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CHCS Virtual Classroom VC Instructor Guide For Patient

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					                       DEFENSE HEALTH INFORMATION MANAGEMENT SYSTEM




    CHCS Virtual Classroom (VC) Instructor Guide
                         For
    Patient Appointment Scheduling/Managed Care
                 Program (PAS/MCP):
          Ambulatory Procedure Visits Menu




                                       Visit Us Online at:
                                    http://dhims.health.mil

The DHIMS Program Office is a component of the Military Health System Office of the Chief Information Officer.
                              Course Notes
          •    Purpose of Course
          •    Target Audience
          •    Environment for Application Share
          •    Acronyms/Pronunciations




          August 2007               VC_APV Menu_IG, v2                  2




Instructor Notes:
Purpose of Course:
This virtual classroom (VC) course will enable designated site personnel to perform
the duties necessary to enter data in the menu options of the Ambulatory Procedure
Visits Menu. The course covers the entry of minutes of service; creating
wristbands, cover sheets, and embossed cards; viewing reports, and entering prior
authorization numbers.
Target Audience:
This course is intended for clerks and nurses who are responsible for completing
processes through the Ambulatory Procedure Visits Menu options in CHCS.
Environment for Application Share:
The Ambulatory Procedure Visits Menu course uses the Composite Health Care
System (CHCS) Training Database (TDB) environment (Host: FWAC; Username:
JABBER; Password: WOCKY; User: Training Manager.
Acronyms/Pronunciations:
Acronyms and pronunciations are listed on the following slide.




                                                                                      2
                        Course Notes: (cont.)
           • Data to set up in the Training Database (TDB)




          August 2007                VC_APV Menu_IG, v2                    3




Data to set up in the TDB:
Book an appointment for patient Dodd,Allan, into the General Surgery APU for
today at 0800 (or other appropriate time of day that will coordinate with the time of
day the course is taught) with Dr. Aaron. Check the patient into the unit.
Make a second appointment for the same patient for later in the day, maybe at
1400, and check the patient in. This appointment will be used for Lesson 2.




                                                                                        3
                       Acronyms/Pronunciations
          APP(a-p-p)           Ambulatory Procedure Profile
          APV(a-p-v)           Ambulatory Procedure Visits
          CHCS (c-h-c-s)       Composite Health Care System
          CPT(c-p-t)           Current Procedural Terminology
          MAPV (m-a-p-v)       APV Minutes of Service Menu Option
          MEPRS(mepers)        Medical Expense and Performance
                               Reporting System
          MOS(moss)            Minutes of Service
          TDB (t-d-b)          Training Database
          VAP(vap)             Ambulatory Procedure Visit option

         August 2007               VC_APV Menu_IG, v2                  4




Instructor Notes:
The acronyms with their pronunciations and meanings are listed here for your
reference.




                                                                               4
                         Table of Contents
          Agenda                                                   7
          Course Objectives                                       8
          Introduction                                             9
          Lesson 1: Minutes of Service (MAPV) Menu                10
          Lesson 2: Printing Patient Identifiers                  48
          Lesson 3: Prior Authorizations, Profiles, and Reports   60
          Course Summary                                          77
          References                                              78
          Questions                                               79


         August 2007               VC_APV Menu_IG, v2                  5




Instructor Notes:
This Table of Contents is intended for the hard-copy reader and should be skipped
for the presentation.




                                                                                    5
                                 Welcome

               Ambulatory Procedure Visits Menu

             Clerks and Nurses who are responsible for completing
                         ambulatory procedure visit data




          August 2007                                                  6




Instructor Notes:
Be sure to complete a sound check before beginning the class.
Text:
Welcome to the Ambulatory Procedure Visits Menu class.
This course is for nurses and clerks who are responsible for completing ambulatory
procedure visit data.
To begin our session, let’s review the agenda for the course.




                                                                                     6
                                    Agenda
           •   Course Objectives
           •   Introduction
           •   Lesson 1: Minutes of Service (MAPV) Menu
           •   Lesson 2: Printing Patient Identifiers
           •   Lesson 3: Prior Authorizations, Profiles, and Reports
           •   Course Summary
           •   References
           •   Questions



          August 2007                VC_APV Menu_IG, v2                7




Instructor Notes:
Read the bulleted items when mentioned in the text.
Text:
Let’s take a look at the agenda for this course.




                                                                           7
                           Course Objectives
           Upon completion of this course, you will be able to:
           • Select patients and enter/edit minutes of service
           • Print patient identifiers
           • Enter authorization numbers, print AP reports, and enter
             location profiles (Ambulatory Procedure Profiles or
             APPs)




          August 2007                 VC_APV Menu_IG, v2                     8




Instructor Notes:
Read the slide.
Text:
Upon completion of this course you will be able to select patients and enter/edit
minutes of service, print patient identifiers, in addition to entering authorization
numbers, printing AP reports, and entering location profiles, also known as
Ambulatory Procedure Profiles or APPs.




                                                                                       8
                                Introduction
          • Need for Training
          • Target Audience
          • Methodology
            - PowerPoint Slides
            - Software Demonstrations
            - Test Questions




          August 2007                  VC_APV Menu_IG, v2               9




Text:
It is important that clerks and nurses become adept at completing the Ambulatory
Procedure Visits Menu. Successful completion of data through the menu options
will ensure accurate selection of patients through various options; proper entry of
minutes of service; correct printing of wristbands/cover sheets/and embossed cards;
accurate entry of authorization numbers; and accurate printing of APV reports.
This training targets clerks and nurses who are responsible for completing
Ambulatory Procedure Visit data in CHCS.
This course is written and designed to be delivered by an instructor in a virtual
classroom setting. The instructor will narrate the training session and use
PowerPoint slides and, when possible, application sharing, in a simulated training
environment to demonstrate functionality related to the Ambulatory Procedure Visits
Menu. Students will participate in classroom discussion, and will respond to
interactive polling and quiz questions.
Now let’s get started with Lesson 1.




