Telligen is excited to announce its third release of updates and enhancements to Qualitrac for 2021. Our clinical and technical experts work year-round to maintain and enhance the product. This continuous effort is one of the reasons why Qualitrac is the preferred population health management application nationwide among government agencies, employers and health plans. For a look at the previously announced updates in 2021, click here.

In support of recent interoperability standards and to continuously improve upon the provider and member health experience, Telligen now supports a number of new API services as part of our expanding Enterprise Data Management and Interoperability solution, including:

FHIR-based Prior Authorization Support (PAS) API
Qualitrac’s Utilization Management module can now receive real-time prior authorization requests from provider EHR systems via the PAS API. Implementation of this new service reduces provider and payer burden by eliminating the need for fax, phone and logging into individual portals when submitting authorization requests.

Call Center Integration APIs
With this latest release, we are introducing the first of many new API services to integrate with Call Center systems. Real-time provider and member information can be integrated with call center Interactive Voice Response (IVR) and automated messaging systems. Services now available include:

  • Authorization Status Checks – Integration between Qualitrac and IVR systems to allow providers to enter case information and receive automated responses regarding the status of authorization requests, reducing provider wait time on the phone and call backlog for payers.
  • Outbound Call Automation – Qualitrac API services provide Call Center systems authorization decisions and updates, supporting the ability for automated outbound notification calls to providers and members.

PASRR Level II Updates – Our PASRR Workflows continue to evolve with the needs of the industry.

  • Our PASRR Level II assessment review workflow now supports multiple levels of assessment review and signature collection from multiple parties.
  • New PASRR Level II Follow Up workflow – A unique feature of our PASRR solution is our Follow Up workflow. This configurable feature allows reviewers to document provider confirmation that the member is receiving the services recommended from the Level II assessment.

Continued Enhancements to Standard Reporting Package and Workflows

  • Avoided Procedure Reporting – This report provides data regarding procedures that were avoided as a result of the utilization management review and the associated cost savings. Results are displayed at both the overall case and the individual review line level giving you a true picture of the impact of utilization management.
  • Assessment Management Case Status Override – Workflow flexibility within our product is important to us. New administrative override capabilities for the assessment management module allow administrative users the ability to move an assessment case to any status within the workflow at any given point.

Care Management Time Tracking
This new client configurable feature allows care management clients to track system activities and time spent on CM cases, at both the solution level and the program level, which provides more granular reporting capabilities.