Referrals and Authorizations Flashcards
A Connect site refers a patient to the host. What would this referral’s class be?
Internal
A referral has two coverages, one with an authorization number at the coverage level and one with three SLAs. How many rows would appear in ReferralFact? How many rows would appear in AuthorizationFact?
How many rows would appear in ReferralFact? 1
How many rows would appear in AuthorizationFact? 4
You work at a Community Connect organization that shares its instance of Epic with a couple satellite facilities. Which of the following would be an example of a referral that would store ‘Internal’ in ReferralFact.Class? Choose ALL answers that apply.
A. A referral from one of the satellite facilities to another of the satellite facilities
B. A referral from one of the satellite facilities to your organization
C. A referral from your organization to one of the satellite facilities
D. A referral from your organization to a provider who works at neither your organization nor any of the satellite facilities
a, b, c
What is the unit used for the value returned by ReferralFact.AuthorizationToScheduledDate? Choose just ONE of the following. A. Minutes B. Hours C. Calendar days D. Business days
d
True or False: ReferralFact excludes rows about auth/certs.
True
A referral has three coverages, and each coverage provides one authorization number for the referral. How many rows in AuthorizationFact describe this RFL record?
A. 0
B. 1
C. 3
D. It is impossible to determine from the information provided
c
What data element reflects whether a visit has been authorized?
VisitFact.AuthorizationStatus
What Caboodle table is used to link a visit to its referrals?
VisitReferralMappingFact
What are two of the master files for referrals?
RFL and REF
What is stored in ReferredByProviderDurableKey?
The ID of the provider who placed the order.
What master file stores the source of a referral?
REF
What is the purpose of the referral class?
It indicates key information about its origin and destination.
Which field indicates if a referral was leaked?
IsLeaked
What information is stored in the FirstEncounterKey
The first encounter associated with the referral.
What information is stored in the LinkedToAnEncounter?
1 or 0 to indicate if the referral is associated with an encounter.
What information is stored in IsComplete?
1 or 0 to indicate if the referral is considered incomplete
What is stored in the field, IsLoopClosed
1 or 0 indicating the look is closed for the referral.
What is the primary table used in Caboodle to report on authorizations?
AuthorizationFact
What is Service-Level Authorization?
Authorization is granted at the level of each procedure/date range
When is Coverage-Level Authorization used?
- The coverage provides an authorization number for the entire RFL record.
- The record is not an auth/cert, and
- The coverage has no SLAs that have authorization numbers for this record.
A referral has two coverages, one with an authorization number at the coverage level and one with three SLAs.
- How many rows would appear in ReferralFact?
- How many rows would appear in AuthorizationFact?
- How many rows would appear in ReferralFact? 1
- How many rows would appear in AuthorizationFact? 4
What is the granularity of ReferralFact?
One row for non-auth/cert referrals, regardless of what levels are associated with the RFL record
What is one of the primary reporting uses for ReferralFact?
Calculating the referral’s cycle time
What does referral cycle time measure?
It measures how efficient an organization is at processing referrals and quickly seeing referred patients.
True/False: The ReferralFact and ReferralEventFact tables exclude auth/certs.
True
What table in Caboodle includes auth/certs?
AuthorizationFact
What is the granularity for REFERRAL_CVG_BED?
One row for each coverage’s summary of bed days for an auth/cert
What are bed days?
Number of days requested to cover the patients stay in the hospital.
What is the granularity of the the table REFERRAL_BED_DAY?
One row for each classification of bed days for an auth/cert
You work at a Community Connect organization that shares its instance of Epic with a couple satellite facilities. Which of the following would be an example of a referral that would store ‘Internal’ in ReferralFact.Class? Choose ALL answers that apply.
A. A referral from one of the satellite facilities to another of the satellite facilities
B. A referral from one of the satellite facilities to your organization
C. A referral from your organization to one of the satellite facilities
D. A referral from your organization to a provider who works at neither your organization nor any of the satellite facilities
a, b, c
What is the unit used for the value returned by ReferralFact.AuthorizationToScheduledDate? Choose just ONE of the following. A. Minutes B. Hours C. Calendar days D. Business days
d
True or False: ReferralFact excludes rows about auth/certs.
True
A referral has three coverages, and each coverage provides one authorization number for the referral. How many rows in AuthorizationFact describe this RFL record?
A. 0
B. 1
C. 3
D. It is impossible to determine from the information provided
c
