intergy claim control - greenway health€¦ · your claims and proactively identify claims that...

1© Greenway Health, LLC. All rights reserved. Confidential and proprietary. Not for distribution except to authorized persons.

Intergy Claim Control


Claim Control allows you to monitor the lifecycle of your claims and proactively identify claims that may be at-risk for payment. With this feature, you get detailed information about each claim, letting you know why claims are at risk and enabling you to act accordingly. See what you may be missing out on!

• In this webinar, we will explore: – Leveraging Claim Control to recoup unpaid monies.

– Key features and benefits you didn’t know you were missing.

– Getting started and best practices for your team.


Welcome

• James Hartman

Product Marketing Specialist

• Shanny Feighny

Manager, Product Management


Agenda

• Leveraging Claim Control – Overview of Claim Control.

• Features– Worklist features.

– What’s new.

• Getting Started – Workflow analysis.

– Setting it up.

– Claim Tracking.

Leverage

Learn

Live


LEVERAGING CLAIM CONTROL

Leverage Learn Live


Does following up on claims have you frazzled?

https://sylvias-serpentine.deviantart.com/art/Frazzled-278601166


Poll no. 1

• How does your practice follow up on unpaid claims?

– Run aging reports from Intergy and work them daily, weekly, monthly etc.

– Use reporting from Practice Analytics and work them daily, weekly, monthly etc.

– Use the Collections Module to follow up on outstanding Insurance due claims.

– Use Claim Control and work them daily, weekly, monthly etc.

– Something else (describe).


Poll no. 2

• How does your practice follow up on denials?– Run denial reports from Intergy and work them daily,

weekly, monthly etc.

– Use reporting from Practice Analytics and work them daily, weekly, monthly etc.

– Use Charge Tasks and work them daily, weekly, monthly etc.

– Use Intergy’s Claim Control.

– Use Claim Vision Portal.

– Something else?


What is Claim Control and how will it help?

• Early warning system for claims which are ATRISK for NOT being paid on time.




• Intergy's solution for customers that want to monitor the lifecycle of their submitted claims.




• Intergy's solution for customers that want to monitor the lifecycle of their submitted claims.

• Enable your practice to easily track problemsand focus on troubled claims.


Your claims under control

• How does Claim Control work?




– Rejections Simply, the claim has bad information or is invalid. It needs to be fixed to have any hope of being paid.





– Expired Milestones Claims have an expectation to be somewhere at a certain time. If it takes too long, it is flagged as "Past Due."





– Expired Milestones Claims have an expectation to be somewhere at a certain time. If it takes too long, it is flagged as "Past Due."

– Denials Claims that have been denied by the payer.



• How does the backend of Claim Control work?

– Milestone Calculations — Claim analytics that figure out where a claim should be during its lifecycle.

– Worklist — The Claim Control window with all the at risk claims.

• These components work together to determine which claims should enter and exit Claim Control and why.


What are milestones?

• Claim Milestones are events that we expect to occur during the Claim Lifecycle.

• Specific to Claim Control to help determine where a claim should be any number of days after it was billed.

• For the most part, milestones are calculated automatically by a weekly schedule system job.


Claim Control will help

http://www.psychics4today.com/how-to-use-crystal-ball/


LEARN ABOUT FEATURES

Leverage Learn Live


At-Risk Claims Worklist

Claims that are at risk because they were rejected by the clearinghouse or by the payer.

Claims that at risk because they are past due for reaching a claim lifecycle milestone or step

Claims that are at risk for not being paid within the established timely filing limits

Claims that are at risk because they have one or more denials

Timely FilingRejections Past Due Denials

At-Risk Claims Worklist in Intergy Claim Control




Claims that at risk because they are past due for reaching a claim lifecycle milestone or step.

Claims that are at risk for not being paid within the established timely filing limits








Claims that are at risk for not being paid within the established timely filing limits.








Claims that are at risk for not being paid within the established timely filing limits.

Claims that are at risk because they have one or more denials.




Navigation — Tool Bar


Tool Bar


Claim Control — Tool Bar


Worklist


Worklist — Totals New in v11.10


Worklist — Jelly Beans


Rejections


Past Due


Timely Filing


Denied


Hover


Right Click


Rebill


Note


Create a Task


Snooze


Letter


Write Off


Search by Claim Number


Search


Claim Details


Header — DOB New in v11.10


Claim Status Indicators


Claim Tracking


Policy Information


Plan Information


Member Information


Eligibility Check — New in v11.10


Plan Contact Numbers — New in v11.10


Worklist


Poll no. 3

• Did you know about these features prior to the Webinar?

– YES

– NO

– SOME


Poll no. 4

• I think that Claim Control:

– has all the features that my practice needs.

– needs productivity reporting.

– needs task queues

– needs the ability to select multiple items


LIVE

Leverage Learn Live


Put it to practice

• Analyze your current workflow.

• What is your current state?

• What works, what does not work?

• What is getting missed?


Put it to practice


• Create a vision with your team.

• What is your current state?

• What works, what does not work?

• What is getting missed?

• Draw out a workflow with your team.

• Compare and contrast your current workflows with the proposed Claim Control flow.


Put it to practice


• Create a vision with your team.

• Get your hands dirty.

• What is your current state?• What works, what does not

work? • What is getting missed?

• Draw out a workflow with your team.

• Compare and contrast your current workflows with the proposed Claim Control flow.

• Set up custom work queues• Set security• Update timely filing settings


Claim Workflow example

Billing Batch Claim CreatedBatch Sent to Clearinghouse

Claim Not

Paid!




Claim Not

Paid!




Claim not paid!

Timely Filing

Rejections

Past Due

Denials


Dividing it up

• Sort the Worklist.

– Balance

– Days Past Due

– Plan

– Billing Provider

– Service Center

– Service Date

– Bill Date


Dividing it up

• Filter the Worklist.

– Electronic

– Paper

– Both


Dividing it up


– Provider


Dividing it up


– Provider

– Insurance• Carrier

• Plan Classes

• Plans


Dividing it up


– Provider


• Plan Classes

• Plans

– Location-based• Service Center

• Department


Dividing it up


– Provider


• Plan Classes

• Plans


• Department


Dividing it up


– Provider


• Plan Classes

• Plans


• Department

– Diagnosis

– Procedure


Dividing it up

• Filter the Worklist.– Provider


• Plan Classes

• Plans

– Location Based• Service Center

• Department

– Diagnosis

– Procedure

– Service Date


New views in v11.10


User Assignments


New concept for v11.10


Poll no. 5

• Do you think you will implement claim control at your practice?

– YES, we will.

– NO, we won’t.

– We already did.

– After version 11.10.


WRAP UP


Agenda

• Leveraging Claim Control – Overview of Claim Control.

• Features– Worklist features.

– What’s new.

• Getting started – Workflow analysis.

– Setting it up.

– New designs.

Leverage

Learn

Live


Poll no. 6

• Would you like to receive more information on Claim Control and/or on beta testing Intergy v11.10?

• Yes – more information on Claim Control

• Yes – more information on beta testing v11.10

• Yes – both

• No thank you

intergy claim control - greenway health€¦ · your claims and proactively identify claims that...

Documents