CRM WebApp Online Documentation Training For MFP Managed Care Organization Staff Updated April 2015



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Transcription:

CRM WebApp Online Documentation Training For MFP Managed Care Organization Staff Updated April 2015 p p

This presentation provides an overview of the MFP Pathways to Community Living i documentation ti processes for MFPMCOMCO staff. MFP Documentation is completed online in the MFP CRM (Customer Relationship Management) Web Application (aka CRM, web app ) WebApp URL: http://mfp.medicaid.illinois.gov 2

CRM Training materials are posted here: http://nursing mfp.webhost.uic.edu/crm_training.shtml t i /CRM t i i Includes links to training, PowerPoint/Manual, recorded webinars, video tutorials, and additional resources 3

System Requirements Web Browsers Network Requirements Licenses andcredentials Sign in and Sign Out Terms and Definitions

Minimum and recommended hardware requirements for the Microsoft Dynamics CRM web application. Component Minimum Recommended Processor 2.9 gigahertz (GHz) or faster x86- or x64-bit dual core processor with SSE2 instruction set 3.3 gigahertz (GHz) or faster 64-bit dual core processor with SSE2 instruction set and 3 MB or more L3 cache Memory 2-GB RAM 4-GB RAM or more Display Super VGA with a resolution of Super VGA with a resolution of 1024 1024 x 768 x 768 Source: http://msdn.microsoft.com/enus/library/hh699710.aspx 5

Browsers are compatible with CRM as long as they have the specified operating system: Internet Explorer version 10 and above (newer is better) Mozilla Firefox (latest publicly released version) running on Windows 8.1 or Windows 8, Windows 7, or Windows Vista Google Chrome (latest publicly released version) running on Windows 8.1 or Windows 8, Windows 7, Windows Vista, or Google Nexus 10 tablet Apple Safari (latest publicly released version) running on Mac OS X 10.8 (Mountain Lion), 10.9 (Mavericks), or Apple ipad 6

Microsoft Dynamics CRM is designed to work best over networks that have the following elements: Bandwidth greater than 50 KBps Lt Latency under 150 ms Notice that these values are recommendations and don t guaranteesatisfactoryperformance performance. SeeAll Requirements here: http://msdn.microsoft.com/enus/library/hh699710.aspx 7

Every user needs a license for Microsoft Office 365. Inform UIC of new staff that need licenses/access to CRM. Staff at HFS will assign licenses to users. Then, staff at UIC will create user profiles in CRM and notify users of their sign in credentials Agencies should notify UIC and/or HFS when users no longer need access to CRM Since licenses cost the state, inactive users will be removed from CRM after they have been verified as inactive 8

When you are given access to CRM for the first time, you will receive a temporary password When you log in with this temporary password you will receive a message that t your temporary password has expired. Now create your own password and write it down. UIC/HFS doesn t have access to it. If you cannot log into CRM you may need your password reset. Email HFS.MFP@illinois.gov to request to have your CRM password reset 9

Sign in at Microsoft Office 365 10

The system will automatically sign you out after extended periods of inactivity or during planned system down time. To sign yourself out, click the gray person icon in the top right corner and select Sign Out 11

Case: A case is created when a referral submitted through the Views: lists of participants organized by specific data such as: online referral form passes the data quality checks at HFS and is routed to an agency home page. Participant s should usually have Cases not Contacted Cases Considering MFP with No Informed Consent Pre Transition Cases only one case per agency. Terms and Definitions Transition Cases Disenrolled Cases Stages: Participants progress through stages Dashboard: Home screen that Contact contains one or more views. Can be customized by you Informed Consent Pre transition Transition Queue: Special lists not yet implemented Reports: Some forms can be printed as reports (G, J, K) 12

MFP Referral Process Process Overview 13

Submission of online referrals starts the MFP process. Anyone can enter referrals online. If there are no issues with the referral ldt data, it will be routed tddirectly to the agency based on routing rules. (See the Referral Routing Flow sheet to determine how referrals are distributed) If there are issues (e.g., discrepancies, no RIN), the referral will be processed by HFS and manually distributed. Once a referral is passed to an agency, it becomes a Case on the agency s WebApp dashboard. Participant referrals should receive follow up from an MFP provider agency within 10 business days. Cases can be sent back to HFS if they need follow up from a different state agency. Referrals are entered here: https://mfp.hfs.illinois.gov/mfpreferral.aspx 14

