Telligen is excited to announce its latest update on enhancements made to our latest Qualitrac release (2024.03). Our clinical and technical experts work year-round to enhance and advance the product, which is how we’re able to help our clients achieve their goals for quality and outcomes improvement, and cost savings.
Utilization Management Enhancements
Electronic Visit Verification Transmissions – Development of a new transmission process with electronic visit verification vendors to provide prior authorization information for visit verification.
PASRR Level 1 Upload Document Requirement – An enhancement has been made in Qualitrac for Provider Portal users with a new requirement to upload documentation. Documentation for PASRR Level 1 reviews are now flagged as required when a member has an Exempted Hospital Discharge (EHD). This enhancement allows users to reference this information during audits.
New UM Case Page – Utilization Management (UM) cases managed by a workflow have access to a new UM Case page in Qualitrac. This new screen will show the workflow Case Status History, upcoming SLAs, and details about the Episode of Care including the Treating Facility, Admission Date, Final Diagnosis and Discharge information.
Member Admit to Alternate Facility – New functionality has been implemented in Qualitrac that allows providers to assign a UM case to a different treating facility when the member does not get admitted to the facility on the initial UM authorization request.
Continued Stay Review Status Report – A new report is now available in Qualitrac that details the number of Nursing Facilities CSR reviews completed along with details about each episode of care.
Authorization Number Editing Restriction – A new client preference has been implemented in the Qualitrac system that gives clients the option to restrict editing of authorization numbers within the system.
Modifier Defaults – An enhancement to the Qualitrac Utilization Management module to now default modifiers for Review Types where a Procedure Code is also defaulted. This provides ease of use when entering an Authorization Request and reduces the number of fields requestors have to manually complete.
Dx Code Defaults – New functionality added that provides clients with the ability to default diagnoses codes based upon the Review Type, Place of Service (POS), and Type of Service (TOS) entered for the authorization request.
Assessment Management Enhancements
Case Notes – New functionality was added in the Qualitrac Assessment Management module to display administrative workflow Transition Notes and Task Notes on the Assessment Case page. This enhancement allows users to easily view these notes while they are working on an assessment.
PASRR Level 2 Assessment – Updates to the current PASRR Level 2 assessment form. These updates fulfill compliance with federal regulation as well as introduce efficiencies for assessors completing the assessment as we have improved the ordering of the assessment questions and input fields.
PASRR Level 2 Volume Report – A new report is now available in Qualitrac that details the number of PASRR 2 reviews completed along with the questions / answers data from assessments.
Care Management Enhancements
Program Eligibility Indicator – A new client preference has been integrated into Qualitrac that, when enabled, will display an indicator to Care Coordinators to review the member’s eligibility. The badge “Review Eligibility” will display on the Care Management panel title if the member does not have an active plan or policy on file.
New Prenatal Substance Abuse Assessment – A new assessment has been added to the Assessment Management module in Qualitrac: “5Ps Prenatal Substance Abuse Screen Assessment,” which is currently available under the maternity management program.
Core System Enhancements
Large File Uploads – Enhanced file processing support to utilize AWS S3 buckets. This means the Qualitrac application now has the ability to accept up to five terabytes! This new feature allows users to provide large amounts of data to Qualitrac in a quick and easy manner that is safe and secure, is a cornerstone of our Qualitrac application.
Certified Mail Option – Enhancement to Qualitrac correspondence functionality to allow business units to utilize certified mailing as an option when sending letters.