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Clocks & prior casesClients / Record workspace
Sam Rivera
Open an item for evidence, ownership and a review decision.
Initial approval request needs reviewSam Rivera · E-21:AUTH-REQUESTUtilization reviewDue 2026-09-28urgent
Verified payer profile
Source evidence
A-011 · TIME-AUTH-REQUEST
Payer: DMAS · 2.5 · open
Assigned to
Cameron Lee · Utilization review · Due 2026-09-28
Initial treatment plan (initial ISP)Sam Rivera · E-21:ISP-INITIALUtilization reviewDue 2026-09-27important
Clock overdue; Within 24 hours of admission, covering immediate service, health and safety needs.
Source evidence
A-022, L-010 · TIME-ISP-INITIAL
Payer: DMAS · 2.5 · open
Assigned to
Cameron Lee · Utilization review · Due 2026-09-27
Approved note has no matching claimSam Rivera · N-DEMO-APPROVEDBillingDue 2026-10-05important
Condition requires review
Source evidence
Versioned house policy · REV-APPROVED-NO-CLAIM
Payer: DMAS · 2.5 · open
Assigned to
Drew Santos · Billing · Due 2026-10-05
Delivery compared with complete planned periodSam Rivera · PS-21Clinical directorDue 2026-10-14important
Condition requires review
Source evidence
A-026 · CLAR-PLAN-VS-DELIVERY
Payer: DMAS · 2.5 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-14
Treatment week outside the hour rangeSam Rivera · E-21:2026-09-27Clinical directorDue 2026-10-15watch
Condition requires review
Source evidence
A-016 · WEEK-HOURS
Payer: DMAS · 2.5 · open
Assigned to
Harper Brooks · Clinical director · Due 2026-10-15
Mindful Note Review
| Note | Service date | Readiness | Review state |
|---|---|---|---|
| N-SHOW-21-0 → | 2026-10-02 | ready | reconciled |
| N-SHOW-21-1 → | 2026-10-03 | ready | reconciled |
| N-SHOW-21-2 → | 2026-10-04 | ready | reconciled |
| N-DEMO-APPROVED → | 2026-09-30 | ready | approved |
Units ledger
| Authorization / payer | Authorized | Delivered / approved / billed | Remaining / end |
|---|---|---|---|
| AU-DEMO-21DMAS · S0201 · day | 30 | 4 / 4 / 3 | 262026-11-02 |
Claims and remittances
| Claim · service | Units · payer | Status · related note |
|---|---|---|
| CLM-SHOW-21-0 2026-10-02 · S0201 | 1 day DMAS | denied N-SHOW-21-0 |
| CLM-SHOW-21-1 2026-10-03 · S0201 | 1 day DMAS | submitted N-SHOW-21-1 |
| CLM-SHOW-21-2 2026-10-04 · S0201 | 1 day DMAS | submitted N-SHOW-21-2 |
Remittances and denial follow-up
| Claim | Decision · date | Follow-up |
|---|---|---|
| CLM-SHOW-21-0 | denied · 2026-10-04 DEMO-REVIEW | 2026-10-05 |
| CLM-SHOW-21-1 | partial · 2026-10-05 DEMO-REVIEW | No work action recorded |
| CLM-SHOW-21-2 | partial · 2026-10-06 DEMO-REVIEW | No work action recorded |
Episode clocks
| Clock | Due | Result / evidence |
|---|---|---|
| Initial treatment plan (initial ISP)TIME-ISP-INITIAL | 2026-09-27 | failDMAS · Clock overdue; Within 24 hours of admission, covering immediate service, health and safety needs. |
| Initial approval request sent to the planTIME-AUTH-REQUEST | 2026-09-28 | failDMAS · Verified payer profile |
| Plan's decision dueTIME-AUTH-DECISION | 2026-09-29 | passDMAS · Verified payer profile; exact due 2026-09-29T13:00:00.000Z |
| Comprehensive treatment plan (comprehensive ISP)TIME-ISP-COMPREHENSIVE | 2026-10-26 | passDMAS · 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-FRESH | 2026-10-26 | passDMAS · 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-REVIEW | 2026-10-26 | passDMAS · Clock upcoming; At least every 30 calendar days at ASAM 2.5, and whenever needs change. A plan not updated on time is "outdated". |
| Extension (continued-stay) requestTIME-EXT-REQUEST | 2026-11-01 | passDMAS · Verified payer profile |
