Pre-Billing Worklist & Visit-Level Billing Status Tracking

Hello CareSmartz360 Team,

I would like to suggest adding a Pre-Billing Worklist feature that would allow agencies to easily identify, manage, and track visits that have been completed and approved but have not yet been billed or submitted to insurance.

Currently, once visits are completed and verified through the Time Tracking screen, we can proceed with creating invoices. However, invoice creation and EVV submission through Tellus or HHAeXchange are handled through separate processes.

This makes it difficult to keep track of which service dates have already been invoiced, which visits have been submitted to insurance, and which visits are still pending billing. At the moment, we have to navigate between invoices, time tracking, and individual Tellus or HHAeXchange reports to reconcile this information.

For agencies managing a high volume of visits across multiple insurance providers, this becomes extremely time-consuming and increases the possibility of overlooking visits that should have been billed.

1. Create a Centralized Pre-Billing Worklist

I would like to suggest adding a dedicated "Pre-Billing" or "Worklist" tab that automatically displays all visits that have been completed and approved through the Time Tracking screen and are ready for billing.

Ideally, the worklist would display the following information for each visit:

• Patient Name
• Caregiver Name
• Insurance Provider
• Date of Service
• Approved Hours/Units
• Invoice Status (Created / Not Created)
• Invoice Number, if applicable
• EVV Submission Status (Submitted / Not Submitted)
• Claim/Billing Status (Billed / Not Billed)

The most important aspect would be that every approved visit appears on this worklist regardless of whether an invoice has already been created, allowing us to identify exactly where each visit stands in the billing process.

2. Separate Invoice Creation From EVV/Insurance Submission Status

One of the biggest challenges with the current workflow is that creating an invoice does not necessarily mean the visit has been submitted to insurance.

For example:

• Visit A: Approved, but no invoice has been created.
• Visit B: Approved, invoice created, but EVV has not been submitted to Tellus or HHAeXchange.
• Visit C: Approved, invoice created, EVV submitted, but claim has not yet been submitted.
• Visit D: Approved, invoice created, EVV submitted, and claim submitted to insurance.

Currently, identifying these differences requires checking multiple areas of the system.

With a centralized worklist, each visit could display its individual status, making it immediately clear what still needs to be completed.

It would also be important for the system to distinguish between a report being generated/exported and the EVV data actually being submitted or accepted by the insurance platform, whenever that information is available.

3. Filtering and Bulk Actions

To make the feature even more useful, it would be helpful to include filters such as:

• Date of Service or Date Range
• Insurance Provider
• Patient
• Invoice Status
• EVV Submission Status
• Claim Submission Status

For example, I should be able to filter all approved visits for Humana between October 1st and October 15th that have not yet been invoiced, or all Simply visits for that same period that have an invoice but have not yet been submitted.

Ideally, we could also select multiple visits directly from the worklist and perform actions such as:

• Create invoices for selected visits.
• Generate the appropriate Tellus or HHAeXchange EVV report.
• Mark visits as submitted when submission is completed outside of CareSmartz360.
• Record the submission date and any relevant reference information.
• Export the filtered worklist to Excel for reconciliation purposes.

4. Preventing Missed or Duplicate Billing

Another significant benefit of this feature would be reducing the risk of missed or duplicate billing.

The system could automatically identify visits that already have an invoice associated with them, preventing agencies from accidentally creating duplicate invoices for the same services.

It would also help identify older approved visits that remain uninvoiced or unsubmitted, ensuring that services do not go unbilled simply because they were overlooked.

Ideally, visits would remain visible in the worklist until the necessary billing steps have been completed, with the ability to filter completed and pending items separately.

5. Overall Goal

The goal is to create a centralized billing workflow where agencies can see all approved visits and their billing progress in one place, rather than having to navigate between Time Tracking, invoices, and separate EVV reports.

For agencies like ours that work with multiple Medicaid LTC insurance providers and submit EVV data through different platforms, having this level of visibility would make a significant difference in day-to-day billing operations.

It would allow us to quickly answer three very important questions:

1. Which approved visits have not yet been invoiced?
2. Which visits have been invoiced but have not yet been submitted to insurance?
3. Which visits have completed all the necessary billing and submission steps?

I believe this would be an extremely valuable enhancement to CareSmartz360, particularly for agencies handling a large volume of Medicaid and managed care visits.

Thank you again for considering our suggestions. I would appreciate knowing whether something similar is currently being developed or could be considered for a future update.