GENERAL
Provider Specialty Header
Users will now be able to identify provider specialty when referencing chase header details.
RETRIEVAL
Expanded Standardized Call Notes/Reason
We added values to our dropdown of pre-written call notes that a user can select from when progressing through the call flow. These reasons include:
- New Successfully-Connected Call Notes:
- Verified providers & Set Commit
- Verified providers but setting commit was refused
- Left Voicemail
- Refused to validate information
- Left message for contact with a live person
- Refused to give commit date
- New Unable to Connect Call Notes:
- Voicemail box is full
- No option to leave message after long hold
- Immediately hung up on
- Line hung up while on hold (disconnect/timeout)
- Line went dead before pickup
- Office closed for lunch
- Office closed for the day
Standardizing Pend Reasons
In our effort to standardized Pend reasons, we now give users the option to pick pre-written pend reason values from a dropdown within the apply pend code interaction/modal. 
We added standardized Pend Reasons to the following pend codes:
PC100 - Provider Refusal
- Provider or facility refuses to participate in the current audit.
- Provider or facility refuses to work with the retrieval team due to abrasion.
- Provider or facility refuses because the plan has not paid their bill.
- Provider or facility refuses because the request is not HIPAA compliant.
- Provider or facility refuses because their contract expired and no longer mandated to comply with the audit.
- Provider or facility refuses because the request is improperly addressed.
PC107 - Exhausted Attempts
Have not made a live contact to date.
Contact does not respond.
Past due and made over five calls
Commit date has been missed more than once.
Successful contacts, no commit set, no traction on retrieval.
Failed Fax Reasons Captured in Contact History
We now display the reason why a fax might have failed during provider outreach within the Contact History of each AID.
Possible failed fax reasons include:
- General Error
- Fax line was busy
- Voice Answer
- Not a Fax Machine
- Transmission Failed
- Invalid Fax Number
- Blocked Number
- Sending fax failed
Last Contact Date Added to all Retrieval Grids
We now capture the last date an AID was contacted across all retrieval grids.
CLINICAL
Risk/IVA Data Entry Updates
- Changed label from "Encounter Type" to "ServiceType"
- Disable Service Type by default. If the project config is set to Require Service Type, then it's enabled only for non-admin encounters.
- Remove "Confirm" dropdown for Service Date From/Through & Provider.
- Service Date From/Through & Provider:
- For existing encounters (loaded via dataload) - disable the coder values for Service Date From/Through & Provider by default and only enable Provider if Project Config "Enable Provider Changes" is set to true.
- For new encounters (added be coder) - enable the coder values for Service Date From/Through & Provider.
Changes to the COA Data Entry Screen
- FUNCTIONAL STATUS ASSESSMENT IN MY
- Complete ADLs Date in MY
- ADL Components (Minimum of 5 for compliance) (can now be multiple DOS, can cross score between chases, must be five unique events for compliance)
- Bathing Date in MY
- Dressing Date in MY
- Eating Date in MY
- Transferring Date in MY
- Using Toilet Date in MY
- Walking Date in MY
- Complete IADLs Date in MY
- IADL Components (Minimum of 4 for compliance) (can be now multiple DOS, can cross score between chases, must be four unique events for compliance)
- Shopping for Groceries Date in MY
- Driving or Using Public Transportation Date in MY
- Using the Telephone Date in MY
- Cooking or Meal Preparation Date in MY
- Housework Date in MY
- Home Repair Date in MY
- Laundry Date in MY
- Taking Medications Date in MY
- Handling Finances Date in MY
- Standardized FSA Tool Date in MY
Exclusion Added to Statin Therapy for Patients With Cardiovascular Disease and Diabetes (SPC)
- Member received palliative care during MY
Updated the Development Screening measure acronym from DSC to DEV
Updated list of medication values for the Disease-Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis (ART) measure
- Updated:
- Mycophenolate mofetil
- Added:
- Mycophenolic acid
- Upadacitinib
REPORTING
IVA Reports
