This document provides a legend and definitions for process maps of a client's patient intake process. It explains that each step of a process is illustrated and defines terms like "STEP" and "PROCESS". It also notes that the map is of the client's process before optimization.

1. Process Map Legend
Each STEP of a PROCESS is detailed as illustrated below.
This page provides a legend for the process maps presented on the folliwing pages.
This is the client’s process map before optimization.
STEP 2a PATIENT INTAKE
1. Enter Patient Demographic Data (AllScripts) (m)
Payer Codes
ICD-9 Diagnostic Codes
2. Check Benefits (m)
3. Check Eligibility (m)
4. Get Initial authorization (Insurer Web or Voice) (m)
5. Verify & Enter Insurance Coverage Number (m)
INTAKE NURSE 6. Create New Insured Patient (Allscripts) (o)
Patient Intake 7. Vailidate Doctor’s License Status(State Web Site) (m)
8. Review Availability of Internal Resources (o)
9. Research Unusual Diagnosis (o)
10. Enter Doctor Orders (Allscripts) (m)
11. Review For Medicare Guideline Compliance (m)
12. Print Chart (Basic Referal Info.) (m)
13. Review History & Physical (m)
14. Send Chart to Appropriate Line of Service (m)
15 .Enter Medication Therapies (AllScripts) (o)
Copyright 2009 FlowLogic FlowLogic
This process map is shared with permission from the Michael R. Neece, EVP Global Services
client organization o. 508-435-2647 m. 508-735-4656
mneece@flowlogic.com
10/27/2009 1 of 23

2. Start HHHC Patient Intake
STEP 1 PATIENT HOSPICE EVALUATION
1. Complete Hospice Eval Form (m)
2. Complete Discharge Form (o)
LIASON 3. Gather Medical Records (m)
Patient Hospice Medications, History & Physical
Evaluation Last Clinical Notes
4. Send Referral to Intake (AllScripts) (m)
5. Arrange Transportation (o)
6. Arrange Medical Hockups (o)
STEP 2a PATIENT INTAKE
Referal 1. Enter Patient Demographic Data (AllScripts) (m)
Payer Codes
ICD-9 Diagnostic Codes
2. Check Benefits (m)
3. Check Eligibility (m)
STEP 2b CASE INTAKE
4. Get Initial authorization (Insurer Web or Voice) (m)
1. Check Primary Payer (AllScripts) (m)
5. Verify & Enter Insurance Coverage Number (m)
2. Check Benefit Limits (AllScripts) (m) CASE
INTAKE NURSE 6. Create New Insured Patient (Allscripts) (o)
3. Check Pre Authorization Levels & End Dates MANAGEMENT
Patient Intake 7. Vailidate Doctor’s License Status(State Web Site) (m)
(AllScripts) (m) Case Intake
8. Review Availability of Internal Resources (o)
4. Get Insurance Authorization (Web or Phone) (m)
9. Research Unusual Diagnosis (o)
5. Review Patient Clinical Needs (AllScripts) (m)
10. Enter Doctor Orders (Allscripts) (m)
11. Review For Medicare Guideline Compliance (m)
12. Print Chart (Basic Referal Info.) (m)
PAYER 13. Review History & Physical (m)
Referal
Authorization 14. Send Chart to Appropriate Line of Service (m)
15 .Enter Medication Therapies (AllScripts) (o)
Home Hospice Home
Palliative Private
Health House Hospice
Care Duty
Care In-Patient Care
Skilled Nursing Hospice Home Care Home Health Aid
Nursing
Physical Therapy Hospice Nursing Home Making
Home Health Aid
Home Care Companion
Occupational Therapy
Hospice General In- Foot Clinic
Speech Therapy Patient (GIP)
Medical Social Worker Grief Counseling
Home Health Aid Volunteers
10/27/2009 2 of 23