An MFP provider agency receives a new case in CRM The agency contacts the participant and completes a case contact. Initial contacts cannot be entered in CRM without ih a referral. If initial case contact was completed by an ADRC or Resident review agency then the case will be reassigned to a TC agency for enrollment. The participant enrolls or declines MFP If the participant enrolls, s/he proceeds to transition or disenroll. If the participant p declines, s/he can be contacted again later. 15

MCO users have access to all MFP participants who are enrolled in that MCO MCO staff participate in pre transition and post transition case reviews andincident reviews for MFPparticipantswho are enrolled in their MCO MCO staff can view all parts of the participant s case including case notes, attachments (Medicaid Claims), 24 hour Backup Plan MCO staff enter the dates incentive payments were disbursed to MFP provider agencies at 3 month and 12 month intervals, according to policy. 16

When you sign into CRM, you land on a Dashboard. Home icon returns you to your default Dashboard. Use Set As Default to change your default Dashboard Select other Dashboards to view. Click the view icon to see that chart or list in a new window. 18

Not Contacted (more than 10 days) [Chart displays referrals by date that are enrolled in the MCO and haven t been contacted by an MFP provider within 10 business days] All MFP Cases by Stage [A stacked chart displaying the number of that MCOs participants ii by stage] Close to 365 Complete [MCO Enrollees that are close to completing 365 days in MFP by case creation date] 3 Month Incentive Payment [MCO Enrollees that are transitioned for 3 months or greater (without disenrolling) and do not have the 3 month Incentive Payment date] 12 Month Incentive Payment [MCO Enrollees that are transitioned for 12 months or greater (without disenrolling) and do not have the 12 month Incentive Payment date] 19

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Hover your mouse over HFS MFP Click DASHBOARDS get to your dashboard. Click ACTIVITIES to see any Activities that may exist for you or your MCO. Click on MFP CASES to view various lists of cases that are enrolled with your MCO Click on REFERRALS to see referrals sent from HFS that are enrolled with your MCO. 21

Hover over HFS MFP, select MFP Cases Use the drop-down down menu to switch between views System views are defined d here: http://mfpweb.nursing.uic.edu/crm/c RM-ILHFS- MFPCaseViewsGlossary.pdf Saved/shared Advanced Find views are under My Views 22

MCO Users have access to all cases that are enrolled in their MCO MCO Enrollment is updated automatically in the WebApp Find participants by: Conducting a Search Looking at various lists under MFP Cases Using Advanced dfind searches 24

Use any quick search box on your dashboard To search for Florence Jones, You can enter: Florence Jones *Florence J (the * is called a wildcard and you must use it when you want to search for the First & Last Name combined) *Florence Jones Medicaid RIN number You can also find a participant by entering the case ID number, eg e.g., MFP-001001 26

Click on the magnifying i glass to do a global search. Then enter your search term and select a category (optional), e.g., cases, referrals, users, etc 27

H t Gtt th C P How to Get to the Case Page Parts of the Case Page

Click on a Case Number in any dashboard or view. When you click on the case number you will be taken to the participant s case page Use your browser s s back button to go back to the previous page or the home icon to get back to your dashboard 29

Case Name/Number Progress Bar, Stage Checklist, Stage Indicator & Next/Previous Stage Buttons General Information and Important Dates Referral Summary Footer (Enrollment Status) Participant Summary. Contact UIC or HFS with edits to this data. 30

Case Number: Begins with MFP- and is followed by a random six-digit number, e.g., MFP-123456. Can be used in emails to refer to participants without revealing any PHI. Participant s First and Last Name Participant s Medicaid RIN 31

Progress/Stage Bar Displays the various stages of MFP Stage Indicator (blue flag) Indicates the stage the participant is current or last stage they were in. Stage Checklist It s different for each stage. It displays the required activities in the highlighted stage. It s completed manually and/or by completing documents. Next Stage/Previous Stage Buttons These move the blue flag stage indicator forward and backward on the progress bar. 32

Program, Agency and Transition Coordinator (owner, lead TC) Important Dates Complete Case Contact, Informed Consent and Transition to fill in the dates. Class/Consent Decree Membership. 33

