Core of the Transformation Center
Detailed Findings
Every one of the 114 transformation opportunities drawn from the corrected Detailed Transformation Assessment, with current state, desired future state and the recommended path.
Showing 77 of 114 opportunities
Connect Dashboard
Enterprise Intelligence & Performance
Regular review Connect Dashboard by Regional Directors and Executive team to get the overview of NPS performance at the organizational level.
Executive Dashboard
Enterprise Intelligence & Performance
Begin using the Executive Dashboard while evaluating overall BI reports and providing Raintree with the list of BI reports that they need a custom version of to accommodate the unique Location grouping option
RCM Dashboard
Enterprise Intelligence & Performance
Begin using the RCM Dashboard while evaluating overall BI reports and providing Raintree with the list of BI reports that they need a custom version of to accommodate the unique Location grouping option
Standard Operations Dashboard
Enterprise Intelligence & Performance
SME TO COMPLETE / VALIDATE
RCM At a Glance
Enterprise Intelligence & Performance
SME TO COMPLETE / VALIDATE
Provider Scorecard
Enterprise Intelligence & Performance
PRN administrative team to use Provider Scorecard to monitor productivity.
Copay report mismatch with Core Raintree
Enterprise Intelligence & Performance
Teresa and Marko met with Shama and tweaked the BI report to match the classic Raintree report which can now be used by PRN
Clinic Directors Report (Classic Raintree)
Enterprise Intelligence & Performance
Have the Lead to Patient Conversion Report> Not Converted Option run via report scheduler and delivered to Clinic Directors on a weekly basis.
Transformation Roadmap & Action Plan
Enterprise Intelligence & Performance
SME TO COMPLETE / VALIDATE
Tab / Session Performance
Clinical Experience & Provider Productivity
Review performance limitations, browser/session behavior, and recommended workflow
Regional Capacity / Cancellation Reporting
Clinical Experience & Provider Productivity
Evaluate Raintree reporting or AnalyticsIQ options for regional rollups
Medical History Documentation
Clinical Experience & Provider Productivity
Map patient-entered PMH into the clinical record and Scribe/evaluation workflow “Sync History data” button will pull over Subjective Tab: Mechanism of Onset Current Surgery Data Current Surgery Details Pain rating scores Work Status DOI Tracking Tab: Next MD Visit
Legacy Questionnaires
Clinical Experience & Provider Productivity
Review migration of legacy questionnaires to Kiosk/Portal/Limber workflows
Template Governance
Clinical Experience & Provider Productivity
Define governance model for enterprise, regional, clinic, and provider templates GLOBALTEMPL = E is the security right needed for the ability to modify and save a global TVIST note template. Recommend creating a naming convention to help clinics / regions create specific templates as the table containing all templates is shared across the database. Individual providers do have the ability to create note templates for themselves. Individual providers should leverage individual abilities such as abbreviations, picklist templates, and favorites lists within picklists. This eliminates the master templates table becoming too cluttered.
Template Administration
Clinical Experience & Provider Productivity
Review permissions and workflow for clinical template administration GLOBALTEMPL = E gives the ability to modify/save global templates. MODIFYPCK = FAEPDV gives the ability to modify/save picklist entries at the global level.
RTWeb Adoption
Clinical Experience & Provider Productivity
Complete Web vs. Classic workflow assessment and address identified gaps Differences between Web and Classic PDF can be sent
Diagnosis Code Ordering
Clinical Experience & Provider Productivity
Validate ScribeIQ and intake diagnosis-code mapping logic
PT / PTA Handoff
Clinical Experience & Provider Productivity
Review handoff functionality, scheduling, Activities, and billing ownership Pre-Visit Planning could also be leveraged to help gain quick and easy access to the Activity Log (prior to notes), to update the Provider column.
Progress Report Goal Updates
Clinical Experience & Provider Productivity
Evaluate alerts, validations, required fields, and AI-assisted goal updates
Goal Documentation for Authorization
Clinical Experience & Provider Productivity
Build workflow alerts/validation around goal review and authorization milestones Add custom events to validate that goal status column values are updated / reviewed in specific note types.
Tracking Tab Adoption
Clinical Experience & Provider Productivity
Conduct workflow demonstration and use-case review Tracking gives visibility into POC records, authorizations, prescriptions, Medicare Cap, Appointment Comments, attachments, as well as Progress Note due dates. It is recommended to use this tab as needed for visibility purposes.
Patient-Specific Payer Forms
Clinical Experience & Provider Productivity
Review Kiosk/Portal/custom forms and structured capture options by payer/region
In-App Chat
Clinical Experience & Provider Productivity
Evaluate enabling internal Raintree Chat for defined use cases
Referral Entry/ Intake
Patient Access & Front Office Excellence
Some fine tuning of our Journey Dashboard, should be managed internally with partnership of our DI Team. Discussed having further conversations w/ Michelle & Indhu
New Patient Appointment Reminders
Patient Access & Front Office Excellence
Already have texting in place
Greeting Patients
Patient Access & Front Office Excellence
The core idea is that by using AI to handle administrative burdens, PSRs can dedicate their time to warm patient welcomes and meaningful engagement rather than being distracted by phone calls and paperwork.