| Provider's informal appeal at DMASTIME-DMAS-PROVIDER-APPEAL-30 | Exact anchor unavailable | skippedDMAS · Primary applicable source unavailable: A-029 |
| No contact for 31 days: discharge decisionTIME-NO-CONTACT-31 | 2026-11-07 | passDMAS · Clock upcoming; A lapse of more than 31 consecutive days with no communication means the program shall discharge the person. This date is the day to decide, one day early on purpose. |
| Member's appeal to the health plan (provider files only with the member's written consent)TIME-MEMBER-APPEAL-60 | 2026-11-30 | passDMAS · 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 · date | Author · status | Evidence |
|---|---|---|
| demographics SHOW-21-FACE 2026-09-26 | Jamie Ross (S-08) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 FACE No structured element list Created 2026-09-26T16:00:00-04:00 |
| plan SHOW-21-PLAN 2026-09-26 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 PLAN needs, goals, services, agencies, discharge, family, aftercare, pharmacotherapy, choice, signature, levelOfCare Created 2026-09-26T16:00:00-04:00 |
| assessment SHOW-21-ASSESS 2026-09-26 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 ASSESS history, medical, psychiatric, substance, risk, strengths, riskRating, immediateNeeds Created 2026-09-26T16:00:00-04:00 |
| medication-list SHOW-21-MEDS 2026-09-26 | Dr. Quinn Mercer (S-09) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 MEDS No structured element list Created 2026-09-26T16:00:00-04:00 |
| consent SHOW-21-CONSENT 2026-09-26 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 CONSENT signature, signedDate Created 2026-09-26T16:00:00-04:00 |
| authorization SHOW-21-AUTH 2026-09-26 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO RECORD SHOW-21 AUTH No structured element list Created 2026-09-26T16:00:00-04:00 |
| note D-N-SHOW-21-0 2026-10-02 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO NOTE 21 0 setting, intervention, response, goal, humanSemanticReviewed Created 2026-10-02T16:00:00-04:00 |
| note D-N-SHOW-21-1 2026-10-03 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO NOTE 21 1 setting, intervention, response, goal, humanSemanticReviewed Created 2026-10-03T16:00:00-04:00 |
| note D-N-SHOW-21-2 2026-10-04 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO NOTE 21 2 setting, intervention, response, goal, humanSemanticReviewed Created 2026-10-04T16:00:00-04:00 |
| note D-N-DEMO-APPROVED 2026-09-30 | Dana Patel (S-01) signed · version 1 | View supplied demo artifactDEMO QUEUE N-DEMO-APPROVED setting, intervention, response, goal, humanSemanticReviewed Created 2026-09-30T16:00:00-04:00 |
Diagnoses, medication and planned services
Fictional chart facts. Medication codes and doses are demonstration placeholders.
Diagnoses
| Code | Document | Recorded by |
|---|---|---|
| F10.20 | SHOW-21-ASSESS | Dr. Quinn Mercer (S-09) |
| F10.20 | SHOW-21-PLAN | Dr. Quinn Mercer (S-09) |
Medication reconciliation
| Medication | Dose · route · schedule | Record |
|---|---|---|
| DEMO-MED-A | DEMO-DOSE-A · demo-route demo-schedule | SHOW-21-MEDS · active |
| DEMO-MED-A | DEMO-DOSE-A · demo-route demo-schedule | SHOW-21-PLAN · active |
Planned services
| Service | Frequency · target | Source |
|---|---|---|
| S0201 | 3 sessions weekly 2026-10-26 | SHOW-21-PLAN |
Consent and coverage
| Record | Scope | Status |
|---|---|---|
| CON-SHOW-21 | part2 · demo-payment DMAS | 2026-09-26 through 2027-10-08 9 structured elements |
| CV-Sam Rivera (C-0021) | DMAS | 2026-01-01 through open ended Verified demo coverage |
Mailbox and team
Open messages →| Recorded activity | Status |
|---|---|
| Confirmation of receipt for Sam Rivera (C-0021).CH-044 | Cataloged receipt |
