Re: Proposed Process for WellSky Reactivations & Alignment Questions

--0000000000005bab39064c23d55a Content-Type: multipart/alternative; boundary="0000000000005bab38064c23d559" --0000000000005bab38064c23d559 Content-Type: text/plain; charset="UTF-8" Content-Transfer-Encoding: quoted-printable Hi Team, I wanted to share an update and align across regions on clients who return to service under an existing WellSky profile. Recently, a concern was raised that reactivated profiles are not reviewed by OTC when clients resume service. After reviewing our current process, we identified the gap: Our New Client Audit (NCA) only triggers on brand new WellSky profiles. When a client is reactivated under an existing profile, even if a new Opportunity is created in Salesforce and it appears as a new start in reporting, it does not trigger our onboarding review. Based on that, we are implementing the following control: *Weekly Readmission Audit* Each Monday, FOB will pull a NetSuite report identifying clients whose =E2=80=9CDeactivated=E2=80=9D checkbox has been removed. PSG will review al= l readmissions from the prior week to validate: - CCA on file and alignment with the payment method - PAF, if applicable - Autopay/ACH is properly set up in VersaPay If anything fails the audit or involves specialty billing such as LTC, VA WC etc, a ticket will generate for FOB to follow up. Current volume averages ~30 readmissions per week, which is operationally manageable and gives us a consistent safeguard. For clarity, based on feedback from the Southeast region: - If a client resumes within 90 days, the existing WellSky profile is reactivated. - A new CCA is only generated if there is a change that triggers a new document (e.g., a change in the financially responsible party, or a paye= r type change). - The preference is to maintain one profile per client to preserve history. Before we formalize this as a standard process, I would like to confirm that all regions follow the same approach: 1. If a client resumes services within 90 days, will you reactivate the existing WellSky profile rather than create a new one? 2. If the client is deactivated for more than 90 days, is a new CCA the standard? 3. Are there any regional variances we should account for? Our goal is alignment and consistency so that OTC can apply one standard review process across all offices. Please let me know if your region follows a different approach or if you have input before we move forward with full implementation. Thank you, Jeannie On Fri, Feb 27, 2026 at 1:49=E2=80=AFPM Jaime Cittadino wrote: > Hi Jeannie, > > If a client is resuming service within 90 days, we reactivate their > WellSky profile. The CCA on file updates only when a change triggers a ne= w > document, such as a change in the financial responsible party. We do not > want multiple profiles for the same individual. Having access to the > history in one account is preferred. > > Jaime Cittadino > > Regional Manager, SouthEast Florida > *TheKey & TheKey Concierge Nursing* > Mobile: 561.365.6099 > [image: TheKey] > > > On Fri, Feb 27, 2026 at 12:41=E2=80=AFPM Jeannie Ortiz > wrote: > >> Hi Jaime, >> >> Thank you for the clarification. This is very helpful, and I appreciate >> you confirming the 90 day standard and that a new CCA is obtained when t= hat >> threshold is met. >> >> To clarify, when a client resumes under the same WellSky profile, even i= f >> a new Opportunity is created in Salesforce and appears as a new start in >> operational reporting, it does not trigger our NCA process. Our audit is >> tied to brand new WellSky profiles, not to reactivations of existing one= s. >> That is why OTC would not have automatically reviewed this account. >> >> I have one more question to confirm our reporting logic aligns with your >> process: If a client returns to service within 90 days, should the offic= es >> create a new WellSky profile or reactivate the existing one? >> >> I=E2=80=99m excited to share that the weekly readmission audit I=E2=80= =99m implementing >> will address this by reviewing all profiles where the deactivation check= box >> has been removed, regardless of payer type. This way, we can validate CC= A >> alignment, autopay setup, and specialty billing configurations before >> balances start to accumulate. >> >> Understanding the process for clients returning within 90 days will >> definitely help us ensure our audit captures all the necessary scenarios= . >> >> Thanks again for your partnership on this! >> >> Thank you, >> Jeannie >> >> On Fri, Feb 27, 2026 at 12:31=E2=80=AFPM Jaime Cittadino >> wrote: >> >>> Hi Jeannie, >>> >>> To clarify the situation, a client ended services in 2022 and resumed >>> care this month. A new opportunity was created in Salesforce under the >>> existing account, which reactivated the profile in WellSky rather than >>> creating a new one. >>> >>> Regarding documentation, we did receive a new CCA. Our standard process >>> is to obtain a new CCA for all clients who have been deactivated for ov= er >>> 90 days. >>> >>