Clients / Record workspace
Sofia Grant
Open an item for evidence, ownership and a review decision.
Initial approval request needs reviewSofia Grant · E-4:AUTH-REQUESTUtilization reviewDue 2026-09-24urgent
DMAS fallback — verify payer contract
Source evidence
A-011 · TIME-AUTH-REQUEST
Payer: HUMANA · 2.1 · open
Assigned to
Cameron Lee · Utilization review · Due 2026-09-24
Attended session is missing its noteSofia Grant · SES-12Note authorDue 2026-09-25urgent
Attended day still has no note after the next business day
Source evidence
A-023, A-062 · REV-ATTEND-NO-NOTE
Payer: HUMANA · 2.1 · open
Assigned to
Dana Patel · Note author · Due 2026-09-25
Attended session is missing its noteSofia Grant · SES-13Note authorDue 2026-09-28urgent
Attended day still has no note after the next business day
Source evidence
A-023, A-062 · REV-ATTEND-NO-NOTE
Payer: HUMANA · 2.1 · open
Assigned to
Dana Patel · Note author · Due 2026-09-28
Attended session is missing its noteSofia Grant · SES-14Note authorDue 2026-09-28urgent
Attended day still has no note after the next business day
Source evidence
A-023, A-062 · REV-ATTEND-NO-NOTE
Payer: HUMANA · 2.1 · open
Assigned to
Dana Patel · Note author · Due 2026-09-28
Claim needs a matching approved noteSofia Grant · CL-ORPHANBillingDue 2026-10-09urgent
Condition requires review
Source evidence
A-034, A-062, F-017 · REV-CLAIM-NO-NOTE
Payer: HUMANA · 2.1 · open
Assigned to
Drew Santos · Billing · Due 2026-10-09
Service day with no approval covering itSofia Grant · E-4:gapUtilization reviewDue 2026-10-09urgent
Condition requires review
Source evidence
A-011, A-052 · SERVICE-NO-AUTH
Payer: HUMANA · 2.1 · open
Assigned to
Cameron Lee · Utilization review · Due 2026-10-09
Submitted note is waiting for approvalSofia Grant · N-FLOWNote approverDue 2026-09-28important
Condition requires review
Source evidence
Versioned house policy · REV-APPROVAL-LAG
Payer: HUMANA · 2.1 · open
Assigned to
Dr. Tessa Nguyen · Note approver · Due 2026-09-28
Denied claim needs follow-upSofia Grant · RM-SHOW-UNWORKEDBillingDue 2026-10-06important
House follow-up deadline; payer appeal clock is separately sourced
Source evidence
Versioned house policy · REV-DENIAL-UNWORKED
Payer: HUMANA · 2.1 · open
Assigned to
Drew Santos · Billing · Due 2026-10-06
Multidimensional assessment missing dimensionsSofia Grant · AS-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-021, A-048 · ASSESS-DIMENSIONS
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Planned frequency needs clarificationSofia Grant · PS-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
L-011 · CLAR-ISP-FREQ-AMBIG
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Delivery compared with complete planned periodSofia Grant · PS-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-026 · CLAR-PLAN-VS-DELIVERY
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Comparable chart facts disagreeSofia Grant · E-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-050 · CONS-DX
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Comparable chart facts disagreeSofia Grant · E-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-049 · CONS-LOC
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Comparable chart facts disagreeSofia Grant · E-4Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
Versioned house policy · CONS-MEDS
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
flow mismatchSofia Grant · N-FLOWNote approverDue 2026-10-14important
Condition requires review
Source evidence
Versioned house policy · FLOW-MISMATCH
Payer: HUMANA · 2.1 · open
Assigned to
Dr. Tessa Nguyen · Note approver · Due 2026-10-14
Comprehensive plan missing required elementsSofia Grant · P-4CClinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-049, A-022 · PLAN-ELEMENTS
