Real Time Alerts

The Authorization Expiring Real-Time Alert notifies the Payer that a Member Authorization is expiring within a set number of days.

Alerts are not generated for Members in a Discharged or Waiting status.

Payer users who need to access Authorization Expiring Real-Time Alerts in Admin, Alerts Management are required to have the View Authorization Expiring permission assigned to their Role in the Payer Portal under Admin > User Management > Roles and Role Assignments > expand Role > set Permissions for to Action.

To add an Authorization Expiring Alert:

1. From the Admin menu, select Alerts Management.

2. On the Alerts Management page, click Add Alert.

   

3. Complete the Add Alert page fields and click Save.

   

Field	Action
Alert Type	Select Authorization Expiring.
Alert Description	Type a description to help clarify the Alert Type.
Alert Priority	Select the priority of the alert.
Send Email Notification	When an action has generated an alert, a notification email is sent to the Users, Roles, Member Teams, and Coordinators specified in the Alert Assignment section. The notification email tells the recipient that an alert has been generated and provides a link to open the Alerts page in Communications.
Send Alert After Authorization Expires In	Set the number of days until the Authorization expires to generate the alert.
Member Team assigned to Member	Select to automatically alert the Member Team that is assigned to the Member when an alert is generated.
Coordinator assigned to Member	Select to automatically alert the Coordinator who is assigned to the Member when an alert is generated.
Roles	Select the roles assigned to the alert.
Member Teams	Select the member teams assigned to the alert.
Users	Select the users assigned to the alert.

When a Member changes plans, a new Payer can be designated. If the Provider hasn’t received timely notice of the change, the Member can be covered by a new plan and Payer while care is provided under an old and no longer authorized plan and Payer.

The Real-Time Alert for Member Change of Plan notifies the Payer of both incoming and outgoing Members. The alert for an outgoing Member includes basic information to identify the Member and the change date. The alert for an incoming member includes that same information, plus an Authorization History from the former Payer to help in setting up the Member in the new plan.

Both the former and the current Payer must be in the HHAeXchange system and must belong to the same Payer Group in order to receive Member Change of Plan alerts. Payer Groups are created and maintained by HHAeXchange.

Users in authorized roles can add, edit, and delete Real Time Alerts for Member Change of Plan.

To add a Member Change of Plan Alert:

1. From the Admin menu, select Alerts Management.

2. On the Alerts Management page, click Add Alert.

   

3. Complete the Add Alert page fields and click Save.

   

Field	Action
Alert Type	Select Member Change of Plan. Member Change of Plan is only available for Payers that belong to at least one Payer Group.
Alert Description	Type a description to help clarify the Alert Type.
Alert Priority	Select the priority of the alert.
Send Email Notification	When an action has generated an alert, a notification email is sent to the Users, Roles, Member Teams, and Coordinators specified in the Alert Assignment section. The notification email tells the recipient that an alert has been generated and provides a link to open the Alerts page in Communications.
Payer Group	Select a Payer Group. Only one Payer Group is allowed per Alert. If multiple Payer Groups must be alerted, multiple Alerts must be created; one for each Payer Group.
Notify Associated Providers When Member is Transferred Out	Select if Providers are to receive Member Change of Plan Alert notifications.
Member Team assigned to Member	Select to automatically alert the Member Team that is assigned to the Member when an alert is generated.
Coordinator assigned to Member	Select to automatically alert the Coordinator who is assigned to the Member when an alert is generated.
Roles	Select the roles assigned to the alert.
Member Teams	Select the member teams assigned to the alert.
Users	Select the users assigned to the alert.

Users in authorized roles can add, edit, and delete Real Time Alerts for Missed Visits.

To add a Missed Visit Alert:

1. From the Admin menu, select Alerts Management.

2. In the Alerts Management window, click Add Alert.

   

3. Complete the Add Alert window fields and click Save.

   

Field	Action
Alert Type	Select Missed Visits.
Alert Description	Type a description to help clarify the Alert Type.
Alert Priority	Select the priority of the alert.
Send Email Notification	When an action has generated an alert, a notification email is sent to the Users, Roles, Member Teams, and Coordinators specified in the Alert Assignment section. The notification email tells the recipient that an alert has been generated and provides a link to open the Alerts page in Communications.
Send Alert After	Set the number of consecutive missed visits that generates an alert.
Make Recurring	Select to re-trigger the alert after the number of consecutive missed visits is reached again. For example, if the alert is configured to trigger after every 3 consecutive missed visits, selecting Make Recurring will re-trigger the alert after 6/9/12/etc. missed visits. This will also add a recurring badge to the alert under the Date/Time column.
Service Codes	Select the service codes that describe the missed visits.
Age Range	Enter an age range to trigger the alert for Members within that range only.
Member Team assigned to member	Select to automatically alert the Member Team that is assigned to the Member when an alert is generated.
Coordinator assigned to Member	Select to automatically alert the Coordinator who is assigned to the Member when an alert is generated.
Roles	Select the roles assigned to the alert.
Member Teams	Select the Member Teams assigned to the alert.
Users	Select the Users assigned to the alert.

The No Active Authorization Real-Time Alert notifies the Payer that a Member who has not been Discharged has no Active Authorization.

The Alert can be generated after a set number of days has elapsed for Members that have never had an Authorization and for Members whose Authorizations have expired. Alerts are not generated for Members in a Discharged or Waiting status.

Users in authorized roles can add, edit, and delete Real Time Alerts for No Active Authorization.

To add a No Active Authorization Alert:

1. From the Admin menu, select Alerts Management.

2. On the Alerts Management page, click Add Alert.

   

3. Complete the Add Alert page fields and click Save.

   

Field	Action
Alert Type	Select No Active Authorization.
Alert Description	Type a description to help clarify the Alert Type.
Alert Priority	Select the priority of the alert.
Send Email Notification	When an action has generated an alert, a notification email is sent to the Users, Roles, Member Teams, and Coordinators specified in the Alert Assignment section. The notification email tells the recipient that an alert has been generated and provides a link to open the Alerts page in Communications.
Send Alert After	Set the number of days after No Active Authorization exists to generate the alert.
Member Team assigned to Member	Select to automatically alert the Member Team that is assigned to the Member when an alert is generated.
Coordinator assigned to Member	Select to automatically alert the Coordinator who is assigned to the Member when an alert is generated.
Roles	Select the roles assigned to the alert.
Member Teams	Select the member teams assigned to the alert.
Users	Select the users assigned to the alert.

To add a Placement Accepted Alert:

1. From the Admin menu, select Alerts Management.

2. On the Alerts Management page, click Add Alert.

   

3. Complete the Add Alert fields described below, and then click Save.

   Field	Action
   Alert Type	Select Placement Accepted.
   Alert Description	Type a description to help clarify the Alert Type.
   Alert Priority	Select the priority of the alert.
   Send Email Notification	When an action has generated an alert, a notification email is sent to the recipients specified in the Alert Assignment section. The notification email tells the recipient that an alert has been generated and provides a link to open the Alerts page in Communications.
   Member Team assigned to Member	Select to automatically alert the Member Team that is assigned to the Member when an alert is generated.
   Coordinator assigned to Member	Select to automatically alert the Coordinator who is assigned to the Member when an alert is generated.
   Requester of Placement	Select to automatically alert the user who sent the broadcast placement.
   Roles	Select to automatically alert the roles selected when the alert is generated.
   Member Teams	Select to automatically alert the member teams selected when the alert is generated.
   Users	Select to automatically alert the users selected when the alert is generated.