Workspace/Client recordPrivate demo
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Clients / Record workspace

Miles Carter

3.3 · AETNA · Admitted 2026-09-26

Clocks & prior cases

Open an item for evidence, ownership and a review decision.

Initial treatment plan (initial ISP)Miles Carter · E-11:ISP-INITIALUtilization reviewDue 2026-09-27important

Clock overdue; Within 24 hours of admission, covering immediate service, health and safety needs.

Source evidence
L-010 · TIME-ISP-INITIAL
Payer: AETNA · 3.3 · open

Assigned to
Cameron Lee · Utilization review · Due 2026-09-27

Open client record
A reply or acknowledgement does not resolve the finding.

Mindful Note Review

NoteService dateReadinessReview state
N-SHOW-11-0 →2026-10-02not readynot reviewed
N-SHOW-11-1 →2026-10-03not readynot reviewed
N-SHOW-11-2 →2026-10-04not readynot reviewed

Units ledger

Authorization / payerAuthorizedDelivered / approved / billedRemaining / end
AU-DEMO-11AETNA · DEMO · day303 / 0 / 0272026-11-02

Claims and remittances

Claim · serviceUnits · payerStatus · related note

No claim has been supplied for this client. An approved note awaiting a claim appears in the audit findings when its billing deadline passes.

Remittances and denial follow-up

ClaimDecision · dateFollow-up

Episode clocks

ClockDueResult / evidence
Initial treatment plan (initial ISP)TIME-ISP-INITIAL2026-09-27failAETNA · Clock overdue; Within 24 hours of admission, covering immediate service, health and safety needs.
Initial approval request sent to the planTIME-AUTH-REQUEST2026-09-28passAETNA · Clock met; DMAS-recommended initial filing within 1 business day of service initiation. FFS follows these recommendations; MCO deadlines require the signed payer contract (M-002).
Plan's decision dueTIME-AUTH-DECISION2026-09-29passAETNA · Clock met; 72 hours from submission for ARTS service authorization requests (A-010, A-060). Receipt is not the anchor.
Active written discharge plan in the recordTIME-DISCHARGE-PLAN2026-10-11passAETNA · Clock due-soon; At least 7 calendar days before discharge at Level 3.3.
Comprehensive treatment plan (comprehensive ISP)TIME-ISP-COMPREHENSIVE2026-10-26passAETNA · Clock met; Within 30 calendar days of starting services, required even if the person is discharged earlier.
Services must start within 30 days of the assessmentTIME-ASSESS-FRESH2026-10-26passAETNA · Clock met; If services start later than 30 days after the assessment is completed, the assessment has to be redone.
Next treatment plan reviewTIME-ISP-REVIEW2026-10-26passAETNA · Clock upcoming; At least every 30 calendar days at 3.3, and whenever needs change. A plan not updated on time is "outdated".
Extension (continued-stay) requestTIME-EXT-REQUEST2026-11-01passAETNA · Clock upcoming; DMAS-recommended window: before authorization ends and no more than 5 calendar days before its end. FFS follows these recommendations; MCO timing requires the signed payer contract (M-002).
Provider's informal appeal at DMASTIME-DMAS-PROVIDER-APPEAL-30Exact anchor unavailableskippedAETNA · Primary applicable source unavailable: A-029
Member's appeal to the health plan (provider files only with the member's written consent)TIME-MEMBER-APPEAL-602026-11-30passAETNA · Clock upcoming; 60 calendar days from the date on the notice. A provider needs the member’s written consent and cannot request continued benefits.

Documents in this record

Supplied demo artifacts. Open a document to inspect its type, version and structured evidence.

Document · dateAuthor · statusEvidence
demographics
SHOW-11-FACE
2026-09-26
Jamie Ross (S-08)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 FACE

No structured element list

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

plan
SHOW-11-PLAN
2026-09-26
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 PLAN

needs, goals, services, agencies, discharge, family, aftercare, pharmacotherapy, choice, signature, levelOfCare

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

assessment
SHOW-11-ASSESS
2026-09-26
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 ASSESS

history, medical, psychiatric, substance, risk, strengths, riskRating, immediateNeeds

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

medication-list
SHOW-11-MEDS
2026-09-26
Dr. Quinn Mercer (S-09)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 MEDS

No structured element list

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

consent
SHOW-11-CONSENT
2026-09-26
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 CONSENT

signature, signedDate

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

authorization
SHOW-11-AUTH
2026-09-26
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO RECORD SHOW-11 AUTH

