PHW Review

Amcord Care

  • NCQA Accredited External Service Coordination Entity
  • PHW & Keystone First
  • Southeast & Southwest
  • Nearly 3000 participants
    • Nearly 1000 PHW
  • Internal System and Processes
  • QA Department
  • Nurse on staff for reviews
  • Utilization Management

MCA

  • 35 character limit
  • Box is narrow

  • Due to the fact that note does not fit in MCA, the note must be entered into “Notes”
  • Due to high volume of notes the note is not read or is lost
  • Incoming/Outgoing Calls
    • For Miscellaneous calls: there are no fields to support the conversation
      • Example: A call concerning HHA not showing up: this has nothing with clients health or a change in demographics.
        • It needs new fields
  • MCA does not show up after 24 hours
    • Even though the portal indicates “Submitted Successfully”
    • Even though the note is documented in Notes section it appears that the client was not contacted due to a failed MCA.
      • It appears that the mandated Monthly Contact for the client did not occur.

PCSP/Complex PCSP

  • After submitting PCSP, the PCSP does not show up in Assessments within 24 hrs
  • Envolve indicated: “Submitted Successfully”
  • Uploaded assessments also many times do not show up in Assessments
  • No save button
  • Page reloads
  • Page Times Out
  • No E-Signature
  • Complex PCSP does not submit after multiple attempts
    • 0% success rate
Our favorite response from Envolve

Signature

  • Have to use Adobe or external source to get and upload a signature.
  • If there is an error, QA cannot fix it and PCSP must be redone and another signature must be obtained.
  • Signature is only seen on the documents uploaded not in the PCSP in Assessments.
  • Timed out PCSPs/402 Error
    • The quality of the PCSP is decreased after multiple attempts to complete PCSP with the same information.
    • SC must extend visit length due to multiple attempts.
    • Client gets frustrated and the SC looks untrained and uneducated in the PHW system.

Integrated InteRAI

  • Integrated InterRAI must be done on a Windows PC
  • Due to it being a PDF Form, it cannot be done on the visit
  • SC is completing double the work
    • Maybe separate the Needs Tool from InterRAI or added that portion to the regular InterRAI?
  • PAHW is unable to see the Document after it is uploaded
  • When it is saved as PDF, only some fields save.

Envolve System

  • Times out after 5 minutes of inactivity.
  • Cookies must be cleared from web browsers before each login attempt.
  • Cannot open multiple at once because the systems kicks the SC out and goes back to the first page opened.
  • Manually assign/reassign each individual participant
    • No batch assign
Keystone

SRT

  • After the SRT is completed in the Envolve Portal, PHW is not notified of the Task and SC must also call in to complete a repetitive SRT in order to create the task.
  • Tasks are not completed within 48-72 hrs even if escalated as advised by PHW representative
  • Clients/PAS providers call repeatedly and SC is unable to help due the the length it takes PHW to complete the task
    • Ex: PAS provider switch takes longer than 2 weeks with multiple call in attempts

Authorizations

  • Authorizations represent total amount of units instead of weekly/ monthly
    • PAS provider call to have us explain how many hours the client actually has been approved for
PHW PAS Auth
Keystone PAS Auth