Reporting
Insurance
August WIGs
Provider Relationships
Pipeline Management
100

What report is helpful in a pinch

Quick starting dashboard

TTR opps

Auth attained not HB

Insurance time eligible

ect.

100

what is the retx tat for medicare

30 days

100
What is the overall KPI commit?

$3.15M

100

what is a solid was to motivate a provider?

review patients in treatment recently in remission. 

compare the tms pts vs pts w/ no tms remission rates

tms rvus

100

how many overdue LOs are too many?

maximum 12

200

What reporting shows your closed?

KPI Closed/Pending
200

what is the minimum phq9 for medicare

12+

200

what is the alumni capture minimum %?

50%

200

if a provider does not refer a patient due to non clinical issues, how do you manage this? and within what timeline should it be handled?

provide clinical information on the patient and remind the provider your role is to be able to manage and find solution to the non clinical issues a patient may have. remind the provider that the patient may not know the solutions we can provide and not educating them on a clinically appropriate treatment due to non-clinical reasons is unfair and that you would appreciate the ability to get in front of the patient to be able to help navigate the obstacles. 

should be handled within 5 mins of no handoff

200

how many overdue referrals are too many?

0

maximum 12

300

what reporting is helpful to see who is coming in that is a potential tms candidate

sh apts phq9 15+

tableau all flag

all open LOs by apt

300

does medicare require therapy trial?

yes

300

what is the cash commit

75k

300

when would you get bailey involved in provider conversations?

when you have already talked to provider without change (3 days) and looked through reporting and came with solution or information on where you think the gap may lie. I should not have to find the gap for you

300

if you are $100k short at the end of the month, what did you do wrong?

pipeline management

400

what is baileys dashboard called?

tms growth - megadash

400

if a patient has completed tms in the past but did not hit 50% response and is wanting to retreat what is the next step?

ask if they have the same insurance

if they do look through the chart for phq9s around time of start and end that would be able to be submitted. tms continues to work after completion 

400

what is the alumni commit

775k

400

how do you approach a potential diagnosis adjustment?

"Based on your expertise do you believe it is clinically appropriate for the patients dx to be X?"

400

why is conversion rate important to pipeline management?

it shows how many leads you need to capture to be able to hit commit

500

how do you calculate if you are on pace for the week?

find your end of week commit on pace sheet. subtract closed for the month and hb remaining for that week from commit.

500

if a patient does not yet meet medication criteria, what do you do?

self pay

ask about side effects, many insurances dont have to have duration if patient had to discontinue medication due to side effects

lomn w submission

set follow up tasks and speak with provider about making medication adjustment if not enough med trials at that visit. sometimes they will go ahead and start another medication right then if pt is wanting to start


500

what is week 2 commit closed?

$1.5M closed

500

what reporting is good to comb through and review with a provider if they are not referring well and you are behind on internal referrals?

np mdd no tms order on tableau

500

what is the most important part of being able to hit commit?

staying on pace. having conversations with patients timely, submitting auths timely, shrinking TAT from consult to start, making sure internal referrals stay on pace..... everything. it all adds up

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