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CHAPTER 22 PENDING RESULTS

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Pending results. Chapter 22. objectives. Process the incomplete charts using the Pending processors Process a referral using the Referral dashboard. Key concepts. Results pending Incomplete visits Referrals and referral reminders Surgery/procedure authorizations - PowerPoint PPT Presentation

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Page 1: Pending results

C H A P T E R 2 2

PENDING RESULTS

Page 2: Pending results

OBJECTIVES

• Process the incomplete charts using the Pending processors• Process a referral using the Referral dashboard

Page 3: Pending results

KEY CONCEPTS• Results pending• Incomplete visits• Referrals and referral reminders• Surgery/procedure authorizations• Appointments need authorizations• Further review needed• Charts needing review• Employee health• Open cases• On-line open case aging• Rehab services appointments to schedule• Company log review

Page 4: Pending results

PENDING RESULTS

• When patient leaves facility medical treatment for visit is complete but there could still be results pending for tests, treatments not provided at facility• Incomplete visits are defined as patient

encounters which results are pending for x-rays, lab tests, treatments and opinions from referrals/specialists• Important to track results of outside

testing/treatments• Physician needs to review results of these in

timely fashion as the patient’s health care is important

Page 5: Pending results

PENDING RESULTS

• Patient’s health could be at risk is these results are delayed• Every step in patient’s treatment could be perfect

but misfiling test results or lack of notification to physician that results are back could cancel all of the positive effects of patient’s care• MedTrak’s Pending module also provides

functionality to manage billing issues, track referrals, manage authorizations and review company demographic changes

Page 6: Pending results

PENDING MENU

• To access Pending Menu sign in to MedTrak click Pending Menu tab at top of screen-Figure 22-1• Pending Menu provides access to the following:• Incomplete Visits-consultations, occupational

medicine, orthopedic visits• Patient Responsibility• Physicals-employee physical examinations, drug

screens• Rehab Services-for physical/occupational therapy• Referrals-reminders

Page 7: Pending results

PENDING MENU• Surgery/Procedure authorizations needed• Appointments• Further Review Needed• Charts Needing Review• Open Cases-tracks open workers 'compensation• On-Line Open Cases Aging-monitors open time of workers

'compensation cases• Held Cases-physician waiting on additional info before

clearing them• RS Appts to Schedule-manages appointment authorization for

referrals to in-house rehab• Company Log Review-reviews demographic changes to

employers information

Page 8: Pending results

INCOMPLETE VISITS

• Typically within 1-2 days radiologist will finish reading x-ray(overread) and communicate results to facility

• When results arrive administrative staff member enters information in patient’s x-ray overread order in MedTrak

• You can do this by accessing MedTrak Main Menu and click Pending Menu

• Click Patient Responsibility button in Incomplete Visits section on Pending Menu

• Next screen is Incomplete Patient Responsibility screen-Figure 22-2

Page 9: Pending results

INCOMPLETE VISITS

• Initial view for this screen is alphabetical by patient’s last name to find a patient you can reset the view by date of service or by company is it is workers’ compensation• All incomplete visits screens list patient names,

their employers(patient responsibility) flags representing what is still incomplete for visit, date of service, type of visit(I-initial, R-return) and MedTrak employee initials of provider

Page 10: Pending results

INCOMPLETE VISITS

• Each Incomplete Visits screen uses FLAG to indicate what is still pending for visit• These flags represent incomplete steps in

processing patient’s visit• Administrative staff member completes step

represented by one of flags the flag clears from line and once all flags clear patient drops off processing screen• Incomplete Visit table lists incomplete visit flags

and what screens use them-Figure 22-3

Page 11: Pending results

FIGURE 22-3

Page 12: Pending results

INCOMPLETE VISITS

• To enter results of over-read by radiologist place cursor in command field for patient and click X-ray orders button• Next screen is Radiology(x-ray) category of Visit

Orders screen-Figure 22-4• This screen reflects information related to report

from radiologist• Enter date report arrived back at facility• Scan radiologist’s report including

narrative/summary and attach to patient’s case

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FIGURE 22-4 & 22-5

Page 14: Pending results

INCOMPLETE VISITS

• In each Narrative and Summary fields enter “sr”(trigger for See report)• Enter employee initials for radiologist in

Radiologist answer field-Figure 22-6• If you do not know radiologist’s initials use F1 key

in answer field to access help screen displaying all available radiologist for facility• After entering data click Submit Answers button• X-RAY OVERREAD order details screen refreshes

with answers showing to right of questions-Figure 22-7

Page 15: Pending results

INCOMPLETE VISITS

• The remaining step in medical workflow is ordering physician to review narrative and summary from radiologist• Click EXIT screen on X-RAY OVERREAD order details

screen and return to x-ray section of Visit Orders screen-Figure 22-8• X-RAY OVERREAD order is still incomplete because

ordering physician needs to review radiologist repot• Click Exit screen on Visit Orders screen to return to

Incomplete Patient Responsibility screen to process next results report that facility has received-Figure 22-9

Page 16: Pending results

INCOMPLETE VISITS

• Once physician reviews radiologist’s report the XR flag will automatically clear and patient visit will drop of incomplete processing screen• Click Exit screen again to return to Pending Menu• The medical workflow disciplines for over-read of

x-ray called for administrative staff to prepare the x-ray to send to radiologist and then record results of read• Final step is ordering physician to review report• Do This! Pg. 268