3. From INTAKE
A Home
Referal
Health HHHC Home Health Care 1 of 4
Care
STEP 2a ASSIGN REFERAL
1. Enter On Referal Assignment Board (m)
2. Enter Existing Patient Doctor’s Orders (o)
3. Triage Patients (o)
4. Clinical Calls (o)
5. Balance Case Load (Allscripts) (m)
CASE
6. Schedule Services
MANAGER TEAM LEADER
7. Fax Referal To Non-Computer Clinicians (o)
Medicare Assign Referal
8. Place Referal Order In Clinician’s Mailbox
Discharge
9. Send Medicare Patient Discharge Info To Case Manager (o)
10. Hold Occupational Therapy Until Admitted (o)
11. Schedule Pre-Habilitation (o)
12. Notify Hospital of Resumption/Re-Intake (for pre habilitation) (o)
13. Review Medicare Compliance (m)
14. Send Referal To TeleHealth Nurse (o)
Referal TEAM LEADER
STEP 2b CASE LOAD REVIEW & AUTHORIZATION
Assigment Case Load
1. Review Clinician Case Load (Allscripts) (m)
Board Review &
2. Check Initial Authorization (Allscripts) (m)
Authorization
STEP 3a SCHEDULE SERVICES
1. Enter Assignment Board (Allscripts) (m)
2. Notify Patient (m)
SCHEDULER 3. Notify Clinicians (voice mail) (m)
PATIENT Schedule 4. Schedule Services From Clinicians (m)
Services 5. Schedule Home Health Aids (o)
6. Notify Hospital For Re-Intake After Hospitalization (o)
7. Review & Enter Telephone Data (Allscripts)
Validate Codes
STEP 4a PRE-ADMISSION
1. Synchronize Laptop (Allscripts) (m)
2. Check Schedule (Allscripts) (m)
3. Review Doctor’s Orders (Allscripts) (m)
CLINICIAN
4. Review Insurance Coverage (Allscripts) (m)
Pre-Admission
5. Review Discharge Paperwork (Allscripts) (m)
6. Assess Medicare Status (m)
7. Enter I.V. Status (for IV Patients) (Allscripts) (o)
8. Schedule Initial Visit with Patient (m)
Continued Home
10/27/2009 Health Care 2 3 of 23

4. From Home
Health Care 1 HHHC Home Health Care 2 of 4
STEP 5a.1 PATIENT ADMISSION
1. Confirm Identity (Allscripts) (m)
2. Verify Insurance Data (Allscripts) (m)
3. Interview Patient (Allscripts) (m)
4. Conduct Full Assessment (Allscripts) (m)
5. Create Plan of Care (Allscripts) (m)
STEP 5a.2 CASE INTAKE 6. Create Orders (Allscripts) (m)
1. Check Frequency & Duration of Visit (AllScripts) (m) 7. Review Admit Book With Patient (m)
2. Get Pre-Authorization for Care (AllScripts) (m) 8. Complete Signed Admission Contract (Allscripts) (m)
9. Complete Consent to Treat (Allscripts) (m)
10. Review & Sign Medicare Supply Coverage-Medicare Patients (o/m)
11. Review Emergency Prepare Plan With Patient (m)
CASE CLINICIAN
12. Enter Patient Priority (n/a, 1, 2, 3) (Allscripts) (m)
MANAGER Patient
13. Complete I.V. Consent for Medicare Patients (o/m)
Case Intake Admission
14. Educate Patient: Review Plan for Discharge (m)
15. Complete Problem Chart (m)
16 Complete Appropriate Tasks (Allscripts) (o)
17. Signed Paperwork to Admin Assistant (m)
18. Review Admin. Visit with Primary Clinician (m)
PAYER
19. Notify Doctor of Plan-of-Care (Allscripts) (m)
Authorization
20. Order Supplies (o)
21. Give Patient Copies of Paperwork (m)
-Contract (m), -Consent to Treat (m)
-Admissions Book (m) -Medicare Discharge Notice (m)
-Medication Planner (o) -Schedule (m)
-Medical Supplies (o)
Orders for Copies of Orders for Signed
Contract Paperwork
Care Paperwork Supplies
MEDICAL ADMIN. SCHEDULER STEP 6a.1 Schedule Care
SUPPLY ASSISTANT
BILLING PRIMARY MD PATIENT OR CLINICIAN 1. Schedule Ongoing Care (Allscripts) (m)
VENDOR Audit Admission Schedule Care 2. Schedule Home Health Aid (o)
Order
Continued
Home Health
Continued
Care 3
Accounting1
10/27/2009 4 of 23

