Attachment K Consult Tracking Log.xlsx

XLSX spreadsheet 223 KB Posted Sep 29, 2022

Attached to: Comprehensive Medical Services
Solicitation number: S000000125
Issued by: Arkansas

About this file

Written by GovTribe AI · Jul 31, 2024

The document provided is a detailed Excel spreadsheet titled "Attachment K Consult Tracking Log" related to a Comprehensive Medical Services contract opportunity for the state of Arkansas. The spreadsheet contains instructions for tracking and managing medical consultation requests, including fields for date of request, patient information, request type, specialty clinic, appointment details, reviewer decision, and notes. The contract opportunity is for a range of medical services and procedures, with specific clinic types and specialties listed. The contract term is not specified, but the document indicates the need to "carry over" open consults to the next month's tracking log.

The pricing terms, set-asides, incumbent providers, funding sources, and award details are not included in the document provided. However, the comprehensive nature of the medical services requested suggests this is a significant contract opportunity for healthcare providers in the state of Arkansas.

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Sheet1 Attachment K

	Month/Year	CONSULT TRACKING LOG
INSTRUCTIONS:

Complete this section from eOMIS Consultation Request Search Results screen OCSS011B

			INSTRUCTIONS:
Complete this section from eOMIS Consultation Request screen OCSS011C				INSTRUCTIONS:
Complete this column when appt is scheduled	INSTRUCTIONS: Complete this column after appointment is held	READ THESE INSTRUCTIONS!!!!

Sort by this column at the end of the month to group consults together that need to be carried over to next month's log for continued tracking. If no information is entered for the patient in this column, you need to continue tracking the consult. Copy/ paste the open consults into next month's tracking log. Delete copied information from this month's log after copying into next month. DO NOT USE "CUT" COMMAND!! USE "COPY/PASTE" to move to next month then use "DELETE" to remove patient data from this month so patients are not counted twice on the Totals Tab.

Date Consult Written (PINK= not reviewed within 5 business days

RED= no review date entered in Column K)

First Name

Last Name

ADC #

Request Type

Specialty Clinic Type

Procedure requested, diagnosis, or reason for referral

Referral Ordered By

Priority: Urgent / Routine / Retro

Fine abatement: Reason why fine should not be assessed

Date RMD-RDD review completed (RED=more than 5 business days to review)

Reviewer's Decision

Reasons review took > 5 days (letters turn red in Column K)

Expected appointment date

Actual Date of Service

Location of services

Transport

General comments, reasons for appointment cancellations, date report received, date eOMIS updated to indicate the provider report was reviewed, etc. Information to help others understand the status and details of this consult.

Enter date consult completed and closed, transfers, or any reason pt should NOT be carried over to next month's log

