Key Features:
Capture referral and intake information
Verify Medicaid eligibility and MLTC assessment completion
Assign care manager for enrollment coordination
Track MLTC selection and plan submission
Manage enrollment status updates and approvals
Key Features:
Intake and eligibility validation for MCO programs
Manage plan selection forms and consent
Assign tasks for benefits coordination and documentation collection
Track enrollment status milestones (submitted, pending, confirmed)
Generate follow-ups for missing information or delays
Key Features:
Intake pre-screening to determine Medicaid eligibility
Document checklist management (proof of income, residency, ID, etc.)
Submit Medicaid applications electronically or manually
Track application progress and caseworker communication
Flag urgent cases for expedited handling
Key Features:
Capture reason for plan change request
Validate new plan eligibility requirements
Submit change forms and update payer records
Notify providers and care teams of the change
Monitor approval/confirmation from the new plan
Key Features:
Capture client request and reason for agency switch
Notify current and new agencies of transfer intent
Manage discharge planning with the outgoing agency
Set up service initiation with incoming agency
Update payer and authorization records accordingly
Key Features:
Intake request for service change (e.g., increase in hours, different service type)
Validate medical necessity or authorization requirements
Update service orders and care plans
Assign staff/resources for updated services
Key Features:
Capture client and caregiver preferences (language, skills, personality traits)
Search caregiver database based on location and qualifications
Present best matches to intake or care management teams
Assign caregiver and notify both parties
Track caregiver acceptance and first visit confirmation
Key Features:
Referral Source Database Management:
Maintain an up-to-date directory of referral partners with contact details, type (hospital, clinic, social worker, etc.), and engagement history.
Source Categorization and Scoring:
Categorize sources by type, performance, and potential. Score based on volume and quality of referrals.
Visit Tracking and Relationship Management:
Schedule and log source visits, calls, and touchpoints. Track relationship health over time.
Referral Volume Reporting:
Monitor number of referrals by source, identify top performers, and flag underperforming sources for re-engagement strategies.
Source Development Action Plans:
Set follow-up tasks and campaigns (e.g., educational events, materials delivery) to build or revive source relationships.
Key Features:
Credential and Background Verification:
Manage document collection (licenses, certifications, background checks) and track onboarding status.
Territory Assignment:
Assign reps to specific geographic territories or market segments based on strategic coverage needs.
Training Program Management:
Assign and track completion of required training (e.g., home care services overview, compliance, sales protocols).
Onboarding Checklist Automation:
Guide reps through onboarding steps: system access setup, materials distribution, introductory meetings, shadowing sessions.
Performance Ramp-Up Tracking:
Monitor early activity and engagement (first source visits, first referrals generated) to ensure reps are ramping successfully.