                                                                                      9
                    Lesson 1: Minutes of Service
                          (MAPV) Menu

           • Topic 1: Patient Selection Options
           • Topic 2: Initial MAPV Options
           • Topic 3: Minutes of Service Enter/Edit




          August 2007                VC_APV Menu_IG, v2                 10




Instructor Notes:
Point to each topic as it is read.
Text:
In Lesson 1 of our class today, we will discuss the Minutes of Service (MAPV)
Menu. The topics for this lesson are listed here. Now let’s take a look at the
objectives for Lesson 1.




                                                                                 10
                         Lesson 1 Objectives
           • Identify and use the patient selection options
           • Identify and use the MAPV options
           • Enter/edit minutes of service




          August 2007               VC_APV Menu_IG, v2                   11




Instructor Notes:
Read the text below.
Text:
These are the objectives for Lesson 1. By the end of this lesson, you will be able to
[read bullets].
Now let’s start with Topic 1.




                                                                                        11
             Topic 1: Patient Selection Options
           • Objective: Upon completion of this topic, you will be able
             to identify and use the patient selection options.




          August 2007                 VC_APV Menu_IG, v2                 12




Instructor Notes:
In this topic you will identify and use the patient selection options.




                                                                              12
                        PAS System Menu




         August 2007               VC_APV Menu_IG, v2                 13




Text:
CHCS users have various primary menus. Now let’s see how we would access the
Ambulatory Procedure Visits Menu from different starting points. On this slide you
see the PAS System Menu. You may have a different primary menu when you
access CHCS. If this is your menu, and you need to access the Ambulatory
Procedure Visits Menu, you would enter M for Managed Care Program at the Select
PAS System Menu Option: prompt and then press the <Enter> key.




                                                                                     13
                Managed Care Program Menu




        August 2007             VC_APV Menu_IG, v2              14




Text:
This is the Managed Care Program Menu. You would enter CDSK at the Managed
Care Program Menu prompt for the Clerk Front Desk Functions Menu and then
press the <Enter> key.




                                                                             14
             Clerk Front Desk Functions Menu




         August 2007              VC_APV Menu_IG, v2                 15




Text:
At the Clerk Front Desk Functions Menu, enter VAP at the prompt and then press
the <Enter> key.




                                                                                 15
            Ambulatory Procedure Visits Menu




          August 2007               VC_APV Menu_IG, v2                  16




Text:
This slide displays the Ambulatory Procedure Visits Menu. In this topic you are
going to see the various ways you can select a patient visit. Here you would enter
MAPV at the prompt and then press the <Enter> key.
Now, I’m going to demonstrate the patient selection options in the training database.




                                                                                        16
               Demo: Patient Selection Options
          • Menu Path to the Ambulatory Procedure Visits Menu




          August 2007               VC_APV Menu_IG, v2                   17




Instructor Notes:
Log into the demonstration environment using the Access/Verify codes of
JABBER/WOCKY.
Text:
I will log into the training system now to demonstrate the patient selection options.
In the live CHCS system, you may have various primary and secondary menus. I
am signed in as Training Manager, so my primary menu is the System Manager
Menu. I’ll begin the demonstration with the menu path to the Ambulatory Procedure
Visits Menu.
If the System Manager Menu is your primary menu, you would type the menu path
as follows:
CA->PAS->MAN->CDSK->VAP to display the Ambulatory Procedure Visits Menu.




                                                                                        17
             Demo: Patient Selection Options
          • The Ambulatory Patient Visits (APV) Minutes of Service
            Enter/Edit (MAPV) Menu




         August 2007              VC_APV Menu_IG, v2                 18




Text:
You now see the Ambulatory Procedure Visits Menu. To see the patient selection
options you would type MAPV and press the <Enter> key.




                                                                                 18
               Demo: Patient Selection Options
          • The Patient Name option




          August 2007               VC_APV Menu_IG, v2                   19




Text:
You now see the various patient selection options. You could select the patient by
Patient Name, Location, Order Number, or Tracking Number. Let’s type P for
Patient Name and press the <Enter> key. At the Enter Patient Name prompt type
DODD and press the <Enter> key. Then select the patient Dodd, Allan A by typing
1 and then press the <Enter> key. You then see a display of the MAPV Enter/Edit
Screen. You will come back to this screen later. Notice the Exit option in the
bottom right hand corner of the screen. Type X to exit this screen and return to the
patient selection options.




                                                                                       19
               Demo: Patient Selection Options
          • The Location option




          August 2007               VC_APV Menu_IG, v2                   20




Text:
Once again you see the patient selection options. Now let’s use the Location
option. Type L and press the <Enter> key. Now at the Location Name prompt, type
APU GENERAL SURGERY and press the <Enter> key. Note that you could also
type the Medical Performance and Reporting System (MEPRS) code in the Location
Name prompt. In this case the MEPRS code is BBA5. The screen displays a list of
all patients that meet the criteria.
Next you need to enter the date of the procedure. Notice that the default is today’s
date. Press the <Enter> key to accept the default. Then type X to return to the
patient selection options.




                                                                                       20
               Demo: Patient Selection Options
          • The Order option




          August 2007               VC_APV Menu_IG, v2                  21




Text:
Now let’s use the Order option. Type O and press the <Enter> key. You are
prompted to enter the order number. You will do that in a moment, but for now type
?? and press the <Enter> key. A list of order numbers, patient names, and
locations appears. You can always do this if you need to search for a particular
order. Now type ^6 to exit this list. Then type 010620-06549 and press the
<Enter> key. Once again you see the Minutes of Service Enter/Edit Screen. If you
knew the first part of the order number, you could type what you know and then you
would see a shorter list of selections. Now type X to exit this screen and return to
the patient selection options.




