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Consult LOA by Mind Map: Consult LOA

1. Search Authorization

1.1. Filter by Coverage

1.1.1. Consultation

1.2. Filter by Source

1.2.1. Payorlink

1.2.2. MemberGateway

1.2.3. Providerlink

1.3. Filter by Status

1.3.1. Approved

1.3.2. Cancelled

1.3.3. Pending

1.4. Filter by DateStamp

1.4.1. Current Date

1.4.2. Past Date

1.5. Filter by Tags

1.5.1. VIP

1.5.2. Black-list

1.5.3. Orange-list

1.6. Filter by Account

1.6.1. Account Code

1.6.2. Account Name

2. Request Authorization

2.1. Member Validation

2.1.1. By Maxicare ID

2.1.1.1. Incorrect ID

2.1.1.2. No ID

2.1.1.3. Correct ID

2.1.2. By Valid ID

2.1.2.1. Expired ID

2.1.2.2. No ID

2.1.2.3. Valid ID

2.1.3. Security Questions

2.1.3.1. Correct Answers

2.1.3.2. Incorrect Answers

2.2. Search Facility

2.2.1. Risk Share

2.2.1.1. Co-pay

2.2.1.2. Coinsurance

2.2.1.3. NONE

2.2.2. Coverage

2.2.2.1. Consult

2.2.3. Procedure

2.2.4. Facility Name

2.2.5. Location

2.3. LOA Details

2.3.1. Consultation

2.3.1.1. Initial

2.3.1.2. Follow-up

2.3.2. Chief Complaint

2.3.2.1. No Complaint

2.3.2.2. 1 complaint

2.3.2.3. >1 complaint

2.3.2.4. Duplicate complaints

2.3.2.5. Other

2.3.2.5.1. No Other Chief Complaint

2.3.2.5.2. With Other Chief Complaint

2.3.3. Practitioner

2.3.3.1. Filter by Specialization

2.3.3.1.1. No Specialization

2.3.3.1.2. With 1 specialization

2.3.3.1.3. >1 Specialization

2.3.3.2. Filter by Schedule

2.3.3.2.1. No schedule

2.3.3.2.2. 1 Schedule selected

2.3.3.2.3. >1 schedule selected

2.3.3.3. Affiliated

2.3.3.3.1. Yes

2.3.3.3.2. No

2.3.3.4. No Practitioner

2.3.4. Diagnosis

2.3.4.1. Initial

2.3.4.1.1. No Initial

2.3.4.1.2. 1 initial

2.3.4.1.3. >1 initial

2.3.4.2. Final

2.3.4.2.1. No final

2.3.4.2.2. 1 Final

2.3.4.2.3. >1 Final

2.3.5. Adjustment Details

2.3.5.1. CG

2.3.5.2. ASO

2.3.5.3. Member pays

2.3.5.3.1. Greater than

2.3.5.3.2. Less than

2.3.5.3.3. No amount

2.3.5.4. Ex-Gratia

2.3.5.5. Fee for Service

2.3.6. Status

2.3.6.1. Approve

2.3.6.2. Disapprove

2.3.6.3. Cancelled

2.3.6.4. Pending

2.3.7. Validations

2.3.7.1. Plan Setup

2.3.7.1.1. Outright denial

2.3.7.1.2. Within Inner limit

2.3.7.1.3. Within outer limit

2.3.7.1.4. Sonny Medina

2.3.7.1.5. With PEC

2.3.7.2. ICD Availment

2.3.7.2.1. Age

2.3.7.2.2. Gender

2.3.7.3. Within approver's limit

2.3.7.3.1. yes

2.3.7.3.2. no

3. Login

3.1. Invalid login credentials

3.2. Valid login credentials