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Volume 4, Issue 45 | October 3, 2023
Highlights of Outreach and Collaborative Efforts of the
Beneficiary and Family Centered Care - Quality Improvement Organization (BFCC-QIO)
The Livanta Compass. Supporting patients and families in their healthcare journey.
Look Inside Livanta: A Changing Landscape, Part 5 of 5
Livanta Rises to Meet the Challenge
Recent installments of this year’s Look Inside Livanta series have explored several possible factors contributing to the recent increases in call and case volumes. For example, the public health policies enacted in 2020 to mitigate the spread of the COVID-19 virus changed how healthcare providers delivered patient care—policies that positively and negatively affected countless lives due to waiving certain requirements or implementing infection control procedures. Numerous challenges during the pandemic, such as rapidly changing local conditions, isolation procedures, and travel restrictions, led to significant increases in requests for immediate advocacy, discharge and service termination appeal requests, and quality of care complaints.

Even while COVID-19 cases have decreased over time, Medicare’s population has continued to grow, information continues to be available at the click of a button, and Medicare Advantage (MA) Plan enrollment continues to grow by leaps and bounds. Data from Livanta’s 2022 Annual Medical Review Services Reports show that call and case volumes have remained significantly higher than in previous years, owing to the pandemic and these other recent trends.

Consider the following statistics derived from Livanta’s 2019 and 2022 Annual Medical Review Services Reports (2019 figures listed below were calculated using a formula to annualize the case counts).

In 2019:
  • Livanta conducted reviews on 158,000 beneficiary appeals.
  • The volume of beneficiary complaints reached just over 900.
  • Livanta’s immediate advocacy program logged nearly 3,000 cases.

In 2022:
  • Livanta’s beneficiary appeals cases exceeded 200,000.
  • The volume of beneficiary complaints to Livanta neared 1,800.
  • Livanta’s immediate advocacy program completed 7,770 cases.

Despite the increasing volume of work—which, as noted throughout this Compass series, has been higher than projected and higher than ever before seen in the history of the QIO Program—Livanta’s dedicated staff apply themselves diligently to meet these new challenges and ensure that Medicare beneficiaries and their family members, caregivers, and other representatives can call Livanta’s Medicare Helpline and receive needed assistance.

This week’s Compass issue is dedicated to Livanta’s call center staff and details Livanta’s proactive response to Medicare beneficiaries’ ever-changing needs.
Livanta’s Call Center – the Heartbeat of the Organization
diverse call center employees looking at computers
It may seem strange that in 2023, when everything from car alarms to bug zappers can be ordered and delivered with minimal human interaction, a fully staffed call center would remain at the heart of the Beneficiary and Family Centered Care - Quality Improvement Organization (BFCC-QIO). However, something as simple as a single phone call can make the difference between a full recovery from a severe or traumatic illness and a potential relapse or readmission. When a Medicare beneficiary or caregiver calls Livanta’s BFCC-QIO Helpline, the next step of their healthcare journey often hangs in the balance.

Livanta’s call center staff are the front line of every case review conducted by Livanta, and these dedicated professionals are poised to make a difference in the lives of hundreds of thousands of people each year. Call center staff maintain a wealth of knowledge to educate the caller about the BFCC-QIO’s purpose, route their call to the appropriate department, or provide additional resources to address concerns outside of Livanta’s core services. Call center staff receive specialized training to help them understand the perspectives of Medicare beneficiaries, their families, and other representatives.

Improving the patient and caregiver experience is a goal and a corporate value at Livanta. Call center staff receive in-depth training on active listening and empathy during their new hire orientation and onboarding at Livanta. Additionally, training and coaching sessions are conducted year-round to ensure all staff demonstrate excellence in customer service. Moreover, call center staff are cross-trained to complete a variety of functions to maximize the organization’s flexibility when needed.
Strategies to Meet Rising Call Volumes
Livanta’s call center leadership has incorporated several strategies to maintain stellar performance despite unprecedented case and call volumes. For example, Livanta’s customer service culture is described during the new hire interview process, and emphasis is placed on hiring candidates based on organizational fit. Additionally, call center managers and supervisors routinely monitor and adjust staffing and scheduling to ensure an adequate response to daily call volumes.

