Journeys
The journeys an accounts receivable (A/R) user walks, step by step. Each step opens the screen it happens on.
For an accounts receivable (A/R) user
See what payers owe
Match payments to claims.Chase a claim
Find out why money has not arrived.Read what NPHIES accepted
Check the last batch before you chase anything.Match a notice to its claims
Follow a payment notice down to the claims it paid.Chase a denied claim with the claims desk
You find the problem, they fix it.Open the Denied queue.
Open screen 2Claim detailRead the claim. Check its status. Assign it to a claims officer.
Open screen 3Status checkerCheck the status of the transaction.
Open screen 4MessagesOpen the payer message linked to the claim.
Open screen 5Send communicationReply on that claim only.
Open screenWork across facilities
A central desk follows more than one hospital.Month-end hand-off to finance
Give the finance manager the numbers without a report screen.For everyone
Sign in
Get in safely. After sign in the wireframes ask who you are; the real portal opens the home of your own role.First sign in
Replace the temporary password, then enroll.First time with two-step sign in
Enroll before you continue.Lost your phone
Get in without the Authenticator app.Forgot the password
Recover without calling anyone.Your password expired
Replace it when the policy says so.Ask for an account or for access
No account yet, or the wrong role.Look after your own account
Password, sessions, history and notifications.Time out and sign out
What happens when you step away.When you cannot open something
A clear reason and a way forward.A record of another facility (CL-30091) shows as a hidden row with no patient details. The Administrator and the Auditor read every facility, so they see it listed with its facility in the Multi-facility state.
Open screen 2This record belongs to another facilityClick the hidden row. Read why, then go back.
Open screen 3HomeOpen an area your role does not have.
Open screen 4No access to this areaAsk for access. The request is sent and logged.
Open screen 5Page not foundA wrong address ends here.
Open screenWhen the portal or NPHIES is down
Know what is saved and what is not.Find help
Get an answer without leaving the portal.Hospital flows, end to end
Flows that cross roles. Each step names the role that does it. A step you can open in your own menu is a link. A step that only another role can open is shown as text with that role named.
Patient arrives to cash collected
The revenue cycle, from the front desk to the bank.Check eligibility before the visit.
Opens in the Receptionist menuRead the answer, print it for the file, hand the case to the approval desk.
Opens in the Receptionist menuAsk for prior authorization.
Opens in the Insurance approval officer menuRead the approval. It now shows in Ready to bill.
Opens in the Insurance approval officer menuTake it from the Ready to bill queue.
Open screenReview and submit the claim.
Opens in the Claims officer menuSend it in a batch.
Opens in the Claims officer menuMatch the payment.
Open screenRecord the payment notice.
Opens in the Accounts payable (A/P) menuRead the notice.
Open screenDenial and resubmission
From a denied claim to an accepted one, with a trail.The denial arrives.
Open screen 2Claims officerWork queuesOpen the Denied queue.
Open screen 3A/R (you)Claim detailSpotted it first and assigned it.
Open screen 4Claims officerCase timelineAdd a note about the payer call.
Open screenCorrect and resubmit.
Opens in the Claims officer menuFollow the new result.
Open screenWhen NPHIES is down
Nothing is lost and nothing is sent twice.A banner says NPHIES is not answering.
Open screenSave and send later.
Opens in the Receptionist menuSave and send later.
Opens in the Insurance approval officer menuSave and send later.
Opens in the Claims officer menuSee what is saved.
Open screenSee what was sent after the recovery (second release option).
Opens in the Administrator menuWhen the hospital system is down
Desks keep working where the fallback allows, and nothing is lost.A banner says the hospital system is not answering.
Open screenLookup is unavailable. Enter the patient by hand if the fallback allows.
Opens in the Receptionist menuPractitioners come from the last known copy, marked as not refreshed.
Opens in the Insurance approval officer menuThe service catalogue is read only until the source is back.
Opens in the Claims officer menuRead the status and the fallback per entity.
Opens in the Super admin menuAfter recovery, fix the rows that failed.
Opens in the Super admin menuMonth-end
Hand finance the numbers with CSV exports in the first release.Export the month's claims.
Open screen 2A/R (you)Reconciliation historyExport reconciliation by facility.
Open screen 3A/PPayment noticesExport the payment notices.
Open screen 4A/R (you)Reconciliation exceptionsShort-paid and unmatched claims (second release option).
Open screen