Patient Evaluations Go Missing: Is There a Hole in Your Scheduling Workflow
Many home healthcare agencies have their own methods for creating a workflow to schedule patient evaluations and ensure appointments are kept. Some workflows for agencies are automated with the help of their current electronic medical record (EMR) system. But even with the use of an EMR, gaps can be found. For some, internal workflows are managed better than others. Every agency has unique needs that should be taken into account when fine-tuning their workflow.
Consider a workflow example of a large home healthcare agency and then compare it to your own. Initially, Start of Care (SOC) requests are received through the intake department and checked for prior authorization. Next, a scheduler is notified by e-mail which includes relevant details in the draft (name, insurance information, diagnosis, etc.). Here, the scheduler considers if and when the patient can be accommodated based on their productivity log sheet. When all signals are green lighted, intake then receives authorization from the patient’s insurance. From there an admit ROC note is delivered through the EMR system’s workflow. As a final step, the scheduler scans the details and assigns the SOC visit to a clinician who is available and meets the criteria required for this case. It’s imperative that the scheduler regularly check the task list on their EMR system to stay up-to-date on which patients have been approved and need scheduling.
If there were any additional disciplines ordered by the referring clinician, the scheduler has to assign initial evaluations to those disciplines. After a clinician opens a case, the scheduler will review any add-ons submitted by the opening clinician, and check the availability of clinicians to assign an evaluation from there. Again, the scheduler must refresh their task list to periodically check for new cases, as there are no alerts in the system. Some clinicians may write notes or make requests through the EMRs workflow, requiring the scheduler to follow through with their request for either patient cancellation, rescheduling, reassignment, or service being declined.
For instance, schedulers must read comments left by clinicians to understand what steps are to be taken. An outcome of this may be, in the event that a clinician declines a patient evaluation, a patient can slip through the cracks and be left unattended. If a scheduler fails to interpret properly why a clinician declined the patient evaluation, this scheduler may not move forward in rescheduling the visit. The workflow used to manage a patient’s evaluation needs to be robust to catch these blind spots. Understanding our sample workflow illuminates the importance of having a well oiled scheduling workflow that catches errors when managing patient evaluations.
The most notable reasons for safeguarding against errors in patient start of care’s and evaluations are to ensure financial success, quality of care, and to bolster productivity in the workplace. There’s no question about it — lost evaluations equal lost income. When the initiation of care is accounted for and properly managed, your agency ensures revenues are preserved and intact.
We have a HIPAA compliant system to help you manage, organize and communicate cases to all pertinent parties. Contact us today to learn more about how we can help close all gaps in your scheduling workflow.
Originally published at https://www.carestitch.com on December 3, 2020.
