Work Center Overview

  • Updated

The Work Center allows you to manage each phase of the billing lifecycle, from verification of benefits and authorizations, to claim submission, follow-up, and payment posting. 

Additionally, organizations using Patient Billing will use the Work Center to create patient billables, generate statements, and post patient payments. 

Work Center Home

The Home tab allows you to: 

  • View Assignments: This area will show you a dashboard view of all VOB, U/R, and claims assigned to you. Clicking on each tile will open the Work Center location where you can work on these assignments.
  • Dashboard: This tab is specific to organizations with Patient Billing enabled and will display the assigned patient billable and statement follow-up tasks. 
  • Upload Documents: A central place to upload all documents pertaining to patients and payments such as EOBs, medical records, authorization letters, payer letters of request, and other general documents. All practices and billing organizations maintain file-sharing relationships and use third-party services to transfer files back and forth. This section of AveaOffice eliminates the need for a third-party service. Click here to learn more.

VOB and U/R

The VOB and U/R portion of the Work Center allows you to manage incoming VOBs and expiring authorization plans.

  • Verification of Benefits (VOB): Once a patient’s insurance information has been entered, the VOB Work Center will begin the service level agreements process. There are four different time buckets for the VOBs: 120+ Minutes, 31-120 Minutes, 0-30 Minutes, and Overdue. As time passes, the patients will pass through each of these buckets. Once a VOB has been marked complete in the Benefits tab, the patient will be removed from this queue.
  • U/R: The U/R tab allows you to track follow-up and edit details for a patient’s utilization plans. Here you can filter by Case Manager, Practice, Facility, Rendering Provider, Payer, or Episode U/R status.
  • Eligibility Status: The Eligibility Status tab on the Work Center (under VOB and U/R) displays each patient with an active treatment episode and groups them into three segments: Inactive Coverage, Coverage Needs Review, and Active Coverage based on the results returned from the latest scheduled batch eligibility check.

Insurance Claims

The Insurance Claims section of the Work Center allows you to create claims, manage rejections and corrections, and submit claims for processing.

  • Work Claims: This tab helps organize your claim management workflow and automatically sorts claims by follow-up date. 
  • Create New Claims: This is where all treatments submitted from the Attendance Calendar will appear until the claims are created. 
  • Create Corrected Claims: The corrections generator is a system task that automatically runs each night and compares the submitted claim data to the data present in Avea. Any claims with data changes since the original claim submission will be flagged and placed in this tab for review. 
  • Submit Claims: Submit or resubmit claims from this tab. Claims have not been sent to the payer if they are in this section. 
  • Currently Rejected/Held Claims: All claims that fail the scrubbing process appear in this tab for review and resubmission. 

Insurance Payments

The Insurance Payments section of the Work Center allows you to resolve issues with automatically-posted ERA payments and manually post payments. 

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