Work Queue Assignments
A user-driven tasking feature is introduced for the revenue cycle management system. The configuration allows the creation of similar functional user groups (known as “teams”) and the setting up of predefined workflow assignments that would essentially drive the provisioning and allocation of a user’s daily tasks and user worklists. The benefits of this new feature are the following:
* Clearly defined work allocation with time expiration based on the configured assignments.
* Work automation: Human intervention is not required for the daily provisioning of work.
This feature is currently implemented in the Work Queue and Collections Manager.
Setup
RCM workflow setup can be done from Advanced Setup->Billing Options (see Image 1). Click Configure to move to the Work Queue Assignments screen.
Work Queue Assignments Screen
On clicking Configure on the Billing Options page, the user is taken to the Work Queue Assignments screen, where all the existing assignments are listed. These can be edited using 
icon provided at the right end (Image 2).
To view the teams, click 
on the top right-hand corner in Image 2. The Teams screen opens up, where all the teams are listed (see Image 3).
Team Setup Screen
You can add new teams using the 
button. A team should have at least one user.
Work Queue Assignment Screen
To add a new assignment, click 
button on the top right-hand corner of Image 2. The assignment setup screen pops up (Image 5).
Fields in the Work Queue Assignment Screen
| Field | Description |
| Assignment Name | Name of the Assignment: Provide a unique name |
| Assignment Code | Unique code for the Assignment |
| Assigned to Team(s) | Select teams to be part of this assignment. This is a multi-select drop-down. |
| Legal Entity | If the assignment is based on specific LEs, select the LEs. This is a multi-select drop-down |
| Provider | If the assignment is based on providers, select the providers here. This is a multi-select drop-down. |
| Payer ID | Multi-select drop-down; select the payer IDs for the assignment. |
| Payer Name | Multi-select drop-down: select the payer names for the assignment. |
| Payer Type | If the assignment is to be based on payer types, select them. Multi-select drop-down |
| Case Type | If the assignment is based on case types, select them. Multi-select drop-down |
| Denial category | If the assignment is based on certain denial categories, select them. All denial codes from the repository will be available for selection. |
| Category | This is a multi-select field. This drop-down presents general categories available in the Work Queue, such as Charges, Claims Payments, Denials, Patients, and others. This enhances efficiency by consolidating categories and reducing worklist clutter. |
| SL | A service location or state name can be provided here. If the user starts typing in a state name, all service locations under the state will be listed. If the user starts typing in a service location name, all matching names will appear. |
| Patient | This is a smart search field; users can search by first name, last name, or the MR# |
| Claim Age | If the Assignment is based on claim age, select the range here, giving the ‘From’ and ‘To’ days |
| Charge Amount | Provide the charge amount range here. |
| Resp. Threshold | If the response limit threshold is part of the Assignment, provide the range here |
| UTL | If the untimely Limit is included, provide the range here |
| DOS Age | Provide the DOS age range here |
| Balance Amount | Provide a range for the balance amount range; negative amounts are allowed, enabling the creation of worklists to track overpayments and overadjustments. |
| Apply Work Queue Assignment to this Priority | Select 1, 2, 3, 4, or 5 from the drop-down |
RCM workflow in Collections Manager
When a user logs into Collections Manager, the system will load only those claims assigned to the team of which the user is a part.
However, the Assigned To filter will default to ALL in the following scenarios:
a. When the user is not part of any team
b. When the user’s assigned team does not have any active rules
c. When the account has not configured the new RCM workflow
RCM in Work Queue & Collection Manager
When a user logs into Work Queue or Collections Manager, the system will load only those claims assigned to the team of which the user is a part. If the user’s assignment or rule is inactive or if the user is not part of any team, no claims will be listed when the Work Queue opens up.
RCM Audit Log
RCM workflow configuration, team setup, and user assignments to teams are all tracked for audit purposes. You can view the details under the following sections in the Audit Viewer module:
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RCM Workflow Configuration
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Teams