Soarian All Patient Access Training Soarian: Patient Access Facilitator Guide 1 Soarian All Patient Access Training Facilitator Guide © 2012, BJC HealthCare (St Louis, Missouri). All Rights Reserved Proprietary & Confidential 2 Soarian All Patient Access Training TABLE OF CONTENTS CLASS LOGISTICS .....................................................................................................5 Materials Needed ...................................................................................................5 Classroom setup.....................................................................................................5 Greetings ...............................................................................................................5 Objectives..............................................................................................................5 MODULE 1: CHECK IN OVERVIEW .............................................................................7 Log-in and Review of Homepage .............................................................................7 View Encounter Details ...........................................................................................8 What is an Encounter? ........................................................................................8 ENC and ECD Numbers .......................................................................................9 Encounter Status ................................................................................................9 Viewing an Encounter ....................................................................................... 10 Check In a New Patient ........................................................................................ 12 Patient Demographics Form .............................................................................. 14 Encounter Details Form .................................................................................... 18 Insurance Form ................................................................................................ 20 Guarantor Demographics Form.......................................................................... 22 Maintain Comments Form ................................................................................. 22 Finish Check-In & Print Encounter Artifacts ........................................................ 23 Check In an Existing Patient.................................................................................. 24 Quick Check-In .................................................................................................... 25 Completing a Quick Check In from the Incomplete Worklist .................................... 28 Check In a Newborn ............................................................................................. 31 MODULE 2: PRE-ADMIT and CONTINUATION VISITS ................................................ 34 Pre-Admit an Adult ............................................................................................... 34 Pre-Admit a Newborn ........................................................................................... 34 Continuation Visits................................................................................................ 36 MODULE 3: CHANGE PATIENT STATUS .................................................................... 39 Change Patient Status – Transition ........................................................................ 39 Change Patient Status – Revise ............................................................................. 39 Change Patient Status – Cancel and Resume ......................................................... 40 3 Soarian All Patient Access Training MODULE 4: ADDITIONAL FUNCTIONS IN SOARIAN .................................................. 48 Revise Encounter Details Function ......................................................................... 48 No Show Function ................................................................................................ 53 Recording a No Show ....................................................................................... 53 Reversing a No Show........................................................................................ 54 View Patient Function ........................................................................................... 54 Add/Revise Person Function .................................................................................. 55 Revise a Patient Function ...................................................................................... 55 Cancel Check Out Function ................................................................................... 55 Cancel Encounter Function .................................................................................... 56 MODULE 5: BED MANAGEMENT ............................................................................... 58 Find a Patient’s Location ....................................................................................... 58 Transfer Patient Function ...................................................................................... 58 Swap Patient Function .......................................................................................... 59 Check Patient Out Function ................................................................................... 60 MODULE 6: WORKLISTS.......................................................................................... 64 Census Worklist ................................................................................................... 64 Encounter Prep Worklist ....................................................................................... 64 Today’s Scheduled Encounters Worklist ................................................................. 65 Today’s Encounters Worklist ................................................................................. 65 Unviewed Eligibility Response Worklist................................................................... 66 Missing or Incomplete MSPQ ................................................................................. 66 Incomplete Check-In Worklist ............................................................................... 67 Encounters in Progress Worklist ............................................................................ 68 MODULE 7: Downtime ............................................................................................. 70 MODULE 8: EDM ..................................................................................................... 71 Scanning in EDM .................................................................................................. 71 Viewing Documents in EDM .................................................................................. 