A.01.02_Exhibit_C_–_Example_Specialty_Care_Appointing_Criteria.xlsx

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Attached to
Puget Sound eMSM PAS, Referral Management, and CLR
Solicitation number
W81K04-18-R-0002
Issued by

About this file

This document contains details regarding a federal contract opportunity for patient appointment, referral management, and clear and legible report services. The solicitation seeks these services for TRICARE beneficiaries within the Puget Sound Enhanced Multi-Service Market, including Madigan Army Medical Center, Joint Base Lewis McChord and its clinics, the 62nd Medical Squadron, Naval Hospital Bremerton and its clinics, and Navy Health Clinic Oak Harbor. Interested parties are requested to provide comments and questions on the draft solicitation by September 27, 2018. The final solicitation will be issued on or around September 28, 2018 as a Request for Proposal to be posted on beta.SAM.gov. One contract will be awarded for a four month base period and five one-year option periods from the date of award. The NAICS code is 561110 with a small business size standard of $7.5 million.

Exhibit C

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Gen Info BREMERTON AUDIOLOGY CLINIC APPOINTMENT CRITERIA PSMAC Update: 08/23/2018 Clinic Update: 08/23/2018

Hours of Operation:

Mon-Fri 0800-1600 0126C-AUDIO-CL Location:

2nd Floor

Book in Revenue Cycle

Eligibility

Consult Required: Yes
EXCEPTION: Patients Under Age 3 that have received a
Newborn Hearing Letter from NHB DO NOT Require a Consult and will be booked by the Clinic360-475-4214

AD, Non-AD limited per ORDER review comment

Appointment Types
Appointment TypeDetailsScheduler Note

AUDIO-Specialty-60 Initial Appointment

AUDIO-Procedure-60 Procedure Appointments

Special Instructions for the Patient

Check in at your scheduled appointment time.

AD in uniform of the day

No children without appointments.

Dependent children 18 and under need parental consent for anything other than sexual issues (i.e., STD, pregnancy, contraception), drug/alcohol and mental health.

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

AUDIO-Specialty-60

SPECIALTY APPOINTING GUIDELINES
APPTBRIEF DESCRIPTION
AUDIO-Specialty-60Designated for Initial Visits with an Audiologist

SPECIAL INSTRUCTIONS FOR THE SCHEDULER

May also be used as a "F/U" appt for pts who have been seen within the past 1 yr.

Remember to EXTEND your dates out 180 Days Revenue Cycle Booking

BOOKING PRIORITY
STEPDetailsScheduler Notes
1. ORDER
(Formerly AOP)Book Per Review Comments

If No Appointments Available within 28 Days, Offer to book an appointment Outside of 28 Days Slot Type:

SPEC AUDIO 0126

2. WARM TRANSFER Warm Transfer to Clinic If Warm Transfer is UNSUCCESSFUL, or it is Outside of Clinic Hours go to Step 3 360-475-4214

3. ENTER UAREnter UNMET APPOINTMENT REQUEST
Clinic will contact patient to book appointmentRevCycle 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 AUDIO-Procedure-60

SPECIALTY APPOINTING GUIDELINES
APPTBRIEF DESCRIPTION
AUDIO-Procedure-60Designed for patients who are requiring a medical procedure

SCHEDULER INSTRUCTIONS

Booked only as an Auditory Brainstem Response (ABR).

Appointments are only available on Tuesday mornings.

Remember to EXTEND your dates out 180 Days Revenue Cycle Booking

BOOKING PRIORITY
STEPDetailsScheduler Notes
1. ORDER
(Formerly AOP)Book Per Review Comments

If No Appointments Available within 28 Days, Offer to book an appointment Outside of 28 Days Slot Type:

PROC AUDIO 0126

2. WARM TRANSFER Warm Transfer to Clinic If Warm Transfer is UNSUCCESSFUL, or it is Outside of Clinic Hours go to Step 3 360-475-4214

3. ENTER UAREnter UNMET APPOINTMENT REQUEST
Clinic will contact patient to book appointmentRevCycle 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 Providers

PROVIDERS FOR BREMERTON ENT
Cat.ProviderFieldRestriction
MDNethery, KathrynAudio

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