Managing Treatment Modifications (Article)

Welcome to the guide for navigating the Treatment Modification Workflow! This process ensures all modifications to treatment plans are carefully reviewed and approved by both internal and external stakeholders, making sure that decisions are transparent and collaborative. Let's walk through this two-step approval process together.

Why was this workflow created?

Treatment Modifications require close collaboration between the clinical team and external stakeholders (such as referral sources). This process adds extra layers of review, ensuring changes are authorized by the appropriate people, both within your organization and externally.

Key players involved:

• Internal approvers: Members of the treatment team with specific privileges to approve modifications.
• External approvers: Referral sources or stakeholders, often listed in the client’s enrollment profile.

Step 1: Requesting internal approval

When a clinician (who doesn’t have the authority to approve modifications) completes a treatment modification, they need to request internal approval from a qualified team member.

How to request internal approval:

1. Save your draft: After making the modification, you can either save it as a draft or move forward with requesting approval.
2. Select “Request internal approval”: This option brings up a list of authorized approvers from your team.
3. Choose the approver: The system will display a dropdown of internal approvers with the “Treatment Modification Approver” privilege. If the approver happens to be the clinician’s supervisor, or if the owner is the only approver, their name will auto-populate. Otherwise, select from the list.

Once submitted, a Treatment Modification Task will appear on the selected approver’s dashboard.

Please note: If you have the privileges to self-approve your own modifications you will receive a dialog box that provides the option to self-approve.

Step 2: Internal Approval Process

The internal approver will receive a task with all the necessary details to review the modification.

What happens next:

• The internal approver can approve, reject, or request changes to the treatment modification.
• If approved, the modification moves to the next step: external approval (if applicable).
• If rejected, the clinician will receive a notification along with the approver’s justification.
• If changes are requested, an “Amend” task is created for the clinician to make the necessary adjustments.

Step 3: Requesting external approval

Once internal approval is secured, the modification may also need approval from external stakeholders, such as a referral source. This step ensures that third parties have visibility and input on significant changes to the client’s treatment plan.

How to request external approval:

1. Select external approvers: When requesting external approval, a dialog box will appear where you can choose the referral source or stakeholder who needs to approve the modification.
   • By default, the Primary Referrer (as listed in the client’s profile) will be preselected.
   • You can also add other stakeholders from the client’s profile, though they will be notified rather than given the ability to approve.
     
     
     
     
2. Send for approval: Once you’ve selected the approvers, click “SEND.” The modification will now move to Awaiting external approval status.

Step 4: External approval process

After the request is sent, the external approver will receive an email asking them to approve or deny the treatment modification.

Possible outcomes:

• Approval: The external approver confirms the change, and the treatment modification is finalized.
• Denial: The external approver can reject the modification, which will prompt the system to notify the clinician. The approver may provide a reason for the rejection.
• Expired request: If the approval period expires, the clinician will need to resend the request. The duration of the request will last 21 days.
  
  

Who has treatment modifications approval privileges?

Only individuals who have been assigned the Treatment Modification Approver privilege can approve internal treatment modification requests. This privilege is granted to those at a supervisory or administrative level, ensuring that only experienced and qualified personnel are responsible for these approvals.

Key roles with approval privileges:

• Supervisors: By default, those in a supervisory role can be granted the ability to approve treatment modifications.
• Administrative staff: Administrative users can also be assigned approval privileges, but only if they are granted the relevant authority to manage clinical artifacts.
  
  

Key points to remember within treatment modification workflow:

• Two-Step Process: All treatment modifications require internal approval first, followed by external approval (if necessary).
• Internal Approvers: Only individuals with the "Treatment Modification Approver" privilege can approve internally.
• External Approval: External approvers (such as referral sources) must approve changes before they are finalized. Staff members are notified but cannot approve externally.
• Single Approval: Once one approver (internal or external) approves the request, no additional approvals are necessary.

Conclusion

This enhanced workflow ensures that all treatment modifications are thoroughly reviewed and approved by the right people, both inside and outside your organization. By following this guide, you can ensure that modifications to treatment plans are handled with care, maintaining clear accountability at every step.