Sunwave 8.9

Table of Contents

CRM Enhancements

Calendar Appointments – Schedule Opportunities

What’s New

Admissions users can now schedule Opportunities directly into Calendar Appointments. A new “Opportunity” field has been added to the appointment window, allowing users to link active opportunities instead of existing patients.

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Why It Matters

It supports outreach workflows, and ensures visibility of opportunity-related appointments throughout the calendar and roster views.

Who’s It For

Admissions and intake staff who coordinate appointments for opportunities and prospects prior to conversion into patients.

How to Use It

• On the Calendar Appointment screen, use the new “Opportunity” selector to search for and select from active opportunities.

• When an opportunity is selected, the Patient field becomes disabled (and vice versa).

• The Detail Tile in the calendar view and the Roster View will reflect opportunity-based appointments.

• Appointments created this way will also appear in the Intake Calendar, improving intake tracking from lead to conversion.

🔒 Access remains restricted to opportunities and facilities the user is already permitted to view, per their profile settings.

EMR Enhancements

EMR - Q's Report - Add Location to Export CSV Functionality

What’s New
The Q’s Report export to CSV now includes the Location associated with each patient’s Q-time entry. This update brings greater visibility and operational detail to exported data, supporting downstream reporting and analysis.

Why It Matters

• Enhanced Reporting Clarity: Including the Location field ensures teams can easily identify where services or observations occurred.

• Improved Workflow Coordination: Enables better coordination across teams managing patients across multiple facilities or units.

• Supports Data Analysis: Adds geographic or departmental granularity to Q-time data for operational reporting, compliance tracking, and internal auditing.

Who’s It For
This update benefits:

• Clinical Managers and Team Leads

• Operations and Quality Improvement Analysts

• Administrative and Compliance Teams

• Anyone exporting and analyzing Q’s Report data

How to Use It

• Open the Q’s Report in the EMR.

• Click “Dowload CSV”

• Open the downloaded file – a new column labeled Location will now appear alongside each Q-time entry.

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Patients on LoA Now Filterable in Q’s Report

What’s New
The Patient Q’s Report has been enhanced to support Leave of Absence (LoA) logic. A new filter, “Exclude LoA,” allows users to optionally hide patients who are on an LoA during the selected reporting period. This ensures more accurate and operationally meaningful Q-time reporting.

Why It Matters

• Prevents accidental assignment or tracking of patients not available for care due to LoA.

• Enhanced Reporting Accuracy: Ensures teams are working with the most up-to-date and relevant patient availability data.

Who’s It For
Medical and clinical staff who utilize the Q’s report for ensuring correct documentation.

How to Use It

1. Open the Q’s Report from the reports tab in the left menu bar.

2. Locate the new checkbox labeled: Exclude LoA

3. Check the box to hide all patients who have an LoA that overlaps with the reporting time frame.

   • If the checkbox is left unchecked (default setting), all patients, including those on an LoA, will appear in the report.

   • Patients who return from LoA during the report period will reappear for Q times after their return.

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OP Methadone - Improve Check In Screen for Payment Collection

What’s New

The Detailed Patient Check-In Modal within Inventory → Patient Check-In has been enhanced to provide front desk staff with critical information at the time of patient check-in. New fields now display:

• Total doses scheduled today (including take-homes and split doses)

• Treatment (Order) Code

• Number of days covered by the current order

These updates enable staff to accurately collect payments without navigating to other modules or waiting for intake to be completed.

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Why It Matters
Previously, front desk staff had to access multiple areas of the system—such as Med Census, Chart, Prepack, and Inventory—to confirm full dose schedules and treatment codes. This created inefficiencies and increased the risk of:

• Charging the incorrect amount at check-in

• Processing refunds or requiring additional payments

• Delays in workflow and patient throughput

With these new enhancements, all key medication and billing details are accessible in one place.

Who’s It For

• Front Desk Staff

• Any staff member responsible for check-ins and upfront payment collection for medicated treatment programs

How to Use It
Navigate to:
Inventory → Patient Check-In → Type the Patient Name and hit search

Select Patient from the list in drop down.

A new window with order code, total doses today and number of days will be listed as well as take home doses.

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OP Methadone Inventory Orders Now Showing in Med Orders Ready for Approval

What’s New

Inventory Orders created by non-licensed users (e.g., clinical support staff or case managers) will now route to the supervising provider’s approval queue, ensuring compliance and visibility for all medications—including controlled substances—in Outpatient MAT and Methadone treatment realms.

This update standardizes approval routing across all medication entry paths, including Inventory Orders, to ensure no controlled or non-controlled substance is dispensed without provider review.

Why It Matters

Previously, medications entered via the Inventory Order workflow in Current Medications > Create Order > Custom Orders were not appearing in the provider's “Med Orders Ready for Approval” or “Controlled Substance Orders Ready for Approval” queues. As a result, providers were unaware of orders placed in their name, introducing potential clinical, regulatory, and safety risks.

Who’s It For

• Clinical Support Staff and Case Managers who initiate medication orders on behalf of a provider

• Supervising Providers responsible for reviewing and signing off on orders

• Compliance and Operations Teams in MAT programs

Form Builder - Add CIWA - Implement Full Scoring Range

What’s New
The CIWA (Clinical Institute Withdrawal Assessment) component within the Form Builder has been updated to support the full scoring range across key symptoms. This change ensures that clinical assessments can capture all necessary severity levels without restriction.

