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Sample Workflow & Diagram
We understand that each organization has their own workflow process and we will work with
each client to determine the most efficient process that will achieve the goal of total savings.
Sample workflow process:
- Medical bills sent to your office are scanned, automatically sending an image of
the bill into a work queue for someone to assign the image to a claim file.
Alternatively, bills can be sent directly to iVOS Review Service for scanning and
assignment to the claim file.
- The bill is assigned to a claim file and the image is designated as a "Medical Bill"
which automatically routes a copy of the image to the Bill Review Processor's
work queue and the document inbox of the examiner assigned to the claim.
- Using Dual Display workstations, the Bill Review Processor connects to your
Valley Oak claims management system and views on one screen an image of the
scanned bill and on the other screen views the iVOS Review Software where the
bill is entered and adjusted by the appropriate state fee schedules and PPOs.
- Once the bill is repriced, it is routed to a Bill Review Supervisor for quality
control. The Bill Review Supervisor then changes the status of the bill to "Release
for Payment", which routes the bill to another work queue for an examiner or the
examiner's supervisor (depending on the iVOS payment authority limits) to
approve the bill in order for payment processing.
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Kevin Confetti