Data Load
UPDATE: Chase File
HEDIS 2022 Chase File Updates.
For detailed descriptions of the field changes, please see the latest HEDIS RY2022 Inbound Data Format specification.
UPDATE: Attribute File
HEDIS 2022 Attribute File Updates.
NEW: Compliance File
For HEDIS 2022, we will be adding a new compliance file to be added during data load. The Compliance file should contain compliance data at the measure/numerator level (sample level) to display admin member compliance.
Service Org Settings
NEW: Custom VRCs for Risk and IVA Projects
In addition to being able to create custom Omission codes, Admins can now create custom VRCs. Custom VRCs do not determine whether a diagnosis is submittable or non-submittable. Users must select a Default VRC in combination with their custom VRC. Can be accessed from the DX Code Manager Tab.
Data Entry Rules:
User must select at least 1 Default VRC code in order to submit a chase (as it works today)
Custom VRC can be to be combined with VRC 00
Project Settings
NEW: Project Creation – New Fields
HEDIS PROJECT:
Two NEW, Required fields have been added to the Project Creation screen when a User is creating a HEDIS Project.
- MEASUREMENT YEAR
- REPORTING YEAR
Measurement Year and Reporting Year will default on HEDIS Settings of Project.
Project Start Year and Project End Year will default on Project\Provider Packet\Document Requests\Time Frame fields. These are editable fields. When you add a new row to the Document Requests, it will default to Project start Year and Project End Year again.
RISK/IVA PROJECT:
Two NEW, Required fields have been added to the Project Creation screen when a User is creating a RISK/IVA Project.
- REVIEW PERIOD FROM DATE
- REVIEW PERIOD TO DATE
REVIEW PERIOD FROM DATE & REVIEW PERIOD END DATE will default on RISK Settings of the Project
Project Start Year and Project End Year will default on Project\Provider Packet\Document Requests\Time Frame fields. These are editable fields. When you add a new row to the Document Requests, it will default to Project start Year and Project End Year again.
UPDATE: Provider Packet Preview
When downloading a preview of the provider packet, it will render all measures – not just the one you are selected on.
Co-Retrieval
Platform clients will not see any co-retrieval functionality. The following features will only be visible when using a co-retrieval SO.
NEW: Chase Retriever Attribute
For Co-Retrieval projects, all chases will be assigned a retriever. ‘Retriever’ is set to one of the following options
- Reveleer
- Client
You can see the Retriever for a chase in the chase info tab as well as in the chase query grid and AID chase grid. If you wish for this to be visible in these grids, these values must be selected as part of a custom view.
NEW: Change Retriever
Admin users can manually update the Retriever from the Address Chase table or chase query. In either grid, use the 3-dot action to update an individual chase or multi-select to update many.
NEW: Address Retriever
Chase Retriever attributes are rolled up into an address retriever attribute.
- If all open chases all an address have a retriever of ‘Reveleer’ then the address will have a retriever of Reveleer.
- If all open chases all an address have a retriever of ‘Client’ then the address will have a retriever of Client.
- If an address has a combination of chases with a retriever of ‘Client’ and ‘Reveleer’, then the Retriever for the address will be set to ‘Mixed’.
This is visible in the Address Information section as shown below:
NEW: User Attribute - Organization
Users in co-retrieval SOs will now have a required attribute that indicates whether they are a Reveleer or Client user. This attribute will be used to ensure users are assigned the proper chases and addresses for retrieval.
NEW: Retriever – Get Next Updates
GetNext considers the Retriever for chases and the Organization for users to ensure the right chases are assigned to the correct user.
NEW: Retriever – Manual Assignment Updates
Manual assignment will only let you assign chases that belong to the correct user based on chase Retriever and user Organization.
NEW: Co-Retrieval Pursuits and Child Chases
With new Co-Retrieval workflow, all child chases and pursuits created will inherit the Retriever of the parent chase.
