Field Technician Training Manual - ECS Web Center · 925 North Point Parkway, Suite 350, Alpharetta, GA 30005 CONFIDENTIAL Field Technician Training Manual

925 North Point Parkway, Suite 350, Alpharetta, GA 30005 CONFIDENTIAL

Field Technician Training Manual

© 2016, CIOX Health. All Rights Reserved. 2

Table of Contents

Overview .............................................................................................................. 4

About CIOX Health ............................................................................................... 5

Travel Case Contents ........................................................................................... 6

Important Phone Numbers ................................................................................... 7

Job Overview and Daily Checklist ........................................................................ 8

Equipment ................................................................................................................. 10

Overview ............................................................................................................ 10

Equipment Usage ............................................................................................... 11

Equipment Set Up .............................................................................................. 12

Laptop Lock ........................................................................................................ 15

Internet Connectivity – No Connection ............................................................... 17

Equipment Return ............................................................................................... 19

Equipment Return Checklist ............................................................................... 20

Medical Record and Vocabulary ............................................................................ 21

Overview ............................................................................................................ 21

Vocabulary Unique to Field Technician .............................................................. 22

The Medical Record ........................................................................................... 24

Components of the Medical Record ................................................................... 26

Medical Record Filing ......................................................................................... 32

Medical Record Locations .................................................................................. 33

Important Forms ..................................................................................................... 34

Overview ............................................................................................................ 34

Confidentiality and Compliance Statement ......................................................... 35

QRG ................................................................................................................... 36

Chart Review Cover Sheet ................................................................................. 37

Pull List ............................................................................................................... 38

Pull List with Attestation ...................................................................................... 39

Signature Log ..................................................................................................... 40

Provider Requested Release Forms ................................................................... 41

Business Associate Agreement .......................................................................... 42


Release/Access Form ........................................................................................ 43

MobiWork Time Tracking System .......................................................................... 44

Overview ............................................................................................................ 44

Accessing MobiWork .......................................................................................... 45

Web Center ............................................................................................................ 49

Overview ............................................................................................................ 49

Before the Retrieval ............................................................................................ 50

While You Are Performing a Retrieval ................................................................ 54

After the Retrieval ............................................................................................... 55

Scanning Paper Charts .......................................................................................... 58

Overview ............................................................................................................ 58

How to Scan Paper Charts ................................................................................. 59

Trouble Shooting Paper Jams on Scanner ......................................................... 65

EMR – Retrieving Charts On to IronKey Flash Drive ............................................. 66

Overview ............................................................................................................ 66

How to Retrieve Charts on to IronKey Flash Drive ............................................. 67

Transfer Charts from IronKey to CIOX Health Laptop ........................................ 75

Uploading from CIOX Health Laptop to CIOX Health ......................................... 79

Test Upload ........................................................................................................ 82

Wrap Up Before Leaving the Site ....................................................................... 83

Important Information ............................................................................................. 84

Overview ............................................................................................................ 84

Field Technician Reference Guide ..................................................................... 85

Summary of Privacy and Security Policies and Procedures ............................... 87


Overview

Introduction Congratulations! You have joined a leader in the industry and we welcome you! Please ensure you have the following before you proceed through this manual: A personal computer with a high-speed internet connection A printer A personal Smart Phone A personal e-mail address Your Field Tech Coordinator’s (FTC) contact information

If you do not have all of these items, please contact the Field Tech Emergency number at 877-442-4145

Contents Topic See Page About CIOX Health 5 Travel Case Contents 6 Important Phone Numbers 7 Job Overview and Daily Checklist 8


About CIOX Health

Introduction CIOX Health is the nation’s largest and most secure provider of medical record retrieval services. CIOX Health’s 2,500 on-site retrieval personnel and 250 person call center leverage the industry’s most proven and robust technology platform to ensure customer and Provider satisfaction with the retrieval process. In addition to retrieving paper and electronic medical records for Medicare and Medicaid Risk Adjustment, HEDIS and RADV audits, CIOX Health can distribute and retrieve any document, from any Provider office, at any time. CIOX Health processes more than four million medical record retrieval requests from 65,000 physician offices annually. We have the highest Provider satisfaction rating of any medical record retrieval company in the industry because we work with the Provider to utilize the chart retrieval method they choose: on-site scanning, fax, mail, e-mail, on-site EMR, and remote EMR. In addition to medical record retrieval services, we provide state of the art web based software solutions that streamline Risk Adjustment Coding, Medicare Risk Adjustment Data Validation Audits (RADV Audits), and credentialing site reviews.

What We Do We fulfill contracts for our clients by retrieving charts for review. CIOX Health is contracted as the retrieval vendor to retrieve medical records selected as part of a chart review. CIOX Health works diligently to attain Provider cooperation with a medical record review and to minimize disruptions in patient care activities. Our clients have executed Business Associate Agreements with CIOX Health and their employees. Any information shared during chart retrieval is kept in the strictest confidence in accordance with all applicable State and Federal laws regarding the confidentiality of patient records including current HIPAA (Health Insurance Portability and Accountability Act) regulations.


Travel Case Contents

Verify Travel Case Contents

Please verify that the travel case contains all of the following items: Laptop Scanner and the

scanner’s paper tray IronKey flash drive

Bag of cords which include: Laptop and scanner power cords, USB cord, Extension cord

Laptop lock CIOX Health ECS badge

Compliance and Confidentiality Statement

Upon completion of this project, all of these items must be returned to CIOX Health. Note: A return checklist is included at the end of this manual.

Protected Health Information (PHI) must be secured at all times. Under no circumstances is the medical record or copies of the medical record to be removed from the provider office/site. In addition, never remove the Pull List (or copies of it) from the provider office/site. The Pull List and any copies of it must be returned to the site contact at the end of the retrieval for the day. In addition, prior to leaving a Provider office/site, all equipment must be returned to the Travel Case, and the Travel Case MUST BE LOCKED; under no circumstances should any equipment be housed outside of the locked Travel Case when transporting/traveling.


Important Phone Numbers

Field Technician Emergency Line

If you do not know your Field Tech Coordinator’s contact information or if you need immediate assistance and cannot reach your Field Tech Coordinator, please call the Field Technician Emergency Line at 877-442-4145.

Technical Support

If you are experiencing problems with your laptop, scanner, IronKey Flash Drive, or other CIOX Health related technology please call 1-877-442-4139 or email [email protected].

Other Phone Numbers

Field Technician Equipment Coordinator

623-207-5685

Field Technician Recruiting 877-358-8721 Payroll 623-207-5624

mailto:[email protected]


Job Overview and Daily Checklist

Introduction Field Technicians travel to assigned medical provider offices/sites and are responsible for retrieving specific medical charts in accordance with Company procedures.

The Night Before

Check your schedule in Web Center from your home computer every day after 7:00 p.m. your local time.

Print the QRG and chart coversheets from Web Center from your home computer

Print out driving directions. Use your Smart Phone navigation system for more reliable directions.

Before Leaving Home the Day of Retrieval

Ensure you have your CIOX Health badge, CIOX Health equipment, printed documents (cover sheets, QRG, driving directions), cell phone

Update your status on MobiWork “Leaving Home”, or make the first call to your FTC

During the Visit

Arrive 10-15 minutes early Update your status on MobiWork “Onsite”, or make the second call

to your FTC Dress in business casual attire and conduct yourself professionally Introduce yourself to the site contact Present your Confidentiality and Compliance statement to the site

contact Ask the site contact for the Pull List and Signature Log Set-up your equipment in the space provided Protect all CIOX Health Equipment Retrieve charts while adhering to all CIOX Health retrieval

guidelines Take notes on any charts you were unable to retrieve, use Chart

ID’s only Scan the completed Pull List (Only when all charts have been

retrieved for the project. At that time, scan the entire Pull List and Signature Log (if available). Ask site contact to sign attestation statement when applicable on both forms

Ask the site contact to fax the Pull List and Chart Review Satisfaction Survey to CIOX Health

If you will work over 8 hours, including drive time, you must take a 30-minute lunch period break (unpaid).

