firstREV Revenue Cycle Management

There are two steps to making billing changes. The first step of our integration with ABILITY is migrating Medicare connectivity. We will follow the release schedule below for making these system changes.

Wave 1: Jurisdiction K Clients – April 11

Wave 2: Jurisdiction 6 Clients – April 18

Wave 3: Jurisdiction 15 Clients – April 20

Wave 4: Jurisdiction M Clients – April 24

The second step is enrolling in firstREV and setting up your payors so that you can bill for all payors electronically. Both steps can be happening together. The Medicare connectivity update will be quick and easy. The firstREV enrollment will require action from you to complete the setup process and enrollment of each of your payors. This FAQ document will answer many of your questions. We have a dedicated team here to assist you through the process as well.

 

Learn about what is changing and what you need to do to be prepared by attending one of these upcoming webinars. If you can’t attend or miss the session, don’t worry! We will send you the recording.

firstREV Basics

Tuesday, April 18 | 1:00pm-2:00pm CT | Register Here

Wednesday, April 26 | 10:00am-11:00am CT | Register Here

Tuesday, May 9 | 10:00am-11:00am CT | Register Here

 

Providers will see a difference on the Download Claims tab. You will no longer be able to edit claims in the UB04 format from this screen. However, this does not prevent you from billing Medicare claims. In order to edit your claims, you will need to enroll in the new firstREV platform. To minimize claim errors during this transition, it is important to work through all of the billing errors on the Work with Batches screen to ensure a clean submission of your claims.

 

This functionality will be available in the new firstREV platform along with other tools for streamlining billing processes. To gain this new functionality, providers must first enroll. During the transition, it is important to work through all of the billing errors on the Work With Batches screen to ensure a clean submission of your claims.

 

firstREV is a smarter way for home health and hospice providers to manage their entire revenue cycle. From billing electronic claims, checking eligibility, appeals and managing the remittance process, billers will have total visibility to every aspect of the claim lifecycle with 100% acknowledgement on all transactions. HEALTHCAREfirst has partnered with ABILITY, a Network Service Vendor and clearinghouse, to leverage their direct connection to Medicare and other payors and fully integrate this along with a robust user interface within firstHOMECARE and firstHOSPICE. The result is a seamless experience that includes the ability to manage all payors with quick access to every detail you would ever want to know about your transactions. It’s built on newer technology that links directly to source data. The result is faster transaction processing, reliable information and an easy to use interface. Managing your revenue just got better!

 

With firstREV, providers will be able to electronically submit claims and receive responses to all payors within the platform with one simple and consistent process regardless of payor. Billers will be able to check eligibility for all payors individually or in a batch mode and receive responses back in under seven seconds. All compliant media will be in one place making it easy to attach items to each other and easily follow the lifecycle of the claim. Billers will be able to handle appeals within the platform and no longer have to use their clearinghouse for this. Detailed audit trails will provide pinpointed information about breakdowns in any part of the claim process helping to prevent future errors. There is complete visibility so you can see every little detail of the claim as it moves through the process. The system will update with all payors every hour and provide 100% acknowledgement on all transactions. We consume every bit of information provided by your payor so you always have the latest information. No more waiting overnight for updates like with other clearinghouses. Strong edits with custom edits on the fly will ensure clean and accurate claims for all given payors. Agencies will now have the opportunity to more tightly control user rights within the system as well, giving billers access to a specific office or specific functionality within the system. Detailed analytics will provide insight to the entire billing process so you can more effectively manage your revenue cycle.

Without firstREV, providers may still generate 837 claim files and submit to Medicare through the Download Claims tab and also submit to other payors by uploading those electronic files directly to payors. However, more utilities and insights exist in firstREV so it is recommended that agencies enroll to receive the full benefit of these billing enhancements.

 

There will not be any increase in your monthly invoice for this enhancement. Our goal is to strengthen your ability to effectively manage your revenue cycle and get paid everything you are owed. It’s never been more important than now with decreasing reimbursements and increasing demands. We’re happy to say your agency will enjoy greater billing functionality on us!

