RevNet User Guide - Payer Information

Payer Verification Pre-Requisites

There are some pre-requisites that must be completed before a Bill Record can be created and appear in Payer Verification. These pre-requisites are: ePCR must match to CAD, ePCR must match to Patient and for CAD only calls, the CAD must be matched to a patient.

Unmatched PCR to CAD records

ePCRs with no matching CAD can be seen on the Unmatched PCR -> CAD records dashboard. This is a Data Collection Dashboard Item. This can also been filtered for on the Basic ePCR Search (eChart -> Basic ePCR Search) page. Filter Items would be Date Range, No Matching CAD: Yes, Run Disposition: Treated/Transported, Dead After Arrival.

Unmatched CAD to PCR

CAD records that have not been associated with a PCR can be seen on the Unmatched CAD -> PCR records dashboard. This is a Data Collection Dashboard Item. This can also been filtered for on the CAD Search (eChart -> CAD Search) page. Filter Items would be Date Range, Required Matching PCR: Yes, No Matching PCR: Yes.

CAD Records with No Matching Patient

CAD records that have not been associated with a Patient can be seen on the CAD Records with No Matching Patient dashboard. This is a Data Collection Dashboard Item. Click the # on the record to be navigated to the CAD Records with No Matching Patient Page.

PCRs with No Matching Patient

ePCR that have not bee matched to a patient can be seen on the ePCRs with No Matching Patient Dashboard. This is a Data Collection Dashboard Item. Click the # on the record to be navigated to the ePCRs with No Matching Patient page. This can also be accessed from the Payer Verification page by clicking the link on the Payer Verification Page.

 

After clicking on the link to be navigated to the filter page, use the filter to limit the list of ePCRs. Filter Options include Service Date (Default Date Range is Today. Use the Custom Setting or use the Service Date Drop Down to select Date Option (Today, Yesterday, Last 2 Days, Last 3 Days, Last 7 Days, This Month, Last Month, Last 60 Days, Last 90 Days, Last Quarter, This Year or Last Year), Call #, Transport To, Billable (All/Not Billable/Billable), ePCR Branch (Items/Groups), Vehicle Unit # (Items/Groups), and/or Shift.

 

Results will be seen below the filter and will show the Call #, Service Date, Branch, Patient Name, Vehicle, Transport To, Matching CAD (Yes/No), Billable (Yes/No) and Hold Status. To Match Patient to ePCR click on the Call # to match.

 

Match ePCR to existing Patient

If there are existing patients that could match the ePCR patient they will be seen in the Patients with matching data. Information displayed include Score (1-5, 5 being a perfect match), Patient #, First Name, Last Name, Gender, DOB, SSN, Home Phone, Drivers Lic., Medicare, Medicaid from the Patient Information page. Fields highlighted in Green match between the ePCR and Patient Information. Click to match the ePCR to the Patient.

 

Click OK to confirm the match.

 

The match is confirmed when Successfully matched patient to call # message is seen.

     

Match Patient to ePCR - Create Patient

If there are no existing patients that could match the ePCR patient No matching patients found. will be seen in the Patients with matching data section. Below will display information from the ePCR. Click Search.

 

After the search, click Add Patient from this data (Override) to add the patient.