ASO Policies and Procedures

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Each invoice will obtain a status. The status of an invoice can be further described by the sub-status. An invoice’s status or sub-status can be changed by taking action on the invoice; different user groups will have the ability to perform different actions.


Status and Sub-status Relationships

Some sub-statuses are shared across statuses. Some sub-status are no longer obtainable once an invoice has moved into a particular status. The following diagram depicts the mapping between invoice statuses and sub-statuses.


Invoice Statuses

The following table further describes the statuses in which an invoice can be placed. An invoice’s status is the ‘broadest’ description of its state.

Status

Description

Pending Approval

‘Pending Approval’ represents the initial status for all invoices; as soon as the invoice is created, an Approver needs to take action on the invoice.

'Pending Approval’ is also applied if the Approver deemed the invoice in need of corrections, and the Provider has since completed those corrections.

Pending Payment

‘Pending Payment’ represents the status immediately following the approval of an invoice; after the invoice is approved, the only decision left is to pay or not to pay.

Corrections Required

If an Approver identifies an issue with the services on a invoice (e.g., dates or amounts are incorrect, the wrong file was mistakenly attached to the invoice, etc.), then the Approver will set the invoice’s status to ‘Corrections Required’. This will signal to the Provider that they correct the identified issue(s) before approval and/or payment can be completed.

Invoice History

An invoice obtains an ‘Invoice History’ status as soon as a payment decision has been made.
If Falling Colors is not responsible for paying the invoice, then there will be no further movement once the invoice becomes historical - it will be either be ‘Paid’ or ‘Denied’.
If Falling Colors is the payor, however, the historical invoice will obtain two sub-statuses ('Processed' and ‘Paid’) before movement ceases.

Sometimes, the (distinct) statuses ‘Pending Approval’ and ‘Pending Payment’ are used in conjunction with another and simply referred to as ‘All Pending’ or just ‘Pending’.


Invoice Sub-statuses

The following table further describes the sub-statuses in which an invoice can be placed. An invoice’s sub-status describes an invoice’s state with greater detail than the status alone.

Sub-status

Description

Awaiting Action

‘Awaiting Action’ sub-status is applied when the invoice requires approval from a BHSD user, payment from the Payor, or corrections from the Provider.
Note: when the system creates an invoice, the ‘Awaiting Action’ sub-status is applied.

In Review

‘In Review’ sub-status can be applied by an Approver or Payor if the invoice is under review.
This status is not required; an Approver or Payor can review the invoice without applying the ‘In Review’ sub-status. The sub-status is merely informative and can help improve communication between stakeholders.

Administrative Hold

‘Administrative Hold’ sub-status can be applied by an Approver or Payor if they need to ‘stop’ movement of an invoice. This might occur if outside factors (i.e., external to the application) require the invoice to be placed on hold.
This status is not required; an Approver or Payor can simply not take action on the invoice / leave the invoice as is. The sub-status is merely informative and can help improve communication between stakeholders.

In Process

The ‘In Process’ sub-status is only available if Falling Colors is the payor. Invoices will not be approved; instead, they will be moved to ‘In Process’.

Processed

The ‘Processed’ sub-status is only available if Falling Colors is the payor. A two-step payment process is required in this case; moving the invoice to ‘Processed’ is the first step.
An invoice with a ‘Processed’ sub-status is still considered historical (i.e., it has an ‘Invoice History’ status). Processed invoices will move to ‘Paid’ before movement ceases.

Paid

When an invoice is paid, it obtains the ‘Paid’ sub-status. At this point, providers will have received their money, and no further action can be taken on the invoice / movement will cease.

Denied

If an invoice is denied, the provider will not receive money for those services. No further action can be taken on the invoice / movement will cease.


Invoice Actions

The following table describes the actions which update an invoice’s status and/or sub-status, creating movement. These actions are made available to Approvers, Payors and Providers in the ‘Action’ drop-down list on the Invoice Details page (with the exception of System-performed actions and the ‘Submit for payment’ action). Actions are limited to the corresponding group to which the user taking the action belongs.

E.g., only “Provider” users can take the ‘Corrections completed’ action; “Approver” or “Payor” users can take the ‘Provider corrections required’ action; etc.

After an action is taken on an invoice, it will be displayed in the ‘Last Action Taken’ column on the Invoice List with a matching icon.

User Group

Action

Invoice Moves To…

Status (Sub-status)

System

Invoice Generated

Pending Approval (Awaiting Action)

System

Process Payment

Invoice History (Paid)

Provider

Corrections completed

Pending Approval (Awaiting Action)
If Approver was the previous actor

Pending Payment (Awaiting Action)
If Payor was the previous actor

Approver

Approved by the lead agency

Pending Payment (Awaiting Action)

Approver

Denied by the lead agency

Invoice History (Denied)

Payor

Payment authorized by the payor

Invoice History (Paid)

Payor

Denied by the payor

Invoice History (Denied)

Payor

First level payment approval completed

Pending Payment (In Process)

Payor

Submit for Payment

Invoice History (Processed)

Approver or Payor

Provider corrections required

Corrections Required (Awaiting Action)

Approver or Payor

In review

Pending Approval (In Review)
If action is taken by the Approver

Pending Payment (In Review)
If action is taken by the Payor

Approver or Payor

Placed on administrative hold

Pending Approval (Administrative Hold)
If action is taken by the Approver

Pending Payment (Administrative Hold)
If action is taken by the Payor


Invoice Workflows

The diagram below depicts all the possible paths an invoice may follow, from its conception (invoice generation) to its termination (Invoice History).

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