Protect PHI! Give the Pull List back to the Site contact for disposal

Continued on next page


Job Overview and Daily Checklist, Continued

After the Visit Ensure all PHI is returned to the site. Do not remove the Pull List or copies of it or any medical record or

medical record copies. Update your status on MobiWork “Leaving Site”, or make the third

call to your FTC Update your status on MobiWork “Arriving Home”, or make the

fourth call to your FTC Once at home, upload the charts immediately

o (no later than 7:00 pm) Login to Web Center from your HOME COMPUTER and record

your drive, wait, retrieval, upload times, round trip mileage, and any notes about the retrieval

Calls to Your FTC only if MobiWork is Unavailable

Each call or voicemail to your FTC needs to include your first and last name, your equipment number, the time of your call and which call of the day you are making

First Call is to be placed when leaving home heading to site. If an errand will be taking place prior to your site, you will need to place your call when you are actually on your way to site

Second Call is to be placed after you have parked and unloaded equipment case but prior to entering the site

Third Cal is to be placed when you are leaving the site and heading home

Fourth Call is to be placed when you arrive home. This call needs to include whether a 30-minute lunch was taken. Note: A 30-minute unpaid meal period break must be taken when working eight hours or more.



Equipment Overview

Introduction CIOX Health shall provide equipment to employee, including without limitation a laptop computer, scanner and travel case. The equipment is, and shall remain the property of CIOX Health at all times. Employee's possession of the equipment is pursuant to a bailment at-will. Employee is responsible for the safe upkeep and repair of the equipment and for all loss or damage to the equipment while possession is entrusted to employee.

Contents Topic See Page Equipment Usage 11 Equipment Set Up 12 Laptop Lock 15 Internet Connectivity – No Connection 17 Equipment Return 19 Equipment Return Checklist 20


Equipment Usage

Equipment The equipment shall be used by employee solely for services in the course of employee's employment with CIOX Health and for no other purpose. Equipment will be returned using a prepaid shipping account to be provided by CIOX Health, with a tracking number to be obtained by employee and furnished to CIOX Health. If the equipment is not promptly returned by employee after request from CIOX Health, employee agrees that CIOX Health shall have the immediate right to retake possession of the equipment without payment of any kind and without the necessity of obtaining a court order. Failure to return equipment may cause employee to forfeit part or all earned bonus if any. If employee does not promptly return the equipment to CIOX Health after request by CIOX Health, for every day thereafter that employee fails to return the equipment, employee shall pay a use fee to CIOX Health of $100.00 per day. The use fee is a reasonable estimate of the loss to CIOX Health for deprivation of the use of its equipment and is liquidated damages and not a penalty. Employee shall be responsible for all costs and expenses, including actual attorney fees incurred by CIOX Health to recover the equipment and/or enforce this Agreement.



Equipment Set Up

Setting Up the Equipment

Perform the following actions: Step Action

1 Remove the laptop, scanner, and bag of cords from the travel case.

2 Insert the power cord into the laptop and plug it into an outlet.

3 Insert the power cord into the scanner and plug it into an outlet.

4 The cord that connects the laptop and scanner is either black or white. Plug the flat end of the cord into the laptop USB port. Plug the square end of the cord into the scanner.



Equipment Set Up, Continued

Setting Up the Equipment, continued

Step Action 5 The laptop and scanner are now connected.

6 Insert the top paper tray into the back of the scanner.

7 Extend the top and bottom paper trays.

8 Power on the laptop.



Equipment Set Up, Continued

Setting Up the Equipment, continued

Step Action 9 Power on the Scanner

10 Log into the laptop. You will receive login instructions from your Field Tech Coordinator (FTC).



Laptop Lock

Laptop Lock

Important: You must use the laptop lock every time the laptop is out of the case at a Provider’s office or other Wi-Fi location. It is included with the equipment and looks like the image below.

How to Use the Laptop Lock


1 Loop the cable around a stationary object, like a table leg. Important: Do not loop the lock around a chair leg. A chair is not a stationary object.

2 Identify the location of the laptop lock port on the side or back of the laptop.

3 Push in the black button on the lock and insert the lock into the laptop lock port.



Laptop Lock, Continued

How to Use the Laptop Lock, continued

Step Action 4 The combination for the lock is on the white sticker on the

lock. The combination of the lock is every other number on the sticker starting with the first number. Example: The combination for this lock in the image below is 7824.

5 To unlock, line up the combination for the lock with the yellow arrow on the lock. Push the black button to release the lock from the laptop.



Internet Connectivity – No Connection

No Connection to the Internet

If the network icon on the laptop screen has a red ‘X’, you are not connected to the internet. Important: Internet connection is only required when uploading charts and when/if Technical Support (IT) needs to remotely log in.

Steps to Perform if no Internet Connection

Perform the following actions if there is no internet connectivity: Step Action

1 Verify that the switch for the wireless antenna is turned on. The switch must be slid all the way to the right. Note: Not all laptops will have a toggle switch to open the Wi-Fi connections. Some laptops may have Fn/F2 buttons on the keyboard to access Wi-Fi connections.

2 Click on the network icon to display connection options. Select ‘Connect to a Network’ to display available networks. Select the network you want to connect to, and click ‘Connect’.



Internet Connectivity – No Connection, Continued

Steps to Perform if no Internet Connection, continued

Step Action 3 The progress of establishing the connection to the selected

network will be displayed. Once the connection is successfully established click ‘Close’.


Equipment Return

Equipment Return

Complete the Equipment Return Checklist at the end of your project (available on the next page). A return shipping label will be emailed to you at the end of the project. Place all equipment securely in the travel case and lock it before shipping. If there is a FedEx store near you, you can drop the travel case off. Be sure to get a drop-off receipt from FedEx for tracking purposes. YOU MUST RETURN THE EQUIPMENT WITHIN 24 HOURS OF RECEIVING THE SHIPPING LABEL. Any earned bonuses are paid only upon return of the CIOX Health equipment.


Equipment Return Checklist

Checklist The items in this checklist are to be completed within 24 hours of receiving notification from your Field Technician Coordinator that your project has ended.

Verify that the following items are packed into the equipment case: Laptop and laptop power cord Scanner, scanner paper tray, and scanner power cord USB and extension Cord Flash drive CIOX Health ID Badge Laptop lock

Place paperwork that you have in the equipment case.

CIOX Health paperwork includes copies of Chart Cover Sheets, Review Satisfaction Survey forms, and any other documents that bear the CIOX Health logo.

Print out the return shipping label. If you do not receive a return shipping

label via email within 48 hours of notification of the end of the project, contact the Equipment Coordinator at 623-207-5685.

Secure the equipment case. Insert a signed copy of this form in the travel case before you lock it to confirm that you have verified the items listed above are inside the equipment case.

Take the equipment case to your local FedEx store.

If there is not a FedEx store near you, contact your Equipment Coordinator to schedule a pick-up, 623-207-5685.

Field Tech Name (printed): ___________________________________________

Field Tech Signature: _______________________________________________

Date: _________________________________________


Medical Record and Vocabulary Overview

Introduction In this section you will learn about what makes up a medical record and important vocabulary terms unique to your field tech position. It is important to understand all the components of a medical record in order to release all that is requested for the requests you will be processing.

Contents Topic See Page Vocabulary Unique to Field Technician 22 The Medical Record 24 Components of the Medical Record 26 Medical Record Filing 32 Medical Record Locations 33


Vocabulary Unique to Field Technician

Vocabulary Word Definition

CNA Chart Not Available. CNA is indicated on the Pull List when a chart is not available and CNA’s (if any) are updated in Web Center in the Notes from Tech area when the retrieval is finished for the shift.