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Treatment week outside the hour rangeSofia Grant · E-4:2026-09-27Clinical directorDue 2026-10-15watch
Condition requires review
Source evidence
A-015 · WEEK-HOURS
Payer: HUMANA · 2.1 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-15
Mindful Note Review
| Note | Service date | Readiness | Review state |
|---|---|---|---|
| N-FLOW → | 2026-09-27 | ready | mismatch |
Units ledger
| Authorization / payer | Authorized | Delivered / approved / billed | Remaining / end |
|---|---|---|---|
| AU-FLOWHUMANA · H0015 · day | 1 | 1 / 0 / 0 | 02026-09-27 |
Claims and remittances
| Claim · service | Units · payer | Status · related note |
|---|---|---|
| CLM-1 2026-09-28 · H0015 | 1 day HUMANA | denied No matched note supplied |
Remittances and denial follow-up
| Claim | Decision · date | Follow-up |
|---|---|---|
| CLM-1 | denied · 2026-10-01 DEMO-ATTACHMENT-MISSING | No work action recorded |
Episode clocks
| Clock | Due | Result / evidence |
|---|---|---|
| Initial treatment plan (initial ISP)TIME-ISP-INITIAL | Exact anchor unavailable | skippedHUMANA · Clock needs an exact source timestamp or anchor |
| Initial approval request sent to the planTIME-AUTH-REQUEST | 2026-09-24 | failHUMANA · DMAS fallback — verify payer contract |
| Comprehensive treatment plan (comprehensive ISP)TIME-ISP-COMPREHENSIVE | 2026-10-23 | passHUMANA · Clock met; Within 30 calendar days of starting services, required even if the person is discharged earlier. |
| Fee-for-service reconsideration (Acentra)TIME-FFS-RECONSIDERATION | 2026-10-27 | passHUMANA · Clock upcoming; Submitted in ANG within 30 calendar days of the initial determination letter, with added evidence. Late reconsiderations are denied as untimely, and this step must be exhausted before a DMAS appeal. |
| Next treatment plan reviewTIME-ISP-REVIEW | 2026-12-22 | passHUMANA · Clock upcoming; At least every 90 calendar days at ASAM 2.1, and whenever needs change. A plan not updated on time is "outdated". |
Documents in this record
Supplied demo artifacts. Open a document to inspect its type, version and structured evidence.
| Document · date | Author · status | Evidence |
|---|---|---|
| note D-N-FLOW 2026-09-27 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactSynthetic workflow verification sample N-FLOW. No clinical content. setting, intervention, response, goal, humanSemanticReviewed Created 2026-09-27T15:00:00-04:00 |
| demographics SHOW-4-FACE 2026-09-23 | Jamie Ross (S-08) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 FACE No structured element list Created 2026-09-23T16:00:00-04:00 |
| plan SHOW-4-PLAN 2026-09-23 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 PLAN needs, goals, services, agencies, discharge, family, aftercare, pharmacotherapy, choice, signature, levelOfCare Created 2026-09-23T16:00:00-04:00 |
| assessment SHOW-4-ASSESS 2026-09-23 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 ASSESS history, medical, psychiatric, substance, risk, strengths, riskRating, immediateNeeds Created 2026-09-23T16:00:00-04:00 |
| medication-list SHOW-4-MEDS 2026-09-23 | Dr. Quinn Mercer (S-09) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 MEDS No structured element list Created 2026-09-23T16:00:00-04:00 |
| consent SHOW-4-CONSENT 2026-09-23 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 CONSENT signature, signedDate Created 2026-09-23T16:00:00-04:00 |
| authorization SHOW-4-AUTH 2026-09-23 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-4 AUTH No structured element list Created 2026-09-23T16:00:00-04:00 |
Diagnoses, medication and planned services
Fictional chart facts. Medication codes and doses are demonstration placeholders.
