36C10X19Q0200-016.pptx

Use of Peer Review Tracking System

February 22, 2019

Comprehensive training manual, including screen shots and text directions for SOP for vendor role.

Vendor February 22, 2019

Any contracted VENDOR should use this section.

Landing Page https://vaww.oqsv.med.va.gov/functions/mindfulness/rm/pr/default.aspx

The landing page is the entry portal to the Peer Review Tracking System.

To access this page, you must be behind the VA Firewall (Logged into the VA system via PIV card) https://vaww.oqsv.med.va.gov/functions/mindfulness/rm/pr/default.aspx

AS this system is role based, every individual user should see their log in information after the “browsing as” line on the right half of the page in the Security Acknowledgement box.

You must agree to these terms in order to enter the portal. You do this by clicking on “I agree”.

Peer Review Dashboard

After selecting “I Agree” the next page is the Dashboard.

This page has an icon of tools, and a blue lower case i for information.

On the table there are two tabs. One for pending cases (tasks), and one for active cases.

There is a blue circular arrow “refresh” button in the upper right corner. This refreshes the task list.

In this photo, it shows available tasks for AUD (Audit Cases) and FRR (Facility Requested Review) cases.

The number in the count column, reflects the amount of cases in each task area.

If you click on the Hyperlinks named “AUD Cases Requiring Reviewer Assignment” or “FRR Cases Requiring Reviewer Assignment” you will be re-directed to the “Assign Reviewers to Cases” screen, but only for that type of review selected.

Tools Icon

Information Icon

If you hover over the Tools Icon, two options exist. Manage Reviewers and Assign Reviewers to Cases.

If you hover over the Information Icon, this re-directs you to a page that gives the system version, a summary of the data system, security information, and links to supporting documents. These documents include trainings and source material for all user roles.

Manage Reviewers

There are three icons on the top. The House Icon, will Return you to the dashboard.

The Tool Icon is the same as it was before: Manage Reviewers and Assign Reviewers to Cases.

The Information Icon is the same as it was before, directing you to an information page.

This is where you can add, modify, or inactivate reviewer. You are also able to insert specific date ranges where a reviewer may not be available. (i.e. Vacation, Leave of Absence, Studying for Boards, etc)

Reviewer Management - Details

When you click on a name on the Left, A second table will expand at the top of the page.

This table has “details”, “specialties” and “non-availability” as options.

On the details tab, is a place for reviewer demographics. First and Last Names are required elements.

The status of the reviewer must be “active” in order for a case to be assigned to them.

If the reviewer is not eligible to take a case, or has resigned, this should be marked Inactive.

Then Click Save, and go to the specialties tab.

Reviewer Management - Specialties

Select the specialty on the right and click the top button to move it to the list of specialties assigned to the reviewer named in the details tab.

You may add as many specialties as needed to accurately represent the types of cases the reviewer is appropriate to review.

For MD/DO, list the specialties for which they are board certified.

For NPs and PAs, list the specialties they have experience in and are able to review.

For RNs, select Nursing.

To unselect a specialty, click specialty on left, and click the bottom button.

Specialty Holds

If you need to put a hold on one of the assigned specialties, Click the icon to the right of the assigned specialty. Fill out the dates as requested and click save. It will show up on the assigned specialty for the assigned provider.

This is optional.

Reviewer Management – Non Availability

On this screen, if chosen to be used, a reviewer’s availability can be altered.

If a reviewer is taking any sort of leave, you may click on the “add” button. That will create a pop up.

This popup contains calendar options for you to select the dates and give a reason for unavailability. A reason is required.

When the dates arrive, the users status will be marked “Unavailable” until after the end date passes.

Assign Reviewers to Cases

Selecting this from the tools icon combines all case types into one area.

You can search for a case by name in the case list.

Once you have found your case, click on its name to highlight it in gray.

Then select the reviewer from the list on the right. If it is a longer list, you may search by reviewer name. Select the name, and it will highlight it in gray.

Then, click the “Assign” button. The case will be removed from the list.

If the provider is not listed in the list on the right, be sure that the specialty assigned to the case is listed under that provider’s approved specialties in the Reviewer Management tab.

As reviewers are assigned, the number of “pending cases” on the Peer Review Dashboard should decrease.