73 4 Soarian All Patient Access Training CLASS LOGISTICS Materials Needed Tent cards Workbooks Log Ins Markers Dry erase board Projector Shoots & Ladders Game Classroom setup This section should contain any information regarding how to set up the room. Detail here what patients to set-up before class. (Series, L&D, etc.) Greetings Break times Bathrooms Cell phone use Food/drink Length of class Class Materials Objectives At the conclusion of the course, student will be able to. . . Log in and out of Soarian Navigate the Soarian Homepage Check In Patients Using Various Functions Complete a Pre-Admit Perform a No Show Log in and view Patient Encounters Revise a Person, Patient, and Encounter Change Patient Status Check out a Patient Work in Worklists Navigate Soarian During Downtime 5 Soarian All Patient Access Training 6 Find, Transfer, and Swap a Patient Scan and View Documents in EDM Soarian All Patient Access Training MODULE 1: CHECK IN OVERVIEW Log-in and Review of Homepage We are going to log in to the Soarian Homepage. Today we are going to be using practice log-in IDs and passwords. Note: They will receive their actual log in ID and password once they have passed the exam. Their log in log-in ID will end with an sf. Log In Screen Instructor and Class: Log in to Soarian 1. Type your username and password in the given fields 2. Click Logon Once you log in, you arrive at the Soarian Home Page. 7 Soarian All Patient Access Training Soarian Homepage Instructor: Point out the different quadrants and its contents. Note there are four quadrants. On the left you have your Worklists. Your Enhanced Worklist section contains the Worklists you use most frequently. On the right you have your Tasks. Tasks are divided into two sections, your Primary Tasks and your Secondary Tasks. View Encounter Details Before attending class today, you should have reviewed an e-learning about viewing encounter details. Let’s quickly review what we learned. What is an Encounter? An encounter is created when a patient schedules a visit, or checks in for services and begins the patient experience with the health service organization. 8 Soarian All Patient Access Training A number of things occur when an encounter is created. The patient, demographics, guarantors, encounter specific clinic information, and insurance are identified. The patient or their representative sign any and all necessary forms to receive treatment and indicate financial responsibility. Insurance eligibility is verified for the encounter. Each encounter requires three very important pieces of data: The patient – who is receiving services? The encounter location – where is the encounter taking place? The encounter provider – why is the patient presenting? An encounter takes place over a specific period of time, will include a check-in and admitting diagnosis, and ends with the status of checked out, attended, no show, or end of treatment series. Each time an encounter is created for a patient in Soarian, relevant information is pulled from that person’s record into the encounter, reducing the amount of information that has to be keyed at each visit. ENC and ECD Numbers Each encounter is assigned two numbers: The Encounter ID Number (ENC) The Encounter Common Data Number (ECD) ENC numbers are always generated from a Check-In, Pre-Admit, or a change of patient status. ECD numbers are generated when a patient first presents, but are used to link some encounters together. Example: When a patient is checked into the Emergency Department, an ENC and ECD are both created. When the patient is then admitted as an inpatient, a new ENC is created, but the ECD remains the same. Encounter Status Encounters can have the following statuses: Checked In Attended Scheduled Checked out Cancelled No Show 9 Soarian All Patient Access Training Viewing an Encounter The view encounters detail function will let you look up information on a particular encounter. As you learning in your pre-class e-learning, this function does not allow changes to be made to the encounter. Instructor: To get more class involvement, ask questions like:”When might you want to view an encounter without making changes?” Instructor and Class: View an Encounter via the View Encounter Details Function 1. Click on the View Encounter Details link in your Tasks Task List A dialog box appears. If you know the Encounter Number or Encounter Common Data Number, you can search by those identifiers. However, most often you will search by the patient’s name. 2. Click on the Find Patient button to search by patient name. 10 Soarian All Patient Access Training Search By Fields 3. Type in the patient’s last name, and any other relevant information you might have to help locate the patient. 4. Click on the Search button. 5. A list of patients who match your search will populate. Place a checkmark in the box next to the appropriate patient, and click Select. A list of encounters will appear. You can use the information provided to select the correct encounter. For instance, I know the encounter I am looking for took place on 10/1/12. You can also check to verify the location of the encounter, or the provider of the encounter. 6. Place a checkmark in the box next to the appropriate encounter, and click Select. You are now viewing the patient’s encounter that you selected. Notice there are forms at the bottom. Currently, we are in the Encounter Details Form. Each form has tabs at the top. I know you reviewed this in your pre-class elearning, but let’s quickly review each form, and the tabs they contain, as a refresher. We can do this by… 11 Soarian All Patient Access Training Activity One: Break the class into groups, and give them each a form in Soarian. Have them write (on a white board or flip chart) all the things they think would be filled out or found in their form. Forms to Use: Patient Demographics Form, Encounter Details Form, Insurance Form Forms not to use: Skip Check In Summary Form as we are checking in a new patient, and skip “Maintain Comments” Form, as this has no information until we add it. Discuss their answers, most of which are below. 1. Patient Demographics Form: name, address, telephone, SSN, Birthday, Gender, Preferred Language, Religion, Race and Ethnicity, Care Providers, HIPPA Privacy Statement, Relations, etc. 2. Encounter Details Form: Encounter date and time, Reason for Encounter, Encounter Source, Admission Type, Admitting Diagnosis, Clinical Service, Health Professional assigned to this encounter, Guarantor information, Benefits assignment certification, Release of Information, Encounter Prep information, etc. 3. Insurance Form: Policies, Plan, Policy #, Group Name, Group #, Coverage, Insurance Contact Information, etc. Check In a New Patient Now that we have reviewed what a finished encounter looks like in Soarian, let’s work on starting an encounter of our own by checking in a new patient. If the patient is new, his or her information will not be in the Master Person Index, and you will have to start the check in from scratch. I am going to walk you through the check in process for a new patient, and then we will practice together. 12 Soarian All Patient Access Training Instructor: Check In New Patient 1. I need to enter the appropriate search criteria for my patient. You can use social security number, last name, date of birth, etc., to narrow your search results. 2. From there, I can click Search. 