5. From Home HHHC Home Health Care 3 of 4
Health Care 2
STEP 6a.2 AUDIT PAPERWORK
1. Verify Contract Signed (m)
2. Verify Consent to Treat (m) STEP 6a.4 ONGOING CARE
3. Audit Entire Patient Record (Allscripts) (m) 1. Record Change in Care
4. Resolve Discrepencies (Allscripts) (o) 2. Record Doctor Changes (Allscripts) (o)
5. Print & Send Orders to M.D. (m) 3. Deliver Plan of Care
6. Set Follow-up Tasks (Allscripts) (m) 4. Notify Doctor of Changes
ADMIN. 7. Review M.D. Orders to Treat (m) 5. Notify Clinician Team of Changes
CLINICIAN
ASSISTANT 8. Get Signed M.D. Orders (30-days) (m) 6. Chart Visit (Allscripts) (m)
Deliver Care
Audit Paperwork 9. Verify SS# & Medicare # (Medicare Sys) (o) - Assessment - Clinical Notes
10. Verify New M.D. (o) - Problem Charting
11. Send Referral (o) - Transactions (times in/out/travel)
12. Enter NPI# for M.D. (Allscripts) (o) 7. Discuss Plan for Discharge with Patient (m)
13. Complete Open Tasks (m) 8. Enter tasks as Needed (Allscripts) (o)
14. OASIS Complete (Medicare/caid) (m) 9. Give Appropiate Forms/Notice to Patient (o)
15. Review Emergency Prep. Plan (m)
16. Notify Clinicians of Recertification Due (o)
Orders
STEP 6a.5 CASE REVIEW
CASE 1. Review Pre-Authorization Cycle
MANAGER (AllScripts) (m)
Ongoing Care
Case Review 2. Get Pre-Authorization for Care
(AllScripts) (o)
PAYER
Authorization
PRIMARY MD
Audit Paperwork
SCHEDULER STEP 7a Schedule Care
OR CLINICIAN 1. Schedule Ongoing Care (Allscripts) (m)
Schedule Care 2. Schedule Home Health Aid (o)
Discharge
Discharge
Continued Home
Paperwork
Health Care 4
10/27/2009 5 of 23

6. From Home Discharge
Health Care 3 Notification HHHC Home Health Care 4 of 4
(Allscripts)
Discharge STEP 8a.2 DISCHARGE
CLINICIAN or
PRIMARY MD 1. Delete Future Tasks & Visits (Allscripts) (o)
SCHEDULER
2. Notify Case Mgr. of Discharge (m)
Notification
Discharge
Paperwork
CASE
MANAGER STEP 8b.2 PAYER NOTIFICATION
Payer 1. Notify Payer of Patient Discharge (m)
Notification
STEP 8a.1 DISCHARGE
1. Audit Contract for Completeness
2. Audit Consent to Treat PAYER
3. Audit Admit Orders from Intake Discharge
Notification
4. Check Assessments & OASIS Assements Notification
5. Verify Admissions Data (Allscripts) (m)
6. Resolve Discrepencies (Allscripts) (o)
ADMIN.
- Clinicians - Billing - Doctor
ASSISTANT
7. Audit Regulatory Paperwork (Allscripts) (m)
Discharge
8. Print & Send Orders to Doctor for Signature (Allscripts) (m)
9. Perform Assigned Tasks (Allscripts) (o)
10. Run Reoports (Allscripts) (m)
11. Contact Clinician for Patient Recertification
12. Contact Doctor to Resolve Open Orders
13. Audit & Resolve OASIS Inaccuracies (Allscripts) (m)
14. Send Survey to Patient (m)
Orders Orders MEDICAL
PRIMARY MD END
RECORDS
10/27/2009 6 of 23

