Part 1 of Request Note format

Two things needed in verification box

Called 123-456-7890 and spoke to Daffy, issued payment on received invoice. Tina stated that records would be uploaded by 4.13. Set call back to 123-456-7890 to verify records will be uploaded by the commitment date.

No more workable requests after a call still requires this

Located upload reference number and we have emailed our internal team to associate the documents. Allowing the allotted time for the documents to be associated. Set callback to email internal team to have documents associated if not done within three business days of receiving the documents. Name 2 thing wrong with this note.

Part 2 of Request Note format

Which call should pushback first be offered?

Called 855-687-0618 and spoke to Tweety who verified Jerry has to verify provider affiliation and was transferred to his voicemail. We are in the process of verifying facility information. Set callback to fax the request once information has been verified.

Note any different phone numbers or contacts not listed on the site in what part of the request note?

After requests have been mailed how many days is the commitment date set for?

Part 3 or Request Note format

How to offer face to face according to the guide

Called 254-724-4713 and spoke to Julie who verified the request was not received. Advised the facility to provide Face to Face documentation. Verified the request will be forwarded to their copy service on 8/7. Request faxed. Set callback to verify if the request was received and obtain a copy date.

How long is a site note valid for?

Multiple requests not applicable

Another name for Follow-up Statement

The correct Prefix to re-note a request due to note error

Yesterday we received an inbound call from 123-456-7890, spoke with Goofy in medical records. Verified receipt of request and confirmed best fax number to send invoices to matches the one listed on the request. Advised to include face to face consults. Set callback to check status of request and allow time for invoice to be received.

Name 1 missing item from this note: Provider and facility information have been verified using website. I sent request via email to my contact Shrek. In email I advised to provide all face to face documentation. Set call back to confirm request was received, obtain a commitment date, and how records will be sent.

Give a correct follow up statement for this request note: As this is a restricted copy service team. We will have our internal team send out the request. Set call back if no records or invoice is received.

Not an acceptable follow up statement

Name 2 items missing from this note: I received email confirmation from my contact that she has received the request and that she will begin processing the request in the order they were received. She reminded that the copy service normally takes 30 days to process these requests. Set call back to verify we are still on track to obtain records for this request.

Reaching out to Road Runner via email to confirm receipt of request and check status. Set callback once follow up is received and proceed accordingly.

Note when no tracking number.

Five items that cannot be in the Request Note