Revenue Cycle Management

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Table of Contents

• Quick Notes + Overview
• The Revenue Cycle Management Dashboard
  
  • Page Headings
  • The "Assigned Claims" Section
  • The "Claim Denial Analysis" Section
• Communicating With the RCM Team

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Quick Notes + Overview

• If you have not signed up for revenue cycle management (RCM) services with Billiyo, and are interested in learning more, please reach out to your Customer Success Manager.
• The page discussed in this article is only visible to those that have signed up for Billiyo's RCM services.
• Communication with the RCM team is done directly through the page discussed in this article to keep claim information in one unified location.

Overview

 

 

The Revenue Cycle Management Dashboard

In Billiyo there is a designated "Revenue Cycle Management" dashboard. Within it, all RCM work and communication is housed. 

To access the "Revenue Cycle Management" dashboard, click here or navigate to:

Dashboards > Revenue Cycle Management

To learn about a specific area in the "Revenue Cycle Management" dashboard, click on it below:

• Page Headings
• The "Assigned Claims" Section
• The "Claim Denial Analysis" Section

 

Communicating With the RCM Team

To send a message to the RCM team, click on the that appears in the "Assigned Claims" section.

Then, fill out the contact form. (required fields are marked with a ⭐)

Denial type selection break-downs:

Denial Type
Service Auth	The claim was denied due to a service authorization issue.
Timely Filing	The claim was denied due to timely filing requirements.
Affiliation	The claim was denied due to an affiliation issue with the PCA or agency.
EV Issue	The claim was denied because the member is either inactive or active under a different payer.

After clicking the button, a task is created for the Billiyo RCM team, notifying them to review the message (or note) that was sent. 

Once the RCM team reviews and responds, the task will appear under "My Agency" filter.

Additionally, if there are any tasks (claims) assigned to "My Agency", each morning an email notification will be sent to the email address listed in the account's company settings page.

To review the message (note) history or send a new message, click on the icon in the table line.

 

 

Page Headings

At the top of this page, several headings appear:

Each heading, except Denials, can be clicked on to view additional information.

 

 

The "Assigned Claims" Section

Below the headings at the top of the page, an "Assigned Claims" section appears. Claims that are being currently being worked should appear within this section. 

Use the filters to locate specific claims:

Each column in the table will display information about the claim that's being worked on.

• TF Days are the number of days remaining for timely filing.
• The Summary column displays the last message (note) that was left.
• Click on the icon to review the claim (task) history, including all messages (notes).    

Additional information about the TF Days column:

Timely filing time frame examples:

If the status of a single claim needs to be changed, click on the drop-down in the "Status" column and select the new status it should be moved to.

The status of multiple claims can also be updated at once, by using the checkboxes next to them.

The "Claim Denial Analysis" Section

Once the remittance has been received by Billiyo, claims that are denied or partially paid will appear in the "Claim Denial Analysis" section.

Within this table, click on the to the left of a claim line to review its denial information and even take action.

Actions that can be taken within this section:

Once work is started on the claim, it is moved to it's respective filter ("Billiyo" or "My Agency") in the "Assigned Claims" section.