At a glance, the following processes represent the end-to-end invoicing process in Star:
Invoice generation
Invoice Approval
Provider Corrections (if required)
Payment Approval
Payment
Service Entry (pre-invoicing)
Providers will record billable services in the Star application. These services will eventually be bundled into invoices. How they are bundled together, and when the invoice(s) gets created, depend on several factors (detailed in the next section).
Invoice Generation
The system will generate an invoice for outstanding (i.e., non-invoiced) services which that share the following attributes:
Provider Location
Project
Fund Source
Service month
If two services are recorded and do not share all of the attributes listed above, then two separate invoices will be generated.
For example: if a provider records two services at the same location, under the same project and funded by the same fund source, but the services are spread out across two months (e.g., one service was rendered in January; the other, in February), then the system will create two invoices.
Similarly, if a provider records two services, both within the month of January, both recorded under the same project and funded by the same fund source, but the services are spread across two locations, then the system will create two invoices.
The Star application will generate invoices according to the corresponding project’s invoice configurations; typically, this will be either on on the 1st of every month (at ~12:01am01 am) or on the 16th of every month (again at ~12:01am01 am), though other invoice generation cycles are available.
After system generation, Approvers will see new invoices in a Pending Approval status on the Invoice List.
Invoice Approval
Approvers will take action on invoices in a Pending Approval state. Approvers may approve, deny or require corrections; these actions will create movement and change the invoice’s status. Approvers may also choose to place an invoice on hold or in review; these actions will not create movement (invoice status will remain as ‘Pending Approval’) but will change the invoice’s sub-status.
If the invoice is approved, it will become subject for to payment approval.
Provider Corrections
An Approver (or Payor) may find a mistake with one (or more) of the services on an invoice. If the mistake can be fixed, the Approver can flag the invoice for corrections.
An Approver (or Payor) may not flag a service for corrections if a mistake is discovered pertaining to the following four (4) attributes:
Provider Location
Project
Fund Source
Service Month
These attributes cannot be edited; thus, if there is a mistake with one of these attributes, the Approver must deny the invoice, and the Provider must re-submit services.
Once the invoice has moved into a Provider Corrections state, only the Provider can take action on the invoice.
After the Provider has applied corrections, the invoice will move back into a Pending Approval/Pending Payment state, where the Approver/Payor will once again be responsible for taking action on the invoice.
Providers have 30 days to submit corrections. If the required corrections are not submitted within the 30 days, the invoice will be auto-denied.
Payment Approval
Payment approval will occur every Wednesday by the corresponding paying agency.
Payors will take action on invoices in a Pending Payment state. Payors may approve, deny or require corrections; these actions will create movement and change the invoice’s status. Payors may also choose to place an invoice on hold or in review; these actions will not create movement (invoice status will remain as ‘Pending Approval’) but will change the invoice’s sub-status.
If payment is approved or denied, then the invoice will move to an Invoice History status, and no further action can be taken upon it.
Payment
If Falling Colors is responsible for payment, then the invoice will be submitted for payment processing, and the funds will be deposited into the provider’s bank account within 2-3 days (processing times vary across banks / financial institutions).
If Falling Colors is not responsible for payment, then fund transfer will occur external to the Star application; Payors will be responsible for recording the payment date and check number, if applicable.
Reasons for Denial…
If an invoice is denied (by the Approver or Payor), no further action can be taken upon it. The following denial reasons are available to choose from (and are required) when an Approver or Payor denies an invoice:
Denial Reason | Description |
|---|---|
Funding exhausted | This reason will rarely be used, as the rules engine found in Star will prevent services from being created unless there is sufficient funding to pay for it. |
Provider signature missing | This reason is used if a provider signature is missing from Workbook Upload or Provider Invoice Upload services. |
Insufficient backup supporting documentation | This reason is used if services on the invoice require supporting documentation, and the Approver or Payor deem them to be insufficient (or if they are missing altogether). |
Incorrect Dates | This reason is used if the services on an invoice were entered with the incorrect month. Service dates can be changed via Provider Corrections, however, they must stay within the bounds of the month attributed to the invoice. If the service’s date of activity needs to be set to a different month, the invoice must be denied or the provider must remove the service altogether (and then re-bill for it later). |
Incorrect formula total | This reason is used if the provider enters a cost for a Workbook Upload or Provider Invoice Upload service which does not match the value shown/calculated in the corresponding PDF/Excel files. |
Can't determine Provider or funding stream | This reason is used if the provider location or fund source attributed to the invoice is incorrect. Location and fund source attributes cannot be changed via Provider Corrections. If the location and/or fund source is incorrect, the invoice must be denied or the provider must remove the service altogether (and then re-bill for it later). |
Other, please specify | This reason is used if none of the other options are appropriate. If selected, the system will require the Approver or Payor to provide further details via free-text field. |
Amount entered does not match amount uploaded | This reason is used if the provider enters a cost for a Workbook Upload or Provider Invoice Upload service which does not match the value shown/calculated in the corresponding PDF/Excel files. |
Provider corrections not submitted within 30 days | This reason is used if the provider does not submit their corrections (having been required by an Approver or Payor) in a timely fashion. |
Invoice Workflow Diagrams
Pending Approval to Pending Payment
There are three sub-statuses within the Pending Approval status: ‘Awaiting Action’, ‘In Review’, and ‘Administrative Hold’.
An invoice can move within the Pending Approval status:
Awaiting Action → In Review (this motion occurs when the Approver takes the ‘Placed in review’ action)
Awaiting Action → Administrative Hold (this motion occurs when the Approver takes the ‘Placed on administrative hold’ action)
An invoice can move from Pending Approval (any sub-status) to Pending Payment:
Pending Approval → Pending Payment: Awaiting Action (this motion occurs when the Approver takes the ‘Approved by the Lead Agency’ action)
Pending Approval to Pending Payment (with Provider Corrections Required)
The Approver may deem an invoice in need of corrections. By taking the ‘Provider corrections required’ action, an invoice will move from Pending Approval (any sub-status) to Corrections Required.
Once the ‘Provider corrections required action’ has been taken, the invoice moves back to Pending Approval (status): Awaiting Action (sub-status).
Pending Payment to Invoice History
There are three sub-statuses within the Pending Payment status: ‘Awaiting Action’, ‘In Review’, and ‘In Process’.
An invoice can move within the Pending Payment status:
Awaiting Action → In Review (this motion occurs when the Payor takes the ‘Placed in review’ action)
Awaiting Action → In Process (this motion occurs when the Payor takes the ‘First level payment approval completed’ action)
An invoice can move from Pending Payment (any sub-status) to Invoice History:
Pending Payment → Invoice History: Paid (this motion occurs when the Payor takes the ‘Payment authorized by payor’ action)
Pending Payment → Invoice History: Denied (this motion occurs when the Payor takes the ‘Payment denied by payor’ action)
Pending Payment to Invoice History (with Provider Corrections Required)
The Payor may deem an invoice in need of corrections. By taking the ‘Provider corrections required’ action, an invoice will move from Pending Payment (any sub-status) to Corrections Required.
Once the ‘Provider corrections required’ action has been taken, the invoice moves back to Pending Payment (status): Awaiting Action (sub-status).
Full Process Diagram
The diagram below combines the ones shown above to depict all possible paths an invoice can travel from its conception to termination.
