Workflow

Welcome to the GoRev Workflow Tutorial. In this tutorial, we will focus on the process of navigating to and utilizing the Workflow module in GoRev.

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1 : Navigating to the Workflow Module

As a GoRev user, the Workflow module will allow you to view and complete most work needed for a Patient Account to be properly processed after the claim has been Coded and properly Batched to the Clearinghouse. The Workflow module can be accessed in two ways.

Accessing Your Workflow Through The Patient Overview

First, the Workflow module that pertains to a particular Patient Account can be accessed by navigating to the Patient Overview window for that Patient Account. To begin, please navigate to the Patient Overview window for the required Patient Account by using the Search field on the GoRev Homepage.

Once the Patient Overview window is visible, please navigate to the Workflow module for this Patient Account by clicking on the “Workflow” button present in the Patient Overview toolbar.

Accessing Your Workflow Through Follow Up

Second, the Workflow module can be accessed in the Follow Up module. To begin, please navigate to the billing tab at the top of your GoRev toolbar. Then, click on the follow up option from the toolbar.

Once you have selected the follow up bucket and filters you currently require, the Follow Up bucket should be present on your device. From here, please select the Patient Account you'd like to work on from the list in this window.

Next, please navigate to the Workflow module for the selected Patient Account by clicking on the “Workflow” button present in the Follow Up toolbar.

Note: You may, also, double click on the Patient Account in the Follow Up bucket to navigate to the Workflow module for the selected Patient Account.

2 : Navigating & Understanding the Workflow Module Sections

At this point, the Workflow module for the selected Patient Account will be present on your screen. The Workflow Module is made up of 8 major sections titled “Visit Information”, “Claim Timeline”, "Visit Tags", “Transaction Overview”, “Patient Responsibility”, “Statement Approval”, “Payer”, “File Management”, and “Account Notes”.

Visit Information

The “Visit Information” section of this window contains Visit information for the selected Patient Visit, including the Account Number, the Facility, the Patient's Name, the Patient's DOB, and the Dates of Service.

In addition to altering this information, you may also use the "copy" Button to quickly copy the patients date of birth.

Next, the Visit Information section will allow you to manage the Visit Status, Coding Status, MRN Follow Up Status, and the Visit Follow Up Status for this Patient Visit by utilizing the corresponding fields provided.

Note: When adding a Visit Follow Up Status or a MRN Follow Up Status to the Patient Account, please make sure to assign the Follow Up for this Patient Account to a Current Biller and select a Follow Up Date.

Furthermore, you will also have the ability to Void a claim by selecting the "Void Claim" checkbox present above the coding status field.

Note: When voiding a claim in GoRev, please ensure you set the coding status to 'Coding Approved' after selecting the void claim checkbox. Please note that this function will only work if the ICN number is added in the patient's overview window.

Lastly, the Visit Information section of the Workflow module will allow you to view, change, copy, or add the Location NPI, Location Tax ID, Patient Financial Status, Delay Reason, the External ID, and the Service Type for this Patient Visit.

Claim Timeline

In the Workflow module, the “Claim Timeline” section is accessed by clicking on the “Claim Timeline” tab in this window.

The “Claim Timeline” section contains a log of all Status Changes made to the Patient Account since the creation of the Visit. Specifically, this section will provide you with the Status Change Date, the New Status, who created the status change, the Status Change Reason, and any payment information associated with each Status Change that has occurred since the creation of this Patient Visit.

Note: The number of days since the last Status Change for this Patient Visit is present in the upper section of the Claim Timeline area.

Applying Visit Tags

The "Visit Tag" section of this window will allow you to add or remove any visit tags needed for the patient in question. This visit tagging system can be used to facilitate more robust analytics along with enhanced registration and RCM processes. To begin adding a visit tag simply start by typing in the visit tag field and select an option from the drop-down menu.

Note: In order to add new visit tags to the system, an admin must add these visit tags to the visit tag lookup list located within the admin module. For further information please see the Visit Tagging tutorial.

