Accepting Linked Contract Patients

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New Linked Contract Patient cases are presented to Agencies from an authorizing Payer as Placements. An Agency is free to review the Patient’s case before ultimately deciding whether to accept or reject it. If an Agency accepts a case, all Patient information stored on the Payer’s Professional system transfers to the Enterprise system. The following section covers the review and acceptance of new Linked Contract Patients as well as all correspondence between an Agency and the authorizing Payer for any Linked Contract Patients.

 

Linked Communication

The Link Communication tab in the Home Module facilitates communication between an Agency and all Payers (Linked Contracts). This is where any data shared between the Professional and Enterprise systems is stored for review. In the Home page, Pending Placements and Notes (described under the following image) are seen.

Linked Communication Tab

Linked Communication Tab

 

Sections

Description

Pending Placements

New Patient cases are presented to Providers from an authorizing Payer as “Placements”. Agencies are free to review the Patient’s case before deciding whether to accept or reject it.

Notes

All miscellaneous communications between an Agency and the Payer pertaining to Linked Contract Patient cases.

 

Use the Office(s) and Coordinator fields to sort information under the Home tab.

Pending Placements

The Pending Placements section contains new Linked Contract Patient cases sent to an Agency from Linked Payers (as illustrated in the following image). The table under the image describes the information seen per line item.

All Pending Placements

All Pending Placements

 

Sections

Description

Admission ID

Patient’s Admission ID

Office

The Office within the Agency where a Patient is assigned.

Start/Stop Dates

Specifies the case’s start and stop dates.

Frequency

Specifies the frequency of service to provide for the Patient.

Service Category

Indicates the service category such as Home Health or Non-Home Health.

Service Type

Indicates the type of service required by the Patient.

Request Sent At

The time the Payer sent the Placement.

Status

Indicates the Status of the case (whether it has been accepted or not).

Cut Off Time

Indicates the date and time when the system will automatically remove the Pending Placement from the queue.

 

The value in the Request Sent At column is highlighted in red text when a Placement is nearing Cut Off Time; signifying immediate action is required.

Case nearing Cut Off Time

Case nearing Cut Off Time

Payer Name

Indicates the Payer sending the Placement.

Accepting a Pending Placement

Complete the following steps to accept or deny a Pending Placement.

 

Step

Action

1

From the Pending Placements queue, click on the Placement Admission ID (hyperlink).

Placement’s Admission ID

Placement’s Admission ID

2

The Patient Info page opens to display Patient information such as General, Demographics, Special Requests and Authorizations. Review the details and scroll to the bottom to proceed.

Patient Info Page

Patient Info Page

3

There are several Placement options to include: Accept, Request More Time (from the Payer to further review the case), Accept and Print, and Deny (to reject the Placement).

Accept, Request More Time, or Deny Placement

Accept, Request More Time, or Deny Placement

  • If accepting the Placement, an Agency Coordinator must be selected from the Coordinator dropdown options.

  • If denying the case, select a rejection reason from the dropdown menu (to the left of the Deny button).

4

Once a Placement is Accepted or Denied, it is cleared from the Pending Placement section.

 

Notes

The Notes section contains all open correspondence between an Agency and Payers. Notes may include information such as Caregiver observations, Patient requests, or any other information pertaining to the Patient’s case.

 

Refer to the Communications (Linked Contracts) category for complete details and instructions on using the Notes feature throughout the system.