Ambiki Release Note: Modifier Visibility & Accurate Payment Statuses

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Samuel Okoth avatar

Samuel Okoth 5 days ago

Date: 07/30/2025

Summary by Persona (Grouped by Role)


👩‍⚕️ Clinicians / Therapists

  • Payment Status Accuracy: More precise billing statuses give you a clearer picture of where each treatment report stands—denials, over‑/under‑payments, patient responsibility, and more.


🧑‍💼 Admins

  • View/Filter by Modifier: Quickly identify which modifiers are linked to each treatment report service for easier auditing and claim preparation.

  • Enhanced Payment Statuses: Real‑time, granular statuses (e.g., Denied, Paid less than expected) improve tracking and help surface billing issues sooner.


đź’ł Billers / Guardians

  • Payment Variance Insight: New statuses reveal over‑ or under‑payments and patient‑responsibility scenarios, streamlining follow‑ups and write‑off decisions.


🚀 New Feature – View/filter by modifier on the Treatment Report Service record center


đź‘Ą Audience: Admins
 🛠️ Steps to Access: Visit the Treatment Report Service record center
 📢 What's new?: You can now view any modifiers associated with a treatment report service. This includes both modifiers linked to the billing code and any additional modifiers applied directly to that specific treatment report service. Please note that Ambiki also supports modifiers tied to invoices, which are not included in this view.


🛠️ Fix – Improved Treatment Report Payment Status Accuracy


đź‘Ą Audience: Admins

❗ Issue: Treatment report payment statuses were not always accurate or specific enough to reflect the actual billing state. The previous system lacked granularity for various payment scenarios, including denials, partial payments, and zero‑dollar claims.

âś… What's New:

  • More Specific Payment Statuses: Added new statuses to better reflect real‑world billing scenarios:

    • "Denied" – for claims explicitly denied by insurance

    • "Paid more than expected" / "Paid less than expected" – for payment variance tracking

    • "Not covered – Patient responsible" – for non‑covered services

    • "Written off" – for fully written‑off claims

    • Additional zero‑dollar payment categorizations

  • Visual Improvements:

    • Denied claims now display with a red badge indicator

    • Enhanced billing progress visual with color‑coded status tracking

    • Clearer distinction between different payment states in the UI

  • Real‑Time Status Calculation: New calculation engine provides more accurate, real‑time payment status updates based on ERA data and payment records.

  • Multi‑Payer Support: Improved handling of scenarios with multiple insurance payers (primary/secondary).

đź“Š What Status Changes to Expect:

  • Generic statuses have become more specific (e.g., many "Partially paid" claims now show reasons like "Patient responsible" or "Paid less than expected").

  • "Paid" statuses now differentiate between expected payments, overpayments, underpayments, and patient‑responsibility scenarios.

  • Secondary‑insurance handling refined with clearer "Secondary awaiting primary" or "Secondary ready to submit" indicators.

  • Zero‑dollar and special scenarios are now categorized accurately.

âś… Action Steps: None required. Treatment report statuses will be automatically recalculated and updated. The new status system will provide more detailed and accurate billing information going forward.

đź’ˇ Benefits:

  • Better visibility into claim denials and payment variances

  • More accurate tracking of patient responsibility

  • Improved workflow management with clearer status indicators

  • Enhanced ability to identify and address billing issues quickly



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