7. A From INTAKE
Hospice HHHC Hospice House In-Patient 1 of 2
Referal
House In-
Patient
STEP 3b.1 PRE-ADMIT: CLINICAL REVIEW
CASE CLINICAL 1. Assess Hospice Level of Care (m)
STEP 3b.2 INITIAL AUTHORIZATION MANAGER MANAGER 2. Assess Safety (m)
Update
1. Obtain Initial Authorization From Payer (m) Initial Pre-Admission 3. Order Hook-ups & Equipment (m)
Authorization Clinical Review 4. Order Medications (Allscripts) (m)
5. Collect Signed Orders (m)
Notification
STEP 2b ASSIGN REFERAL
Orders for ADMIN.
PAYER 1. Request Standing Orders From Primary Care MD (m)
PRIMARY MD Care ASSISTANT
Aurthorization 2. Enter Hospice Certification (Allscripts) (m)
Assign Referal
6. Create Patient Chart (m)
Notification
STEP 4b.1 PATIENT ADMISSION
1. Conduct Full Assessment (Allscripts) (m)
2. Review Medication (Allscripts) (m)
CASE 3. Order Medication (o)
CLINICIAN
STEP 4b.2 UPDATE AUTHORIZATION MANAGER 4. Order Hockups, Special Equipment (to Vendor) (o)
Update Patient
1. Update auth and LOC with payer (m) Update 5. Execute Consents & Contracts (paper) (m)
Admission
Authorization 6. Create Medication Administration Record (MAR) (paper) (m)
7. Create Plan of Care (Allscripts) (m)
8. Signed Paperwork to Admin Assistant (m)
9. Create KARDEX (m)
DME
PHARMACY VENDOR
Prescription Equipment &
Hoockups
STEP 5b AUDIT ADMISSION
ADMIN. 1. Send Plan of Care to Primary Care Doctor (m)
Plan of Care 2. Collect Signed Plan of Care from Doctor (Allscripts) (m)
PRIMARY MD ASSISTANT
Audit Admission 3. Create Daily Census Report (m)
4. Send Daily Census Report to Billing/Merrimack/Nashua (m)
Continued
Hospice Houce
10/27/2009 7 of 23
In-Patient 2

8. From Hospice HHHC Hospice House In-Patient 2 of 2
Houce In-Patient 1
STEP 6b.1 ONGOING CARE
1. Review Medication Administration Record (MAR) (paper) (m)
2. Review KARDEX Daily Task List (paper) (m)
3. Deliver Plan of Care (m)
CASE 4. Review Patient Record (Allscripts) (o)
STEP 6b.2 UPDATE AUTHORIZATION
MANAGER 5. Record Care Delivered (Allscripts) (m)
1. Update auth and LOC with payer (m) Update
Update CLINICIAN 6. Update KARDEX Daily Task List (o)
Authorization Deliver Care 7. Voice Record Clinical Info (for next shift) (m)
8. Review Hospice Level of Care (daily) (Allscripts) (m)
Notification 9. Create Discharge Plan (Allscripts) (paper) (o)
10. Create Discharge Summary (upon patient death)(Allscripts) (o)
Ongoing Care
11. Complete Death Certificate (Allscripts)(paper) (o)
12. Notify Berevement Coordiator (upon patient death) (o)
Every 2 weeks 13. Create Discharge / Transfer Notice (Allscripts)(paper) (o)
Inter-disciplinary STEP 7b Patient Care Review
PAYER Notification Team 1. Review Plan of Care (m)
Aurthorization Patient Care 2. Document Meeting Notes (Allscripts)(paper) (m)
Review Meeting 3. Sign Attendance Sheet (paper) (m)
Inter-disciplinary Team
MD Nurse Nurse Manager
Social Worker Therapy LNA
Counselor (Spiritual, Bereavement, Volunteer)
Discharge / CASE
Death STEP 8b UPDATE AUTHORIZATION
Transfer MANAGER
Certificate 1. Update authorization and LOC with payer (m)
Notice Update
Authorization
Home External
Bereavement Funeral
Hospice Nursing
Coordination Home
Care Home
10/27/2009 8 of 23