Name, RIN, SSN, DOB and MCO Enrollment Facility Summary Community Residence 34

You will find these stage headings when you scroll down the case page. As participant s advance through stages, more sections/headings become available for TC documentation. Expand any heading by clicking it to view documents in that stage. 35

The Enrollment Status is in the footer of the participant case page. Status changes as documentation is completed and participants i t progress through h stages. MFP Stage/Status t Enrollment Statust Contact Informed Consent, Pre-Transition, Transition Dis-Enroll Form Completed Undefined Enrolled (after Informed Consent documentation is complete) Disenrolled 36

The Referral Summary on the Participant s case page includes: Referral number (Linksk to original i submitted referral) Referral type (e.g., MDS Q, Ombudsman, MCO, Family, etc.) Name of Referred Individual, History of ANE (substantiated claim of abuse, neglect or exploitation for individuals age 18+) Note: Some older cases don t have a referral summary 38

Each of the blue headings can be expanded to view the information. Contact HFS.MFP@illinois.gov with referral questions. TIP: Use your browser s back button to return to the participant s case page. 39

MFP providers who receive referrals are requested to complete a case contact within 10 days of receiving the new participant p case from HFS. Completed for all individuals who have been screened or received a brief face to face assessment. Participants must be contacted face to face in order to engage/enroll in MFP Completed when participant s are no longer in the facility to close the loop on the referral. 41

Date of the Case Contact : The date TC met with the participant (or date of attempted contact/change in status). Participants that are still living i in the facility of referral are required dto have a face to face contact. Outcome of the Contact: multiple choice must choose the best option Comments: a brief description of the contact outcome, particularly for those not proceeding to enroll in MFP. 42

The outcomes available on the case contact form are: Other Individual is considering MFP transition and is a possible MFP transitional candidate Family/caregivers refused participation Guardian refused participation i Preference is to continue living in the nursing home Service needs due to physical health are greater than what could be provided in the community Service needs due to mental health are greater than what could be provided in the community Would not be able to locate appropriate housing If a potential participant Individual is not interested in participating (refused) is Considering MFP Individual is not eligible that means they are Individual is deceased engaged in MFP and Would be better served by a different state agency expected to Enroll. 43

If the most recent case contact outcome is Considering MFP then this field says Yes and the participant is engaged in MFP. Completed Case contacts are listed here. Click the Name link to view a contact. Use your browser s back button to return to the case page from a case contact. 44

A participant is enrolled in MFP if, and only if, the participant (and/or guardian) has agreed to participate in MFP by signing the Informed Consent document. The date of the participant s signature on the Informed Consent is the date of enrollment. TC uploads the signed document to the WebApp under Attachments. When the TC completes the Informed Consent documentation in the WebApp, the Enrollment Status of the participant becomes Enrolled 46

1. TC Completes Informed Consent Outcome and Date 2. TC uploads signed form to Attachments 3. TC Completes checklist and Advances Case to Pre-Transition Stage 47

This Stage includes: Face Sheet Medication and Supplies list Risk Inventory and Mitigation Plan 24Hour Backup Plan QOL Baseline Survey LOC (Level of Care) Assessment Medicaid Claims Case Review This checklist provides a visual reminder of the components in a stage. PDF Versions of MFP Forms are available here: http://nursingmfp.webhost.uic.edu/process.shtml 49

To view a form, Click on the links in the Name column 50

Includes social, criminal, eviction history, history of unpaid bills, active diagnoses, sensory needs/impairments, participant goals and willingness/ability to work on self management Required to be completed before transition TCs add information as needed both pre and posttransition Click on Face Sheet links to view info 51

Required to be completed before transition and provided to participant Includes Allergies/Adverse Reactions, Preferred Pharmacies, Preferred Lab, Prescription and Non Prescription medications, supplies and supplements Must have 2 weeks of prescriptions ready for day of transition UIC clinical staff, pharmacists, institutional care setting facility staff can assist with med list when needed Click on Medication and Supplies List linkstoview i info 52

In the Medication List click, select > Run Report > Medication List to see a printable version 53

TCs should review the list during monthly home visits. Update it in CRM then print a new list and mail it to the participant. 54

