Latest Qualitrac Updates and Enhancements

Telligen is excited to announce its final 2025 update on enhancements made to our latest Qualitrac release (2025.04). 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.

Assessment Management Enhancements

AM Scheduled Tasks Queue – Developed a new, high-performance task queue specifically for Assessment Management with comprehensive filtering and sorting capabilities. The queue displays critical case information including referral dates, appointment details, service end dates, and due dates, with improved accuracy and performance for large case volumes.

Provider Portal Case Visibility – Added new Assessment Management Cases tab for Provider Portal Users (PPU) and External Case Management (ECM) users to view their submitted referrals. This enhancement provides comprehensive filtering and sorting capabilities for efficient case management and improved visibility into referral status.

Duplicate Referral Prevention – Added intelligent warning system to prevent duplicate referrals in assessment management. The system displays alerts when attempting to create referrals for in-progress assessments or those completed within a given timeframe to help in reducing redundant case creation.

Letter Distribution Compliance Tracking – Enhanced SLA tracking to monitor letter delivery compliance for completed and canceled assessments. Includes detailed metrics for letter delivery methods, timing compliance, and distribution status to ensure contractual requirements are met.

Quality Assurance Process Improvements – Added requirement for QA reviewers to explicitly indicate when no errors are found before completing case status, ensuring thorough review documentation. Enhanced QA checklist workflow to properly preserve existing reviews while allowing updates for new cases.

PAR Integration Enhancements – Implemented External Authorization History panel to display Prior Authorization Request (PAR) data including service details, dates, and units approved.

Distance-Based Scheduling Optimization – Implemented enhanced distance calculation logic for appointment scheduling based on assessor’s previous appointment locations and home address. This improvement helps schedulers assign appointments to assessors who are closest to the appointment location, maximizing efficiency.

Provider Cancellation Capability – Enabled provider portal users to cancel assessments during intake, RFI, or scheduling phases. The system automatically applies “Agency Cancellation” as the reason and sends appropriate notification emails to affected parties.

SMS Appointment Reminders – Developed service for supporting automated SMS appointment reminders to members aimed at improving appointment attendance rates.

Client Representative Role – Created new Assessment Management ‘Client Representative’ role with permissions for viewing client reports, assessment cases, and access to member and AM case search functionality, providing appropriate oversight capabilities.

Utilization Management Enhancements

Expedited Review Request Framework – As part of CMS Final Rule compliance regarding public reporting of Prior Authorization data, implemented foundational infrastructure for expedited review tracking. Includes client preference toggles, allowing flexible rollout to clients. This framework supports future reporting metrics around standard versus expedited review timelines.

Provider Information Enhancement – Enhanced the UM request provider panel to include expanded provider information, incorporating provider type and specialty details directly within the main display interface for improved decision-making during the authorization process.

Provider Address Management – Added functionality to allow clients to choose whether provider letters should be sent to physical or mailing addresses, improving address management flexibility and ensuring correspondence reaches the intended recipient.

Transmission File Enhancements – Multiple improvements to transmission file processing including but not limited to updated header formats, subscriber SSN handling, specialized service exclusions, and Electronic Visit Verification (EVV) file transmission modifications.

Auto-Approval Business Rules Refinement – Continued expansion of auto-authorization capabilities to support scenarios where clinical criteria does not apply or is bypassed, offering greater flexibility in authorization workflows while maintaining appropriate controls.

Care Management Enhancements

Care Plan Auto-Completion – Updated care plan status handling to automatically complete care plans when all associated programs are disengaged. This change ensures proper care plan closure and addresses URAC audit requirements for care plan lifecycle management.

Core System Enhancements

Comprehensive Accessibility Enhancement Initiative – Completed extensive Section 508 Level A compliance improvements across all platform modules, enhancing the experience for users with disabilities.

Reports & Dashboard Enhancements

Assessment Management Dashboards – Enhanced Quality Assurance, Assessment Monitoring, and Scheduling dashboards with improved drill-down capabilities, filtering options, and new widgets. Key improvements include referral start/end date filters to compliance summary drilldowns, benefit type drilldowns, and search filter functionality across detail reports.

SLA Compliance Dashboard – Implemented SLA compliance data display on QA dashboard showing initial contact, follow-up contacts, completion timeliness and assessment metrics. Provides real-time monitoring capabilities for both standard and expedited assessments to support contract compliance.

Scheduler Workload Tracking – Updated Scheduler Dashboard to display confirmed appointments with improved accuracy and filtering capabilities. Added canceled counts to Current Case Statuses widget for better workload visibility.

Connect Portal & Mobile Enhancements

Multi-Factor Authentication (MFA) Deployment – Successfully deployed enterprise-grade Multi-Factor Authentication across Connect web and mobile platforms.

Assessment Results Viewing – Implemented assessment results viewing capability for members to access completed Skilled Nursing Assessments directly through the Connect portal and mobile app, providing transparency in the assessment process.

Biometric Data Reporting System – Developed comprehensive biometrics reporting capability with filtering options for client data and vital statistics.