DNA Feature Enhancement

There is now a new option in ‘Financial Settings’ to ‘Limit not attended sessions’ which will be explained in more detail later, however, it may be useful to give you an overview of the existing DNA feature to help understand how it all works.

Have you ever waited for a patient that has not attended one or more sessions? Users can now define charge codes specifically for “Not Attended” sessions or billings. To create Not Attended charge codes, in the Charges menu, you need to click on the Codes tab/New and select Not Attended in the drop down box for Type as shown below:

You can also edit existing charge codes if you have already defined codes specific for not attended billings. This feature can be used in combination with the Limitation feature so you can have billings that are both marked as not attended and are also limited for a period of time. As an example, you may choose to limit up to 3 not attended billings (codes) for a period of 12 months. These settings are also used for the reports detailed below.

Some IINSIGHT users intend to decrease the number of not attended sessions. Trying to look at billing by billing and then identifying common characteristics in these not attended sessions might be an extremely time consuming task. In order to help users find where to diminish the not attended rates, a new report has been added to IINSIGHT showing not attended rates optionally per Bill To, Service Contract or Referrer as examples.

This new report shows the numbers of attended billings and not attended billings within a given date range and calculates the not attended rate. With this report, users can see from which aspects they will need to implement a strategy to reduce not attended rates.

The report displays data including:

Then, when you have the required permission, please go to the Reports Menu/Non-Attendance Report to select the required criteria:

Please see below a screenshot example after the Non-Attendance Report is built:

The attendance calculation is performed using the attendance charge code setting. Before running this report for the first time, iinsight administrators need to set up this setting in charges/charge code table as shown earlier. National Average: the total number of cases for each outcome in the database is divided by the total number of closed cases in the database. The only filter used for the national average calculation is date range.
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There is a saying in management that states “what is not measured is not managed”. To help administrators to easily measure successful outcome rates and seek performance improvements, a new report is built. As an example, a report showing “Service Contract” performance will look like the following:

Please see the below example of a Case Outcome Report showing the “Service Contract” status:

In the above example, “Service Contract” is used as a “Grouping field” so all cases that have a specific Service Contract will be grouped per row and then calculations are applied for each group. In this example, 20% of closed cases for “NSW: Insurance Co ABC” have “Work completed” as outcome.

Outcome Settings

The case outcome report is based on closed cases only. The colour scheme to be used when showing data in the report depends on the “success” status of the outcome. As an example, 1% “Return to Work” rate is a bad thing (should be highlighted red) but 1% permanent disability might be green. For the colour scheme to work, some steps need to be followed.

In the Options Menu/Common Lists Tab/Outcome Status:

In the Options Menu/Common Lists Tab/Outcome/Outcome Status list, success for each outcome needs to be mapped as per below example:

To access the new Case Outcome Report, you require permission in Admin/Manage Users/User View tab as shown below:

Then when you have the required permission, please go the Reports Menu/Case Outcome Report to select the required criteria:

Please see below a screenshot example after the Case Outcome Report is built:

There is also a bar chart available:

Setting up Outcome Reports

There are 3 entries that need to be populated to ensure the reports function correctly:

They can all be accessed from the Options menu, Common Lists tab. The first two fields are then mapped to the Outcome field.

Closure Status Option

Under the list type, select “Closure Status Option”. Add, edit or delete the closure status descriptions to achieve the headings that should appear in the report.

The Outcome Status

This field defines whether the outcome is a “success” and the report will display a 100% status. If “unsuccessful” the rate is 0%.

Setting up the Outcome

Ensure that the list of entries in the Outcome tab are complete. Then add, delete and/or edit entries as required. Note that you can also set up the Outcome to be:

An entry for Outcome will be required when the case is closed

Other Outcome options

Specific Outcome rules can also be set up via the Charges menu that apply only for one Service Level Contract. These are defined in the Charges menu.

The second step is to add/delete or edit the entries for each contract if needed via the Templates tab and the Outcomes sub-tab.

You may need to check the Force Outcome Rules option in the Charges Menu (Selected Service Contract) /Options tab as below:

If you then stay in the Charges Menu for the same service contract and click on the Templates Tab and then the Outcomes tab as per the below screenshot (highlighted with the arrows), the outcome list is specific for that Service contract and a reduced list from the full list in the Options menu/Outcomes, if you need to add any more outcomes for this particular Service Contract you can click Add as shown below:

Please note: Before you can use Case Outcome Reports they must be configured as shown above and will only work for Closed Cases (as this is a report on the outcome and not the current status)

Following the overview of the existing DNA feature it is applicable to now show you the latest DNA feature enhancement which is already live:

In the Options menu/Financial Settings Tab there is an option to enforce the ‘Limitation of not attended sessions’ globally to the number of Sessions within a given period of time, for example 3 sessions per year as per the below example:

The limitation is applied to all cases that share the same claim number, therefore, the limitation is enforced per claim. In cases that do not have a claim number, the limitation is applied to the case only.