A.01.02_Exhibit_B_–_Example_Primary_Care_Appointing_Criteria.xlsx

Gen Info MAMC INTERNAL MEDICINE CLINIC APPOINTMENT CRITERIA PSMAC Update: 07/13/2018 Clinic Update: 06/26/2018

Hours of Operation: M-F 0730-1630 Except Federal Holidays 0125C-IM1-ASPEN (Primary Care) 0125C-IM1-MAPLE (Primary Care) 0125C-IM1-WILLOW (Primary Care) 0125C-IM2-EMPRESS (Primary Care) 0125C-IM2-EVERGREEN (Primary Care) 0125C-IM2-MAGNOLIA (Primary Care) Location:

Ground Floor - Medical Mall Clinic will be closed on the 3rd Friday of each month for staff training from 1430 - 1600, and quarterly Jan/Apr/Jul/Oct from 1330-1600 0125C-IM1-NOPCP (Behavioral Health, Clinical Pharmacist Provider Leaf, Acute & Minor Illness Clinic)

0125C-IM2-NOPCP (Behavioral Health Provider Pritchard, Clinical Pharmacist Providers Booth & Foster, Acute & Minor Illness Clinic)

0125C-IMS-CL (Specialty Care) - CLINIC BOOK ONLY

Book in Revenue Cycle Clinic Phone Number:

253-968-2462

ELIGIBILITY

Patients enrolled to IMC for their Primary Care

May be booked SAME DAY ONLY for Same Day and Future Appointment Types

Student status, Travel status, Transitioning enrollment between MTF's, Transferring enrollment between regional support contractors, or Terminal/Appellate Leave status

BOTD will also be given to Tricare for Life patients Benefit of the Doubt (BOTD)

MED-Same Day-30 Appointment requests within 24 Hours

MED-Future-30 Appointment requests beyond 24 Hours

WWE / PAP APPOINTMENTS

FM-Future-20 PAP APPOINTMENTS

MED-Virtual-10 House Call Appointments

Special Instructions for the Scheduler: DO NOT BOOK

DO NOT BOOK: Pharmacist Appointments These appointments are waitlisted/auto booked or booked by clinic.

Exception: If patient requests to cancel appt, you may do so.

Special Instructions for the Scheduler: REFER to CLINIC

Special Instructions for the Scheduler: WALK IN ITEMS

Blood Pressure Checks

Pregnancy Test (Patients will receive results via phone within 2 business days)

Injections: Depo-Provera, B-12, and Testosterone Injections

Immunizations: i.e., Flu (in season), Pneumovax, Zoster, Tetanus-Diphtheria-Pertussis

Special Instructions for the Scheduler: Additional Information

Patients who require an appointment with the M IMC Consult clinic or who wish to re-schedule their appointment will be advised to call the consult coordinator. Refer to Consult Coordinator:

253-968-3726

PRE-OP APPOINTMENTS

Patients who request to schedule a Pre-Operative evaluation:

Please advise to call the consult coordinator.

Pre-Operative evaluations are CLINIC BOOK ONLY.

Pregnant Patients will be seen in the OB/GYN Clinic from the time of their OB Intake Appointment until 8 weeks post-partum.

Once past 8 weeks post-partum, book in IMC per these criteria.

Exception: Active Duty patients needing a PHA, refer patient to the clinic for scheduling 253-968-2462. Madigan OB- Obstetrics

Flu Vaccination Information:

Patients may call 253-968-4744 for Madigan's Flu Vaccine availability

AD PHAs (Periodic Health Assessment) REFER TO CLINIC 253-968-2462

Active Duty Requesting CHAPTER or ETS Physicals REFER TO CLINIC 253-968-2462

Active Duty Green to Gold, Retirement/VA Retirement, and Specialty Physicals are to be booked at Physical Exams. Madigan Physical Exams

MUST ANNOTATE "PSMAC / INITIALS / PCM NAME"

BEFORE REASON FOR APPOINTMENT

OVERSEAS/EFMP

Patients requesting an Overseas physical:

Ask the patient if they have spoken to EFMP.