Page 17: Pending results

FURTHER REVIEW NEEDED

• MedTrak alerts ordering physician that over-read x-ray by radiologist is back and ready to review by placing an entry in Physician’s Further Review Needed processor• Click Further Review button on Clinic Status

screen or click Further Review Needed button on Pending Menu-Figure 22-10• Screen displays MedTrak employee initials of staff

of facility who have action items that need further review

Page 18: Pending results

FURTHER REVIEW NEEDED

• These items could involve one of the following:• X-ray over-read results• Lab results• Referring treatment results• Questions concerning billing• Any other question about a case from another staff

member• To review chart place cursor in Command field next to

physician’s MedTrak employee initials and click Submit button

• Next screen to appear is Further Review Needed/Staff screen-Figure 22-1

Page 19: Pending results

FURTHER REVIEW NEEDED• To review X-RAY OVERREAD order place cursor in command field

next to it and click Show Order button• On X-RAY OVERREAD order details screen review radiologists

report by opening up scanned document that administrative staff attached to patient case

• Enter MedTrak employee initials in Reviewed By answer field-Figure 22-12

• Click Submit Answers button, X-RAYS OVERREAD order details screen refreshes with physician’s name to right of Reviewed By question

• After reviewing screen click Exit Screen button to return to Further Review Needed details processor-Figure 22-13

• Click Exit Screen button again to return to Pending Menu• Do This! Pg. 271

Page 20: Pending results

REFERRALS TO SPECIALISTS

• When physician refers a patient to specialist to have scheduled test he/she places order for a referral• In a referral order the physician documents these:• Body parts needing examination or treatment• Any special notes specialist should know about

patient• How soon visit must happen• Whether referral is for evaluation only or

evaluation and treatment or for specialist to take over patient care

Page 21: Pending results

REFERRALS TO SPECIALISTS

• Once physician place referral order appears on Referred Dashboard for scheduling/processing by administrative staff• Click Pending Menu tab on MedTrak main Menu

then Dashboard button in Referrals section of Pending Menu-Figure 22-14• Next screen is Figure 22-15-Referral Dashboard• The totals on this screen represent total number

of referrals that are: pending, approved, denied, scheduled, completed, and reviewed• Do This! Pg. 273

Page 22: Pending results

REFERRALS TO SPECIALISTS

• To display individual referrals on Referral Dashboard click on number which displays:

• Location• Status• View• Search• Date ordered• Patient name• Type of referral• Referral status• Select

Page 23: Pending results

REFERRALS TO SPECIALISTS• From this screen, use buttons to:• Select• Visit Log• Case• Visit• Notes• Reminders• Pending column displays Referrals screen for patient-Figure 22-

16 an asterisk next to number on Referral Dashboard indicates referral needs immediate attention

• Place cursor in command field next to patient order and click Select button-Figure 22-17 first detail screen displays individual questions that need answering to process and complete referral

Page 24: Pending results

REFERRALS TO SPECIALISTS

• Referral order screen displays:• Header-referral order name, date ordered, clinic

location, company name, patient name, reason for visit

• Function field-allows access to many other functions• Order details-physician questions• Administrative staff(clerical) questions-Referral step• Referral step• Referral notes• Reminder• Consultation/Specialist

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REFERRALS TO SPECIALISTS

• Appointment Date• Appointment Time• Medical records• Scheduling Clerk• Consultant Report Return Date• Consultant Summary• Answering this question moved referral to

Completed column on Referral Dashboard• Physician questions-reviewed by-answering this

question moves referral to consultant report using Further review Needed processor

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REFERRALS TO SPECIALISTS

• Figures 22-19 and 22-20 and 22-21• Do This! Pg. 278 & 279

Page 27: Pending results

AFTER THE REFERRAL VISIT

• After patient’s referral visit referral specialist will report back to referring physician

• When report arrives back at facility and administrative staff member enters information in referral order for patient in MedTrak

• Figure 22-2 Referral Dashboard • Figure 22-23 Referrals• Figure 22-24 Orthopedic Consultation• Figure 22-25 Orthopedic Consultation• Figure 22-26 Referral Dashboard• Do This! Pg. 282

Page 28: Pending results

FURTHER REVIEW NEEDED

• MedTrak alerts ordering physician that report from orthopedic consultant is back and read y for physician to review by placing an entry on physicians Further Review Needed processor• Figure 22-27 Further Review Needed• Figure 22-28 Further Review Needed/Staff• Figure 22-29 Orthopedic Consultation• Figure 22-30 Further Review Needed/Staff• Do This! Pg. 285

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CLOSING THE REFERRAL• Since physician has reviewed the consultant’s report

referral is now in Reviewed column on Referral Dashboard• Administrative staff can now close referral• Access referral access Referral Dashboard off Pending

Menu Click on number in Reviewed column for facility location –Figure 22-31

• On Referral screen listing from Reviewed column close referral and clear it from Referral Dashboard enter “clos” in command field-Figure 22-32

• Press Enter key Referrals screen refreshes with referral cleared off screen-when done Exit screen and return to Referral Dashboard to continue processing others

• Do This! Pg. 287

Page 30: Pending results

PRINTING THE PATIENT’S CHART

• You will need to print patient’s chart for incomplete visit documentation to turn in for your assignment• Do This! Pg. 288