                                                                                       21
               Demo: Patient Selection Options
          • The Tracking Number option




          August 2007               VC_APV Menu_IG, v2                   22




Instructor Notes:
Complete the text for this slide. Then return to the PowerPoint for the question.
Text:
The fourth and final patient selection option is the tracking number. Type T and
press the <Enter> key. If you knew all or part of the tracking number, you could
enter it here. You could also enter the patient name at the tracking number prompt.
For now, let’s again type ?? and press the <Enter> key. You see another list of
possible selections. Type ^6 to exit the list; then type 2001-05150001 and press
the <Enter> key to display the Minutes of Service Enter/Edit screen.
Then type X to exit this screen.
That concludes our demonstration of the patient selection options. Now, I have a
question for you.




                                                                                      22
                                  Question
          Which of the following is NOT an option for patient
          selection in the MAPV Menu?
          a.    Patient
          b.    Location
          c.    Date
          d.    Order number




          August 2007               VC_APV Menu_IG, v2                   23




Instructor Notes:
Answer: c. Date
Text:
The correct answer is c - Date. The other three choices; patient, location, and order
number, are all patient selection options in addition to the tracking number.
That concludes our discussion of Topic 1. If there are no questions, let’s go on to
the next topic.




                                                                                        23
                    Topic 2: Initial MAPV Options
           Objective: Upon completion of this topic, you will be able to
           identify and use the initial MAPV options.




          August 2007              VC_APV Menu_IG, v2                 24




Instructor Notes:
Read the slide. Then read the text below.
Text:
Let’s get started.




                                                                           24
                                    New APV Patient: Add
          • Patient without previous visit
          • Use Patient option
          • Add patient




              -----------------------------------------------------------------------------------------------------------------------------------
                         Ambulatory Procedure Visit                            -                 Minutes of Service Enter/Edit
              -----------------------------------------------------------------------------------------------------------------------------------
              Select (P)atient Name, (L)ocation, (O)rder, (T)racking Number, or (Q)uit




         August 2007                                                   VC_APV Menu_IG, v2                                                           25




Instructor Notes:
Read the text below.
Text:
Sometimes you will have a patient arrive for care who might not have a scheduled
visit. When that is the case, you would use the “Patient” option to add this new
patient.




                                                                                                                                                         25
                        New APV Patient: Pre-admit
           • Pre-admit




                  ---------------------------------------------------------------------
           Edit   New Pre-admit   Status   pRint   Help eXit




          August 2007                                  VC_APV Menu_IG, v2                 26




Instructor Notes:
Read the text below.
Text:
When you add a new patient, you can immediately proceed to pre-admit the patient.
If the File and Table is completed for the Pre-Admit (Teaching Location-T-Type or
Ward with a cost pool code, you will be able to enter MOS for the pre-teaching MOS
and link this to the order. Also, since the File and Table is completed, an
appointment can be created in the background for the pre-admit teaching location.
Remember, once the order is written, MOS can be entered.
Note that you are not pre-admitting the patient into the hospital.




                                                                                               26
                                    APV Appointment
          • MCP Booking
          • Access to Care Category-Future
          • Patient Check-In




               0800 Davis,Allan     20/6509   APV   Doctor,Davi 21 Jun 01 BBA5 Kept
               1200 Dodd, Barbara B 20/6615   APV   Doctor,Lamp 21 Jun 01 BBA5 Pending




          August 2007                                VC_APV Menu_IG, v2                  27




Instructor Notes:
Read the text below.
Text:
You should be familiar with booking an appointment into your APV clinic. As you
know, you would use MCP Booking. Remember that when you are booking an
appointment into an ambulatory patient unit, you must use the access to care
category of ‘Future.’ Once you have scheduled the appointment, the status of that
appointment would be ‘Pending.’ In your Front Desk Clerk Menu, you would use
the ‘Individual Patient Check-In’ option to change the appointment status to ‘Kept.’




                                                                                              27
                         Initial MAPV Options: Edit
          • Edit




               ---------------------------------------------------------------------
               Edit     New Pre-admit   Status   pRint    Help eXit




          August 2007                                    VC_APV Menu_IG, v2            28




Instructor Notes:
Read the text below.
Text:
If you select a patient who has an appointment, or who has been seen in your
ambulatory procedure unit prior to this event, you will see displayed the initial MAPV
options. The first option is ‘Edit’. This option is used to make any revisions to the
selected procedure, pre-admission, or observation event.




                                                                                            28
                               Initial MAPV Options:
                                    Add/Pre-admit

          • Add
          • Pre-admit




               ---------------------------------------------------------------------
               Edit     New Pre-admit   Status   pRint   Help eXit




          August 2007                                VC_APV Menu_IG, v2                29




Instructor Notes:
Read the text below.
Text:
The next two MAPV options are ‘Add’ and ‘Pre-admit’. You have already discussed
these two options when a new patient was added. You can add a new ambulatory
procedure record for the selected patient. You can also enter a pre-
admission/encounter.
If the File and Table is completed for the Pre-Admit (Teaching Location-T-Type or
Ward with a cost pool code, you will be able to enter MOS for the pre-teaching MOS
and link this to the order. Also, since the File and Table is completed, an
appointment can be created in the background for the pre-admit teaching location.
Remember, once the order is written, MOS can be entered.
Now let’s discuss the remaining initial MAPV options.




                                                                                            29
                               Initial MAPV Options:
                                  Status/Print/Exit

          • Status
          • Print
          • Exit




               ---------------------------------------------------------------------
               Edit     New Pre-admit   Status   pRint   Help eXit



          August 2007                                VC_APV Menu_IG, v2                30




Instructor Notes:
Read the text below.
Text:
The ‘Status’ option allows you to enter or edit the appointment status for the
selected procedure. The ‘Print’ option allows you to print a hardcopy of the
procedure. A ‘Device Name’ prompt will require you to enter your printer’s name.
Finally, you would select the ‘Exit’ option to leave these initial MAPV options.
Now let’s look at a demonstration of these options.




