Plato RAC Track Training Guide Part I

OVERVIEW

The Plato RAC Track is a web based, easy to use tracking software application designed to monitor, track and report on many facets of requests for health information. This tool is designed to track RAC as well as other requests to meet your auditing/tracking needs.

WORK ENVIRONMENT

Log In

Choose Facility - This application can be used for multiple facilities

Click on the drop down arrow and choose your desired facility, and then click ‘Go’

TABS (across the top of the Workflow Screen)

Plato RAC Track displays several “Tabs” across the top of the window providing for easy accessibility to the various functionalities within the application. When a tab is clicked on, a double red line appears to the left of the tab identifying where you are within the application. The tabs are described in the following section:

Home Page Tab - This page shows you a “Dashboard” of the following functions divided by sections:

Search & Add – Entry for either Account/Request search or access to add a new Account/Request
Search” for any existing request or account; or
Add Request” button – To directly add any new account and request
ROI button - Connects directly to your Release of Information vendor (Contact CPR Technologies for more information on set up)
Tasks – Tasks that are due that week
Recent - Most recent Searches by Account and/or Requests
Graph - Picture of the last graph generated

Account Tab - This allows you to go directly to your list of specific patient accounts created in the tracking system. You can also add new accounts from this area

Request Tab - This allows you to go directly to your list of specific requests created in the tracking system. You can also add new requests from this area.

Report Tab - A variety of easy to use, canned reports provide you with various views of the data entered related to your requests.

Analyzer Tab - The analyzer cube is a unique and innovative tool that allows you to redefine the way you view your data.

Graphs Tab - Graphs are another way to be able to view your data in terms of pictorial percentages and values.

STEP BY STEP

Adding an Account

There are three ways to add an account:

The demographic information can be populated through an ADT interface, which would need to be configured. Please contact CPR Technologies for more information or
When adding a Request, you can click the ‘Add’ button, above in the (purple) section or
Click on the ‘Account’ tab, and then click ‘Add’ and complete the following fields.

Account ID# - Encounter or visit number
Patient ID – Medical Record number
DOB – Date of Birth
Admit Date – Date patient was admitted
MSDRG - Medical Severity Diagnosis Related Group; Table is populated for you
Initial payment – Date payment was received
Physician – Physician associated with request (If applicable)
Financial Class - Medicare, Medi-Cal, Private Pay etc..
Patient Name – Patient associated with request
Payor ID – Health Insurance Claim Number from CMS
Discharge Date – Date patient was discharged
Patient Type – Inpatient, outpatient etc…
Date of Service – Date service was performed
Coder – Coder associated with request (If applicable)

When completed click Save.

You can drill down for more account detailed information by double clicking on the hyper link, Account ID

Adding a Request (Dark blue section)

After the account has been populated either through the ADT interface or manually, your next step would be to add the request.

From the ‘Search and Add’ box, click on ‘Add Request”, or click on the ‘Request’ tab and then click ‘Add’.
Complete the following fields by entering all the audit request information

Request ID – CMS or other auditor request number
Audit Type – Type of audit being requested i.e., RAC, CERT, PERM etc
Category – Automated or Complex
Subject – Audit reason
Request Date – Date on the actual form received
Original $ - Amount already paid (Not always on the form)
Batch ID – Multiple requests for records may come in batches
Request Type – Medical Necessity, One Day Stay, DRG Change etc.

Initial Status – New, In progress, Appealed etc.

Final Status – Denied, approved, withdrawn
Received Date – Date the request was received at your facility
Suggested $ - The amount the specific auditor is suggesting they should have paid (Not always on the form)
Comments – Anything you want to note or message you want to pass on
Finalized $ - Amount settled in the end See NOTE
Finalized Date – Date it was settled

NOTE

You have the option to have 4 more numeric fields to define specifically for your financial class needs. See ADMINISTRATIVE SECTION and SYSTEM TABLES -> Additional Request Fields

When completed click Save

*The copying of records is very time sensitive. Depending on the chosen request ‘Status’ for RAC the system is set up to send automatic reminders that will populate the Plato RAC Home page/Task List, your Outlook Calendar and e-mail to the appropriate people. (See section on Adding a Reminder Activity).

Edit or Retrieve an already entered Request

From the ‘Search & Add’ box enter the Request ID or click on the Request tab and locate the desired Request ID, and double click.

