Knowledge Management System Overview

Tier 1: Foundation

Core terminology, organizational structure, and system foundations

Tier 2: Processes

Patient workflows, clinical operations, and administrative procedures

Tier 3: Role-Specific

Customized guides for each team role and responsibility

Tier 4: Support

FAQ, troubleshooting, and reference materials

New in Version 2.0

Complete Provider Scheduling Directory: All providers with detailed schedules, locations, and constraints
Law Firm Specific Requirements: Comprehensive guidelines for each law firm partnership
Dr. Valdez Workflow: Specialized appointment booking and management procedures
Location-Based Scheduling: Detailed rules for each clinic location
Specialty Referral System: Complete KB for specialty coordination
Enhanced Integration: Unified system combining CA and LV operations

Locations Covered

• Hawthorne (Main)
• Riverside
• Las Vegas (LVSS)
• Encino
• Anaheim
• + 10 additional locations

Provider Directory

• 15+ Named Providers
• MDs, PAs, NPs
• Specialty Providers
• External Partners
• Surgery Centers

Law Firm Partners

• 25+ Active Partnerships
• Specific Requirements
• Provider Preferences
• Visit Type Rules
• Documentation Needs

TIER 1: CORE FOUNDATION LAYER

Essential terminology, organizational structure, and system foundations

Master Glossary & Terminology Hub

Core Medical Terms

PCP: Primary Care Provider / Primary Care Physician

Referral: Written or electronic order from PCP to see specialist or get medical services

Medical Specialty: Branch of medicine focusing on specific patient groups, diseases, or skills

EMG: Electromyography - nerve and muscle testing

Injection: Administration of medication via needle and syringe

Administrative Terms

Case Manager (CM): Professional managing administrative and logistical aspects of legal cases

DOL: Date of Loss (accident date)

DOS: Date of Service

Policy Limits: Maximum dollar amount insurer pays for covered damages

LIEN: Security interest over property for debt/obligation payment

Patient Types & Imaging

Patient Types

PI: Personal Injury
Insurance: Commercial Insurance
Workers Comp: Work-related injury
Cash Pay: Self-pay patients

Imaging Types

X-Rays: Basic bone imaging
MRI: Detailed soft tissue (30+ min, expensive, high quality)
CT Scan: Fast imaging (10-15 min, less expensive)

Systems

Practice Fusion (PF): Main EMR system
Monday.com: Task management
Charts: Registered cases in system

Organizational Structure & Contact Directory

Key Personnel

LVSS Team (Las Vegas)

Referral Coordinator: Diana Perez
Virtual Assistant: Sebastian
Billing Manager: Jennifer Hatkoff
Billing Liaison: Megan
Marketers: Chelsea & Theresa

CA Team

Patient Access Supervisor: Cristina N.
Medical Records: Karen Coll-Aralar, Kaiya Dale
Translation Services: Jane Leviste-Ouch

System Access & Tools

Practice Fusion: Charts, scheduling, encounters, prescriptions

Monday.com: Daily work management (Mexico email → Google sign-in)

Curogram: Text messaging system

8x8: Phone system

Propio: Translation (213-377-6621, Client ID: 23459)

Key Email Addresses

referrals@casportsandspine.com - New PI referrals
recommendations@casportsandspine.com - CM communications
specialty@casportsandspine.com - Specialty referrals
no-reply@casportsandspine.com - Automated communications

medicalrecords@californiasportsandspine.com - Medical records
PI-PATEL@CORONISHEALTH.COM - Billing
injections@hawthornesurgery.com - Injection procedures
referrals@lvsportsandspine.com - LVSS referrals

Contact Numbers

(213) 465-0994

Personal Injury Line

(213) 444-2772

General Line

(951) 679-4311

Billing Follow-up

COMPREHENSIVE PROVIDER SCHEDULING DIRECTORY

Complete scheduling information for all providers and locations

All Providers Directory

Dr. Valdez

Hours: 8:00 AM - 4:00 PM

Lunch: 12:00 PM - 1:00 PM

Appointments: 30 minutes each

Preference: In-person appointments

Types: Follow-ups & Direct referrals

Tracking: Monday.com required

NPP: English patients only

Dr. Kajbaf, Jason

Hawthorne: 8:00 AM - 4:00 PM (Cap: 60)

