They are changing things so often, I don't know what to say any longer and there are more call audits now that they have a team of people doing them. They dissect every word that comes out of your mouth. They don't want you to be to personal but then they don't want you getting into the surveys too quick either. Why can't they let us be people and speak with our members. They will find something wrong with every call you make.
5 replies (most recent on top)
I do feel that a lot of the changes are the result of manangment needing to justify their existence. When I was a head nurse in the hospital...I had 24 hour accountability and was in charge of 50 nurses. Not sure what the coaches do with all their time when they are only accountable for 12-17. And is what they are doing, really providing a better experience for members directly or indirectly. I have to shake my head at some of their stumbling. Remember a couple years ago when management told us that RN's no longer needed licenses in the states that they coached . So I think most of us are trying to do what is the "next best thing" ....but for some of us who have been around for awhile, we know that the next best thing is not always the "best thing" .......but we are never asked for input. Look at the expense, bad publicity, bad relations, high turnover, etc this has all caused because management wanted to make some misguided changes. Looking forward to the next MF mtg.
Actually, it's a 180.... that's the opposite...360 is where you are
Yes, you are correct. Four or five years ago we were told to get to know our members. Things like the deceased wife's name, anniversary dates, dog's names. we were advised to chart all this in the considerations section so each time we call the member we can work this in the conversations. There was no emphasis on metrics when I started as long as we "flipped the phones" and got 100% contact attempts per month. Then things changed and we were to have a success rate of 70% and 100% attempts. Then things changed...basically things change. This is health care. Things will change all the time. SNP is guided by CMS so there is a specific reason we are being told to do things, like state a disclaimer word for word. CMS guidelines change year to year, so what we did four years ago is no longer acceptable now. We were told this in orientation: "get ready for change." We were told the process will change constantly and to be successful we will have to adjust. Life is also about change. I hated losing my four 10 hr shifts. I hated working Saturdays for the BIA gap project during the holidays a couple years ago. I hate 2.0. But this is the job we have to change. The call audits are to make sure we are following CMS guidelines. If we are audited and the call doesn't match what we chart, that affects reimbursement and the future of the company. I don't like auto dialer and that I don't have a relationship with my members anymore, but there is a reason we are being told to change and a reason for the call audits. SNP isn't the only program being audited. Hospitals, nursing homes, and home health all get audited. The only difference is we aren't face to face with patients here like in the hospital. Listening to calls is the only way to prove what is in the chart was actually ever done with the member. The reason for the call audits is to make sure everyone actually is working. Now everyone here may be honest in charting, but not everyone is, and that is the reason for the increased call auditing. Our team was told charting is not "member centric" and we can't use templates anymore. This is CMS. When we are told to conduct a call a certain way and it isn't done, there will be more audits. When documenting isn't done per policy, there will be more TQR. If everyone would just do what is asked of us, there wouldn't be so much auditing
Call audits have to find something wrong to justify their job and keep them relevant. We all hate it when we see one has been done .
It's because MF & his team don't know what the h__ they're doing.
I remember 4 years ago being told to Know Your Members. They went on to say , for example, if your member has a pet-know it's name & incorporate that into next conversations. LoL-management there does 360's ALL THE TIME cause they don't know what the h__ they're doing!