Telligen is excited to announce its latest update on enhancements made to our latest Qualitrac release (2024.04). 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.
Utilization Management Enhancements
Clinical Guideline Bypass – New business rule configuration option available for review types where there are no clinical guidelines applicable. In this scenario users submitting a request will proceed through the request flow without being directed to the clinical guidelines documentation.
Transmission File Feedback Tool – New functionality for operational personnel to help manage transmission file feedback. This new tool helps to ensure the transmission of UM data is received in an accurate and timely manner which helps to ensure timely payment for services.
Large File Processing – Qualitrac has added an update to the ‘Large File’ upload to include a progress bar. The user will now see a spinning circle until the file has finished uploading. This enhancement will allow a user to receive an indication of the progress and completion of the file upload.
Correspondence Report – New correspondence report for operational personnel to track volume of letter communications and correspondence sent to members, providers and other key persons.
Partial Denial Outcomes – A new client preference has been added to Qualitrac that, when enabled, will allow a case that is partially denied to retain the number of units on the review while still allowing other components of the request to be adjusted. This is a change from the current workflow in Qualitrac where the system previously required units to be adjusted on a partially denied case.
Review Closure Task Editing – Review Coordinators (RC) and Operation Managers (OM) users completing a “UMP Closure Task” will now have the same ‘Edit’ functions available within the closure workflow as they have in the ‘Review’ task.
Personal Representative Information on UM Dashboard – The review outcomes by review type drill down on the UM dashboard now includes primary personal representative information when it has been indicated on UM requests.
Provider Portal Cases Queue – Two new columns have been added to the ‘Cases’ tab of the Task Queue. The new columns allow Provider Portal users and Authorized Officials to limit/filter visible cases by Service Start Date and/or Treating Facility/Provider NPI.
Enrollment Period for Hospice Reviews – Qualitrac now includes a new client preference that, when activated, permits providers to input the enrollment period for Hospice authorization requests. Reviewers will use this information to determine the appropriate number of days to approve based on the provided enrollment period.
Provider Portal Cases Queue – Two new columns have been added to the ‘Cases’ tab of the Task Queue. The new columns allow Provider Portal users and Authorized Officials to limit/filter visible cases by Service Start Date and/or Treating Facility/Provider NPI.
Enrollment Period for Hospice Reviews – Qualitrac now includes a new client preference that, when activated, permits providers to input the enrollment period for Hospice authorization requests. Reviewers will use this information to determine the appropriate number of days to approve based on the provided enrollment period.
Care/Case Management Enhancements
Person Centered Service Plan Export – New functionality in our Community Based and Provider Organization portal for case management services that allows providers to view, download, export and share a Person-Centered Service Plan if appropriate access to view the plan has been granted.
Service Referral Document Upload – New functionality in our Community Based and Provider Organization portal for LTSS Case Management services that allows providers working service referrals to upload and attach documentation to a referral.
Core System Enhancements
Multi Factor Authentication (MFA) – New log in and authentication option for Qualitrac users to apply multi factor authentication. Multi factor authentication is an important tool to protect the safety of Qualitrac users by reducing the threat of unauthorized access.
Terms of Use Page – Update to Qualitracs terms of use page. New Qualitrac users will continue to see a ‘Terms of Use’ acceptance modal on the Qualitrac Sign in screen, and will need to check “Accept” to proceed with logging in.