3. My results are zero, can I will click the Add New button. Search Results 4. Next I see a screen asking me for my Encounter Location and Encounter Provider. I will choose the correct pair. Encounter Location and Encounter Provider Selections 13 Soarian All Patient Access Training Instructor Note: Students will see fewer EL and EPs when they use their actual assigned log in. We see many here because it is the training environment. Patient Demographics Form Our first form is the Patient Demographics Form. Notice that tabs run across the top of this form. All forms are set up similarly. Some forms overlap, so we can also put the address here. Or, we can click on the Address and Telephone tab above. Also notice that some of the fields are in yellow. These are Soarian required fields. Tabs on Patient Demographics Form Name Tab 1. I need to work through each tab. I will start with the first tab: Name. Here I should fill out the patient’s first and last name. Name Tab 14 Soarian All Patient Access Training Address and Telephone Tab 2. Choose what kind of address it is from the drop down (mailing or residence). Address Type 3. Enter the street address. 4. Enter the Zip Code – this will populate the state, city, and country for me. Address Fields 5. Enter the telephone number and click the Add/Update Phone button to save it. I can also click the checkbox next to “Preferred Phone” to make it the preferred number. Telephone Number Fields Personal Information Tab 6. Here I should fill out… Gender Patient Preferred language Marital status Race Ethnicity Employment 15 Soarian All Patient Access Training More detail on adding Employment: Click the Manage Employment button, and use the flashlight to search for the employer. Put a checkmark next to the correct employer, and click the Add button. Note: Explain to the class that we should never add a new employer. If there employer is not found in the system, type it in as “Misc Employer” and then put the information in the Maintain Comments Form (free-form). Personal Information Fields Care Providers Tab 7. Fill out the patient’s PCP, etc. Patient Documentation Tab 16 Soarian All Patient Access Training In patient documentation, I want to be sure to capture the HIPAA Privacy Statement information. 8. Fill out that the HIPAA Statement was provided, the date on which it was provided, and that you will obtain the patient’s signature. Relationships Tab In the relationships tab, I can add the patient’s relationships. 9. Type in a last name, and click the Search button. 10. If you find the person in the list, select them by placing a check mark next to their name. 11. If you cannot find the person, click the “Add New” button, after you have filled out the rest of the information (First Name, Address, Phone Number, etc.). Searching for a contact in the Relations Tab Additional Data Tab 17 Soarian All Patient Access Training In the Patient Demographics Form, we also find a tab for Additional Data. If the choices under the Patient Information Tab were not appropriate, you could come to this tab and key in the proper information. Fields in the Additional Data Tab Encounter Details Form Our next form is the Encounter Details Form. Notice again that we have tabs running across the top of this form. Tabs at the top of the Encounter Details Form I need to work through each tab. I will start with the first tab: About this Encounter. About this Encounter Tab The information found on these tabs pertains to the current encounter. I will click through the required fields and fill in the needed information. 18 Soarian All Patient Access Training About this Encounter fields Instructor: Fill out the applicable fields in this tab Health Professionals Tab All encounters require an admitting and attending physician. If a requisition is signed by a Nurse Practitioner or Physician Assistant the health professional must be added to the encounter with a “Copy Results To” responsibility type. If you cannot find the health professional, use the Misc value. Make sure to go to Maintain Comments to add the coded comment PA HP NOT AVAIL. If they do not have a health professional, use No Physician. If they do not know their health professional, use Unknown. Financial Responsibility Tab Again, I will scroll through to make sure all the information is there. Encounter Prep Tab The Encounter Prep tab can be used to record the actions to be taken in preparation for the encounter, as well as the status (complete, incomplete) of those actions. This will most likely be done by the scheduler. 19 Soarian All Patient Access Training Additional Data tab If I need to list an external medical record number, or external encounter number, I can do so here. Insurance Form The next form is the Insurance Form. Here I will fill out the patient’s insurance information. Because the patient is new, I will have to add their policy. I know you learned a bit about insurance in your e-learning. But let’s briefly go through this form to revisit. 1. Click on the Manage List button to add a new policy. 2. Click on Create New Policy. You can choose to look up a policy by a related person, or to search via the “Create a New Policy using the following Payer/Plan information” section. You can add an insurance policy here by either choosing the most common payer/plan combinations from the Quick Pick List, or by choosing from the database of all available payers/plans (search by payer name or by payer ID). Like most carriers, my patient’s insurance is on the quick pick list, so I will select it. 3. Choose the insurance carrier from the drop down quick pick list. Instructor: Choose BJC Gold from the dropdown list. Make sure you have checked the Allocate box. Payer/Plan Quick Pick Drop Down Once I have the insurance plan, I need to fill in the rest of the information. 20 Soarian All Patient Access Training 4. Go through and fill out all the policy information, like policy number, group name, and group number. Insurance Basics Fields 5. Once I have entered the information, from the manage list button, I can choose Initiate Eligibility Request. 6. Then, I click on View Eligibility Response to see if the policy is eligible. 7. Once that is able to be viewed, I can click have verified the policy for this encounter. to mark that I Authorizations and Referrals I can also add any Referral or Authorization information by clicking on the right had tab labeled Auths/Referrals. Reason, procedure codes, diagnosis codes, etc., may be optionally entered. The status of the authorization is required. Days or visits, once entered, calculate as appropriate (15 visits for 15 physical therapy visits). 21 Soarian All Patient Access Training Once the authorization is fulfilled, it automatically qualifies for the fulfilled or expired worklist. Once entered, Auths always appear in the Auth UI for the patient. If an authorization is allocated to a given encounter, then a green check mark appears in the authorization UI. Processing for referrals and authorizations is identical except in how they appear on claim forms. In Soarian, a referral is a type of authorization. At times you may see only the term “Authorizations”; unless otherwise stated, you can assume that the information applies to authorizations and referrals. Auths/Referrals Form Guarantor Demographics Form If the patient is their own guarantor, this folder will be grayed out, as it is here. Maintain Comments Form In this section, you can add comments. You can choose a coded comment, or you can free form, or do both. For example, earlier we discussed that you may run across a case where the patient’s doctor is not in the system. On this form, I could choose the coded comment “PA HP NOT AVAIL” and it would populate the text for me. I can then put as much information on the doctor as I have, so that they can be added to our database. 