                                                                                            30
                        Demo: Adding a Patient
           • Adding a New Patient




          August 2007                VC_APV Menu_IG, v2                    31




Instructor Notes:
Re-display the TDB. Then read the text below.
Text:
You again see the initial MAPV options. Since you are going to enter a new patient,
the only option that would do this is the ‘Patient’ option. Type P and press the
<Enter> key. Now type Picard,A and press the <Enter> key twice. That brings you
to the MAPV Enter/Edit Screen. At the top of the screen you see the patient’s
name, age, family member prefix, and social security number. You also see in the
text area of the screen that there is no data found for this patient. Since this patient
has no APV encounters in your clinic, it will be necessary to add a new one. Notice
the highlighted word ‘New’ in the options at the bottom of the screen. When you use
the ‘ADD’ option, an APR is automatically created in the background and is
accessible for AOP for booking to the APU. Press the <Enter> key to add a new
ambulatory procedure record for this patient.




                                                                                           31
                       Demo: Requesting Provider/
                             APV Location
           • Requesting Provider
           • APV Location




         August 2007               VC_APV Menu_IG, v2                  32




Text:
The ‘Requesting Provider’ prompt displays. Type Caldwell twice to accept Dr
Lorraine Caldwell. This is the provider who is requesting the procedure. Next, you
need to enter the AVP location for this encounter. Type APU General for the
General Surgery Unit and press the <Enter> key.




                                                                                     32
                           Demo: APR Order
                        Screen/Procedure Profile
          • Ambulatory Procedure Request Screen
          • Procedure Profile prompt




          August 2007                VC_APV Menu_IG, v2                  33




Text:
The Ambulatory Procedure Request Screen displays. Data at the top of the screen
includes the patient’s name, age, family member prefix, social security number and
order number. The General Surgery unit displays in the location field. The cursor is
located in the ‘Procedure Profile’ field. Type ?? and press the <Enter> key. A
display box appears describing the purpose of this field. Note that this field defines
the APV locations (APPs) for this record. If no location is defined, the system will
automatically default to the location defined for your division. Data is not required
for this field, so press the <Enter> key to continue.
We will discuss APPs in more detail later in this course.




                                                                                         33
                       Demo: APV Physician/
                         APV Date/Time
          • APV Physician
          • APV Date/Time




         August 2007               VC_APV Menu_IG, v2                  34




Text:
Next you would enter the APV physician. Type DOCTOR,AARON and press the
<Enter> key twice to confirm the physician who will perform the procedure. Next,
you need to enter the date and time of the procedure. Your patient is expected
today at 1400. Type T@1400 and press the <Enter> key.




                                                                                   34
                        Demo: APV Procedure/
                        Appointment Comment
          • APV Procedure
          • Appointment Comment




          August 2007               VC_APV Menu_IG, v2                  35




Text:
Next you need to enter the APV procedure that is expected to occur. You can enter
free text or an actual procedure code number. Type Ingrown Toenail and press
the <Enter> key. For the appointment comment, type Big toe, left foot and press
the <Enter> key four times to exit the screen.
Now, let’s continue the demonstration with a patient who currently has a record.




                                                                                    35
                        Demo: Current Patient
           • Enter current patient
           • MAPV Enter/Edit Screen




          August 2007                VC_APV Menu_IG, v2                   36




Instructor Notes:
For this demonstration you will use the pre-existing data for patient Allan Dodd
booked to an appointment with Dr. Aaron.
Text:
You learned in the first topic of this lesson the various ways to enter a patient. Type
P for patient and press the <Enter> key. Then type Dodd,A and press the <Enter>
key twice. (Instructor Note: if there is more than one choice, select the first one).
You have seen this MAPV Enter/Edit Screen several times already during this
lesson. At the top you have the data previously discussed. Notice in the body of
the screen that there are three events already listed. Two are from previous
encounters. The encounters display in chronological order with the most recent at
the top of the list. At the bottom of the screen you have the various options
available to you. Let’s discuss each of them in order.




                                                                                          36
                        Demo: Edit/New/Pre-Admit
          • Edit
          • New
          • Pre-Admit




          August 2007                VC_APV Menu_IG, v2                  37




Text:
You can use each of these options after you have selected the record. In order to
select a record, you position your cursor in front of the record and then press the
<End> key. The record you want is the first one. The cursor is already there, so
press the <End> key to select it. An asterisk appears to the left of the selection.
Edit is highlighted in the options at the bottom of the screen. To edit this record,
press the <Enter> key to continue. That takes you to the next level of options that
will be discussed in the next topic. For now, type X to exit this screen.
The next two actions are ‘New’ and ‘Pre-Admit.’ Remember that pre-admit is the
teaching that is conducted prior to the procedure. These work exactly as they did
when you entered a new patient and went through the pre-admission process. If
there are any questions on either of these actions, I can re-demonstrate them for
you now.
(Note: there is an order entered for Photon, F, if the pre-admit MOS entry is
demonstrated.)
If there are no questions, I’ll continue with the remaining actions.




                                                                                       37
                        Demo: Status/Print/Exit
          • Status
          • Print
          • Exit




          August 2007               VC_APV Menu_IG, v2                   38




Text:
The ‘Status’ option allows you to edit the current status of the record. Notice that
the current status is ‘Kept,’ so we won’t change that. The next option is ‘Print.’
Type P and press the <Enter> key. Then you see the ‘Device’ prompt. Here you
would type the name of your printer and press the <Enter> key. We won’t print it
now, so press the <Enter> key once more. To exit the screen, press <X> to return
to the patient selection options.
Now, I have another question for you.




                                                                                       38
                                   Question
          Which of the following fields display on the MAPV
          Enter/Edit Screen?
          a.    APV Location
          b.    APV Provider
          c.    APV Date/Time
          d.    APV Procedure
          e.    All of the Above




          August 2007                  VC_APV Menu_IG, v2                 39




Instructor Notes:
Correct answer: e - All of the Above
Text:
The correct answer is e - All of the Above. All of these APV items are listed in
addition to any appointment comment.
That concludes the discussion of Topic 2. If there are no questions, let’s proceed
with Topic 3.




                                                                                     39
                        Topic 3: Minutes of Service
                                 Enter/Edit
           Objective: At the conclusion of this topic, you will be able
           to enter and/or edit minutes of service.




