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All Cguros applications are designed in an effort to achieve scalability.  Our team of user interface designers and software architects take time when designing each feature to make sure that its something our users are asking for and ultimately something that we will be able to implement in a beneficial manner.  While we aim to design each application to be self explanatory, requiring no formal training, or implementation period, we recognize some users will have questions, User Tutorials bring a portion of the many features within to the surface.

Searching For A Patient

Searching For A Patient Profile

search for a patient - complete prior authorization

    • Searching For A Patient Profile can be accomplished by submitting a number of unique identifiers for that patient, once patient information has been entered please click “Search
      • Patient email address and phone number are likely identifiers that will render search results the quickest, however many times patients will forget the email address or phone number within their profile, or possibly even share email accounts with a spouse
      • Cguros recommends using the patients full name accompanied by their DOB or SSN to return the most accurate and finite results.
        • DOB Data Field: Automatically normalizes user input, ( 09.25.1975  |  09-25-1975  |  09/25/1975 ) will all work to render the same patient.
        • Stratus prefers patients include the entire (nine digit) SSN however in the event some portion of patients refuses, searching with the last four digits will return accurate results as well.
    • In the event your search is Successful, the user will be able to …
      • Build a new order for the patient by selecting “Show Orders” followed by “New Orders
      • Edit the patient profile by selecting “Edit Patient
      • Or, view all active orders for the patient, by selecting “Show Orders
    • In some cases you’ll find searching for the patient profile to be Unsuccessful, reason being, the patient has yet to be entered within Stratus, the next step becomes adding that patient, this can be done by selecting “New Patient” button, located just above the search fields.

NOTE:  The underlying goal is simply to maintain a single record for each patient; making it critical to search for each patient prior to adding any new patients.

Adding A New Patient

Adding New Patient

Adding New Patients Profile Information Propagates The Value & Footprint Of  Network For All Providers

Before Adding A New Patient:

  • Users need to determine the patient profile does not exist, accomplished by Searching for the patient (see instructions below)

Searching For A Patient

      • Searching For A Patient Profile can be accomplished by submitting a number of unique identifiers for that patient, (within the “Search” module) once patient information has been entered click “Search
      • In the event your search is Successful, in locating the patient profile your looking for, move forward by adding an additional order to the active patient profile (there is no need to add the patient twice)
        • In the event patient information has changed since the patients last visit the “Edit Patient” button, allows users the ability to bring records current.
      • In the event your Unsuccessful in searching for a particular patient your looking for, the next step becomes adding a new patient
  • Adding a new patient profile can be accomplished by clicking the “New Patient” button found just above the same search fields uses to originally search for the patient.
  • Once current patient information has been entered select “Save” to store the patient profile

Patient Address:

Please fill in all data fields for the patient address then select “Save

Patient Insurance Provider Information:

  • Please fill in all data fields for the patient insurance information then select “Save
  • In the event the patient has more than one insurance company, please select the button from the menu titled “Add New Insurance” and document any coinsurances options
  • Please remember to “Delete” (via the “X” in the upper right hand corner of the tab) any outdated insurance records for the patient – as this insures Cguros is able to retrieve a pre-certification status.

Adding A New Insurance Company:

Once general patient information has been entered – user then have opportunity to add additional specifics to the patient profile, such as patients insurance provider, any Co-Insurer and Patient address.

  • Simple start typing the payers full name, within the text box instantly the insurance payers will appear.

However, in some cases if your unable to find the insurance provider your looking for, you’ll need to add a new option altogether

  • To add a new insurance provider for that patient, simply select the icon to the right of the text field, at which point a pop up window will appear and allow the user to add a new provider.

Patient referral & pre-certification

  • At this point moving forward not only will the selected insurance provider remain within the patients profile, but Cguros will continue to work in the background to maintain the selected payer profile.  Allowing every user to then select that payer as needed in the future.

Keep In Mind:

  • Facilities benefit in always documenting patient cell phone number, & email address as primary forms of contact – which enables patient notifications.
  • Controlling denials starts with maintaining accurate patient profile for all users to work form.  Remember to always take a quick glance at patients profile before submitting any order, to verify all fields are current.

 

Edit Patient Profile

Edit Patient Profile 

Controlling denials starts with maintaining accurate patient profile for all users to work form.  Remember to always take a quick glance at patients profile before submitting any new orders, verifying all fields are accurate and kept current.

