O-11-390 Review-Edit Clinical Summary Pathway

👤 RESPONSIBLE POSITION  |  ROLE

Clinical Supervisor

Clinical Quality Specialist

Clinical Compliance Specialist

🎯 PURPOSE

This process identifies the steps to review and update the Clinical Summary pathway in the back office as needed during clinical review.

🔄 PROCESS

1. The SBAR/Summary can be reviewed/edited in Edit POC Order:

   

2. Re-order sequence so Clinical Summary prints at the top of the 485:

   1. Select appropriate pathway, select Move Up to move to top:

      

3. If the summary is missing, select Order Text and Add to add treatment code:

   

   1. Select appropriate treatment code to add pathway:

      

      • Each discipline has a specific treatment code:
        • Clinical Summary (SOC/ROC): SUM
        • Functional Limitations : FUN
        • Recertification Summary: 999
        • Follow Up/Change in Condition: FU

   2. Obtain narrative information from clinician and edit text:

      

4. If the summary/SBAR is present but needs to be edited, select the appropriate pathway and click Edit:

   

   • Utilize spell check as resource available:

     

5. When POC is approved, SBAR/summary will print to the 485 to be sent to the physician:

   

📅 Effective: 04.14.2023  |  🛠️ Revised: 10.20.2026  |  ✅ Approved by: JS