rm-care-month-spec.txt 4.4 KB

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  1. care_month:
  2. 1. There have to be 16 measurement days. (is_cellular).
  3. 2. At the 16th measurement day:
  4. BOTH the MCP and the RME/RMM are prompted to sign off.
  5. --> we have to somehow make sure MCP time billed >= 30.
  6. --> we have to somehow make sure EXTRA time >= 20.
  7. 3. THE EASIEST WAY to do this is going to be by enabling a stamp feature on measurements.
  8. // stamp all within safe range on UI
  9. class MeasurementStamp // have to be done within that month...
  10. Measurement measurement;
  11. Pro pro;
  12. String memo; // auto-suggest
  13. Boolean communicatedToPatient; //
  14. // NOT OKAY!!!!! FIRST TIME REQUIRED - after first time, no forcing - in order to click this checkbox, you first have to fire off an email or text message to the patient - autosuggested message: "Hi {name}! Your weight looks normal, keep it up!".
  15. // THIS REQUIRES A PHONE-CALL ATTESTATION BY NON-HCP.
  16. ALTER TABLE measurement ADD COLUMN has_been_stamped_by_mcp BOOLEAN DEFAULT FALSE;
  17. ALTER TABLE measurement ADD COLUMN has_been_stamped_by_non_hcp BOOLEAN DEFAULT FALSE;
  18. ** For curiosity sake...
  19. ALTER TABLE measurement ADD COLUMN has_been_stamped_by_rme BOOLEAN DEFAULT FALSE;
  20. ALTER TABLE measurement ADD COLUMN has_been_stamped_by_rmm BOOLEAN DEFAULT FALSE;
  21. 4. DISABLE THE CONVENTIONAL CRUD UI for 'care_month_entry' for anyone.
  22. We literally ONLY want the time they can bill each month to = 30 / 20 and it only becomes relevant if 16 measurement days.
  23. * From now on, we will only submit RM30_HCP or RM30_HCP_PLUS_20EXTRA. We don't want to bill anything else.
  24. Remember - it is not possible for a care_month to be billed unless 16 days anyway, so no sense in care_month_entries that are accruing time that won't be paid anyway.
  25. So once you reach day 16, auto care-month-entry to reach MCP to 30 mins.
  26. *** BAD IDEA *** If there is also a MeasurementStamp by a non-HCP, then there is another prompt for any non-MCP to bill their 20 mins.
  27. *** WE DON'T WANT THEM TO RMM to think in 'minutes', just measurement days and at least one stamp needs to be communicatedToPatient = true.
  28. *** So literally, for non-HCP it's just a scoreboard - hit 16 and get paid!!!
  29. There are two possibilities:
  30. MCP can bill 30 mins. but the non-MCP can or can't bill 20 mins. properly - because they did not have communicatedToPatient=true.
  31. ONCE WE HAVE REACHED THE APPROPRIATE #16 measurement days and generated approp. MINUTES (30 HCP, and possibly 20 non-HCP extra IF there is a communicatedToPatient=true record), we auto-generate RM30_HCP_PLUS_EXTRA20 if possible OR... at the stroke of midnight EST on the next month start 1st of month (**or some weird logic for Feb. maybe), we generate RM30_HCP and digitize warning to the RMM.
  32. *** so offline, what may happen in a bad case is: "Hey NA/RMM, did you guys not do anything? Oh - okay. Guess we will bill RM30_HCP, but next month please focus and let's do RM30_HCP_PLUS_EXTRA20 aka, you need to stamp and contact patient at least once on a month they measured 16 times!"
  33. For MCP:
  34. MCP sees a pending bill for them to sign, and they sign it.
  35. The UI should not say "RM30_HCP" it should say simply "Billable time: 30 minutes, {{RM30_HCP rate}}"
  36. For RMM:
  37. RMM sees a pending bill for them to sign, and they sign it.
  38. The UI should not say "RM30_HCP_PLUS_EXTRA20" it should say simply "Congrats! 16 days achieved. {{RM30_HCP rate for RMM}}"
  39. 5. TO PROCESS THESE CARE-MONTHS:
  40. - understand that what we need flows like this:
  41. - ENCOURAGE VIGILENCE to make sure everyone reaches 16.
  42. - Pt. list with measurement days column, green row if >= 16.
  43. - red row if 15...
  44. - orange if 14...
  45. - gray if dead... can't achieve 16 even if they want.
  46. FOR BILLERS: no work.
  47. Auto-generate claim as per billable code.
  48. There needs to be a simple UI similar to Note Resolver where you see the CareMonth including stamps and the ultra-important ONE or TWO care-month-entries that correlate to what bill to process. With one click - generate claim with lines as per spec. That's it.
  49. FOR ICD:::
  50. - ClientCmRmReason // ... limit to 4 per cm/rm
  51. - CareMonthCmRmReason // ... TODO @Josh... make sure...
  52. // NEEDED IN SYSTEM:
  53. explicit crud on ClientCmRmReason && CareMonthCmRmReason
  54. // Josh dev endpoint to generate...
  55. -------------------------------------------------------------------------------------
  56. Ongoing: reminders to push ppl to reach 16.