Sunwave 7.7

Release Highlights

RCM: Enhancement in Auto-billing: Seamless Collaboration of "Service Type" with "First Provider" Setting

What's New: We've fine-tuned the auto-billing mechanism to allow the "Service Type" attribute and the "First Provider" setting to operate harmoniously. This enhancement permits a provider, when signing a form, to trigger the system into recognizing both the form’s signature and its specified "Service Type" to deduce the right billing rates.

Why It Matters: By utilizing a single form, the system can now automatically charge the correct amount, regardless of the provider. Service-specific billing demands meticulous attention, especially when rates can vary, as seen with services like the Master Treatment Plan. These rates can differ based on delivery method (in-person vs telehealth) or its nature (new vs review). This enhancement ensures the billing process remains both accurate and versatile, adapting to the precise type of service provided.

Who It's For: This upgrade is pivotal for Billing Coordinators, Providers, and all stakeholders in the billing procedure. Providers benefit as they can work with a single form, irrespective of the service type, eliminating the hassle of selecting distinct forms. It's particularly advantageous for those managing outpatient services where the "First Provider" functionality is active.

How to Use This Update:

1. While creating a form like the Master Treatment Plan, utilize the "Service Type" component to designate the kind of service (In-person, Telehealth, New, Review).

2. Upon the form being endorsed by the first provider (anyone from the listed Providers or more specific based on a service business rule), the system simultaneously acknowledges the "Service Type" and the form’s signature.

3. Subsequently, the auto-bill mechanism will select the appropriate service and rate contingent on the designated "Service Type".

4. This facilitates an accurate and automated billing process, substantially simplifying the billing workflow.

Billing - Manage EOBs - Enhanced Patient Name Search Functionality

What's New: Users can now use the "Patient Name" as a search parameter under the "Manage EOBs".

Why It Matters: By introducing the "Patient Name" as a distinct search parameter, we're ensuring a cleaner, more organized, and efficient way to manage EOBs.

Who It's For: This enhancement is for all users who frequently navigate and manage the EOBs, especially those who felt the need for a dedicated "Patient Name" search function.

How to Use This Update:

1. Navigate to the billing tab.

2. Access the "Manage EOBs" section.

3. Locate the search bar and select the "Patient Name" parameter.

4. Input the patient's name you wish to search for.

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Note: Although "Patient Name" can be used as a search criterion, it won't be displayed in the search results for Insurance payments, ensuring a more focused result set. The feature impacts the line level, not the header level.

Therapist Tools - Enhanced Calendar Selection in Patient Engagement Packages

What's New: Therapists can now pick their personal calendar when sending out booking invites, instead of just the general one. This means patients can easily schedule their next session with the same therapist.

Why It Matters: It makes sure patients see the same therapist every time.

Who It’s For: Therapists sending out booking invites, and patients booking their next session.

How It Works:

1. Go to the Patient Chart.

2. Click on "Patient Engagement Tab".

3. Select "Create Envelope".

4. Check "Include Calendar Request".

5. In the "Calendar" dropdown, you'll now see therapist names. Pick one.

6. Send the invite as usual.

Remember: You can pick a personal calendar or the general one, but not both at once. Happy booking!

Faster Access to Pending Forms

What's New: Enhanced loading speed for viewing sent patient engagement packets in "Pending Forms". We've also introduced pagination, displaying up to 500 results per page.

Why It Matters: Therapists and Administrators are on-boarding many patients simultaneously and require fast access to review engagement packets.

Who It's For: Therapists and Administrators managing and reviewing multiple patient engagements.

How It Works: When you select “Pending Forms,” the optimized page loads quickly. Results are divided into easily navigable pages, each containing up to 500 results.

Billing - Automated Condition Codes for UB04 Claims

What's New: We’ve introduced automation for setting Condition Codes on UB04 Claims, especially designed for BCBS of MS at Addiction Campuses Mississippi OP. Now, the system can automatically populate the required codes, ensuring your claims are always in line with what insurance providers expect.

Why It Matters: As insurance requirements evolve, we're committed to staying ahead. With just a single setup of your desired codes, our upgraded system takes over the heavy lifting.

Who It’s For:
Perfect for those handling BCBS of MS for Addiction Campuses Mississippi OP claims. Plus, it's flexible for any future requirements from different insurance providers.

How It Works:

1. Navigate to Master Data > Manage Services.

2. Choose a Service to see "Service Business Rules".

3. Under UB04 rules, look for the new "Boxes 18-28 Condition Code(s)" option.

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4. Input the codes you need, starting with Box 18.

5. Important: Box 18 needs a code before you can add one to Box 19, and so on.

Billing - Enhanced Refund Capabilities for Credit Card Payments

What's New: We're introducing the ability to process partial refunds on credit card payments, be it from patients or insurance companies. Now, overcharged amounts can be managed more flexibly, ensuring the right amount is returned without the need to refund the entire payment.

Why It Matters: Our enhancement streamlines the refund process, providing more control and efficiency for billing users, and ensuring customer satisfaction.

Who It’s For: Any Billings User working with credit card transactions.

How It Works:

1. Navigate to the settled credit card transaction you wish to refund.

2. Click on "REFUND".

3. Enter the desired refund amount. The system will display the UNALLOCATED AMOUNT – this is the maximum you can refund.

4. Confirm the refund.

Key Points:

• Refunds can only be processed for settled transactions.

• The refund functionality ensures that you cannot refund more than the unallocated amount. For example, if $100 was charged and $50 was allocated elsewhere, you can refund the remaining $50. If $51 was allocated, the refund option becomes unavailable.

Patient Chart - Enhanced Warning History Tracking

What's New: We've introduced a history tracker for warnings within the patient chart. This feature ensures that you are fully informed about all adjustments made to warnings, from their inception to any subsequent modifications.

Why It Matters: By keeping track of changes, we can easily look back and see what was changed, when, and why. This helps in catching mistakes, understanding past decisions, and making sure everything is correct.

Who It’s For: Designed primarily for Admins, but any authorized user with the necessary permissions can view these changes.

How It Works:

1. Within a patient’s chart, navigate to Menu.

2. Select the "Edit Warnings" option.

3. Find the "History" button and click it.

4. The Warnings History dialog will be displayed, detailing all changes, including additions, deletions, and modifications to warnings.

All Tickets in Release

• SUN-3013 - PE - Pending Forms - Increase Performant Load Time of Set of Results

• SUN-2971 - Patient Engagement - Add Filters to Pending Forms

• SUN-2923 - Financials - Baseline and Capture Changes made to Chart of Accounts

• SUN-2859 - CP Enhance "First Provider" to Support "Service Type" in Autobilling

• SUN-2843 - Billing - Manage EOBs - Search and Add Patient Name

• SUN-2431 - Patient Engagement Envelope - Invite Patients to Book on User Cal

• SUN-2243 - Enhancement Request: Configurable Condition Codes for UB04 Claims

• SUN-1908 - Ability to do Partial Refunds on Credit Card payments

• SUN-1766 - Users - Remediate Duplicate Form Approval Behavior within Departments

• SUN-921 - Ability to track history on changes to Warnings

• SUN-43 - Custom Fields Report: Insurance Provider field blank and Admission Date filter not applied