DOB Date of Birth

DOS Date of Service. The dates a member rendered services from a Provider site.

EMR Electronic Medical Record

FT Field Technician

FTC Field Tech Coordinator

HIPAA Health Insurance Portability and Accountability Act

PHI Protected Health Information

Hybrid Site A site where charts are uploaded using two different methods such as EMR and paper.

Member The patient. A member of a Health Plan.

Problem List A list of medical conditions that the patient has experienced, diagnoses.

Provider The Physician(s) that rendered services to the health plan members. Field Technician goes to the Provider’s office to perform the retrieval.

Provider Package

The Provider Package is sent to the Provider’s office before charts are retrieved by CIOX Health. The Provider Package includes the Pull List, a letter from the Health Plan, a CIOX Health cover sheet, a signature log and instruction sheet.

PPQA Provider Package Quality Assurance team. This team will review the accuracy of notes made by a scheduler when they schedule a retrieval. If it is complete and accurate, the PPQA team will send out the provider package.

Scheduler Agent in the Arizona CIOX Health office who contacts Provider offices to schedule appointments for Field Technicians to retrieve charts.

Site Provider’s office where charts are located. This can be a doctor’s office, a hospital, or even a corporate office for the practice.

Test Upload To ensure compatibility, must upload five charts as a test upload when at an EMR- Flash Drive site. See Test Upload section for details.

MobiWork An application available for iPhone/Android that is used to manage time worked and Tech status.

MRA Medicare Risk Adjustment – Market Managing Audit Process

CRA Commercial Risk Adjustment -Market Managing Audit Process

RADV Risk Adjustment Data Validation – Market Managing Audit Process



Vocabulary Unique to Field Technician, Continued

Vocabulary, continued

Word Definition

HEDIS Healthcare Effectiveness and Data Information Set – Used to measure performance of healthcare by assigning a grade. Gives consumers information to select a medical plan that works for them.

Paper Scan First method of medical record retrieval. Field Technician scans medical records requested for audit from a paper medical record/hard copy medical record.

Print-to-Scan Second method of medical record retrieval. Field Technician prints to paper the required medical records requested for retrieval from the Provider’s EMR system

IronKey Flash Drive

Third method of medical record retrieval. Field Technician transfers the Electronic Medical Record (EMR) directly to a secure CIOX Health IronKey flash drive. No actual printing of the paper medical record is required. The term IronKey Flash Drive may also be referred as a USB, Flash Drive, Thumb Drive, by the Provider/Site.

Pull List The Pull List is sent to the site contact prior to the retrieval date. You will need the pull list to complete any chart retrieval. When you arrive on site-ask the site contact for the pull list. If the site does not have the pull list, contact your FTC or the emergency line immediately, and the pull list will be sent to the site contact immediately. The pull list is updated by the FT throughout the retrieval process indicating if the chart is a CNA, or pulled and processed. The entire pull list is scanned ONLY once all the charts have been processed on the pull list to indicate the project for that particular site is complete. Never remove the pull list or copies of it from the site.

QRG Document printed from Web Center application the night before a retrieval from your HOME Computer and taken with you to the site/provider office to perform the retrieval. The QRG gives you the information for the Date of Service (DOS) and components that are being requested by the health plan for each patient on the pull list. You will use the QRG for all patients on the pull list. Pay close attention to the QRG and read it thoroughly.

Cover Sheet Document(s) printed from Web Center application the night before a retrieval from your HOME Computer and taken with you to the site/provider office to perform the retrieval. You must print all of the Cover Sheets (or at least 150) if the site is a Print-to-Scan or Paper Scan site. If the site is an EMR IronKey Flash Drive site, you will need to print at least 50 Cover Sheets just in case the site’s EMR system is not compatible with the IronKey Flash Drive. The cover sheet must be scanned for each patient on the pull list. The Cover Sheet contains a Chart ID number, and it matches the Chart ID number that is next to the patient name on the Pull List.


The Medical Record

Definition A collection of facts about a patient’s health history, including past and present illness. This contains the essential information related to who, what, where, when, why, and how of patient care. Medical data makes up the largest portion of a patient’s medical record and is the data most often requested and reproduced. There are many medical forms and reports within the medical record and we must be able to identify them.

Designated Record Set

A group of records maintained by or for a covered entity that may include patient medical and billing records; the enrollment, payment, claims adjudication, and cases or medical management record systems maintained by or for a health plan; or information used, in whole or in part, to make patient care–related decisions. The facility determines what documents constitute a designated record set. Medical Record Component – contains information used in making treatment and payment decisions about an individual. Billing Record Component – contains information such as claim and claim summary, explanation of benefits, eligibility, notice of non-coverage, and copy of insurance card.

Medical Record Use

The primary resource used to determine clinical and administrative decisions. It is used to provide medical treatment to a patient but can also be used for: Communication among the health care team Reviewing for quality of care Legal use Research and education to expand medical knowledge and

resources Determining eligibility for medical coverage Validating payment of claims by insurance companies Assist decision makers in determining facility services and the use

of facility resources. Protect the legal interests of patients, providers, and the medical

facility through attorneys and courts.



The Medical Record, Continued

Custodian of Medical Records

The health system is responsible for providing a medical record for each patient and the HIM Director/Manager is considered the custodian of medical records. It is the responsibility of the health system to safeguard medical records from loss, damage, alteration, and unauthorized uses.

The medical record is the physical property of the health system/Provider office; however, the information contained in the record is owned by the patient which gives them the rights to control the release of their health information.

Medical Record Retention

State laws mandate how long medical records must be retained by a medical facility. All states have individual requirements refer to your facility and state laws regarding record retention.

Medical Record Formats

A medical record can come in one or more of the formats described in the table below. It is important for you to know which format your medical facility/provider uses.

Format Description Hard copy

Paper medical record

Electronic Medical Record (EMR)

Medical records maintained and/or created on a computer.

Microfilm A hard copy medical record that has been filmed in order on a roll cartridge. Multiple patients will be found on a single roll cartridge.

Microfiche A hard copy medical record that has been micro imaged onto a 3x5 or 5x7 transparent rectangle of film.

CD/DVD Medical Records are scanned or burned onto a CD/DVD


Components of the Medical Record

Introduction In this section you will learn about the different reports and tests that make up the medical record. Each medical facility/provider has its own standard format for organizing a medical record. A clinic chart will be formatted differently than a regular hospital chart. Medical records are a compilation of documents containing patient information, diagnosis and treatment during an encounter or admission.

Encounters and Admissions

A medical record may be classified as the type of encounter or admission and the length of stay. Some health facilities/provider offices file all admission types in one record called a unit record. Others file by the different admission types. It’s important to learn how your facility/provider files records.

Encounter/ Admission

Description

Inpatient A patient is admitted into the hospital and occupies a bed for a period of 48 hours or longer.

Outpatient A patient receives treatment or testing at the hospital or health facility but never occupies a bed. This encounter of care is usually less than 24 hours at a time and can be spread out over days, weeks, or even months.

Ambulatory or Same Day

Surgery

A patient is admitted into the hospital and receives treatment and or procedure but released the same day.

Observation A patient is admitted into the hospital for treatment and occupies a bed for 24-48 hours.

Emergency Room(ER) Emergency

Department (ED)

A patient enters the hospital by way of the ER/ED, receives treatment and is released from the ER/ED. A patient may enter the hospital through the ER/ED and receive treatment but due to the nature of the illness be admitted to the hospital. This admission is then classified as an Inpatient stay.



Components of the Medical Record, Continued

Medical Record Components

The following table contains some of the components found in a medical record and their definition. This isn’t an all-inclusive list, as sites handle their medical charts differently. At some sites, the charts will be organized and neat. At other sites, the charts may be messy, unorganized, and falling apart.

