Appeal Management Module

Need to take our Manage Print Services module one step further to manage an effective appeal life cycle? Use our Appeal Management Module to customize appeal packets, e-fax completed packets, and track timeline of appeal transmissions. The guide below will walk through these processes.

Accessing the Appeal Management Module

The appeal management module can be accessed from two areas. From within Patient Overview:

and from within Workflow

The following window will open

Start a New Appeal

To start a new appeal on the account click

Select payer you are wanting to generate an appeal for. Note: you can generate appeals on any payer listed on an account (primary, secondary, tertiary, etc)

All of your print services documents can be selected as an appeal template. To create and maintain your templates see this guide: Manage Print Services. For the guide, we have selected a BCBS Reconsideration Form.

Click Load Appeal

You will see the appeal template load up into the below UI with any system fields you have configured populated with their actual values relative to the patient you are processing an appeal for.

Adding Text, Dates, and populating checkboxes on your new appeal

To add a text box where you can add static or system field driven text click, click on the Add Text Box button to toggle it active. It will darken the button slightly. Click the top left corner and drag your mouse to "draw" a box onto the appeal form where you want to place this new text. You will see a green box as you drag the mouse.

Note: Be sure to click the green checkbox or click completely off/outside the text box when you are done. The system attempts to automatically save when you deselect an item or click the green check.

As soon as you let go of the mouse the text box will show a green check mark and red x towards the top right. You can now begin typing into the text box. Note, you can add print services dynamic system fields just as you would to one of your templates.

To populate checkbox fields, click the Add Selection Mark button and then mouse click in the center of the checkbox you want to populate. Be sure to either click off the checkbox or click the green Check Mark to save your selection mark.

Saving and Using Overlay Templates

If you want to save all of the text boxes, dates, selection marks you've added on "top" of this appeal template for re-use you can click the Save Overlay Template.

Select an existing template to overwrite it or type a new template name in the highlighted box below.

If you do not check the Share Overlay button it will only be usable by your username. If you click the share overlay checkbox any user with access to the appeal management system can user your overlay template.

To use an overlay template, open up an appeal form as if you were creating a new appeal for an account, click on Apply Overlay Template, select the overlay template and click Apply Overlay

This will immediately apply all of the customizations you have configured in your overlay

Adding attachments to your appeal such as medical records, lab results, lab orders, eobs, etc.

To add attachments to your appeal click on the Attachments button

Any file currently found within Patient Overview's file management for the patient can be attached to an appeal. Check the files you want to attach and click Attach Files

Click the Page Thumbnails button to see the newly attached files.

Transmitting your appeal

There are two supported methods to transmit your appeal. Print and Fax.

Clicking the Print button will generate the appeal combined PDF (your appeal form plus attachments) and save to patient overview. You can then print a physical copy for manual mailing.

A complete Appeal window will present the below. Clicking Yes will mark the appeal as generated/transmitted with your name and current timestamp.

Clicking Fax allows for use of the integrated Westfax e-fax system (a guide can be found on this here: GoRev Faxing Module). Type the fax number into the drop down box. It will remember your entries and allow you to reselect them from the drop down next time.

Populating Attention and Message fields are optional as they simply update your cover page contents. The cover page is a static form that cannot be altered.

Click Transmit. The system will queue the outbound fax.

Viewing appeal history

Click the View History button to see a history of all actions taken on this appeal. This is where you can review faxing confirmation status as well as see where an appeal was mailed to.

Reopening a previously submitted appeal

If you go to open an appeal and you see it is highlighted green this indicates the appeal has already been transmitted and is now locked.

You can always retransmit a locked appeal by using the buttons again. However, you cannot alter any contents of the appeal. This is intentional to maintain historical integrity of what was transmitted to the payer. If you need to change and resend the appeal click Restart Appeal. This will clear all appeal form contents at which point you can redo the appeal. When you transmit a second time a second entry will be added to the View History UI.

GoRev Support Team

If you have any questions, concerns, or problems regarding this GoRev Tutorial, please contact the GoRev Support Team by submitting an IT Support Ticket, by phone at 1-(317)-794-3900, and/or by email at ask@gorev.com.

Note: If possible, always submit an IT Support Ticket detailing any problem that you are experiencing within GoRev. This will give GoRev Support Agents access to additional 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 theIT Support Ticket Creation for assistance.