Patients requesting EFMP enrollment or paperwork update:

Book with PCM.

DO NOT redirect to EFMP.

SPECIAL INSTRUCTIONS FOR THE PATIENT

Due to Madigan's parking limitations, it is strongly encouraged that you arrive early.

Childcare is not available in the clinic.

Bring a listing of all medications (to include over-the-counter medications and supplements.)

Patients with diabetic meters should bring them.

Check in Location will be "Appointment Check-in Window" for patients that have an appointment

Check in location will be Walk-In Services Window for patients that do NOT have an appointment, but are coming to the clinic for walk-in items such as:

Blood pressure checks Pregnancy tests Injections/immunizations

To offer availability to other patients, please call us back at the appointment center if you need to cancel or reschedule.

http://sp.humgov.com/sites/csc/ps/JobAids/CHCS%20Job%20Aids/BOTD,%20Non-Enrollee%20and%20Enrolled%20Elsewhere%20Booking.docxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/Madigan/Madigan%20Physical%20Exams.xlsxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/Madigan/Madigan%20Hearing%20Program.xlsxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/Madigan/Madigan%20Preventive%20Medicine.xlsxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/General/Benefit%20of%20the%20Doubt%20(BOTD).docxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/Madigan/Madigan%20OB-%20Obstetrics.xlsx MED-Same Day-30

24HR IM 0125

SPECIAL INSTRUCTIONS FOR THE SCHEDULER

MUST ANNOTATE "PSMAC / INITIALS / PCM NAME"

BEFORE REASON FOR APPOINTMENT

24HR IM 0125

2. FUTURE WITH PCM Book open FUTURE appointment with PCM within 24 HOURS If no FUTURE is available with PCM. Move to Step 3.

3. STAFF ADVISOR Is PCM a Resident?

Yes - Book SAME DAY appointment with Resident's assigned Staff Advisor listed on Provider Listing.

If nothing available with assigned Staff Advisor, Move to Step 4.

No - Move to Step 4.

4. TEAM Book SAME DAY appointment with any Provider (STAFF or RESIDENT) on the SAME clinic team If nothing available on the same clinic team, Move to Step 5.

5. CLINIC Book SAME DAY appointment with any IMC Provider (STAFF or RESIDENT) on ANY clinic team.

If nothing available, Move to Step 6.

6. 0125C-IM1-NOPCP Book MED-Same Day-20 with Acute & Minor Illness Clinic Provider If no appointment available, Move to Step 7.

DO NOT BOOK WITH: Clinical Pharmacist Provider Leaf

7. 0125C-IM2-NOPCP Book MED-Same Day-20 with Acute & Minor Illness Clinic Provider If no appointment available, Move to Step 8.

DO NOT BOOK WITH: Behavioral Health Provider Pritchard, Clinical Pharmacist Providers Booth & Foster

Network Primary Care Clinic Information is available at www.tricare-west.com or (844) 866-9378

*You can call the TRICARE Nurse Advice Line and the Nurse will triage your healthcare needs.

Nurse Advice Line 1-800-874-2273 Option 1

Patients with the following symptoms/concerns Are not eligible for UCC (1-14 Below)

(Patients whose Prime enrollment is not yet effective)

9. ENTER UAR Enter UNMET APPOINTMENT REQUEST Select 0125 INTERNAL MEDICINE APPOINTMENT REQUEST Standby List Clinic will contact patient to book appointment RevCycle UAR JOB AID file://///sp.humgov.com/DavWWWRoot/sites/csc/ps/Shared%20Documents/General/ER%20List.dochttp://sp.humgov.com/sites/csc/ps/JobAids/MHS%20Genesis/MHS_Genesis-RevCycle_UnmetAppointmentRequests.docx../../../mrl0675/AppData/Local/Microsoft/Windows/Temporary%20Internet%20Files/NETWORK%20UCC%20CLINICS.xlsx MED-Future-30