Now, your visit tag should be visible within the visit tag section of this window. To add additional visit tags, simply repeat the steps above.

Transaction Overview

The “Transaction Overview” section of this window contains a Financial Overview for this Patient Visit, including both the Insurance and Patient portions of the claim. Specifically, the Transaction Overview section contains the total Charges for the account, the insurance Payment(s), any Adjustments made to the account, the Patient Charges, any Insurance Balance, and the Allowed Amount.

Additionally, the Transaction Overview section will provide you with the total Filed Charges, the Clearinghouse Claim Received date, and the Collection status for this Patient Visit.

Patient Responsibility (All Visits)

In the Workflow module, the “Patient Responsibility” section is accessed by clicking on the “Patient Responsibility (All Visits)“ tab in this window.

The “Patient Responsibility” section contains financial information pertaining to the Patient's Responsibility for all of the Patient's Visits in the current Facility. Specifically, the “Patient Responsibility” section contains the current Patient Total Charges, Total Payments, Total Adjustments, and Total Balance, which are accumulative figures from all Patient Visits in this Facility.

In addition to these fields, the “Patient Responsibility” section contains a Patient Statement Cycle tracker, the Date of the Patient's Last Statement, the Patient Statement Status, and the Patient's Approved Balance.

Statement Approval

In the Workflow module, the “Statement Approval” section is accessed by clicking on the corresponding tab in this window.

The “Statement Approval” section provides you with the ability to finalize the Patient Responsibility amount that will be present on the next Patient Statement sent to the Patient. In the Statement Approval section, there is a list of all Patient Visits in the Facility and the Patient Responsibility associated with each Visit.

Each Patient Responsibility amount present in this list must be Approved before the amount will be added to the next Patient Statement. In order to Approve a specific Patient Responsibility amount, please click on the corresponding “Approve” button present in the “State” column of this list.

If a Patient Responsibility amount that was previously Approved needs to be removed from the Patient Statement, please click on the corresponding “Reject” button in the “State” column.

Note: If you would like to accept all Patient Responsibility entries or reject all Patient Responsibility entries, please use the “Approve All” and the “Reject All” buttons, respectively.

Payer

The “Payer” section of the Workflow module contains information about all Payer(s) that have been added into the system for the Patient at this Facility. Specifically, the “Payer” section provides you with the “Carrier”, “Payer Name”, “Payer Phone”, “Claim Number”, “Member ID”, "HIOS ID", “Group Info”, "Plan Type", “Group Number”, “Finclass”, “Payer ID”, and activity “State” of the Payer.

If a particular Payer for this Patient Account needs to be Activated, please utilize the corresponding “Make Active” button present in the “State” column of the Payer list.

Note: If there is no previously entered Insurance information for this Patient, the only information present in the Payer section will be Self-Pay information.

Additionally, the “Payer” section will allow you to Copy insurance information by using the “Copy to Clipboard” button in the Payer section toolbar.

File Management

The "File Management" section in the "Workflow" window allows you to access and manage all patient files uploaded to GoRev for the current visit.

Note: If you would like to view Patient Files from all Patient Visits, please click on the “Show Files From All Visits” checkbox in this area to view the files.

In order to open a Patient File, double click on the required File from list.

Alternatively, if you would like to Upload a Patient File to the GoRev System, please utilize the “Upload” button in the File Management area to complete this task.

Note: You will also have the ability to Scan a document into the file management section by utilizing the Scan button located to the left of the upload files option.

Account Notation

The “Account Notation” section of the Workflow module allows you to view the Account Notes for this Patient Visit.

The "Account Notation" section also enables you to add follow-up notes, update the workflow status, and assign a biller to follow up on the patient account using the "Follow Up" button. In order to set and assign a workflow status, begin by clicking on the follow up button.

Now, enter your Follow Up Comment into the provided field and fill in the workflow status, set a follow up date, and assign the follow up to the correct individual.

Note: You will also have the ability to mark this as a patient financial follow up or mark any denials as resolved by utilizing the checkboxes directly under the assign to field.