Misc Site Specific Information

											DATA FOR DROPDOWN LISTS
ADC #	Last Name	First Name	Clinic Type	Date Reviewed	Date of Appt	Days between	Requirement	LATE?	Fine abatement: Reason why fine should not be assessed	Notes by RVP	Clinic Type	Requirement	URGENT?	SPECIALTY CLINIC TYPE	Locations	Sites	Request Status	Transportation type	Reviewer's Decision	Priority	Fine abatement
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Audiology	60		Audiology	ADC / ACC Site	Benton	ATP Accepted	Ambulance	Alt tmt recommended	Retro	1 mo follow-up
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Audiometry	60		Audiometry	Affinity Healthcare for Women	CAC	ATP Not Accepted	Air Ambulance	Criteria met	Routine	3 mo follow-up
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			CVI	90		CVI	Affordable Hearing Solutions	Cummins	ATP Recommended	Security Van	Criteria not met	Urgent	6 mo follow-up
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Cardiology	60		Cardiology	AR Cancer Inst	Delta	Appt Held (Consult Occurred)	Other	Medical necessity met		1 yr follow-up
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			CardioEval	60		CardioEval	AR Children's Hospital	DGU	Authorized		Medical/surgical indicators not met		Consult cancelled
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			CardioProcedure	60		CardioProcedure	AR Diagnostic Ctr	EARU	Cancelled Appt		Need more information		Rescheduled
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Cardiovascular Surg	60		Cardiovascular Surg	AR Foot & Ankle Clinic	ECCC	Consult Cancelled		UM Not Required		Follow-up per orders
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Chemotherapy	60		Chemotherapy	AR Heart Hospital	Ester	Consult Completed- ATP
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Chest Clinic	60		Chest Clinic	AR Nephrology Services	Grimes	Consult Completed-Results not received
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Dermatology	90		Dermatology	AR Orthopaedic Surgery & Wellness Ctr	Hawkins	Consult Completed-Results received
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			DermatologyEval	90		DermatologyEval	AR Orthotics & Prosthetics	McP	Criteria Met
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			DermatologyProc	90		DermatologyProc	AR Otolaryngology	MCWR	Criteria Not Met
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			DiagRad	60		DiagRad	AR Surgery & Endoscopy	MSU	Med Nec Met
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Dialysis	60		Dialysis	Arnold Knee Ortho	NCU	Med/Surg Indicators Not Met
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Dysplasia Clinic	60		Dysplasia Clinic	Austin Reeves Podiatry	NEC	More Info Provided
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			ENT	60		ENT	Baptist Eye Center	NWC	Need More Info
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			ENT-Eval	60		ENT-Eval	Baptist Health	Omega	Re-scheduled Appt
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Emergency Room (Ambulance)	ERROR:#N/A		Emergency Room (Ambulance)	Batesville Cardiology	ORCU	Ref RMD to review
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Emergency Room (Non-Ambulance)	ERROR:#N/A		Emergency Room (Non-Ambulance)	Batesville Neurology	PBU	Scheduled Appt
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			EndoClinic	60		EndoClinic	Batesville Oncology	RLW	UM Not Required
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Endocrinology	60		Endocrinology	Batesville Surgery & CT Imaging	SWC
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Follow up	60		Follow up	Baxter Reg Bone & Joint Assoc	TRCC
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			FootClinic	60		FootClinic	Baxter Reg Med Ctr	Tucker
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GU	60		GU	Benton Neuro Care	Varner
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Gastroenterology	60		Gastroenterology	Blood & Cancer Center	WRV
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GenSurgery	60		GenSurgery	Bone & Joint Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GenSurgEval	60		GenSurgEval	The Breast Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GenSurgProc	60		GenSurgProc	Breast Center of NW Ark
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GynEval	60		GynEval	Brian Buell Eye Care
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			GynProcedure	60		GynProcedure	Caridac & Vasc Ctr of AR
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Hand Surg	60		Hand Surg	Cardiovascular Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Hem/Onc	60		Hem/Onc	CARTI
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-CT	60		Imaging-CT	Cashman-Fincher ENT
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-MRI	60		Imaging-MRI	Collom & Carney Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-Nuclear	60		Imaging-Nuclear	Christus Surgery Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-Other	60		Imaging-Other	Cristus St. Michaels
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-PET	60		Imaging-PET	Creekside Women's Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-Ultrasound	60		Imaging-Ultrasound	Delta Memorial Hosp
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Imaging-X-ray	60		Imaging-X-ray	Dermatology Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			InfectDisSpec	90		InfectDisSpec	Dunn Eye Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			InfectiousDisNOS	90		InfectiousDisNOS	Ear, Nose Throat Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			InternalMed/Gastro	60		InternalMed/Gastro	ENT Group-Texarkana
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			InternalMed	60		InternalMed	Family Eye Care (Texarkana)
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Mammogram	60		Mammogram	Fant Eye Care
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Minor Surgery	60		Minor Surgery	Foot & Ankle Ctr of LR
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Nephrology	60		Nephrology	Forrest City Med Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			NeuroSurg	60		NeuroSurg	Gastro Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Neurology	60		Neurology	Hall Dermatology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OB/Gyn	60		OB/Gyn	Hall's Eye Care
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OB/Gyn Telemedicine	60		OB/Gyn Telemedicine	Harris Hospital
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			ObstetricsEval	60		ObstetricsEval	HealthSouth Rehab
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			ObstetricsProc	60		ObstetricsProc	Her Health