22 Soarian All Patient Access Training Maintain Comments Form Finish Check-In & Print Encounter Artifacts Check in is ready to complete. If there are selectable items to print for check-in, you will be transferred to Print Artifacts to make those selections. Otherwise, any notices and artifacts will be generated automatically. Be certain that all the data you entered is ready before moving on. 1. Click Done and then Yes to finish the Check Patient In Function. 2. Select any Artifacts needed to print. 3. Capture and signature scans you need. 4. Click Done. Now that I have walked you through the process of checking in a new patient, it is time for you to give it a try… 23 Soarian All Patient Access Training Activity Two: Have your students get in pairs and practice checking one another in. You can use specific scenarios, or let them make up their own. However, have them check in as: EL: AMH EP: Ancillary Make sure to circulate the room answering any questions that arise during the classes practice time. Check In an Existing Patient Now that we have all checked in a new patient, let’s look at the check in process for an existing patient. You will notice the process is much quicker. Let’s work through one together. Instructor and Class: Check in an Existing Patient 1. Find the Check Patient In function on your homepage. 2. Enter the appropriate search criteria, then click Search. 3. Use the checkbox to select the appropriate EL and EL, then click OK. We are brought to the Check-In Summary form. We did not use this form when we checked in a new patient. That is because we had to fill in all the information on that patient from scratch. Because this patient is already in the MPI, we only have limited information to fill out. Most, if not all, of your needed information can be found on the Check In Summary form. 4. Move through the Check In Summary form, filling out the required information. 5. Once completed, click “done” 6. You are brought to the print artifacts screen. Finish your check in. 24 Soarian All Patient Access Training Quick Check-In Quick Check-In is used when the identity of a patient is unknown, or if a patient requires immediate attention. It is used primarily in the ER and L&D departments. Minimal information is required to create an encounter: Birth date or estimated age and gender Patient first and last name Encounter start date and time (system generated) Today, we are going to work with a partner to complete a Quick Check-In. But first, I am going to complete a Check Check-In so you can see the process once before working on your own Instructor: Complete a Quick Check In 1. I start out at my Soarian Homepage. 2. From my tasks list, I find the Quick Check In task and click on it. Task List 3. I then check the appropriate location and click OK. 25 Soarian All Patient Access Training Searching for a EP and EL I am brought to the “About the patient” section of the Quick Check-In. I need to see if my patient is in the system. 4. I will click the Find Patient button. Look up the patient using the “Find Patient” button 5. I am going to search for [New Patient], so I will use his first and last name. 26 Soarian All Patient Access Training 6. Once I have typed in my information, I can click the Search button. Search Button If I have possible matches, a list of them will populate at the bottom of my screen. If I see your match listed, I can choose my patient by placing a check mark by their name. However, my patient is not yet in the system. 7. Therefore, I will click on the Add New button at the bottom of the screen. Add New Button 8. First, I fill out the Gender and Date of Birth. 9. I then come to the ER Arrival Date/Time fields to fill them out. 10. Last, I need to put in an Attending HP. 11. When I am done filling in the required fields, I can click Done at the bottom right side of the screen. 27 Soarian All Patient Access Training 12. The Finish Check-In dialog box and Print Artifacts screens will follow. 13. You can check items off to print. Facesheets will automatically print. 14. Now, I can capture any signatures or scan documents, such as insurance cards or IDs. 15. Once I have completed that, I can click Done at the bottom right hand corner of my screen. Unidentifiable Patients Sometimes a patient’s name will not be known. If you do not know a patient’s name, you can check them in by using the “Unidentifiable” option. Each location uses a different name to label unidentified patients. It usually follows the format of: Doe, Fishname-HospitalPrefix# = Doe, Goldfish-CH2235 Now it is time to do our own Quick Check Ins. Activity 3: Have your students get in pairs and use their information to complete a Quick Check-In on your own. Then, have their partner complete a Quick Check-In on them. Make sure to circulate the room to make sure users are able to complete their Quick Check In. Completing a Quick Check In from the Incomplete Worklist Now that we have done a Quick Check-In on our own, it is time to complete the Check- 28 Soarian All Patient Access Training In process. To do so, we need to find the quick check in we started on the Incomplete Worklist. Instructor and Class: Complete the Quick Check In 1. First, click on the Incomplete Worklist. Standard Worklists A dialog box will come up. Note, though, that I do have the option to sort my list a certain way here. I will also have that option on the next screen. 2. Choose your location and provider press OK. 29 Soarian All Patient Access Training Encounter Location and Provider After we press “OK”, a list of patients will come up. My list is quite long. Currently the list of patients is sorted by Patient Name. I can scroll through the pages and find my patient, or I can also choose here to sort a different way. 3. I will click Change View. Changing the View 4. I know my Quick Check-In was done today, so I am going to sort by date (descending), and click OK. Sort By 30 Soarian All Patient Access Training Now my list is sorted by date, in descending order. I can now find my patient and click on them. 5. Click on your patient. 6. A popup box appears. I want to complete my Check-In. I will click Complete Check In. Complete Check In Soarian takes me into the Encounter to complete the check in. The first form I come to is the Check-In Summary Form. Let’s each finish our Check In in from here. Activity 4: Have the students finish their check in on their own. Make sure to circulate the room answering any questions that arise during the classes practice time. Check In a Newborn When a newborn is delivered at your hospital, we need to check them in. We can do this by finding the mother on the Census Worklist, and from there choose the “Check Newborn In” function. Selected data from the mother and her encounter will default to 31 Soarian All Patient Access Training the newborn’s encounter. A link is also created between the mother’s and newborn’s encounters. Let’s check in a newborn together. Instructor Note: Use… MBC / Nurse’s Station: Select All / Clinical Service: Obstetrics Instructor and Class: Check In Newborn 1. From your Soarian Homepage, select the Census Worklist. 