This work flow screen will give you a birds-eye view of the action that has occurred with the specific request and consists of the following sections:

1st Section – Patient Account information (Purple)
2nd Section – Action Panel (Light blue)
3rd Section – Request Information (Blue)
4th Section – Action Activity (Green)
5th Section – Reminder Activity (Red)
6th Section – Notes (Orange)

You can drill down for more account detailed information by left clicking on the hyper links; Account ID, Request ID, Batch ID or Subject.

Action Panel (Light blue section)

After adding the initial Request, from the workflow screen you have the option to use the ‘Action Panel’ to Add Action Activity, Add Reminder, Send an E-mail or Add a Note.

Click on the ‘Request’ tab and locate the desired Request ID, and double click.
From the Action Panel choose the desired function

Add Action Activity – See section on ‘Adding an Action Activity’
Add Reminder Activity – See section on ‘Adding a Reminder Activity’
Send E-Mail – See section on ‘Sending an E-mail’
Add a Note – See section on ‘Adding a Note’ or scroll down to each individual section to perform the function.

When completed click Save

Adding Action Activities (Green section)

From the ‘Search & Add’ box enter the Request ID or
Click on the Request tab and locate the desired Request ID, and double click or
Utilize the Action Panel section to add an Action Activity
From the ‘Action Activities’ section, click on ‘Add’ and complete the following fields.

Action Date – Date the Action was taken
Action Type – Type of Action taken i.e. Researched, Faxed, and Meeting planned etc.
Stage – Initial request, Discussion Period, Appealed etc.
Tracking – How and who it was delivered with Tracking number
Pages – The amount of pages sent
Subject – Which action was taken
Comments - Anything you want to note or message you want to pass on

When completed click Save

The patient account and request information always appears in the section above the Action Activity so you always know which patient you are working with. You can drill down for more account detailed information by double clicking on the hyper link; Account ID, Request ID or Batch ID.

Adding a Reminder (Red Section)

From the ‘Search & Add ‘ box enter the Request ID or
Click on the Request tab and locate the desired Request ID, and double click or
Utilize the Action Panel to Add Reminder
From the ‘Reminder’ section, click on ‘Add’ and complete the following fields.

Date – Date you are setting the Reminder
Subject – Which action taken

Due Date – Date the request is due

Remind User – Who you would like to remind about this due date/request

Completed % - What percentage of this request is completed

Stage – What stage is this request/reminder in

Remind Before – How many days do you want to be reminded before the due date

Priority – High, Medium or Low
Comments - Anything you want to note or message you want to pass on

When completed click Save

*The copying of records is very time sensitive. Depending on the chosen ‘Stage’ the system is set up to send automatic reminders that will populate the Plato RAC Home page/Task List, your Outlook Calendar and e-mail to the appropriate people.

The patient account and request information always appears in the section above the Reminder so you always know which patient you are working with. You can drill down for more account detailed information by double clicking on the hyper link; Account ID, Request ID or Batch ID.

Adding a Note (Orange Section)

Notes provide additional comments that you would like your team to know regarding a specific request. This section also gives you the ability to attach any document from your hard drive. For example; scanned documents, letters, support documentation, correspondence etc.

From the ‘Search & Add box enter the Request ID or
Click on the Request tab and locate the desired Request ID, and double click or
Utilize the Action Panel to Add a Note or
From the ‘Notes’ section, click on ‘Add’ and complete the following fields.

Date – Date of the note
Subject – Action taken

Stage - Initial request, Discussion Period, Appealed etc.

Comment - Anything you want to note or message you want to pass on to the team
Attachment – Browse out to your hard drive and attach any pertinent documents
System Flag – By checking this box it will allow you view all the notes taken in the notes section for that request.

When completed click Save

The patient account information always appears in the section above the Note section so you always know which patient you are working with. Drill down for more account detailed information by double clicking on the hyper link; Account ID, Request ID or Batch ID.

Sending an E-Mail

You can send an e-mail to anyone with an e-mail in the Plato RAC system or to anyone entered in your Contact list that has an e-mail.

Click on the ‘Request’ tab and locate the desired Request ID, and double click.
From the ‘Action Panel’ section, click on ‘Send an E-mail’or scroll down to the green Activities section and click on 'Send E-mail'
Complete the following fields by entering all information.

To – Intended recipient
CC – If applicable
BCC – If applicable
Stage – Initial request, Discussion Period, Appealed etc.
Subject – Will automatically populate the Request ID#
Insert Account ID – By clicking this button, it will automatically populate the Account ID you are working with in the Body of the e-mail. Enter any other desired information needed for your team to know. The Body section cannot be left blank.