    1. Use the search functionality to locate the patient profile your interested in (Search Tutorial also Available)
    2. Click on the patient profile in the search results you intended to originally locate
    3. Then, click “Edit Patient” – found just above the search fields
    4. This allows the user to confirm that all patient information is up to date, in the event patient information need to be changed the user is able to do so by clicking within the text box and simply deleting current profile information
    5. Once the patient profile has been determined as current save your changes by clicking “Save

Keep In Mind:

    • Facilities benefit in always documenting patient cell phone number, & email address as primary forms of contact, this enables Stratus to notify patient of upcoming appointments
Patient Pipeline Navigation

Navigating the Patient Pipeline

The Current Patient Table Is Structured A Lot Like An Email Inbox

    • By default users view the Patient Pipeline in the Incoming View (notice the drop down – used to edit the current view, between inbound and outbound)
      • Inbound orders are patients referred to your facility, AKA the healthcare facility you work at
      • Notice in the first column you will find a number of patient names enabling the user to select a patient at a glance
        • For Further Action:
          • Selecting a patient followed by the button labeled “View Orders” enables the user to see all orders for that patient
          • Selecting a patient followed by the button labeled “New Order” empowers the user to begin building a new order for that patient
          • Selecting a patient followed by the button labeled “Edit Patient” allows the user to edit any profile information for the patient
      • Please take note of an additional drop down – by selecting “Rejected” the users is able to view any patients refereed in error, possibly the incorrect specialty or simply the provider was not able to accept the patient
    • The Outgoing View is very similar, the only difference being that users are able to monitor patients they have referred out to other facilities all in an effort to stay abreast of patient progress

Patient Status Key

      • Pending:  Patients cert request have been transmitted to Cguros, and is currently being processed, patient won’t be pending for long
      • Conditional: Patients that have been denied for the procedure the members doctor felt required, but check the order notes, its possible the pre-certification requires a peer to peer review, or maybe the payor has suggested a slightly different procedure
      • Approved: Congratulations, patient have been approved, pre-certification & all relevant documentation can be found within the order
      • Denied: Patient has been denied, check oder notes, pre-certifications can be denied for a number of reasons – notes always provide clarification

Flagged Patients

Flagged Patients

Flagged Patients Need Immediate Action!

Stratus has integrated a Flagged Patient early warning system, we fully grasp the trials of communicating accurate computerized orders, our goal is to get each order to the appropriate destination as fast as possible.  Rather than being forced to play phone tag with other healthcare professionals all relevant parties to a particular order work from the same record.  Stratus works in the background to notify all privileged individuals in real time, as to the patients current pre-certification status along with any order notes that may keep an order from being approved or interpreted accurately.

    • Notice the Flagged Icon alert-circle-notification visible from the patient pipeline, working to notify the user at a glance of patients in need of immediate attention
      • A patient pre-certification request can be flagged for a number of reason, insufficient, or inaccurate information from the referral facility, the receiving facility might also flag an order in an effort to notify the referring facility a portion of the order are unclear, or missing
      • In selecting the patient that has been flagged, users will be able to view the reason the order was flagged (really for any number of reasons) and take the appropriate action to clear up any confusion.
        • Once the concern has been resolved, by simply selecting the button “Remove Flag” all parties will be notified appropriately
Submitting New Electronic Medical Orders

Build & Submit Electronic Orders

Users are able to submit electron order built from current CPT & ICD codes searchable via text or numeric value and communicate the referral to a facility of their choice in real time.  In an effort to provide an all inclusive accurate order free of holes the first time, uploading supporting documentation, along with any order notes are always suggested.

How To Navigate:

