CareControl offers many tools to help streamline Provider management processes to assist you in capturing the required information for the Provider while staying in compliance.
The Provider Review is one of them; it is a self-assessment tool to allow you, a Provider Specialist, to check for any potential errors. The Provider Review rules stem from the CDSS SPR exceptions; however, it can be designed to fit your Agency's needs and can be used to report any information that may be missing from a Provider’s records.
Running the Provider Review
The starting point to run the Provider Review is from the “Provider Info” Tab.
a. If you are accessing a Licensed Provider, you can access this Tab from the “Details” Tab drop-down menu.Exempt Provider ViewLicensed Provider View
Click Review button, at the bottom left of the page, to start the Provider Review process. You can also find this button at any point on the top right of the provider record in any tab.
After you’ve started the Review process, CareControl will redirect you to the “Reviews” Tab for a record of all reviews performed.
Within the “Reviews” Tab, you will have access to all the review records. The review record lists include:a. Review ID, which is a hyperlink to view all the error details for each review.
b. Reviewed Time, By, Status of the Review.
When your Review ID returns a number of errors, click on the specific Review ID hyperlink to view the Review details.a. This will open a new slide-out window from the right to show the description of the errors, in order to resolve them.
Once the errors are resolved accordingly for the Provider record, you may repeat the process to re-run another Provider Review process (from Step 2).
❗️TIP: The Review tool is a self-assessment tool for you to self-check the Provider records, you may delete the Review ID with the error details once the corrections are made.
When your new Review ID returns a 0 error, click on the specific Review ID hyperlink to view the Review details.
a. This will open a new slide-out window from the right to show the 0 errors in the details. From here you may Approve the Review Process to store it in the Provider record.
i. When approving the Review, you may choose to:
1. Add a Tag to capture the reason for the Review, such as New Provider Approval, Licenses Update, etc.
2. Add a Comment to capture more information for this Review record.