Cadence Check In and Check Out workflows include a number of tasks such as updating patient and appointment registration, collecting copays, printing after-visit summaries and parking vouchers, and updating appointment statistics. Check In and Check Out are primarily completed using the Department Appointments Report (DAR).

Resources

The following documents that provide information on Check In/Check Out functionality in Cadence.

Accident Related

• Accident-Related Encounters (Claim Information Record) - (Handout) When scheduling or checking in an accident-related appointment, additional information needs to be collected regarding the accident. Claim Information Records keep track of information related to an encounter that is accident-related. A Claim Information Record must be created for the accident and attached to each encounter related to that accident.

Cash Drawer

Cash Drawer (Cadence)

Check In Workflows

• Canceling Check In - (Handout) Once the Check In workflow is completed for an appointment, the Check In can be canceled if needed from the Appointment Desk or Department Appointments Report (DAR). This most typically occurs when a patient is Checked In and cannot stay to complete the appointment. Check In cannot be canceled after end of day processing has run on the appointment.

• Checking In a “No Show” Appointment - (Handout) “No Show” appointments that have already gone through End of Day processing need to be Checked In using the normal Check-In workflow while the appointment is still in a “No Show” status. Completion of the Check-In workflow will place the appointment in a “Completed” status. Current-day "No Show" appointments must have EOD status changed to "Arrived" before completing the Check-In workflow. Check Out must also be completed for current-day appointments.

• Checking in an Appointment - (Handout) An appointment can be checked in from the Department Appointments Report (DAR) or from the patient’s Appointment Desk.

• Checking In a Patient with an Identity Theft FYI Flag - (Handout) When a patient with the Identity Theft FYI Flag presents for Check In for a clinic visit (not Emergency Department or Urgent Care), staff will first verify the patient’s identity, and then document the patient’s identity was verified within the Check In workflow.

• Clinical Workflow for Patient Check In - (Handout) Clinical staff may need to check in patient appointments in areas where patients are transported directly for patient care or when there is not a front desk staff available.

• Completing the MyChart Signup Prompt during Check-In - (Handout) During the Check-In workflow, if a patient does not have an active MyChart account, the MyChart Signup prompt will display. Check-In staff will use the prompt to indicate the patient’s response.

Check Out Workflows

• Checking out an Appointment - (Handout) During Check Out, registration information can be updated, copays collected, and follow-up appointments scheduled.

Chart Review

• Opening Chart Review for Front Desk Users - (Handout) Front Desk users can most easily open Chart Review from Patient Station.

Customer Relationship Management (CRM)

• CRM for Schedule Variance Tracking - (Handout) When a scheduling variance is identified or perceived to be outside of “ideal” scheduling or check-in times, a CRM is created to document the variance and outcome.

Department Appointments Report (DAR)

• Customizing the DAR - (Handout)) The DAR can be customized to better fit day-to-day tasks by creating a private report, specifying the criteria for the report, and adjusting the columns to display.

• Patient Updates from the DAR - (Handout) In case of a clinic delay or similar clinic disruption in which a patient notification is necessary or of benefit, supervisors can send a message for affected appointments from the Department Appointments Report (DAR).

• Reviewing the DAR - (Handout) The Department Appointments Report (DAR) is the central report for Cadence patient check-in and check-out workflows. The DAR provides information about the day’s appointments, may be used to check patients in or out, and provides access to other workflows such as printing parking validation or updating End of Day status.

eCheck-In/Welcome Tablet

MyChart

Welcome

• Assigning and Un-Assigning Welcome Tablets - (Handout) For departments using Welcome Tablets for Check-In, the Tablets can be assigned and un-assigned to patients using the Department Appointments Report (DAR). The user must be logged into a department that uses the Tablet.

• Charging a Credit Card during Check-In for Patients Who Pre-authorized Copayment during eCheck-In (MyChart) - (Handout) Patients can complete Check-In from within MyChart using “eCheck-In” up to five days prior to their appointment, including paying their copay by credit card. The credit card is ‘authorized’, but not charged until the date of service when the UIHC staff must complete the Check-In in Epic.

• Identifying Patients’ Check In Status: eCheck-In - (Handout) Patients can check in early for an appointment using MyChart prior to arriving for their visit (called eCheck-In). The Department Appointments Report (DAR) displays unique columns to track eCheck-In (MyChart) by patients for these appointments. Users must be logged into a participating department to see the columns. The Interactive Face Sheet in Registration will also display coverage changes indicated by the patient during eCheck-In (MyChart) if any were indicated.

End of Day Status (EOD)

• Changing the 'End of Day' (EOD) Status - (Handout) The End of Day (EOD) status for outpatient appointments can be updated from the Department Appointments Report (DAR) or the Appointment Desk. Common status changes include “Left without seen”, “No Show”, and “Scheduled”. Statuses can be changed multiple times for the same appointment as needed, up to three days from the date of service (check with a supervisor for clinic specific EOD processing timelines).