| Clarification requires follow-up for Sam Rivera (C-0021).CH-045 | Open clarification / follow-up |
| Team update recorded; not posted for Sam Rivera (C-0021).CH-046 | Not posted |
| Follow-up required for Sam Rivera (C-0021).CH-049 | Not sent |
Executed checks and source gaps
113 passed · 5 failed · 29 skipped
| Rule / subject | Result | Evidence |
|---|---|---|
| NOTE-LATEN-SHOW-21-0 | pass | Required inputs checked |
| NOTE-UNSIGNEDN-SHOW-21-0 | pass | Required inputs checked |
| NOTE-NO-TIMEN-SHOW-21-0 | pass | Required inputs checked |
| NOTE-CLONEDN-SHOW-21-0 | pass | Required inputs checked |
| NOTE-COSIGNN-SHOW-21-0 | pass | Required inputs checked |
| NOTE-TIMESN-SHOW-21-0 | skipped | MH time rule not applicable |
| GROUP-SIZEN-SHOW-21-0 | skipped | Group size not supplied or not a group note |
| NOTE-LATEN-SHOW-21-1 | pass | Required inputs checked |
| NOTE-UNSIGNEDN-SHOW-21-1 | pass | Required inputs checked |
| NOTE-NO-TIMEN-SHOW-21-1 | pass | Required inputs checked |
| NOTE-CLONEDN-SHOW-21-1 | pass | Required inputs checked |
| NOTE-COSIGNN-SHOW-21-1 | pass | Required inputs checked |
| NOTE-TIMESN-SHOW-21-1 | skipped | MH time rule not applicable |
| GROUP-SIZEN-SHOW-21-1 | skipped | Group size not supplied or not a group note |
| NOTE-LATEN-SHOW-21-2 | pass | Required inputs checked |
| NOTE-UNSIGNEDN-SHOW-21-2 | pass | Required inputs checked |
| NOTE-NO-TIMEN-SHOW-21-2 | pass | Required inputs checked |
| NOTE-CLONEDN-SHOW-21-2 | pass | Required inputs checked |
| NOTE-COSIGNN-SHOW-21-2 | pass | Required inputs checked |
| NOTE-TIMESN-SHOW-21-2 | skipped | MH time rule not applicable |
| GROUP-SIZEN-SHOW-21-2 | skipped | Group size not supplied or not a group note |
| NOTE-LATEN-DEMO-APPROVED | pass | Required inputs checked |
| NOTE-UNSIGNEDN-DEMO-APPROVED | pass | Required inputs checked |
| NOTE-NO-TIMEN-DEMO-APPROVED | pass | Required inputs checked |
| NOTE-CLONEDN-DEMO-APPROVED | pass | Required inputs checked |
| NOTE-COSIGNN-DEMO-APPROVED | pass | Required inputs checked |
| NOTE-TIMESN-DEMO-APPROVED | skipped | MH time rule not applicable |
| GROUP-SIZEN-DEMO-APPROVED | skipped | Group size not supplied or not a group note |
| WEEK-HOURSE-21:2026-09-27 | fail | Condition requires review |
| DAY-HOURSE-21:2026-10-02 | pass | Required inputs checked |
| DAY-HOURSE-21:2026-10-03 | pass | Required inputs checked |
| DAY-HOURSE-21:2026-10-04 | pass | Required inputs checked |
| SERVICE-NO-AUTHE-21:gap | pass | Required inputs checked |
| SERVICE-NO-AUTHE-21:pending | pass | Required inputs checked |
| PLAN-ELEMENTSP-SHOW-21 | pass | Required inputs checked |
| ASSESS-DIMENSIONSAS-SHOW-21 | pass | Required inputs checked |
| ASSESS-MISSINGE-21 | pass | Required inputs checked |
| TIME-ISP-INITIALE-21:ISP-INITIAL | fail | Clock overdue; Within 24 hours of admission, covering immediate service, health and safety needs. |
| TIME-AUTH-REQUESTE-21:AUTH-REQUEST | fail | Verified payer profile |
| TIME-AUTH-DECISIONE-21:AUTH-DECISION | pass | Verified payer profile; exact due 2026-09-29T13:00:00.000Z |
| TIME-ISP-COMPREHENSIVEE-21:ISP-COMPREHENSIVE | pass | Clock met; Within 30 calendar days of starting services, required even if the person is discharged earlier. |
| TIME-ASSESS-FRESHE-21:ASSESS-FRESH | pass | Clock met; If services start later than 30 days after the assessment is completed, the assessment has to be redone. |
| TIME-ISP-REVIEWE-21:ISP-REVIEW | pass | Clock upcoming; At least every 30 calendar days at ASAM 2.5, and whenever needs change. A plan not updated on time is "outdated". |
| TIME-EXT-REQUESTE-21:EXT-REQUEST:AU-DEMO-21 | pass | Verified payer profile |
| TIME-DMAS-PROVIDER-APPEAL-30E-21:DMAS-PROVIDER-APPEAL-30:D-SHOW-21 | skipped | Primary applicable source unavailable: A-029 |
