Patient Intake

Overview

The patient intake process transforms a referral into an active patient ready for care. This workflow includes eligibility verification, decision making, and care team assignment.

Intake Workflow Overview

The intake process follows these key steps:

1. Referral Received → New referral created
2. Eligibility Verification → Verify patient insurance and eligibility
3. Decision Making → Accept or decline referral
4. Authorization → Request service authorization if needed
5. Care Team Assignment → Assign clinicians to patient
6. Intake Complete → Patient ready for scheduling and care

Accessing the Intake Interface

Admin Intake Dashboard

1. Navigate to Intake

   • Go to /admin/intake
   • View all referrals in the intake queue

2. Filter Referrals

   • Use filters to find specific referrals
   • Filter by status, eligibility, response submitted, etc.

3. Open Referral

   • Click on a referral to open detail page
   • Or navigate to /admin/intake/[referralId]

Clinician Intake Page

1. Patient-Specific View

   • Navigate to /p/[referralId]/intake
   • Focused view for a specific patient

2. Streamlined Interface

   • Shows only relevant information for this patient
   • Simplified workflow for clinicians

Step-by-Step Intake Process

Step 1: Review Referral Information

1. Patient Demographics

   • Verify patient name, DOB, contact information
   • Check MRN and insurance information
   • Review referral reason and comments

2. Documents and Files

   • Review any uploaded documents
   • Download and review files as needed
   • Ensure all required documents are present

3. Referral Source

   • Note how referral was received (web form, manual, etc.)
   • Review intake metadata if available

Step 2: Verify Eligibility

1. Check Eligibility Status

   • Review current eligibility status
   • If needs_eligibility_check is true, proceed to verification

2. Initiate Verification

   • Click "Verify Eligibility" button
   • Enter plan description and member ID
   • Select service codes

3. Review Results

   • Check eligibility status
   • Review any restrictions or limitations
   • Update status as needed

For detailed eligibility verification steps, see Eligibility Verification.

Step 3: Make Decision

1. AI-Assisted Decision (Optional)

   • Click "Make Decision" to get AI recommendation
   • System analyzes patient information
   • Review AI suggestion

2. Select Decision

   • Accept: Patient will receive care
   • Decline: Patient will not receive care
   • Pending: Decision deferred, needs more information

3. Enter Reason

   • Provide reason for decision
   • Add any relevant comments
   • Document special considerations

4. Submit Response

   • Review decision and reason
   • Click "Submit Response" to finalize
   • Decision is recorded and status updated

Step 4: Request Authorization (If Needed)

1. Determine Need

   • Check if services require prior authorization
   • Review insurance plan requirements

2. Request Authorization

   • Click "Authorize Patient" button
   • Enter plan description and member ID
   • Select service codes to authorize

3. Monitor Status

   • Track authorization request
   • Wait for approval before scheduling
   • Document authorization number

Step 5: Assign Care Team

1. Select Care Team Members

   • Click "Assign to Care Team" button
   • Choose clinicians and staff members
   • Multiple users can be assigned

2. Confirm Assignment

   • Review selected team members
   • Click "Confirm" to save
   • Team members receive access to patient

3. Verify Assignment

   • Check that care team is correctly assigned
   • Ensure all necessary roles are covered
   • Update assignments as needed

Step 6: Complete Intake

1. Final Review

   • Verify all steps are complete
   • Check that eligibility is verified
   • Ensure decision is submitted
   • Confirm care team is assigned

2. Update Status

   • Change referral status to "active" or "intake_complete"
   • Patient is now ready for scheduling

3. Next Steps

   • Schedule initial visit
   • Create care plan
   • Set up patient chart

Intake Status Tracking

Status Indicators

• needs_eligibility_check: Eligibility verification required
• eligibility_status: Current eligibility status (eligible, not_eligible, pending)
• response_submitted: Whether decision response has been submitted
• care_team: List of assigned care team members

Monitoring Progress

1. Dashboard View

   • See status of all referrals at a glance
   • Filter by intake status
   • Identify referrals needing attention

2. Detail View

   • View complete intake status for a referral
   • See which steps are complete
   • Identify missing information

Decision Workflow

Decision Types

• Accept: Patient will receive care

  • Proceed with authorization and scheduling
  • Assign care team
  • Create patient chart

• Decline: Patient will not receive care

  • Document reason for decline
  • Update referral status
  • Archive referral

• Pending: Decision deferred

  • Needs additional information
  • Waiting for authorization
  • Requires review

AI Decision Assistance

The system can provide AI-assisted decision recommendations:

1. Generate Recommendation

   • System analyzes patient information
   • Reviews eligibility status
   • Considers service requirements

2. Review Suggestion

   • AI provides decision recommendation
   • Shows confidence level
   • Explains reasoning

3. Override if Needed

   • You can override AI recommendation
   • Enter manual decision
   • Document reason for override

Care Team Assignment

Selecting Team Members

1. Choose Roles

   • Primary clinician
   • Care coordinator
   • Support staff
   • Specialists (if needed)

2. Multiple Assignments

   • Multiple users can be assigned
   • Each user gets access to patient
   • All team members can collaborate

3. Access Control

   • Only assigned users can view patient
   • Admins have access to all patients
   • Permissions based on role

Managing Care Team

• Add Members: Add additional team members as needed
• Remove Members: Remove team members if no longer needed
• Update Roles: Change team member roles
• View Team: See all assigned team members

Best Practices

Intake Efficiency

• Complete Information: Gather all information before starting intake
• Verify Early: Verify eligibility as soon as possible
• Quick Decisions: Make decisions promptly to avoid delays
• Team Assignment: Assign care team early in the process

Documentation

• Complete Notes: Document all decisions and actions
• Reason Codes: Use consistent reason codes for decisions
• Authorization Numbers: Record authorization numbers and dates
• Team Communication: Use notes to communicate with team

Quality Assurance

• Review Before Complete: Review all information before marking intake complete
• Verify Accuracy: Double-check patient information
• Confirm Eligibility: Ensure eligibility is current
• Validate Team: Confirm care team assignments

Troubleshooting

Common Issues

Intake Stuck in Pending

• Check if eligibility is verified
• Verify decision has been submitted
• Ensure care team is assigned
• Review for missing information

Cannot Submit Decision

• Verify all required fields are completed
• Check that eligibility status is set
• Ensure you have permission to make decisions
• Try refreshing the page

Care Team Not Saving

• Verify users belong to same organization
• Check user permissions
• Ensure referral is not locked
• Try assigning one user at a time

Authorization Not Processing

• Verify service codes are correct
• Check that member ID is accurate
• Ensure plan description matches
• Wait a few minutes and retry

Related Documentation

• Referral Management
• Eligibility Verification
• Visit Scheduling
• User Roles and Permissions