Guarantor

• Adding Guarantor Notes at Check In - (Handout) At Check In, if a patient identifies a change to their insurance, front desk staff can add a guarantor note using Note type "Check In Insurance Information [340]" with the updated insurance information. This note type populates a PFS Registration workqueue. Front Desk staff should also scan the new insurance card.

• Updating a Guarantor Address During Check In - (Handout) During Check In, the guarantor address should be updated if it is missing or incorrectly formatted.

Medicare Secondary Payor Questionnaire (MSPQ)

• Medicare Secondary Payor Questionnaire - (Handout) The MSPQ is the questionnaire associated with Medicare coverage for senior citizens and disabled persons and will be initiated at Check In and during insurance creation.

Patient Care Teams and Sensitive Visit

Patient Care Teams

• Adding a Provider on the Fly - (Handout) The Provider on the Fly activity allows users to create a provider record when it does not currently exist in the system.

• Marking a Visit as Sensitive - (Handout) Marking a visit as “Sensitive” will prevent the visit-level documentation from being shared with outside entities. The documentation will not be available through the Iowa Health Information Network (IHIN), Care Everywhere, UI CareLink, or Comm Management, but will be viewable to the patient in MyChart. This functionality is only available for outpatient visits.

• Patient Care Team/EMR Information Sharing Matrix - (Handout) This matrix provides details on the Epic activities used to share patient information from the Epic system.

• Updating the Patient Care Team During Scheduling, Check In, and Registration - (Handout) The Patient Care Team activity provides a single access point for managing the relationships a patient may have with a variety of providers involved in their healthcare. The Patient Care Team is reviewed and updated during Scheduling, Check In and Registration. (Other roles have access to edit the Care Team, as well.) In addition, the PCP is verified on the Checklist during Scheduling and Check In workflows when it displays as unverified.

Patient Not Present

• Patient Not Present Appointments - (Handout) The “Patient Not Present” (PNP) scheduling workflow is used when a Hospital Account Record (HAR) needs to be created for a patient that is not present but for whom billable services are being provided. Examples of when a Patient Not Present encounter would be used include: • Various lab specimens received • Outside tests are performed and sent to the UIHC to be read by our providers, including radiology exams • Optical Shop & contact lens • Pathology specimens for diagnosis/consultation • Other reasons Staff may schedule same-day appointments using the standard scheduling workflow or they may use One Click. One Click must be set up for a department. To schedule appointments for past dates, the standard scheduling workflow must be used.

Patient Status & Rooming

• Delete Dashboard Status Using the Event Log - (Handout) If a patient’s appointment status is manually updated in error, the erroneous status should be deleted using the Event Log. This button can be found on the Schedule activity toolbar, within certain provider and nurse navigators, and on the toolbar for the Department Appointment Report (DAR).

• Manually Updating a Patient's Dashboard Status - (Handout) Dashboard statuses allow users to track the movement of a patient throughout the clinic. A status may be updated manually from the Schedule activity, from within nursing and provider navigators, and from the Department Appointments Report (DAR).

• Rooming a Patient on the Schedule - (Handout) Rooming a patient on the Patient Multi-Provider Schedule activity allows clinic staff to keep track of patients as they move throughout their clinic visit. The rooming tool also helps clinic staff easily see which rooms are available and ready for patients. The Room Patient button may be accessed in the Schedule toolbar, the Visit Navigator, and the Department Appointments Report (DAR).

Patient Transport

• Requesting Transport for a Patient - (Handout) The Patient Transport activity is used to alert transport staff that assistance is needed to move a patient.

Pharmacy Benefits Plan

• Verifying the Primary Pharmacy Benefit Plan during Check In - (Handout) How to verify pharmacy benefits when presents as warning during Check In.

• Verify Pharmacy Benefits – Medical & Rx Benefit Crosswalk - (Handout) A patient’s pharmacy benefit plan (prescription coverage) is not necessarily the same as their medical insurance coverage. When more than one pharmacy benefit plan exists, a primary must be verified with the patient and selected.

Quick Care and Urgent Care

• Checking In an "On My Way" Appointment for QuickCare and Urgent Care - (Handout) Patients may self-schedule appointments at Quick Care and Urgent Care locations using “On My Way" from both MyChart and the UIHC webpage. These visits will display on the DAR, and the patient will need to be checked in upon their arrival at the clinic.

Workqueues

Workqueues

• Filtering Workqueues - (Handout) Workqueues can be filtered and saved as favorites to provide quick and easy access to the most commonly used workqueues.

• Reviewing Workqueue List Basics - (Handout) To find patients that have referrals and need to be scheduled, the Referrals Workqueue List is used to quickly find these patients.

• Working Front Line Patient Workqueues - (Handout) Front line Patient workqueues are worked by staff on a daily basis to correct errors on appointments that must be fixed.

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