    1. First, search for the patient (reference tutorials for guidance) your interested in building a new order for
      1. If the patient does not have a record the user will need to add the patient as a New Patient 
      2. Select the appropriate patient from the Search Results, then select “Show Orders
    2. At this point the user will be able to see the history, including all pre-certification request previously made for that patient, select “New Order” button in the upper right hand corner
    3. Fill in the web form with appropriate order information
      • Insurance:  User needs to select the insurance company, for that patient, as it relates to the pre-certificaion request
      • Physician:  User must select the physician requesting the patient pre-certification
        • Users are able to only select from the physicians they have permission to request certs on behalf of
      • Procedure:  Standard CPT codes, searchable via numeric or textual description
        • Reference notes – “Use 00000 if Unknown” in the event a referral is being made to another healthcare practice and the procedure is unknown
        • Take note of the gear icon, uses as a quick reference guide for the user to select from CPT codes often used
      • Diagnosis:  Standard ICD codes, searchable via numeric or textual description
        • Take note of the gear icon, uses as a quick reference guide for the user to select from ICD codes often used
        • Users are able to select multiple diagnosis codes when appropriate
        • Reference notes – “Use 00000 if Unknown” in the event a referral is being made to another healthcare practice and the diagnosis is unknown
      • Referral Facility:
        • Existing Location:  Pick from a fellow facility currently also using Stratus
          • Take note of the gear icon, uses as a quick reference guide for the user to select from locations often used
        • Kept In House:  Select kept in house, in the event the patient pre-certification request is for internal (the users home facility) use
        • New Location:  Allows the user to denote the patient pre-certification request or patient referral to be made on behalf of a facility not currently leveraging the power of Stratus (not likely the case for long, a member of the team at Cguros will be contacting the facility shortly)
      • Notes Section:  Order notes could not be more critical, they let the receiving physician know whats going on, please include everything relevant to the order
        • PRE-CERTIFICATION REQUEST CAN’T BE COMPLETED & APPROVED WITHOUT EXPLICIT ORDER NOTES
          • Please include things like, is the patient a candidate for injections?
          • Has the patient competed physical therapy?
          • What is the physician looking to determine based on the results of the procedure, or imaging?
          • What is the patient symptoms and or complaints?
          • What are the findings of the physician, during the initial check up?
      • Pre-certificaion:  Users will notice check box, by default notice it remains checked
        • When selected:  Patient pre-certification will be attained & communicated
        • Bypassing:  Denotes the choice to communicate simply as an electronic order aka. referral without a pre-certificaion
      • Expedite Order:  When selected, Stratus works that much quicker to return a pre-certificaion authorization number
    4. Select “Save

Calendar View

Calendar View

Calendar Patient Precertification

 

Viewing Options:

  • Day:  Shows a single day view for all patients scheduled to be seen that day
  • Week:  Shows all patients scheduled that week
  • Month:  Shoes a one month view

 
 

  • Notice the “Green Check Icon” letting the user know at a glance not only has the patient been scheduled, but they have also confirmed the appointment via either text or email notification.  60% of patient referrals go unscheduled, Stratus works in the background to limit no-show appointments.
  • By selecting the icon to the left of the patients name, the user is immediately taken to a copy of that individual patients electronic order.
  • In Addition, by double clicking into the body of the event the user has the ability to leave any required scheduling notes (these notes are automatically saved back into the order)


Scheduling Portal

Patient Scheduling Interface

The Scheduling Interface Allows Users To Manage Patients At A Glance

  • By default users view the Scheduling Module from the Inbound perspectivenotice the drop down – used to edit the current view, between inbound and outbound
    • Inbound orders” are patients referred to your facility, AKA the healthcare facility you work at
    • The “Outgoing View” is very similar, the only difference being that users are able to monitor patients their home facility has referred out to other facilities all in an effort to stay abreast of patient progress
    • Notice in the first column you will find a number of patient names enabling the user to select a patient at a glance
      • For Further Action:
        • Selecting a patient followed by the button labeled “View Orders” enables the user to see all orders for that patient
        • Selecting a patient followed by the button labeled “New Order” empowers the user to begin building a new order for that patient
        • Selecting a patient followed by the button labeled “Edit Patient” allows the user to edit any profile information for the user
    • Please take note of an additional drop down, labels “Status
      • By selecting “Rejected” the users is able to view any patients refereed in error, possibly the incorrect specialty or simply the provider was not able to accept the patient
      • By choosing “Closed” users are able to see all closed orders
    • Within the menu users also have the opportunity to select specific dates to narrow down the search parameters in the event a particular patient is of interest
    • Choosing an oder followed by “Export PDF” will automatically force a notification to appear in the upper right corner of the screen housing a link within it, allowing the user to open a new tab within in browser populated by a downloadable copy of the patient order/ pre-certification.

