EMIRATES HOME CARE Tel. +971-2-5556503 | F ! +971-2-555650" L.L.C. #$ %l& %'()*e$%+ ,e-.)$e/ +e.

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CODING PROCESS DESCRIPTION
1. A patient is presented as a potential candidate for Home Care services. 2. The Nursing Supervisor from the Nursing Department will collate and complete Medical eport! Discharge Summar"#if availa$le%! Home Care eferral &orm' (nsurance Card Cop" from the famil" or the treating facilit". ). The Nursing Supervisor will then perform initial assessment of the patient either the patient still in the Hospital #if the patient still confined% or at home within 2* hours to *+ hours after receiving home care referrals. Mandator" visit at home or patient,s residence will $e done after the assessment. *. (f criteria for home care is met after assessment of the patient,s residence! the nursing department will thoroughl" discuss and colla$orate and prepare for the Nursing Care -lan. .. All Collected Medical eport! Discharge Summar"! eferral Summar"! (nsurance Card! Assessment eport of -atient and esidence and Nursing Care -lan will $e forwarded to the Medical Coder for verification of completeness of documents. /. An" missing documents needed will $e consulted $ac0 $" the Medical Coder to the Head of Nursing Department t for completion. 1. After successful review of the completeness and veracit" of documents! the Medical Coder will determine the diagnosis and procedural codes $ase on (CD 2 and C-T * for Medical Coding. +. The Medical Coder will colla$orate and refer $ac0 to -h"sician and3or Nursing Supervisor for an" clarifications on diagnosis and home care services to $e given to the patient so that the clinical Medical Coder will assign the most specific and applica$le codes possi$le. 2. (f there are no more clarifications! the Medical Coder will produce the coding paper #Diagnosis ' -rocedures% and fill up the authori4ation re5uest form for 6utpatient Services.

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17. The Medical Coder will su$mit the completed documents #such as Home Care eferrals! Coding -apers! Authori4ation re5uest form signed $" the patient or $" the significant others #Claim &orm%! Dul" signed (nsurance Consent &orm! Nursing Care -lan! Assessment &orm! Discharge Summar" #if applica$le%! 8alid (nsurance Card Cop"! 9icense cop" of the Nurse to $e assigned% to re5uest for authori4ation from the (nsurance Compan".

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EMIRATES HOME CARE Tel. +971-2-5556503 | F ! +971-2-555650" L.L.C. #$ %l& %'()*e$%+ ,e-.)$e/ +e. e
11. (f authori4ed! the Medical Coder will inform the Nursing Supervisor a$out the specific home care services to $e given including the num$er of hours approved. The Nursing Supervisor will then deplo" the assigned egistered Nurses to patient,s home for nursing services and inform the treating facilit" and the famil" on the approval. 12. (f re:ected! the Medical Coder and Head of Nursing Department will colla$orate and conduct a case re:ection review and will do revision if there is an" possi$ilit" to appeal the re:ection and re5uest for re;approval. (f not necessar"! close the case and inform the treating facilit" and the famil" of the reason. 1). Complete and concise documentations should $e done $" the assigned nurses dail" and properl" endorsed to the Nursing Supervisor for continous monitoring of patient,s current condition and changes on the services rendered. 1*. The Nursing Supervisor will immediatel" inform and update the Medical Coder in the sudden changes #additional service or discontinued services%. Medical Coder will then update the (nsurance Compan" for approval of additional 3 discontinued services. 1.. The Medical Coder will dail" code the diagnoses and services rendered $" the assigned nurse. 1.. A monthl" generation of <ml file from electronic s"stem will $e done $" Medical Coder which serves as the $illing statement. 1/. The <ml file will $e uploaded to HAAD -ost 6ffice via =reenrain Messenger $" the Medical Coder 11. The (nsurance Compan"3-a"or will advise the -rovider if there are an" re:ections or denials on the claims su$mitted $" the Medical Coder. The denials will $e corrected and will $e appealed for re;approval. 1+. (f there are no error seen $" the (nsurance Compan"! emittance advice will $e received $" the -rovider.

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