Account Support Ticket SOP

Account Support Ticket SOP

1          Purpose/Background

This Standard Operating Procedure (SOP) provides the general requirements to notify PMB/ HPI Ops Consultant or Account Managers of any account item that requires an operations consultant to work with provider/ practice to correct. Ticket reasons could consist of, but is not limited to; coding issues, rejections, credentialing denials, payer logins, patient balance disputes, patient refund requests, etc.

2          Overview:

This process will utilize Hubspot to notify the operations consultant or account manager of issues, allow for tracking of actions and resolution and also close the loop with the customer and all affected departments. The ticket will also allow for the Ops consultants to communicate direct with practice via email &  logged calls for documentation.

3          Process:

Once an issue is identified and assistance is needed you will proceed to 3.1

3.1      Create Hubspot Ticket

From Company record (use parent company unless child company is the one affected)

• click + Add Ticket.

• Ticket Name: Support + Issue (be brief, for example: Support- Modifier GW)

• Pipeline: Account Support Pipeline

• Ticket Status- allow default “1-Submitted” do not edit

• Ticket Type: Billing Issue

• Ticket Description: provide detailed information on what the issue is that you have identified, any supporting documents (use ID only do NOT attach PHI to Hubspot), recommendations, etc.

• Source: Leave blank

• Ticket owner: Creator is the owner throughout the life of the ticket. You own resolution

• Assignment: Account manager name OR Ops Consultant

  • whomever is listed in the “Assignment” field will then need to create a task for work to be done:

    • Tasks should be created for:

      • functional managers to do work or

      • patient relations manager, etc.

• Priority: select appropriate

  • Consultant and account manager (initial priority)= LOW (Usually always the starting priority)

  • Escalate ticket to Manager= MEDIUM

• Associated Company

Escalate ticket to Director & VP of Client Success= HIGH

• Click Create

3.1.1     Ticket Assignment and Follow up

1. Support Type: Must be marked within the ticket by selecting the most appropriate type of issue (used in reporting) below are the options (select multiple if needed).

   1. Charge Issue

   2. Payment Issue

   3. Insurance AR Issue

   4. Patient AR Issue

   5. Coding Issue

   6. Other Issue

2. Due Date: select the date allowing 3 days to work and resolve. If date needs to be updated to allow time for all updates, work, Etc. to be completed you should meet with AM/ Ops Consultant to agree upon due date.

3. Assignment: The ticket creator will list the ops consultant or account manager in this field. (when this is done an automated email is sent to that individual notifying them of ticket assignment)

   1. The assigned user in “Assignment” field will then create tasks for functional managers.

   2. Action Items- mark the action item complete to acknowledge receipt of ticket/ assignment.

      1. check box ‘Intake Meeting with internal teams’ under the ‘Account Support Actions’ drop-down list (displayed on the left pane, right above due date). This moves your ticket status from ‘Submitted’ status to ‘In Progress’ .

      2. AM or ops consultant who is assigned to the ticket MUST ensure there is understanding of what needs to be done and do the following:

         1. mark action item “intake meeting with internal teams” to move the ticket to an intake status

         2. create tasks for functional managers/ teams to begin working

      3. Functional Managers- once you have picked up the task and have begun working the ticket please mark action item in ticket “Work in Progress” to update ticket status to in progress.

         1. Note: don't forget to also notate your task accordingly. Date and Initials are required for all task notes.

4. Ticket follow up: Contact between the account manager/ Ops Consultant and all functional managers or task assignee's should be done within the appropriate ticket (recommended: updates should be done using task notes whenever possible).

   1. you can tag some by using @ and username

   2. you can log an email if needed.

   3. or you can log a call if needed

   4. task update should be noted in the task related to the work being done

      1. Reminder: task notes must contain Date and Initials.

5. Communication with practice (by Ops consultant):

   1. Action Pan: If multiple actions / billing issues need attention, it is recommended to add to or create a Corrective Action Plan - template found in the At Risk SOP

      1. Contact to practice for any issues affecting revenue on the account is required.

      2. You can add the practice main contact to the ticket in order to email customer with updates, action plans, etc.

      3. Log any calls with customer and/ or internal staff and add all details

      4. Log emails not sent via Hubspot (if NO PHI emails should go out of Hubspot)

3.1.2 Tasking In Hubspot

Please visit Hubspot Tasking for help on creating and managing tasks.

Tickets can have multiple tasks.

4.0 Action Items

1. Intake meeting with internal teams- marked by assignment users to indicate they have received ticket and tasks are being created.
   
   
2. Work In Progress- marked by functional managers once tasks have been picked up and work has begun.
3. Added to agenda for next client meeting- (Optional)- Depending on issue at hand, you may or may not need to communicate with the client. If you feel its warranted to discuss with your customer, and you have communicated any issue identified to the practice or added to next meeting agenda/ action plan you should check this.
4. Review status of issue- This is where the reminder task to review status is documented and completed. Review notes in tasks and ensure ticket is progressing as it should.
5. Resolution Communicated- once the tasks are completed you should also communicate any resolution to the practice in completed action plan , upcoming meeting, email update or phone meeting then mark this action.

6. 1. at this point you will also need to mark ‘Resolution’ YES.

4.1 Ticket Progression