LA: 8:00 AM - 2:40 PM (Cap: 45)

Insurance New: Mon/Wed 8-3PM only

EMG: PI patients, Mondays, Hawthorne

Booking: Triple if others full

Commercial PI: Last option

Dr. Parikh, Hardik

Hawthorne: 8:00 AM - 4:00 PM (Cap: 56)

Culver: 8:00 AM - 12:00 PM (Cap: 30)

Encino: 8:00 AM - 4:00 PM (Cap: 40)

Booking: ONLY double booking

Last New PI: 3:15 PM

Last Follow-up: 3:45 PM

Specialty: Medicare & selected insurance

Dr. Patel, Reekesh

Hawthorne: 8:30 AM - 12:30 PM (Cap: 40)

Types: Commercial PI, Workers Comp

Priority: Second option

Booking: Triple only if others full

Commercial: $250K+ policies

Transportation: Uber/Lyft accepted

Dr. Kim, James

Hours: 8:00 AM - 4:00 PM (Cap: 56)

Locations: Hawthorne, Downey, IE locations

Types: New/Follow-up PI

Booking: ONLY double booking

Restriction: NO Yerushalmi Law

IE Locations: SA, Corona, SB, Rancho, Temecula, Riverside

Mark Jamali (PA)

Hours: 8:00 AM - 4:30 PM

Cap: 60 (up to 75 if needed)

Locations: Multiple (Hawthorne, LA, Culver, Encino, Downey, IE)

Booking: Triple booking allowed

Restrictions: NO Sweet James, Carpenter, Larry H Parker

Priority: In-person patients

Irma Tan (NP)

Hours: 8:00 AM - 4:00 PM (Cap: 60)

Location: Hawthorne

Specialty: Follow-up Insurance (First Option)

Booking: ONLY double booking

Restriction: NO Workers Comp

Harsh Brar (NP)

Hours: 8:00 AM - 4:00 PM (Cap: 60)

Location: Hawthorne

Types: New PI, Follow-up PI, Follow-up INS (Second Option)

Booking: Triple booking allowed

Restrictions: NO MD-only law firms, NO Workers Comp

LVSS Providers

Christina (APRN): 8AM-2PM, Cap 42, Last new 12:45PM

Alyssa: 10AM-6PM, Cap 40

Dr. Parikh: Hours vary, check Google Calendar

Scheduling Order: Christina → Alyssa → Dr. Parikh

Slots: 15-minute increments

Location-Based Scheduling Guidelines

Hawthorne (Main - Mixed Location)

Hours: 8:00 AM - 4:00 PM

Front Office: Leaves at 4:30 PM

Max Patients: In-person only: 45 | With telemed: 60

Injections: Insurance patients until 2:00 PM

Triple Booking: Until 11:45 AM only

Double Booking Injections: Until 2:00 PM

Provider Assignments:

• Dr. Patel: 8:30-12:30, 5th Floor
• Dr. Parikh: 8:00-4:00, 3rd Floor
• Dr. Kajbaf: 8:00-4:00
• Dr. Kim: 8:00-4:00
• Irma Tan: 8:00-4:00, 3rd Floor
• Harsh Brar: 8:00-4:00, 3rd Floor
• Mark: 8:00-4:30

Encino

Hours: 8:00 AM - 4:00 PM

Priority: In-person PI/Insurance

Suite: 246 (2nd floor, right, down hall, last door)

Telemedicine: Only if authorized

Providers:

• Dr. Parikh: 8:00-4:00, Cap 40, Medicare/select insurance
• Mark: 8:00-4:30, Cap 45
• Dr. Kajbaf: Insurance new patients Mon/Wed 8-3PM

Los Angeles

Type: In-person location

Priority: In-person PI patients

Max Patients: 45-60

Providers:

• Mark: 8:00-4:30, Cap 45-60, Priority in-person
• Dr. Kajbaf: 8:00-2:40, Cap 45

Culver

Hours: 8:00 AM - 12:00 PM

Priority: In-person PI

Telemedicine: Only if authorized

Providers:

• Dr. Parikh: 8:00-12:00, Cap 30, Last patient 11:45
• Mark: 8:00-4:30, Cap 45

Downey

Hours: 8:00 AM - 4:00 PM

Priority: In-person PI

Providers:

• Dr. Kim: 8:00-4:00, Cap 45, NO Yerushalmi Law
• Mark: 8:00-4:30, Cap 45 (up to 75)

Inland Empire Locations

Locations: Santa Ana, Corona, San Bernardino, Rancho, Temecula, Riverside

Hours: 8:00 AM - 4:00 PM

Riverside Special: Once monthly 8:30-4:30 PM

Standard Providers for All IE:

• Dr. Kim: 8:00-4:00, Cap 45, NO Yerushalmi Law
• Mark: 8:00-4:30, Cap 45-75, Law firm restrictions

General Scheduling Rules

Booking Limits

• In-person only locations: Max 45 patients
• Telemedicine locations: Max 60 patients
• Triple booking: Only until 11:45 AM
• Double booking: Varies by provider

Time Constraints

• Front office: Leaves at 4:30 PM
• Insurance injections: Until 2:00 PM only
• Lunch break: 12:00-1:00 PM universal
• Telemedicine: Within hour or end of day callback

Law Firm Specific Requirements

Universal Requirements

• Initial consultations: Should be in-person
• MD Only: Add to pin note when required

MD ONLY Required

Larry H Parker: Only MD appointments

Mendez & Sanchez: Only MD, no telemed initial

Law Office of Daniel Kim: MD only all appointments

Elite Medical: Third parties, MD only (add to pin note)

In-Person Requirements

Noravian Law: Initial AND follow-up in-person

Inland Empire Law: Initial consultation in-person

Edward Shkolnikov: Initial & follow-up in-person (notify management if telemed found)

Wilshire Law: Just in-person appointments

Provider Restrictions

Mark cannot see: Sweet James, Carpenter & Zuckerman

Dr. Kim cannot see: Yerushalmi Law

Harsh cannot see: MD-only firms

Telemedicine Rules

Yerushalmi Law: Every 2-3 telemed, then in-person

Yagoubzadeh Law: No telemed appointments

Raiszadeh Law: No telemed, only in-person (Updated 2025-04-03)

Special Approvals

Saeedian Law: Do not proceed without written approval

Bill J. Sayed: Do not schedule follow-up unless requested by CM

All Partner Firms

• Sweet James

• Mendez & Sanchez

• Yerushalmi Law

• Larry H Parker

• Carpenter & Zuckerman

• Noravian Law Firm

• Inland Empire Law

• Edward Shkolnikov

• Daniel Kim

• Panah Law

• Samer Habbas & Associates

• UNITED LAW

• Cabral Law Group

• Law Collective

• Bill J. Sayed

• Saeedian Law Group

• Arash Khorshandi

• Jesse Rodriguez Referrals

• Raiszadeh Law Firm

• Eldaber Ritter

• Wilshire Law

• Yagoubzadeh Law

• ACTS LAW

TIER 2: PROCESS ARCHITECTURE LAYER

Core workflows, patient journey, and operational procedures

Master Patient Journey Workflow

1. Referral Intake

Email, Text, Fax, Phone

2. Chart Prep

Schedule, MRIs, Documentation

3. Scheduling

Provider, Location, Confirmation

4. Encounter

Check-in, Visit, Documentation

5. Recommendations

Reports, Referrals, Approvals

6. Case Management

Follow-up, Billing, Legal

Stage 1: Referral Intake

Multiple Channels:

• Email: referrals@casportsandspine.com / referrals@lvsportsandspine.com
• Text: Screenshot and email to referrals address
• Fax: Virtual Assistant forwards to referrals email
• Phone: Gather all information real-time

Documentation:

• Document in Excel spreadsheet
• Create Practice Fusion entry
• Verify insurance/payer information
• Upload supporting documents

Stage 2: Chart Preparation

New Patients:

• Print daily schedule
• Check for MRIs/imaging
• Contact patients for missing documentation
• Call Case Manager if needed
• CRITICAL: New appointments cannot be canceled

Follow-Up Patients:

• Review last encounter
• Check Recs email for reports
• Verify documents in Practice Fusion
• Reschedule if imaging incomplete
• Clear copay appropriately

Stage 3: Appointment Management

Scheduling Rules:

• Use Practice Fusion (15-minute slots for LVSS)
• Check Google Calendar for current schedules
• Verify provider preferences and restrictions
• Apply law firm specific requirements

