Client Medical Screens

The Client medical screens are utilized to keep medical history, authorize Special Authorization Medical Numbers, keep track of medical appointments and document Health Check (EPSDT) screening of clients. As this information is contained in several reports generated by the system and used by workers, it is imperative these screens be maintained and contain accurate information. Policy also dictates all Foster Care children have an appointment scheduled for a Health Check (EPSDT) screening within 30 days of placement and this is documented in the Client Medical Screens section. The information entered on the medical screens populates several reports which can be generated by the system.

In all the screens there are required fields and mandatory fields. The required fields are blue and are needed for IV-E, AFCARS and NCANDS reporting. For children in custody and placement, be sure and complete the required fields.

There are eleven screens in the Client medical Screens section. Not all screens are used for all the different types of cases in the system and the worker needs to keep this in mind. For example, the Hartley Eligibility screen is not used for a foster child and the Health Check screen is not used for an adult services client.

Workload-Case-Client-Medical

Screen Description

Medical Background This tabbed screen captures the client=s medically diagnosed conditions as well as any medical conditions observed by the worker.

Health Check This tabbed screen captures the Health Check (EPSDT) history of a foster care child and is used by both the case worker and the Sanders Field Liaison (SFL).

Medical Appointment This screen maintains a history of a client=s medical appointments and reflects the outcomes of medical visits and if further appointments are scheduled.

Psychological Evaluations This tabbed screen maintains a history of any psychological evaluations performed on a client and the subsequent results and findings.

Medications This screen maintains a record of all the medications a client is prescribed along with the dosage.

Shots This screen maintains the immunization record of a client.

Disabilities This screen is used to document all the medically diagnosed conditions of a client. This screen is also used to document instances of a parent not obtaining medical treatment for a disabled child.

Providers This screen is used to authorize payment of medical services when a client has no medical coverage to pay for a medical service.

Gatekeeper This screen is used to keep a history of medical gatekeepers assigned to clients who are in psychiatric facilities.

Insurance This screen is used to reflect the medical insurances with whom a client may have coverage.

Hartley Eligibility This screen captures a client=s eligibility information for the Hartley deduction on payment of care to an Adult Services care provider.

Workload-Case-Client-Medical-Medical Background

The Medical Background screen is in the tabbed format. It is recommended both tabs be completed before Adding the screen. The worker builds an inset grid to maintain a history of the client=s medical diagnosis by entering all pertinent information on the lower part of the screen.

To document the medical condition has been verified in writing, the worker enters on the Document Tracking screen the receipt particulars of the documentation. The New Doc command button allows access to the Document Tracking screen without leaving the Medical Screens section.

Medical Background-Medical Background tab

The Creation Date is system populated dependant on the time and day the worker entering the information is logged onto the system. Using a select box, the worker chooses the client=s Clinically Diagnosed medical Conditions. In the text fields the worker records observed physical Conditions, Developmental History and any Dental Problems.

Medical Background-Special Conditions tab

Using text fields, the worker records Special Conditions, Drug/Alcohol Problems, Allergies and Special Diets/Nutritional Status of the client.

After the tabs have been completed, click on the Add command button to add the screen. When finished, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Medical Care

This area allows the worker to document Health Checks, Medical Appointments, Psychological Evaluations, Medications and Shots.

Health Check

This screen is completed only for children in placement.

The Health Check screen consist of two tabs and an inset grid that allows a history of appointments to be documented. You will have two steps, documenting that the appointment was scheduled and after the appointment has occurred documenting what took place.

Within 5 days of placement, a referral to a Health Check provider must be made to schedule an appointment for each child. The Office of Maternal and Child Health receives a daily placement report of all children that have been placed that day. They will schedule Health Check appointments and document these in FACTS. When they receive back the HCFA1500 billing form they document that the child kept or did not keep the appointment and the results.

You should check to insure information has been entered prior to printing Child, Youth and Family Case Plan or creation of a stateward. You can enter information yourself if you choose to.

Health Check-Health Check Tab

1. Enter the physician information in the appropriate fields, if the physician is in FACTS as a provider use the FIND button to locate the provider, if not just type the information in the fields. Indicate the type of screening and the date of the appointment. If child=s birth date is not in FACTS then periodicity will not appear. ADD the screen - this will save information to FACTS.

2. To document that an appointment was kept, select the appointment kept check box and in comments document what occurred during visit. Go to the NEW DOC button- this will take you to the document tracking screen where you need to document the HCFA 1500 billing form and it=s hard copy location. From document category picklist select Foster Care, then from the next picklist find HCFA 1500. When Health Check tab is completed go to second tab - Referrals.

Health Check-Referrals tab

Using the Select button, the Health Check Referrals response window allows you to document all the referrals which resulted from the screening. An inset grid maintains a history of the appointments and results of the appointments.