The information in the table is only to help you get familiar with some of the chart sections and their contents. Also, some of the information in the table is for hospitals only, clinics only, or a combination. You will need to feel comfortable with each of the terms/abbreviations and their definitions to succeed as a Field Technician Retrieval Specialist.

Component Definition Admission/Face Sheet

The first sheet on the top of each admission at a hospital. It is a computerized form completed when the patient is admitted. This is a demographic page containing personal and financial data about a patient. It is usually the first page in a medical record and contains the ICD-9, ICD-10, or CPT diagnosis and procedure codes used for billing and classification. It includes the patient’s name, address, dates of admission and discharge, insurance carrier, social security number (SSN), date of birth (DOB), etc. It is scanned as the first sheet in a paper chart.

Authorizations Documents permitting treatments and require a patient’s signature. They are often found in the record near the procedure for which they were necessary. An authorization for release of information is the Form signed by the patient to release their medical records.

Condition of Admission

Form signed by the patient where they agree to receive the treatment, pay for it and/or release the information to a third party payer.

Consent for Treatment

Documents that permit treatments and require a patient’s signature. They are often found in the record near the procedure for which they were necessary (example: a surgical consent).




Medical Record Components, continued

Component Definition Consultations Summarizes the findings and assessments

made by a consulting physician at the request of the patients attending physician. There can be more than one consult in any given record. It is also possible there may be no consults. These are usually typed reports but can sometimes be handwritten.

Diagnostic Tests Written interpretation of objective data from a test, such as radiology reports, lab reports, etc.

Discharge Summary

A summary of all treatment, observations, and tests given to the patient during that admission. The final diagnosis and condition at discharge are listed here. Reports may vary from one to ten pages in length; depending on how detailed the physician chooses to be. It is usually a typed report that is filed close to the top of the admission. If the patient was at the facility for less than 24 hours, a discharge summary may not be required by the facility.

Discharge Instructions

Instructions for the patient to follow. These are given upon discharge from the hospital.

Doctor’s Orders (also known as Physician’s Orders)

These are the handwritten orders from the doctor for specific patient treatment. Medication and treatment ordered by a doctor is recorded in this section.

Echocardiogram Sound waves of the heart that determines how the heart pumps the blood from the ventricles to the rest of the body. Determined in percentages.

Electroencephalo-gram (EEG)

An Electroencephalogram is a recording of brain activity. An EEF picks up the brain’s electrical signals.





Component Definition Emergency Room Report (also known as Emergency Department Note, ED report, ER Report)

This report is usually several handwritten pages that show the patient’s condition and course of treatment when they were seen in the ER. Patients are sometimes admitted to a hospital as a result of an ER visit.

Graphic Records Graphs of the temperature, pulse rates, etc. for the doctor to see in a quick overview of the patient’s vital statistics.

History and Physical (also known as Admit Note, Admission Note, H&P)

A description of the patient’s medical history and medical condition at the time of admission. This portion includes past medical testing results as well as social habits (such as smoking, alcohol consumption) and family medical history. The Physical portion is the physical description of the patient’s condition and the doctor’s evaluations at the time of admission. These two portions are usually combined into one report that is completed upon each admission to the hospital.

Immunization Records (Also known as Shot Records, Vaccinations)

A document that records vaccinations or shots administered by the healthcare provider to prevent certain conditions, such as measles, mumps, polio, diphtheria, tetanus, pertussis (whooping cough), etc. Most immunization records are for children under the age of 18.

Laboratory Reports Test results from various samples from the body. These include blood, urine and mucous. There may be summary lab reports that summarize all tests done. Note: Occasionally you will find small lab slips that are affixed to a sheet of paper. As many as 10 to 15 may overlap on one page.

Monitor Strips Tracings of the electrical activity of the heart.





Component Definition Medication Administration Records (MAR). (Also known as BC-MAR or e-Mar)

Contains an account of medications administered along with a recording of the quantity and time of the medication. Used as a check and balance of the medications ordered by the physician and recorded in the doctor’s orders.

Medication Reconciliation/ Medication Profile

Medication reconciliation is the process of comparing a patient's medication orders to all of the medications that the patient has been taking prior to admission. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions.

Magnetic Resonance Imaging (MRI)

The use of nuclear magnetic resonance to produce images of the molecules that makes up a substance, especially of the soft tissues of the human body. MRI is used to diagnose disorders of body structures that don’t show well on x-ray.

Nurse’s Notes Record of every nurse visit to the patient. A general review of the patient progress during their hospital stay.

Office Notes (Also known as Office Visits or Doctor’s Notes)

Notes from the doctor or other members of the healthcare team documenting care received by a patient.

Operative Reports (Also known as Procedure Report/Note or Surgical Report)

Provides detailed description of each operation or surgical procedure performed during a hospital stay.





Component Definition Pathology Reports These are tissue or cytology reports from the

pathologist following surgery or tests before surgery to determine if surgery is needed. They usually precede or immediately follow the operative report(s). There will not be a pathology report if no specimen was taken for analysis.

Progress Notes (also known as Physician’s Notes, Doctor’s Notes, or Office Visits)

Daily notes on the care and response of the patient. Anyone who sees the patient for any reason notes the visit in the progress notes. This includes: Physicians, Clergy, Social work, Dietary, and any other health care hospital staff visiting the patient.

Radiology Reports (Also known as X-Ray Reports)

Detail findings of the radiologist’s analysis of x-rays. The part of the body x-rayed will usually be listed on the report just before the findings. This section could also include MRI, CT, Ultrasound and Nuclear Medicine Reports.

Recovery Room Report

Documentation of a patient’s condition upon conclusion of surgery. This continues until the patient is transferred to a nursing unit.

Rehabilitation notes

The general term for notes on specific rehabilitation procedures, including speech therapy, physical therapy, and occupational therapy.

Ultrasound A report documenting the finding of a therapy or diagnostic test administered by sound waves.

Electrocardiogram (EKG)

A full-page graph of the patient’s heart tracing that sometimes has a narrative report on the same or separate page. The report should not be confused with electrocardiogram tracings or rhythm strips/monitor strips that are strips of paper about an inch in width.


Medical Record Filing

Medical Record Filing System

Medical records are given an identifier called the medical record number. The medical record number that is assigned to a paper record is a numeric identifier that is in terminal digit order. Paper records are filed in terminal digit order by the medical record number. The filing system may be different in HIM departments/Provider Offices. The following are different types of filing systems: Alphabetical Numeric Social security number Random assigned number Alphanumeric, or Terminal digit order

TDO – Terminal Digit Order

The most common filing system for paper records in HIM is terminal digit order. This system uses a six-digit number (or higher) that is divided into three parts, whereby the last two digits are considered primary. Each facility determines how many numbers are used as the unique patient identifying number.

How to Use TDO to Locate a Paper Chart

TDO is read from left to right, but it is filed/searched for, right to left, in groupings of two: Primary digits: The last two digits to the right in the number. Secondary digits: The middle two digits in the number. Tertiary digits: Any remaining digits For example, 456789 would break down into grouping of two digits 45-67-89. Refer to the example below to file medical record 45-67-89. 45 67 89 Tertiary Secondary Primary

Verification of Correct Record Retrieved

Once the records are retrieved, either by the facility/provider, or by CIOX Health, it is imperative that the patient identifying information (name, DOB/SSN, etc.) on the request/authorization is verified and matches the information in the medical record.


Medical Record Locations

Introduction It is important for you to know where to locate medical records within the HIM Department/Providers Office. The medical record may be filed in the HIM Department in several different ways, according to the rules of the department. The table below describes the different areas and ways records are filed.

Location/ Description

Location Description Permanent (Perm) File

Most HIM departments have a permanent file section where they keep their most recent records.

Alternate on-site storage

This could be in another area of the hospital/provider office such as the basement or in another building on campus.

Off-site storage HIM departments regularly remove or “purge” old medical records to make room for more recent records. The facility often contracts with an outside vendor to store these records for them. It is important for you to know the years and types of records stored at an offsite storage facility.

