The Claims History Request feature in RFX allows insurance companies to submit claims/loss documents electronically.
Helpful Hint: Completed Claims History documents can still be uploaded manually without using this feature.
Claims History Requests can be completed in the Checklist during the provider’s privileging periods (see Managing Provider Checklists).
To assist with this process, two new workflows have been added to the document library:
- Authorization and Release
- Claims History
These workflows can be accessed in the Provider and Staff Document Library under system settings (see Setting Up the Provider Library).
The Authorization and Release workflow must first be created. The document can either be a fillable form completed by the provider or one uploaded.
The Claims History workflow must also be created. The document can be either a fillable form completed by the insurance company or manually uploaded.
Once the Claims History document is added to the checklist, a document (+) icon will appear next to the trashcan. This icon allows the user to send a document request directly to the insurance company.
Sending a Claims History Request
To send a Claims History Request, a completed Authorization and Release document must be included in the checklist. If the authorization is not attached, a warning message will appear.
Once the Authorization and Release document is attached, a Claims History Request can be sent. If the provider has filled out the Malpractice Insurance section of the application, those contacts will be available for selection.
If the provider hasn’t filled out the section, or if a different reference needs to be chosen, the contact information (including name and email) can be entered manually.
Once the request is sent, the status will be updated in the checklist.
Insurance Contact Email and Portal Access
The insurance contact will receive an email with a link to complete the form. By clicking the Fill Out Form button, they will be automatically logged into RFX and their portal, without needing to create an account.
In their portal, the insurance contact will see the request to complete and can fill out the attached form. They will also have access to the signed release form.
After completion, the checklist item will be updated in the checklist as normal.