No structured element list

Created 2026-09-26T16:00:00-04:00
Signed 2026-09-26T16:00:00-04:00

note
D-N-SHOW-11-0
2026-10-02
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO NOTE 11 0

setting, intervention, response, goal, humanSemanticReviewed

Created 2026-10-02T16:00:00-04:00
Signed 2026-10-02T16:00:00-04:00

Open Note Review →
note
D-N-SHOW-11-1
2026-10-03
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO NOTE 11 1

setting, intervention, response, goal, humanSemanticReviewed

Created 2026-10-03T16:00:00-04:00
Signed 2026-10-03T16:00:00-04:00

Open Note Review →
note
D-N-SHOW-11-2
2026-10-04
Dana Patel (S-01)
signed · version 1
View supplied demo artifact

DEMO NOTE 11 2

setting, intervention, response, goal, humanSemanticReviewed

Created 2026-10-04T16:00:00-04:00
Signed 2026-10-04T16:00:00-04:00

Open Note Review →

Diagnoses, medication and planned services

Fictional chart facts. Medication codes and doses are demonstration placeholders.

Diagnoses

CodeDocumentRecorded by
F10.20SHOW-11-ASSESSDr. Quinn Mercer (S-09)
F10.20SHOW-11-PLANDr. Quinn Mercer (S-09)

Medication reconciliation

MedicationDose · route · scheduleRecord
DEMO-MED-ADEMO-DOSE-A · demo-route
demo-schedule
SHOW-11-MEDS · active
DEMO-MED-ADEMO-DOSE-A · demo-route
demo-schedule
SHOW-11-PLAN · active

Planned services

ServiceFrequency · targetSource
DEMO3 sessions weekly
2026-10-26
SHOW-11-PLAN

Consent and coverage

RecordScopeStatus
CON-SHOW-11part2 · demo-payment
AETNA
2026-09-26 through 2027-10-08
9 structured elements
CV-Miles Carter (C-0011)AETNA2026-01-01 through open ended
Verified demo coverage

Mailbox and team

Open messages →
Recorded activityStatus
Confirmation of receipt for Miles Carter (C-0011).CH-023Cataloged receipt
Question requires follow-up for Miles Carter (C-0011).CH-024Open clarification / follow-up
Team update recorded; not posted for Miles Carter (C-0011).CH-025Not posted

