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. When you identify that the provider signature does not match the provider (Physician/NPP) that is addressed on the order as generated from HCHB, pause your normal process. Do not mark the order as signed or attached to HCHB until the issue has been resolved by the following steps.
2. Unless the notation clearly explains the reason another provider signed or the reason has already been communicated in another way, call the provider who signed the 485/POC to determine why the order was signed by an alternative provider. Possible reasons include, but are not limited to, the following options. Follow the subsequent steps which apply to that reason.
   1. Addressed provider is currently out of office for the short term- Follow step 3.
   2. Listed provider is on leave and signing provider has been authorized to care for the certifying physician’s patients in his/her absence - Follow step 4.
   3. Addressed provider was incorrect - Follow step 4.
3. If the the addressed provider is currently out of office for the short term:
   1. Notify the provider that the order will be resent 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. If the addressed provider was incorrect, or the addressed provider is on leave and the signing provider is covering during their absence:
   1. Review the client's other unsigned orders in HCHB.
      • If other unsigned orders for the client are also addressed to the incorrect provider, follow the remaining steps of this process for each of those orders as well, but following this process to update them to the correct provider: C-11-380 Orders Management: Update Provider on Signed Physician Order (Non-485).
      • 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 the branch Clinical Supervisor to collaborate on that determination.
   2. Ensure that the correct signing provider’s name and NPI is printed on the 485/POC and update the provider on the order in HCHB. Follow the steps in this process: C-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: C-11-340 Orders Management- Physician Correction- Order/OASIS Coordination Note.
5. Once the provider has been updated and all the steps above have been completed, follow all remaining steps needed for processing the signed order as described in this process: C-11-320 Orders Management- Reviewing Received Orders

📅 Effective: 04.29.2026  | 🛠️ Revised: 08.12.2026   |  ✅ Approved: JFJ