Panviva
This list will allow you to access most commonly used workflows, tip sheets, pathways
What is Favorites?
Prior to researching a denial, this area should be reviewed
What is Activity History?
This activity is used to write off outstanding balances on the claim when all efforts have been exhausted and/or the service cannot be billed to the patient nor will be reimbursed by the payer
What is Adjust?
This process is where individuals review medical charts and diagnoses to translate the information into standardized codes
What is Medical Coding?
This activity is informally known as a "Tickler"
What is Reminder Set?
This tip sheet outlines the reasons a claim may be postponed, the expected duration of the postponement, and any necessary ticklers
What is Deferral Reasons List?
This tool allows you to check eligibility for a past DOS
What is New E-Cvg?
This activity is used when documenting a claim before performing a VFO update
What is Note?
The Claim Status grouping in the sidebar can state either of these two statuses from the Clearinghouse
What is Accepted or Rejected?
This grouping in Professional Tx Inquiry is helpful when identifying claim statuses
What is Invoices grouping?
This workflow provides guidance on how to send a claim back for reprocessing with an insurance carrier, but with fixed information
What is Corrected Claims Workflow?
This common plan is registered twice for PB and HB
What is NYSHIP?
This activity may be used when unable to determine who a patient's primary insurance carrier is
What is NRP?
This process is where insurance companies review healthcare claims and decide whether they will pay the claim in full, pay a partial amount, deny the claim, and process as in or out of network
What is Claims Adjudication?
This Go-To option will be helpful when the insurance company is requesting medical documentation
What is Chart?
This pathway outlines specific denial remit codes and provides guidance on how to resolve them.
What is Eligibility Denial Pathway?
This common plan contains two insurance carriers for PB and HB, yet is registered only once.
What is BCBS GHI Composite?
This activity may be used when a claim was denied wrongfully and we must provide documentation to support a wrongful denial reason
What is Denial Appeal?
This workqueue is where all claims initially live
What is No Response workqueue?
These two Guarantor Account Tabs must be reviewed prior to sending communication to the patient
What is Statements/Letters and CRM List?
This workflow provides a list of billing activities that invoices may move over to when additional information is required.
What is Routing Invoice?
This coverage order applies to a specific DOS
What is Visit Filing Order/VFO?
This activity is used for a coding review directly to the practice
What is CBO Billing Coordinator Communication WQ?
This is the stage where the lifecycle of a claim begins
What is Pre-Appointment?
This area is where AR Reps and CS reps will be able to find previous AR resolution notes