Microfilm Microfilm may be stored either on site or off site Microfiche May be stored either on site or off site. Electronic Medical Record (EMR)

Generally, there is one software system in which these records are stored. You may find in your HIM department multiple software systems for storing medical records.

Incomplete Chart Room

Records are kept here until they have been completed by the physician. Check with your medical facility policy for releasing these records.

Cd ROM/DVD Medical records that have been scanned or “burned” onto a CD/DVD


Important Forms Overview

Introduction There are important forms that you will be exposed to as a Field Technician. This section will go over these forms.

Contents Topic See Page Confidentiality and Compliance Statement 35 QRG 36 Chart Review Cover Sheet 37 Pull List 38 Pull List with Attestation 39 Signature Log 40 Provider Requested Release Forms 41 Business Associate Agreement 42 Release/Access Form 43


Confidentiality and Compliance Statement

C & C Statement

The Confidentiality and Compliance Statement will be in the equipment case. This form is to be presented to the site contact. Encourage the site contact to make a copy of this form and return the original to you.


QRG

QRG The QRG guide must be printed from Web Center prior to each site retrieval. The QRG outlines the Elements and Date of Service of the charts to be retrieved for each site. There could be a different QRG guide per each site.


Chart Review Cover Sheet

Cover Sheet The Field Tech is responsible, prior to each retrieval and from their Home Computer, to print the coversheets from Web Center for each site they will visit in the work day. Cover sheets must accompany you to every site regardless of what retrieval method you are scheduled for. If site is Print-to Scan or Paper Scan: Print all of the Cover Sheets, or at least 150 of them and take them with you to the site. (Preferably stored in the Locked Travel Case) If site is EMR IronKey Flash Drive: Print at least 50 Cover Sheets and take them with you to the site in case the site’s EMR system is not compatible with the IronKey Flash Drive. (Preferably stored in the Locked Travel Case).


Pull List

Pull List

The Pull List is sent to the site contact prior to the retrieval date. You will need the Pull List to complete the chart retrieval. Ask the site contact for the Pull List upon your arrival. If the site does not have a copy of the Pull List, contact your FTC or the Emergency line to request that a copy be sent immediately. Update the pull list throughout the retrieval process, indicating if the chart is a CNA or pulled and processed. Important: The entire Pull List is scanned ONLY once all the charts have been processed on the Pull List to indicate the project for that site is complete. At that time, scan ALL pages of the Pull List.


Pull List with Attestation

Pull List with Attestation

The Pull List is sent to the site contact prior to the retrieval date. You will need the Pull List to complete the chart retrieval. Ask the site contact for the Pull List upon your arrival. If the site does not have a copy of the Pull List, contact your FTC or the Emergency line to request that a copy be sent immediately. Upon arrival/completion of the retrieval, ask the site contact for a signature and scan all pages of the Pull List. If the signor is unavailable, ask them to fax it to the number listed at the bottom when completed. (Please scan all Pull List pages, signed or unsigned)


Signature Log

Signature Log

The signature log is sent to the site contact prior to the retrieval date. Ask for the Signature Log at the same time you ask the site contact for the Pull List. Scan the completed signature log with the retrieved charts. If contact states that the Signature Log has not been signed by all Providers, advise the site to fax it in when it is completed.


Provider Requested Release Forms

Provider Requested Release Forms

These are requested by certain providers for EMR access. Check email daily for forms (check spam box as well) Print, fill out, scan and upload to CIOX Health using the scanning

process. You should return the forms no later than 24 hours after it was

emailed to you. Do not send forms to your FTC via email (scan and upload using

the scanning process. Important: It is very important that you DO NOT sign any form at the Provider’s office without contacting your Field Tech Coordinator first. All forms must be reviewed by CIOX Health’s VP of Compliance. DO NOT sign any forms presented to you upon arrival at the site. Contact your Field Tech Coordinator.


Business Associate Agreement

Business Associate Agreement

Some sites may request a signed Business Associate Agreement (BAA). Important: It is very important to note that you may NOT sign a form at the Provider’s office without contacting your Field Tech Coordinator first. All forms must be reviewed by CIOX Health’s VP of Compliance. Do not sign any forms presented to you upon arrival at a site, contact your Field Tech Coordinator.


Release/Access Form

Release/ Access Form

Some sites may request a signed Security or Access form. Important: It is very important to note that you may NOT sign a form at the Provider’s office without contacting your Field Tech Coordinator first. All forms must be reviewed by CIOX Health VP of Compliance. Do not sign any forms presented to you upon arrival at a site, contact your Field Tech Coordinator.


MobiWork Time Tracking System Overview

Introduction MobiWork is the application you will use for your labor hours/time tracking. It is available on iPhone and Android at no cost to you. This program allows us to easily keep track of hours worked and daily expenses as well as check a technician’s current status.

Contents Topic See Page Accessing MobiWork 45


Accessing MobiWork

Accessing MobiWork


1 Open the MobiWork icon app.

2 Log in using your email address as the Login ID. Password: Tech@623



Accessing MobiWork, Continued

Accessing MobiWork, continued

Step Action Info Only

MobiWork Home Screen View

Part Description

Update your status and view the day’s status.

N/A

N/A

Log Out





Step Action 3 Time Tracking:

Select Status Press Start Icon will be next to current status

Info Only

Time Tracking – Screen View Will be blank each morning Will show status throughout the day View current status View status times of the day Site location and time Select ‘Custom’ to change status





Step Action 4 Note: Only on days that you are scheduled for a site will

you have an ‘Onsite’ status. When you arrive at the site, you will select this status as the arriving on site status. Note: When scheduled for multiple sites in a day, there will be multiple ‘Onsite’ statuses. Select according to the site you have arrived to.

Info Only

Time tracking status screen – Android App Press + sign in upper right hand corner to access list of statuses.

Info Only

Time Tracking status screen – IPhone App Press ‘Add’ at bottom of screen to access list of statuses.


Web Center Overview

Introduction

Web Center is a system you will access to obtain your work schedule and site information. Schedules are subject to change up until 7:00 pm (your local time zone) for the following business day. Important: You must log in to Web Center from your HOME COMPUTER each night after 7:00 PM to obtain the most updated schedule for the following business day. Logging in any earlier can potentially mean you will not obtain the most up-to-date schedule. Important: You are encouraged to log in to Web Center in advance of the next business day’s retrieval to look at your monthly schedule. Check: To see if you are scheduled to work at a site where you have been

previously employed or received treatment or have knowledge that a friend or relative receives care at the site where you are scheduled. Notify your FTC immediately if this is the case to avoid a conflict of interest.

Mileage for sites on your schedule. If a site is out of your driving distance, notify your FTC so it can be removed from your schedule.

Contents Topic See Page Before the Retrieval 50 While You Are Performing a Retrieval 54 After the Retrieval 55


Before the Retrieval

Before the Retrieval

Before the retrieval and after 7:00 PM the night before the retrieval, perform the following actions.

Step Action 1 Navigate to www.ECSWebCenter.com

2 Enter the Username and Password that was provided to

you via email and click Submit. 3 Check the Web Center Panel daily for new information

such as policy changes, updates and PHI reminders. There is also a ‘Links’ section. Here you will find Assessment and the Field Tech Training Manual


http://www.ecswebcenter.com/


Before the Retrieval, Continued

Before the Retrieval, continued

Step Action 4 Web Center defaults to the Month View upon log in. On

the Calendar, click on a specific date on the calendar to view the details of your schedule for that specific date.