9. A From INTAKE
Referal Home HHHC Home Hospice 1 of 3
Hospice
ADMIN.
ASSISTANT STEP 1 PATIENT ADMISSION
Patient 1. Create Patient Case File (m)
Admission
DME
DME
Request
VENDORS
STEP 2 LEVEL OF CARE REVIEW
CLINICAL
1. Review Level of Care (m)
MANAGER
2. Schedule Admission Visit (Allscripts) (m)
Level of Care
3. Coordinate DME (Durable Med. Equip.) w/Vendors (m)
Review
4. Get Admission Approval from Physician (m)
Admission
Approval
STEP 3 PATIENT ADMISSION
1. Pick up Case File (m)
2. Conduct Full Assessment (Allscripts) (m)
2. Review Medication (Allscripts) (m)
CLINICIAN 3. Order Medication (o)
PRIMARY MD Patient 4. Execute Consents & Contracts (paper) (m)
Admission 5. Create Plan of Care (Allscripts) (m)
6. Determine Level of Care (Allscripts) (m)
7. Print Care Plan (for Hospital or Nursing Home) (o)
8. Educate Facility Staff (o)
Plan of Care 9. Deliver Case file to Admin Assistant (m)
&
Hospice
STEP 4 ADMISSION FORM REVIEW
Certification ADMIN
1. Review Admission Forms (m)
ASSISTANT
2. Send Plan of Care to Primary MD (m)
Patient
3. Get Signed Hospice Certification from Primary Doctor (m)
Admission
4. Get Signed Hospice Certification from Hospice MD (m)
HOSPICE Hospice
MEDICAL Certification
DIRECTOR
Continued Home
Hospice 2
10/27/2009 9 of 23

10. PATIENT Contract From Home HHHC Home Hospice 2 of 3
FAMILY Hospice 1
STEP 5 DELIVER CARE
1. Self Schedule Visits (Allscripts) (m)
FACILITY
2. Deliver Plan of Care
STAFF Plan of 3. Update Patient Record (Allscripts) (m)
Review Care
4. Obtain Orders From Doctor (Allscripts) (m)
Plan of
5. Order Medications (o)
Care
6. Order DME (Allscripts) (o)
7. Print Care Plan Updates for Facilities (o)
8. Review Care Plan Updates with Facilities Staff (Allscripts) (m)
PHARMACY Medication 9. Schedule Other Clinicians (Allscripts) (o)
CLINICIAN
Medication Request 10. Prepare Referral Transfer Forms
Deliver Care
Process 11. Notify Case Manager of Changes in Care or Setting (o)
12. Obtain Signed Contracts from Family (o)
13. Discuss Plan for Transfer with Patient (o)
14. Enter tasks as Needed (Allscripts) (o)
15. Give Appropiate Forms/Notice to Patient (o)
DME 16. Notify Doctor of Changes
VENDOR DME 17. Notify Clinician Team of Changes
Request 18. Chart Visit (Allscripts) (m)
Equipment
Request - Assessment - Clinical Notes
- Problem Charting - Transactions (times in/out/travel)
PRIMARY MD Orders
Sign Orders
BILLING Contract
ASSOCIATE
Continued
Accounting1
Continued Home
Hospice 3
10/27/2009 10 of 23