          August 2007               VC_APV Menu_IG, v2                    40




Instructor Notes:
Read the slide. Then continue with the text below.
Text:
Let’s get started.




                                                                               40
                        Enter Patient/Edit/Minutes of
                              Service Options
           •    Select new patient option
           •    Edit current record
           •    MAPV Edit Options
                         1.        MOS
                         2.        CPT
                         3.        Print
                         4.        Exit
                         ------------------------------------------------------------------------------------------------
                         Mos Cpt Print Help eXit 

          August 2007                                                VC_APV Menu_IG, v2                                     41




Instructor Notes:
Read the text below.
Text:
When you are ready to enter the minutes of service, you would select the patient
option to access the record. After selecting the appropriate record, you would then
select the ‘Edit’ option to enter the minutes of service. The options available to you
in minutes of service include Minutes of Service (‘MOS’), Current Procedural
Terminology (‘CPT’), ‘Print,’ and ‘Exit.’ In a few minutes we’ll discuss those options.




                                                                                                                                 41
                        Minutes of Service Options
           The Minutes of Service options include the following:
           • Pre-screen
           • Pre-op
           • Post-op
           • Extended
           • Print
           • Exit




          August 2007                  VC_APV Menu_IG, v2                   42




Instructor Notes:
Read the text below.
Text:
The Minutes of Service option is subdivided into additional options to enter data.
The options include ‘Pre-screen’ to enter pre-screen data (T-Type location usually
2-3 days prior to the actual procedure,)
’Pre-op’ to enter pre-op data (day of surgery,)
‘Post-op’ to enter post-op data (post PACU,)
‘Extended’ to recorded any extended care data (not in-patient,)
‘Print’ to print the record, and ‘Exit’ to return to the previous screen.




                                                                                     42
                                    The CPT Code Option
          • CPT Codes




                ------------------------------------------------------------------------------------------------
                Mos Cpt Print Help eXit




          August 2007                                                  VC_APV Menu_IG, v2                          43




Instructor Notes:
Read the text below.
Text:
The CPT code option takes you to the area of the record to enter the current
procedure code. You can enter free text or the code number.
Let’s look at a demonstration of the Minutes of Service options.




                                                                                                                        43
                       Demo: Enter Patient/Edit/
                           MOS Options
          • Enter patient
          • Edit option
          • MOS options




         August 2007               VC_APV Menu_IG, v2                  44




Text:
Type P to select the ‘Patient’ option. Then, type Dodd,A and press the <Enter> key
twice. Next, select the first record on the screen by pressing the <End> key. You
see the familiar MAPV Enter/Edit Screen with ‘MOS’ highlighted at the bottom of the
screen. Press the <End> key and then press the <Enter> key to open the record
and to display the ‘MOS’ options.




                                                                                      44
                        Demo: MOS Options
                         Post-op/Extended
          • Post-op
          • Extended




          August 2007               VC_APV Menu_IG, v2                  45




Text:
Type O to move the cursor to the ‘Post-op’ field. It is important to remember that
post-op is post PACU. Note the pre-positioned data on this screen. You could edit
the information, or press the <Enter> key to accept the data and advance through
the screen. For now, press the <Enter> key five times to position the cursor at the
‘Outpatient Disposition’ field. Type ?? to display the various choices. Press the
<Enter> key, and then type Home and press the <Enter> key three times to display
the ‘Extended’ option. Type T and press the <Enter> key to place the cursor in the
‘Extended Recovery Location’ field. This field is used to enter/edit a ward location
where the patient was admitted for further observation. You won’t need that for this
patient, so press the <Enter> key twice to display the CPT option.




                                                                                       45
                          Demo: CPT Option
           • The CPT option




          August 2007                VC_APV Menu_IG, v2                    46




Text:
Exit the MOS screens.
Now, It is time to enter the CPT code, if you kNow, It. The CPT code is not a
required field. Type C to access the ‘Pre-ADM CPT Codes’ field. You could type
the actual numerical code if you kNow, It. Another possibility is to type the first (up
to five) letters of the code descriptor. Type Ingro and press the <Enter> key.
There are three options to choose from. You want ‘11765’, so arrow down twice
and then press the <End> key. The code and the description will display. This field
writes to the ADM patient encounter and is editable u and until the ADM file is
complete. If the coder or provider were to change the CPT code in the ADM, the
new code will write to this field. When the ADM is closed, this field is not editable.
Press the <Enter> key twice to return to the patient selection screen.
Now, I have another question for you.




                                                                                          46
                                    Question
          Which of the following is not a Minutes of Service option?
            a.     Pre-op
            b.     Post-op
            c.     Outpatient Disposition
            d.     Extended




          August 2007                 VC_APV Menu_IG, v2                 47




Instructor Notes:
Correct answer: c - Outpatient Disposition.
Text:
The correct answer is c. Outpatient Disposition is not a Minutes of Service option.
That concludes the discussion of Lesson 1. If there are no questions, let’s go on to
the next lesson.




                                                                                       47
                        Lesson 2: Printing Patient
                               Identifiers
           Objective: At the conclusion of this lesson, you will be able
           to print patient wristband, cover sheet, and embossed card
           identifiers.




          August 2007               VC_APV Menu_IG, v2                 48




Instructor Notes:
Read the slide; then read the text below.
Text:
Let’s get started.




                                                                            48
                         Topic 1: Wristband
          Objective: At the conclusion of this topic, you will be able
          to print a patient wristband.




          August 2007               VC_APV Menu_IG, v2                   49




Instructor Notes:
Read the slide; then read the text below.
Text:
Let’s see how this is done.




                                                                              49
                                 Wristband
          • Wristband




          August 2007               VC_APV Menu_IG, v2                  50




Instructor Notes:
Read the text below.
Text:
The patient’s wristband contains valuable information for patient care. The
wristband can only be printed after the patient has been admitted, and it cannot be
printed after the patient has been dispositioned.




