Revenue Cycle Worklist

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Revenue Cycle Worklist Melissa Wagner Senior Consultant mwagner@brightree.

1 Revenue Cycle Worklist Melissa Wagner Senior Consultant Cynthia Walters Billing Supervisor Sanford HME

2 What you will learn: Benefits and Value of Using Revenue Cycle Tools Prioritization of Activities Overview of RC Worklist and Ad hoc report Tips for successful implementation of RCW

3 Cynthia Walters Sanford Home Medical Equipment, Inc. Billing Supervisor Sanford HME

4 One month after implementation, my DSO went down by 4 days. Today, our DSO went from 60 days to 50 days. - Cynthia Walters, Billing Supervisor, Sanford Home Medical Equipment, Inc.

6 Revenue Cycle Activity and Workflow The Old Way Denial and AR Management Worked but clunky Results not predictable Inefficient navigation

7 Revenue Cycle Activity and Workflow The New Way Denial and AR Management Real time workflow Cleaner configuration Smoother navigation More features Get to results faster

8 Melissa Wagner Brightree LLC. Senior Consultant

9 Revenue Cycle Worklist Purpose The Revenue Cycle Work List contains all of the Revenue Cycle Activity Tasks that Activity Teams work. Billing workflow By pushing tasks to the user, unpaid invoices/accounts are recognized more timely, and once resolved can have a positive impact on preventing future denials including those for timely filing Collection Workflow By pushing tasks to the user, timely resolution of denials can greatly improve cash flow Expected Benefits Eliminate timely filing denials, reduce/eliminate subsequent denials improve DSO, identify escalating account balances, improve visibility to outstanding CMNS and PARS

10 Activity Types Denials Denied Invoices where a balance still exists on the invoice It is recommended that you evaluate how denials are received and how billers/collectors currently work denials. It is also recommended to group like denials together since working like items together is overall more efficient and effective. Billed Claim Follow Up Invoices sent to insurance company that have not been processed (denied) within a specified timeframe Timely Filing Invoices that have not been printed or submitted within a specified period of time. This is the number of days that you want to be notified of the unsent claim. The actual timely filing limit should not be entered. Partial Payments Invoices that have a payment (applied payment or deductible) but on which a balance still remain

11 Activity Types-continued CMN Follow Up Identifies pending CMN s which have Not been printed/faxed Have been printed/faxed over a specified time period PAR Follow Up Identifies pending PARS which have Not been printed/faxed Have been printed faxed over a specified time period Patient Collections Looks at all open patient invoices collectively (aggregate balance), does not look at individual invoices Audits Used to manage and maintain invoices that were flagged for audit by providers or insurances. The Audit & Appeals/Audits sub-tab on the invoice allows users to track the Audit Invoice process. Data entered on the Invoice Audit tab generates RC Activity Tasks for the RC Worklist

12 Gremlins at work.. What does do? Nightly services process looks for new denials after the last print/submit date If claim is not closed During next nightly services evaluates if claim is closed and closes activity

13 Other Activities For all other activities, with the exception of Audit activities, Brightree nightly services evaluates the activity configurations to determine invoices that will be pushed to the Revenue Cycle Worklist. For Patient Collections, the configuration is based on an aggregated patient account balance. Nightly services will evaluate patient accounts to be pushed to the Revenue Cycle Worklist

14 Activity Tasks Activity tasks are the actions that are taken when an invoice, account, or CMN is worked. Tasks are configured with a name, description, and follow up time frame. Tasks are also configured for specific activities so that only those tasks associated with a specific activity are available to choose.

15 Activity Tasks- continued Activity Tasks Follow Up dates are designed to automate the repopulation of the task on the Revenue Cycle Worklist. A Task is set to Open status by default by the system when populated on the RC Worklist Once the user changes the task status the item is removed from the list (considered closed) until the next follow up date is recognized. If the invoice is still open, the item will reappear on the RC Worklist. If the invoice is closed at any time by payment or otherwise brought to a zero balance, the invoice will not reappear on the RC Worklist.

16 Revenue Cycle Worklist Population of the Revenue Cycle Worklist is a result of the nightly services evaluation of the Activity configuration and posting of denials AR Management/Revenue Cycle Worklist Default View = Displays non-closed tasks assigned to the current user Tasks that do not have a follow-up date in the future Use the Next Task button to get the next task based on create date and priority. The first time a user views the list, they may not have any assigned tasks

Revenue Cycle Worklist Smart Assign built into Next Task When assigning a Denial, Billed Claim Follow Up, Timely Filing, or Partial Payment Activity The system will look for any

17 Revenue Cycle Worklist Smart Assign built into Next Task When assigning a Denial, Billed Claim Follow Up, Timely Filing, or Partial Payment Activity The system will look for any other Unassigned Activities for the same Patient Policy and Activity Type and assign them to the same User (providing the user is assigned to a Team that can work the related Activities).

18 Activity Notes The Activity Note is NOT the same as the Invoice Note. Each company will need to put their policy and procedure in place as to which note should be used. The Activity Note is reportable in the Revenue Cycle Ad- Hoc Reporting.

19 Ad-Hoc Reporting Home My Ad-Hoc Reports Design a New Report Revenue Cycle Activities

20 Resources Spring 2016 RC Activity Guide: aspx?pi=zhmzohuqbzbei0z0 RC Activity Overview & Demonstration: aspx?pi=zhrzlnpi1zbei0z0 Additional materials available in the Brightree Learning Center All New Release materials can be found in the Brightree Support Center

Things to Consider Before Configuration Define current workflow This may be a good time to rethink current workflow How is/will the work distributed By insurance,

21 Things to Consider Before Configuration Define current workflow This may be a good time to rethink current workflow How is/will the work distributed By insurance, by branch, by dollar amount, by product, by denial type What is/will be the basis for responsibilities Are there senior/junior level staff By complexity of claims

23 Thank you Melissa Wagner, Senior Consultant Cynthia Walters Billing Supervisor Sanford HME

Claim Inbox: a new way of working holds. Mallory Mahoney Manager, Product Innovation

Claim Inbox: a new way of working holds Mallory Mahoney Manager, Product Innovation Agenda Claim Inbox Overview Claim Inbox Basics Claim Inbox s Key Workflows & Features Key Takeaways Resources Q&A 2 Claim