NEW: Bulk Update or Bulk Create Users
Bulk update users and bulk create users will take into account the Organization attribute for co-retrieval users.
Addresses
NEW: Hide Open Pends
Above the chase table within an address, there is now an option to ‘Hide Open Pends’. Upon clicking this check box, all chases with open pends will be automatically filtered out of the chase grid.
NEW: Max Chase Assignment
When assigning chases for retrieval that are for EMR or Field Tech sites, you can optionally choose to set a max number of chases to be assigned to that user. This is helpful when working large volume sites. If no max number is selected, then all chases are assigned to that user.
NEW: Custom View Option
New column option available on Chase views: Assigned To. This is useful for EMR and FT sites that have multiple users assigned for retrieval.
Vendor Management
NEW: New Vendor Creation Fields
New optional fields have been added to Vendor Creation. These can be used to track details around arrangements made with vendors.
MSA in place
YES
NO
Request Method
BestFit
BestFit / PSR Identified
PSR Identified
Invoicing
Pre-billed
Reconciled
Other
NEW: Custom Views
You can now create custom table views on the Vendor Homepage. Additional column options are measure, first name, last name, gender, DOB, Provider name, Provider NPI, Date of service from, Date of service to, Address 1, Address 2, City, State, and Zip code. We recommend no more than 8 columns per view.
UPDATE: Vendor Profile Table Sorting
To help better prioritize, the following fields can be sorted from the Vendor Homepage:
AID
Status
Project
UPDATE: Invoice Pend 1008
PC1008 is created when an invoice is denied for a chase. This pend will automatically close upon creation, so users do not have to do it manually.
UPDATE: Auto Update Invoice Status
When a user completes data entry for an invoice and clicks Submit, the invoice status will automatically update:
- If Vendor is NET30 the status will be: To Be Paid
- If Vendor is COD with an amount below threshold the status will be: To Be Paid
- If invoice goes to Invoice Approval, the status will be: Needs Approval
- If invoice is Approved, the status will be: New
Document Intake
NEW: Display Address ID
If a document has been received from the Provider Gateway, the Address ID will display after the File Name.
Document Thumbnails
Now available for all projects!
NEW: Document thumbnails
Please be aware that the Document Thumbnails have replaced the Document Tab. Watch this short video to learn more: https://vimeo.com/657217062
- Quick and Expanded Views
- Sort through Multiple Documents
- View Document Details
- Add New Documents
- Request New Documents
- Manage Individual Pages
- New Pages Badge
Page Thumbnails
Document Management View
Sort
Manage Pages
Document Details
Add Document or Request Document
UPDATE: Chase Status Limitation
We’ve removed the chase status limitation for thumbnails.
Data Entry
UPDATE: NCQA update for Blood Pressure Control for both CBP and CDC measures
- Partial BP reading is allowed from medical record and admin data for the same DOS.
- When you are scoring partial BP readings:
- The DOS must be on the same date
- Take incomplete BP readings and combine them for scoring
Example:
Admin DOS 2/21/MY | Systolic 120 | Diastolic NULL |
MR DOS 2/21/MY | Systolic NULL | Diastolic 70 |
- The DOS would be 2/21/MY
- BP reading would be 120/70
- It should score COMPLIANT
- Additionally, you can take BP readings from multiple chases and combine if on the same DOS.
Example:
Chase #1 | DOS 2/21/MY | Systolic 120 | Diastolic 92 |
Chase #2 | DOS 2/21/MY | Systolic 150 | Diastolic 78 |
- The DOS would be 2/21/MY
- BP reading would be 120/78
- It should score COMPLIANT
*All the above is based on the abstractor entering information from treating provider (CBP only) or coming in from admin data (Claims and Supplemental).
UPDATE: Page margins
Updated page margins for application consistency.
UPDATE: Dropdown height
Updated dropdown height to match other fields on the screen.