 

As a HEALTHCAREfirst billing services customer, we will manage this setup for you. You do not need to do anything at this time.

 

To get started with firstREV, agencies will need to complete an onboarding process. Read the Enrolling in firstREV topic to get started with enrollment.

 

This decision is completely up to your agency. If you wish to continue working with your current clearinghouse, you can still generate electronic files as you do today and submit them to the clearinghouse. However, claim editing abilities are only available in firstREV. By using firstREV, your claims will be processed quicker and you will enjoy a seamless work experience within the HEALTHCAREfirst software with everything at your fingertips. Claims will be well organized and you will have greater visibility to every part of the claim process. You will also eliminate expenses with your current clearinghouse generating a cost savings for your agency.

 

Billers will create the batch and work with batches to clean up any errors just as you normally do. Once claims are in a clean status and are ready to be submitted, simply go to the Post Batches tab and click Submit. The software will automatically send your claim to the appropriate Medicare payor. Once you transition to firstREV and are live in the system, all claims will be submitted through firstREV.

 

Billers can continue submitting as they do today by generating the electronic file, downloading it to your computer and uploading it to the payor’s portal. With firstREV, providers will now have the ABILITY to submit all claims electronically. To do this, providers must enroll in order for payors to be set up for electronic submission.

 

HEALTHCAREfirst will offer webinar trainings on the new platform. Look for invitations in your e-mail for these trainings. We will also make recorded trainings available very soon!

 

Please contact your account representative at ABILITY.

 

Once enrolled, HEALTHCAREfirst and our partner, ABILITY, will follow up with your payors to complete the setup process with each payor enabling you to submit claims electronically. We will notify you once this has been completed. Until this is complete, it is recommended that you generate your claim files from the system and upload them directly to your payor to ensure timely receipt and no delay in payments. Once the enrollment and payor set up process is complete, you will be able to start billing through firstREV. The amount of time it takes to complete this process will vary for each agency as it is dependent upon several variables including payor responsiveness.

 

Within firstHOMECARE, Medicare eligibility will be checked upon admission just as it is today. Ongoing eligibility checking for all payors will be available in firstREV. This will replace your current login to firstCONNECT as it will happen right within the system without having to login to a new screen. You will also have additional functionality including being able to enable features in the system to automatically check eligibility before the claim is submitted as a failsafe for eligibility related denials or issues. Take advantage of this enhanced functionality by enrolling in firstREV.

 

ABILITY is HEALTHCAREfirst’s revenue cycle management partner. ABILITY is an approved Network Service Vendor (NSV) and is the largest submitter of Medicare claims in the country. By partnering with ABILITY, HEALTHCAREfirst clients will have the strongest revenue cycle engine for submitting electronic claims, verifying eligibility and managing the entire lifecycle of the claim with quick insights and easy to follow audit trails.

 

HEALTHCAREfirst is changing NSVs to bring customers greater billing functionality that will further streamline the billing process, and provide more utilities and insights to your financial performance.

 

A Network Service Vendor (NSV) is a company approved by CMS to offer connectivity service(s) to software vendors, providers, billing services and clearinghouses so that they can submit claims and retrieve reports directly to and from Medicare and other entities.

 

Medicare Administrative Contractors normally assign each PTAN, NPI, or location its own Medicare submitter ID number. Clearinghouse’s normally assign one submitter ID number for an agency to use for all of their locations. Medicaid programs will either assign one submitter for all locations or each location its own. Your Medicare Submitter number is located in the Identifiers section (in Master Files | Agency) in both firstHOMECARE and firstHOSPICE. Clearinghouse and Medicare submitter numbers can be located on the paperwork you received from them when you enrolled to submit electronically with them.

 

Setup one receiver ID record for each submitter number a Receiver assigns for your agency.

Example 1: You submit electronically to NGS and have two NGS Submitter numbers, one for each of your locations/PTANs. Create a Receiver ID record for each:

Example 2: You submit electronically to CGS, Zirmed, and Iowa. CGS and Medicaid assigned each of your 2 locations/PTANs their own Submitter number. Zirmed assigned one submitter ID number to use for both of your locations.