                                                                                      50
                                            WAPV Option
          • The WAPV option



                        MAPV APV Minutes of Service Enter/Edit
                        WAPV Ambulatory Care Wristband
                        CAPV Ambulatory Care Record Cover Sheet
                        EAPV Ambulatory Care Embossed Card
                        RAPV APV Prior Authorization Report
                        PAPV Enter APV Prior Authorization Number
                        AAPP Ambulatory Procedure Profile Enter/Edit
                        IAPV Industry Average & Actual MOS Comparison Report

               Select Ambulatory Procedure Visits Menu Option: WAPV




          August 2007                                 VC_APV Menu_IG, v2       51




Instructor Notes:
Read the text below.
Text:
A subset of the Ambulatory Procedure Visits Menu is the WAPV option. This option
is used to print the patient’s wristband. You will need to include the patient’s name,
the ambulatory procedure visit, and the device used to print the wristband. A
sample of the wristband will appear on your screen. You will see a demonstration
of wristband printing in a few moments. The topics in the lesson are all quite short,
so we’ll go through each topic and then proceed to the demonstration.
Now let’s go to Topic 2.




                                                                                         51
                        Topic 2: Cover Sheet
          Objective: Upon completion of this topic, you will be able to
          print a patient cover sheet.




          August 2007               VC_APV Menu_IG, v2                   52




Instructor Notes:
Read the slide; then read the text below.
Text:
The patient record cover sheet can be printed at any time before, during, or after a
patient’s admission. The cover sheet contains patient demographics, insurance
information, minutes of service information, emergency contact, and more. This
document is useful for compiling data entry information for MOS. You will see an
example of a patient cover sheet in a few moments.




                                                                                       52
                                      The CAPV Option
          • The CAPV option


                        MAPV APV Minutes of Service Enter/Edit
                        WAPV Ambulatory Care Wristband
                        CAPV Ambulatory Care Record Cover Sheet
                        EAPV Ambulatory Care Embossed Card
                        RAPV APV Prior Authorization Report
                        PAPV Enter APV Prior Authorization Number
                        AAPP Ambulatory Procedure Profile Enter/Edit
                        IAPV Industry Average & Actual MOS Comparison Report

               Select Ambulatory Procedure Visits Menu Option: CAPV




          August 2007                                 VC_APV Menu_IG, v2       53




Instructor Notes:
Read the text below.
Text:
The CAPV option on the Ambulatory Procedure Visits Menu is used to print the
Patient Cover Sheet.
Now let’s go to Topic 3.




                                                                                    53
                        Topic 3: Embossed Card
          Objective: Upon completion of this topic, you will be able to
          print a patient embossed card.




          August 2007               VC_APV Menu_IG, v2                 54




Instructor Notes:
Read the slide; then read the text below.
Text:
The embossed card contains pertinent patient registration and administration data.
The option to print the embossed card is used to print any inpatient or outpatient
card.




                                                                                     54
                                      The EAPV Option
           • The EAPV Option




                        MAPV APV Minutes of Service Enter/Edit
                        WAPV Ambulatory Care Wristband
                        CAPV Ambulatory Care Record Cover Sheet
                        EAPV Ambulatory Care Embossed Card
                        RAPV APV Prior Authorization Report
                        PAPV Enter APV Prior Authorization Number
                        AAPP Ambulatory Procedure Profile Enter/Edit
                        IAPV Industry Average & Actual MOS Comparison Report



               Select Ambulatory Procedure Visits Menu Option: EAPV




          August 2007                                  VC_APV Menu_IG, v2      55




Instructor Notes:
Read the text below.
Text:
The EAPV option located on the Ambulatory Procedure Visits Menu is used to print
embossed cards.
Now let’s proceed to a demonstration of printing all three of these patient identifiers.




                                                                                           55
                        Demo: Printing Wristband
          • Printing Wristband




          August 2007               VC_APV Menu_IG, v2                  56




Instructor Notes:
Go to the TDB and begin at the Ambulatory Procedure Visits Menu. Read the text
below.
Text:
For this lesson you will begin at the Ambulatory Procedure Visits Menu. First, to
type a patient’s wristband, type WAPV and press the <Enter> key. Then, type
Dodd,A and press the <Enter> key. Next, select the June 21, 2001, 1400 patient
appointment by positioning your cursor in front of that appointment and pressing the
<End> key. At the device prompt, you would enter the name of your printer. For
now, press the <Enter> key to display the wristband data. The data includes the
patient’s demographic information, the date, and the APV location. Press the
<Enter> key to return to the main menu.




                                                                                       56
                        Demo: Printing Cover Sheet
          • Printing the cover sheet




          August 2007               VC_APV Menu_IG, v2                  57




Text:
The patient cover sheet is printed using the CAPV option. Type CAPV and press
the <Enter> key. At the patient name prompt you could retype the name. Since
you just used Allan Dodd as your patient to print the wristband, you can press
<Spacebar> and then <Enter> to duplicate the same name. Then move your cursor
and select the 1400 appointment once again with your <End> key. Again, you
would enter your device name. I’ll press the <Enter> key to print the cover sheet to
the screen. The cover sheet displays. Included are the patient demographics,
insurance information, and APV information.
Some clinics print the cover sheet prior to the procedure. Re-Admit MOS will be
listed on the cover sheet. Then the MOS for other areas can be hand-written on
the sheet in pre-op, post-op, or extended care. Press the <Enter> key twice to
return to the main menu.




                                                                                       57
               Demo: Printing Embossed Cards
          • Printing embossed cards




          August 2007              VC_APV Menu_IG, v2                58




Text:
Embossed cards are printed using the EAPV option. Type EAPV and press the
<Enter> key. Press <Spacebar> and <Enter> to bring up patient Allan Dodd.
Notice that you can choose an embossed card from a list of inpatient, outpatient,
and APV cards. Type APV and press the <Enter> key. Move the cursor and select
the 1400 appointment. Accept the ‘Yes’ default to display the card by pressing
<Enter>. You now see the data as it will appear on the card. Since you can see
what the card would look like, type No at the print prompt and press the <Enter>
key to return to the main menu.
Now, I have a question for you.




