Client Success Story
Pine Park Health, a client of ForeSee Medical based in Oakland, California, specializes in delivering comprehensive care to seniors, particularly those in assisted living facilities. Alex Tong, a Product Manager, collaborates with internal team members, providers, and care support staff to understand their challenges and explore technological solutions. Sheri Knutson, certified in Clinical Documentation Improvement for Outpatient Settings and Risk Adjustment Coding, joins Alex in this interview. They discuss their risk adjustment workflow before and after implementing ForeSee, the value of their account manager, and the surprises they encountered during the process.
Read the Full Interview Here
Sheri: My name is Sheri Knutson, and I am a Certified Coder, CPC Certified in Clinical Documentation Improvement for Outpatient Setting and also Certified in Risk Adjustment Coding. I joined Pine Park Health in October of 2023 and my official role here is the HCC coder with a little extra bonus of provider education, auditor, coder educator.
Alex: I’m Alex Tong, I’m a Product Manager at Pine Park Health. I’ve been on the team for about two and a half years. I work with our internal team members, our providers, our care support staff, as well as our external partners like community partners to understand what problems that they deal with and figure out how technology may be able to help.
How was your risk adjustment workflow before ForeSee?
Sheri: We didn’t have any type of tools that ForeSee offers. It was either you really just had what was coded last year, and you were looking for that recapture. You had maybe some reporting tools from different Medicare Advantage plans, and they had some suspects depending on medications, maybe some lab values, different tools that they had available to them. So it was very manual labor intensive work where you were doing queries to providers on different indications, different rationales. So this has been quite enlightening for me and pretty exciting that this (ForeSee) is out there and the way it works is pretty amazing as well.
And now?
Alex: All the findings are available in one place for someone like Sheri to be able to reference and have a first pass at evaluating whether or not we want those recommendations to show up in front of our providers. Then deciding how we want our providers to have that end experience. The offerings that ForeSee has in terms of information, tooling, as well as the relationship we have with the ForeSee team is going to be beneficial for us in the long run.
How’s the accuracy of the software?
“I feel the accuracy is very spot on….”
- Sheri Knutson
Sheri: I feel the accuracy is very spot on from the audits and reviews that I’ve been working with. The rationale that ForeSee offers is just so detailed. If it’s not a rationale that isn’t a definitive reason to diagnose or recapture the suspect code I feel it’s really good indications for the provider to do some additional testing. To look at an additional exam, element, or referral that might be needed because of the rationale that is suggested. So I think it’s very spot on. The rationale ForeSee provides for the suspect conditions really promotes critical thinking opportunities to providers that might otherwise be missed. I love the stars and the bars to show the quality of the suspect or the rationale. I feel like everything I’ve looked at so far is really user friendly.
How important has your account manager been?
“…it’s rare to have an implementation partner that is consistent throughout the whole experience…”
- Alex Tong
Alex: On my side it’s been extremely valuable to have Emily Feider from the beginning to today. I think it’s rare to have an implementation partner that is consistent throughout the whole experience in terms of who they are, but also consistent in their level of accessibility.
I think it’s typical to have an implementation manager give you a lot of attention in the beginning but once you’re fully set-up you don’t hear from them as often. But Emily, and I’m sure it’s a ton of work, and she’s probably providing a lot of time to other clients, has kept a weekly recurring meeting on the calendar with us, and she’s always made herself available. So it’s been awesome working with Emily, it’s been valuable having a consistent partner through our ForeSee experience. I’ve been able to talk to Emily, Caleb Vandenberg and Arnold Mentze from the ForeSee team about a lot of technical pieces. Now that we have Sheri she’s been having some good conversations with Emily as well.
Sheri: I would just really echo everything that Alex just said about how rare it is to have somebody that you’re guaranteed a weekly meeting, if and when needed, and to have that instant feedback. I think that’s rare and a very excellent offering.
What made ForeSee stand out from other options?
Alex: We felt like the product that ForeSee’s team has built is focused on the clinical provider experience and that perspective. When we were evaluating other tools, their end goal was to produce good recommendations, but the user experience wasn’t maybe as tailored to clinical individuals. So that was a big plus for us.
In terms of operations and implementation it was really just the team and the way they made themselves available. Again the consistency, they’re very clear about expectations that we should have, should not have and throughout the experience as Sheri mentioned it is very rare to have that relationship. And it’s been great, it does feel very collaborative. It’s not like we just hit you with requests, well maybe we do (laughs), but I feel like we’re able to share feedback on content within ForeSee. I know Emily and Sheri have had some good conversations on Sheri's perspective from a coder and how that may help ForeSee improve even more.
I think to summarize and not necessarily surprising but something that was delightful in terms of our experience is just the continued collaboration throughout the process.