Working on a procedure request case in Workspace
Summarize
Summary of Working on a Procedure Request Case in Workspace
The Pre-Visit Management application allows patient service representatives to effectively manage procedure request cases and schedule important procedures for patients. The playbook feature enhances visibility into workflows and provides actionable steps to complete tasks efficiently within ServiceNow Workspace.
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Key Features
- Playbook Activation: When activated, the Playbook tab appears for assigned procedure request cases, enabling quick access to necessary workflows.
- Stages in the Playbook: The playbook consists of four key stages:
- Intake: Review initial procedure orders.
- Pre-authorizations: Capture pre-authorization details.
- Schedule procedure: Review appointments for scheduled procedures.
- Resolve and Close: Ensure all activities are completed for case closure.
- Automated Patient Notifications: The workflow sends to-do items for consent and insurance verification to patients, with email notifications to keep them informed.
Key Outcomes
By using the playbook, patient service representatives can efficiently complete pre-visit activities, track patient consent, manage insurance information, and ensure proper pre-authorization. This streamlined process not only enhances productivity but also improves patient experience by ensuring timely communication and completion of necessary pre-visit steps.
Use the playbook available with the Pre-Visit Management application to manage procedure request cases and schedule a high value procedure for patients.
The playbook experience provides fulfillers with visibility into cross-business workflows and the actionable activities used to complete these workflows. When the playbook experience is activated with Workspace in Pre-Visit Management, the Playbook tab appears for a procedure request case. For more information on how to interact with a playbook, see Interact with Playbook.
As a patient service representative with the sn_previsit.patient_service_agent role assigned to you, you can use the playbook to complete all pre-visit activities for a patient. You can access the Playbook tab on your Workspace when a procedure request case is assigned to you. The Pre-Visit Management workflow populates the case data for all launched activities on the Playbook tab. You can select a stage in the playbook to complete the activities associated with the stage.
By default, the following stages are available to you as a patient service representative with the sn_previsit.patient_service_agent role on the Playbook tab of the Procedure request workspace.
| Stage | Description |
|---|---|
Complete the initial procedure order review activities. |
|
Capture pre-authorization details for follow-up and audit purposes. |
|
Review appointments created for the procedure. |
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Wait until all child activities are completed so that the procedure request is automatically closed. |
Completing the initial review activities
In the Intake stage of the playbook, complete the following activities:
- Review order: Review a procedure request order for a patient. When the review order activity is set to complete, the Pre-Visit Management workflow automatically assigns to-dos to the patient and sends an email notification about to-do items to the patient.
- Patient To-dos: Check the status of to-dos items for a procedure request assigned to the patient. By default, the to-do items configured for the patients are to review their insurance information and sign the privacy consent form.
- Review Insurance: Capture or review the insurance information of
the patient. As a patient service representative, you can contact the patient directly to verify the insurance payment information. You can enter or review the insurance payment information from the Review Insurance activity of the playbook for Pre-Visit Management in your Workspace and mark the activity as complete when done. The Verify payment information form also includes the procedure payment type detail. Pre-authorization is only required with the insurance payment type. If the self-pay payment type is selected, the Pre-authorizations stage is automatically removed from the Pre-Visit Management playbook.Note:A patient can also access the to-do list from their patient portal and complete the insurance information verification activity. After the patient completes the to-do item for the insurance payment information, the Review Insurance activity is automatically set to Pending review. As a patient service representative, you can then mark the Review Insurance activity as complete in the playbook.
- Review patient consent: Check the status of completion of the patient consent form assigned to the patient. After the patient completes the to-do item for the consent form, the consent is listed in the activity. As a patient service representative, you can then review the consent and mark the Review patient consent activity to complete in the playbook.
Completing the pre-authorization activities
- Create pre-authorization: Enter the pre-authorization reference number as provided by the insurance company.
- Review pre-authorization: Capture the pre-authorization final status, approval or denial reasons, and other details for audit purposes.
Reviewing appointments for procedures
In the Schedule procedure stage, complete the Review appointments activity.
Only after the booked appointment details are entered by using the Create appointment UI action, the patient service representative can review the appointment details and mark the Review appointments activity of the Schedule procedure stage as complete in the Pre-Visit Management playbook. For more information, see Managing appointment bookings for procedure requests.
Closing the procedure request
The Resolve and Close stage is automatically closed when all the child activities associated with a procedure request case are completed.