Governor Bevin has created the Red Tape Reduction Initiative in an effort to review…
Case Managers Brittney Such (Blue Sky), Cynthia Coomes (HMR), Mary Allen (Seven Counties) , Nick Tallent (WFC), Angie Harris (Barrowman) and Stacy Tomlinson (Cornerstone) attended as KAPP Case Management Representatives. This is a summary by Brittney:
Stacy Fish, Bikash, and many others were very helpful. Stacy took down some great suggestions from the group as a whole that would make MWMA use smoother and more user friendly. While not being able to guarantee these changes, it was nice to feel heard and for the case managers present, to hear that we all agreed on some that would be very important to gain the support of case managers behind the use of MWMA.
Two big things the case managers mentioned that would help are:
- When submitting an LOC request, it says Save and Exit instead of submit, making it very unclear for case managers if they actually submitted an LOC recertification request. Stacy agreed that it can feel like it disappears into a black hole.
- When selecting view caseload and then clicking on a clients name, you go to an individual summary screen showing a snapshot of demographic information. This same screen comes up several other places when you click the clients name and the natural expectation is that you will go to the “clients world” in MWMA screen where you can click on to actually work on their case/manage their POC, view assessments. This can cause CMs to get frustrated bc they end up spending so much time clicking around trying to get to the screen so that they can work on the case.
Other things discussed that may be contributing to CM frustrations included:
- When calling the help desk, the first thing they tell you to do is to make sure you are selecting the radio button before clicking continue on a task. Frustrating because CMs either don’t know what they mean by radio button or they know its a silly statement because you should get the same result clicking start or continue for the task regardless of if the radio button (little bullet) by the task is selected.
- Blue Sky clients and clients from other agencies couldn’t be on-boarded for similar issues with phone numbers/zip-codes. The system will ask you to input the correct phone number or the last 4 of the zip code when on boarding but we don’t have control over editing these boxes. Somehow they appear filled with just zeros. CMs directed to call DCBS to fix this, but the small change needed feels like a mis-use of case managers time to spend hours on hold with local DCBS offices.
- They took many of these cases for us and stated they would help expedite these with their contacts at the DCBS offices.
- Misunderstandings of LOC request necessary documents – LOIs being generated for not submitting Life Story’s or SIS assessments with LOC request but the SCL LOC recert form should be the only thing needed.
- While not a technical issues, they planned to take this information back to someone to provide additional education for reviewers
- We also requested task notifications for the non-365 day Prior Auth services such as Consultative Clinical services and Community Access
New Things Learned:
- If you complete an LOC request and/or a POC via fax and it is approved by carewise, you can still enter it into MWMA after that if you wish to have all of your cases in MWMA. In the comments section if you note to carewise that the PA’s and LOC have already been approved and generated but you are submitting to transition the Plan into MWMA, carewise has agreed to approve the cases. After re-approval in MWMA, modifications can be completed in MWMA.
- They will be removing/stopping the generation of the task of “Enter Service Actual Start Date” for new POCs. (yay! this has confused many CMs)
- They are working on revising the printable view/length/layout of the POC. (yay! Providers have no idea what it is or how to read it when we send it!)
As a whole, I believe the group present came to the same conclusions that while many case managers/providers have expressed frustration and dislike for the system, sometimes that doesn’t mean there are specific case issues. Rather an accumulation of little issues and a fear of “playing” in the system to learn your way around. A very justifiable fear as no one wants to accidentally click something that causes gaps in waiver participant services. Its changing frequently right now as well, so a link or menu located in one spot may move or disappear the next time you log in, so you end up guessing again as to how you get to your intended screen.
Personally, MWMA has potential but seems to built like a website from 10 years ago. It seems like it was developed to change/improve the review process for carewise and for Medicaid to gather other information about waiver participants. Not to help improve the time management and workflow for case managers and providers. I can see how after all of the cases you are working with as a CM have active Plans of Care in MWMA, some workflow could be improved through that streamline.