11. From Home HHHC Home Hospice 3 of 3
Hospice 2
STEP 6b AUDIT CONTRACT
1. Audit Contract (m)
ADMIN CASE STEP 6a CASE REVIEW
2. Enter Level of Care Changes (AllScripts) (m)
ASSISTANT MANAGER 1. Review Pre-Authorization Cycle (AllScripts) (m)
3. Create Daily Census Report (AllScripts) (m)
Audit Contract Case Review 2. Get Pre-Authorization for Care (AllScripts) (o)
4. Distribute Census Reports (m)
5. Send Updated Orders to Primary MD (AllScripts) (o)
Ongoing PAYER
Care Aurthorization
Updated
PRIMARY MD
Orders
Updated Orders
STEP 6c ONGOING CARE
1. Self Schedule Visits (Allscripts) (m)
2. Deliver Plan of Care
3. Update Patient Record (Allscripts) (m)
4. Order Medications (o)
Death
FUNERAL 5. Order DME (Allscripts) (o)
Certificate
HOME 6. Print Care Plan Updates for Facilities (o)
7. Review Care Plan Updates with Facilities Staff (Allscripts) (m)
8. Schedule Other Clinicians (Allscripts) (o)
CLINICIAN
9. Prepare Referral Transfer Forms
Ongoing Care
10. Notify Case Manager of Changes in Care or Setting (o)
11. Enter Tasks as Needed (Allscripts) (o)
12. Notify Doctor of Changes (o)
13. Notify Clinician Team of Changes (o)
BEREAVEMENT
14. Chart Visit (Allscripts) (m)
15. Prepare & Submit Referral Transfer (o)
16. Prepare & Submit Discharge Notice (o)
17. Prepare & Submit Death Certificate (o)
18. Notify Bereavement Coordinator (o)
Referral
Every 2 weeks Transfer or
Discharge
Inter-disciplinary STEP 7 Patient Care Review
HOSPICE
Team 1. Review Plan of Care (m) PALLATIV PRIVATE
HOUSE IN-
Patient Care 2. Document Meeting Notes (Allscripts)(paper) (m) E CARE DUTY
PATIENT
Review Meeting 3. Sign Attendance Sheet (paper) (m)
10/27/2009 11 of 23

12. Accounting 1 of 3
Home Health & Commercial Hospice
From Patient
BILLING
Admit.
Contract
STEP 1 REVIEW PAYER & PATIENT SETUP
1. Check Payer Status & Date (Allscripts) (m)
Medicare / PPS / MHB BILLING
2. Check Patient Eligibility (phone, web) (m)
VA / Title 20 / Government ASSOCIATE
3. Review Contract (m)
Anthem / Cigna Revew Payer &
4. Enter Negotiated Rate (Allscripts) (o)
Medicade / Private / Self Pay Patient Setup
5. Review Letter of Agreement (o)
6. Enter Room & Board Fees (Allscripts) (o)
STEP 2 BILLING
1. Run & Review Pre-Billing Audit Report (Allscripts) (m)
(Eligibility Report for Each Payer)
2. Process Billing Cycle (Allscripts) (m)
3. Print Billing Register (Allscripts) (m)
4. Compare Reports (Allscripts) (m)
5. Recalculate Payer (Allscripts) (m)
6. Verify & Correct Accuity Levels (Allscripts) (m)
7. Check Authorization (Comm. Payers) (Allscripts) (o)
8. Check Daily Census (Hospice House) (Allscripts) (o)
9. Enter Clinician Visits @ Hospice House (Allscripts) (o)
10. Get Notice of Benefit Election (Hospice House) (document) (o)
11. Get Certificaton of Terminal Illness (Hospice House) (document) (o)
BILLING
12. Review Patient Contract (o)
ASSOCIATE
13. Review Letter of Agreement (Comm. Payer/Hospice House) (o)
Billing Cycle
14. Send 81A To Medicare (Allscripts) (o)
15. Force Date & Process Corrections (Allscripts) (m)
16. Print Claims (Allscripts) (m)
17. Verify Claims vs. Home Care Visits (Allscripts) (m)
18. Verify Revenue Codes/HCPSC Codes & Rates (Allscripts) (o)
Claim 19. Print & Check Assessments & Dr. Orders (o)
20. Check Dr. Visits (Hospice, Medicare) (Allscripts) (o)
21. Submit Claims to Payer (Allscripts, electronic, paper) (m)
22. Verify Authorizations Match on Claim (Allscripts) (m)
23. Check Projected Visits for Medicare/PPS (o)
24. Check OASIS is Complete (o)
Medicare, Harvard Freedom, Medicare Private
To Accounting2 25. Reconcile Accounts Receivables
10/27/2009 12 of 23

