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Clarification of EWC DETEC ‘Lost to Follow-up’ and ‘Refused Care’ Statuses

December 6, 2018

The DETEC (DETecting Early Cancer) “lost to follow-up” and “refused care” statuses for the Every Woman Counts (EWC) program are clarified as follows.

DETEC “Lost to Follow-up” Status
Recipients are considered to have a “lost to follow-up” status if they require immediate diagnostic work but cannot be reached because 1) they do not reside at the stated address and 2) their phone is disconnected or they can no longer be reached via the stated phone number.

Providers should document three or more attempts to contact the recipient in the recipient’s medical record, including documenting that a sent, certified letter was undeliverable and returned. Documentation that a certified letter was sent is not sufficient. Recipients are not considered “lost to follow-up” if they can be located.

DETEC “Refused Care” Status
Recipients are considered to have a “refused care” status if they require immediate diagnostic work but the recipient does one of the following:

  • Refuses the procedure
  • Changes their PCP for any reason
  • Fails to respond to the certified letter or telephone messages
  • Fails to schedule or keep appointments

Providers should document three or more attempts to contact the recipient in the recipient’s medical record, including documenting a reason for refused care and that a certified letter was sent.

Updated manual pages reflecting this change will be released in a future Medi-Cal-Update.