Diagnoses
| Code | Document | Recorded by |
|---|---|---|
| F10.20 | SHOW-4-ASSESS | Dr. Quinn Mercer (S-09) |
| F11.20 | SHOW-4-PLAN | Dr. Quinn Mercer (S-09) |
Medication reconciliation
| Medication | Dose · route · schedule | Record |
|---|---|---|
| DEMO-MED-A | DEMO-DOSE-A · demo-route demo-schedule | SHOW-4-MEDS · active |
| DEMO-MED-A | DEMO-DOSE-B · demo-route demo-schedule | SHOW-4-PLAN · active |
Planned services
| Service | Frequency · target | Source |
|---|---|---|
| H0015 | 3 weekly and PRN 2026-10-23 | SHOW-4-PLAN |
Consent and coverage
| Record | Scope | Status |
|---|---|---|
| CON-SHOW-4 | part2 · demo-payment HUMANA | 2026-09-23 through 2027-10-08 9 structured elements |
| CV-Sofia Grant (C-0004) | HUMANA | 2026-07-26 through open ended Verified demo coverage |
Mailbox and team
Open messages →| Recorded activity | Status |
|---|---|
| Confirmation of receipt for Sofia Grant (C-0004).CH-008 | Cataloged receipt |
| Clarification requires follow-up for Sofia Grant (C-0004).CH-009 | Open clarification / follow-up |
| Team update recorded; not posted for Sofia Grant (C-0004).CH-010 | Not posted |
| Follow-up required for Sofia Grant (C-0004).CH-048 | Not sent |
Executed checks and source gaps
47 passed · 17 failed · 21 skipped
| Rule / subject | Result | Evidence |
|---|---|---|
| NOTE-LATEN-FLOW | pass | Required inputs checked |
| NOTE-UNSIGNEDN-FLOW | pass | Required inputs checked |
| NOTE-NO-TIMEN-FLOW | pass | Required inputs checked |
| NOTE-CLONEDN-FLOW | pass | Required inputs checked |
| NOTE-COSIGNN-FLOW | pass | Required inputs checked |
| NOTE-TIMESN-FLOW | skipped | MH time rule not applicable |
| GROUP-SIZEN-FLOW | skipped | Group size not supplied or not a group note |
| SERVICE-NO-AUTHE-4:gap | fail | Condition requires review |
| ASSESS-DIMENSIONSAS-4 | fail | Condition requires review |
| PLAN-ELEMENTSP-4C | fail | Condition requires review |
| WEEK-HOURSE-4:2026-09-27 | fail | Condition requires review |
| DAY-HOURSE-4:2026-09-24 | pass | Required inputs checked |
| DAY-HOURSE-4:2026-09-25 | pass | Required inputs checked |
| DAY-HOURSE-4:2026-09-26 | pass | Required inputs checked |
| DAY-HOURSE-4:2026-09-27 | pass | Required inputs checked |
| WEEK-HOURSE-4:2026-09-20 | pass | Required inputs checked |
| SERVICE-NO-AUTHE-4:pending | pass | Required inputs checked |
| PLAN-ELEMENTSP-SHOW-4 | pass | Required inputs checked |
| ASSESS-DIMENSIONSAS-SHOW-4 | pass | Required inputs checked |
| ASSESS-MISSINGE-4 | pass | Required inputs checked |
| TIME-ISP-INITIALE-4:ISP-INITIAL | skipped | Clock needs an exact source timestamp or anchor |
| TIME-AUTH-REQUESTE-4:AUTH-REQUEST | fail | DMAS fallback — verify payer contract |
| TIME-ISP-COMPREHENSIVEE-4:ISP-COMPREHENSIVE | pass | Clock met; Within 30 calendar days of starting services, required even if the person is discharged earlier. |
| TIME-FFS-RECONSIDERATIONE-4:FFS-RECONSIDERATION:D-FFS | pass | Clock upcoming; Submitted in ANG within 30 calendar days of the initial determination letter, with added evidence. Late reconsiderations are denied as untimely, and this step must be exhausted before a DMAS appeal. |
| TIME-ISP-REVIEWE-4:ISP-REVIEW | pass | Clock upcoming; At least every 90 calendar days at ASAM 2.1, and whenever needs change. A plan not updated on time is "outdated". |
| CONS-DEMO-NAMEE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-DOBE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-ADDRESSE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-PHONEE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-SSNE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-GENDERE-4 | skipped | Two comparable identity sources are required |