Completely updated questions and format 80 questions 10 domains Required to be completed prior to transition and must be operational on first day of transition Identifies risks and plans to address risks Should include everything the TC will be doing to structure and maintain a safe transition 55

New format no additional data entry required Required to be completed before transition after Risk Inventory has been completed. Has a printable report in CRM. TCs Discuss Mitigation Plan with participant and their support. Document agreement and participant i t signature. Upload to CRM Evaluate effectiveness of plan during follow up visits. Send or give Participant an updated copy as needed 56

To View the Mitigation Plan Report. Click to access the most recent completed Risk Inventory. Click Then Select Run Report Then Select Mitigation Plan. 57

Risks and Description ofwhy it s a risk Pre Transition Plan Post Transition Plan 58

Required to be completed prior to transition and must be operational on first day of transition. Backup providers should be identified for all critical services. Participant should be educated on how to use the back up plan in different scenarios. Now includes the Personal Resource List (L) Has a printable report in CRM Participant/Caregivers get a copy 59

Select the most recent completed Backup Plan. Click Select Run Report Select ect Backup Plan. 60

Once the TC has completed the Level of Care (LOC) Assessment, the latest assessment scores are visible on the case above CONTACT. TCs Update the LOC assessment at Transition and once the participant is in the community as required by their agency policy. LOC Assessments by Division/Department e t DMH LOCUS IDoA DON DRS DON DDD - ICAP 61

Staff who have access to a participants case can use the notes feature to provide information and updates about MFP participants before and after transition. Click the + to add a case note. 62

Select Contact Date Select Contact Type: face to face visit, phone call, email, fax, other Select Location: Participant home, TC office, Hospital/Facility, Provider (medical, mental health, etc.) Office, Community, Other 63

Select Persons Contacted (Select All): Participant i t SOAP Note format (optional lfor Family/Guardian/Significant Other/Power of Attorney for Health Care TCs to use) includes: Subjective findings: Objective findings: Physician(s) Hospital Staff (nurses, social worker, discharge planner) Facility Staff Community Providers/Workers/Case Managers Other Community Based Other: Assessment findings: Plan: Other Notes: 64

On the Participant s Case Page Click Then Select ect Run Report Then Select Case Notes. Export to Word to Print 65

Medicaid Claims, Informed Consent, Resident Review assessment and other agencyassessments, plans not in CRM may be uploaded to Attachments. Click on an attachment to view/save it. To Add an attachment Scroll down case page to Attachments Type file name in the space provided under Title. (example title: InformedConsent_9.8.2014) Click Attach then click Choose file Browse to the file on your computer. Click Open, Then click Done. 66

Claims are reviewed by UIC staff and used to develop a Case Review document Medicaid Claims include 2+ years of: Institutional Visits by Day Diagnosis Groupings Prescription Groupings Procedure Groupings Facility Services Received Provider Frequency Institutional Admissions Institutional Discharges 67

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IMPORTANT: TCs notify collaborating group (UIC, MCO, other) of upcoming transitions so that a case review conference can be scheduled. Allow 2 3 weeks prior to transition. UIC schedules case review and sends agenda to collaborating group Contact, Informed Consent, Face Sheet, Medications and Supplies, Risk Inventory, Mitigation Plan and 24 Hour Backup Plan must all be completed prior to case review. 71

Federal requirement. Must be completed prior to transition and faxed to UIC or emailed in a password protected document to ticrowle@uic.edu.. edu. Complete one week to 30 days prior to transition, no earlier If participant p refuses, contact Farris Watson at Farris.Watson@illinois.gov for more information. Second QoL Survey: conducted by UIC College of Nursing at First Follow Up (about 11 12 months post transition) ( Or by DDD) Follow Up (about 11 12 months post transition) ( Or by DDD) Third QoL Survey: conducted by UIC College of Nursing at Second Follow Up (about 2 yrs. Post transition) (Or by DDD) 72

To be completed on the day of transition or within 2 business days post transition Starts a 365 day clock of eligibility Records housing information, living with family, housing supplements, new community address & county and planned waiver, state plan and demonstration services. 74

The date of transition is on the case page and in the checklist. Click the Transition Form to view the rest of the details. 75

