatically populate. 5. Click the Pushpin icon. A map of the service location displays. 6. Move the pushpin on the map, if necessary. 7. Click Save & Close to close the map. 8. Document Travel Directions and Service Location Notes, if desired. Page 5

6 9. Click Save. The service location is added to the grid. Note: After saving the initial service location, use the Add Service Location button to add additional service locations. 10. Scroll down to the Contacts section. 11. Click Add Contact. Note: Contacts are not required. 12. Click the Patient Contact Type drop-down arrow; then click the appropriate contact type. 13. Enter the contact s name and relationship to the patient. Note: If the contact lives with the patient, select the Use Address and Home Phone from Client Service Location check box. 14. Click Save & Close. The contact is listed in the grid. 15. Add additional contacts if needed. Note: Use the Patient/Emergency Contact Information fields above the grid to document the patient s primary emergency contact. 16. Scroll down to the Claim Addresses section. 17. Click Add Address to document the address where the patient s bills are to be sent. Note: If the claim address is the same as the service location, leave this information blank. 18. Click Save & Continue. Document Referral Source The Referral Source tab includes referral information, care types, admission coordinator, and other information. From the Referral Source tab of a new referral: 1. Select the appropriate referral source. Additional fields display. 2. Complete the referral source information. The fields available depend on the referral source type that you selected. 3. Scroll down to the Care Types section. 4. Add care types for the patient based on your agency s policies. 5. Scroll down to the Admission Coordinator section. Note: If desired, you can select someone at your agency to be the Homecare Coordinator. Depending on your agency s policy, the Admission Coordinator, or Page 6

7 marketer, may default for the selected physician and referral source. If an Admission Coordinator helped obtain this referral, you can credit them here. If desired, you can elect someone at your agency to be the Homecare Coordinator. 6. Click Save & Continue. Document Payor Sources The Payor Sources tab includes authorization details and payor source information. From the Payor Sources tab of a new referral: 1. Click Add Payor Source. 2. Click the Payor Type drop-down arrow; then select the correct payor type. 3. Click the Payor Source drop-down arrow; then select the payor source. 4. Complete all payor source information as appropriate. The fields and options available may vary by the payor type and source you select. Note: Most of the Payor Source Information will default based on the payor chosen. 5. Click Save & Close to save the payor information. 6. Click Save & Continue. Document Physicians The Physicians tab includes physicians, F2F documentation, and ACOs. From the Physicians tab: Note: If you entered a physician for the referral source, the physician displays in the upper grid. To add a new physician, click Add Physician and complete the appropriate information. Indicate the primary physician by selecting the Attending/Primary Physician for Orders check box. To edit a physician or add protocols, double-click the physician s name. 1. After the appropriate physician information is documented, click F2F Encounter, if available. Note: Depending on the patient s payor source requirements, you may have to add Face-to-Face encounter details, even if you do not have all necessary information. Adding the encounter here initiates the workflow process in the system. If a F2F encounter is not needed for this referral, the button will be grayed out. 2. Click Add F2F Encounter. 3. Click the Date of Face-to-Face Encounter Calendar icon; then click the appropriate date of the encounter, if known. Page 7

8 4. Click Save & Close. 5. Click OK. The encounter is listed in the Face-to-Face Encounters window. 6. Click Close. 7. Click Save & Continue. Document Diagnoses From the Diagnoses tab of a new referral: 1. Click the ICD-10 Codes tab. 2. Click Add Diagnosis. Note: The first documented diagnosis defaults to the primary diagnosis. 3. Click the Magnifying Glass icon in the ICD-10 Code field. Note: If you know the ICD code, you can type it directly in the field without searching for it. 4. Click the Search By drop-down arrow to search by description, code, or category. 5. Enter the search term in the Search For field; then click the Magnifying Glass icon. 6. Select the diagnosis in the list of results. 7. Click Apply Selections. 8. Click Onset or Exacerbation. 9. Click the Date Calendar icon; then select the onset/exacerbation date. 10. Select the date. 11. Click Save & Close. 12. Continue adding diagnoses as needed. Note: To add payment diagnoses, select the appropriate diagnosis in the grid; then click Add Optional Diagnosis. 13. Click Save & Continue. Document Scheduling The Scheduling tab includes evaluation and initiation visits, skills, and qualifiers. From the Scheduling tab: 1. Click the Requested Date of Evaluation Calendar icon; then click the appropriate date. 2. Update the admitting discipline and scheduling acuity as needed. 3. If there are additional evaluations to be performed, select the Perform Add-On Evaluation prior to Approval of the POC check box. Page 8

