Overview:
The Patient Enrollment Module is a new workflow designed to manage the complete patient onboarding journey within the platform, from initial identification and outreach to active enrollment in care programs.
It consolidates patient demographic, clinical, and insurance data with advanced tracking, outreach management, and analytics capabilities. By bringing all related functions into one place, it enables care teams to act faster, streamline workflows, and maintain compliance with regulatory requirements.
This module supports multiple programs types, ensures clear visibility into patient progress, and equips operations teams with powerful filtering, reporting, and bulk action tools to improve efficiency and accuracy.
Core Functions:
Patient Identification & Intake: Capture and store demographic, insurance, and clinical data; determine eligibility for programs such as APCM, CCM, or RPM; flag incomplete records for follow-up.
Consent Management: Record verbal or written consent; store documents securely; maintain audit trails for HIPAA and CMS compliance.
Eligibility Verification: Automatically validate payer requirements and program criteria; highlight data gaps; flag patients for additional review.
Status Tracking & Workflow: Track patient movement through stages: Interested → Contacted → Consented → Enrolled. Assign cases to care managers, update statuses/sub-statuses, and set follow-up actions.
Communication & Documentation: Log all patient interactions (calls, SMS, emails) directly in the system; attach enrollment-related files; provide quick-action buttons for outreach and updates.
Integration with Care Plans: On enrollment, trigger care plan creation, schedule initial assessments, and ensure a smooth handover to care management teams.
Enhancements by Tab
1. Patient Population Tab
Enhancement: Upgraded dashboard for enhanced visibility and advanced filtering. The Patient data is pooled here directly from EHR only.
Key Updates:
Real-time metrics for:
Total Patients
Patients with 2+ Conditions
Patients Over 65
Medicare Patients
Visual progress bars for easy metric comparison.
Expanded data columns: Name, MRN No, Primary/Secondary Insurance, Diagnosis, Changes in Last 30 Days, Outreach Status, Action.
Under Action: EHR Synced status (Green, Amber, and Grey) and the Add to Outreach icon (This action will move the patient from patient population tab to Patient Outreach tab).
Bulk action functionality to manage multiple patient records simultaneously.
Filters Available:
Primary/Secondary Insurance
Appointment Since (date)
Provider Name
Chronic Conditions / ICD
Location / Department
Medication
Allergies
Tags
Min./Max. No. of Conditions
Multi-selection across all the filters, Clear All, Save & Search, Search functions.
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2. Patient Outreach Tab
Enhancement: Improved outreach tracking for faster follow-ups and streamlined campaign management.
Key Updates:
Add the Patient Manually or via Bulk upload to the enrollment module.
Enhanced list view with Insurance, Assigned To, Status, Sub-Status, and Follow-up Date.
Campaign History button to view outreach activity and campaign details.
Color-coded statuses for prioritization (New, Interested, declined, unable to reach, Not eligible, do not contact, enrolled and SMS campaign).
Quick actions for Call, View details, EHR Sync status, Updating the patient status, SMS received and Edit patient data.
Bulk action capabilities for multiple patient follow-ups.
Filters Available:
Primary/Secondary Insurance
Status / Sub-Status
Patient Follow-Up Date (date range)
Provider Name
Chronic Conditions / ICD
Referral Physician
Location / Department
Assigned To
Tags
With Advanced filters to enable based on Patient data changes.
Multi-selection across all the filters, Clear All, Save & Search, Search functions.
3. Interested Patients Tab
Enhancement: A dedicated workspace to track patient interest levels, prioritize follow-ups, and segment patient lists.
Key Updates:
New columns for Sub-Status, Tags, Follow-up Date, and Last Activity.
Tagging system for patient segmentation.
Highlighted sub-statuses for critical cases (e.g., Wants to Speak with Doctor).
Bulk Action is available to export bulk data.
Integrated quick actions for call, view details, EHR Sync status, updating patient status and edit option.
Color-coded statuses for prioritization (New, Interested, declined, unable to reach, not eligible, Do not contact, enrolled and SMS campaign).
· If the patient wishes to enroll, the care team can either proceed with direct enrollment and onboarding or schedule a visit for the patient—offering options such as audio call, video call, in-person appointment, or SMS-based interaction.
Filters Available:
Primary/Secondary Insurance
Appointment Since (date)
Provider Name
Chronic Conditions / ICD
Location / Department
Medication
Allergies
Referral Physician
Tags
Min./Max. No. of Conditions
With Advanced filters to enable based on Patient data changes.
Multi-selection across all the filters, Clear All, Search functions.
4. Enrolled Patients Tab
Enhancement: Optimized view for managing actively enrolled patients and their care assignments.
Key Updates:
Added columns for Assigned Care Manager, Lifecycle Stage (e.g., Initiating Visit), Status, Sub-Status, and Last Activity.
Visual indicators for quick patient progress recognition.
Quick-action buttons for communication, updates, and case management.
Filters Available:
MRN
Patient Name
Assigned Care Manager
Lifecycle Stage
Status
Sub-Status
Clear All, Search functions.
Universal Features Across All Tabs
Tab-specific advanced filters for precise patient searches.
Bulk export to Excel for reporting and offline analysis.
Standardized bulk action workflows to speed up repetitive tasks.
EHR Sync:
Patients originating from the EHR are automatically and regularly synchronized with our system. Consequently, any modifications made within our portal for an EHR-linked patient will be overwritten during the next sync, restoring the values from the EHR.
This workflow is designed based on the following principles:
Single Source of Truth: The EHR serves as the authoritative source for all patient data.
Data Update Process: If any patient information—such as primary insurance—requires an update, it must be modified directly in the EHR. These changes will then be reflected in our portal during the subsequent sync.
Operational Purpose: The primary need for EHR-synced data in our portal is to provide a consolidated view that enables nurses to quickly assess patient eligibility and make informed enrollment decisions.
Overall Benefit
Phase 1 of the Patient Enrollment Module delivers a more data-rich, action-oriented, and visually intuitive interface for operational teams. With real-time metrics, improved filtering, bulk actions, and quick-action buttons, teams can manage larger patient volumes efficiently, reduce administrative bottlenecks, and ensure higher accuracy in reporting and compliance.