Implementation of Inquiry Tracking System (ITS) Report delivers 25 percent downstream time savings

In the fall of 2019, the Customer Service-related Warm Transfer Process (WTP) was implemented. The WTP utilized the Inquiry Tracking System (ITS) to log provider inquiries. The Provider Enrollment Team was responsible for reviewing, resolving, and reporting the items assigned in ITS. This year the team developed a new report to track six key metrics.

Originally data was manually pulled from ITS, populated into a report and then analyzed. With the new report, results from ITS are placed into the master file and saved—all results then self-populate daily and provide a daily/MTD overview of the current ITS Inquiry Tickets assigned to Provider Enrollment.

The implementation of this report allowed management to obtain results quickly and more efficiently with a 25 percent downstream time savings. It also earned Process Improvement of the Quarter for Division M.

Team Members:
Clint Griffin, Teresa Newton, Ashley D. Rice, Lakoskski Williams

This duo is driven to help Home Health and Hospice providers learn best practices Medicare utilization

Charles Canaan and Dan George are Palmetto GBA’s power team for Home Health and Hospice Medicare education. Their continued leadership in this area is just one reason they have been named Team of the Quarter.

This team collaborated with other Home Health and Hospice Medicare Administrative Contractors (MACs) to present a two-part webcast series on the new Patient Driven Grouping Model (PDGM) for Home Health. Part one of the series had more than 2,200 attendees and part two had 1,700 attendees. This team also hosted and presented in a national hospice webcast “Demystifying Hospice and Physician Billing” with more than 900 participating.

Charles and Dan were also an integral part of the Medicare Summit. More than 2,800 providers attended the 2020 Virtual A/B MAC Home Health and Hospice Medicare Summit: Understanding Medicare as a Whole. This virtual experience delivered 28 live Medicare A/B, Home Health and Hospice courses, hosted within four theaters. Subject matter experts from MAC’s, government agencies and the private sector educated on topics such as Medicare Secondary Payer, Planning for a Pandemic, Cost Reporting, Medicare Fraud and Abuse, Medicare Appeals, and more.

The education results were demonstrated in more effective service utilization and billing practices by providers.

Coach of the Quarter provides guidance and inspiration to his team

Need a subject matter expert for Home Health and Hospice? Dan George a Senior Provider Relations Representative is a go-to resource. He leads a 16 state Hospice coalition that resolves complex issues and works with the National Association for Home Care and the National Hospice and Palliative Care Organization.

Dan created the Low Utilization Payment Authorization (LUPA) education for the Home Health billing changes related to the Home Health Patient Driven Grouping Model (PDGM). He also presented during the PDGM Collaborations webcast series. After the education initiative the utilization of LUPA Home Health claims increased almost 9 percent. This year, Dan also undertook the important task of educating our Home Health and Hospice providers on changes for COVID-19. 

As busy as he is Dan can always be counted on to provide guidance and training to newer, less experienced teammates.

Tamie Long recognized as September 2020 Associate of the Month for her commitment to customer service

An Outreach Training Coordinator, Tamie Long’s experience and talent is appreciated by the entire Provider Contact Center (PCC). She guides the Customer Service Associates in their telephone experience helping them attain and retain information. Tamie consistently provides suggestions, alerts, knowledge checks, training and other learning activities to support customer service.

Tamie has shown time and again that she is committed to securing the best from her teammates and has shown that she is resourceful in helping achieve company goals. She is always pleasant and sincere with her help. What Tamie does is more than a job, it is a gift she willingly shares.