CRM Enhancements

Collection Warning Enhancements

What’s New
The Collections Warning feature has been enhanced to support deactivation workflows including the ability to capture a removal reason, removal comments, and a timestamp with user attribution. These changes improve traceability and compliance while allowing more granular control over the end of collection statuses. Collection Statuses will now be displayed at the Opportunity and Account Level

Why It Matters
This update enhances financial documentation workflows by requiring a justification. By enforcing removal reason selection, the system now ensures better transparency and provides a foundation for future reporting on financial risk interventions.

Who’s It For

• RCM & Billing Teams managing collection workflows

• CRM Users interacting with collections on Opportunities and Accounts

• Compliance & Admin Users configuring and auditing collections data

How to Use It

Navigate to List of Values → CRM → Collection Warning Removal Reasons and use the + New Registry button to add removal reasons.

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Collection Warnings Removal Reasons

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When a Collections Warning is deactivated, new fields will be presented to capture the Removal Reason and optionally a note. The Date, Time and User are logged for reporting purposes.

Collection Warnings History

The Collections Warning history modal now includes a “Removal Reason” column. This view is accessible by pressing the History icon in the Collection Warning Modal

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Account Support for Collection Warnings

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The CRM → Account → Detailed Account View now displays if an active collection warning is associated to the patient via the Collections text across the top of the view. Press Collections or navigate through Menu → Collections Warning to view or resolve the warning.

Opportunity Admissions Info Support for Collection Warning

CRM → Create Opportunity → Admissions Info now surfaces any collection warnings for related records.

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When creating an opportunity, if Sunwave finds a pre-existing account, Collections Warning will be surfaced. Click Collections to view.

Collections Warning Report

Whats New
A new Collections Warning Report has been added under the CRM module. This report allows users to audit all active and expired collections warnings across patients and accounts. It includes both initial activation details and removal metadata such as removal reason, removal date, and user activity—bringing greater visibility and compliance traceability.

Why This Matters
This report ensures full transparency for all warnings—past and present—by capturing key lifecycle events, reasons, and user accountability in a single place.

Who It's For
CRM and billing administrators, finance teams, and compliance personnel in the Parent Realm with hasCRM permissions who need visibility into collections warnings across facilities. This includes managing patient billing follow-up, evaluating removal trends, or verifying compliance with internal financial policies.

How it works
Users can navigate to CRM → Collections Warning Report, where they’ll find configurable filters:

• Status Filter: Active, Expired, or All (default: All)

• Date Range: Filters by Effective Date (Active) or Removal Date (Expired)

The report displays one row per warning

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EMR Enhancements

Incident Report

Whats New
A new Incident Reports module has been added to support the creation and management of facility-related incidents t. Users can now record, view, and track incidents involving staff, buildings, or operational issues directly within the platform. This includes a new left menu navigation option, a searchable summary page, and a detailed modal for entering incident details.

Why This Matters
Regulatory compliance, internal auditing, and facility-level risk management all require accurate, timely documentation of events that occur outside of patient care.This enhancement provides staff with a purpose-built interface to record such events, improving transparency, coordination, and audit readiness across departments.

Who It's For
Facility Staff, Shift Supervisors, and Administrative Users responsible for compliance, quality assurance, or facility operations oversight. Admin users can manage all incident records across facilities, while standard users can only access reports in their assigned locations.

How it works
Users can now navigate to Incident Reports from the left-hand menu (near “Shift Notes”). This opens a dedicated dashboard with filters for Service Facility, Incident Date, Staff, Patients, and Incident Type. The page displays incidents in a sortable, chronological list. A [+ New Incident Report] button launches a modal with fields for incident metadata, descriptions, attachments, and signatures.

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Reports can be created with or without patient or staff involvement. Incident types are driven by a configurable list of values located in Practice Set-Up.

Use the small down arrow to the right of the row to expose a detailed view

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Users can only view or manage reports for the facilities they’re assigned to.

Access to Incident Reports is currently Role Based

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SUNWAVE Enhancements

Extended Healthcare Team Selection in Role Templates

What’s New

You can now select Extended Healthcare Team members when creating or editing a Role Template under
Practice Setup>Roles

These members are pulled directly from the Extended Healthcare Team configured in the Realm
(Practice Setup → List of Values → EMR → Extended Healthcare Team).

This enhancement also allows you to assign and remove permissions for those team members within a role, and have them automatically applied when assigning the role to a user.