| TIME-NO-CONTACT-31E-21:NO-CONTACT-31 | pass | Clock upcoming; A lapse of more than 31 consecutive days with no communication means the program shall discharge the person. This date is the day to decide, one day early on purpose. |
| TIME-MEMBER-APPEAL-60E-21:MEMBER-APPEAL-60:D-SHOW-21 | pass | Clock 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-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-DOBE-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-ADDRESSE-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-PHONEE-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-SSNE-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-GENDERE-21 | skipped | Two comparable identity sources are required |
| CONS-DEMO-MEDICAIDE-21 | skipped | Two comparable identity sources are required |
| CONS-DXE-21 | pass | Required inputs checked |
| CONS-MEDSE-21 | pass | Required inputs checked |
| CONS-LOCE-21 | pass | Required inputs checked |
| CONS-PAYERE-21 | pass | Required inputs checked |
| CONS-DATESE-21 | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-FACE | pass | Required inputs checked |
| COMP-ISP-CLIENT-SIGSHOW-21-PLAN | pass | Required inputs checked |
| COMP-INFORMED-CHOICESHOW-21-PLAN | pass | Required inputs checked |
| COMP-DISCHARGE-PLANSHOW-21-PLAN | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-PLAN | pass | Required inputs checked |
| COMP-ASSESS-PROFILESHOW-21-ASSESS | pass | Required inputs checked |
| COMP-ASSESS-ELEMENTSSHOW-21-ASSESS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-ASSESS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-MEDS | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-CONSENT | pass | Required inputs checked |
| COMP-SIGNEDSHOW-21-AUTH | pass | Required inputs checked |
| COMP-NOTE-FIELDSD-N-SHOW-21-0 | pass | Required inputs checked |
| COMP-SIGNEDD-N-SHOW-21-0 | pass | Required inputs checked |
| COMP-NOTE-FIELDSD-N-SHOW-21-1 | pass | Required inputs checked |
| COMP-SIGNEDD-N-SHOW-21-1 | pass | Required inputs checked |
| COMP-NOTE-FIELDSD-N-SHOW-21-2 | pass | Required inputs checked |
| COMP-SIGNEDD-N-SHOW-21-2 | pass | Required inputs checked |
| COMP-NOTE-FIELDSD-N-DEMO-APPROVED | pass | Required inputs checked |
| COMP-SIGNEDD-N-DEMO-APPROVED | pass | Required inputs checked |
| COMP-MOUDE-21 | pass | Required inputs checked |
| PEOPLE-CRED-SCOPESHOW-21-PLAN | pass | Required inputs checked |
| PEOPLE-CRED-SCOPESHOW-21-ASSESS | pass | Required inputs checked |
| ASAM-DX-BY-LICENSEDDX-A-21 | pass | Required inputs checked |
| ASAM-DX-BY-LICENSEDDX-P-21 | pass | Required inputs checked |
| CLAR-ISP-FREQ-MISSINGPS-21 | pass | Required inputs checked |
| CLAR-ISP-FREQ-AMBIGPS-21 | pass | Required inputs checked |
| CLAR-PLAN-VS-DELIVERYPS-21 | fail | Condition requires review |
| CLAR-GOALS-MEASURABLEE-21 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-NOTE-GOAL-LINKE-21 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-NOTE-TIME-SUPPORTE-21 | skipped | No qualified text-reader assessment supplied; not a pass |
| CLAR-CONTRADICTIONE-21 | skipped | No qualified text-reader assessment supplied; not a pass |
| ASAM-CONTINUED-STAYE-21 | skipped | No qualified text-reader assessment supplied; not a pass |
| COMP-PART2-CONSENTCON-SHOW-21 | pass | Required inputs checked |
| COMP-PART2-DISCLOSURECON-SHOW-21 | pass | Required inputs checked |
| COMP-CRIMINAL-JUSTICE-CONSENTCON-SHOW-21 | skipped | Not a criminal justice referral |
| REV-ATTEND-NO-NOTESES-SHOW-21-0 | pass | Note exists |
| REV-ATTEND-NO-NOTESES-SHOW-21-1 | pass | Note exists |
| REV-ATTEND-NO-NOTESES-SHOW-21-2 | pass | Note exists |
