TMS Workflow: Before Treatment

TMS Workflow: Before Treatment


Screening 

  1. If a provider refers a patient to TMS treatments an Internal Referral https://geodehealth.zohodesk.com/portal/en/kb/articles/internal-pr will be created and routed to the TMS Coordinator or Technician. The patient can also book screenings from the Geode Health online booking tool.
    1.  Once the Internal Referral is Received the TMS Coordinator or Technician will schedule a 15 min screening “TMS Screening” Appointment type on the TMS schedule.
      1. Missing slips are not required for this appt type. Please select No Services Performed during checkout. (Mark sure that you mark the appointment for NO CHARGE ENTRY) 
  2. The TMS Screening questionnaire will be documented in a patient case and closed the case for documentation using the text macro: .tms_screening 

Benefits Verification  

  1. Prior to scheduling a consultation with the provider, the TMS coordinator or technician will need to review the completed benefits verification form.   Benefits verification forms will be uploaded into the patient’s chart (either benefit verification specialist or TMS tech).
    1. Use the text macro .ivb and send to the following Insurance Verification Specialist in a Patient Case

    3. The Insurance Verification Form will uploaded to the chart.

Scheduling Consult with Provider

  • 1. When scheduling an established Geode Health patient, select “TMS Consult Office 60 Est" 

  • 2. When scheduling a new Geode Health patient, select “TMS Consult Office 60 New"


Prior Authorization-Enter after Provider Submits Order during Consult

TMS Coordinators, Technicians, or Insurance Authorization Specialist (IAS) should reference the following workflow for all patients requiring prior auth for TMS procedures. At most locations Insurance Authorization Specialist in billing are responsible for obtaining prior authorization.  TMS Technician and Coordinators should be aware of the process of completing prior authorization regardless of if their location is supported by the Insurance Authorization Specialist.  

 

  1. 1. Make sure you’ve selected your state TMS inbox in Athena 

  1. Naming conventions will appear as tms(lower case state abbreviation) ex: tmsil is the TMS inbox of Illinois. 

  1. 2. The physician will submit the TMS order during the TMS Consult.

  2. 3. “TMS” Orders will route to the ORDERS/RXS/AUTHS bucket in the Clinical Inbox.  

  1. 4. From the TMS order, check "Add auth to Quickview" as "Incoming"  




  1. 4. Click "EDIT AUTHORIZATION" to edit the Authorization as needed  

  1. If additional information is required for the prior authorization Insurance Authorization Specialist will work with TMS Coordinator or Technician, as well as the requesting Provider, to provide all the required information and documentation 

  1. 5. Click "Save" at the bottom  

  1. 6. Submit Prior Authorization outside of Athena.



  1. 7. Once authorization is obtained Click "View in Quickview" to view the Authorization


Scheduling TMS Appointments 

Once the authorization is approved, and all consents have been completed and reviewed, the TMS Coordinator or Technician can move forward with scheduling the initial appointment.  

 

  1. 1. From the scheduling screen, schedule an appointment with the following info:  

  1. 2. Provider: State_TMS_City  

  1. 3. “TMS Mapping 60” appointment type for 1st appointment 

  






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