HealthCORE

RapidTrac

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RapidTrac is a SaaS platform that allows healthcare facilities to process and track follow up on the credentialing and payer enrollment of their healthcare providers.

Providers are required to “enroll” with each payer (insurance company) that they intend to submit claims to on behalf of their patients for paper work.

This process involves multiples steps including phone calls to research the process with the payer, and then form submission along with multiple documents from the provider such as license, proof of malpractice, EIN paperwork from the facility with which they are enrolling under.

Stages of RapidTrac development will be as follows:

  1. V1.0 
    1. User management
    2. Status Tracking
    3. Task Management
    4. Audit Log of communication and action steps taken
    5. V1.0 will be used only by Rapid Credentialing which will allow us to evolve and test to make sure it is ready to be sold to other entities
  2. V1.5
    1. Email updates from RapidTrac
      1. Updates are emailed to our clients every week as to the status of their applications
      2. In V1.0 we can screen shot their workflow update to keep them informed
      3. In V1.5 we will be able to review the workflow updates in the system and easily send right from the application
  3. V2.0
    1. Subscription-based SaaS platform
    2. Create a Super Admin level that can add accounts 
    3. Each account has all the functionally of V1.0 
  4. V3.0
    1. Information request feature
    2. Currently use Content Snare to send a link to providers for them to complete information and upload documents.  
    3. V1.0 we will have to manually enter that into RapidTrac or import from .csv file 
    4. V3.0 will create the intake process to gather that information directly from provider to RapidTrac to eliminate the need for another application
  5. V4.0
    1. Automated Form completion
    2. Some payers use online portals for applications and for those there is no way to autocomplete.  Many payers still use paper forms so for those we should be able to create form templates in the system using drag and drop merge fields that utilize the information entered into RapidTrac to autocomplete the forms for signing.

Security

Even though there will be no patient Protected Health Information requiring HIPAA security standards, there is private information on the healthcare provider that needs to be protected at the same level of security.

Branding and Colors

Complementary to the brand colors in the Rapid Credentialing logo (utilize that logo until a RapidTrac logo is created.

Login Access

  • Initially it will only be our team accessing the system so it can be a very basic login page with “Forgot Password”

Dashboard

1. User - only selection at this time will be to "Log Off"

2. Navigation (Dashboard will be default home page.  "Users" tab will only show up to those who have User Management permissions)

 

User Workflow

  • Each user will have a certain number of entities that they are working on Credentialing and enrollment for their providers
  • This workflow is basically a running list of each application that is in process by that User
  • By selecting a specific row (1) it takes you into the workflow for that application
  • The icon on the end  (2) is “add task” icon that will open the New Task window with the provider, payer, and entity already filled out.

Facility Manager

  • shows a list of Facilities in the system (accessible by that user unless checked in User Manager to access all entities)

Add New Entity

Clicking on the entity name will bring up Entity Info.  Adding new brings up that same screen just with no information populated.

Locations

  • The Primary location is always the same information as the Facility then they can click Add Location which would just create another blank line for Name, Address, and phone number

Providers

  • This just shows providers connected with this entity and the locations they are affiliated.  Should default to primary location (entity).

Add Provider

  • Clicking Add Provider takes you into the Provider Manager (Add Provider) screen show below
  • The primary facility field would already be populated on the right (see below)
  • Since there is no "Workflow" or "Payers" it would default to Payers on the bottom

Provider Manager

Provider Manager would get you to the same screen by clicking the name hyperlink

Selecting a Provider takes you to the screen shown below where their (and their associated entity) is listed at the top with it defaulting to Enrollment Workflow.  In the example this is a new provider, we just added their information (which is now under the Provider Info tab (1)).    Next we would connect this Provider to the Payers they are enrolling (or already enrolled with)

Add Payer

Brings up a list of all Payers in the system that is searchable.  And ability to Add New Payer not in the system.  

Double clicking on any payer in the list adds them to the payer list for that Provider (see Wellmark of IA below)

When complete, Done closes the selection window and back to Provider Payer screen

Now I can add the specifics for each payer for this provider with dropdowns in the the following with the associated options:

Type: Group / Individual

Enrollment: Group / Individual

NPI - should pull from the Facility NPI shown in the top right ... if a Facility has more than 1 NPI then there should be a dropdown in that top right screen to be able to choose which NPI this provider is attached to ... that would then autopopulate under NPI down below

In Network: Yes / No

Effective Date: click on pulls up a calendar to choose a date once the application has been approved

Locations:  (this can be removed as it shouldn't be with Payers)

Re-enrollment: Date selector

Status Dropdown:  Not Started, In Process, RFP Submitted,  Application Submitted, Follow-up Process,  Network Closed, Completed

Because the Payer has a Status as "In Process" it will now show in Workflow until status is changed to Completed"

Clicking on any Payer will open the details for that Payer with this Provider.  

 

The Payer Details on the bottom pull directly from the Payer Manager but still allows them to Edit it here if they find out something new that applies to all Providers using this Payer in the future.

Add Note

Clicking the Add Note icon

The "Include as Update" check box when selected adds that note to the "Notes" field in the workflow summary (1)

Allow both text and drag/drop images into the note details to save screenshots of emails etc

Order from most recent ... defaults to all collapsed but if double clicked expands open to show note detail

Payer List tab

This tab just shows all the payers associated with this provider INCLUDING those marked as "Completed" ... those marked with anything but Complete or Closed will be in the workflow as well and at the top of this list because those would be the Payers that are actively being enrolled with

Payer Manager

Edit/Add New Payer

User Manager

Expanding the details of a user would show:

1. Facilities this user has access to

2. Add additional Facilities to this user

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