đĽď¸ For practice admins using Practice HQ on the web. This applies only if your practice is on fully-managed RCM, and the Practice HQ billing screens need the Billing permission.
This article explains how fully-managed RCM (revenue cycle management) works: what the Oasys billing team handles, what your practice still does, what changes in Practice HQ and for your providers, how auto-billing works, where to track claims processing fees, and how to change plans.
In this article
1. What is fully-managed RCM?
This section explains what the plan is and who it covers.
Fully-managed RCM is a billing plan where the Oasys billing team files and tracks your insurance claims for you.
It is different from self-serve billing, where your practice submits and follows up on claims itself from the Billing tab.
The plan is normally set for your whole practice. A solo provider has their own plan.
When a practice is on fully-managed RCM, every provider in it is on the plan. An individual provider can't be moved back to self-serve on their own.
2. What Oasys manages for you
This section lists the work the Oasys billing team takes on, and the work that stays with your practice.
Enrolling your practice with insurance payers.
Submitting claims to insurance payers.
Following up on claims and correcting them.
Posting remittances (ERAs, the payer's payment reports) and payments.
Handling denials and resubmission.
â ď¸ Important: Your practice still needs to complete sessions with proper documentation, keep client insurance information accurate, and set diagnosis and CPT codes on sessions. The billing team uses this information to submit claims.
How claims reach the billing team
Once a session is complete and has everything it needs, it is billed automatically at the end of the day.
Providers see this in their Bill sessions banner: "Managed by Oasys. Sessions marked ready are automatically billed at the end of the day. Sessions needing information remain pending until updated."
A session that's missing information, such as insurance details or codes, waits until someone fixes it. Keep an eye on sessions that can't be billed (see What changes in Practice HQ).
3. What changes in Practice HQ
This section covers what you see in Practice HQ. Anyone with the Billing permission keeps the Practice HQ Billing tab, so you can follow the billing team's work. A few session-level actions are handled by the plan instead.
In Bill sessions, waiving a session, un-waiving it, marking it paid externally, and editing a session's billing amount or type aren't available. If you try, you'll see a message such as "Waiving sessions is unavailable for managed RCM practices."
In Manage invoices, you can still create one-off invoices with Create standalone.
Invoices created by automatic billing appear in Manage invoices with your other invoices, and you can send reminders for, void, refund or retry them in the same way.
On the Practice HQ calendar, the send-invoice, charge and send-claim buttons are replaced with a Managed by Oasys status.
In Client billing, clients of managed providers show an Auto-Bill On pill. A client you've excluded from automatic billing shows Auto-Bill Off.
A client's Activity tab in Client billing shows a Managed by Oasys badge.
The overview's attention strip still counts Sessions that cannot be billed. These are the sessions the billing team can't bill until your practice adds the missing information.
4. What your providers see
This section describes your providers' own Billing tab on fully-managed RCM, so you can answer their questions.
Claims and remittances
Claims are read-only. Providers see a Managed by Oasys banner: "Claims are filed and tracked by the Oasys billing team. You can monitor claim status and payments here."
Providers can still see claim statuses and payment history, but can't create or submit claims themselves.
On a claim, providers can still record that the client's share was paid outside Oasys with Mark externally paid, and reverse it with Undo external payment. This records money your practice collected. It doesn't change the insurance claim.
Payment remittances shows a Managed by Oasys note: "Payment remittances are processed by the Oasys billing team. Patient responsibility billing is handled automatically." It has no archive tabs.
Accepted payers: solo providers on fully-managed RCM still see it. It's hidden from providers only when your practice also bills insurance under its own practice setup, because the practice manages payers in Practice HQ.
Sessions, invoices and payments
Cash-pay invoicing stays self-serve. In Bill sessions, providers can still use Mark as Paid (External) on a cash-pay session. Other sessions show a dash instead of a button. Hover over it to see that the Oasys billing team handles the session.
If a client's share was collected in advance, providers can reverse it with Undo Client Responsibility Collected.
Invoices show "Oasys manages automated billing. You can still create and correct individual invoices here."
Providers can still create one-off invoices (including no-show and late-cancellation fees), and send reminders for, void, refund or retry them.
Providers can still add and refund client credits, create superbills and Good Faith Estimates, and record external payments.
Their own auto-billing switches are locked (see Auto-billing on fully-managed RCM).
5. Auto-billing on fully-managed RCM
This section explains who controls automatic billing on the plan.
The plan controls auto-billing for your providers. In Billing â Client billing â Auto billing, managed providers show Managed by Oasys and their switch is locked: "Their billing plan controls Autobilling, so practice changes do not affect them."
If you change Auto Billing for all providers at once, managed providers are skipped and the confirmation tells you how many were "managed by Oasys and not changed."
You can still exclude an individual client from automatic billing: open the client in Client billing â Settings â Billing settings and turn off Auto-Billing for that client.
â ď¸ Important: When your practice moves onto fully-managed RCM, or a provider joins a practice that's on it, existing per-client auto-billing exclusions for those clients are cleared. Re-check any clients you want to keep excluded.
6. Claims processing fees
This section shows where to follow the fees Oasys bills for claims processing. You need the Billing permission.
Open Settings â Subscription & fees.
Find the Claims Processing Fees card. These fees are separate from your practice subscription.
Review each monthly invoice: its status, the number of billing events, and the total.
Click Pay Now to pay an outstanding invoice, or Show paid invoices and View Invoice to see past ones.
If nothing is outstanding, the card says you're all caught up, with no fees due.
If a payer later takes back a payment that a fee was charged on, Oasys returns that fee to your account as a credit. The credit is applied to a later claims processing fee invoice.
This page isn't shown for practices set up in Charter School mode.
đĄ Tip: For questions about fully-managed RCM pricing, fees or invoices from Oasys, contact your Oasys representative.
7. Switching plans
This section covers moving between fully-managed RCM and self-serve billing.
There's no in-app switch between fully-managed RCM and self-serve billing.
To discuss switching plans, contact your Oasys representative.
Frequently asked questions
Do I still need to set up insurance info for my clients?
Yes. Client insurance details, diagnosis codes and CPT codes still need to be accurate. Oasys uses this information to submit claims for you.
What happens if a claim is denied?
The Oasys billing team handles denial follow-up and resubmission. Your providers can see the claim's status in their Billing tab.
What does fully-managed RCM cost?
Contact your Oasys representative for pricing and fees.
Can my providers still send invoices?
Yes. Providers can still create and correct individual invoices, add and refund credits, and create superbills. Automatic billing is handled by the plan.
Can I create a standalone invoice from Practice HQ?
Yes. Use Create standalone in Billing â Manage invoices. It's available once your practice's payment processing is set up.
Why can't I turn auto-billing on or off for a provider?
On fully-managed RCM, the plan controls each provider's auto-billing. You can still exclude individual clients from automatic billing in their billing settings.
What happens to a fee if a payer takes money back?
The fee charged on that money is returned to your account as a credit and applied to a later claims processing fee invoice.