EMR to RCM Connection

This article explains how services flow from Alleva's EMR to RCM.

Client chart details such as insurance information, diagnoses, demographic data, and additional relevant information will seamlessly integrate into the "patient account" within Alleva Billing. Services are transmitted from the EMR to the billing system via the encounter transmission table, accompanied by specific codes and details defined by the Billing Rules.

This is how services flow from the EMR into Alleva Billing:

1. Services are provided in the EMR. These can include individual sessions, group sessions, intakes, and "daily drop" for days in treatment.

2. Based on custom billing rules, encounters are created in the encounter transmission table whenever a service is provided that match the rule. The rule determines the billing code, revenue code, modifiers, charges, units, and more based on the client's level of care, insurance, and other factors as determined in the billing rule.
(Learn more about billing rules and ETT here >)

3. After review, encounters are manually submitted from the Encounter Transmission Table to Alleva Billing. 

4. Encounters land in the "Service Management" tab of Alleva Billing. These encounters can then be reviewed and submitted to Waystar, creating a claim in the claim management tab.