FTR IM 0125

SPECIAL INSTRUCTIONS FOR THE SCHEDULER

MUST ANNOTATE "PSMAC / INITIALS / PCM NAME"

BEFORE REASON FOR APPOINTMENT

Remember to EXTEND your dates out 180 Days Revenue Cycle Booking

1. PCM Book MED-Future-30 with Patient's Primary Care Provider If no FUTURE appointment available which meets patients needs/schedule move to step 2 Slot Type:

FTR IM 0125

2. STAFF ADVISOR Is PCM a Resident?

Yes - Book FUTURE appointment with Resident's assigned Staff Advisor listed on Provider Listing.

If nothing available with assigned Staff Advisor which meets patients needs/schedule, Move to Step 3.

No - Move to step 3

3. STAFF / TEAM Book FUTURE appointment with any STAFF Provider on the SAME clinic team If nothing available on the same clinic team, Move to Step 4.

4. STAFF / CLINIC Book FUTURE appointment with any STAFF Provider in the CLINIC If nothing available, Move to Step 5.

5. ENTER UAR Enter UNMET APPOINTMENT REQUEST

Clinic will contact patient to book appointment RevCycle UAR JOB AID http://sp.humgov.com/sites/csc/ps/JobAids/MHS%20Genesis/MHS_Genesis-Revenue%20Cycle%20Booking_JobAid.docxhttp://sp.humgov.com/sites/csc/ps/JobAids/MHS%20Genesis/MHS_Genesis-RevCycle_UnmetAppointmentRequests.docx FTR - Detail Code PAP FE

SCHEDULER INSTRUCTIONS

FTR with detail code PAP FE appointment type can be booked outside of 28-day access to care guidelines

Use this appointment type for ONLY Annual Pap, Annual Well-Woman, Routine Breast Exams, Acute or Routine GYN concerns, Birth Control (except IUD) Counseling.

Pregnant (OB) patients are normally seen in the OB clinic for all health concerns during pregnancy from initial OB intake appointment until 8-week post-partum check.

Exception: Active Duty patients needing a PHA, refer patient to the clinic for scheduling 253-968-2462.

All questions or concerns regarding IUD's should be referred to GYN Clinic (IMC does not place/remove/evaluate IUD's)

within timeframe requested by patient.

If a FTR - Detail Code PAP FE is not available within timeframe requested, Move to Step 2.

If patient refuses available appointment within timeframe, send UAR All Appointments Refused. 30 Min Duration ONLY DO NOT BOOK 15 Min Slots

Type ONLY team's short name: "___"

AMHI01C"WILLOW" Access schedule through Self Referral Booking.

If no appointments are available within timeframe requested.

No Appointments Available / No Appointments Available to Contractor Notify patient that the Clinic will call the patient within 2 business hours (M-F 0730-1530) to arrange an appointment as soon as possible.

UAR's after 1530 will be contacted within 2 hours of next business day file://///sp.humgov.com/DavWWWRoot/sites/csc/ps/JobAids/CHCS%20Job%20Aids/Self-Referral%20Booking.docxhttp://sp.humgov.com/sites/csc/ps/Shared%20Documents/Madigan/Madigan%20GYN%20-%20Gynecology.xlsx

WWE PAP

FTR IM PAP FE 0125

SPECIAL INSTRUCTIONS FOR THE SCHEDULER

MUST ANNOTATE "PSMAC / INITIALS / PCM NAME"

BEFORE REASON FOR APPOINTMENT

Remember to EXTEND your dates out 180 Days Revenue Cycle Booking

1. 0125C-IM1-NOPCP Book MED-Future-30 with Provider Covington If no appointments available which meets patients needs/schedule move to step 2 Slot Type:

FTR IM PAP FE 0125

2. ENTER UAR Enter UNMET APPOINTMENT REQUEST

Clinic will contact patient to book appointment RevCycle UAR JOB AID http://sp.humgov.com/sites/csc/ps/JobAids/MHS%20Genesis/MHS_Genesis-Revenue%20Cycle%20Booking_JobAid.docxhttp://sp.humgov.com/sites/csc/ps/JobAids/MHS%20Genesis/MHS_Genesis-RevCycle_UnmetAppointmentRequests.docx MED-Virtual-10

TELEPHONE appointments (within the patient's requested timeframe).

