Documentation on Record Review 1 Ineligibles Report: Client/ - - PDF document
10/16/2020 Documentation on Record Review 1 Ineligibles Report: Client/ Miscellaneous/ Communication 2 1 10/16/2020 3 Expiring S hort Certs Report Clinic/ Reports/ Participation/ Expiring S hort Certs Generate Report Review
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Ineligibles Report: Client/ Miscellaneous/ Communication
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Expiring S hort Certs Report Clinic/ Reports/ Participation/ Expiring S hort Certs
Generate Report
Review record to determine if legitimate reason for short certification
(from past 6 months)
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Verify income & Adjunct history (to view verification)
No income, homeless, migrant or cash income self declared
Adj unct eligibility verified? (Champs or MI-Benefit)
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S hort Certification Review
S hort Cert Not Applicable For Income Due To Adj unct Eligibility Confirmation
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Local Agency S tate User Roles Report
staff to determine if meet credentials for role
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S taff Training
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Run ‘ Formula Usage’ Report to select clients for chart audit
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Run the report going back 1 to 3 months. Do monthly or quarterly. S elect Local Agency or Clinic, Month, Y ear, and All Class I, II,& III formulas
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Click on the Images Icon to assure S pecial Formula/ Food Request form has been scanned.
S ections 1, 2, 3, and 5 are completed? S ection 4 completed if a milk choice with different fat content is specified by the physician with a special formula? Provider signature & date?
Is “Medical Documentation Form” Complete?
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Qualifying Condition (QC) Meets Requirement?
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Is Condition included in risk assessment if known at the time of certification or eval?
Medical S creen/ risk assessment Qualifying Condition
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Fields where qualifying condition should be documented
On Medical S creen in MI-WIC Record On Medical S creen pop up in MI- WIC Record- click Details
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Expiration Dates MUST MATCH Expiration Date on MDF
S
ystem will not let you assign past recertification date.
Y
does not exceed 6 months.
Expiration date should be SAME for each food package line
assigned on the food prescription screen to prevent expiration notification postcards from being sent out prematurely .
Expiration Dates
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Expiration Dates Must match Expiration Date on MDF
7.3 a-Does the
agency accurately approve food packages/ formula (Class I, II, III) for clients with special dietary needs? (MI- WIC Policy 7.03)
4.3 a –
Were all known qualifying conditions included in the risk assessment at the last cert, recert, IEVAL or CEVAL or any appt when appropriate? (MI- WIC policy 2.13, 7.03) 6.6a-Are all Class III records designated as High Risk? (MI-WIC policy 5.06)
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Revised when new formulas are added to formulary, formulas are discontinued,
amounts are changed by USDA regulations.
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Policy 5.06 Overview
Local agency must provide ADEQUATE RD coverage to meet
30 days.
HIGH RIS K:
1 or more HR codes (+) Class III Formula LA designated risks Multiple conditions/ circumstances
a)
Any client can request and be scheduled to meet with an RD for development of an ICP .
b)
All clients identified as high risk must receive explanation of the benefits of individual Nutrition Counseling with an RD (NCRD) and be encouraged to use this benefit.
c)
All high risk clients must be offered the opportunity for RD services and an ICP at each certification/ recertification (CERT/ RECERT), Infant/ Child Evaluation (IEVAL/ CEVAL), when a high risk is identified and/ or when a new Class III formula has been approved.
d)
Acceptance or declining the RD services must be documented at each CERT/ RECERT or IEVAL/ CEVAL.
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High Risk Report High Risk Client CP Closed
S
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High Risk Care Plan Closed or Not Needed Report - monitoring Gives you a snapshot of refusals and whether care plans are being closed.
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Instructions: “ S elect 5 nutrition high risk clients who have recently completed a cert period & who have individual care plans in their records.”
Problem List: CP A documents additional information In Notes for client continuity of care
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Behavior change/ goals determined by client & RD Nutrition education documentation Notes may include desired outcomes, additional goals,
handouts provided, etc.
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Monitoring/Evaluation
Next appt type Indicator to monitor client’s progress
toward goal
Follow-up info related to CP to support
continuity of care
“Freeze Care Plan” button within 48 hrs of creation
ICP will be “ READ” only
It can no longer be modified
It will remain on the CP screen until a New ICP is created
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Follow Up Tab:
CP
As & RDs document relevant info in the Follow Up Tab
At next scheduled appointment If resolved, confer with RD to Close
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RD documents rationale:
Client’s Desired Outcomes have been met Client’s planned behaviors are obsolete
RD is only staff who can close the ICP
Policy 5.06
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ICP is complete RD documents Rationale on the Follow up Tab.
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S ummary of all of the information written in the Care Plan by RD
HR Record Review
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Nutrition Education Screen:
NE Pop-Up Grid
NE Plan Non-WIC RD RD Declined Household Summary Screen
Past Appts/ missed= NCRD offered Future Appts. S cheduled
Care Plan completed CPA Notes in Record:
“ Follow up planned with RD.” “ NCRD appt. to be scheduled.”
Nutrition Education S creen: NE Pop-up Grid
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Where to Look? Household S ummary S creen: Past Appts.
No NCRD S cheduled
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Appointments Offered:
EDU (kept) Recert (kept) Appt. Cancelled: NCRD not scheduled
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Dual Enrollment Dual Enrollment Report MI-WIC: Clinic/ reports/ participation/ WIC dual
enrollment
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Dual Enrollment Review
Review Dual Participation reports to
determine if resolved within 45 days
If resolved within 45 days-Met If unresolved after 45 days- Not Met
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Certification Timeframes
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Compliance Report
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Compliance Investigation
Miscellaneous/ Compliance Investigations
Compliance Investigation screen
S ee Investigation notes for follow up steps
S tatus-complete within 31 days?
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Reports Overdue Breast Pump Report Client List by Pump Model Issued
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Breast Pump Monitoring Reports
Breastpump Monitoring Reports Overdue Breastpump Report: S elect current list-review up to 10 records or 50%
(Clinic/ Reports/ Breastpump/ Overdue Breastpump Report) # of Pumps b/ a=%
pumps monitored a # of Pumps due? b Follow-up documented (monthly follow – ups) MPR 9.1a Is the agency monitoring past due pumps? (cite if more than 20% with no follow-up) Y Cite if No
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Overdue Breastpump Report
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