                                                                                    58
                                  Question
          Which one of the patient identifiers is the patient most likely
          to see?
          a. Wristband
          b. Embossed Card
          c. Cover Sheet
          d. None of the above




          August 2007                 VC_APV Menu_IG, v2                 59




Instructor Notes:
The correct answer is a - Wristband
Text:
The correct answer is a - Wristband. The patient may or may not see the
embossed card or the cover sheet.
That concludes the discussion of Lesson 2. If there are no questions, let’s go on to
Lesson 3.




                                                                                       59
                  Lesson 3: Prior Authorizations,
                      Profiles, and Reports
           Objective: Upon completion of this lesson, you will be able
           to identify and use prior authorizations, location profiles,
           and reports.




          August 2007               VC_APV Menu_IG, v2                    60




Instructor Notes:
Read the slide; then read the text below.
Text:
Let’s start with Topic 1.




                                                                               60
            Topic 1: Prior Authorization Report
           Objective: Upon completion of this topic, you will be able to
           generate the Prior Authorization Report.




          August 2007               VC_APV Menu_IG, v2                 61




Instructor Notes:
Read the slide; then read the text below.
Text:
Let’s get started.




                                                                            61
                        Prior Authorization Report
           • The Prior Authorization Report




          August 2007                VC_APV Menu_IG, v2                    62




Instructor Notes:
Read the text below.
Text:
The Prior Authorization Report displays those orders, referrals, or appointments that
require a prior authorization from the patient’s insurance company. The Prior
Authorization Report can be displayed by various search criteria. Sort items include
one, multiple, or all divisions; one, multiple, or all clinics; by orders, referrals, or
appointments.




                                                                                           62
                                      The RAPV Option
          • The RAPV Option




                        MAPV APV Minutes of Service Enter/Edit
                        WAPV Ambulatory Care Wristband
                        CAPV Ambulatory Care Record Cover Sheet
                        EAPV Ambulatory Care Embossed Card
                        RAPV APV Prior Authorization Report
                        PAPV Enter APV Prior Authorization Number
                        AAPP Ambulatory Procedure Profile Enter/Edit
                        IAPV Industry Average & Actual MOS Comparison Report

               Select Ambulatory Procedure Visits Menu Option: RAPV




          August 2007                                 VC_APV Menu_IG, v2       63




Instructor Notes:
Read the text below.
Text:
From the Ambulatory Procedure Visits Menu, you would access the RAPV option to
generate the Prior Authorization Report.
Let’s go to a demonstration of how to generate the Prior Authorization Report.




                                                                                    63
              Demo: Prior Authorization Report
           • The Prior Authorization Report




          August 2007                VC_APV Menu_IG, v2                    64




Instructor Notes:
Go to the TDB and start at the Ambulatory Procedure Visits Menu.
Text:
The Prior Authorization Report is generated using the RAPV option. Type RAPV
and press the <Enter> key. You can choose one, multiple, or all divisions located
on your platform. Type A for all divisions and press the <Enter> key. You can
choose one, multiple, or all clinics. Type A for all clinics and press the <Enter> key.
You can choose among orders, referrals, or appointments. Type A for
appointments and press the <Enter> key. Next, type D for ‘Date Range’ and press
the <Enter> key. For the start date, type t-365 to go back one year. At the stop
date, type T for today. You notice a warning that the report may be lengthy and
might impact other users. Normally, you would queue the report to run overnight.
For Now, In the TDB, you can print it to the screen. Type Y and press the <Enter>
key twice to generate the report.
Notice the details on the report: the title, sort criteria, appointments, demographic
information, and authorization details including the insurance company and contact
number. Press the <Enter> key to return to the main menu.
Now let’s look at a question.




                                                                                          64
                                    Question
           True or False:
           The Prior Authorization Report can be sorted by orders,
           referrals, AND appointments.




          August 2007                 VC_APV Menu_IG, v2               65




Instructor Notes:
Correct answer - False
Text:
The correct answer is False. The report can be sorted by orders, referral, OR
appointments.
If there are no questions, let’s go on to the next topic.




                                                                                65
                        Topic 2: Prior Authorization
                              Number Entry
           Objective: Upon completion of this topic, you will know how
           to enter a prior authorization number.




          August 2007                  VC_APV Menu_IG, v2                     66




Instructor Notes:
Read the slide; then read the text below.
Text:
If prior authorization is required for patient care, the insurance carrier for the patient
would be notified. The insurance company would then provide an authorization
number for entry into CHCS.




                                                                                             66
                           The PAPV Option
          • The PAPV option




          August 2007                VC_APV Menu_IG, v2                  67




Instructor Notes:
Read the text below.
Text:
The PAPV option is used to enter prior authorization numbers. This number
becomes part of the patient record and verifies that authorization was given for the
patient care. Your would access the PAPV option, insert the patient’s name, and
then enter the prior authorization number.
Since the TDB is not connected to outside insurance companies, I cannot
demonstrate this option. You would simply follow the steps listed above in the live
system.
For now, let’s move on to the next topic.




                                                                                       67
                    Topic 3: AP Location Profiles
           Objective: Upon completion of this topic, you will be able to
           identify and use location profiles.




          August 2007               VC_APV Menu_IG, v2                 68




Instructor Notes:
Read the slide; then read the text below.
Text:
Let’s get started.




                                                                            68
                        AP Location Profiles
          • AP Location Profiles




          August 2007               VC_APV Menu_IG, v2                   69




Instructor Notes:
Read the text below.
Text:
The Ambulatory Procedure Profile option permits the entry of a location in the user’s
division for pre-day and post-procedure teaching or nursing care and/or a location
for extended recovery. The locations represent a typical patient flow for the
procedure performed in the ambulatory procedure unit. APPs are optional, but they
allow for easier entry of MOS for both the clerk and nursing personnel.