9 4. Select the number of add-on evaluations to be associated with the Comprehensive Assessment visit, if appropriate. 5. Complete the information for the add-on evaluation(s). Note: To add an Initiation Visit, click Add in the Initiation Visits section of the Scheduling tab. Use initiation visits according to your agency s policy. 6. Add skills and qualifiers based on the patient s needs. Note: This section may not apply to you depending on your agency s policy. 7. Click Save & Continue. Document Clinical Information The Clinical Information tab includes patient information, medications, allergies, case manager/team members, inpatient events, other facilities, vaccination history, advance directives, home health care survey, and patient programs. There are no system-required fields on this tab, although your agency may require some information. From the Clinical Information tab: 1. Complete the Patient Information fields as necessary. Note: If the referral is Pending, you can document a Pending Reason here. 2. To add patient medications, click Medications. 3. Enter medications as they appear on the referral form. Click Add. 4. Adjust the Start Date, if necessary. 5. Enter an End Date for prescriptions that are not ongoing. 6. Click the Magnifying Glass icon in the Drug Name field. 7. Select the medication from the list. Note: You can scroll through the list to find the medication or use the search options at the top of the window. 8. Click Select. 9. Complete the dose, frequency, amount, and additional medication information as needed. 10. Select the necessary check boxes if the medication is PRN or High Risk. 11. Click Save & Close. 12. Add additional medications as needed. 13. Click Close. Note: All medications must be reviewed during the admission visit. 14. Scroll down to the Allergies section. Page 9

10 15. Click Add Allergy. 16. Select the allergy from the list. Note: You can scroll through the list to find the allergy or use the search options at the top of the window. 17. Click Select. 18. Continue adding allergies as needed. 19. Scroll down to the Case Manager & Team Members section. 20. Click Add Case Manager. 21. Select the case manager from the list. 22. Click Apply Selection. 23. Click Add Team Member. 24. Select the team member from the list. 25. Click Apply Selection. 26. Continue adding team members. Note: Use the Set Team Member to Case Manager button to change the case manager, if needed. 27. Scroll down to the Inpatient Events and Other Facilities section. Note: If this referral is the result of a hospitalization, document that inpatient event in the upper grid. Use the lower grid to add other patient facilities such as pharmacies or funeral homes. 28. Click Add Inpatient Event. 29. Click the Magnifying Glass icon in the Inpatient Facility field. 30. Complete the Inpatient Event information. 31. Click Save & Close. 32. Click Add Other Facility. 33. Complete the facility information. 34. Click Save & Close. 35. Scroll down to the Vaccination History section. 36. Click Add Vaccination. Note: Check with your agency to determine which vaccines need to be documented. 37. Complete the vaccination information. 38. Click Save & Close. 39. Continue adding vaccinations as needed. 40. Scroll down to the Advance Directives section. 41. Click Add. 42. Complete the advance directive information. 43. Click Save & Close. Page 10

11 44. Scroll down to the Home Health Care Survey section. Note: The survey information is to be completed by a clinical manager at a later task. 45. Scroll down to the Patient Programs section. 46. If a Patient Program needs to be added to this referral, click Add. 47. Click the Patient Program drop-down arrow; then click the appropriate program. 48. Click the Effective From Calendar icon; then click the appropriate date. 49. Click Save & Close. Add Coordination Notes You can add coordination notes and other information to the referral using the bottom buttons. From any tab of an open referral: 1. Click Coordination Notes. 2. Click Add to add a new note, per your agency s policy. 3. Click the Note Type drop-down arrow; then select the appropriate type. 4. Document the note in the Note Details field. 5. Click Save & Close. Note: All notes entered for the patient display in the grid. You can click a note to view the note details below. 6. Click Close. Print Patient Information 1. Click Print Patient Info. Note: The Client Information Report is the patient s face sheet. Print the report to send to the patient s facility or physician, if needed. 2. Click Yes to print coordination notes; click No if you do not need to print coordination notes. 3. Click the Print icon to print the information. 4. Select the printer. 5. Click Print. 6. Click the Close button to close the report. Complete the Referral Verify that the completion bar at the top shows 100% Complete. All tabs should also display a green bar across the tab. Any tab with an orange bar requires additional information to be completed. Page 11

12 From a new, completed referral: 1. Click Save & Close. Note: After a referral is saved as complete, you can find and edit the referral from the Clinical Input console. Process Pending Referral Note: Clicking Save & Close in an incomplete referral saves and closes the referral in Pending status. A Workflow task is triggered, prompting you to open and complete the referral. From the Clinical Manager tab of the Home screen: 1. Click Workflow Console. 2. Double-click the PROCESS PENDING REFERRAL task line. 3. Click Edit/View Referral Intake Form. 4. Complete the remaining information on the referral. 5. Click Save & Close. Page 12