Perhaps most importantly, Livanta’s call center supports and promotes a positive workplace culture—one that encourages staff and helps them understand the successes and strains on the systems that are required to maintain BFCC-QIO operations. In fact, staff are routinely consulted and provide input related to improvements in Livanta’s procedures and systems.

Livanta’s call center leadership team also cites enhancements within CompassWeb, Livanta’s proprietary case review system, in helping call center staff complete their work more efficiently. For example, Livanta’s IT department has added an application that quickly confirms a Medicare beneficiary’s eligibility status. Other CompassWeb enhancements developed by Livanta’s innovative IT group are described below. 
The Responsiveness of Livanta’s IT Department
With the exponential increase in case volumes in recent years, Livanta’s call center also notes dramatic increases in inbound calls. Because of this significant growth, Livanta’s development team has sought efficiencies while protecting patient rights and providing first-rate customer service. Read on for examples of these innovations. With these enhancements to CompassWeb, Livanta simultaneously reduced provider burden and achieved system-wide quality improvement through its innovative technical solutions.

Automated Notification of Determination (AND) By 2022, Livanta launched a process to notify healthcare providers of Medicare beneficiary appeals outcomes via an automated facsimile process. This process, called Automated Notification of Determination (AND), decreases the volume of outbound calls, as healthcare providers receive information via fax instead of manual phone calls. With AND, Livanta’s staff can take incoming calls more quickly and spend more time assisting Medicare beneficiaries with their needs. Auto-faxing appeal notifications has allowed Livanta to counter efficiently the increasing case volumes, using a novel approach that automates a routine case review function. Providers can still speak directly to one of Livanta’s patient service coordinators or review coordinators when needed. However, most of the time, the faxed notification is sufficient to convey the needed information.

electronic Livanta File Transfer (e-LiFT) portal – In years past, medical record transmission was highly labor-intensive, often requiring providers to spend hours printing and faxing hundreds or thousands of pages of medical documentation. To assist providers with compliance with an October 2020 Final Rule requiring electronic submission of medical records to the BFCC-QIO, Livanta’s IT group worked around the clock to ensure that new supportive systems were in place. In a matter of days, Livanta developed and launched its e-LiFT portal, a dedicated medical records upload platform, on the Livanta website. This provider-focused web application enables healthcare organizations and individual practitioners to transmit medical records securely and rapidly to Livanta for review. The e-LiFT portal can accept PDF files from all types of electronic medical record (EMR) systems. If needed, providers may still submit medical record files via fax or postal mail. 
Livanta’s Performance Dashboard
Medicare BFCC-QIOs play a unique role in patient experience and patient satisfaction, and through its case review activities, Livanta is deeply rooted in the Medicare quality infrastructure. To express its commitment to excellence in customer service and transparency, Livanta created a BFCC-QIO Performance Dashboard. This dashboard displays customer feedback data from Medicare beneficiaries, their family members, and other caregivers who have participated in a telephone interaction with Livanta staff. The dashboard contains additional metrics, including call volume, wait times, case counts, and other BFCC-QIO indicators.

To capture the caller’s real-time satisfaction and experience feedback, Livanta’s Medicare Helpline contains a feature that allows individuals to share their experiences at the end of the phone call. Callers can rate their satisfaction with Livanta’s BFCC-QIO Program using their telephone keypad. This customer feedback process allows individuals to rate their interactions with Livanta staff and processes. Using the feature, Medicare beneficiaries or their representatives can also escalate a customer service concern and speak directly to a manager if they are unsatisfied with their interaction. Livanta implemented its automated customer feedback system in 2016, and it is an integral part of the organization’s internal quality management system.

To view Livanta’s BFCC-QIO Performance Dashboard, click here or go to the following link: https://LivantaQIO.com/en/About/Dashboard
Livanta’s Annual Medical Review Services Reports 
Livanta hopes you have enjoyed this special five-part Look Inside Livanta series. Should you have feedback or questions, please email Communications@Livanta.com.

Have you seen Livanta’s 2022 Annual Medical Review Services Reports? Click the links below to download the files.

Region 2

Region 3

Region 5

Region 7

Region 9
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12-SOW-MD-2023-QIOBFCC-CP302