| CONS-DEMO-MEDICAIDE-4 | skipped | Two comparable identity sources are required |
| CONS-DXE-4 | fail | Condition requires review |
| CONS-MEDSE-4 | fail | Condition requires review |
| CONS-LOCE-4 | fail | Condition requires review |
| CONS-PAYERE-4 | pass | Required inputs checked |
| CONS-DATESE-4 | pass | Required inputs checked |
| COMP-NOTE-FIELDSD-N-FLOW | pass | Required inputs checked |
| COMP-SIGNEDD-N-FLOW | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-FACE | pass | Required inputs checked |
| COMP-ISP-CLIENT-SIGSHOW-4-PLAN | pass | Required inputs checked |
| COMP-INFORMED-CHOICESHOW-4-PLAN | pass | Required inputs checked |
| COMP-DISCHARGE-PLANSHOW-4-PLAN | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-PLAN | pass | Required inputs checked |
| COMP-ASSESS-PROFILESHOW-4-ASSESS | pass | Required inputs checked |
| COMP-ASSESS-ELEMENTSSHOW-4-ASSESS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-ASSESS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-MEDS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-CONSENT | pass | Required inputs checked |
| COMP-SIGNEDSHOW-4-AUTH | pass | Required inputs checked |
| COMP-MOUDE-4 | pass | Required inputs checked |
| PEOPLE-CRED-SCOPESHOW-4-PLAN | pass | Required inputs checked |
| PEOPLE-CRED-SCOPESHOW-4-ASSESS | pass | Required inputs checked |
| ASAM-DX-BY-LICENSEDDX-A-4 | pass | Required inputs checked |
| ASAM-DX-BY-LICENSEDDX-P-4 | pass | Required inputs checked |
| CLAR-ISP-FREQ-MISSINGPS-4 | pass | Required inputs checked |
| CLAR-ISP-FREQ-AMBIGPS-4 | fail | Condition requires review |
| CLAR-PLAN-VS-DELIVERYPS-4 | fail | Condition requires review |
| CLAR-GOALS-MEASURABLEE-4 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-NOTE-GOAL-LINKE-4 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-NOTE-TIME-SUPPORTE-4 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-CONTRADICTIONE-4 | skipped | No qualified text-reader assessment supplied; not a pass |
| ASAM-CONTINUED-STAYE-4 | skipped | No qualified text-reader assessment supplied; not a pass |
| COMP-PART2-CONSENTCON-SHOW-4 | pass | Required inputs checked |
| COMP-PART2-DISCLOSURECON-SHOW-4 | pass | Required inputs checked |
| COMP-CRIMINAL-JUSTICE-CONSENTCON-SHOW-4 | skipped | Not a criminal justice referral |
| REV-ATTEND-NO-NOTESES-12 | fail | Attended day still has no note after the next business day |
| REV-ATTEND-NO-NOTESES-13 | fail | Attended day still has no note after the next business day |
| REV-ATTEND-NO-NOTESES-14 | fail | Attended day still has no note after the next business day |
| REV-ATTEND-NO-NOTESES-15 | pass | Note exists |
| REV-NOTE-RETURNED-OPENN-FLOW | pass | Required inputs checked |
| REV-APPROVAL-LAGN-FLOW | fail | Condition requires review |
| REV-LATE-ENTRY-HOLDN-FLOW | pass | Required inputs checked |
| REV-APPROVED-NO-CLAIMN-FLOW | skipped | Note is not approved and ready |
| REV-TIMELY-FILINGN-FLOW | skipped | Unapproved note cannot be queued for filing |
| REV-SERVICE-UNBILLEDN-FLOW | skipped | No separately billable configured service |
| FLOW-UNREVIEWEDN-FLOW | pass | Required inputs checked |
| FLOW-MISMATCHN-FLOW | fail | Condition requires review |
| REV-CLAIM-NO-NOTECL-ORPHAN | fail | Condition requires review |
| REV-PAYER-CREDENTIALCL-ORPHAN | pass | Required inputs checked |
| REV-COVERAGE-CHANGECL-ORPHAN | pass | Required inputs checked |
| REV-UNITS-OVER-AUTHAU-FLOW | pass | Required inputs checked |
| REV-UNITS-BURNAU-FLOW | skipped | Authorization period ended |
| PAYER-DENIAL-DEADLINERM-SHOW-UNWORKED | skipped | Guide and claims website disagree on anchor. |
| REV-DENIAL-UNWORKEDRM-SHOW-UNWORKED | fail | House follow-up deadline; payer appeal clock is separately sourced |