We can help you improve care for patients that over-utilize the Emergency Department.
Frequently Asked Questions
How are patients referred for review by the Consistent Care Program?
Any Spokane area health care provider can refer a patient for review by calling the patient referral hotline and leaving a message with the patient's name and a brief history.
What happens after a patient is referred?
Each referred patient has their medical history reviewed by the Consistent Care program coordinator. If the patient is found to be appropriate for review a summary of the patient's medical history and ED visit history is compiled.
The patient's primary care physician is contacted for background information and recommendations. The program coordinator presents this information to the multi-disciplinary ED Care Guidelines Committee who formulate recommendations for treatment on subsequent ED visits by the patient.
How will I know if ED Care Guidelines have been formulated for a patient?
The first screen of the patient's electronic medical record will contain a section called "ED Care Guidelines Reports." This heading typically is located below the "Transcription Service Reports" heading.
What is the Patient Review and Restriction program of the Washington DSHS?
The Patient Review and Restriction program (PRR) is a federal and state requirement of Medicaid to control the over-utilization and inappropriate use of medical services by clients, allowing restriction of clients to certain providers. The PRR program prevents Washington medicaid patients from seeing multiple doctors and filling prescriptions at multiple pharmacies. The program restricts a patient to one physician, one pharmacy, and one hospital. Only these assigned providers are reimbursed by Medicaid services.
The PRR program does not limit a patient's access to the ED.