Life Cycle of a Provider

Please keep in mind this was one of many drafts I did for the process but it serves well to show the level of detail I put into my writing. It is now an old procedure and has no HIPPA violations as Minnie Mouse, Mickey Mouse House and Acme are NOT real but were used frequently as test records in the database system. Please also note that DS3 is no longer used by the State of Alaska as well. Yes, it is very long (80 pages) but the final version was almost 200 pages and then it was discarded by management.

This is simply to demonstrate my writing.

 

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Archiving Categories

At the start of my time with the State of Alaska I was a Administrative Clerk. As a clerk I was placed in charge of archiving old files to make space for current files. This was a monumental task that had not been tackled in several years so there were 20+ boxes to start with. Based on the Archive Guidelines I developed a simplified chart to help me sort the files.

Over the course of 9.5 years I and the teams of MASST (Mature Alaskans Seeking Skills Training) and DVR (Department of Vocational Rehabilitation) participants along with a non-perm Office Assistant archived over 3,500 files. I was involved in all the aspects of hiring, training and day to day leadership of these individuals.

archives guide

One of the training tools I used to assist everyone who was helping with the massive project included the following guide.

In the process of doing this it became known that no matter how many closed files I archived and sent off site there would never be enough space for the ever expanding files that were open. It was then determined that we also needed to categorize the open files for archiving as well. There was no guidelines to do this at the time and so in talking to the head of the archives we determined that we needed to collaborate with my management to setup the mechanisms to archive open files.

There were many types of both open and closed providers as detailed below. The categories assisted in retrieving files for quality assurance and compliance investigations over the years. Our oldest files were so old that the early volumes dated back into the 1990’s when Senior Services was founded! It was fantastic to get so many old files offsite and out of our over full file cabinets. It also reduced injuries (I was injured by the drawers being too full) and reduced fire risks. Once older files were offsite archives was able to either store the files or add them to micro film or scan them for DVD backup media.

Archive Categories

Copiers & Technical Issues

I worked as support for a the Certification & Compliance/Quality Assurance Unit for the State of Alaska. During my time there the repair techs for the copiers and other equipment were gracious enough to give me lessons in reading codes and handling a variety of basic issues. They also helped me understand which codes were necessary to call repair for and which I could fix. 

When I started the copiers were very old and not under warranty as well as continuously breaking down as a result there were many calls for repair which were roughly $400-600 per visit plus parts.

I spent an afternoon once fixing 3 of the same old model copiers. After I had exhausted my knowledge and every trick I could Google I informed Admin that copiers would get 3 tries for me to fix them and then I’d have them call for repair. They were shocked that I’d been willing to work so hard to keep the office running and readily agreed to my three strikes rule.  I saved the state thousands of dollars because I was willing to take the time to patiently work out issues and fix as many things as I could.

The latest copier was under a warranty lease and repair calls were no longer expensive however were still some old copiers and other older equipment in the building and the techs still sought me out to see what I might know and especially if I knew where the latest stash of supplies might be.

Process Improvements

In 2011 my employer lost a legal case based on a simple reason: the documents were not date stamped. I remembered a couple years before dropping off paperwork and the office had a machine that my packet had gone on to, zipped through and out of curiosity I asked the clerk what the machine was. It was a date stamper, so I suggested we procure the same type of machine. Since it was my idea management agreed happily and asked me to do the research on machines, features and costs. I came back with a simple machine that would print a short line of text and the current or a programmed date. Exactly what we needed. 

A process was developed so that everyone knew how to use the machine correctly and for several years and several hundred thousand pages the machine worked perfectly. Basic maintenance kept it going until it needed a full refurbish. I again sought permission for sending the machine for repair after finding out timelines and costs. Meanwhile we had to keep up with the date stamping some other way. I tried a funky trick with Word and footers that was bad and finally settled on using Adobe Pro. I had one of the very few copies of Adobe everyone else had Adobe Reader at the time. After a few minutes of exploring the options (I’d only had the software for a few days at the time) I found a way to add footers to all the pages of a document quickly, then I found the Workflows and automated it. Finally I presented my solution to management who again enthusiastically gave the green light to use the tricks I’d learned.

It wasn’t long until everyone else received an upgrade to Adobe DC, an enterprise edition of Adobe that has all the bells and whistles. I exported my workflow, sent it around to the team and now everyone can use either the machine which is up and running smoothly or they can use the Adobe Workflow.

The next major process improvement was for only part of the team and a specific project but it saves a lot of time. The basics of the process is to compare 2 or sometimes more documents for differences. This was being done manually, on paper and was taking a very long time when the project was on a very tight deadline.

Not long after this portion of the project was getting underway Adobe DC received an update with some new features. Being the sort who likes to know what software does I’d played with the feature of comparing documents, thought it was cool and filed the idea away in memory.

While chatting with my new office mate I found out what exactly she was doing, manually comparing documents so I described the new tool, showed it off briefly as it was late on a Friday, and left for home. Much to everyone’s delight the new tool was adopted Monday morning and has saved the team roughly 88% of their time on that not so small portion of the project.

