Member File
A brand new product that allows users to perform research and analysis at the member level.
Member File - Member Query
New Page: Users can query at the member level. They will get a results table with a list of members. They will be able to take some actions from here as well as access a Member File.
Member File
The Member File shows you details about that Member as well as all Chases for that member – both active and archived. They will be able to take some actions from here as well as access archived chases.
Member File - Archived Chase View
This page is read-only. This is an archive view of final abstraction and medical record associated with an archived chase.
General Enhancements
Generating (V)alidated, (D)elete, and (A)dded attributes for VRC Codes
When a diagnosis code is audited and VRCs codes are applied, they are now being assessed with a new attribute that determines whether a code was (V)alidated, (D)eleted, or (A)dded. Our data extract will reflect the appropriate attributes based on the following logic:
- If any VRCs for a code are Non-Submittable, the logic will return (D)
- If all VRCs are submittable and they have a source type of "coder" then (A)
- Else, if all VRCs are submittable, then (V)
Admin > Project Configurations
Coding Level Dropdown removal
We removed the Coding Level Dropdown value within IVA Settings tab and now all IVA projects will be set to Diagnosis only by default.
BOT settings for IVA
The ability to enable or disable the NLP bot for IVA projects.
Admin > User Management
Admin Role
We removed extra steps when setting up an Admin user. Admins will no longer need to select a Primary Permission, as they will already have full access by default.
Reporting Manager
We removed some permissions for the Reporting Manager role - they no longer have access to the My Work pages.
Address Details
Address Call Flow Updates
As a Call Center Rep, you will now be prompted to validate providers if they were not previously validated, regardless of AID status.
Provider Call Notes Sequence Update
The Call workflow is now based on the status of the AID. If a site has not been contacted or all providers have not been validated, the user is prompted to begin with step 1 of the call flow (validate address). If all providers at the AID have been validated, or the chases associated with providers who have not been validated are pended, user will now be prompted to start on step 3 of the call flow (finish call and enter notes).
AID Stat UI Update
Small tweaks to the UI. Removing gap at top of page and adjusting border color.
Gap Tab Optimizations
In an effort to optimize page load time, Gap info will not load until a user actually clicks on the tab. We also shut off the automatic outreach prompts associated with Gap projects.
Multi-Select Tag Management - AID Chase Grid
Based on permissions, users now have the ability to add, remove, or replace tags across multiple chases in the Chase grid within the AID details page. Users can select 1 or more chases, then click ‘manage tags’ to be presented with a modal allowing them to add, remove, or replace tags.
3rd Party Addresses - Past Due
The date at which a chase will turn past due is now displayed in the chase grid within an AID. This can either be set directly with a “Due Date” selection or will default to 30 days after the request date.
3rd Party Chases – Extend/Customize Due Date
The date at which a chase will turn to a past due status can now be set directly using a calendar style drop down similar to the commitment date functionality.
Document Intake
Tags in Doc Intake
Retrieval users now have the ability to see the tags column and filter by tag values when working within the Doc Intake Grid.
Clinical
Risk NLP
Persist keywords for Diagnosis in database. This data will eventually be used for in-house NLP processing.
Improved results around HCC Rules
Invoicing
Net30 Chases Denied from Data Entry
We now prevent chases associated with denied Net30 vendors from advancing to data entry. Users will be able to create an invoice ‘shell’ upon denial and send the invoice to the approval center for closer review.
Download Invoices from invoice module
Users now have the ability to download invoices as PDF files directly from the Invoice-Chases grid. Once successfully downloaded, output files will be saved to a project specific folder within the new 'Invoice Downloads' page.
Reporting
IVA Overview Dashboard
To enhance our platform with new IVA related features, the Analytics team released the first version of the IVA Overview dashboard to provide comprehensive visibility into IVA project health. Referencing this dashboard will help our clients navigate to key IVA project information to understand the current project state in real-time and provide action oriented insights that drive projects to completion.
The first version of the IVA dashboard presents comprehensive information on substantiated HCCs, unsubstantiated HCCs, an overview of member diagnosis, claims and doctor encounters. The dashboard is expected to evolve with improved data metric and visualization as we gather collective feedback from our IVA clients.
IVA Productivity Dashboards
We’ve also added 2 new IVA productivity dashboards (Retrieval and Clinical) to provide insights for our IVA clients on project progress and HCC performance.