Audit Tips: Changes to Client Diagnosis and Referring Provider Functionality
- Dawn Mackey
- Scott LaPorta
As we continue working towards more billing functionalities within the Rethink system we are incrementally launching enhancements along the way.
The changes and improvements we made required us to account for existing data in your system. Please check out the areas that we think you need to know about below and please take the time to review our recommendations for performing proactive auditing of your system.
Here is what you need to know about the latest enhancements:
Diagnoses can be connected to any client’s active Service Line (ABA, Speech, OT etc).
Client Diagnoses can be inactivated.
Client Diagnoses can be put into the correct order for claim submissions. (although claims cannot currently be generated from Rethink - “yet”, good time to them in ORDER.
Referring Providers can be added and managed in your Company account now.
Referring Providers will no longer be connected to a client’s diagnosis.
Referring Providers can be added directly to any client authorization IF the payor requires.
Your Existing Data | We recommend you: | |
|---|---|---|
| 1 | Client Diagnosis Assignments
Inactive and Active Auths apply. F84.0 diagnosis assigned to Client Auth for service Early Intervention  F84.0 diagnosis was added to Client Service Line Early Intervention in the Client’s Profile.  2**. If a diagnosis was present in client record but not assigned to an authorization we added it to all service lines for that client. | Audit all client diagnosis assignments Check that all diagnoses are added to the correct service line Inactivate or delete any diagnosis as needed Auditing Client Diagnosis Tip: Clean up client diagnoses assigned to service lines that are not needed. This is specific to #2** outlined in the table to the left. See the video below for more details:
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| 2 | Company Account Referring Provider Assignments We added Referring Providers to your company account IF they were added to a client diagnosis. IMPORTANT:
In the sample below there are 2 versions for Referring Provider “A.Referring Provider 3”. One with an NPI and one without and the name was entered differently.
| Review Referring Providers in your company account. Check for different versions of the same provider. IMPORTANT:
Check out our Auditing Tips Below: TIP 1: Find client authorizations assigned to Inactive Referring Provider with existing appointments:
TIP 2: Find client authorizations assigned to Inactive Referring Provider with No Scheduled appointments |
| 3 | NPI Entries Previously users could enter NPI’s without any validation Update now includes NPI lookup to the NPIIS Registry | Check the NPI’s are valid right within your Rethink system. |
| 4 | We assigned a Referring Provider to any client authorization IF the client diagnosis had a connected Referring Provider with an NPI or First and Last Name.
| If you have inactivated any Referring Providers at the company account then you will want to watch the Audit Tips in # 2 above.
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For more information about these features click on the links below:
Managing Referring Providers in your Company Account