Patient Registration/ 1st Visit
Patient Access & Front Office Excellence
Patient forms can include a Spanish translation, provided the Spanish text is built into the same form as the English version. By setting it up this way, you avoid the need to send separate form sets to your patients. Patient Portal currently has the ability for patients to upload an insurance card, however, patients are not given the capability to type in information. Medication: patients do have the capability to upload/add medication within adult medical history.
Authorizations
Patient Access & Front Office Excellence
Agentic AI/RCM
Patient Collections
Patient Access & Front Office Excellence
Use current checkin alerts within checkin process along with payment alerts within Touchpoints Kiosk. QR code and Wallet are already available with AI Agents coming in 2027.
Schedule Management
Patient Access & Front Office Excellence
Currently there are no tasks that are sent to the PSR group when a patient drops. You can create a stage in Active Patient Journeys to track these patients and create a stage to send a message to the patient that they have fallen off the schedule and need to reach back out to get back on the books. You are also able to use the audience report to get the data you are looking for to catch the patients sooner.
Welcome Letter Automation (HIPAA)
Patient Access & Front Office Excellence
Automate Welcome Letter & appropriate document attachments (Ticket in process to Update HIPAA Communication preferences SF Case: 447968)
Review Patient Portal Tab
Patient Access & Front Office Excellence
Review Patient Portal Tab daily. Update patient data or remove updates.
Scheduler Views
Patient Access & Front Office Excellence
KPI
Patient Access & Front Office Excellence
Touchpoints - Patient Forms
Patient Access & Front Office Excellence
Touchpoints - Kiosk (Medical History)
Patient Access & Front Office Excellence
Touchpoints - RTPay
Patient Access & Front Office Excellence
Report Scheduler
Patient Access & Front Office Excellence
Knowledge - Scheduler Search
Patient Access & Front Office Excellence
Knowledge - Block Booking - Schedule
Patient Access & Front Office Excellence
Knowledge - Block Book - Delete/Reschedule
Patient Access & Front Office Excellence
Knowledge - Default Scheduler View
Patient Access & Front Office Excellence
Knowledge - Work ScheduleTemplates - On Boarding Providers
Patient Access & Front Office Excellence
Knowledge - Appointment (Color Legend)
Patient Access & Front Office Excellence
Knowledge - Appointment Recapture
Patient Access & Front Office Excellence
RT Web - Scheduler
Patient Access & Front Office Excellence
Dashboard - RTConnect (Unread Notes/Messages)
Patient Access & Front Office Excellence
First Come First Serve Waitlist
Patient Access & Front Office Excellence
Waitlist Clean up
Patient Access & Front Office Excellence
Location Resources
Patient Access & Front Office Excellence
Team Scheduler/View
Patient Access & Front Office Excellence
NPS Survey - HIgh score - Review
Patient Access & Front Office Excellence
Journey - Follow up actions
Patient Access & Front Office Excellence
Lead Journey - Email or Cell Requirement
Patient Access & Front Office Excellence
Lead Journey - Duplicate Records Handling
Patient Access & Front Office Excellence
Dropped Patients - Handling
Patient Access & Front Office Excellence
Healthcare Exemption
Patient Access & Front Office Excellence
Growth, Referral & Patient Journey
The new lead to patient conversion report in BI allows users to look at all leads by lead creation date and can be view by Location category/Region.
Non Converted records by Clinic
Growth, Referral & Patient Journey
SME TO COMPLETE / VALIDATE
NPS
Growth, Referral & Patient Journey
PRN team can use the NPS report with high and low scores to begin with (screenshot below) and sort in ascending order to see just low scores and can also have this scheduled to go out to CDs on a weekly or daily basis.
Growth, Referral & Patient Journey
SME TO COMPLETE / VALIDATE
Growth, Referral & Patient Journey
SME TO COMPLETE / VALIDATE
Custom Report (Lead to Patient Conversion) - Delivered
Growth, Referral & Patient Journey
SME TO COMPLETE / VALIDATE
Scheduling Restrictions in the Provider Table
Revenue Cycle Transformation
This would be an enhancement that would allow the scheduler restrictions to be put in place specific to the filtered entries within the provider table.
Reports in Raintree - Report Scheduler
Revenue Cycle Transformation
This was discussed further in the calls with BI dashboards and tools as these export data and show similar data, but the filtering in some cases is different than what had been used historically. To allow reports within Raintree to run with the same historical filters and to allow enough time for them to successfully finalize, we would suggest to run these based on the report scheduler to allow them to run with an automated process that can kick off behind the scenes and run during off hours. The resulting report can then be sent to a task or email to be waiting for the applicable user to review the subsequent business day.
