Revenue Cycle Management

Agencies that have signed up for the Billiyo revenue cycle management (RCM) program will use this page to work with the revenue cycle management (RCM) team.

If you have not signed up for the revenue cycle management (RCM) program, and are interested in learning more about it, please reach out with your Customer Success Manager.

Jump To:
Accessing the Revenue Cycle Management Page
Page Headings
RCM Performance Graph
Assigned Claims Table
Claim Denial Analysis Table

Accessing the Revenue Cycle Management Page

To access this page, head to “Dashboards” > “Revenue Cycle Management”.

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Page Headings

At the top of this page there will be several headings:

Here is what each represents:

Denials — Billiyo has not recovered payment yet or Billiyo is needing information from the agency. This number represents the total of claims that are Waiting on Agency, Waiting to Rebill, and Pending to Be Paid.
Waiting on Agency — Information is needed from the agency to move forward.
Waiting to Rebill — Claims that have been reassigned to Billiyo to be rebilled after necessary action has been taken.
Pending to paid — Billiyo has rebilled these claims and they are pending processing at this point.
Received — Rebilled claim amounts that have been recovered.
Write-offs — Claims that have been written off — i.e. patient liability, timely filing exceeded, etc — and funds will not be recouped.

Clicking on each heading will present additional information:

The “In Denials” heading is not clickable.

Client
Claim Number (Claim No#)
Charge Amount
Paid Amount
Claim Note — The last note that was left on the claim will appear here.
Marked By/On — This will only show for “Pending to be paid” and “Write offs”

On the pop-up that appears when clicking on a heading, the option to download a CSV file of the information will appear:

Assigned Claims Table

Below the headings at the top of the page, a table for assigned claims will appear. In this table, we'll see claims that are being worked on.

In the top right corner of the table there will be a drop-down menu, to toggle between "My Agency" and "Billiyo.

Any claims that appear when "My Agency" is selected are claims that need to be worked on by the agency, any claims that appear when "Billiyo" is selected are claims that need to be worked on by Billiyo.

To add a claim to be reviewed, click on the + sign above the top right of the table. After clicking on the + sign, a pop-up will appear that will include following information to fill out:

Claim Number — Select the claim that needs to be reviewed.
Assign To — Assign the claim to either the agency or Billiyo.
Enter Note — Notate why the claim needs to be reviewed. It is super important to leave detailed notes so that the RCM team knows what is going on!
Click or Drop files to upload — If anything needs to be attached, this option will allow us to do so.

After the fields have been filled out, click on the blue “Add” button.

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All claims to be/being reviewed will appear on the table. Under the “Summary” heading, only the latest note that has been left on the claim will appear.

To review all notes for a claim, click on the blue eye icon that appears on the far right of the claim line. New notes can be left as well, by entering the note in the “Enter Claim Note” field and clicking “Save”.

Always leave detailed notes so the RCM team is aware of any action that is being taken or needs to be taken!

To change the status of a claim, use the drop-down under the “Status” column. When viewing as “My Agency” the following statuses will appear to select from:

To Do
In Progress
Done

Upon selecting the new status, a note will need to be left — make sure to leave detailed notes so that the RCM team is aware of what is happening!

When changing status, the amounts in the headings at the top of the page will update accordingly.

Claim Denial Analysis Table

The information that shows in this table pulls from the denial analysis report page.

Clicking on the green + sign to the left of a claim line will allow us to see additional information about the claim and it’s denial, and we can take the following actions using the buttons that are displayed:

[Add/Review] Claim Notes
Archive Claim
Void Claim
Mark as Paid

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