Patient Status Key

  • Pending:  Patients cert request have been transmitted to Cguros, and is currently being processed, patient won’t be pending for long
  • Conditional: Patients that have been denied for the procedure the members doctor felt required, but check the order notes, its possible the pre-certification requires a peer to peer review, or maybe the payor has suggested a slightly different procedure
  • Approved: Congratulations, patient have been approved, pre-certification & all relevant documentation can be found within the order
  • Denied: Patient has been denied, check oder notes, pre-certifications can be denied for a number of reasons – notes always provide clarification
Reporting Analytics

Actionable Reporting Metrics

After all, you cant fix what your not aware of, the Cguros team strives to be able to provide clarity, in illuminating where referrals are currently coming from, and what percentage is approved vs denied we enable providers with the ability to make informed decisions in regards to the direction of their practice.  Ultimately elevating the bottom line, and reducing healthcare cost for all.

 

Pre-certification Report

number of patient precerts, build in reporting

Users are able to query the cloud, returning quantified results as to the number of pre-certifications or referrals requested, coupled with an accurate ratio of approved to denied procedures, ultimately promoting transparence.

 

Insurance Provider Analytics

pre-certification reporting insurance approval denial claims

Clear, vibrant analytics bring clarity to once elusive operating margins, being knowledgeable when it come to recognizing payers that your practice frequently struggles to receive a reimbursement from allows your practice to stay in touch with the bottom line.

 

Referring Facility Reporting

referring physician pre-certification report  facility

By leveraging the cloud, Stratus is able to provide real time actionable metrics, facilities are able to monitor who referred patients, overlaid with the current status of all patients  (i.e. – approved & denied).  Remember all reports are exportable.

Department Administrative Settings

Managing Departments Within A Facility

Administrators have full control over all facilities, we recognize each client footprint to be somewhat unique, as a result each client’s facilities can be broken down into a number of subsection.  All done in an effort to maintain security and HIPAA policy as they relate to permission levels for each individual user.

    • Account: Likely a large all in encompassing healthcare group
    • Facilities: An actual brick and mortar location within that group
    • Department: A sub level of the facility (Ex. Lung Cancer Department)

Edit Department Settings:

    1. Select “Administration” from the dashboard
      1. By selecting “New” facility administrators are able add facilities that form the footprint of their Account
      2. Administrators are also able to edit departments by selecting the appropriate “Department” (by clicking on it) then selecting “Manage” (from the above menu) which allows the user to add, edit, and delete departments that form that facility as needed
      3. To Delete a department simply select that line item, followed by clicking “Delete
Facility Administrative Settings

Administrator Facility Settings

Administrators have full control over all facilities, we recognize each client geographical layout is somewhat unique, as a result each client’s footprint can be broken down to each subsection.

Account:
Likely a large all in encompassing healthcare group
Facilities:
An actual brick and mortar location within that group
Department:
A sub level of the facility (Ex. Lung Cancer Department)

To Configure Facility Settings:

    1. Select “Administration” from the dashboard
      1. By selecting “New” facility administrators are able add facilities that form the footprint of their Account
      2. Administrators are also able to edit departments by selecting the appropriate “Department” (by clicking on it) then selecting “Manage” (from the above menu) which allows the user to add, edit, and delete departments that form that facility as needed
      3. To Delete a department simply select that line item, followed by clicking “Delete

Templates Builder

Administrative level users are able to alter any one of the notifications used to communicate updates with facility staff or with patient in regards to appointment times

Scheduling Email Template
Scheduling Text Message Template
New Account User Welcome Email Template
Scheduling Changes Email Template
Scheduling Changes Text Message Template
Nurse or PA Assigned To A Physician Email Template

Message Content

By making a selection from any of the canned data fields (available via the drop down) users are able to build and communicate personal messages that include the patients name, and appointment location for example.

Patient Name
Patient Email Address
Patient Cell Phone Number
Patient Home Phone Number
Patient Full Name
Physicians Name
Patient Preferred Contact
Facility Name
Schedule Start Time
Schedule End Time
Schedule Location
Schedule Confirmation Code
Facility Name
Facility Department
Facility Address Line 1
Facility City, Zip, State

Frequency Settings

Immediately upon scheduling the patient for an appointment a text/email message is delivered to the patients mobile device, ultimately working to limit no show appointments.  The team at Cguros recommends sending an additional notification about 3 days out, allowing the patient to save the event to their personal calendar.

Day Of Appointment
3 Days Out From Appointment
6 Days Out From Appointment
1 Day Out From Appointment
4 Days Out From Appointment
7 Days Out From Appointment
2 Days Out From Appointment
5 Days Out From Appointment

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