The “Decline” button, is to refuse a case before a reviewer is assigned to it. This should be used if you do not have a reviewer in the assigned specialty.

Active Cases

The Tools Icon contains the same options.

The information icon contains the same options.

The Active Cases include all cases that are ready for work to occur.

The Lists are filterable by time period (marked by Fiscal Year and Quarter), then VISN, then Facility, or, a text search is available.

The Lists are also sortable by any of the column titles with the exception of status.

If you click on a case, a second page opens. On the top of the page is the type of review, and then all the case details. This is the Case Management Page.

Case Management

Case Management

The Case management screen shows the type of review, the status of the review, and all the case details.

The Orange Banner will describe where the case is in the process.

Below the Supplemental Materials line, would be all the PHI/PII of the case.

Case Management Part 2

All of these headers will have real patient data. It has been cleared for the purpose of this training guide.

Case Management Options

The first two options you have on a new case are to “Assign a Reviewer” or to “Request Supplemental Materials”.

If you select “assign reviewer” a modified “Assign Reviewer” screen pops up. You Select the Reviewer’s Name and then click Assign.

If you select “Request Supplemental Materials, you are able to describe the materials you would like, and then click submit.

This notifies VACO RM to ask for additional supplemental materials.

At any point after the request for supplemental materials, you are able to assign a reviewer.

Case Management Options 2

After a Reviewer has been Assigned, a notification is sent to VACO RM to assign the case in Community Viewer (or similar system).

While the case is awaiting assignment in CV, no options are available. There is no item in the drop down.

Once the case has been assigned in CV, a message will be sent to the VENDOR user role.

Then 4 options will appear.

Reviewer Refused – Assign new = This means that the particular reviewer originally selected, is not able to perform the review, but there is another reviewer on the panel that may be able to perform the review.

Reviewer Refused – Decline Case = This means that the particular reviewer originally selected, is not able to perform the review and there is NOT another reviewer on the panel that may be able to perform the review, so VENDOR is denying the case.

Submit Case to VACO – The Reviewer has completed the case, and it is now time to submit the case to VACO RM.

Request Supplemental Materials – The Reviewer has identified additional items needed to adequately perform the review.

Case Management Options 3 Case Refusal

If a Case is refused: one of these two boxes will appear.

The box on the left is for a reviewer refusing the case, but there is another reviewer who could be assigned.

Put in the date, and list why the reviewer refused. Comments are required. Then select Decline.

This will notify VACO RM that the case has been declined.

The box on the right is for when a reviewer has refused the case and there is NOT another reviewer available.

Put in the date, and list why the reviewer declined AND why you are unable to assign another reviewer. Then select Decline.

This will notify VACO RM that the case has been declined.

VACO RM will assess these reasons, and either concur or reject the refusal.

A message will be sent to VENDOR with that information.

The case banner will also reflect these decisions.

If VACO rejected the refusal, case will return to VENDOR task list, for vendor to assign a reviewer.

If VACO accepts the refusal, the case is no longer active. A new case, if available, will be assigned and waiting in the VENDOR task list.

Case Management Options 3 Submit Case

When submitting a case, Select what Level of Care was given by the Reviewer (1, 2, or 3).

Enter any notes that may be relevant for VACO RM to know. (optional)

Click Submit.

A message is generated to the VACO RM RNs.

The case status changes to “Awaiting Acceptance” .

VACO RM may accept the case, making it eligible for invoice.

VACO RM may reject the case, outlining the reason for rejection. (i.e., corrections)

If the case is rejected, notification will be sent to VENDOR. VENDOR will have opportunity to re-submit case, using the above process.

The ribbon will state: The case has been submitted and approved by VACO; no additional action can be taken.

Final Thoughts & Reminders You will only receive an email if you are in the role that receives emails.

If you think there is an error, send a help desk ticket to the Peer Review Helpdesk. (Link is on bottom of page)

Emails every day at 7am ET image2.png image3.PNG image4.png image5.png image6.png image7.png image8.png image9.png image10.png image11.png image12.png image13.png image14.png image15.png image16.png image17.png image18.png image19.png image20.png image21.png image22.png image23.png image24.png image25.png image26.png