2. Fill in the appropriate information in order to locate your mom patient. 3. Click on the appropriate patient’s name. 4. Select “Check Newborn In.” 5. Fill out the necessary information on the summary page. 32 Name: Babygirl or Babyboy Last Name: Mom’s Last Name Birthdate and time Gender Reason for Encounter: Newborn Clinical Service: Nursery Admission Source: Born Inside The Hospital Admitting Diagnosis: V30.00 Attending & Admitting: Make sure you pick a doc with rights (just search using “S”) Guarantor: Mom’s Name Soarian All Patient Access Training Summary Page for Check In Newborn 6. Most of the other folders will have complete information in them. However, make sure to go to the Pt Demographics Folder and put in the Race and Ethnicity. Race & Ethnicity on Patient Demographics Form 7. Finish your complete check in by clicking Done. Instructor Note: Usually the discharging nurse will update the baby’s name. 33 Soarian All Patient Access Training MODULE 2: PRE-ADMIT and CONTINUATION VISITS Pre-admitting a patient is the method of generating an encounter for a future date in Soarian Financials. Pre-Admit an Adult Let’s walk through the Pre-Admit adult function together. Instructor and Class: Pre-Admit and Adult Patient 1. Find the Pre-Admit function on your homepage under tasks, and select it. Finding the Pre-Admit Function 2. Now enter the needed information to find your patient. If the patient is new, you can also select the “add new” button to enter their information. 3. Enter the EL and EP. 4. You will get a dialog box asking for the encounter start date and time. Enter the information. (Make sure date/time is in the future) 5. Proceed through the Schedule Encounter Summary form and populate the needed information. Pre-Admit a Newborn 34 Soarian All Patient Access Training The Pre-Admit Newborn function if used to pre-admit a newborn encounter. It allows data to be entered as required for pre-admission. The mother’s inpatient encounter must be in a scheduled or checked-in status. 1. Find the Pre-Admit Newborn function on your homepage and select it. Finding the Pre-Admit Newborn Function 2. Enter the appropriate search criteria to find and select the mother. 3. Check the box for the mother’s correct encounter and click Select. 4. Populate the required fields: First Name: Newborn (or OneNewborn, TwoNewborn if twins) Last Name: Mom’s last name Gender: Choose Start Date and Time: Choose Clinical Service: Nursery Level of Care: Nursery 1 5. Click Done. 35 Soarian All Patient Access Training Pre-Admit Newborn Screen 6. When you are finished, click Yes. Finish Pre-Admit Newborn Screen Continuation Visits Continuation visits, or ongoing treatments, create a new encounter using information from a previous encounter for the same treatment series within the same organization. Continuation visits enable you to check-in a patient more quickly, as much of the information you need will already be populated. You may never have to check in a continuation visit, as it will also automatically check in when it is billed. Some patients never stop at the registration desk when they go to their continuation visit. But, just in case you come across a patient that needs to check into a continuation visit, here are the steps. Watch me as I walk you through them. 36 Soarian All Patient Access Training You can access Continuation Visits using: Check Patient In Pre-Admit Instructor: Check In a Continuation Visit Because you do not already have an initial visit in a treatment series set up, please watch as I check in a Continuation Visit. Instructor Note: Make sure to set up a patient with a series visit, and remember that for this Continuation Visit check in. 1. From the “Check Patient In” function, I will enter the appropriate search criteria and select my patient. 2. Put in the date and time (must be past or current. 3. Highlight the correct treatment series and click “select” to proceed with the check in. 4. Progress through the form, verifying and populating fields. Continuation Visit Screen Note: If you have not checked in the initial visit using the continuation visit path, you will get a warning tell you that you must check in the initial visit before first. 37 Soarian All Patient Access Training Warning 38 Soarian All Patient Access Training MODULE 3: CHANGE PATIENT STATUS Soarian allows us to make a status change on patients. We can modify an encounter to reflect changes in the patient’s level of care and/or encounter provider. You can change the patient status from OP to IP, etc. Trainer: To get the class more involved, ask them why they might want to change the status of a patient. A patient status change is often the result of: Payer regulations that state that certain levels of care must be billed as either inpatient or outpatient in order to be reimbursed. A review by Utilization Management/Care Coordination where a determination is made that the patient did or did not qualify for a certain level of patient care. o These determinations are usually made through “after the fact” reviews of the patient chart and can occur at any time in the patient’s care, including post discharge. Before practicing them, I wanted to give you an overview of each one first. Change Patient Status – Transition A Change Patient Status Transition allows the user to move from a lower level of acuity to a higher level of acuity. It is movement in only one direction. Outpatient to Inpatient o Emergency Department to Inpatient o Same Day Surgery to Inpatient o Observation to Inpatient Change Patient Status – Revise A Change Patient Status Revise allows the user to move between different encounter providers at the same level of acuity and from a higher level of acuity back down. In other words, movement can be lateral as well as down. Lateral movement within an Encounter Provider Inpatient to Outpatient Outpatient to Outpatient 39 Soarian All Patient Access Training o Same Day Surgery to Observation o Emergency Department to Same Day Surgery o Emergency Department to Observation Change Patient Status – Cancel and Resume A Change Patient Status Cancel and Resume (management functionality) allows the user to cancel a “Change Patient Status Transition” to resume the previous encounter. Flow of Change Patient Status – ALL Activity 5: Play a game of “Shoots and Ladders.” The game board and dice should be with your classroom set up material. Does everyone understand when you will use each? Now, let’s take some time to practice all three. We will start with Change Patient Status - Transition. 40 Soarian All Patient Access Training Instructor and Class: Change Patient Status - Transition 1. From the homepage, find the Encounters in Progress Worklist Find the Encounters in Progress Worklist 2. Select the Encounter Provider and Encounter Location. You can also narrow your search by dates and clinical service. Trainer Note: Fill out the “Include Encounters starting between” portion or you might get an error. There seems to be a glitch in the training system. Choose an EL & EP 41 Soarian All Patient Access Training 3. Select a patient. Select your patient 4. This will bring up a dialog box for you to choose the function to perform. Select Change Patient Status: Transition. Select Change Patient Status - Transition You will come to the Patient Status Change Transition screen. Here you can view details of the existing encounter as well as the new encounter’s details. Note that the ECD# remains the same between encounters. 