Refunds
Revenue Cycle Transformation
The recommendations here approach the topic from two points of view: Retroactive Refunds: to ensure an easy process with the Refunds that need to be issued. With refunds there are a few standard tools that can be employed to aid efficiency of the processing of refunds: Find potential refunds - https://kb.raintreeinc.com/help-10-2-500=find-potential-refunds-utility and Import issued refunds- to in bulk post those so that these are not an item a user would need to enter. - https://kb.raintreeinc.com/help-10-2-500=import-issued-refunds-screen Review and processing using Rev-Edition Follow up Dashboard for visibility into the processing - https://kb.raintreeinc.com/help-10-2-500=work-with-refunds-in-rev-edition Proactive: to help ensure that at time of service the amount collected is as close to accurate as possible. This is where tools and options within the Patient Payment Agreement and Counseling Form (PPAC) can be used and templates to aid in their setup defined to model specific common scenarios. For example, setting models for when there is a high deductible plan and payment condition would indicate to only use the required payment while deductible not met, or for patients where insurance coverage may be inconsistent to only use when no insurance coverage.
OTC Collections
Revenue Cycle Transformation
For this I would suggest a follow up working session on PPAC templates to setup a few samples, which can be set to use the payment terms only while the deductible is not met, or to estimate when then deductible will be met, to more closely align with what the patient owes after insurance adjudication. As noted with the section on refunds these common use cases for a PPAC can be set as a templated model for the teams to work from. Another feedback mechanism that is helpful to use as an indication that amounts to collect should be updated are decreasing copay follow up notes within the Follow Up Dashboard. Sorting by this follow up code and then by reason codes can help to give an indication when deductible and/or out of pocket maximums have been met and time of visit collections are no longer needed. An additional avenue to consider is that PPAC’s can be sent to patients for signature via the patient portal prior to the first visit. If the patient has the opportunity to review the details in a more focused environment if they do have an HSA that will issue payments to cover their responsibility amount this can provide them more time to share this feedback with the team to ensure that the front desk team does not collect in scenarios where the patient would have payments sent from the HSA with the payor directly following payor adjudication.
BILLING REPORTING
Revenue Cycle Transformation
The time here is also discussed with BI reporting. Some of these can be set to run on report scheduler to run during off hours. The report scheduler tool can run reports that are consistently reviewed on a defined scheduled date. This can be used to ensure that the same report is run with consistent filtering from one run to the next so that metrics can be true comparisons. As the time for these runs can be defined by the user these can be set to run during off hours so that system performance will not be impacted and run time does not leave a user waiting. For reports where different iterations and drill downs would want to be review, these can be found in BI and these drill downs and components within the reports will be items that are accessible without having to completely re-run the report.
Location History
Revenue Cycle Transformation
As this is consistent with the historical entries in their location table, continuing to use this method will maintain consistency and not need to update form script setup options. If this becomes difficult to manage we do have an option that would require a change to form scripts to use a fall back sequence from provider table to location table and could use a "default" provider with filtered entries to accomplish the accurate name with the applicable time frame for locations.
Automated Follow Up Actions
Revenue Cycle Transformation
There is an attachment below that shows the process in a detailed recording: https://drive.google.com/file/d/1GfMiEsw7YKsc8hw2IAlipBfzMBlj6Hhr/view?usp=drive_link The suggestion would be to begin with some of the straightforward follow up actions like a sending of medical records and identify when the team is taking this action consistently - Which payors is that done for? What ANSI reason code does that payor process with? Once these questions are clearly known a routing rule can be defined to take action automatically on behalf of the team. Below in the workflow to define the rules section, we will see an example for an insurance of Aetna and reason code 252 defined to run an automatic action of “medical records sending”.
"Not Touched" as a dropdown filtering options on Follow Up Dashboard
Revenue Cycle Transformation
Reviewed definitions during call. Not touched - a real person user has not needed to complete a follow up action on this claim
Vendor for Insurance Coverage Detection
Revenue Cycle Transformation
With Waystar the prerequisites were that they were already using the eligibility results being retrieved from Waystar and that contracting with Waystar as the clearinghouse was updated to include coverage detection. As the offering would become expanded to Availity and beta groups are reviewed the PRN team should be considered as a group to work with the beta offering.
Under Payment Detection
Revenue Cycle Transformation
This can be defined differently for payors that reimburse based on a fee for service model or a flat fee per visit. Below will be a link to slides from prior TherapyCon sessions that demonstrate not only how to define these behind specific payors but also how to run reporting to help in ensuring the targets defined are in line with actual reimbursements received. Link: Underpayment Detection - Slides TherapyCon 2025.pdf
TVBEN Completion Restrictions
Revenue Cycle Transformation
Capitation Payors
Revenue Cycle Transformation
Ledger Verifier
Revenue Cycle Transformation
Fee Schedule
Revenue Cycle Transformation