ViTel Health

Tong Process as an Enrollment Specialist

Updated on

TABLE OF CONTENTS

Check for Direct Referrals

Add Patient in Zoho for Insurance Check

A Find Patient Info in Elation

B Notify Insurance Eligibilty Team in Slack

C Check Status of Patient in Zoho

Contact Patient (First Attempt)

A Send Email to Eligible Patient

B Notify Doctor in Elation

Contact Patient (Second, Third Attempt, FTO)

Patient Enrolls

A Document Zoho

B Order Devices in Dashboard

C Notify Doctor in Elation

1. Check for Direct Referrals

A. Check for New Tags in Elation

  1. Login to Elation
  2. Click Reports
  3. Click Patient List
  1. Click box next to Patient Tags
  2. Enter CCM/RPM New
  3. Click Generate List
  4. See Patient with New tags

8. Repeat steps 5-7 for Patient Tag: CCM New

9. Repeat steps 5-7 for Patient Tag: RPM New

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B. Notify Doctor in Elation

  1. Go to EHR Client Templates
  2. Find relevant message and copy
  1. Go to Elation
  2. Check if doctor sent a message regarding this patient in Elation
    1. If doctor sent a message regarding this patient in Elation, Go to Quick Reply and paste message (ctrl V)
    2. If there is no message in Elation regarding this patient, go to Step 7
  3. Add initials and adjust message as needed
  4. Click Send

7. Go to Find patient chart... and type patient's name

8. Click Patient's Name

9. Click Msg

  1. Go to To and add Doctor's Name
  2. Go to Msg and add message
  3. Add your initials to message
  4. Click Send

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2. Add Patient in Zoho for Insurance Check

Click here for steps to create patient in Zoho

A. Find Patient Info in Elation

  1. Go to Elation
  2. Go to  Find patient chart... and type patient's name

3. Click Patient's Name

4. Click Patient Name

  1. Go to Patient Details and copy (using highlight, then CTRL c) the following information for Zoho patient chart:
    1. Patient's First Name
    2. Patient's Last Name
    3. Date of Birth
    4. Sex
    5. Telephone Number(s)
    6. Email Address
  1. Address
  2. Insurance Carrier name (primary and secondary if applicable)
  3. Member ID (primary and secondary if applicable)
  4. Click Cancel

16. Go to Problem List and search for CCM Health Conditions

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B. Notify Insurance Eligibility Team in Slack

  1. Go to Zoho to Patient's chart
  2. Highlight patient's link and copy with (Ctrl C)
  1. Go to Slack
  2. Click insurance-elig channel
  1. Go to Message and type @ins-elig Please check Tong Pt
  2. Paste pt zoho link (Ctrl v)
  3. Click Send Icon
  1. Wait until Insurance Eligibility team notifies you via Slack that they have completed the eligibility check

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C. Check Status of Patient in Zoho

  1. Go to Slack, and check if Insurance Eligibility team has notified you that they've completed the check.
  2. Go to Zoho by clicking Zoho patient link in Slack message

3. Review Status of Patient

4. Go to Insurance Status, Ins Pt Responsibility and Insurance Status Reason and verify that these confirm the patient's status

5. For patients with deductibles not met, check Enrollment Specialist Guide for eligibilty guidelines for Dr. Tong's patients for how to tag patient in Elation, tag patients in Zoho and whether to recheck insurance later.

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3. Contact Patient (First Attempt)

  1. Call the patient using RingCentral and the phone number in the patient's Zoho chart
  2. If the patient answers
    1. Inform the patient of the program, their status (covered, partial coverage, or no coverage) and next steps
    2. Create Outreach Log in Zoho
    3. Proceed to Notify Doctor in Elation
  3. If the patient does not answer, leave a voicemail requesting a return call if further discussion is needed (ensuring not to disclose any sensitive details in the voicemail)
    1. If patient is ineligible, create Outreach Log in Zoho and proceed to Notify Doctor in Elation
    2. If patient is eligible, send patient an email as per steps below

A. Send Email to Eligible Patient in Gmail

  1. Go to Gmail
  2. Go to Search mail and search inbox for last email you sent to patient
  3. Click on email
  1. Click Reply icon
  1. Go to To and ensure it has the patient's email
  2. Go to From and ensure it is Enrollment Team
  3. Click BCC

9. Go to BCC and add Enrollment Team

  1. Highlight and copy (ctrl C) text below
    1. Hi [Patient], I’m reaching out about the new CCM/RPM program Dr. Tong recommended. I tried calling but missed you and left a voicemail. If there’s a better number to reach you, please let us know—or feel free to call us at the number below. Looking forward to speaking with you. Thank you,
  2. Paste (Ctrl v) text in body of the email
  3. Add the name of the patient and modify text as needed
  4. Click Send
  1. Create Outreach Log in Zoho include call and email
  2. Proceed to notify doctor in elation

Back to Table of Contents

B. Notify Doctor in Elation

Find Patient

  1. Go to Elation
  2. Go to  Find patient chart... and type patient's name

3. Click Patient's Name

4. Click Patient Name

Tag Patient

1. Click edit pencil icon

2. Click X next to remove current tags

  1. In Search patient tags, add relevant tag
  2. Click Update Tags

Send Message to Doctor

  1. If patient did not enroll, continue to steps below. If patient did enroll, skip to Patient Enrolls.
  2. Go to EHR Client Templates
  3. Find relevant message and copy
  1. Go to Elation
  2. Click Msg
  1. Go to To and add Doctor's Name
  2. Go to Msg and paste message
  3. Add your initials to message
  4. Click Send

Back to Table of Contents

4. Contact Patient (Second, Third Attempt, FTO)

  1. Follow the usual outreach log process in Zoho and notify the Doctor in Elation after every attempt using method outlined in steps 3B
  2. Make sure to update tags as needed

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5. Patient Enrolls

A. Document in Zoho

  1. Follow usual onboard procedures in Zoho
  2. Go to Dashboard
  3. Go to Patient's Chart
  4. Click Notes
  1. Verify enrollment note transferred to Dashboard
    1. If enrollment note did not transfer to Dashboard, add the enrollment note

 

B. Order Devices in Dashboard

  1. Determine if you need to order devices for patient
    1. If the patient is RPM only or the CCM/RPM appointment is more than 5-7 days away, follow steps to order devices for the patient
    2. If the patient's first CCM/RPM appointment is scheduled within a few days, do not order devices. Health Coach will order.

Back to Table of Contents

C. Notify Doctor in Elation

  1. Follow steps to Log into Elation, Find Patient, Tag Patient and Send Message to Doctor as outlined in 3B

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