Unsuccessful Calls/UTL Process

Unsuccessful Calls/UTL Process

Unsuccessful Outreach 

Used to document unsuccessful outreaches to the participant. Coordinators MUST call all other contacts/emergency contact and PAS agency after unsuccessfully reaching the participant in order to document as an Unsuccessful Outreach

Note: This session cannot be submitted if the participant has Inactive Eligibility. Document the call as “Office Note” or “Other”

  • Session Requires:
  • Appropriate answers to all required fields

Process:

  1. Service Coordinators are responsible for documenting all attempts to reach a participant, their Providers (PAS/PERS/HDM), their Emergency Contact, and their PCP.
  2. Each participant is required to have 2 visits per year and 2 Quarterly contacts, an SC should begin attempts to schedule and complete these visits at least fourteen (14) days prior to the due date.
    1. If an SC is making attempts to schedule and is unable to reach the participant to schedule before the due date then there must be clear documentation that the participant is “Unable to locate” prior to the actual due date.
  3. Before a participant can be considered Unable to locate, the following must take place
    1. Three (3) consecutive days of Unsuccessful calls with Unsuccessful sessions documented in Function Portal, all taking place within the same month.

Documentation: 

  1. Call Conditions
  2. Visit Type – How are you contacting the participant?
  • Answer should always be Telephone
  1. Where did the visit take place? – Better known as “where did the contact take place?
  • Answer should always be Other
  • Then in Other visit location, details and reason, you should put Telephonic and then list the specifics of the call

Example:

  1. Where does the participant currently reside? – Coordinator should be confirming the client’s address and type of residence, then choose the appropriate answer.
    • If you do not know where the participant currently resides answer “Other”
      • In Other Residential Location put “Unknown due to Unsuccessful Outreach”
    • If the answer was “Home (with a caregiver)” then the coordinator needs the following information about the caregiver.
      • Caregiver name
      • Caregiver relationship 
      • Does the caregiver live with member? 
      • Does the caregiver provide natural support? – meaning does the caregiver provide informal/unpaid support?
      • Is the caregiver paid?– meaning does the caregiver provide formal/paid support?
    • If the answer was “Other” then the coordinator needs to state what the Other residential location is
    • If the answer was: “AFCH, ALF, Hospice, or Nursing Home” the the caregiver must state what the Residential location facility name
  1. Unsuccessful Contact
    1. Who were you trying to contact? – which primary contact were you calling
    2. Method of contact – What type of contact you were completing (Likely Telephonic)
    3. Reason for contact – What type of session were you trying to complete?
    4. Reason for contact details – How the call to the emergency contact was completed.
      • Note: An attempt to the Emergency contact MUST be made
    5. Reason for Unsuccessful contact – Result of the contact to the participant
      • Note: If you were able to leave a voicemail, do so with your name, reason for the contact, and Amcord’s phone number. 
    6. Reason for contact details – How the call to the PAS agency was completed
      • Note: Almost all participants have a PAS agency. Be sure to check the authorization spreadsheet
    7. Contact attempt number – Number of consecutive unsuccessful attempts that have been made
  • This is done by the system automatically.

UTL/Refusal Process

UTL/Refusal Process:

Refusals and UTL’s AFTER the Annual/NPO due date only:

  1. 3 call attempts on 3 different days/times made to participant (back to back with no successful calls in between and all attempts must be in the same month) prior to visit due date
  2. Call all Providers prior to visit due date
  3. Supervisor calls PTP prior to wellness check
    1. If successful, then schedule visit
    2. If unsuccessful, then have SC schedule Wellness check
  4. Wellness Check by police prior to pop up visit
    1. If successful, then schedule visit
    2. If unsuccessful, then have SC schedule pop up visit in a Visit Scheduled session in FP
  5. Complete POP-UP 
  6. Pop up was unsuccessful-AVP notified Account Manager that all unsuccessful contacts were completed and documented
    1. PAHW will send certified letter 30 days from the Pop-up visit
  7. At day 30, Amcord Supervisor will check FP to see if any successful contact has been made since the Pop-up visit and if not, PAHW will mail a UTL letter.
    1. If Supervisor sees Successful contact to ptp/POA was made, Supervisor must email AVP so termination process is stopped
  8. SCE will get a task to complete 1768 after additional 20 days (and approval of OLTL), Supervisor will check FP to see if any successful contact has been made since the Pop-up visit
    1. If Supervisor sees Successful contact to ptp/POA was made, Supervisor must email AVP so termination process is stopped
  9. On the day 1768 is submitted to the AM only (NOT CAO), the Supervisor uploads the 1768 into Envolve and completes Certified UTC Letter Session (SC is not completing this, supervisor is)
  1. What is the frequency of the service(s)
    1. For example, PAS: 20 hours/week or Home Delivered Meals: 2 meals/day or PERS 1 time per month or Nursing Facility 1 time per day
  1. If any authorized services are not currently being provided, when was the last date said service was provided?

Pop up Visits

Pop-up visits are to be done for participant’s that are past due for an Annual or NPO visit after they are Unable to Locate (UTL), with 3 Unsuccessful calls back to back in one month.

Scheduling/Planning

How to schedule pop-up visit:

  1. In the “Sessions” tab of Function Portal, click the pink “+”
  2. Select from the dropdown “Visit Scheduled”
  3. For “Visit Scheduled” Select the option that says “Pop up visit”
  4. Select the date that you are planning to complete the pop-up for “Visit Scheduled for”
  1. When you leave for pop-up select DEPART (under Successful POP-UP)
  1. When you Arrive Select the appropriate option Successful or Unsuccessful Pop-up Visit
  2. Document

Unsuccessful Pop-up visit

If you were unable to make contact with the ptp and/or their responsible party at the time of the Pop up Visit, to schedule the required visit, complete the Unsuccessful Pop-up visit session in Function Portal

Who was present during the visit: SC

Reason for contact: Select the type of visit that is due

Reason for unsuccessful contact: select the appropriate reason

List two noticeable characteristics of the home: document obvious/easily defined characteristics of the home such as the type of home, color, etc.

Optional: take photos of the home to supplement the characteristics


Successful Pop-up visit

If you were able to talk with the participant and/or responsible party to schedule a visit you will need to complete a Successful Pop-up visit session in Function Portal

Who was present during the visit?: SC and anyone else present

Where did the visit take place? Select if participant was alone in the place of the pop up visit

Where does the participant currently reside? Select if the participant lives alone or not

Information provided by: Select who provided information during the pop-up visit

What is the purpose of the contact? Select the type of visit the participant is due for

Is the contact follow-up visit scheduled? Select if you scheduled the visit at the time of the pop-up

Visit scheduled for: IF you scheduled the visit, when is it scheduled for
Contact follow-up description: If you did NOT schedule the visit, explain why and how/when you will f/u to schedule it.

Reason for contact: Select the type of visit the participant is due for (which is the reason for the pop-up visit)

Practice Unsuccessful Call and Pop-up Visit

  1. In Function Portal for one of the participants assigned to you, complete an Unsuccessful call session.
    • Go to the “sessions” tab and click the pink “+” sign and then select “Unsuccessful Outreach” to begin. Hit submit once completed your session.
  2. For the same participant, schedule a Pop-up Visit using the steps outlined above and submit
  3. Once an alert shows on the right-hand side of the screen, document either an Unsuccessful or Successful Pop-up visit and submit
  4. Let your Supervisor know once you have documented your Unsuccessful Call and your Pop-up visit, so they can review with you and answer any questions you may have.
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