Confirmations:

• Send text confirmations
• Notify case managers
• Update Monday.com tracking
• Prepare pre-visit documentation

Core Process Modules

MODULE A: Patient Intake & Scheduling

A.1 Referral Processing

Steps to Handle Incoming Referral:

Document on referrals Excel spreadsheet
Build in Practice Fusion (demographics, contact, address, payer info)
Upload all supporting documents
Notify Referral Coordinator if new payer needed

A.2 Appointment Scheduling

Scheduling Guidelines:

• Reference Google Calendar for provider schedules
• Use correct appointment types (PI, Insurance, Workers Comp, Cash Pay)
• Apply patient caps and booking rules
• Verify law firm requirements

Special Procedures:

Dr. Valdez Workflow:

• 30-minute appointments only
• Prefer in-person visits
• Add all patients to Monday.com
• NPP for English speakers only

EMG Scheduling:

• Dr. Jason Kajbaf only
• Mondays at Hawthorne
• 30-minute slots, no overlap
• PI patients only

MODULE B: Clinical Operations

B.1 Encounter Management

Documentation Requirements:

• Generate encounter reports after every consultation
• Send to case manager within 48 hours
• Include appointment day and CM email confirmation
• Follow up if not completed within timeframe

B.2 Communication Scripts

4-Week Follow-up Script (English):

Opening: "Hello, this is (Name) from California Sports and Spine for Pain Management. I'm calling on behalf of your attorney to set up your 4 weeks follow up appointment."

Development: Offer available appointment (telemed or in-person)

Closure: "Thank you for taking my call. Have a great day."

MODULE C: Specialty & External Referrals

C.1 Surgery Referral Process

Steps 1-3: Initial Process

Doctor recommends surgical consultation
Recommendations dept emails CM for approval
Handle approval/denial (update Excel status)

Steps 4-6: Scheduling

If approved: assign surgeon, update status
Once scheduled: notify CM, update to "CONSULT SCHEDULED"
Follow up for reports after appointment

Steps 7-9: Completion

Process reports, email to CM
Handle missed appointments
If surgery approved: notify surgeon's office

C.2 Specialty Team Coordination

Specialties Handled by Specialty Team:

• Neuro Spine
• Ortho Spine
• Ortho Extremities
• Hand Specialist
• General Surgeon
• Podiatrist

Special Process for:

• Neurologist/Psych (PTSD): Always include RX form
• External Providers: Lien requirements
• CASS Providers: Internal scheduling

MODULE D: Administrative Functions

D.1 Medical Records & Documentation

Work Notes Process:

• Must be authorized by provider from last consultation
• Get requestor info, reason, timeframe
• Send Practice Fusion message to provider
• Upon approval: assistant emails via no-reply

EDD - Disability Insurance:

• Ask for Claim ID (first-time applications)
• Send PF message to Karen, Kaiya, Dioselia
• Extension requires active appointment

D.2 Billing & Special Procedures

Billing Contacts:

• General: PI-PATEL@CORONISHEALTH.COM
• LVSS: PI-LasVegas@coronishealth.com
• Follow-up: 951-679-4311

Prescriptions:

• Never physical prescriptions
• Sent directly to pharmacy via Practice Fusion
• Only prescriber can change prescriptions
• Always leave PIN note

TIER 3: ROLE-SPECIFIC APPLICATION LAYER

Customized guides for each team role and responsibility

Role-Based Quick Reference Guides

Call Center Staff

Primary Responsibilities:

• Handle incoming referrals via phone
• 4-week follow-up calls
• Patient communication
• Basic scheduling support

Tools Access:

• 8x8 for calls
• Curogram for texting
• Practice Fusion for charts
• Monday for task management

Key Scripts:

• 4-week follow-up (English/Spanish)
• Patient authentication protocols
• Appointment confirmation procedures

Chart Prep Team

Daily Workflow:

Print appointment schedules
Review patient charts for completeness
Check imaging availability
Contact patients for missing documentation
Prepare encounter templates
Update front office on status

Critical Rules:

• New appointments cannot be canceled
• MRI follow-up required for missing imaging
• Document all attempts in PIN notes
• Clear copays appropriately

Recommendations Team

Core Functions:

