Happenings

Division 93 recognizes associates for exemplary work in the second quarter of 2021

Coach of the Quarter – Shawniece Godbee

GodbeeShawniece Godbee is a Customer Service Coach that believes actions speak louder than words. During her four years with the company, Shawniece has worn many hats and believes that hard work and dedication accomplish goals. As a Customer Service Coach, she takes pride in her work and the achievements of the team. She consistently supports the team by providing immediate feedback, recognizing areas for improvement, and conducting weekly follow-ups so that her team better understands goals and timelines.

Shawniece recently became the lead for preparing beneficiary curriculum training. Her actions and influence helped the beneficiary Customer Service Advocates (CSA) pass all required assessments in their first attempt. Shawniece is an inspirational leader who continually makes recommendations to improve processes and productivity. We're excited to see what the team and her will accomplish next


Team of the Quarter – Document Control End-Stage Renal Disease Quality Incentive Program Team

The Augusta Document Control (DC) End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) team is responsible for maintaining all incoming receipts, fax lines, and mailings to designated dialysis facilities. The primary role of the DC Augusta team is to import all records received from the facilities into iFlow, and then index all related documents promptly. During this project, the DC Augusta team mailed approximately 400 letters, inputted over 2,400 medical records into iFlow, and indexed each entry for the nurses' review. Additionally, the team electronically sorted over 450 faxes. All work was completed timely and accurately while maintaining privacy of Protected Health Information (PHI) for outgoing correspondence.

Team Members:  Belinda Campbell, Myra Christian, Janet Costello, Stacy Gagne, Selena Haskins, Yvonne Marshall, John Sessions, Cathy Stroud, and Angela Thomas


Process Improvement of the Quarter – Documentation Received after Audit is Closed

When the Benefit Integrity (BI) unit opens a provider investigation, a letter requesting beneficiary medical records is sent. The provider has thirty days to return the requested records. If the records are not received, the BI associate sends a second request letter, which, in turn, gives the provider an additional fifteen days to send in the requested records. If the provider fails to respond to this second letter, a refund request is initiated for non-response. In some instances, the records come in after the audit is closed. When this happens, the provider must request an appeal.

The BI and appeals teams wanted to simplify the appeal request process. The teams created a letter that is sent to the provider when an appeal must be requested. The letter notifies the recipient that an appeal must be completed and that the records will remain on file, eliminating the need to resubmit. This letter also includes important information regarding the appeal process.

Communicating to the provider that the submitted records will remain on file saves the provider record preparation time and postage expense. This process improvement creates a more efficient process and improves the customer experience.

Team members - Angela Bryant, Van Dixon, Taryn Herrmann, Terra Hold, Tammy Keel, Ricky Newton, Janet Pleiman, Becki Stroud, Debra Watson


Associates of the Month

April – Asahia Cartledge

CartledgeAsahia Cartledge, a Senior Provider Education Consultant has been a part of the Augusta Provider Outreach and Education (POE) team for several years and has quickly established herself in this role. She is proactive in her approach to projects and is willing to take on any additional tasks assigned. Whether she is crafting articles to communicate current Comprehensive Error Rate Testing (CERT) and Medical Review (MR) issues to providers, answering phone calls, generating information for websites, or conducting data review, Asahia meets all timelines and quality measures. Her team says it best, "We appreciate her positive attitude, willingness, and ability to accomplish tasks in the face of challenges”.


May – John Sessions

SesssionsHardworking, responsible, positive, and dedicated are just a few words that you may hear about Document Preparation Clerk, John Sessions. John works in the Augusta Document Control department, where he has been for more than thirteen years. John is an expert in his role where he is responsible for  incoming letters for Jurisdiction M (JM) A/B MAC medical review, appeals, and Medical Secondary Payer (MSP). John also  assists with the Jurisdiction J (JJ) A/B MAC volume as well as the Review Choice Demonstration (RCD) and Outpatient Prior Approval (OPA) efforts. John's positive attitude is contagious and spreads through the team and other departments. "He is a crucial part of our department and pushes our team to perform at the highest quality for our customers” says Manager, Selena Haskins.


June – DeRobert Williamson

Robert Williamson, a Medical Reviewer III, has been with the Railroad Retirement Board (RRB) since December of 2018. He consistently works hard, demonstrating teamwork, an eagerness to learn and a positive outlook. Robert is also regularly seen assisting other areas. Members of his team say, "Robert is a quick and effective member of the team. He works with purpose and accuracy”.