About firstREV

Agencies can now utilize firstREV, a new revenue cycle management and health data analytics feature that is accessible within the Enterprise Edition (EE) software. firstREV acts as a clearinghouse product, where users can upload, edit, and manage claims, retrieve remittance advice, and more, to make claims as clean as possible before submitting to payers — for the quickest possible reimbursement. firstREV is an add-on feature that is completely optional and is offered to all agencies at no additional cost.

firstREV provides a range of tools that help agencies to effectively manage the revenue cycle for all of their payers. Listed below are some of the benefits that come with using the firstREV interface:

● Automatic claim submission and response tracking available for all commercial and Medicare payers

Though there is no cost to this service, some agencies must complete an enrollment process before they can use firstREV. This requirement is based on whether or not is enlisted in HEALTHCAREfirst billing services.

Billing Service Clients

As part of your contracted services, HEALTHCAREfirst will complete all necessary enrollment steps to enable the firstREV interface within your agency’s Enterprise Edition database.

Non-Billing Service Clients

If your agency does not enlist billing services with HEALTHCAREfirst, you will need to complete an enrollment process before using firstREV. Each agency should first determine if they wish to transition to firstREV. Applicable agencies can then follow the brief enrollment process outlined on the next page.

Agencies can opt to continue using their existing clearinghouse(s) for the editing and submission non-Medicare claims. Agencies can still send Medicare claims and receive responses using the EE software.

Though firstREV is completely optional and free of charge, it is also designed to serve as a clearinghouse and can be used to replace your clearinghouse. There is no deadline for enrolling in firstREV. If your agency continues to use an existing vendor for non-Medicare claim submission, you can still opt to enroll in firstREV at any time in the future.

Applicable agencies that choose to take advantage of this feature will need to complete an enrollment process. Users can follow the simple process outlined below to enable the firstREV interface within your agency’s database.

STEP 1: Start Enrollment Process

1. Login to Enterprise Edition.

2. Using the Main Menu, navigate to Reports.

3. For the Report Category field, choose Master Listings.

4. For the Report Name field, select firstREV Enrollment. Your browser will automatically download the enrollment report as an Excel file (.xlsx). The report file separates data into three tabs: Main Agency Info, Additional Facilities, and Payers.

5. Review all information included in the report file to confirm its accuracy. Add any missing information. Ensure that information in this report is complete and correct.

Payers will only be included in the report file if the Send Electronic 837 Bill option is enabled (in Master Files | Payors / Plans | Payors).

6. E-mail your approved firstREV Enrollment Report to firstrevsupport@healthcarefirst.com.

STEP 2: Additional Payer-Specific Enrollment

● Some payers require additional enrollment forms to be completed.

● Based on information submitted in the firstREV Enrollment Report, HEALTHCAREfirst will determine if any of your payers have additional enrollment requirements.

● HEALTHCAREfirst will send your agency any additional payer-specific forms that must be completed.

o Do not leave any fields blank or it may result in a denial of enrollment.

o Once completed, send the additional payer-specific enrollment forms to firstrevsupport@healthcarefirst.com to initiate your firstREV account setup.

o HEALTHCAREfirst will respond as soon as more information is available regarding setup. We will respond as soon as information becomes available regarding your account setup. Payer response times can vary so please be patient throughout this process.

You can continue to submit claims to these payers by generating the 837 claim file from within EE (Accounts | Billing) and uploading it directly to the payer (or through your usual process). By enrolling with the payer through firstREV, your agency will no longer need to upload the claim files through another clearinghouse. Once your agency’s firstREV account is live, you may want to cancel any contractual relationships with the clearinghouse.

Listed in this section are two common questions that are encountered throughout the firstREV transition process. For a comprehensive list of frequently asked questions about firstREV, refer to the firstREV FAQs topic, which is accessed by clicking the firstREV() icon at the top-right of any screen in the software.

Q. How will you submit claims to Medicare?

Billers will create the batch and work with batches to clean up any errors (using the Create Batches and Work With Batches tabs, respectively) just as they do using the current process. Once claims are in a “clean” status and are ready to be submitted, users can proceed to the Post Batches tab and click Submit Bill. The software will automatically send your claim to the appropriate Medicare payer.

Q. How will you submit claims for non-Medicare payers?

Billers can continue submitting as they do currently by generating the electronic file, downloading it to your computer, and then uploading it to the payer’s portal. If you opt to use firstREV, providers will then have the ability to submit all claims electronically. To do this, providers must first enroll in order for payers to be set up for electronic submission.