My “Official Job”

During the process of reclassification, I was asked to rewrite my job description. This is what was accepted resulting in my reclassification to Senior Services Technician.

Under general supervision, this position performs a variety of support and technical functions in
the administration of the Provider Certification & Compliance Unit for the Medicaid Home and Community Based Waiver and Personal Care Assistance program. This position provides support and assistance to program managers and is responsible for program specific work of a senior service-oriented agency, develops and maintains systems to track certification information and prepares reports for professional staff which are used internally and externally. The position serves a key role in the Provider Certification Unit as related to regulatory compliance, client health and safety, and continuous quality improvement.

    • Create and maintain system generated reports for Provider Certification & Compliance Unit process of certification of Medicaid provider applicants, waivers, onsite provider reviews, and other quality assurance processes.
    • Uses various reporting tools to compare data available internally and externally to correct deficiencies in data sets such as providers not showing up on the interactive public Search Tool but are active in the internal DS3 database.
    • Participates in planning and developing system work orders to improve systems support for the unit.
    • Maintains systems to ensure data integrity.
    • Produces reports for management use; assists professional staff in analyzing data and creating reports. Enters and edits data and creates spreadsheets.
    • Enter and track data related to provisional background checks of employees in agencies that obtain initial certification approvals. Work closely with certification application evaluators to communicate changes in background check status for these individuals for follow up measures.
    • Implementation of a centralized repository of required forms and letters into a SharePoint site to use as a resource.
    • Develops Certification forms for internal use and edits Certification Application forms ensuring accessibility for the public.
    • Builds & maintains UMLs of unit processes, writes or updates written processes as assigned
    • Develops Universal Modeling Language (UML) tools for clarifying processes. Ensures procedures are updated as shared electronic documents for the unit.
    • Assists with printing, copying, mass mailings, and organizing materials for meetings, training sessions, investigations, and site reviews or provides lead support to supportive staff.
    • Provides support and maintenance of the unit`s copiers, fax machines and other machinery in the office. Conducts routine maintenance, troubleshooting and periodic repair status checks. Facilitates repair calls as necessary.
    • Prepares materials for dissemination to providers, including recertification notifications
      Prepares mailing lists, merges documents, tracks and archives mailing lists for compliance history.
    • Provides detailed information on program regulations; advises the public on program applicability and requirements; explains related laws, rules, regulations, policies, and procedures to potential providers; advises and assists potential providers in setting up services. Must stay abreast of regulation, policy and systems changes.
    • Provides technical assistance to applicants and providers regarding certification application process, setting up Background Check accounts, and corresponding with the SDS fiscal agent for billing purposes.
    • Processes incoming initial and renewal applications for Medicaid Waiver and Personal Care Assistance Certification Application for completeness of required information according to state and federal regulations.
    • Monitors Provider Certification email inbox which is the publicly posted email and web portal for all providers and applicants. Various reports of incidents, inquiries, complaints and questions flow through this email and must be routinely monitored and re-routed. An in-depth knowledge of SDS programs and their inter-relationships must be maintained in order to able to manage this duty. Responds to and takes appropriate action when within prescribed parameters, redirects to the correct professional staff when beyond knowledge base or those parameters, routes various emails to specific professional staff for decisions and action. Must use good judgment to determine level and routing of communications.
    • Serves as subject matter expert on records retention procedures and archiving/off-site storage processes and advises professional staff on these procedures.
    • Helps keep Provider Certification records and files organized and complete. Ongoing filing and policy and procedures toward electronic record keeping.
    • Provides records copies for various records requests for criminal cases, public requests, etc. Ensure complete records are provided.

File Maintenance

Pile of files I came back to after taking a long weekend....

Pile of files I came back to after taking a long weekend….

While being a clerk has been one of my titles the same duties carried over to being a Senior Services Tech. The number of files for provider certification has varied over the years but has always been more than 800. That is agencies and individual care coordinators that the division certifies.
 
Each of those providers has multiple files. A hard file, an electronic file and a database entry. Each has to reflect the others and older materials have to be archived just in case there is an audit in the future.
 
The processes I complete almost unconsciously have been either developed or modified by me in the last several years. I do the primary process of issuing reminder letters, entering providers and various notes into the database and preparing the file for review.
 
After the review process is complete I take the final file and add it to a current file replacing older materials and archiving them or creating a complete new file as needed. During this file process I check that the required items are present via a tagging system developed internally that matches a checklist. Any files with errors are returned to the worker who signed off on the application for corrections.
 
In addition to the certified agencies there are a number of other agencies or providers that the division cares about and it has fallen to me to keep track of these providers as well. Some are a once a year quick database only update and others require detailed maintenance and changes as part of the general certification process as they are a setting that is contracted to a certified provider. No matter what the number of provider records I maintain numbers over 1200.
 
An additional type of file I care for is the closed providers which by the time the file gets to me I have to deconstruct and label it to enter it into a separate database. This is a tracking system I am one of the administrators for and have steered many changes and improvements to the system.
 
This is just a teeny peek at a segment of the things I do.
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