Insurance Discovery Workflow.pdf
PDF 102 KB Posted
- Attached to
- R612--Insurance Discovery for the San Francisco Veterans Affairs Health Care System (SFVAHCS)
- Solicitation number
- 36C26125Q0147
About this file
This is a workflow diagram detailing the insurance discovery process for the San Francisco Veterans Affairs Health Care System (SFVAHCS). The diagram outlines the sequential steps taken when a patient is admitted, whether planned or unplanned, to determine and verify insurance coverage.
The workflow begins when a patient is admitted and involves multiple stakeholders including the Clinical Command Center, contractor, and social workers. The contractor must identify findings within 24 hours regarding active coverage, inactive coverage, or eligibility. If active coverage is confirmed, the Clinical Command Center coordinates placement and Member Services enters insurance information. If no active coverage exists, the contractor must sit bedside with the patient to complete an application, which is then submitted to a social worker who submits it on behalf of the patient. The process is designed to ensure proper insurance verification and application assistance for veterans receiving care at SFVAHCS.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| WD 2015-5637 Rev 27 dated 7-22-2024.pdf | ||
| 36C26125Q0147.docx | DOCX document | |
| SOP Insurance Discovery.docx | DOCX document |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
START
PATIENT ADMITTED
PLANNED/
UNPLANNED
CLINICAL
COMMAND CENTER
CONTACTS
CONTRACTOR W/
PATIENT INFO
CONTRACTOR
IDENTIFIES
FINDINGS WITHIN
24 HOURS
1. ACTIVE
2. INACTIVE
3. ELIGBILITY
CONTRACTOR
SENDS FINDINGS TO
CLINICAL
COMMAND &
MEMBER SERVICES
CLINICAL
COMMAND CENTER
COORDINATES
PLACEMENT
MEMBER SERVICES
ENTERS INSURANCE
INFORMATION
ACTIVE
COVERAGE?
CONTRACTOR SITS
BEDSIDE W/PATIENT
TO COMPLETE
APPLICATION
END
NO
CONTRACTOR
SUBMITS
APPLICATION TO
SOCIAL WORKER
YES
Insurance Discovery Contract Workflow
SOCIAL WORKER
SUBMITS
APPLICATION ON
BEHALF OF PATIENT
| Insurance Discovery Workflow.vsdx |
| Page-1 |
File details come from the government source that posted it. Updated .