5

Using the scroll bar, read all the notes in the Notes to Tech area. You will not be able to print from the laptop as a printer is not installed, and you cannot install one. (1) This section will contain important details (what entrance to use, if there is more than one technician, who the contact person is, etc.). Click on Print Schedule (2) at the top right of the Day View screen to print your schedule for the selected day. Choose Print Directions (3) to obtain driving

directions to the site. Choose the icon in the top right of the screen to print your directions. Note: These directions are not always accurate. Utilize your Smart Phone Navigation System once you have obtained the site/provider address. Important: Always follow the information in the Notes to Tech area. This area contains the most up- to-date information regarding site address, contact, hours of retrieval, etc.

Important: In the Charts and To Go area: Notify your FTC or Emergency Line immediately if the To Go area reads Zero (0) for future dates on your schedule.





Step Action 6

Click on the ‘Print QRG/Cover’ button to access the Retrieval QRG and the Chart Cover Sheets for the site. You will have the ability to sort by Member or Provider name. Important: Always choose Member. Choose ‘Open’ from the File Download window. Note: If no charts have been retrieved from a site, the ‘Print QRG/Cover Sheet’ button will be active to print cover sheets and QRG and the ‘Print Remaining Chart ID’s’ button will be inactive. Note: If at least one chart has been retrieved from a site the ‘Print Remaining Chart ID’s’ button will be active and the ‘Print QRG/Cover Sheet’ button will be inactive.

Important: The Outreach ID will match the number on the Pull List. Always verify this number against the Pull List, as some sites may have more than one pull list. Always go the site/provider address that is listed in the Notes to Tech area. If another FT’s name is on your calendar schedule, it only means you have replaced that FT for the retrieval. If you do not show up for a retrieval, you will be considered a no call/no show and can face disciplinary action up to and including termination.





Step Action 7 Select the ‘Print’ icon to print the Retrieval QRG and Chart

Cover Sheets for the site. Note: You must take the printed Retrieval QRG and Chart Cover Sheets with you to the site for all retrievals. You will not be able to print these documents from the Provider site.

Before you leave for the site, ensure you have the following documents: Retrieval QRG: Use as a reference to ensure you are retrieving

the correct elements for the correct dates of service for each member chart.

Chart Cover Sheets: These need to be scanned with each chart during Paper Scan or EMR Print-to-Scan retrievals. Important: You must take with you AT LEAST 150 Cover Sheets for Paper Scan or EMR Print-to-Scan retrievals. For EMR IronKey Flash Drive retrievals, you must print and take with you a minimum of 50 coversheets to the site (to be used if the site’s EMR system is not compatible with the IronKey flash drive).

Compliance and Confidentiality Statement: Needs to be presented to the site contact the first time you visit the site. The site is able to make a copy; however, you must ensure that the original is returned to you.


While You Are Performing a Retrieval

While Processing Retrieval

It is a good idea to have a notepad with you. If there are no components found in the medical record for the dates of service requested, or if only the demographic sheet is available, you must indicate on the PULL LIST that the chart is a CNA (Chart Not Available). On your notepad, write down the Chart ID number and the reason the chart is a CNA. You will have to indicate this information in Web Center (in the Notes From Tech area) when you return home after the retrieval. You will access Web Center from your home computer. Never provide the patient name or identifying information in Web Center. Instead, if the date of birth or name in the chart does not match the pull list, in the Notes From Tech Area in Web Center, indicate “Name does not match” or “DOB does not match.” See example note pad below:


After the Retrieval

After the Retrieval

Step Action 1 Navigate to www.ECSWebCenter.com 2 Enter your Username and Password that were provided to

you via email and click Submit. 3 Click on the date to input the specific information for that

site. (It should be for the retrieval you have just completed for the day.)


http://www.ecswebcenter.com/


After the Retrieval, Continued

After the Retrieval, continued

Step Action 4 Input into Web Center: DO NOT email the below

information to your FTC. You must complete Web Center daily from your Home Computer. Total amount of drive time. From home to site and from site

to home. Total amount of time waiting for the site. For Example:

time waiting for site contact to arrive, waiting for copy of pull list, etc. Wait time and Retrieval time need to total the entire time at the site.

Total amount of time spent onsite until you leave the site. Total miles driven round trip. In the ‘Scanned’ field, enter how many charts you retrieved. Choose ‘Yes’ or ‘No’ if you scanned a Signature Log. In the ‘Notes From Tech’ field, notes must include: Status of

the site – whether site is complete or not, Lunch break – 30-minute lunch is required after eight-hour work shift (8 hours includes drive time), Reimbursements – printed pages from Web Center, parking/tolls/bridge fees, etc.

Any issues that occurred at the site that may have prevented you from reaching your Chart Per Hour (CPH) goal.

All CNA’s for the day. Each CNA must be notated individually with the reason listed next to it. Important: DO NOT put member names or DOB’s in your Web Center notes.

Ensure your information is accurate prior to clicking ‘submit info’ – as you cannot edit/delete the information.

Before clicking Submit Info, ensure all information is correct. Click ‘Submit info’.



After the Retrieval, Continued



Scanning Paper Charts Overview

Introduction The following items are essential to a successful project: Protect PHI to the fullest extent. Be courteous and professional while at the site. For every member on the Pull List, be sure to include all rendering

providers for the dates of service, not just the one Provider listed on the Pull List.

Contents Topic See Page How to Scan Paper Charts 59 Trouble Shooting Paper Jams on Scanner 65


How to Scan Paper Charts

Scanning Paper Chart


1 Locate the corresponding patient’s chart and cover sheet by matching names and chart ID’s on the charts, Cover Sheets and Pull List. Place the cover sheet on top of the patient records, as it will be the first document scanned. Scan all documents with the barcode facing away as shown below.

2 On the laptop, open the ScandAll Pro program by double

clicking on its icon.

3 Click on the Start Batch Scan icon in the ScandAll Pro window. Start Batch Scan is the only icon used to scan in paper charts.



How to Scan Paper Charts, Continued

Scanning Paper Chart, continued

Step Action 4 The scanned image will appear on the computer screen.

After the last document in the scanner’s feeder is scanned, a window asking if you want to continue scanning will appear. If ... Then ... You have more pages to scan

Insert more pages into the scanners feeder and select Yes.

You have no more pages to scan

Select No

5 After the completion of each chart, CLOSE (X out of) the ScandAll Pro to view the desktop. On the laptop desktop, double click the Scanned Charts folder.



How to Scan Paper Charts , Continued


Step Action 6 The last folder in the ‘Scanned Charts’ folder directory

should match the CIOX Health Chart ID displayed on the chart Cover Sheet.

If the file name shows as BARCODE or something other than the chart ID of the last chart you scanned in, the file will need to be renamed to the correct Chart ID of the patient’s chart that was just scanned in. To rename the file, right click on ‘BARCODE’ and select ‘Rename’ from the drop down menu, rename it to the correct Chart ID, select ‘Enter’. Note: All file names must match the corresponding Chart ID. If you continue to have problems, please call Technical Support at 1-877-442-4139.





Step Action 6

Cont’d

7 Indicate the chart was scanned on the Pull List.





Step Action 8 Open ScandAll Pro again and continue the retrieval for the

next chart – repeating the process.

When done scanning, choose the X at the top right corner of the screen to close ScandAll Pro




Important When charts are saved onto the CIOX laptop, you will not be able to view the actual documents. If you try to click into the patient’s folder in the Scanned Charts folder, you will see the message below. This message DOES NOT mean the patient’s medical chart images did not save. It DOES mean that the chart is encrypted and you are unable to view the images.


Trouble Shooting Paper Jams on Scanner

Paper Jams with Scanner


1 Wait for the scanner to stop pulling the chart pages. When a paper jam occurs, a window with ‘Paper jammed in the ADF.(Code DS32002)’ will display.

2 Open the cover on the scanner by pressing in on the release button and pulling the cover up. Remove the jammed paged. Close the cover.

3 Re-insert the pages that were not scanned/partially scanned. Click Retry on the dialog window.


EMR – Retrieving Charts On to IronKey Flash Drive Overview

Introduction The following items are essential to a successful project: Protect PHI to the fullest extent Be courteous and professional while at the site For every member on the pull list, be sure to include all rendering

providers for the dates of service, not just the one Provider listed on the Pull List.

