C-11-310 Orders Management: 485/POC Provider Follow-Up and Escalation

👤 ROLE

Medical Records Specialist

🎯 PURPOSE

The Medical Record Specialists review all signed orders for clarity and provider signature/date of signature. If during their review of a signed order they find that the signature of the physician or non-physician practitioner (NPP) does not match the provider that is addressed on the order as generated from HCHB, the Medical Records Specialist must complete the following steps.

🔄 PROCESS

1. After identifying that the provider signature does not match the provider (Physician/NPP) that is addressed on the order as generated from HCHB, the Medical Records Specialist will pause marking the order as received/signed or attached to HCHB until the issue has been resolved by the following steps.
2. The Medical Records Specialist will call the provider who signed 485/POC to determine why order was signed by an alternative provider. Possible reasons include the following. Follow the subsequent steps which apply to that reason.
   1. Addressed provider is currently out of office for short term
   2. Listed provider is on leave and signing provider has been authorized to care for certifying physician’s clients in his/her absence
   3. Addressed provider was incorrect
3. If the the addressed provider is currently out of office for the short term:
   1. Notify the provider that order will be resent to office for the primary care provider to sign when they return to the office, unless the signing provider is willing to be responsible for overseeing plan of care.
   2. Add a follow-up note in Mosai documenting the steps taken and reason why for future reference.
   3. Track the order to be resent at the time the addressed provider will be back in office.
   4. When it is time to resend the 485/POC via Mosai, do so and add another follow-up note.
   5. Continue tracking the order for signature according to routine process.
4. For either of the other two common reasons listed in step 2 (incorrect provider, or provider is on leave and the signing provider is covering during their absence, complete the following).
   1. Review the client's other unsigned orders in HCHB.
      • If other unsigned orders for the client are also addressed to the provider which was incorrect, follow the remaining steps of this process for each of those orders as well.
      • If there are orders addressed to an entirely different provider and it isn't clear whether they need to be rerouted or not, follow up with branch Clinical Supervisor to collaborate on that determination.
   2. Ensure that the correct signing provider’s name and NPI is printed on 485/POC and update the provider on the order in HCHB. Follow the steps in this process: O-11-350 Orders Management- Update Provider on Signed 485/POC.
   3. Enter a PHYSICIAN CORRECTION - ORDER/OASIS Coordination Note in the client's chart, following the steps and using the templates in this process: O-11-340 Orders Management- Physician Correction- Order/OASIS Coordination Note.
5. Once provider has been updated and all above steps have been completed, Medical Records Specialist will follow all remaining steps needed for processing the signed order. PROCESS

📅 Effective: 04.29.2026  | 🛠️ Revised: 07.08.2026   |  ✅ Approved: JFJ