Pends
UPDATE: PC 304
Pend must be resolved before the user can submit the chase.
You will not be able to submit a chase if the chase has the status with PEND PC304: Clinical Clarification Question as New or In Progress. The Submit button will remain disabled until you resolve the PEND and hovering over the Submit button will show the message Resolve the PEND.
Queries
NEW: Chase Query – New Column option
New column option available on Chase Query: TIN
Bulk Actions
UPDATE: Bulk Upload
Not only does bulk upload have a fresh new look, we’ve also simplified the process. As soon as you click Submit, all valid files will begin to upload immediately. We will only report on files that fail validation. Check Jobs for the upload status of your Documents.
UPDATE: Bulk Copy Chart
You can now include notes that will appear in the chase Comments and Timeline tabs
Document Upload
NEW: Submit zip files through SFTP
When submitting through SFTP, file is automatically unzipped and individual pdf documents are dropped in same folder as zip file.
Analytics
UPDATE: New Categories
We have updated the Dashboard and Report categories to provided better clarity and help guide you in the right direction
For Dashboards:
- Project Status
- Retrieval
- Clinical
- Pends
For Reports:
- Project Status
- Retrieval
- Clinical
- Pends
- NLP
- Data Extracts
UPDATE: HEDIS - Overview Dashboard
Executive and program managers can view current status of their HEDIS programs for high-level metrics and information. Drill-downs are available for further detail into specific AID or chase data.
https://reveleer.freshdesk.com/support/solutions/articles/48001199686-hedis-overview-dashboard
UPDATE: HEDIS - Retrieval Summary Dashboard
Executives and program managers can monitor retrieval efficacy for their programs and projects with this high-level status orientation. Drill downs are available to measure outcomes for specific AIDs and chases.
https://reveleer.freshdesk.com/support/solutions/articles/48001199685-retrieval-summary-dashboard
UPDATE: HEDIS - Clinical Summary Dashboard
Executives and clinical managers can quickly see a high-level view of their clinical program performance and drill into any chase or AID details for more detail insights.
https://reveleer.freshdesk.com/support/solutions/articles/48001199687-clinical-summary-dashboard
UPDATE: HEDIS - Pends Summary Dashboard
Executives, Retrieval Managers, and Clinical Manager can view high-level pend information in their programs for and drill into different pend codes for determining areas of focus for pend resolution.
https://reveleer.freshdesk.com/support/solutions/articles/48001199684-pends-summary-dashboard
UPDATE: IVA - Pends Summary Dashboard
Executives, Retrieval Managers, and Clinical Manager can view high-level pend information in their programs for and drill into different pend codes for determining areas of focus for pend resolution.
https://reveleer.freshdesk.com/support/solutions/articles/48001199684-pends-summary-dashboard
UPDATE: Risk - Pends Summary Dashboard
Executives, Retrieval Managers, and Clinical Manager can view high-level pend information in their programs for and drill into different pend codes for determining areas of focus for pend resolution.
https://reveleer.freshdesk.com/support/solutions/articles/48001199684-pends-summary-dashboard
UPDATE: Date Picker improvement
When a user selects a "To" Date that is before the "From" Date on the calendar date picker, it should provide an error code and prevent the user from proceeding with the filter options.
UPDATE: Include Vendor Call & Vendor Note in Retrieval Reports
Call Count Detail Report, PSR Productivity Report, Contacts Report, Top 50 AID's Report and Provider Validation Report have been updated to include Vendor Call and Vendor notes to allow retrieval managers and supervisors to easily track vendor information in outbound retrieval.
General Application
UPDATE: Add Tags
Updated the look and feel of the add tags button
NEW: In-App Tours
We are excited to share that we will be launching in-app tours. You can expect to start to see these throughout the Reveleer Platform. The tours are optional but include valuable information, tips, and links to our knowledgebase. We’ve put our first engagement on the homepage. We would love for you to tell us what you think!
