WHAT’S NEW IN THIS RELEASE
| Feature | QL | SL |
| Refiling Support |  |
OVERVIEW
Refiling Support
Smart-LinQ users need the ability to resubmit existing filings that effectively communicate:
- That this is a "Refiling"
- What the Amount Due is for the Refiling
- What has changed since the previous request for reimbursement on this Filing
- And additional comments that the administrator may need to convey
A New Filing Cover Sheet
The Filing Cover Sheet has been revamped with a fresh, professional experience accompanied with a few new data elements.
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Out with the Old |
In with the New |
FIRST PAGE
Reordering of Sections: This was necessary to elegantly fit all the pertinent information onto one page for easy scanning by the reader.
| Left Side Sections | Right Side Sections |
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-- Header Section --
| # | Description |
| 1 | Added the Organization’s Logo that is issuing the Filing |
| 2 | Added the Original Submit Date of the first time this filing was issued |
| 3 |
If this is a Refiling, a sequence number will be appended to the Filing Id as a “- #”. The first Refiling will display XX-1, the second XX-2, etc. |
| 4 | If this is a Refiling, ”- Refiled” will be appended to the Filing type |
| 5 | Contact information has been moved from the last page to this top section. The Stop Loss Contact Email is now displayed from a new field on the Policy Details screen. |
-- Reimbursement Summary & Comments Sections --
| # | Description |
| 1 | Refiling Adj will display the count of claims that were added or removed since the previous filing |
| 2 | If a Refiling, this will display the claim counts and amount from the previous filing. If not a Refiling, it will display the claim counts and amount in the filing. |
| 3 | If a Refiling, this will display the grand total of adjustments since the previous filing. |
| 4 | Total Claims displays the total claim count and amount in this filing |
| 5 | If an Initial Filing, the Member’s Spec Deductible will display. If not then “n/a” |
| 6 | Reimbursement Entries is a sum of all Payments, Rejections and Agg Spec applications against this filing. |
| 7 | Amount Due is the Net of Total Claims, Spec Deductible & Reimbursement Entries |
| 8 | Comments are added at the time of the Filing Submission and can display up to 500 characters. |
-- Policy & Member Sections --
| # | Description |
| 1 | Carrier is now display from a new text field managed on the Policy Details screen |
| 2 | Added a Laser field that will display “No” or the Spec Deductible if in force |
-- Primary Medical/Pharmacy Section --
| # | Description |
| 1 | No material changes to the Primary Medical and Pharmacy section |
SECOND PAGE
-- Member Filing Summary Table --
This table will display summary view of all the filings for this member. This provides the reader with a birds-eye view of the:
- Original Filing Amount
- Adjusted Amount
- Reimbursement Amount
- Rejected Amount
- Agg Spec Amount
- Receivables Balance
LAST PAGE
-- Filing Balance History Table --
This table will display how this specific Filing's Receivables Balance has changed over time since the original filing event; including refiling, adjustment and reimbursement entry events.
Refiling Support in the User Interface
Add Comments to the Filing Cover Sheet
- Go to the Review Filing feature in the Filing Details screen
- Click on the comments icon displayed next to the Cover Sheet and click Save
- Click on the Cover Sheet eyeball to display the PDF view, including your saved comments.
- Select the documents to include with your filing and click Submit
- Note that if you forget to add comments the Submit button will ask to you add comments or confirm you don't need them
- If you save comment and hit Cancel to leave the Review Filing Package screen you will be warned about losing your comments
Refiling Sequence Number Display
With the introduction of Refiling support, Smart-LinQ will employ a Sequence Number to help users easily identify Refilings.
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Filings will start with a Sequence Number of 0
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Each refile event will increment that number by one. ie. “-1”, then “-2” etc. (ie. 12345-1).
This Sequence Number will be displayed on the Filing Cards in the Claims Manager
| Filing that's been Refiled |
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Filing that's not been Refiled |
The Sequence Number will also be display in the Filing Audit as well as the Filing Ledger Report.
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The Sequence Number will also be display in the Filing and Filing Submission Records
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