Why It Matters

This update makes it easier to align user roles and permissions with your actual healthcare team structure.
Instead of manually configuring permissions for extended team members, practices can now streamline setup by selecting predefined members — ensuring accuracy, consistency, and time savings when onboarding staff or adjusting responsibilities.

Who It’s For

• Practice Administrators and System Configurators managing user roles and permissions.

• Clinical Operations Teams that utilize custom Extended Healthcare Team roles.

How to Use It

1. Navigate to Practice Setup → Roles → Permissions.

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3. Create or edit a role template.

4. Under the permissions tab in the role you now have Extended Healthcare Team Members, select from the list populated from the Realm configuration.

5. Save your changes — the selected team members will automatically load when this role is applied to a user.

RCM

Editable “From Date” (Box 18) in CMS-1500 Claims

What’s New

You can now edit the “From Date” field (Box 18) on the CMS-1500 claim form when the claim is in Edit status.
This field captures the start date of hospitalization.

This enhancement gives users more flexibility to ensure claim submissions meet payer-specific requirements.

Why It Matters

Some payers require the hospitalization start date to be included in Box 18 of the CMS-1500 form.
Previously, this field was not editable once a claim was generated, forcing users to recreate or manually adjust claims outside the system.
Now, users can add or correct hospitalization start dates directly in the claim editor, improving claim accuracy, compliance, and submission efficiency.

Who It’s For

• Billing Specialists and Claims Processors who manage medical claims.

• Revenue Cycle Teams needing to ensure payer-required hospitalization details are captured for timely reimbursement.

How to Use It

1. Open a claim in CMS-1500 format that is in Edit status.

2. Locate Box 18 – “Hospitalization Dates Related to Current Services.”

3. Enter or edit the “From Date” field as needed.

4. Proceed with standard review and submission processes.

Patient Superbill for Non Contract Services

What’s New

We now have a new form builder component called Patient Superbill. The superbill is added to a Form called Superbill.

This form provides patients with the information they need to submit claims directly to their insurance carriers.
It includes all essential billing and clinical details, while ensuring payer-required data is clearly presented.

The new form displays:

• Claim Number

• Date of Service,

• POS

• CPT/Rev Code

• Diagnosis Code(s)

• Description of the Service

• Units

• Fee

• Rendering Provider Name, NPI, and License, Phone and Email

• (Service Facility) NPI

• Service Facility displayed per service order line (above provider)

• Charges only — no payments

Why It Matters

Patients frequently request itemized documentation to submit to their insurance for out-of-network reimbursement.

With this enhancement, users can now quickly generate a compliant insurance reimbursement statement directly from the system, reducing administrative effort and ensuring data accuracy.

The new form:

• Eliminates confusion by excluding payment data (charges only).

• Provides complete provider and facility identifiers needed for payer reimbursement.

Who It’s For

• Billing and Administrative Teams who generate patient statements or superbills.

• Front Office Staff assisting patients with out-of-network insurance submissions.

• Patients needing accurate reimbursement documentation for personal insurance claims.

How to Use It

1. Create a form in form builder called Patient Superbill.

2. Add the form builder component titled Patient Superbill and save the form.

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4. This form can be added to your Insurance or Financial tab and will generate patient superbills as needed.

5. In the patient chart

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6. Exported

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Visible Lines in ERA Posting (Previously Hidden or Transparent)

What’s New

ERA posting lines that were previously hidden or transparent are now fully visible in the ERA posting screen.
This includes scenarios such as:

• Takebacks

• Multiple lines with the same procedure code and date of service

Previously, users could only see the line details (Claim ID, Patient Name, DOS, etc.) by highlighting over the area. Now, those lines are clearly displayed in the grid — eliminating confusion.

• Lines are displayed even when enhanced EOBs are active in Managed Realms.

• The display logic has been adjusted so that information from 835 files is no longer rendered as transparent when not duplicated.

Why It Matters

This update improves clarity and efficiency during ERA payment posting.

Key benefits include:

• Clear visibility of all ERA line items.

• Reduced risk of posting errors or missed transactions.

• Consistent experience across standard and enhanced EOB views.

Who It’s For

• Billing and Payment Posting Teams working in the ERA module.

• Revenue Cycle Management staff handling remittance files and claim reconciliation.

How to Use It

1. Go to Billing → Manage EOBs → New Remit → From ERA.

2. Load an ERA file (e.g., 835 file).

3. All lines, including those with:

   • Same procedure code and date of service, or

   • Takebacks, adjustments, and non-duplicated remittance lines,
     will now be fully visible in the posting grid.

4. Continue with standard posting or reconciliation workflows — no additional steps required.