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Linda Bosque Office of the Medicare Ombudsman

2. Overview of Changes. This is a MAJOR release and screens will look much different to you

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Linda Bosque Office of the Medicare Ombudsman

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    1. 1 Linda Bosque Office of the Medicare Ombudsman Complaints Tracking Module (CTM) April 3, 2009 Release Plan User Updates

    2. 2 Overview of Changes This is a MAJOR release and screens will look much different to you – best way to learn this is to get in and USE it! No functionality has been taken away, although many methods of navigating through the system have been consolidated or streamlined Download and upload file layouts have changed Many new abilities have been added that you are sure to LOVE!

    3. 3 Today’s Discussion Hope to cover all the changes by highlighting the following: Changes to CTM Start Page Viewing and Editing Complaints Reports Downloading Complaints Uploading Complaints Plan CTM SOP Changes Where to turn for help

    4. 4 Changes to CTM Start Page When selecting Monitoring and then Complaints Tracking from the HPMS Start Page, you will be presented with modified options

    5. 5 Viewing and Editing Complaints The Plan Resolution Entry has gone away to be replaced by either My Open Complaints or Search Complaints screens All Plan Casework can be done via these pages View and edit is available on both pages – no longer two distinct buttons – the complaint is accessible by clicking on the Complaint ID My Open Complaints navigational paths have changed Search Complaints allows many more options for searching for complaints

    6. 6 Viewing and Editing Complaints There are 5 new tabs on the Casework Page Complaint Information (default at open) Plan Request Complaint History (view only) Complaint Resolution Print to PDF – allows users to print all tabs and sections! Each tab is arranged into one or more sections which can be expanded or collapsed as needed ! TIP – when first getting used to the changes, click on Expand All until you’re used to where everything is

    7. 7 Viewing and Editing Complaints

    8. 8 Viewing and Editing Complaints To resolve a complaint (old “Plan Resolution Entry”): Click on the “Complaint Resolution” tab and enter a new “Casework Note” entry “Comments” replaces “Notes to Plan” for CMS Users and now provides Plans with a vehicle to send comments back to CMS Indicate whether a complaint has been referred to CMS’ Retro-Processing Contractor (RPC) for final resolution Immediate Need cases with the RPC information populated will not count against a Plan in performance metrics IF the immediacy/access to care issue has been resolved

    9. 9 Viewing and Editing Complaints

    10. 10 Viewing and Editing Complaints To enter a “Plan Request”: Click on the “Plan Request” tab and select/enter the appropriate information Contract reassignment CMS Issue Category/subcategory assignment Issue Level No more reassignment between MA/Part D program types Program type assigned systematically according to complaint subcategory selected Subcategories presented for selection are determined based by the contract entered

    11. 11 Reports The following reports are available: Plan Aging Report (unchanged) Marketing Misrepresentation Report Now sortable by column Repeat Complainant Report (NEW) Can be run by HICN or Beneficiary Name Can limit by Timeframe, Contract, or State Will show the number of complaints that fall under the Open, Closed and Total complaint categories by beneficiary Each number is a link to more detail – when a number is clicked, you will get the “Repeat Complainant Report Detail” All are now downloadable to Excel

    12. 12 Downloading Complaints File Record Layout has changed (after Issue Level Description field)

    13. 13 Downloading Complaints

    14. 14 Uploading Casework File Record Layout has changed

    15. 15 CTM SOP Changes Assignment/reassignment date reset scenarios: Complaint is re-opened Issue Level is changed from a non-Issue Level to Urgent or Immediate Need Issue Level is changed from Urgent to Immediate Need CMS Issue flag is set or removed Contract Number is changed/Plan Request to change Contract Number is accepted or denied

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    21. 21 Where to Go for Help Technical issues and questions, and general questions should be referred to your Lead Caseworker Lead Caseworkers will forward topics they cannot address to the CTM mailbox (CTM@cms.hhs.gov) If the topic cannot be addressed by those reviewing the CTM mailbox, the HPMS/CTM team will have technical resources available to the mailbox team to get answers Questions/comments regarding the CTM SOP should be sent to Linda Bosque (linda.bosque@cms.hhs.gov)

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