Pas Grab Bars Case Study

*Upon checking on the biller, customer’s account has no rate codes yet and there’s WIP for installation of HSD, Cable and XHS however there’s no scheduled date. Before the CAE handled the customer’s account, there’s an ER Ticket(030871771) created for Qouta and Field Escalation requesting for an

On the above listed date and time, I arrived on scene and made contact with the complainant. I gathered the above listed

SC placed call to Pa and CG Annette on 01/5/16. SC asked Antoinette about her employment status with provider to be Sweet Home Health Care and she reported that she was still waiting to hear from the provider. SC informed Annette that it has been over 60 days since Pa’s was approved for service and has not us it. SC asked how Pa’s personal need is are being met and Antoinette reports that she is proving care to Pa. Annette said she did everything and is waiting for the agency. SC end call with Antoinette and placed call to agency. SC got the agency answering service and left detail message, identifying self, Pa, stated reason for calling, and contact informant.

SC asked Soon if Pa could stay late on 1/14/2016 for SC to visit and will she be able to provide her with transportation home. Soon stated that she can try by she can’t promise that. SC thanks Soon and told her SC will discuss above information with SCS and call her at a letter time. SC called with Soon 12 minutes. SC consulted with co-worker about the day care policy and she confirmed that after 4.5 hrs a provider can bill for a full day because it includes transportation. This conversation lasted for several minutes. SC tried to find reading martial about this policy but was not very successful. SC placed call to Active Aid Solution and spoke with Tanya who reported that they had received the service order a while back but it did not include an installation. SC informed Tanya that’s SC had completed service order the installation but SC was not able to put it in before 2/1/2016. SC informed Tanya of this and she stated that the device was installed back in October, 2015. So she was asking SC to back date the service order to match the service delivery

SC completed monitoring telephone call with Pa on 1/20/2016. SC called Pa. Pa reported that ding “good”. Pa reported no new health problems, no medications, no falls, and no hospitalizations. Pa reported no outstanding doctor’s visits. Pa reported that’s he saw her PCP on 1/19/2016. SC reviewed Pa's ISP. Pa confirms that she is receiving services in the following type, scope, amount, frequency and duration of services specified in the ISP agency model aide via Total Home Health Care from 10-2PM, Monday through Sunday. Pa's aide provides assists her with the completion of ADLs, IALDs and supervision as needed. Pa has PERS system which gives her access to emergency medical service. Pa also, receives HMD from PCA weekly. She reported being satisfied

Pa confirmed that there is no duplication of services. Waiver is the payer of last resort for services. Pa reported that his back-up plan that the agency will send a replacement aide if needed has not been utilized, Pa reports that is services are not available, his son, Ralph, will come to assist him, these back up plans remain effective and has never been used per Pa. SC called the Dynamic Home Health Care PAS provider agency and reported that the aide has not shown up for the day and she would the Pa to call out leaving him without proper coverages. The receptionist took SC information and stated that the director of the Waiver service was not in as yet and will have all SC. The called meal site and spoke with Lavern, who resumed Pa’s HMD and set it up for Friday delivery. SC called Theresa the nutritionist at DaVita Dialysis and informed her that the Pa HDM will begin starting 5/13/2016. SC called back Dynamic Home Health Care and spoke with the director of Waiver services. The SC informed her of the Pa’s claims about the aide calling him when she will not be at work instead of the agency so that they can send

At approximately 0813 hours, on 31-Jul-15, the writer, SSS. E.Durani and Sh/S A.Singh responded to call from POC to attend 3-East. The officers attended and upon arrival the officers were informed by the unit clerk that the patient has left the unit. The officers were also told that the patient was going to Cafeteria. The officers cleared from 3-East and attended Cafeteria. Upon arrival the officers met with the patient’s Care Aide, who asked the officers to escort him back to his unit. Sh/S A.Singh got verbally engaged with the patient and asked him to walk back to the unit. The patient was compliant and walked back to the unit. After taking the patient back to his room, the primary nurse requested the officers to put the lap belt. The patient

SC complete monitoring phone call on 01/20/2016 with Pa's PAS (Cheryl). Pa reports receiving all services as outlined in ISP. He remains satisfied with services and feels that they meet his current needs. No falls, hospitalization, changes in health status or medication reported by Pa. No outstanding follow up needs identified. The day before SC received a phone call from Cheryl reporting that Pa’s is running low on heating oil and has exhausted all other option and would like PCA emergency fund to supple Pa with heating oil. SC completed the paperwork and gave to SDCS to review and submit. At the time of this call retreated that the paperwork has been submitted and Pa will receive the heating oil as long as he is qualified and has not use