                                                                                        69
                                      The AAPV Option
          • The AAPV Option




                        MAPV APV Minutes of Service Enter/Edit
                        WAPV Ambulatory Care Wristband
                        CAPV Ambulatory Care Record Cover Sheet
                        EAPV Ambulatory Care Embossed Card
                        RAPV APV Prior Authorization Report
                        PAPV Enter APV Prior Authorization Number
                        AAPP Ambulatory Procedure Profile Enter/Edit
                        IAPV Industry Average & Actual MOS Comparison Report

               Select Ambulatory Procedure Visits Menu Option: AAPV




          August 2007                                 VC_APV Menu_IG, v2       70




Instructor Notes:
Read the text below.
Text:
The option to enter or edit teaching, nursing, or extended recovery locations is
AAPP. You then enter the name of the profile location. These location profiles are
also known as APPs (Ambulatory Procedure Profiles). This option is locked with a
security key and only provided to selected users who enter/edit APPs.
You would then designate any pre-op teaching locations, post-op recovery
locations, or extended recovery locations. Let’s demonstrate this now.




                                                                                     70
                        Demo: AP Location Profiles
           • AP Location Profiles




          August 2007                 VC_APV Menu_IG, v2                   71




Instructor Notes:
Start at the Ambulatory Procedure Visits Menu; then read the text below.
Text:
Type AAPP and press the <Enter> key. Type APU General Surgery and press the
<Enter> key twice to profile this location. The ‘APP Enter/Edit Screen’ displays.
The cursor is at the ‘Pre-op Teaching Location’ prompt. We don’t have any
teaching locations in the TDB set up here, so press the <Enter> key to continue.
Now type APU Gen to set the General Surgery APU as a post-op recover location.
Press the <Enter> key to continue. At the ‘Extended Recovery Location’ prompt,
type ?? and press the <Enter> key twice, then type Y and press the <Enter> key
again to list all of the extended recovery locations at your facility. Select ward ’11A’
with your <End> key as your extended recovery ward. You do not want to inactive
this ward, so press the <Enter> key twice to file and exit this screen.
Now let’s look at another question.




                                                                                           71
                                   Question
           Which of the following can be designated as ambulatory
           teaching or recovery locations?
           a. Pre-op
           b. Post-op
           c. Extended
           d. All of the above
           e. Only a and b




          August 2007                VC_APV Menu_IG, v2             72




Instructor Notes:
Correct answer is d - All of the above.
Text:
The correct answer is d - All of the above.
Now let’s go to our final topic.




                                                                         72
                        Topic 4: Comparison Report
           Objective: Upon completion of this topic, you will be able to
           generate the Comparison Report.




          August 2007               VC_APV Menu_IG, v2                 73




Instructor Notes:
Read the slide, and then read the text below.
Text:
Let’s get started.




                                                                            73
                       The Comparison Report
          • The Comparison Report




         August 2007               VC_APV Menu_IG, v2                  74




Instructor Notes:
Read the text below.
Text:
The Comparison Report displays actual minutes of service captured for an APV
procedure for pre-operative and post-operative nursing care for the CPT code(s).
Also displayed are the industry averages for minutes of service for the same CPT
code(s).




                                                                                   74
                                      The IAPV Option
          • The IAPV Option




                       MAPV APV Minutes of Service Enter/Edit
                       WAPV Ambulatory Care Wristband
                       CAPV Ambulatory Care Record Cover Sheet
                       EAPV Ambulatory Care Embossed Card
                       RAPV APV Prior Authorization Report
                       PAPV Enter APV Prior Authorization Number
                       AAPP Ambulatory Procedure Profile Enter/Edit
                       IAPV Industry Average & Actual MOS Comparison Report

              Select Ambulatory Procedure Visits Menu Option: IAPV




         August 2007                                  VC_APV Menu_IG, v2      75




Instructor Notes:
Read the text below.
Text:
You use the IAPV option to generate the Comparison Report. Let’s take a look at
this option in the TDB.




                                                                                   75
                        Demo: Comparison Report
           • Comparison Report




          August 2007                VC_APV Menu_IG, v2                    76




Instructor Notes:
Start at the Ambulatory Procedure Visits Report. Then read the text below.
Text:
Type IAPV and press the <Enter> key. Press the <Enter> key again to accept the
division default. Next, press the <Enter> key twice to accept the start and stop
date. Note that you could change either of those dates if you wanted to. You need
to choose between one or all clinics. Press the <Enter> key to accept the default of
all clinics. The choice is now one or all CPT codes. Press the <Enter> key to
accept the default of all codes. You can now print the report only, the flat file only,
or both. You want to print the report, so press the <Enter> key to accept the print
default. Note the top of the report shows the report title, dates, and sort criteria.
The report shows no data in the TDB. In your live system you would see CPT code
comparisons between your site and industry wide.
That completes the discussion of this course. Let’s now go to a course summary.




                                                                                          76
                          Course Summary
          In this presentation, you have learned how to:
          • Identify and use patient selection, initial MAPV options,
             and enter minutes of service
          • Print patient identifiers
          • Identify and enter prior authorization numbers, generate
             reports, and designate location profiles




          August 2007               VC_APV Menu_IG, v2                  77




Instructor Notes:
Read the slide, and then the text below.
Text:
Now let’s look at the course references.




                                                                             77
                                References
          The content for this TA Report is derived from the
          contractor’s CHCS PAS and MCP analysts, subject matter
          experts (SMEs), and implementation specialists (ISs). The
          SMEs for this project have drawn on professional
          experience in training, implementing, and troubleshooting
          CHCS software for military sites worldwide.




          August 2007               VC_APV Menu_IG, v2                  78




Instructor Notes:
Read the slide; then read the text below.
Text:
Thank you for your attention throughout the course. Now let’s take any final
questions you may have before concluding the class.




                                                                               78
                                 Questions




          August 2007                VC_APV Menu_IG, v2          79




Instructor Notes:
Ask students for any final questions before closing the class.




                                                                      79

				
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