Executed checks and source gaps

29 passed · 1 failed · 88 skipped

Rule / subjectResultEvidence
NOTE-LATEN-SHOW-11-0skippedRule does not apply to this level
NOTE-UNSIGNEDN-SHOW-11-0skippedRule does not apply to this level
NOTE-NO-TIMEN-SHOW-11-0skippedRule does not apply to this level
NOTE-CLONEDN-SHOW-11-0skippedRule does not apply to this level
NOTE-COSIGNN-SHOW-11-0skippedRule does not apply to this level
NOTE-TIMESN-SHOW-11-0skippedRule does not apply to this level
GROUP-SIZEN-SHOW-11-0skippedRule does not apply to this level
NOTE-LATEN-SHOW-11-1skippedRule does not apply to this level
NOTE-UNSIGNEDN-SHOW-11-1skippedRule does not apply to this level
NOTE-NO-TIMEN-SHOW-11-1skippedRule does not apply to this level
NOTE-CLONEDN-SHOW-11-1skippedRule does not apply to this level
NOTE-COSIGNN-SHOW-11-1skippedRule does not apply to this level
NOTE-TIMESN-SHOW-11-1skippedRule does not apply to this level
GROUP-SIZEN-SHOW-11-1skippedRule does not apply to this level
NOTE-LATEN-SHOW-11-2skippedRule does not apply to this level
NOTE-UNSIGNEDN-SHOW-11-2skippedRule does not apply to this level
NOTE-NO-TIMEN-SHOW-11-2skippedRule does not apply to this level
NOTE-CLONEDN-SHOW-11-2skippedRule does not apply to this level
NOTE-COSIGNN-SHOW-11-2skippedRule does not apply to this level
NOTE-TIMESN-SHOW-11-2skippedRule does not apply to this level
GROUP-SIZEN-SHOW-11-2skippedRule does not apply to this level
DAY-HOURSE-11:2026-10-02skippedRule does not apply to this level
DAY-HOURSE-11:2026-10-03skippedRule does not apply to this level
DAY-HOURSE-11:2026-10-04skippedRule does not apply to this level
WEEK-HOURSE-11:2026-09-27skippedRule does not apply to this level
SERVICE-NO-AUTHE-11:gappassRequired inputs checked
SERVICE-NO-AUTHE-11:pendingpassRequired inputs checked
PLAN-ELEMENTSP-SHOW-11skippedRule does not apply to this level
ASSESS-DIMENSIONSAS-SHOW-11skippedRule does not apply to this level
ASSESS-MISSINGE-11skippedRule does not apply to this level
TIME-ISP-INITIALE-11:ISP-INITIALfailClock overdue; Within 24 hours of admission, covering immediate service, health and safety needs.
TIME-AUTH-REQUESTE-11:AUTH-REQUESTpassClock met; DMAS-recommended initial filing within 1 business day of service initiation. FFS follows these recommendations; MCO deadlines require the signed payer contract (M-002).
TIME-AUTH-DECISIONE-11:AUTH-DECISIONpassClock met; 72 hours from submission for ARTS service authorization requests (A-010, A-060). Receipt is not the anchor.
TIME-DISCHARGE-PLANE-11:DISCHARGE-PLANpassClock due-soon; At least 7 calendar days before discharge at Level 3.3.
TIME-ISP-COMPREHENSIVEE-11:ISP-COMPREHENSIVEpassClock met; Within 30 calendar days of starting services, required even if the person is discharged earlier.
TIME-ASSESS-FRESHE-11:ASSESS-FRESHpassClock met; If services start later than 30 days after the assessment is completed, the assessment has to be redone.
TIME-ISP-REVIEWE-11:ISP-REVIEWpassClock upcoming; At least every 30 calendar days at 3.3, and whenever needs change. A plan not updated on time is "outdated".
TIME-EXT-REQUESTE-11:EXT-REQUEST:AU-DEMO-11passClock upcoming; DMAS-recommended window: before authorization ends and no more than 5 calendar days before its end. FFS follows these recommendations; MCO timing requires the signed payer contract (M-002).
TIME-DMAS-PROVIDER-APPEAL-30E-11:DMAS-PROVIDER-APPEAL-30:D-SHOW-11skippedPrimary applicable source unavailable: A-029
TIME-MEMBER-APPEAL-60E-11:MEMBER-APPEAL-60:D-SHOW-11passClock upcoming; 60 calendar days from the date on the notice. A provider needs the member’s written consent and cannot request continued benefits.
CONS-DEMO-NAMEE-11skippedTwo comparable identity sources are required
CONS-DEMO-DOBE-11skippedTwo comparable identity sources are required
CONS-DEMO-ADDRESSE-11skippedTwo comparable identity sources are required
CONS-DEMO-PHONEE-11skippedTwo comparable identity sources are required
CONS-DEMO-SSNE-11skippedTwo comparable identity sources are required
CONS-DEMO-GENDERE-11skippedTwo comparable identity sources are required
CONS-DEMO-MEDICAIDE-11skippedTwo comparable identity sources are required
CONS-DXE-11passRequired inputs checked
CONS-MEDSE-11passRequired inputs checked
CONS-LOCE-11skippedRule does not apply to this level
CONS-PAYERE-11skippedNo claim payer comparison available