Would you please resubmit the patient DOS 09122017 v#15852640. The patient guarantor just call me very upsed b/c he receive the EOB and he said that we are billing ot his insurance one E&M CODE that we are not suppost to be billed b/c that was a procedure order that the patient needs to get done outside and not at WFH. I review the office notes and the provider order a ECHO exam of heart(93307) but, the provider by mistake select this procedure as a billed procedure and PMG FWD to the payer. Would you please re-bill the service back to the payer with the billing correction ASAP so the patient can get done this procedure. I advise the guarantor that are we are going to make the necessary corrections ASAP. The guarantor understood and he said

Cecelia contacted SC via phone Cecelia. Cecelia informed SC that she was concerned about Audrey’s weight. She noted over 30 pounds in the last year and half. SC asked if she address the concern with the provider. She notes yes. She noted the provider took Audrey to her PCP to have blood work done. She noted the blood work show there was no issue with her thyroid. She noted the provider had the PCP to check for Side-effects from medication. PCP noted her medication don’t has weight lost as a side effect. She know she he a lot but just want SC to monitor her weight. SC agree to monitor Audrey weight. Cecelia also notes she see Audrey once a month and take her to dinner. She not the

Telephone contact made to the pt. Two pt verifier name/dob confirmed. Per PA Aford the pt was advised that her lab came back positive for chlamydia. Informed the she had tested positive for both in November, GC in Feb and now chlamydia. Instructed the to go to public health and schedule a apt with her PCM or women's health. Also, instructed the pt to refrain from intercourse or to use protection, inform partner(s) so they can get tx to prevent the spread of STI.Pt instructed to pick up meds at the pharmacy. Pt states that at this time she is do don't have coverage. Provided the pt with the number to Dr Fank Bryant Health Center, Any Woman Can Clinic and the Eastside Clinic so the she can treatment based off her income. Educated the pt on

Objective A: After 5/2/17, the consumer has missed two appointments with outpatient therapy. The consumer has stated that he wanted to hang out with his friends at the barber shop in lieu of going to his outpatient appointment with the MHSS. The MHSS has discussed the importance of outpatient therapy with the consumer and the consumer acknowledges that he needs outpatient therapy but he refuses to go or makes excuses not to go. Objective B: The consumer and the MHSS reviewed the consumer’s appointments with outpatient therapy and a PCP check up. The consumer was able to review the paper work for the PCP (Dr. Chinnery of Divine Health Group) however he declined help from the MHSS in reviewing the intake packet. The consumer stated that

SC received OLTL ISP approval. SC ordered Pa services in Oracle and generated them in SAMS. SC terminated JEVS Home Care as provider agency and replaces it with BLESSINGS4EVER HOME CARE AGENCY. SC updated both SAMS and Oracle with new provider. SC places order for stir gild assessment and service order instructions sheet. SC placed call to Pa and spoke with Marie/ CG and informed her of the ISP approval asked about her employment status with PAS provider agency and Maries states that she is still in the hiring process SC informed her that at this time she will not be paid for any PAS service she will provider during this time because she is not hired by the agency until she is the service will remain on hold. SC informed Marie that PERS and

CM met with consumer at CREST to complete transfer paperwork. CM inquired into consumer’s medications. Consumer reported no adverse side effects. Consumer was appreciative. CM had client fill out QOL as part of completing transfer paperwork. CM explained to consumer that she will continue with her PCP in regards to her medications. Consumer stated understands and agreed to the same. Consumer reported that when she went to the hospital to check herself after she thought she may have a heart attack due to pain in her chest. Consumer reported that everything went well and she was having a panic attack. Consumer stated that she was supposed to go to the Court in regard to the property between her and her ex-fiancé. Consumer stated that she was upset and anxious and that is why she had the panic attack.

CX called about the line hanging accross their street, Cae wasnt able to refelct reason for contact and did not demonstrate cocnern by using empathy or relate statement. CAE was able to acknowledge the information that was verified through the automated system, he was able to set CX's expectation on what will going to happen if the technician will be at the location. CAE created an SRO for tommorow 8am-8pm, and provided the ticket number. CAE did not pitch for a sale and he had chosen wrong itg.