5. Move over any details you wish from the old encounter to the new encounter. 42 Soarian All Patient Access Training Remember, a Change Patient Status Transition allows the user to move from a lower level of acuity to a higher level of acuity. It is movement in only one direction. It is usually OP to IP. Patient Status Change – Transition Screen 6. Click Next We are now on the Check-In screen. 7. View and populate the appropriate fields to check in the encounter. 43 Soarian All Patient Access Training Check Patient In 8. Click Done at the bottom right hand of the screen when you are finished. 9. Click Yes Finish Check In Pop Up 10. Click Done 44 Soarian All Patient Access Training Congratulations, you have completed your transition! Now let’s practice Change Patient Status –Revise. Instructor Note: Make sure to choose different patient to revise then for Transition and Cancel & Resume. Instructor and Class: Change Patient Status - Revise 1. Click on the Change Patient Status Revise function Click on Change Patient Status Revise 2. Locate your patient 3. Choose the EL and EP combination that is appropriate for our revision, and click OK. 4. Populate and/or revise the fields to reflect the changes. 45 Soarian All Patient Access Training Revise Encounter 5. Click Done when finished. 6. Click Yes You have completed your Change Patient Status – Revise! Now, let’s practice our last Change Patient Status, the Cancel and Resume option. Instructor and Class: Change Patient Status – Cancel and Resume Remember, we use the Cancel and Resume option when we made a mistake – we did a Transition and want to go back to our original encounter. Trainer Note: Make sure to use a patient that has had a Transition already. 1. Find your Change Patient Status – Cancel and Resume function on the homepage. 2. Look up your patient. You will be taken to the Change Patient Status – Cancel and Resume screen. 46 Soarian All Patient Access Training Change Patient Status – Cancel and Resume Screen The left side of the screen displays the information of the selected encounter. This encounter is the one being cancelled. The right side of the screen displays the encounter to be resumed. 3. If Location Assignment or any other census activities should move to the Resumed Encounter, check the box then click the arrow. 4. Verify the encounter to be resumed is correct, and click Done. Congratulations! You have completed your first Change Patient Status – Cancel and Resume! 47 Soarian All Patient Access Training MODULE 4: ADDITIONAL FUNCTIONS IN SOARIAN There are many functions available to you in Soarian. In this class, we will touch on the most commonly used function. This will include: Revise Encounter Details Function No Show Function View Patient Function Add/Revise Person Function Revise Patient Function Cancel Check Out Cancel an Encounter Revise Encounter Details Function Revise Encounter Details allows you to see the history and to make changes to things like a phone number or the clinical service. It is the preferred method of updating patient demographics and insurance information. Instructor: Ask questions for more involvement. Example: In what situation might we want to revise an encounter? You have seen the fields in Soarian that need to be filled out when you check in a patient. When you choose the Revise Encounter Details function, you can change the things that were originally documented in the check in. Let’s revise an encounter together. You can use the patient’s check in you started earlier in class. Instructor and Class: Revise an Encounter 1. First, find the “Revise Encounter Details” function on your homepage and click on it. 2. Next, look up the patient. You can do so using their encounter number, encounter common data number, their name (click on Find Patient), or by using the additional search options. 48 Soarian All Patient Access Training Searching for our patient 3. Once you have looked up your patient, make sure the checkbox is selected for them, and click Select. Selecting your patient 4. You will then get a list of encounters for that patient. Click the correct one, and click Select. 49 Soarian All Patient Access Training Choosing your encounter You will then be taken to the Revise Encounter Details function. You know you are in Revise Encounter Details, because the tab at the left says “Revise Encounter.” Revise Encounter Details Screen Within Revise Encounter Details, you can revise many things for the encounter, like… 50 Soarian All Patient Access Training Maintain Encounter History Maintain Encounter History Link Maintain Encounter History allows you to revise the Location Assignment, Clinical Service, or Level of Care. Maintain Encounter History Screen 51 Soarian All Patient Access Training Revise Encounter Date/Time Revise Encounter Date/Time Link The Revise Encounter Date/Time allows you to revise the dates and times associated with an encounter. Revise Encounter Date/Time Screen You can also move through the screens and change many other pieces of information. Move through the screens now on your own to see what you can revise. Feel free to change things to see what happens. Instructor: Make sure to walk around the room as the class plays in this function. 52 Soarian All Patient Access Training No Show Function Recording a No Show You can No Show a patient when their encounter is in a “scheduled” status. A No Show indicates that the patient did not show up for the appointment, and also did not cancel the appointment. The date and time of the scheduled encounter must be in the past. Note: This function is not available to all users. Let’s work through recording and reversing a No Show together. Instructor and Class: Record a No Show 1. Select Today’s Scheduled Encounters Worklist. 2. Select criteria for your results. Recording a No Show 53 Soarian All Patient Access Training Reversing a No Show 1. Select the Reverse No Show function. Note: Only encounters with a status of “No Show” will be returned. Select Reverse No Show 2. Choose the correct encounter 3. Click Done. View Patient Function This function allows you a view only access to information related to a patient, such as patient demographics and patient insurance. You cannot make any changes or revisions, nor will you be able to view encounter specific information. Let’s look at this function together. Instructor and Class: View Patient 1. Select the View Patient function. 2. Enter the appropriate search criteria. 3. From the return results, select the correct patient and click select. 54 Soarian All Patient Access Training Add/Revise Person Function This function allows you to add/revise a person regardless of the role they play in the system. You can add/revise a person who is not necessarily a patient, outside the context of an encounter. There are four tabs of information available in this function: Person’s Demographics Person’s Insurance Let’s look at this function together. Instructor and Class: Revise Person 1. 