CONS-DATESE-11passRequired inputs checked
COMP-SIGNEDSHOW-11-FACEpassRequired inputs checked
COMP-ISP-CLIENT-SIGSHOW-11-PLANpassRequired inputs checked
COMP-INFORMED-CHOICESHOW-11-PLANpassRequired inputs checked
COMP-DISCHARGE-PLANSHOW-11-PLANskippedRule does not apply to this level
COMP-SIGNEDSHOW-11-PLANpassRequired inputs checked
COMP-ASSESS-PROFILESHOW-11-ASSESSskippedRule does not apply to this level
COMP-ASSESS-ELEMENTSSHOW-11-ASSESSpassRequired inputs checked
COMP-SIGNEDSHOW-11-ASSESSpassRequired inputs checked
COMP-SIGNEDSHOW-11-MEDSpassRequired inputs checked
COMP-SIGNEDSHOW-11-CONSENTpassRequired inputs checked
COMP-SIGNEDSHOW-11-AUTHpassRequired inputs checked
COMP-NOTE-FIELDSD-N-SHOW-11-0skippedRule does not apply to this level
COMP-SIGNEDD-N-SHOW-11-0passRequired inputs checked
COMP-NOTE-FIELDSD-N-SHOW-11-1skippedRule does not apply to this level
COMP-SIGNEDD-N-SHOW-11-1passRequired inputs checked
COMP-NOTE-FIELDSD-N-SHOW-11-2skippedRule does not apply to this level
COMP-SIGNEDD-N-SHOW-11-2passRequired inputs checked
COMP-MOUDE-11skippedRule does not apply to this level
PEOPLE-CRED-SCOPESHOW-11-PLANskippedRule does not apply to this level
PEOPLE-CRED-SCOPESHOW-11-ASSESSskippedRule does not apply to this level
ASAM-DX-BY-LICENSEDDX-A-11skippedRule does not apply to this level
ASAM-DX-BY-LICENSEDDX-P-11skippedRule does not apply to this level
CLAR-ISP-FREQ-MISSINGPS-11passRequired inputs checked
CLAR-ISP-FREQ-AMBIGPS-11passRequired inputs checked
CLAR-PLAN-VS-DELIVERYPS-11skippedPrimary applicable source unavailable: A-026
CLAR-GOALS-MEASURABLEE-11skippedRule does not apply to this level
CLAR-NOTE-GOAL-LINKE-11skippedRule does not apply to this level
CLAR-NOTE-TIME-SUPPORTE-11skippedRule does not apply to this level
CLAR-CONTRADICTIONE-11skippedRule does not apply to this level
ASAM-CONTINUED-STAYE-11skippedRule does not apply to this level
COMP-PART2-CONSENTCON-SHOW-11passRequired inputs checked
COMP-PART2-DISCLOSURECON-SHOW-11passRequired inputs checked
COMP-CRIMINAL-JUSTICE-CONSENTCON-SHOW-11skippedNot a criminal justice referral
REV-ATTEND-NO-NOTESES-SHOW-11-0skippedRule does not apply to this level
REV-ATTEND-NO-NOTESES-SHOW-11-1skippedRule does not apply to this level
REV-ATTEND-NO-NOTESES-SHOW-11-2skippedRule does not apply to this level
REV-NOTE-RETURNED-OPENN-SHOW-11-0skippedRule does not apply to this level
REV-APPROVAL-LAGN-SHOW-11-0skippedRule does not apply to this level
REV-LATE-ENTRY-HOLDN-SHOW-11-0skippedRule does not apply to this level
REV-APPROVED-NO-CLAIMN-SHOW-11-0skippedRule does not apply to this level
REV-TIMELY-FILINGN-SHOW-11-0skippedRule does not apply to this level
REV-SERVICE-UNBILLEDN-SHOW-11-0skippedRule does not apply to this level
FLOW-UNREVIEWEDN-SHOW-11-0skippedRule does not apply to this level
FLOW-MISMATCHN-SHOW-11-0skippedRule does not apply to this level
REV-NOTE-RETURNED-OPENN-SHOW-11-1skippedRule does not apply to this level
REV-APPROVAL-LAGN-SHOW-11-1skippedRule does not apply to this level
REV-LATE-ENTRY-HOLDN-SHOW-11-1skippedRule does not apply to this level
REV-APPROVED-NO-CLAIMN-SHOW-11-1skippedRule does not apply to this level
REV-TIMELY-FILINGN-SHOW-11-1skippedRule does not apply to this level
REV-SERVICE-UNBILLEDN-SHOW-11-1skippedRule does not apply to this level
FLOW-UNREVIEWEDN-SHOW-11-1skippedRule does not apply to this level
FLOW-MISMATCHN-SHOW-11-1skippedRule does not apply to this level
REV-NOTE-RETURNED-OPENN-SHOW-11-2skippedRule does not apply to this level
REV-APPROVAL-LAGN-SHOW-11-2skippedRule does not apply to this level
REV-LATE-ENTRY-HOLDN-SHOW-11-2skippedRule does not apply to this level
REV-APPROVED-NO-CLAIMN-SHOW-11-2skippedRule does not apply to this level
REV-TIMELY-FILINGN-SHOW-11-2skippedRule does not apply to this level
REV-SERVICE-UNBILLEDN-SHOW-11-2skippedRule does not apply to this level
FLOW-UNREVIEWEDN-SHOW-11-2skippedRule does not apply to this level
FLOW-MISMATCHN-SHOW-11-2skippedRule does not apply to this level
REV-UNITS-OVER-AUTHAU-DEMO-11skippedRule does not apply to this level
REV-UNITS-BURNAU-DEMO-11skippedRule does not apply to this level
REV-CLAIM-NO-NOTEE-11skippedRule does not apply to this level
REV-DENIAL-UNWORKEDE-11skippedRule does not apply to this level
REV-PAYER-CREDENTIALE-11skippedRule does not apply to this level
REV-COVERAGE-CHANGEE-11skippedRule does not apply to this level