• Send encounter reports to CMs (48-hour rule)
• Process specialty referral requests
• Track approval/denial status
• Manage ongoing case communications

Email Management:

• recommendations@casportsandspine.com
• Thread management for ongoing cases
• Template usage for standard communications
• Follow-up tracking systems

Specialty Coordinators

Referral Types Managed:

• Surgery consultations (9-step process)
• Imaging referrals
• External specialist appointments
• Follow-up coordination

Key Stakeholders:

• Case Managers (approval authority)
• External surgeon offices
• Dr. Patel (intervention cases)
• Billing department

Billing Team

Primary Contacts:

• PI-PATEL@CORONISHEALTH.COM
• medicalrecords@californiasportsandspine.com
• 951-679-4311 (follow-up calls)

Special Requests:

• Medical records (case closure situations)
• Work notes (provider authorization required)
• EDD forms (disability insurance)
• LOA documentation (leave of absence)

Scheduling Team

Key Responsibilities:

• Provider schedule management
• Law firm requirement compliance
• Patient cap monitoring
• Double/triple booking coordination

Critical Checks:

• Google Calendar for current schedules
• Law firm restrictions by provider
• Patient type and insurance requirements
• Location-specific constraints

TIER 4: SUPPORT & REFERENCE LAYER

FAQ, troubleshooting, and reference materials

Knowledge Base (KB) Quick Reference

KB100001: Data Entry

Procedures for entering patient data into Practice Fusion and other systems

KB100002: Scheduling

Protocols for appointment scheduling across all locations and providers

KB100003: 4 Weeks Follow-up

Process for conducting 4-week follow-up calls and scheduling

KB300001: Translators

Procedures for translation services and bilingual patient support

Pending & No Shows

Management protocols for pending appointments and no-show patients

Intake & Answer Calls

New patient processing and phone handling procedures

FAQ & Troubleshooting Database

Scheduling Questions

Q: Patient says they had MRI but we don't have reports

A: Follow prep chart guidelines: Call patient to confirm completion, get imaging center name and date of service. If 1-3 days before appointment, may need to reschedule. Document all attempts in PIN notes.

Q: How do I handle double/triple booking restrictions?

A: Check provider-specific rules. Some providers (Dr. Parikh, Dr. Kim) only allow double booking. Triple booking generally allowed until 11:45 AM and only if other providers are full.

Clinical Questions

Q: Missing encounter report after 48 hours

A: Send Practice Fusion message to provider and recommendations team member. Include appointment date and CM email confirmation.

Q: Patient requests prescription change

A: Send Practice Fusion message to provider cc assistant. Only prescriber can modify prescriptions. Monitor for response and document in PIN notes.

Referral Questions

Q: Case Manager won't approve specialty referral

A: Forward to appropriate stakeholder (Dr. Patel for surgery cases), update Excel status accordingly, document denial reason.

Q: Patient needs work note but no provider approval

A: Gather requestor info, reason for limitations, timeframe, contact information. Send Practice Fusion message to provider and assistant. Leave PIN note of interaction.

Law Firm Compliance

Q: Which providers can see Yerushalmi Law patients?

A: All providers EXCEPT Dr. Kim. Every 2-3 telemedicine visits should be followed by an in-person visit.

Q: What are the MD-only requirements?

A: Larry H Parker, Mendez & Sanchez, Law Office of Daniel Kim, and Elite Medical patients require MD providers only. Add "MD Only" to pin notes.

Emergency Contacts & Escalation Procedures

Immediate Supervisor Contacts

Medical Records issues: Supervisor to medical records space
Billing non-response: Supervisor escalation required
Complex referral cases: Specialty team supervisor
Translation needs: Jane Leviste-Ouch (Propio services)

System Access Issues

Practice Fusion: Personal credentials
Email systems: Supervisor for access requests
New payer setup: Diana Perez (Referral Coordinator)
Monday.com: Mexico email then Google sign-in

After Hours Procedures

Front office: Leaves at 4:30 PM
Telemedicine callbacks: Within hour or end of day
Weekend referrals: Process Monday morning
Urgent cases: Use designated supervisor contacts

Escalation Path Summary

Staff Member

Team Lead

Supervisor

For complex issues, skip levels if necessary. Document all escalations in appropriate systems.