When completed click Send

Adding a new E-mail or Contact SeeADMINISTRATION & SET UP ->MANAGE

Adding a new User SeeADMINISTRATION & SET UP -> SECURITY

ADMINISTRATIVE SECTION and SYSTEM TABLES

Administration and Set Up

We always recommend you have a System Administrator or Super User to perform higher level, administrative type functions in the application, that we don’t recommend, be done by the end user. The application has a library of “System Tables”. These tables are user defined and are found under the ‘Administration & Set Up’ section located in the upper right corner of the application.

Click on Administration & Set Up

MANAGE

These are system tables/data fields that can be applied to any audit.

Global – The Global fields have been pre-populated with some RAC required fields by CPRT and are used across all facilities and cannot be changed.
Facility – These fields allow the facility to user define each table to specifically fit their facility needs.

Adding values to the System Tables/Data Fields

From the ‘Manage’ section, click on desired table
From the right side, click on ‘Add’.
Enter Description and then click ‘Save’

Patient Type – Inpatient, Outpatient etc.
Audit Type – Type of audit being requested i.e., RAC, CERT, PERM, MIC
Action Type – Type of Action taken i.e. Researched, Faxed, and Meeting planned etc.
MS-DRG – Medical Severity Diagnosis Related Group; This table is populated for you
Service Area – In which area has automated RAC denials occurred this quarter i.e., Inpatient, Psychiatric etc.
Request Stage - Initial request, Discussion Period, Appealed etc.

Description
Set Reminder (Days after request date)
Set Due Date (Days prior to reminder)

Request Status - New, In progress, Won, Appealed etc
Request Type - Medical Necessity, One Day Stay, DRG Change etc.
Contacts – Other contacts you wish to notify that are not users in the application

Description
E-Mail

Physician – Physician table will populated for you (Contact CPR Technologies for more information)

Description
ID

Coder –

Description
ID

Financial Class -

Description
ID

Deactivate Column– Deactivating a field simply removes it from a specific table so it can no longer be used, and puts it in the Deactivate table. It does not affect any data entry against it. You can restore the deactivated field by clicking on the ‘Deactivate’ table, and then click on ‘Restore’
Description Column – Field description
Scope Column – Whether it is a Global or a Facility field. See descriptions above

SECURITY

The security section determines the Users and Roles and the level of permission allowed. Facility allows you to enter multiple facilities that have permission to access the application.

Adding a Role – User defined role that determine the level of permissions a user might have

Click on the ‘Role’ table
From the right side, click on ‘Add’.
Enter Description i.e., RAC Coordinator, Manager, Data Entry etc. and assign appropriate rights, and then click ‘Save’

Can Manage Security Tools – Adding Users, Roles and Facility
Can Manage Object List – These are the user defined system tables
Can Edit Data – Editing already entered data
Can Review Reports – User can only generate and view reports

Adding a User – Defines various users throughout the Plato RAC application

Click on the ‘User’ table
From the right side, click on ‘Add’.
Enter Description i.e., last name, first name, E-mail and Password and then click ‘Save’
When saved locate the user in the membership column and click on Roles. This will allow you to assign a specific Role to that User.

Description – Last name, first name
E-mail – The e-mail the user will use to receive e-mails and reminders etc.
Password – A secure password for security purposes

Adding Facility Fields – The application can be used for multiple facilities and clinics. Each facility will have its own site license. To purchase additional facility licenses please contact CPR Technologies for more information.

Description – Name of Facility Note: The facility name is set up during the initial system set up. However, it can be changed if necessary.
Facility Type – These are populated for you and are mandated by the American Hospital Association (AHA)
Quarter start month – This field allows you to change the month your quarters start, and is associated with the Quarterly Over/Under Payment report in the Reports section.
Logo – You have the ability to attach you own logo to the application. Just browse to your hard drive and attach it.

SET UP

Each user has the ability to change there own password.

Changing a Password

Click on ‘Change Password’. You will automatically be brought to the Reset Password screen.
Complete the following fields and click ‘Save’.
Enter current password
New password
Confirm new password

Additional Request Fields

Here you have the option to add 4 more numeric fields to the 'Request' section to help monitor additional financial class fields.

Field 1
Field 2
Field 3
Field 4

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OVERVIEW

WORK ENVIRONMENT

TABS (across the top of the Workflow Screen)

STEP BY STEP