Happenings
Division 4M Celebrates Award Winners for Q4
November Associate of the Month
Dorinda Porter, a medical reviewer II for Home Health Review Choice Demonstration, is the November Associate of the Month for her admirable performance as a preceptor for new hires. Praised for her knowledge and her kind and approachable demeanor, Dorinda is described as the type of person you would want as a teacher. She answers questions quickly and thoroughly. Dorinda is happy to share her knowledge with others and frequently offers resources that support her answers and are useful for future reference. It’s clear she wants her preceptees to become strong reviewers. Dorinda also encourages teamwork by example. When she picked up a coworker’s preceptees to help, the days she had additional students were just as smooth as the others.
December Associate of the Month
Brittney Dent, December Associate of the Month, is a senior operations analyst in Home Health Review Choice Demonstration. She is a valuable team member because of the knowledge she gained previously in the Provider Contact Center. Brittney is a great help to her coworkers when they have questions about claims or when other issues arise. When her department had to take on additional work, Brittney’s knowledge helped her complete the additional work and her daily workload on time. Patient, responsible and professional, Brittney provides great customer service and is a dependable coworker.
October Associate of the Month
The October Associate of the Month is Silvia Lloyde, a senior medical reviewer in the Repetitive Scheduled Non-Emergent Ambulance Transport Prior Authorization Department. Silvia is a detail-oriented and hardworking team member. Even when she is busy, she takes time to help coworkers. She also will work overtime to ensure metrics are met. Silvia is always willing to assist when needed, so her team knew they could rely on her during a recent challenge. She stepped in to monitor an area and spent several hours doing research to help the team successfully navigate a complicated situation.
Coach of the Quarter
Michelle Charping, a medical review supervisor in Home Health Review Choice Demonstration, is Division 4M’s fourth quarter Coach of the Quarter for 2023. Michelle tells her team that family matters the most and they should be able to be with them when it’s important. Michelle was nominated and won this award because she put those words into action. When her team member’s father was losing his battle with cancer, Michelle guided her through the family medical leave paperwork and approval process and even helped her find resources for her father’s care. Michelle also called her team member regularly to check in on her and her family. Michelle not only stood by her words, but she made a difficult situation as easy as possible.
Team of the Quarter
Debra Moseley’s Home Health Review Choice Demonstration Team
Team members: Donna Brand, Susan Comans, Bernadette Davis, Julie Downs, Amanda Farr, Jennifer Foster, Kyndra Heck, Alicia Hudson, Jane Keefe, Rachel Latta, Pollyana Ludden, Karlie Moore, Jonerika Peoples, Ciera Reynolds, Alyssa Sarte, Carolyn Schmidt, Lashanda Taylor, Kendra Turk, Nikki Williamson, Pharin Worple
Debra Moseley’s team in the Home Health Review Choice Demonstration Department is the Division M4 Team of the Quarter because they truly work as a team. They help and answer one another’s questions every day. But they don’t just give answers, they talk things out until they feel confident about the resolution. If someone needs work completed or monitored while they are out of the office, multiple people volunteer to help. This team teaches, supports and laughs together daily.
Process Improvement of the Quarter
Educational Checklist Tool for Medical Reviewers
Team members: Jennifer Black, Keri Ann Bush, Alicia Choice, Jennifer Dowell, Christina Grable, Tiffani Heyl, Kathi Lacy, Keri Martin, Krystal McDonough, Sheri Mertins, Victoria Parson, Rachel Payne, Margaret Rummell, Tabitha Staples, Laura Strutko, Emily Tidwell, Angela Vitali, Tiffany Yelenic
The Process Improvement of the Quarter was developed by the Home Health Review Choice Demonstration Quality Assurance and Training (QAT) team to reduce inconsistencies in the answers medical reviewers give on additional document requests. The QAT team created an educational checklist tool with clear instructions and educational information on topics prone to inconsistent coding. The tool uses color-coding to simplify its use. It was modeled after a similar tool for pre-claim reviews, so medical reviewers are familiar with the format.
Post implementation, medical reviewers have provided positive reviews on the tool and submitted fewer questions to the quality assurance mailbox. The tool was created in collaboration with Jurisdiction M home health staff, ensuring increased consistency with how checklists are completed among the contracts. The QAT team attributes the tool’s success and the subsequent reduction in errors to achieving an average quality control proficiency score of 100 percent during the first three months post implementation.
