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Business Process

Description

1.1.2 Provider Switches During Pay Period - Permanently

 

There is a need for a permanent switch in provider(s) during a pay period.

1.1.3 Provider Switches During Pay Period - Temporarily

 

There is a need for a one-time switch in provider(s) during a pay period.

1.1.4 Change in Authorizations

 

A change/update in an authorization is needed.

1.1.5 Relinking a Provider and ConsumerProvider begins working for a Consumer they previously had stopped working for.

1.2.1 Add a New Provider

A new provider needs a profile

1.2.2 Change Provider Status

A provider status needs to be changed.

1.2.3 Update Provider InformationProvider information must be updated.
1.2.4 Provider Number ReinstatedProvider number is reinstated after being terminated.

1.3.1 Add a New Consumer

A new consumer needs a profile in OR PTC DCI.

1.3.2 Update Consumer Information

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 a new branch or program.

1.3.4. Return or Request a Fob in the Local OfficeA fob is returned to the local office.

1.4.1 Add or Remove Consumer Employer Representative

CER needs to be added.

1.4.2 Update Consumer Employer Representative Information

CER information must be updated.

1.4.3 Create New Consumer Employer Representative

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 a Profile

OR PTC DCI profile must be unlocked.

1.6.0 Manually Adding or Updating Branch Info

OR PTC DCI support receives notification of branch change from BOTS legacy BAs.

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

 

Case 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 Entry Mistake

 

A mistake has occurred or a consumer/CER disputes an entry.

2.3.0 Entries Claimed After 365 DaysProvider has time to turn in past 365 days.

2.6.2 End Authorization, Expiration, Terminations

A provider is terminated, an authorization ends, or their credentials expire.

3.3.0 Consumer Passes Away

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.

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