Another way they are removing need for HCMSS. That mailbox will cut in half my number of HCMSS tasks. They honestly weren't appropriate for HCMSS anyway, so finally practicing more appropriately. Can't say it looks good for the social workers though. Hate to see people's jobs being basically being eliminated
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4nag, I'm the one who made that comment. I didn't mean that was what made HCMSS relevant or not. Just pointing out that we were, at one point, instructed specifically to boost the numbers no matter what. We were given verbal coaching if we didn't meet a certain expectation of tasks numbers. I'm sorry if you thought I was bashing HCMSS or saying they were not relevant, that was not my intention.
Just a thought. in the last year the PHC's have been hit four times by a RIF, this time the RN's were also impacted by a RIF. Maybe there are no longer enough CM's (PHC/RN) to support that number of HCM-SS's.
I'm an hcmss and I have no idea how to respond to this thread....perhaps hcmss were made not as needed because tasks were because CMs didn't have the time to do their jobs? Because it made them relevant that someone would connect them to CS? There are so many responses to say, but can't even fathom where to start, but the idea that a CM needs to make an hcmss relevant? Coaches giving clear misdirection? I know many hcmss who have "educated " the CMS and PHCs about inappropriate tasks....you shouldn't task the queue for benefits questions, since hcmss doesn't have it, and you can connect them to CS...but the idea that hcmss were made relevant by the tasker either not having the time to do their job? That's a whole new level of passive hcmss bashing, not relevant? Its been a long week for us all, im hoping I misunderstood your posts, or what your coaches instructed you to do, because you all really missed the boat on how awesome of a team we could be together to meet the members needs
2 years ago as an HCM we were told to task HCMSS for everything. We questioned our coach about these instructions, specifically calling out that things she was telling us to send to them were not social work appropriate. She told us to use them for everything. Not to spend the time on those things ourselves, and not to send those members to customer service because they could call customer service themselves and would decide they didn't need us. Send them to HCMSS she said. I don't think people are saying they were tasking inapaproiate tasks as a way to dump on the HCMSS, but because we were told to do so to make tasks numbers higher which justified the need for HCMSS and the entire program. They looked at numbers only. Higher number means they could say we were doing more for those members.
I agree with @Q8ycqj5-3wnk. If you are not sending appropriate tasks to our HCMSS, then you should be notified. I would want someone to tell me and provide education/reason. Moving members to monitored means more survey completions prior to the move, ie: Comp Surveys, HEDIS, and any MDATS that are due now or overdue. I am a HCM RN who cannot take time to do all of the support calls for PAPs and Dual Eligibility now, so those are the ones I refer to HCMSS.
My coach told us to task the HCM SS as much as possible with general needs so they could stay relavent. Sorry thought we were helping. Love the HCM SS. You guys have helped many members
Essentially the higher ups have determined that a large portion of tasks being given to SS are inappropriate and they think if they can cut those out, then they can reevaluate how many SS the program needs overall.
Kind of sad that there is no accountability for those that posted they knew they were tasking inappropriately to the hcmss, and the higher ups confirmed that those taskers were tasking inappropriately....so, if hcmss were tasked appropriately, maybe they wouldn't have been laid off? Or the taskers educated on the appropriateness of tasks? Sad it's the public secret about how the hcmss were dumped on for things that weren't appropriate, just to save the tasker the short time it would've taken so they could move on to the next person.
If this was known and noticed, why didn't the higher ups address the taskers to use the queue correctly?
I talk to my coach privately often, she said that this is being pushed now as a way to trim what is being sent to the SS. Essentially the higher ups have determined that a large portion of tasks being given to SS are inappropriate and they think if they can cut those out, then they can reevaluate how many SS the program needs overall. That's why coaches are now being told to cascade this down to the nurses...and being told to present it like some new great benefit.
I agree. It was almost like a secret before. Your coach was supposed to send the email, I assume to make sure it was being used appropriately. But, I also agree that most of these kinds of issues are not appropriate for HCM SS task as they are customer service or claims issues. I have actually had success with this and had issues resolved for members that probably wouldn't have been otherwise without case manager support.
The things that are being moved are things better answered by claims, Hcmss is not claims or benefits, it helps the member get where they need to go quicker
Interesting that it has been around for years and is just now being pushed on HCMs. An email was sent in September and coaches are now educating HCMs on this. Sounds like they are looking for ways to move HCMSS tasks.
That mailbox isn't new. It has been around for several years.
Hcmss here, I think your coach provided misinformation about what they do
I'm an hcmss , we were told that line was just for claims and billing issues, medication assistance isn't a dump, questions about claims are, since hcmss has nothing to do with that department
I'm HCM. We were told it was a dedicated HCM support line for member issues, such as claims and billing. Our coach told us that, for example, if a member has a denial for something instead of referring them to HCMSS for information on resources to help pay for it we should email or call the mailbox and they will research member benefits and provide alternative benefit options. Such as generic medication that's cheaper, or assist with appeals, or providers that are cheaper. We were told this would eliminate the "dump tasks" sent to HCMSS
I'm an SS and haven't even heard of the mail box, but agree it is not a good sign. Can you give us more information on the what the case manager support mailbox is?? Is it already in place?
what mailbox?
? Are you a CM? PHC?