What’s New?
New Workflow Solution: Financial Clearance
MedEvolve has expanded our Workflow solution offerings with the release of version 8.0 to include a Financial Clearance solution. This new solution provides a streamlined process to review and financially clear a patient prior to their appointment.
Administrators can create worklist configurations, based on appointment date, provider, location, appointment reasons, categories, and patient Insurance to flow to assigned users with the purpose of ‘Financially Clearing’ the patient prior to their appointment.
The Clearance check points include verification of
- • Patient Demographics
- • Insurance and benefits
- • Eligibility
- • Pre-Authorization or Referral requirements
- • Patient Liability (existing balances, Co-Pay, Estimate of upcoming services)
- • Payment Collection
The User’s worklists can be configured to focus review on specific appointments where users can efficiently review the check points prior to upcoming appointments, thus minimizing the revenue cycle risk of the future claim’s adjudication.
Configuration
Create worklists based on multiple configuration parameters and assign clearance checks to Users. Clearance Checks can all be assigned all to a single user or split between multiple users depending on your office workflow.
If a check is not assigned, it will not appear on the Action tab to be completed.
Admins can also mark a Clearance check as ‘Required’. Doing this will cause the appointment to escalate and be flagged as ‘RED’, if the required check is not complete within the designated # of days set in the configuration.
Current Worklist
The user lists for Financial Clearance allow the user to filter and sort the columns to work the appointments as needed. If the user is only responsible for a portion of the clearance checks, they can filter the list to ‘My Responsibility Only’, which will only display appointments where their Clearance check responsibility is incomplete.
Visual alerts help the users quickly assess how much work has been done and what is left to do, as well as which appointments to tackle first.
Action Tab
From the Action tab, users can quickly see which checks are left to complete and navigate to each area to review and / or update information.
General Enhancements
Admin Functions
For MedEvolve PM users, a new ‘Workflow’ user was added to the PM database. This will be the username displayed in the PM, instead of the MedEvolve username, to more easily distinguish data updated or added from the Workflow solution. (Remember: The Workflow username is included as part of the memo text.)
Configurations
Sort Options
in addition to the exiting File Date, 2 new sort options have been added to the Insurance AR configuration options:
- • Date of Service
- • Visit Entry
Denial Codes
A new category of Claim status codes (Denial) was added to the configuration form in Insurance AR to house all ‘Non-Actionable’ codes.
Age Type
A new age type option was added to the Insurance AR configuration page for Timely Filing. Admins can now create worklists based on a # of days prior to the timely filing deadline of a claim.
New Insurance Plan Maintenance Table
Under the Configuration menu, there is a new option for Insurance Plans.
This new maintenance table provides Admins the ability to update Insurance Plan information such as, Plan phone #, Website address, and Timely Filing Deadline.
From the drop down in the upper left corner of the form, the Admin can select the Client and insurance plans will update to display the plans for that client. Admins can add or update the phone, phone ext., Timely filing deadline, and website URL. This information will be updated in the MedEvolve PM, provided there that the client server can support the Azure Hybrid connection.
User Settings Updates
User page now orders users alphabetically.
New User Security options for each of the Workflow Solutions has been added allowing admins to control which users have access to each solution.
Administrators are now able to change the password for ‘Non-Admin’ user without knowing the user’s current password.
Current Worklist
A new column was added the Current Worklist view that contains a “?” symbol. Clicking this link will launch a tab that displays to the user the properties of the claim and why they fell into a one Worklist configuration as appointment to another.
Reports
A new report has been added under the Reports menu, ‘Redistribution Report’.
The purpose of this report is to allow Admins to see the impact of configuration changes may have on the redistribution of claims, accounts, or appointments prior to performing the redistribution.
For all reports, we added the ability with a right click option, to expand/collapse all rows.
User Functions
Current Worklist
New Claims totals have been added to the summary view to provide a clearer picture of the worklist status. Total Claims: This number represents all claims in the Worklist configuration. (NOTE: Some may not be visible in the current list because they are in a Follow-up status.)
Claims Remaining: This number is the number of claims, not in Follow-up that remain in the list to be worked.
Claims in Follow up: This is the number of claims for the selected worklist where the Follow-up date set on the claim is a future date.
Patient Demographics
Users are now able to update patient demographic information displayed on the Account tab in all Workflow solutions, Insurance AR, Patient AR, and Financial Clearance. Newly added or updated information will update in the MedEvolve Practice Management system.
(NOTE: Demographic updates will only be available if the client server can support the Azure Hybrid Connection.)
Managed Visits
Users are now able to view, add and update a patient’s Managed Visit (referral) information from the Account tab in Insurance, Patient and Financial Clearance worklists.
To update an existing Managed Visit, users can click within any of the cells in the grid and enter new or update existing data.
To add a new Managed Visit, click the plus sign (+) to launch the form below. Select the appropriate patient insurance from the drop down and complete the form. Fields with an * indicate the data is required.
Clicking on the Eligibility status hyper-link will launch the results.
Clicking on ‘Check Eligibility’ link will run a new eligibility check for the insurance record selected and display those results in a separate tab.
(NOTE: Eligibility checks will only be available if the client server can support the Azure Hybrid Connection and is enrolled for Eligibility through eSolutions.)
Patient Payment
Users can now process an electronic payment through the InstaMed portal integration from the Action tab of the Patient AR Workflow and Financial Clearance Action tab.
Like all payments received via the InstaMed portal, these will be processed into PM Posting queue during a nightly batch upload.
Redistribution Details
A Redistribution Detail link was added to the Claim Info Tab in Insurance AR, the Patient Ledger tab of Patient AR, and the Action tab of Financial Clearance.
Clicking this link will open the details of the claim, patient balance or appointment, displaying the properties of the item and why it fell on the Worklist.
What’s Fixed
- Fixed issue where CPT codes were sometimes not appearing on the EOB view
- Last distribution date on the configuration page is now always displaying in local time instead of UTC
- Fixed issue on configuration page that caused an error if an Insurance Category that contained no Insurance plans was selected
- Fixed issue that was sometimes causing charge balances in Workflow not reflect the balance shown in the PM
- Now appropriately alerting user when they have entered an invalid Follow-up date on the Action tab and no longer removing all other entered data
- In Patient AR Workflow, we fixed the logic in our calculation of the Bill date aging to ignore visits that have a zero balance and only consider the bill date from the earliest bill-status charge of a visit with a balance
- Fixed issue that was causing updates to patient sequence in the PM not to update in WF
- Improved process of writing back patient memos so that a timeout would not occur when trying to insert notes into the PM
- Fixed the Account ID sort in Insurance AR configurations
- Subscriber information is now showing correctly on the Action Tab in Insurance AR
- Fixed issue when user refiled a secondary claim where the included adjustments from the primary were getting set to the 2nd payer in the PM