Project Setting
NEW: Document Review
For Risk and IVA projects, the ‘Document Review Level’ can now be configured to either ‘Member Validation’ or ‘Member and DOS Validation’. This setting is a dropdown located on the ‘RISK Settings’ or ‘IVA Settings’ page.
Project configured for member validation:
Project configured for member and dates of service validation:
UPDATE: GetNext for Member Centric Projects
For Member Centric projects, GetNext will assign at the member level. For example, if there are 5 chases that belong to the same member, then those 5 chases will count as 1 chase assignment instead of 5 distinct chase assignments. This will ensure that all member chases get assigned to the same user.
Data Entry
UPDATE: Label Update
For HEDIS Chases, the label changed from 'Additional Member Details (Optional)' to 'Additional Chase Details (Optional)'. When a value is selected from the ‘Additional Chase Details (Optional)’ drop-down menu for the member centric project, this value will be displayed only for that chase where it was selected and not all the chases for that member.
UPDATE: HCC Health Card
Chase status has been added to the table.
UPDATE: Overread Feedback & Acknowledgements
Currently, the Overread Feedback Stats on My Work - Chases show the number of chases which are in Overread Feedback for the MRR. Now, this stat will also include the total number of chases that are in the Acknowledgement step for MRR as well as Overreader.
UPDATE: Overread Feedback ‘Challenges’
A Manager has ability to agree either with Coder or Overreader. Currently, this feedback is sent back to either Coder or Overreader with whom the manager does not agree. This update will send the Manager’s feedback to both the Coder and the Overreader.
Documents
UPDATE: Chase Tags
When searching within Document Intake and Document QA, users can now add Chase tags to their custom view.
UPDATE: Provider Gateway
When submitting medical records or other documents through provider gateway, each document will now be processed and analyzed by the chart routing automation separately. This will result in more efficient document processing and will give users visibility into file names used by providers.
Addresses
UPDATE: Address Email Field
We have increased the Address Email Field character limit from 50 to 100 characters.
UPDATE: Overlapping Appointments
When a user had overlapping appointments, we were presenting them with 2 warning messages. We have removed the additional message.
Pends
NEW: Pend Code: PC700
This pend was created to support the new Document QA Pre-Screen updates. This pend is automatically created, resolved and closed based upon the user’s actions. See Document Pre-Screen Manual for additional information.