2. 3. 4. Select the Add/Revise Person function. Complete the person search to Select or Add New. Use the tabs to populate or revise the fields. Click Done. Revise a Patient Function You can use this function to update person/patient information. You can update any patient demographic information as well as insurance. Note: This function updates the MPI with the new patient information. Let’s look at this function together. Instructor and Class: Revise Patient 1. Select the Revise Patient function. 2. Enter the appropriate search criteria and select the correct patient. 3. Once complete with your revisions, click done. Cancel Check Out Function Sometimes, we might need to cancel a check out. This function is given only to certain 55 Soarian All Patient Access Training users, usually managers. But let me quickly show you this function so that you are familiar with it. Instructor: Cancel Check Out 1. From the Soarian Financials Home Page, select the Cancel Check Out function. 2. Use the needed information to find the patient’s encounter (ENC, ECD, Patient’s Name, etc.) 3. Click Search 4. Click Select to choose the right patient 5. Select the correct encounter 6. Click Done 7. Click Yes 8. Click Yes 9. Click Done Cancel Encounter Function As with cancelling a check in, we may sometimes need to cancel an encounter. Again, this is reserved for people with certain access (managers, for example). But let me quickly show you this function so that you are familiar with it. Instructor: Cancel Encounter 1. From the Soarian Financials Home Page, select the Cancel Encounter function. 2. Use the needed information to find the patient’s encounter (ENC, ECD, Patient’s Name, etc.) 3. Click Search 4. Click Select to choose the right patient 5. Select the correct encounter The Cancel Encounter Screen will appear Cancel Encounter Screen 56 Soarian All Patient Access Training 6. Fill out the needed information (like the Reason for missed encounter field) 7. Click the Done button when finished Depending on the reason you chose, you may get a warning or some kind. Example of a warning 8. When finished, click the Yes button Finishing the encounter 57 Soarian All Patient Access Training MODULE 5: BED MANAGEMENT Find a Patient’s Location This function provides view-only access to inpatient locations. It is great for a front desk clerk or volunteer. Soarian requires a patient’s partial last name as the minimum amount of data to initiate a search. Looking up a patient in the Find Patient Location function Let’s look up our patient’s location together. Instructor and Class: Find a Patient Location 1. From the homepage, click on Find a Patient’s Location 2. Look up your patient with whatever information you have available. Transfer Patient Function In this function you can move a patient from one bed to another within a single encounter provider. You can change the patient’s level of care, clinical service, and attending doctor. The change can be effective in the past or present. Note: Changes of location can sometimes mean Level of Care and/or Clinical Service must change in order to post the appropriate room charge on the encounter. Note: Transfers between distinct units of the facility (from Medical Units to Mental Health Units, as one example) should not be performed for billing reasons. The patient should be discharged from one unit and readmitted to the receiving unit. 58 Soarian All Patient Access Training Let’s work through a transfer together. Instructor and Class: Transferring a Patient 1. Begin from the Census Worklist 2. Select the encounter locations to be included and click ok. 3. Select the patient and select Transfer Patient. 4. Fill out in the NEW section to the right, any information that has changed. Transfer a patient screen Swap Patient Function In this function you can switch beds between two patients. This function is mainly used to accommodate patient preference or eliminate a conflict between patients in the same location. It can be effective in the past or in the present. 59 Soarian All Patient Access Training Note: If patients are swapped between different units of the facility, Level of Care and/or Clinical Service may need to be updated to post the appropriate room charge for the patient. Let’s work through a swap together. Instructor and Class: Swap Patient 1. 2. 3. 4. Find a patient on your census worklist. Select the Swap Patient function. You can use a location or a patient to swap with. Review the information and click done to complete. Check Patient Out Function Check-out provides a means to indicate the end of a patient’s encounter – a discharge. Using - the Check Patient Out Function, you can access and update: Patient demographics Encounter details Patient insurance Guarantor demographics Let’s check out a patient together. Instructor and Class: Swap Patient 1. From your home page, select the Census Worklist. A dialog box pops up. 2. Choose the patient location, location group, and clinical service. 60 Soarian All Patient Access Training Choosing Patient Location A list of patients will appear. 3. Select the patient name hyperlink of the patient you would like to check out. Once you have selected your patient, a dialog box will appear. Dialog Box 4. Click Check Patient Out. 61 Soarian All Patient Access Training You will then come to the Check Patient Out screen. Check Patient Out Screen The information should already be populated, but make sure to click on the various sections to double check that the information is there, and is correct. Once you have click on a tab (like Patient Demographics), and verified it, you can click “Next” (bottom right hand corner) to get back to the main page. 5. Verify the information. 6. Click “Done” at the bottom right hand of the screen. A dialogue box will appear, asking if you are sure. Dialog Box 7. If you are finished, click Yes. 62 Soarian All Patient Access Training You are then brought to the Print Encounter Artifacts screen. 8. Select any artifacts you would like to print. 9. Click Done at the bottom right hand corner, when you are finished. Your check out is complete! 63 Soarian All Patient Access Training MODULE 6: WORKLISTS We’ve looked at a few worklists throughout class. However, I wanted to go over a list of common worklists you will use often. Instructor: Display each worklist as it is discussed. Census Worklist The Census Worklist is a list containing all patients on the current census for that Encounter Location. A patient has to be checked in to a bed in the system to be on this worklist. This worklist can be manipulated: Change View: Brings you back to the locator form in order to change the criteria for encounters to view Refresh: Allows you to see if any additions or deletions have been made to the list since their last inquiry Filter Options: Location Group, Nurse Station, Clinical Service, Occupied or Unoccupied Sort Options: Patient location, location group, patient name, patient age, attending HP What you can get to via this worklist: Revise Encounter Transfer Patient Swap Patients Check Patient Out Change Patient Status – Transition Check Newborn In Etc Encounter Prep Worklist The Encounter Prep Worklist displays encounters that are scheduled to occur and the status (complete or incomplete). It is designed to help you organize and monitor the tasks that occur prior to the start of an encounter. 