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OccupTherapy	60		OccupTherapy	Hot Springs Cardiology Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OncologyEval	30		OncologyEval	Hot Spring Co. Medical Cntr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OncologyProc	30		OncologyProc	Hot Springs Diagnostic Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Ophthalmology	60		Ophthalmology	Hull Dermatology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OphthalmologyEval	60		OphthalmologyEval	Ivy Womens Cancer Care
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OphthalmologyProc	60		OphthalmologyProc	Izard Co Med Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Optometry	60		Optometry	Jefferson Comp Care
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OralSurgery	60		OralSurgery	Jones Eye Institute
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OralSurgEval	60		OralSurgEval	JRMC
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OralSurgProc	60		OralSurgProc	Keller Eye Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OrthopedicEval	30		OrthopedicEval	Kidney Care Cntr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			OrthopedicProc	30		OrthopedicProc	Lifetime Vision Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Orthopedics	30		Orthopedics	LR Cardiology Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Orthotics	60		Orthotics	LR Diagnostic Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Ortho/Prosth	60		Ortho/Prosth	LR Surgery Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Other	60		Other	McFarland Eye Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Pap smears	60		Pap smears	McGehee Desha Hospital
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Pain Clinic	60		Pain Clinic	McPherson Unit
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Phys Med Rehab	60		Phys Med Rehab	Medical Emergency Trauma Assoc.
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			PhysTherapy	60		PhysTherapy	Medlock Eye Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			PlasticSurg	60		PlasticSurg	Mercy Endocrinology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Plastics	60		Plastics	Natl. Park Med Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Podiatry	60		Podiatry	Natl Park Ortho
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			PulmonaryEval	60		PulmonaryEval	Neurortho Rehab Services
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			PulmonaryProc	60		PulmonaryProc	New Hope Prosth & Orthotics
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Pulmonology	60		Pulmonology	No AR Radiology Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			RadiationOncol	60		RadiationOncol	Northside Open MRI
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			RadiationTherapy	60		RadiationTherapy	NWAR Gastro Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Radiology	60		Radiology	NW AR Orthopedic & Spine Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Retinal Specialist	60		Retinal Specialist	NW Med Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Rheumatology	60		Rheumatology	OralSurgery Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			STAT Lab	60		STAT Lab	ORCU Hospital
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			SleepStudy	60		SleepStudy	Ortega Gastro Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			SpeechTherapy	60		SpeechTherapy	Ortho. of Hot Springs
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			SpinalClinic	90		SpinalClinic	Ortho Spec of Texark
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Telemed	60		Telemed	Other
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Urology	60		Urology	Outpatient Surgery Cntr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			UrologyEval	60		UrologyEval	Ozark Ortho
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			UrologyProc	60		UrologyProc	Ozark Surg Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Vascular Lab	60		Vascular Lab	Ozark Surgical Group
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A			Wound	60		Wound	Ozark Urology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Physician's Office
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Physician's Sleep Institute
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Premier Imaging
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Retina Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Saline Audiology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Saline Memorial
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Saline Wound Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Searcy Med Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Searcy West
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							SEARK Radiology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Sneed Eye Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Snell Prosthetic & Orthotic Lab
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							So AR Hematology & Oncology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							So AR Nephrology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							So AR Orthopedic Cntr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							SW Pulmonology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							St. Vincent Infirmary
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							St. Vincent North
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Surg Specialist of HS
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Thomas Neurology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Tilley Diagnostic Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Twin Lakes Med Specialists
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							UAMS
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Unity HealthCare Podiatry
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Urology Assoc
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							VA Medical Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Wadley Regional
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Walker Heart Inst
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Washington Reg Med Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Westside MRI
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							White Co Med Ctr
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							White River Cardiology
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							White River Medical Center
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							White River Medical Clinic
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A							Willow Creek Women's Hospital
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A
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0	0	0	0	12/31/99		0	ERROR:#N/A	ERROR:#N/A

File details come from the government source that posted it. Updated Jul 31, 2024.