TCs notify UIC of critical incidents as soon as they learn of them (e.g., hospital/ed/psych/facility h/f ilit admissions, i serious injuries requiring medical attention, other critical events, etc). Incident Review teleconference between UIC, MCO and agency staff is scheduled hdldwithin seven days of notification of incident. UIC schedules and sends agenda to group TCs Submit online Form M as soon as possible Discusses incident details with their supervisor. Complete internal review on Form M. UIC completes external review on Form M after incident review teleconference. A 30 Day follow up teleconference occurs 30 days after the incident review teleconference. UIC schedules this and notifies group 77

Under the Transition heading on the case page, click on an Incident Report number to view the submitted form. Incidents without the Internal Review date and/or External Review date will populate the Critical Incidents Needing Attention list on the TC dashboard. 78

Review and edit (as needed) forms after each follow up contact twith transitioned clients and after critical incidents to ensure that forms remain current and accurate. Use the Structured Notes to record the follow up contacts with their clients. If there are changes to the mitigation plan or forms (new risks, new/changed medications, new/changed medical providers or support, etc.), then transition coordinators should updatetheappropriatethe appropriate forms. 79

MCOs provide incentive payments to MFP providers for participant s that transition and remain in the community Incentive payments of $1000 are disbursed d at: 3 months post transition 12 months post transitiontransition MCO staff use the dashboard views and their own records to monitor for participants that have remained in the community for 3 and 12 months. MCO Staff enter the 3 and 12 month incentive payment dt dates on the participant i t case page under Important Dates 80

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Completed when participant is no longer able or no longer wishes ih to participate ii in MFP but only if informed consent has been signed Participants disenroll before or after transition Participants who transition must disenroll if they have become re institutionalized for > 30 days Participants can re enroll (contact UIC/HFS) Participants can re transition (contact UIC/HFS for case review and assistance) Ask UIC if you have questions about disenrollment 82

Reasons for Disenrollment if participant NEVER transitioned Could not locate appropriate housing arrangement Could not secure affordable housing Death Deterioration of cognitive functioning exceeds community resources and supports Guardian refused participation changed his/her mind Did not choose MFP qualified residence would not cooperate in the care plan development Mental health needs exceeded capacity of program to meet them Physical health needs exceeded capacity of program to meet them Other reason: 83

Reasons for Disenrollment if participant transitioned Re institutionalized i i dfor 30+ days. Moved Death, Please indicate date of death: / / No longer needed services Other reason: Also indicate reason for re institutionalization (if applicable) Acute care hospitalization ti followed by long term rehabilitation ti Deterioration in cognitive functioning Deterioration in physical health Deterioration in mental health Loss of housing Loss of personal caregiver and no other caregiver could be identified By request of parent or guardian Lack of sufficient community resources and supports 84

You can create activities for yourself, such as appointments. These will appear in the Activities view. You must mark activities as Complete to remove them from your activities iti list When participant s with existing cases in the WebApp have another referral form submitted for them, the WebApp creates a Re Referral Activity for the TC to whom the existing case is assigned. The TC re contacts the participant and enters another case contact to close the loop on the referral. 86

In CRM you can filter any view in MFP Cases. This means you can ratchet down your lists to see only the records you want to see. Hover over HFS MFP and select MFP Cases Click the funnel icon on the right hand side near the column headings. This will place a drop down next to each column Then use the drop down menu on any column to filter the list by that column Click the funnel again to remove the filter 87

Using the drop-down down arrow, you can apply a filter to look for cases with specific characteristics, such as Stage Name, TC (Owner), etc. 88

Click on the Advanced Find icon on the top menu bar. Select MFP Cases Add parameters Save your view if desired 89

To print a form, first click on the Name of the form you want to print 90

Click on the gear icon in the top right corner. Select Print Preview 91

Email UIC for Support with the WebApp: Mindy Bristle: mbristle@uic.edu Val Waldschmidt: vwalds@illinois.edu Password Reset: HFS.MFP@illinois.gov All MFP Contact Information: http://mfpweb.nursing.uic.edu/contact.pdf MCO Collaboration Information (UIC Website): http://nursing mfp.webhost.uic.edu/mco.shtml MCO Collaboration (HFS Website): https://www2.illinois.gov/hfs/publicinvolvement/cc/pages /default.aspx 92