13. From Accounting 2 of 3
Accounting1 Commercial Payers
Claim
PRIVATE VA, TITLE
MEDICADE MEDICARE PATIENT
PAYERS 20, GOV.
Claim Claim Claim
Claim Claim
Processing Processing Processing
Processing Processing
Payments
STEP 3 POST & RECONCILE DEPOSITS
1. Post Deposits (Allscripts) (m)
2. Reconcile Deposits (Allscripts) (m)
BILLING 3. Post Medicare (ERA) (Allscripts) (m)
MANAGER 4. Post Manual Payments (Allscripts) (m)
Post & 5. Post Payment Denials (Allscripts) (m)
Reconcile 6. Post Manual Adjustments & Write-Offs (Allscripts) (m)
Deposits 7. Review Accounts Receivables (m)
8. Generate Reports & Graphs (m)
9. Bill Med Cap (m)
10. Bill Patients (o)
End
STEP 1 TELEPHONY
1. Enter Clinician Visits (Telephone) (Allscripts) (m)
BILLING
2. Reconcile Visit Data (Allscripts) (m)
ASSOCIATE
3. Enter Manual Green Day Sheets (Allscripts) (m)
Telephony
4. Enter Contract Services (Allscripts) (m)
5. Generate Reports (Allscripts) (m)
PAYROLL
10/27/2009 13 of 23

14. Accounting 3 of 3
Commercial Payers
MEDICAL
SUPPLY
VENDOR
Invoice
(document)
BILLING STEP 1 MEDICAL SUPPLY BILLING
HOSPICE ASSOCIATE 1. Send For Approvals (m)
HOUSE Approvals Medical 2. Enter Medical Supply Bills (Allscripts) (m)
Supplies 3. Send Supply Bills to A/P (Allscripts) (o)
Invoice
ACCOUNTS
PAYABLE
End
10/27/2009 14 of 23

15. OVERVIEW 1 of 8 HHHC Patient Intake
NURSING
HOSPITAL DR. OFFICE FAMILY
HOME
Patient Hospice Patient Hospice Patient Hospice
Patient Hospice
Referal Referal Referal
Referal
Referal Referal
Start
LIASON
Patient Hospice
Evaluation
CASE
PAYER INTAKE NURSE
MANAGER
Authorization Patient Intake
Case Intake
Home Hospice Home
Palliative Private
Health House Hospice
Care Duty
Care In-Patient Care
10/27/2009 15 of 23

16. OVERVIEW 2 of 8 Home HHHC Home Health Care 1 of 4
A Health
Care
From INTAKE
TEAM LEADER
Assign Referal
SCHEDULER
Schedule
Services
CLINICIAN
Pre-Admission
CASE CLINICIAN
PAYER
MANAGER Patient HHHC Home Health Care 2 of 4
Authorization
Case Intake Admission
DME VENDOR ADMIN. SCHEDULER
PRIMARY MD PATIENT Medical Supply ASSISTANT OR CLINICIAN
Delivery Audit Admission Schedule Care
Continued
Home Health
10/27/2009
Care 3 16 of 23

17. OVERVIEW 3 of 8 From Home HHHC Home Health Care 3 of 4
Health Care 2
ADMIN. CLINICIAN
ASSISTANT Deliver Care
Audit Paperwork
CASE Ongoing Care
MANAGER
Case Audit
Scheduler or
Clinician
Schedule Care
PAYER
HHHC Home Health Care 4 of 4
Aurthorization Discharge
Notification
(Allscripts) Discharge
ADMIN.
PRIMARY MD CLINICIAN OR
ASSISTANT
SCHEDULER
Discharge
Notification Orders
CASE
MANAGER MEDICAL
PRIMARY MD
Payer Orders RECORDS
Notification
Notification
PAYER
Discharge
END
Notification
10/27/2009 17 of 23