Why It Matters
Clinical Accuracy and Improved Decision Support: Complete scoring allows providers to assess and document withdrawal symptoms more accurately, supporting appropriate treatment planning.

• Regulatory & Quality Compliance: Accurate scoring aligns with standardized CIWA protocol expectations for substance withdrawal monitoring.

Who’s It For

This update supports:

• Clinical Staff and Nurses completing CIWA assessments

• Care Teams responsible for withdrawal management

• Quality Assurance & Compliance Teams

• Admins configuring Forms in the EMR

How to Use It

Go to form builder and in the action button select CIWA Assessment.

This must be added new to the form. This will not work moving backwards.

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RCM

RCM- Can’t Quickly View Associated Patient Payments from Claims Screen

What’s New

You can now quickly view patient payment details directly from the Claims screen within the Patient Chart. Just like insurance payments, patient payments are now displayed as blue hyperlinks, making it faster and easier to review payment details without navigating away.

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Why It Matters

• Improved Usability: Allows billing and support teams to instantly view patient payment information with one click.

• Consistent Experience: Aligns the display behavior of patient and insurance payments, improving UI consistency.

Who It’s For

This update benefits:

• RCM and Billing Specialists

• Front Office and Collections Staff

Anyone who uses the Claims screen in the Patient Chart to manage or verify payments will find this enhancement valuable.

How to Use It

1. Navigate to a Patient Chart and open the Claims tab.

2. Locate any claim with a Paid by Patient entry.

3. The payment amount will now appear as a blue hyperlink.

4. Click the link to open a popup window showing full payment details.

RCM - Open end date on cms 1500 claim form for editing

What’s New:
The CMS 1500 Claim Form has been enhanced to support Medication-Assisted Treatment (MAT) 7-day billing by enabling direct user editing of the end date in Box 24A. In addition to editing the end date you can also automate end date to be the Sunday of each week.

Why It Matters

• Supports MAT Billing Protocols: Enables compliance with MAT-specific billing requirements, including multi-day spans such as 7-day episodes of care.

• Enhances Flexibility: Users can now manually adjust the end date as needed for eligible claims without relying on backend adjustments.

• Ensures Consistent Data Flow: Edits are preserved across claim exports, print views, and downloaded claim PDFs, ensuring continuity in documentation and billing systems like Waystar.

Who It’s For

This update supports:

• Billing and Claims Submission Teams

• Clinical Admins Handling MAT Services

• Revenue Cycle Managers

How to Use It

Manually

1. Select a cms 1500 claim for and change the status to edit.

2. Locate Box 24A – Date of Service

3. Edit the End Date Field as appropriate for the service duration (e.g., a 7-day span for MAT services).

4. Change the status to Ready and then Submit or export the form as needed

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Automated

1. In manage realms you must select “is inventory outpatient module enabled.”

2. In Master Data >Service business rules you will have a new checkbox called “is weekly bundle.” When this is selected the end date will automatically populate to the Sunday following the start date.

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RCM - RCM - Box 71 rules for DRG Codes in the business service rules

What’s New:
A new field for Box 71 (DRG Code) has been added to the Service Business Rules interface for UB04 institutional claims. This field allows users to enter a numeric DRG code (up to 3 digits) directly within payer or custom rule configurations.

Why It Matters:
Claim Accuracy: Including the DRG Code helps ensure institutional claims meet payer requirements.

• Better Configuration Control: Teams can now specify DRG codes at the service level, enabling more precise and compliant billing.

• Complete Output Support: The entered DRG Code is now included in both the printed and exported versions of UB04 claims, ensuring consistent documentation and downstream processing.

Who It’s For:
Designed for billing, and accounts receivable staff managing facility-based services or payer-specific UB04 configurations.

How to Use It:

• Navigate to:
  Master Data > Manage Services

• Select a Service

• Open the Payer Rules tab or any applicable business rule section

• Find the new field labeled: Box 71 (DRG Code)

  • Enter the appropriate DRG code (up to 3 numeric digits)

  • Example entries: 003, 217, 999

• This data will now appear on:

  • Box 71 of the UB04 claim form

  • Printed copies of UB04 claims

  • Exported claims

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RCM - Billing Setup: Requires Insurance Auths - has been moved down to Service business rule

What’s New:
The “Requires Insurance Auths” setting has been relocated from the Service Information section and is now available within the Service Business Rules area of the system. This change gives users more granular control over when and where insurance authorizations are required, on a per-service basis.

Why It Matters:
Improved Flexibility: By moving this setting to the service level, organizations can configure authorization requirements tailored to each specific service.

• Enhanced Accuracy: Reduces errors by ensuring that only applicable services enforce authorization logic, aligned with payer and clinical requirements.

• Streamlined Configuration: Centralizes key service-level rules into one cohesive location under Service Business Rules, improving user experience and system maintenance.

Who It’s For:
This update benefits billing staff and anyone involved in service setup, claim configuration or payer rule management.

How to Use It:

• Navigate to:
  Master Data > Manage Services

• Select a Service

• Open the Payer Rules or the applicable business rule section

• Locate the new field: Requires Insurance Auths

  • Enable or disable based on service-specific authorization needs

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Ticket Summary Table