Finally, if you'd like to apply this note to multiple encounters, please use the checkbox provided and select the Submit Comment button to finish creating your follow up note.

3: Navigating & Understanding the Workflow Toolbar

In addition to the 9 major sections of the Workflow Module, this window, also, contains 19 Ribbon Tools in the Workflow toolbar.

Follow Up

The “Follow Up” icon in the toolbar will allow you to access the Follow Up Comment window pertaining to the current Patient Visit.

Rebill

In the Workflow toolbar, the “Rebill” button will allow you to quickly Rebill the Patient Claim for this Visit.

Rebill will automatically set the claim to “Coding Approved”. This function is best used when you have corrected the error in question and are ready to resubmit.

It is important to note that the ICN number from the clearinghouse is required and will need to be entered in the insurance section of the patient overview window. In addition to this, this process will require that the carrier setting "allows corrected claims".

Open linked account

The “Open Linked Account” button in the toolbar will open the Workflow window for any Patient Encounter that is Linked to the currently open Patient Account. For instance, if a Biller is in the Workflow window for an Institutional Claim, clicking on the Open Linked Account button will open the Workflow window for the Professional Account that is Linked to it.

Refresh

In the Workflow toolbar, the “Refresh” button will Refresh the content of the Workflow window.

Patient Payment

The “Patient Payment” button in the toolbar will allow you to quickly enter a Patient Payment into the GoRev system.

Note: If your Facility uses Salucro or OpenEdge to process Patient Payments, the Patient Payment button will allow live processing of Patient Payments.

Patient Overview, Patient Financials, and Coding

In the Workflow toolbar, the “Patient Overview”, “Patient Financials”, and “Coding” buttons will allow you to navigate to the Patient Overview, Patient Financials, and Coding windows for the Patient Account, respectively.

Encounter History

The “Encounter History” button in the toolbar will provide you with a list of Patient Encounters at the current Facility.

Print Forms

In the Workflow toolbar, the “Print Forms” button allows for quick access to Print Services, where Forms for your Facility can be accessed and printed.

Appeals

The "Appeals" button will allow you to manage, create, and edit appeal forms for your facility.

Eligibility

The “Eligibility” button provides quick access to the Eligibility window, which will allow for the completion of real-time Eligibility Requests.

Jump To

In the Workflow toolbar, the "Jump To" button will provide you with the ability to quickly jump to different sections within the Workflow Module

document generation

The "Document Generation" button will allow you to generate a variety of claim forms with artificial intelligence. This versatile tool includes the ability to generate appeal forms, patient communication forms, reconsideration forms, and more.

Contract Allowable

The "Contract Allowable" button allows for quick access to your Allowed Charges, Non-Allowed Charges, and Calculation Summaries for the patient that is currently selected.

request signature

In the Workflow toolbar, the "Request Signature" button allows users to select print forms that can be emailed or texted to patients for signature collection.

Change Coding Status

The “Change Coding Status” button will allow you to rapidly change the Coding Status for the Patient Account.

Manage Insurance

The “Manage Insurance” button in the Workflow toolbar provides quick access to the Manage Insurance module, enabling Billers to efficiently update Insurance information, apply new Insurance to multiple Visits, and utilize additional features without needing to navigate to the Patient Overview window.

Worksheets

The “Worksheets” button in the Workflow toolbar will provide quick access to all Worksheets present on your Server.

Waystar History & EOB

Lastly, in the Workflow toolbar, the “History” button will allow you to access a complete log of the Claim's History in Waystar.

Alternatively, the “EOB” button will provide quick access to the Claim's EOB from Waystar.

GoRev Support Team

If you have any additional questions or concerns regarding this tutorial, please contact the GoRev Support Team by phone at (317) 794-3900 or by email at ask@gorev.com

Note: Always submit an IT Support Ticket detailing the problem that you are experiencing with this portion of GoRev, if possible, as this will give GoRev Support Agents access to information that will help expedite the resolution of your issue. If you are unsure how to submit an IT Support Ticket in GoRev, please see the IT Support Ticket Creation tutorial for assistance.

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