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| AMHMDPHCTM1:
Provider Dai |
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Current as of: 28 June 2012 |
| Clinic Location: |
3920 North Union Blvd. (SW
corner of Union and Austin Bluffs) |
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Colorado Spring, CO 80907. |
| Hours of Operation: Mon - Fri 0730-1600 (except holidays) |
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Pediatric Immunizations (0-17 yrs) at the Pediatric Immunization
Clinic Mon-Fri between 0730-1200 and 1300-1530 |
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| Walk-in: |
Closed during training holidays. |
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DO NOT book an appointment for Walk-in services. |
| Consult |
No |
| Required: |
| Self-Referral |
No |
| Clinic: |
| Beneficiary |
Evans Premier enrolled. |
| Types: |
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| Appt Types: |
Detail Codes: |
Duration: |
Comments / Instructions |
| ACUTE |
0-17 or Blank |
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PCM |
Same Day / Next Day (within
24 hrs ONLY) |
| ALT
Provider |
Same Day Only |
| EST |
0-17 or Blank |
15 / 20 |
Med Refills |
| EST |
0-17 or Blank |
30 |
Join two 15/20 if needed. |
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Annual / School / Camp / Sports physicals ( 2-17 years). |
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New patient consult. |
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Well Baby / Newborn. |
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| 20
/ 30 |
Follow-up |
| Special Instructions for Patients: |
| TO BE READ VERBATIM TO THE PATIENT |
| ► Children cannot be left unattended in the clinic waiting
area. |
| ► "Please arrive at
your appointed time. Early arrival is not necessary. The first 10-15 minutes of your visit will
be with your PCMs nurse |
| who
will screen you for Preventive Medical needs, health risks and review your
expectations for your visit." |
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| Special Instructions for CLERKS: |
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| EVANS TEAM LISTING |
| (click for link) |
| Provider
Restrictions: |
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Marean: Book
with provider Dai
first. If NO access, then other team provider. |
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| Multiple Issues / Concerns |
| ► Book
ONLY one appointment
per patient per day, list ALL concerns - do not join. |
| ► Inform
patient, not all concerns may be addressed in one visit. |
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| ACUTE Booking Priority |
| 1. PCM (Same Day/Next Day) |
| 2. PCMs
Team (Same Day Only) |
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| NON-ACUTE Booking Priority |
| 1. PCM |
| 2. PCMs
Team |
| If there are NO ACUTE slots available then a SAME DAY EST slot
may be used. |
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| Well
Baby: |
| ► Make all attempts to book with their PCM. |
| ► Well baby appointments ( 2 weeks,
2 mos / 4 / 6 / 9 / 12 / 15 / 18 / 24 / 36 months) |
| ►
Early discharge appointments are to be booked
into a EST appt type. |
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| Newborn
Check: |
| ►
An appointment is required for 0-5 day Newborn
checks. |
| ►
Infant MUST be 72-120 hours (3-5 days) of birth
on the day of their scheduled appointment. |
| ►
Schedule through RN at clinic: 234# |
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| School
Physicals: |
| ► Siblings MAY be booked back to back with the SAME PROVIDER. |
| ► Ages 4 - 17 yrs. |
| ► If no Sports/Camp Physicals are available, transfer PT to
clinic: 234# |
| ► Read the following script below for ALL school physicals: |
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| SCHOOL PHYSICAL SCRIPT: |
| Your child is now
booked for a sports/school physical on __(date)__ at __(time)__.
Check-in at least 20 min
prior to your appointment |
| time. A parent or
legal guardian must accompany children 17 and under. In addition, all
required documents must be
brought with |
| you to the
appointment. This includes the school/sports physical form, your child’s shot
record, and the child’s dependent I.D card, |
| if applicable. The
clinic does not provide these forms. |
| Please complete the
basic patient information and patient answerportions before arrival. |
| Note: If caller is
unsure about where to get a school/sports physical form, suggest their school
officer or school website. |
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| Medication Refills / Renewals: |
| ► If the patient requires a prescription RENEWAL |
| (ie. their
prescription has expired or out of refills) book in an EST appointment. |
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| ► If the patient requires a prescription REFILL |
| (their
prescription has refills left) continue with the following: |
| - Ask the
patient to have their prescription bottle present with them. |
| - Explain to
the patient that you will now transfer them to the Med Refill Line where they
may follow the prompts to obtain a refill. |
| - Give the
patient the phone number and attempt to transfer the patient to: 719-524-4081 |
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| ADHD: |
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ADHD patients need 30 min EST for initial visit
and 20 min EST for follow-up appointments. |
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| Circumcisions: |
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All requests for circumcision must be transferred
to clinic: 234# |
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| Child
Abuse Evaluations: |
| ► MUST GO TO SOCIAL WORK SERVICES first. |
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May walk -in Mon - Fri 0730-1630 at Bld. 6236. |
| ► For directions, transfer PT to 526-5050. |
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| Possible
Communicable Diseases: (Chicken Pox, Measles, etc.) |
| ►
Transfer to the clinic at for appointment
booking: 234# |
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| Exceptional
Family Member Program (EFMP) Guidelines: |
| ►
EFMP paperwork - book with patient’s PCM. Join two 30 min EST appointments. |
| ► Overseas Clearance – Transfer to EFMP office at: 237# |
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| Immunizations: |
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►Pediatric Immunizations (0-17 yrs) at the Pediatric
Immunization Clinic Mon-Fri between 0730-1200 and 1300-1530 |
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| ► DO NOT
book an appointment for Walk-in services. |
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| Mental / Behavioral Health Requests |
| ► Non-emergent requests for
non-active duty Mental Health needs, transfer call to 1-888-TRIWEST, and
instruct patient to say: |
| 'Mental Health' |
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| Special Instructions for Lack of Availability: |
| ► If there are no appointments available, transfer patient to clinic
at: 234# |
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