SCENARIOS PANEL MANAGEMENT
RELEASE FOR CALL CENTER AGENTS AND PRCs
With Panel Management, ensuring patient care continuity is crucial, and your role is vital. Here are scenarios you may face with step-by-step approaches, and potential responses
Access to Consumer 360 In LEAP
Scenarios Panel Management
The patient doesn’t accept the change and/or want a specific PCP or location
If the patient understands and accepts their care team
The patient wants more information to understand the change.
Patient is impacted by business decisions
If the patient understands and accepts their care team:
Schedule appointment in eCW and
Script
All Scenarios
The patient wants more information to understand the change.
Some reasons are:
Provider leaves and a new one is hired to backfill position
Provider changes panel or location
Provider becomes unqualified for panel management
All Scenarios
The patient doesn’t accept the change and/or want a specific PCP or location
Some reasons are:
Provider at maximum capacity
Provider requests patient change
Patient gets changed from an MD/DO to an APRN or PA
Patient requests to change Provider or location (specified or not)
All Scenarios
Patient is impacted by business decisions
New center opens in existing market
High patient volume (Open enrollment)
Center closes
All Scenarios
If patient does not accept and wants a specific provider or specific characteristic of provider
1. Filter provider by PCP type and location. 2. Selects new provider. 3. When pop up window pop ups, write the reason of change, lock the connection if applicable, and confirm. * Specify when can I block connection 4. If what the patient request is not possible, then make a feedback to the supervisor.
All Scenarios
Download the complete script
All Scenarios
Patient gets changed from an MD/DO to an Advanced Practice Practitioner (APRN or PA)
If the patient doesn't accept its PCP
All Scenarios
Download the complete Script
Provider changes panel or location
If the patient doesn't accept its PCP
Download the complete Script
All Scenarios
A new center opens in an existing market
If the provider is at maximum capacity
Download the complete script
All Scenarios
Access to Consumer 360 in LEAP
1.Log in Leap 2. Enter to Consumer 360-Profiles 3. Search patient 4. Verify assigned PCP 5. if patient ask, then validate in provider 360 last PCP
Provider at maximum capacity
If the provider is at maximum capacity
Download the complete script
All Scenarios
Provider changes panel
Provider at maximum capacity
If the provider requests patient change, please select buddy PCP and explain the patient with one of those scenarios.
When the pop-up window pops ups, write the reason for the change, lock the connection, and confirm. If there is no buddy PCP then filter provider by pcp type and exact location location. Select a new provider. When the pop-up window pops up, write the reason for the change, lock the connection, and confirm.
Download the complete Script
Download the complete Script
All Scenarios
Patient requests TO change provider OR LOCATION (specified or not)
If the patient is requesting a specific provider
If the panel of the provider is closed
If the Care Team doesn't have the capacity
Download the complete Script
All Scenarios
Provider becomes unqualified for panel management: Changes practice type, employment status or is on leave for 60+ days
If the patient doesn't accept its PCP
All Scenarios
Download the complete Script
Provider leaves and a new provider is hired to backfill the position
If the patient doesn't accept its PCP
Download the complete script
All Scenarios
High patient volume (Open enrollment)
If the provider is at maximum capacity
Download the complete Script
All Scenarios
Center closes
If the patient doesn't accept its PCP
Download the complete Script
All Scenarios
Scenarios Panel Management
Maria Del Giudice
Created on September 29, 2023
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Transcript
SCENARIOS PANEL MANAGEMENT
RELEASE FOR CALL CENTER AGENTS AND PRCs
With Panel Management, ensuring patient care continuity is crucial, and your role is vital. Here are scenarios you may face with step-by-step approaches, and potential responses
Access to Consumer 360 In LEAP
Scenarios Panel Management
The patient doesn’t accept the change and/or want a specific PCP or location
If the patient understands and accepts their care team
The patient wants more information to understand the change.
Patient is impacted by business decisions
If the patient understands and accepts their care team:
Schedule appointment in eCW and
Script
All Scenarios
The patient wants more information to understand the change.
Some reasons are:
Provider leaves and a new one is hired to backfill position
Provider changes panel or location
Provider becomes unqualified for panel management
All Scenarios
The patient doesn’t accept the change and/or want a specific PCP or location
Some reasons are:
Provider at maximum capacity
Provider requests patient change
Patient gets changed from an MD/DO to an APRN or PA
Patient requests to change Provider or location (specified or not)
All Scenarios
Patient is impacted by business decisions
New center opens in existing market
High patient volume (Open enrollment)
Center closes
All Scenarios
If patient does not accept and wants a specific provider or specific characteristic of provider
1. Filter provider by PCP type and location. 2. Selects new provider. 3. When pop up window pop ups, write the reason of change, lock the connection if applicable, and confirm. * Specify when can I block connection 4. If what the patient request is not possible, then make a feedback to the supervisor.
All Scenarios
Download the complete script
All Scenarios
Patient gets changed from an MD/DO to an Advanced Practice Practitioner (APRN or PA)
If the patient doesn't accept its PCP
All Scenarios
Download the complete Script
Provider changes panel or location
If the patient doesn't accept its PCP
Download the complete Script
All Scenarios
A new center opens in an existing market
If the provider is at maximum capacity
Download the complete script
All Scenarios
Access to Consumer 360 in LEAP
1.Log in Leap 2. Enter to Consumer 360-Profiles 3. Search patient 4. Verify assigned PCP 5. if patient ask, then validate in provider 360 last PCP
Provider at maximum capacity
If the provider is at maximum capacity
Download the complete script
All Scenarios
Provider changes panel
Provider at maximum capacity
If the provider requests patient change, please select buddy PCP and explain the patient with one of those scenarios.
When the pop-up window pops ups, write the reason for the change, lock the connection, and confirm. If there is no buddy PCP then filter provider by pcp type and exact location location. Select a new provider. When the pop-up window pops up, write the reason for the change, lock the connection, and confirm.
Download the complete Script
Download the complete Script
All Scenarios
Patient requests TO change provider OR LOCATION (specified or not)
If the patient is requesting a specific provider
If the panel of the provider is closed
If the Care Team doesn't have the capacity
Download the complete Script
All Scenarios
Provider becomes unqualified for panel management: Changes practice type, employment status or is on leave for 60+ days
If the patient doesn't accept its PCP
All Scenarios
Download the complete Script
Provider leaves and a new provider is hired to backfill the position
If the patient doesn't accept its PCP
Download the complete script
All Scenarios
High patient volume (Open enrollment)
If the provider is at maximum capacity
Download the complete Script
All Scenarios
Center closes
If the patient doesn't accept its PCP
Download the complete Script
All Scenarios