May be used for any concern. Slot Type:

VIRT IM 0125

QUESTIONS TO ASK THE PATIENT BEFORE SCHEDULING TELEPHONE APPOINTMENT

Would you like a consult via telephone or would you prefer an in office appointment?

If patient accepts a consult by telephone appointment - go to Step 1 below.

If patient prefers an in office appointment - see MED-Future-30 tab.

SPECIAL INSTRUCTIONS FOR THE SCHEDULER

MED-Virtual-10 with Slot Type: VIRT IM 0125 will ONLY be used for appointing Primary Care TELEPHONE appointments.

TRAC to update BEST contact number within the 30 minutes of House Call appointment selected in Comments

Reason for Appointment Annotate:

Phone number /Reason for Call Back

VIRT IM 0125

2. STAFF ADVISOR Is PCM a Resident?

Yes - Book MED-Virtual-10 appointment with Resident's assigned Staff Advisor listed on Provider Listing.

If nothing available with assigned Staff Advisor, Move to Step 3.

No - Move to Step 3.

3. STAFF / TEAM Book MED-Virtual-10 appointment with any STAFF Provider on the SAME clinic team If no MED-Virtual-10 appointment available which meets patients needs/schedule, Move to Step 4.

4. STAFF / CLINIC Book MED-Virtual-10 appointment with any STAFF Provider in the CLINIC If no MED-Virtual-10 appointment available which meets patients needs/schedule, Move to Step 5.

5. MED-Future-30 Go to Step 1 of the MED-Future-30 Tab MED-Future-30

SPECIAL INSTRUCTIONS FOR THE PATIENT

Your provider will be in contact with you via phone during this 30 minute window.

Patient WILL NOT report to the clinic for FTR Detail Code: HC appointments.

Behavioral Health

SCHEDULER INSTRUCTIONS

Schedule in M IMC clinic ONLY

If accessing schedule through MEPRS: BAAA, use Option 1 If accessing schedule through typing M IMC, use Option 1

**No referrals required for New or Follow Up Patients.

Please use Self-Referral Booking for all IBHC appointments.**

Patients with acute or urgent Behavioral Health concerns (thoughts of harming self or others or concern for personal safety) may be referred directly to the clinic on a walk-in basis during business hours M-F 0730-1630, except holidays, or to the ER after business hours.

BOOKING PRIORITY

Mitrovich for Behavioral Health, or Social Work Services. OR per AOP review.

If no appointments are available within the requested timeframe, Move to Step 2.

No Appointments Available / No Appointments Available to Contractor.

Notify patient that the Clinic will call the patient within 2 business hours (M-F 0730-1530) to arrange an appointment as soon as possible.

UAR's after 1530 will be contacted within 2 hours of next business day

Provider Listing *Only Book Resident Provider appointments with their own assigned patients, unless the appointment slot remains unused/unbooked within 24 hours of the appointment.

In that case the appointment may be booked with other patients per these IMC Appointing Guidelines.

Exception: Resident Provider Virtual appointments are for their own assigned patients ONLY.

** Provider listing is current as of the date of the Appointing Guidelines.

Any unlisted/new providers may be booked per IMC Appointing Guidelines as STAFF provider.” **

South Sound Walk-In

SOUTH SOUND WALK-IN PATIENTS

Patient is to arrive During Clinic Walk-in Hours 0900-1500

Inform Patient of New Clinic location Located in the Memorial Plaza 500 Lilly Rd NE, Suite 120 Olympia, WA 98506

All patients 10 years and older MUST have valid ID Card.

Children 18 and under Must be accompanied with a parent or guardian (with medical power of attorney.) “Exception- Appointment requests related to pregnancy, birth control, STD, abortion, mental health or substance abuse.