Overview
This is a step in the direction of having a full cycle Revenue Cycle Management system within Giv. From the initial point of service through the final reimbursement for the agency. This includes tasks such as billing and claims management, ensuring that the agency receives appropriate reimbursement for the services provided to individuals with IDD. RCM helps streamline financial workflows, reduce errors, and improve cash flow, while ensuring compliance with healthcare regulations and maintaining accurate records for reporting and auditing purposes.
Impacted User and Features
This release impacts Administrators. With most of the noticeable changes on all of the billing pages found within Giv. Bug fixes should be unnoticed by users as fixes were made to ensure current functionality works as expected.
New Features and Feature Enhancements
When you click on the “Finance” drop down, we changed the “Billing” section to now say “Claims”
Summary Page
Clicking on “Claims” will open up a newly redesigned “Summary” page with some newly added functionality:
The new functionality includes:
Drop down rows
each row is a summary of the billing for that specific Code and Client
when the row is expanded you see individual billing records for that Client and that Code that make up the summary row
Summary Table Settings
You can separate the Clients' first and last name into their own columns
You can freeze the first three columns
Filtering
You can filter by Client
You can filter by Code
Create new
you can create a new Batch from the summary view
Service Records Page
If you click on the 6 dot menu to the left of the title of the table you are looking at you’ll see a menu to navigate to different pages. Clicking “Service Records” will bring you to a page that shows individual service records for individual Clients and Codes. This page is horizontally and vertically scrollable.
The new functionality includes:
Service Record Table Settings
You can separate the Clients' first and last name into their own columns
You can separate the Caregivers' first and last name into their own columns
You can freeze the first three columns
Filtering
You can filter by Client
You can filter by Caregiver
You can filter by Code
Fields
You can toggle on and off certain columns so you only see the information that is important to your agency
Exporting
Users now have the ability to export the Summary table, or the Service records table. Clicking “Export” in the top right corner will bring up the view below:
Summary view export:
Service Records view export:
Both views are horizontally and vertically scrollable.
The new functionality includes:
The ability to edit the headers
User can change the names of the column names if they choose.
It is important to note that this feature is specific to the report you are exporting. It does not change the column names in the table. Only the column names on that specific export.
Naming the report
Clicking “export” at the bottom of the modal brings up a new naming modal. Allowing you to name the file you are eporting
Creating a Batch
Users can now create Batches in Giv. There are two ways to create a new Batch to submit for reimbursement. Clicking “Create New” on the Summary page will open up a drop down with two options, “Batch Claims” and “Batch Selected”.
The first way to create a Batch is by clicking “Batch Claims”. This will open a modal where you can select the date range you want for the Batch, the payer, and specific Clients if desired. You will then see a preview before you click “Create Batch”.
The second way to create a Batch is by clicking “Batch Selected” in order to do this, you must first select individual claims from the Summary view. Once you’ve selected the claims you want, and click “Batch Selected” the same Modal pops up. If you create a Batch using this method you will only be able to select a payer. You will then see a preview before you click “Create Batch”.
Once you click “Create Batch” you’ll then be prompted to name the Batch.
When you click “Save” at this step, you will then be directed to that specific Batch’s view. Showing all the Claims that make up that Batch. With the ability to expand rows to see the billing records that make up specific Claims. It’s important to note that you will be able to see the “Status” of Claims and Billing Records.
When viewing a specific Batch’s view you will find:
The claims found within that specific batch
you can expand the row to find the billing records that make up that specific claim
You’ll see the status for each claim and each billing record (when the row is expanded)
The status a billing record can have are:
Ready to bill
Billed
Rejected
Re-Billed
Paid
Statuses were implemented to ensure proper billing record management
It’s important to note that you will be able to see the “Status” of Claims and Billing Records. By clicking the three dots on a billing record within this view, you can change the status of the billing record based on what process of the reimbursement process that record is in.
Batch Page
If you click on the 6 dot menu to the left of the title of the table you are looking at you’ll see a menu to navigate to different pages. Clicking “Batched Claims” will bring you to a page that shows each of the Batches you’ve created.
In this view, before you click in to view a specific Batch you’ll be able to see:
The name you gave the Batch when you create a Batch
When the batch was created
the number of Clients in the Batch
the number of Claims in the Batch
the status of the billing records in the batch and the number of records in that status