Send it, record it, close it out

Once a draft exists, click through to Send in the claim’s panel. Yeam does not send anything. You send it the way you always do, then come back and record it.

1. 1

   Read Where this goes.

   Where Yeam knows the payer, it lists the ways to send, preferred first. A corrected claim goes back through your clearinghouse, with the payer’s EDI payer ID. An appeal goes to the payer’s portal where it has one, because a portal stamps the date and gives you a case number on the spot.

   Where Yeam does not know the payer, it says so. Use the appeals address printed on the remittance or EOB, and Yeam will offer to remember it when you record the submission.

2. 2

   Gather what is under Send with it.

   The documents this kind of denial needs, like the authorization number and approval for a CO-197, or the office notes for the date of service on a CO-50. If the payer requires its own form, a highlighted note names it.

3. 3

   Finish the letter.

   Fill the patient details in Complete the letter, then use Copy completed, Download .txt or Print / Save as PDF. Any blank still left stays in brackets, so you can see it.

4. 4

   Send it through the portal, fax, mail or clearinghouse.

This is your proof of timely filing. If a payer later says the appeal came in late, the date and confirmation number are your answer.

1. 1

   Under Record the submission, pick How it went.

   Portal, Fax, Mail, Clearinghouse, Phone or Other.

2. 2

   Set Date sent.

   It starts at today. Change it if you sent it on another day.

3. 3

   Fill in Where it went.

   The portal name, fax number or mailing address. For a portal, fax or mail address, tick Remember this and every future denial from that payer will show it.

4. 4

   Type the Confirmation number.

   The portal case number, fax confirmation or certified mail tracking number. Yeam lets you skip it. Don’t.

5. 5

   Click Record as sent.

   The row moves to Sent, and Yeam sets a follow-up 30 days out unless you already set one.

A sent row shows, under the payer’s name, whether a call is worth it yet. Yeam compares the days since you sent it with how long that payer usually takes to pay, from your A/R file.

• Don’t call yet: still inside the payer’s usual time. A call would likely hear “in process”.
• Due a chase: past their usual time.
• Overdue: well past it. Call.

Without an A/R file, Yeam has no payer timing, so it uses a plain 30-day rule and says so.

1. 1

   Open Outcome in the claim’s panel and click Record what came back.

2. 2

   Pick the result.

   Paid in full, Paid in part, Denied again, No response or Withdrawn. That one click is enough to save.

3. 3

   Add what you have.

   All optional: Date on the determination, Amount recovered, and for a denial, Code they denied it under. Use What they said for the reason they gave. It is often the only place it gets written down.

4. 4

   Click Save outcome.

What happens next

• Paid in full or in part: the row moves to Recovered and its follow-up clears.
• Denied again or no response: the row goes back on the worklist. A second-level appeal is usually next, and the window for it is shorter.
• Next month’s A/R file can close the loop for you. If it shows a claim you appealed as paid, Yeam marks the row recovered and notes it came from the export.

Record the losses too. Outcomes feed the Appeals won column on the payer scorecard, and a record with only the wins in it tells you nothing about which appeals to stop writing.