Choose the type of referral from the picklist.
You can populate the Physician information by either using the Find command button or by typing the information in the appropriate fields.
Enter the date of the Scheduled appointment and later is the appointment was kept and the date of the next appointment, if needed.
Record the Purpose to Referral and the Results of Referral in the text fields.
For multiple entries, click on the New command button and repeat the above steps. For single entry, click on the OK command button.

After all information has been entered on the tabs, click on the Add command button to add the screen. To document another screening, click on the Clear command button and repeat the screen instructions. When finished, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Medical Care-Medical Appointment

This screen is used to document medical appointments scheduled for a client. An inset grid maintains a history of the appointments. Any written documentation pertaining to the appointment is entered on the Document Tracking screen which can be accessed by clicking on the New Doc command button.

Choose the Appointment Type from the picklist. You can populate the Physician Information section either by utilizing the Find command button or by typing the pertinent information in the related fields. The Appointment Date is entered and later you can enter if the appointment was kept. If the appointment is a result of a Health Check, the check box is clicked on. The next appointment, if needed, is entered in the Next Appt Due field. Record the Purpose of Appointment and Results of Appointment in the text fields.

After all information has been entered, click on the Add command button. If additional appointments need to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Psychological Evaluations

This tabbed screen allows you to document evaluations completed on a client. The inset grid maintains a history fo evaluations and the corresponding diagnosed disorder. Any written documentation pertaining to the evaluation is entered on the Document Tracking screen which can be accessed by clicking on the New Doc command button.

Psychological Evaluations-Appointment tab

You can populate the Provider Information section either by utilizing the Find command button or by typing the pertinent information in the related fields. In the appointment section, the Evaluation Date is entered and if the appointment is the result of a Health Check, the box is checked. After the appointment is kept, if another appointment is scheduled, the date can be entered in the Next Appt. Due field. The Reason for Evaluation is entered in the text field. Type in the name of the Evaluator.

Psychological Evaluations-Diagnosis tab

Using action buttons, reflect the client=s Full Scale IQ, Verbal and Performance ratings. Using picklists, reflect the client=s Diagnosed Disorders for Axis I, II, III, IV and V. Diagnosis Details are entered in the text field. A select box is used to reflect the Tests Administered.

Psychological Evaluations-Results and Recommendations tab

Enter The Results and Recommendations obtained from the evaluation in the text boxes.

After all information has been entered on the tabs, click on the Add command button to add the screen. If additional evaluations need to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Medications

This screen maintains a list and a history of all the medications a client is prescribed. An inset grid maintains a history of the client=s medications as they are prescribed. It is extremely important to keep this information updated if the medications change.

In the Medication Information section, radio buttons are used to reflect the Medical Need and the Type of medication. Enter the name of the medication, the Dosage, the Date of the Prescription, the End Date of the medication and the Reason for the Medication/medical Supplies. Utilizing the Find command button, the Prescribing Physician Information section is completed. Enter the name and phone number of the Pharmacy and any comments in the Pharmacy section.

After all information has been entered, click on the Add command button. If additional medications need to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Shots

The Immunizations screen is used to keep a history of a client=s immunizations or a shot record. An inset grid maintains the immunization history of the client.

In the Immunization Information section, use a picklist to reflect the Type of immunization. A radio button is used to reflect if the shot is current or overdue. The Date of the shot and the Date Due for Next shot is entered. The name, address and phone number of the Doctor/Clinic is entered.

After all information is entered, click on the Add command button to add the screen. If additional immunization information needs to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Disabilities

The Client Disabilities screen is in the tabbed format. It is recommended all three tabs be completed before Adding the screen. An inset grid maintains a history of the type of client=s disabilities. This screen captures any disabilities the client may have which were ascertained in the information gathering process. This information includes any physical, mental, emotional, or learning disabilities that pertain to the client. This screen also captures information regarding a parent not obtaining medical care for a child.

Client Disabilities-Disabilities tab

The creation date is system populated dependant on the day the information is being entered into the system The actual date the disabilities began is entered in the Begin Date field. The date the disability is no longer applicable is entered in the End Date field. Using select boxes, the worker reflect the severity of the disability/disabilities. The select boxes are interactive and a value already chosen in one of the boxes will not appear in the other boxes. How the disability types were verified is reflected by using a select box.

Client Disabilities-Disability Details tab

Using text fields, enter the Primary and Secondary Disability information. In the Diagnosed as section, reflect by checking the appropriate check box. In the Incapacity section reflect if the client is incapacitated to the point they are unable to care for children or other dependents by clicking on the check box.

Client Disabilities-Parent not obtaining medical care tab

If the case is concerning a parent not obtaining medical care for a disabled child, check the box and enter the Medical Consultant=s name and check whether the Medical Consultant has completed the five listed actions.

After all information has been entered on the tabs, Click on the Add command button to add the screen. To document additional disability episodes, click on the Clear command button and repeat the screen instructions. When finished, click on the Cancel command button to exit the screen

Workload-Case-Client-Medical-Medical Providers

This screen is used to document the use of the special authorized medical number and an inset grid keeps a history of the numbers generated. This screen is in the tab format and has to be approved by the worker=s supervisor. The screen opens defaulting to the Provider tab as you need to select a provider before you can do anything else.