18. OVERVIEW 4 of 8 HHHC Hospice House In-Patient 1 of 2
A From INTAKE
Hospice
Referal House In-
Patient
ADMIN.
Orders
PRIMARY MD ASSISTANT
Assign Referal
CASE CLINICAL
MANAGER MANAGER
Update
Initial Pre-Admission
Authorization Clinical Review
Notification
PAYER
Aurthorization
Notification
CASE
CLINICIAN
MANAGER
Update Patient
Update
Admission
Authorization
ADMIN. Continued
ASSISTANT Hospice Houce
Audit Admission In-Patient 2
10/27/2009 18 of 23

19. OVERVIEW 5 of 8 HHHC Hospice House In-Patient 2 of 2
From Hospice
Houce In-Patient 1
CASE Inter-disciplinary
MANAGER CLINICIAN Team
Update
Update Deliver Care Every 2 weeks Patient Care
Authorization Review Meeting
Ongoing Care
Discharge /
Death
Certificate Transfer
Notice
Notification
Update
FUNERAL
HOME
CASE
Home External
PAYER Notification MANAGER
Hospice Nursing Bereavement
Aurthorization Update
Care Home
Authorization
10/27/2009 19 of 23

20. OVERVIEW 6 of 8 From INTAKE HHHC Home Hospice 1 of 3
A
Referal Home
Hospice
ADMIN
ASSISTANT
Patient
DME Admission
VENDORS
DME
Request
CLINICAL
Admission
MANAGER
Approval
Level of Care
Review
PRIMARY
CARE
PHYSICIAN
CLINICIAN
Patient
Admission
Plan of Care
&
Hospice
Certification
Continued Home
Hospice 2
ADMIN
ASSISTANT
Patient
Admission
HOSPICE Hospice
MEDICAL Certification
DIRECTOR
10/27/2009 20 of 23

21. OVERVIEW 7 of 8 HHHC Home Hospice 2 of 3
From Home
PATIENT Contract Hospice 1
FAMILY
FACILITY
STAFF Plan of
Review Care
Plan of
Care
PHARMACY Medication
Medication Request
Process
CLINICIAN Continued Home
DME
VENDOR DME Deliver Care Hospice 3
Request
Equipment
Request
PRIMARY MD Orders
Sign Orders
Continued BILLING Contract
Accounting1 ASSOCIATE
10/27/2009 21 of 23

22. OVERVIEW 8 of 8 HHHC Home Hospice 3 of 3
From Home
Hospice 2
Updated ADMIN CASE
PRIMARY MD Ongoing PAYER
Orders ASSISTANT MANAGER
Updated Orders Care Aurthorization
Audit Contract Case Review
Death
Funeral
Certificate
Home
CLINICIAN
Referral Transfer
Ongoing Care
Or Discharge
Bereavement
Inter-disciplinary
Hospice
Team Every 2 weeks Palliative Private
House
Patient Care Care Duty
In-Patient
Review Meeting
10/27/2009 22 of 23

23. ACCOUNTING OVERVIEW From Patient Accounting
Admit. Home Health & Commercial Hospice
Contract
BILLING
ASSOCIATE
Revew Payer &
Patient Setup
Claim
BILLING
ASSOCIATE
Billing Cycle PRIVATE VA, TITLE
MEDICADE MEDICARE PATIENT
PAYERS 20, GOV.
Claim Claim Claim
Claim Claim
Processing Processing Processing
Processing Processing
BILLING
MANAGER
Post &
Reconcile
Payments
Deposits
End
BILLING MEDICAL
ASSOCIATE SUPPLY Invoice
Telephony VENDOR (document)
BILLING
ASSOCIATE Approvals HOSPICE
Medical HOUSE
Supplies
PAYROLL
Invoice
ACCOUNTS
End
PAYABLE
End
10/27/2009 23 of 23