Release 8.14

Release date: January 20, 2023

NantHealth made the following updates to support the Health Utilization Management (HUM) program.

Language preferences for letters

Patients can receive letters in English, Spanish, or Marshallese. (Feature 13255)

  • The system checks the eligibility file to see if the patient prefers letters in Spanish or Marshallese. 
  • On the Letter Template Management page, users can upload a translated letter in English (the default), Spanish, or Marshallese.
  • The system generates the translated letter and sends the letter to the patient.
  • On the Letter Dashboard, the system indicates if the patient has a preferred language but the translated letter was not uploaded to Letter Template Management.

Accessibility preferences for letters

Patients can receive letters in CBRL (Braille), LPRT (Large Print), or AUCD (Audio/CD). (Feature 123425)

  • The system checks the eligibility file to see if the patient prefers letters in CBRL (Braille), LPRT (Large Print), or AUCD (Audio/CD).
  • When the system sends the nightly letters to Mail My Statements for translation, the system puts the patient details and the letter into a CSV file and sends the file to Brail Works.
  • The system continues to send the written version of the letter to the patient in their preferred language.

Enhanced eligibility date checking

New eligibility date checking ensures the patient is covered at the start of treatment. (Feature 128430)

  • A new configuration compares the treatment start date that the user enters to the service dates in the eligibility file. If the treatment start date is before the eligibility start date, the system generates a deviation for the treatment plan.
  • To support date checking, the Eviti Connect treatment plan entry screens now appear in the following order, after the Diagnosis screen:
    • Justification Questions (if applicable)
    • Site of Service screen (if configured)
    • Treatment Start and End Date screen
    • Deviation/Upload Medical Records screen

Retroactive authorizations support on the Medical Office Dashboard

  • Updated the deviation message to reflect the acceptable timeframe for retroactive authorizations. (Feature 133575)
  • On the Complete Medical Office Review screen, updated the default of the drop-down menus to Retro Authorization Rejected. 

Ohio state regulations for provider outreach

The state of Ohio requires that when we reject a treatment plan or associated drugs, we must call the provider to inform them of the rejection. Additionally, all letters that we mail to providers must also be faxed. (Feature 125327)

  • A new configuration at the payer/LOB level informs us to call providers when a treatment plan is rejected. Letter Dashboard updates:
    • A new button for the rejected items: Phone Outreach for Rejected Treatment Item
    • The following buttons are disabled until the phone outreach is completed: Complete Review, Resend to Fulfillment, Upload.
  • A new configuration at the payer/LOB level informs us to fax letters to the providers (in addition to being mailed).
    • The faxed letters appear below the Notification Letters section of the Payer, Provider, and Patient Management dashboards.
    • The Letter Dashboard for the payer/LOB indicates that letters must be faxed.
    • The Connect system leverages eFax to fax the letters.

Site of service workflow updates

  • The system checks the provider file for the site of service provider information and prepopulates this information on the Site of Service screen. The user can modify the data and search for a different site of service provider. (Feature 125336)
  • The Medical Office user can now modify Site of Service information when the treatment plan originates from Connect or the Intake Dashboard. (User story 132465)