64 Soarian All Patient Access Training Encounters remain on this worklist until they are Attended/Checked In or Cancelled. This worklist can be manipulated: Filter Options: encounter location, encounter provider, attending physician, encounter start date, number of days before encounter start date, prep status, payer Sort Options: encounter start date, patient name, attending physician, encounter provider, encounter location, encounter prep status, payer What you can get to via this worklist: Revise Encounter Cancel Encounter Etc Today’s Scheduled Encounters Worklist This worklist shows you all encounters scheduled for that day. Encounters qualify for this worklist if their status is scheduled and the start date is the current date. Encounters remain on this worklist as long as they are in Scheduled status for the current date, and are not re-scheduled for another day At the end of the day, users can determine the disposition of any encounters remaining on the list. The worklist can be manipulated: Filter Options: Encounter Provider, encounter location, health professional Sort Options: Encounter start date/time within encounter provider within encounter location, encounter start date, patient name, health professional, encounter provider, encounter location What you can do via this worklist: Check Patient in Revise Encounter Cancel Encounter Record No Show Today’s Encounters Worklist 65 Soarian All Patient Access Training This worklist is similar to the Today’s Scheduled Encounters Worklist, except that is shows all of today’s encounters, despite their status. In other words, it shows you the scheduled encounters, as well as the attended, cancelled, etc. You choose a EL/EP, and can also narrow your search by date and clinical service. Unviewed Eligibility Response Worklist This worklist shows you all of the unviewed eligibilities for a certain period of time. When you go into this worklist, you are asked to choose a time frame to view, as well as an encounter location/provider combination. Narrowing our Unviewed Eligibility Response Worklist results Missing or Incomplete MSPQ If an MSPQ was not filled out, or started but not completed, the encounter will end up on this worklist. You can also sort this worklist by date (as well as Encounter Provider/Location). 66 Soarian All Patient Access Training Narrowing our Missing or Incomplete MSPQ Worklist Results | Incomplete Check-In Worklist When a check in is started, but not completed, it will be on this worklist. This is where you would find your Quick Check Ins and complete them. When you click on this worklist from the homepage, a dialog box will appear giving you the option to sort your list a certain way. 67 Soarian All Patient Access Training Choosing EL/EP and sorting the list Once you are in the list, you can also sort by clicking the Change View button. You can sort by date of encounter, etc. Once you find your patient, you can click on them, and then click on Complete Check-In, and finish your check in. Once your check in is complete, it will fall off this worklist. Encounters in Progress Worklist Contained on this worklist are any encounters that are currently in progress. That means they are checked in or attended. Scheduled encounters do not appear on this list, as they are not considered “in progress” until they are checked in or attended. Most of your encounters on this list will be for the current day. However, ED, IP, OBS, OPB could be on this list from earlier dates, and will be on it until they have been checked out. You can sort by Encounter Location/Encounter Provider, dates, and clinical service. 68 Soarian All Patient Access Training Activity 6: Hand out the Worklist Match game and give the class a few minutes to complete it. Then go over it and discuss each worklist again briefly, to reinforce the earlier training. Trainer: Make sure you circulate the room to answer any questions. 69 Soarian All Patient Access Training MODULE 7: Downtime Downtime occurs when Soarian is unavailable. During this time, you will document things on paper. Once Soarian is available again, you will begin the process of Downtime Recovery. The three downtime functions are: Check Patient In (Downtime Recovery) Check Newborn In (Downtime Recovery) Pre-Admit (Downtime Recovery) These functions include fields to manually enter identifiers, like ECD numbers. A list of ECD, encounter, and medical record numbers (for new patients) to be used during downtime will be available in your registration area. After Soarian becomes available, the Check Patient In (Downtime Recovery) function is initiated to record work that was done manually while the system was down. Because they are so similar, we are not going to look at all three of the downtime functions. But let’s look at Check Patient In (Downtime Recovery) so you can see what it will look like. Instructor and Class: Check In Patient Downtime 1. 2. 3. 4. Click on the Check Patient In (Downtime Recovery) function Find your patient. Select your EL & EP From here, we fill out the information needed. Notice how we have fields to add ECD and ENC numbers. If our patient was new, and not in the MPI, we would also have a field to manually enter an MRN number. 70 Soarian All Patient Access Training MODULE 8: EDM EMD, or Enterprise Document Management, is the software embedded within Soarian used to scan insurance cards, photo IDs, and other patient documents. You can also view previously scanned documents. Scanning in EDM The Capture button on the Print Encounter Artifacts screen takes you over to EDM for scanning purposes. Capture Button From there, you can insert the document (upside down and backwards) into the scanner. Click on the appropriate Quick Acquire Profile to scan the document into EDM. When finished scanning, the document will be displayed on the screen. 71 Soarian All Patient Access Training Quick Acquire Profile Button EDM is also where you will have the patient initial for HIPAA and sign the Authorization for Treatment on the signature pad. Initial for HIPAA and sign the Authorization for Treatment 72 Soarian All Patient Access Training Signature Box Viewing Documents in EDM You can also get to EDM via the EDM Icon. This icon is found in various parts of Soarian, and allows youto view documents within EDM. There is also a link to EDM on your homepage. You can choose to view the Encounter folder or the MRN folder. Just double click on the document name to view it. 73 Soarian All Patient Access Training You can view documents like facesheets, eligibility responses, etc. Some of the documents are versioned, and contain older versions and newer versions. Depending on your security, you may have acess to view all versions of a document of only the most recent. Activity 7: Have each student practice scanning on their own. Call them up individually to practice. Note: It may be a good idea to pass out the final exams, and have the class start taking them while you do this activity. That way the whole class does not have to wait around while each person practices scanning. Instructor Note: Mention that this is the only screen in Soarian you should ever “x” out of. 74