| REV-ATTEND-NO-NOTESES-N-DEMO-APPROVED | pass | Note exists |
| REV-NOTE-RETURNED-OPENN-SHOW-21-0 | pass | Required inputs checked |
| REV-APPROVAL-LAGN-SHOW-21-0 | pass | Required inputs checked |
| REV-LATE-ENTRY-HOLDN-SHOW-21-0 | pass | Required inputs checked |
| REV-APPROVED-NO-CLAIMN-SHOW-21-0 | pass | Required inputs checked |
| REV-TIMELY-FILINGN-SHOW-21-0 | pass | Verified payer profile |
| REV-SERVICE-UNBILLEDN-SHOW-21-0 | skipped | No separately billable configured service |
| FLOW-UNREVIEWEDN-SHOW-21-0 | pass | Required inputs checked |
| FLOW-MISMATCHN-SHOW-21-0 | pass | Required inputs checked |
| REV-NOTE-RETURNED-OPENN-SHOW-21-1 | pass | Required inputs checked |
| REV-APPROVAL-LAGN-SHOW-21-1 | pass | Required inputs checked |
| REV-LATE-ENTRY-HOLDN-SHOW-21-1 | pass | Required inputs checked |
| REV-APPROVED-NO-CLAIMN-SHOW-21-1 | pass | Required inputs checked |
| REV-TIMELY-FILINGN-SHOW-21-1 | pass | Verified payer profile |
| REV-SERVICE-UNBILLEDN-SHOW-21-1 | skipped | No separately billable configured service |
| FLOW-UNREVIEWEDN-SHOW-21-1 | pass | Required inputs checked |
| FLOW-MISMATCHN-SHOW-21-1 | pass | Required inputs checked |
| REV-NOTE-RETURNED-OPENN-SHOW-21-2 | pass | Required inputs checked |
| REV-APPROVAL-LAGN-SHOW-21-2 | pass | Required inputs checked |
| REV-LATE-ENTRY-HOLDN-SHOW-21-2 | pass | Required inputs checked |
| REV-APPROVED-NO-CLAIMN-SHOW-21-2 | pass | Required inputs checked |
| REV-TIMELY-FILINGN-SHOW-21-2 | pass | Verified payer profile |
| REV-SERVICE-UNBILLEDN-SHOW-21-2 | skipped | No separately billable configured service |
| FLOW-UNREVIEWEDN-SHOW-21-2 | pass | Required inputs checked |
| FLOW-MISMATCHN-SHOW-21-2 | pass | Required inputs checked |
| REV-NOTE-RETURNED-OPENN-DEMO-APPROVED | pass | Required inputs checked |
| REV-APPROVAL-LAGN-DEMO-APPROVED | pass | Required inputs checked |
| REV-LATE-ENTRY-HOLDN-DEMO-APPROVED | pass | Required inputs checked |
| REV-APPROVED-NO-CLAIMN-DEMO-APPROVED | fail | Condition requires review |
| REV-TIMELY-FILINGN-DEMO-APPROVED | pass | Verified payer profile |
| REV-SERVICE-UNBILLEDN-DEMO-APPROVED | skipped | No separately billable configured service |
| FLOW-UNREVIEWEDN-DEMO-APPROVED | pass | Required inputs checked |
| FLOW-MISMATCHN-DEMO-APPROVED | pass | Required inputs checked |
| REV-CLAIM-NO-NOTECL-CLM-SHOW-21-0 | pass | Required inputs checked |
| REV-PAYER-CREDENTIALCL-CLM-SHOW-21-0 | pass | Required inputs checked |
| REV-COVERAGE-CHANGECL-CLM-SHOW-21-0 | pass | Required inputs checked |
| REV-CLAIM-NO-NOTECL-CLM-SHOW-21-1 | pass | Required inputs checked |
| REV-PAYER-CREDENTIALCL-CLM-SHOW-21-1 | pass | Required inputs checked |
| REV-COVERAGE-CHANGECL-CLM-SHOW-21-1 | pass | Required inputs checked |
| REV-CLAIM-NO-NOTECL-CLM-SHOW-21-2 | pass | Required inputs checked |
| REV-PAYER-CREDENTIALCL-CLM-SHOW-21-2 | pass | Required inputs checked |
| REV-COVERAGE-CHANGECL-CLM-SHOW-21-2 | pass | Required inputs checked |
| REV-UNITS-OVER-AUTHAU-DEMO-21 | pass | Required inputs checked |
| REV-UNITS-BURNAU-DEMO-21 | pass | Required inputs checked |
| PAYER-DENIAL-DEADLINERM-CLM-SHOW-21-0 | skipped | No verified payer field or applicable DMAS fallback |
| REV-DENIAL-UNWORKEDRM-CLM-SHOW-21-0 | pass | House follow-up deadline; payer appeal clock is separately sourced |
| PAYER-DENIAL-DEADLINERM-CLM-SHOW-21-1 | skipped | No denial |
| REV-DENIAL-UNWORKEDRM-CLM-SHOW-21-1 | pass | House follow-up deadline; payer appeal clock is separately sourced |
| PAYER-DENIAL-DEADLINERM-CLM-SHOW-21-2 | skipped | No denial |
| REV-DENIAL-UNWORKEDRM-CLM-SHOW-21-2 | pass | House follow-up deadline; payer appeal clock is separately sourced |