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1.1.2 Provider Switches During Pay Period - Permanently

 This

process There is for if the number of hours between two Providers must change permanently. For example: If a consumer is authorized 40 hours and HCW A has 25 hours but they quit, so you need to lower their hours to zero and increase HCW B’s hours to 40a need for a permanent switch in provider(s) during a pay period.

1.1.3 Provider Switches During Pay Period - Temporary

 This

process There is for if a number of hours between two Providers much change temporarily. For example: If HCW A is on vacation and HCW B must cover those hours.a need for a one-time switch in provider(s) during a pay period.

1.1.4 Change Authorization

Process for if a change in the A change/update in an authorization is needed, including a change in mileage or hours, ending the authorization early, etc.

1.2.1 Add a New ProviderProcess used to add a new Provider.

A new provider needs a profile

1.2.2 Change Provider Status

Process used when a Provider's status must be updatedA provider status needs to be changed.

1.3.1 Add a New Consumer Information

A new consumer needs a profile in OR PTC DCIProcess used to add Consumer information.

1.3.2 Update Consumer Information

Process used to update Consumer information must be updated in OR PTC DCI.

1.3.3 Consumer Transfers to a New Branch or Program

A long-term care consumer moves to Process used to transfer a Consumer to a new branch or program.

1.4.1 Add or Remove Consumer Employer RepresentativeProcess used to

add/remove Consumer Employer RepresentativeCER needs to be added.

1.4.2 Update Consumer Employer Representative Information

Process used to update Consumer Employer informationCER information must be updated.

1.4.3 Create Consumer Employer Representative AccountCreate a Consumer Employer Representative Account

CER profile needs to be created.

1.5.1 Managing Staff Profiles

Staff member needs an OR PTC DCI profile to be created, modified, or closed.

1.5.3 Unlock an Accounta Profile

OR PTC DCI profile must be unlockedProcess to unlock an account.

1.6.0 Manually Adding or Updating Branch InfoProcess to add or update branch information

1.7.0 Setting Up EVV Options with Consumers and Providers

This process includes confirming the option they have chosen, confirming the landline, set up with the fob, set up telephony historical time entry (Consumer needs PIN), set up phone EVV, etc.

2.1.0 Increase in Weekly Cap

 Business

process needed for retroactive increased weekly cap hoursCase manager identified an exception need to increase a provider's weekly cap.

2.12.0 Provider Goes Over Authorized Hours

Pended Entries Management where an entry pends due to the going over the authorized hours.

2.2.3 Correct Punch Entry Mistake

 Process

for if a Provider, State Staff Member, or Consumer notices a mistake in a punch entry after the Consumer has approved the entry (meaning the Provider cannot edit the entry in OR PTC DCI)A mistake has occurred or a consumer/CER disputes an entry.

2.6.2 End Authorization, Expiration, Terminations

Process to follow when a Provider A provider is terminated, an authorization ends, or their credentials expire. This process should be basically the same as it is in the current system with the addition of updating OR PTC DCI.

3.3.0 Consumer Passes Away

Process to follow when a Consumer passes A consumer passed away.

4.1.1 Pending Entries Management

The process for working the pend queue on a daily basis. The purpose is to either approve or reject time entries that have failed a business rule and resolving the issues that caused them to pend.

4.3.0 Time Entry

This is the process for entering time from OR PTC DCI into Mainframe.

4.4.0 Over and Underpayments

How to process under and over payments.

6.1.0 Case with Multiple Providers & Varying Hours

The process for handling cases that have multiple Providers who have varying hours every pay period.