When in doubt, DO NOT Retrieve the document. Contact FTC for Chart Verification.

For EMR retrievals, at least 50 chart Cover Sheets must be printed from your Home Computer, from the Web Center application and taken on site in case the site’s EMR system is not compatible with the IronKey. If this occurs, the site will become and EMR Print-to-Scan retrieval (if approved by the site contact).

Because there are many different EMR systems, you will ask the site contact for an overview of the EMR system where their charts are stored. Supported file formats are Adobe PDF, PDF, MDI, TIF and Microsoft XPS. If none of these file formats/extensions are available, please contact your Field Tech Coordinator for further assistance. Review EMR System FAQ’s from Web Center. For EMR- IronKey Flash Drive retrievals, a test upload is required of five charts on the very first visit at a site with 110 or more charts to go. Refer to the ‘Test Upload’ section for further Test Upload instructions.

Contents Topic See Page How to Retrieve Charts on to IronKey Flash Drive 67 Transfer Charts from IronKey to CIOX Health Laptop

75

Uploading from CIOX Health Laptop to CIOX Health

79

Test Upload 82 Wrap Up Before Leaving the Site 83


How to Retrieve Charts on to IronKey Flash Drive

EMR Flash Drive Process


1 Use the Pull List to identify which members’ charts you will retrieve. If you are unable to locate a patient’s chart by name, try searching using the patient’s date of birth. If you are unable to locate a chart in the site’s EMR system, please ask the site contact for assistance with locating the record.

2 Insert the IronKey Flash Drive into a USB port on the site’s computer. If IronKey un-locker does not come up, access it from the start menuComputerIronKey Un-locker.

Select Run IronKey.exe.

3 Enter the password and click the ‘Unlock’ button. Contact Technical Support at: 1-877-442-4139 if the password is not accepted.

Our software has two log in screens for the IronKey. This is an example of the alternate IronKey log in screen



How to Retrieve Charts on to IronKey Flash Drive, Continued

EMR Flash Drive Process, continued

Step Action 4 After logging into the IronKey, a Microsoft Window may or

may not pop up. If it does, always choose ‘Continue without scanning’. NEVER choose ‘Scan and fix’.

5 Clicking unlock after entering your password will take you directly into the flash drive. Member charts will be saved into individual folders in the ‘Chart Review Files’ folder. Double click on the ‘Chart Review Files’ folder. The folder will be empty. Minimize this screen.

6 During the retrieval, you will create a folder for each member listed on the Pull List in the ‘Chart Review Files’ folder that is located within the IronKey. The folder will be named with the Chart ID, which is next to the member name on the Pull List.





Step Action 7 From the site’s system, Open the member’s chart in the

site’s EMR system. Refer to QRG to determine which components of the patients chart to save. Select the first page of the chart to be saved. Click on the Printer Icon within the EMR system and then select ‘Print’ to access the printer control panel. If you cannot locate the Printer Icon, look for the ‘Save’ button/tab from within the EMR system. Either way will properly print (or save) the document to your IronKey Flash Drive.

8 From the printer control panel, select Adobe PDF, MDI, TIF or Microsoft XPS from the ‘Printer Name’ drop-down list. Select Print.

Printer control panels may vary depending on the site’s computer systems. Select File extension, then select print. Example:





Step Action 9 Click into IronKey directory on the left of the pop-up screen.

Then, click on the ‘Chart Review File’ folder to create a folder with the patient’s chart ID number





Step Action 10 To create a folder inside of the ‘Chart Review File’ folder,

Right click in the ‘Chart Review File’ folder and select New. Select Folder. (Make sure you verify you are creating the folder inside of the ‘Chart Review File’ folder)





Step Action 11 Name the pages that are to be saved in numerical order

beginning with number 1. Click Save

Saved Result:





Step Action 12 After all the elements of the first chart are saved, you will

repeat the process for the next patient on the Pull List. You create another folder within the ‘Chart Review File’ folder for the next patient. Important: If a chart will be a CNA, DO NOT create a folder for it. DO NOT create the folders for the patients ahead of time. ALWAYS verify you are creating the folder within the ‘Chart Review File’ folder. DO NOT name the elements with words. It must be in number format.

13 Mark that the chart was retrieved on the Pull List.

14 Once all charts have been retrieved, it is important to lock the IronKey Flash Drive before removing it from the Provider’s computer. To lock the IronKey Flash Drive, Click on ‘Lock Drive’ on the IronKey control panel. Note: You must lock the IronKey to safely eject the IronKey flash drive. Important: It is ALWAYS necessary to move files from the IronKey Flash Drive to the CIOX Health laptop before leaving the site. This does not require a Wi-Fi connection.






Transfer Charts from IronKey to CIOX Health Laptop

It is always necessary to move files from the IronKey Flash Drive to the CIOX Health laptop before leaving the site. This does not require a Wi-Fi connection.

Process Perform the following actions: Step Action

1 Insert the IronKey Flash Drive into a USB port on the CIOX Health laptop

2 Select ‘Run IronKey.exe’.

3 Enter the password and click the ‘Unlock’ button. Contact Technical Support at 1-877-442-4139 if the password is not accepted.

Alternate IronKey login screen.



Transfer Charts from IronKey to CIOX Health Laptop, Continued

Process, continued

Step Action 4 After logging into the IronKey, a Microsoft Window MAY

OR MAY NOT pop up. If it does pop up, always choose ‘Continue without scanning’.

5 If you are not immediately taken directly into the flash-drive, click on Secured files.

6 Double click on ‘ECSFlashDriveManager’




Process, continued

Step Action 7 A black box appears during the process of moving charts

from the flash drive to the CIOX Health laptop. The transfer is complete when the black box reads ‘Press Enter to Exit’. When it reads this, select Enter.

8 Double click on ‘Chart Review Files’ to ensure all charts have transferred to the laptop from the IronKey. This folder should now be empty if all charts transferred to the laptop.

9 Click the red ‘X’ in the upper right hand corner to close the window. If you have any problems transferring charts from the IronKey Flash Drive to the laptop, call Technical Support at 877-442-4139.

10 Double click on the ‘EMR’ folder located on the CIOX Health laptop’s desktop to ensure all charts transferred to the laptop.

11

The folders named with Chart IDs will be in the ‘EMR’ folder. Once the charts have been transferred to the laptop, you will not be able to view any of the saved documents. If you are able to view any documents, you must contact the IT department for assistance immediately. Failure to do so will result in a PHI violation. Important: Do NOT drag or copy and paste the charts from the IronKey onto the laptop.







Process After completing your retrieval(s) for the day, drive directly home and connect the CIOX Health laptop and establish and internet connection and perform the following actions:

Step Action 1 Double click on the CIOX Tech Uploader icon.

2 The Chart Uploader’ window will appear. Click on the ‘Compress/Upload’ button.

3 The length of the upload depends on the speed of your internet connection. When the upload is complete, two windows will appear. One for the scanned charts and one for the EMR folder. The number of files listed in this window may not be the same as the number of charts retrieved.




Process, continued

Step Action 4 Click OK. Click on the ‘X’ at the top right hand corner of

the ‘Chart Uploader’ window to close the window. 5 Double click on the EMR folder icon on the CIOX laptop to

ensure the folder is empty.

6 Double click on the ‘Scanned Charts’ folder on the CIOX

laptop and ensure the folder is empty. If you have any problems uploading the charts, call Technical Support at 877-442-4139.



Uploading from CIOX Health Laptop to CIOX Health, Continued



Test Upload

Introduction A test upload of five charts must be completed on the first day of every EMR to flash drive retrieval for sites with 110 or more charts to go. The test upload must be completed within the first two hours of your scheduled start time. If you are unable to complete the test upload within the first two hours you must contact your Field Tech Coordinator or the Emergency Line (877-442-4145) to speak with a Field Tech Coordinator.