Medical Providers-Provider tab

Click on the Find button which brings up Select Service Provider response window. Using the criteria on the response window, find and select a provider from whom the client can obtain medical services.
After the provider is selected, click on the Medical Card Requested check box. This brings over the provider info into the Provider section.

Medical Providers-Special Medical Card Info tab

Click on the Medical Card requested check box. This enables the other fields on the tab. All the fields on this tab are mandatory.
Select a category for Recipient Aid. When the category is selected, the system assigns the authorization number and it populates the State Medical Authorization # field. Enter the Begin & End dates for the time period the client is eligible to receive the medical services. NOTE: You can only backdate 60 days from the date you are entering the authorization into the system.
Choose whether or not the authorization is for Court Ordered Services. If it is Court Ordered Services, you must choose the services by using the Select button. On the Court Order Selection response window, put a check in the Court ordered check box by the items you are authorizing. If the MDT recommended the item, be sure and check the box for that, also. Whatever selections you make here will go over to the Service Details tab.
Enter information the Reason requested field. Be sure and do a good detailed account of what you are authorizing.

Medical Providers-Service Details tab

This tab is read only if you did not choose that this is a court ordered service.

The items selected in the Court Ordered Services section on the Special Medical Card info tab will populate over into the Services section on this tab. If you did not choose any services on the other tab, or if you missed one and need to add it, you can do that here. Whatever you add here will show up in the Services section on the other tab. To add additional services on theis tab, click on the Update button and the Select Services box will appear. Make your choices and click OK.
In the Court Information section, the State of Jurisdiction field defaults to West Virginia and you can change it if needed.
Choose the County of Jurisdiction. This will determine what populates the Judge=s name picklist.
Choose the Judge=s name from the picklist. If the person is not on the picklist you need, choose Other, Specify and enter the person=s name in the Specify box.

After all the appropriate fields on all the tabs have been entered, click on the Add button. Click on the Approval button and request an approval by clicking on the Request to Approve check box. This request is then sent to the supervisor for approval.

Each night FACTS will run a batch file which will pick up the names of clients approved by the supervisors for Zero Recipient Medical Cards. FACTS will notify MMIS of their medical eligibility.

Once you have completed the above procedure for a client, you will be able to print a Special Medical Card Authorization Letter (Zero Recipient Medical Card) out of FACTS for that client.

To print the Special Medical Card Authorization Letter, follow these steps:

Go to the main Case menu and click the Reports icon.

2. Select the Special Medical Card Authorization Letter from the reports menu and click Print button. The Select Client response box will appear. Select the client for whom you wish to print the medical card and click the Print button in this box. The Approved Provider response box will appear. Only providers who have been approved to provide medical services for this client in the process outlined above will appear in this box. Select the appropriate provider for the medical card you are printing and click the Print button. This will load the Special Medical Card Authorization Letter into WordPerfect and allow you to print it from there.

Workload-Case-Client-Medical-Gatekeeper

This screen allows a worker to enter information about the party responsible for the coordination of mental health services and approval of medicaid payment of said services. An inset grid keeps a history of the different instances of the need for a gatekeeper and the information about the gatekeeper.

Enter the date of the Mental Health Gatekeeper Screening.
Enter the Agency Name, Address, Phone number, and the name of the Gatekeeper.
Using the picklist, choose the Services Approved for the client.
Enter the Approval Start Date and End Date.
If the Hospital has Requested Title XIX Funding, or Medicaid funding, click in the appropriate box.
If the client was entered into the facility by Involuntary Commitment, complete the fields in that section.

After all the information has been entered on the screen, click on the Add command button to add the screen. If there is an additional gatekeeper occurrence needing documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Insurance

This screen captures information concerning the parties responsible for payment of the client=s medical care. The system maintains a history using an inset grid. Choose the client=s Insurance Type by using the picklist. Using the fields, radio buttons, and picklists, complete the Insurance Information section.

After all the information has been entered on the screen, click on the Add command button to add the screen. If additional medical insurance coverage needs to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen.

Workload-Case-Client-Medical-Hartley

This screen is used to document an Adult Services client=s eligibility for the Hartley deduction when determining the amount of to the client=s care provider. The inset grid maintains a history of the client=s periods of Hartley eligibility.

In the eligibility section choose the appropriate radio button to indicate the type of Hartley eligibility. In the Payment section, enter the start and end dates of the Hartley eligibility. Any comments are entered in the text box. The Staff and the date are populated by the system dependant on who is logged on to the system at the time the information is being entered into the database.

After all information is entered on the screen, click on the Add command button to add the screen. If additional Hartley eligibility periods need to be documented, click on the Clear command button and repeat the above instructions. Otherwise, click on the Cancel command button to exit the screen