Process Perform the following actions: Step Action

1 Retrieve and save five charts into the IronKey Flash Drive. See the EMR Flash Drive–Retrieving Charts onto IronKey Flash Drive section.

2 Move charts from the IronKey Flash Drive to the CIOX Health laptop. See the Transfer Charts from IronKey to CIOX Health Laptop section

3 Find a Wi-Fi spot. This may require leaving to another location, (Starbucks, McDonald’s) if the site does not provide a Wi-Fi password. Do not ask the facility for the password.

4 Upload the charts to CIOX Health. See the Uploading from CIOX Health Laptop to CIOX Health section. If there is a retrieval method change, call the FTC Hotline.

5 Call your Field Tech Coordinator advising of the Test Upload. If your Field Tech Coordinator is unavailable, call the Emergency Line at 877-442-4145.

6 Return to the site after the call and continue with the retrieval until you hear back from your Field Tech Coordinator.

Test Upload Scenarios

If ... Then ... Test charts were received correctly by CIOX Health

Continue with the remaining charts on the Pull List.

Test charts were not received correctly by CIOX Health

Save the same five charts using a different extension than you used before (Adobe PDF, MDI, TIF or Microsoft XPS). Repeat the test upload process outlined above.


Wrap Up Before Leaving the Site

Before Leaving Site

Before you leave the site: Scan all the pages of the Pull List if there are no more charts to be

retrieved at the site. DO NOT scan in any pages of the Pull List if charts still remain to be retrieved.

Give the completed Pull List to the site contact and ask them to fax it along with the completed Chart Review Satisfaction Survey to 817-251-5424

Pack ALL equipment back into the travel case and lock the travel

case! Call your Field Tech Coordinator before you leave the site. Update your status on MobiWork. Important: Do not remove any medical records, copies of medical records, Pull List, copies of Pull List, or anything that contains PHI from the site. Ask the site contact to securely destroy any paper generated from the visit that contains PHI.


Important Information Overview

Introduction Be sure you read the information on the following pages for important information relative to your role as a Field Technician

Contents Topic See Page Field Technician Reference Guide 85 Summary of Privacy and Security Policies and Procedures

87


Field Technician Reference Guide

Daily Guidelines

Retrieval method changes must be approved by your Field Tech Coordinator

Leave all PHI at the site. DO not remove medical records, copies of medical records, the Pull List or copies of the pull list, or any PHI from the site.

Never open a chart of someone you know If the site doesn’t have the Pull List call your Field Tech Coordinator

or the Emergency Line (877-442-4145) Update the MobiWork app with your status throughout the day.

When you leave to site, arrive to site, lunch, leave site, and arrive home. Also update site expenses/reimbursements

When leaving a site, regardless of the retrieval method, return all equipment back to the travel case and lock it!

Update Web Center at the end of each day’s retrieval from your Home Computer.

CIOX Health Laptop Password

The password for the CIOX Health laptop will be provided to you from your FTC.

EMR Flash Drive Sites

Cover Sheets are not scanned during this retrieval process. You must print at least 50 coversheets and taken them to the site in case the EMR is not compatible with the IronKey Flash Drive. Contact your FTC immediately if this is the case.

Save charts to the IronKey Flash Drive using one of the following extensions: PDF, XPS, MDI, and TIF.

Prior to leaving the site for the day, ensure all files are transferred to the CIOX Health laptop.

Test Upload for EMR Flash Drive Sites

The test upload is only required on the first day at an EMR- Flash Drive sites with 110 or more charts to go. Retrieve five charts to the IronKey Flash Drive Transfer the charts from the IronKey Flash Drive to the CIOX

Health laptop Find and access Wi-Fi Upload the five charts to CIOX Health Call your Field Tech Coordinator or the Emergency Line (877-442-

4145) to check if the charts uploaded correctly See the Test Upload section for guidance



Field Technician Reference Guide, Continued

Paper Scan Sites

Cover Sheets are required. Print ALL Cover Sheets or at least 150 of them.

No test upload is needed You may have to pull the charts and put them away at the end of

the day Return all charts in the same condition and order you received

them Make sure you use the correct Cover Sheet for each chart Use the CIOX Health scanner to scan the charts into the CIOX

Health laptop. See the Scanning Paper Charts section for guidance.

EMR Print to Scan Sites

Cover Sheets are required. Print All Cover Sheets or at least 150 of them.

No test upload is needed Charts will be printed from the site’s EMR system The site may print charts prior to your arrival The site may have you print charts from their EMR system Use the CIOX Health scanner to scan the charts into the CIOX

Health laptop See the Scanning Paper Charts section for guidance.



Summary of Privacy and Security Policies and Procedures

1. Access Control and Validation Procedures Workforce members are required to adhere to facility access controls such as displaying their ID badges, using key fobs or memory cards when required, and only being on premises during scheduled work times.

2. Authentication Methods Workforce members are required to utilize their own unique user identifier (user ID) and their own unique password(s).

3. Complaints Workforce members are encouraged to report any suspected breaches of privacy or security violations to the Vice President of Compliance.

4. Device and Media Controls Workforce members must contact the Vice President of Compliance before attempting to move, destroy, or re-use any CIOX Health owned hardware or electronic media devices, regardless of whether those devices contain, contained, accessed or access PHI.

5. Equipment Policy Workforce members are prohibited from using CIOX Health equipment for personal use or accessing the Internet for recreational use. Workforce members will be required to agree to and sign the Equipment Policy Agreement that is located in the Field Technician Handbook.

6. Malicious Software Workforce members are not allowed to install or use any software on any CIOX Health owned equipment, or to access CIOX Health applications and networks on workforce member owned equipment without prior approval.

7. Media and Press Release Workforce members are prohibited from speaking with media or press without prior approval.

8. Minimum Necessary Workforce members are required to safeguard PHI at all times from unauthorized access, and are not allowed to discuss or share PHI with unauthorized users.



Summary of Privacy and Security Policies and Procedures, Continued

9. Password Management Workforce members are required to protect their own unique passwords at all times and are prohibited from using other user’s passwords/ID. Workforce members are required to report immediately to the Vice President of Compliance if a password or a User ID may have been compromised.

10. Sanctions Workforce members will be sanctioned for failing to comply with CIOX Health security and privacy policies, procedures, and practices. Sanctions may include but are not limited to verbal counseling, written counseling, suspension, demotion, transfer and termination of employment, contract penalties, and contract termination. 11. Security Management Workforce members are required to comply with CIOX Health privacy and security policies, procedures, and practices, and to immediately report any security violation or breach to the Vice President of Compliance at (623) 207-5608 or the Compliance Reporting Hotline at (623) 207-5888 12. Training Requirements Workforce members are required to complete privacy and security training, and to pass any required examinations prior to CIOX Health allowing the workforce member access to PHI. 13. Wireless, Remote and Network Policies Workforce members are not allowed to access CIOX Health applications or networks remotely without prior approval. 14. Workforce Clearance and Background Check Procedures Workforce members whose job duties will require access to PHI will undergo verification of academic and/or professional experience and qualifications, background checks, and drug screening. 15. Workstation Use and Security Workforce members must protect workstations from unauthorized access and must lock or log off of workstations before leaving the workstation.



Summary of Privacy and Security Policies and Procedures, Continued

Compliance Reporting Hotline

To report privacy, security, or other compliance concern, or an actual or potential violation, please leave a message with enough detail so that we may promptly investigate. You do not have to leave your name or contact information; however, doing so may allow us to resolve the issue more quickly. Reporting is protected and encouraged. We will make every effort to protect the confidentiality of anyone who makes a report or requests guidance on an issue. There will be no retaliation against workforce members who, in good faith, report an actual or potential violation or questionable behavior. The Compliance Reporting Hotline number is 623-207-5888.