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An ADP claim, from the first call to the closed case.

Every step your office takes on an ADP claim in Fusion Claims, shown on the screen where it happens. Read the route below in a minute, then open any phase to see how each step works.

Screens show invented data from a demo company. Steps marked Beta are in testing.

1

Intake and assessment

The therapist calls or emails, your office books the visit, and the assessment becomes the client record and a draft quotation for the rep to review.

  1. A sales rep books the assessment with the therapist, client, time, place and the equipment to bring.
    1.1
    • Office
    • Sales rep
    • Therapist

    Book the assessment

    What happens
    When the therapist calls or emails, your office or rep enters the booking with the client, location and demo equipment; therapists can also request one from their portal. The therapist gets an invitation and a reminder the evening before.
    What it saves you
    No separate calendar invites or reminder calls to set up for each visit.
  2. The rep records the client, health card details and funding type on the ADP Express form.
    1.2
    • Sales rep

    Run the express assessment

    What happens
    The rep fills in the ADP Assessment Express Form: equipment, client and health card details, assessment dates, client type and reason for application. Completing it creates or links the client and a draft order.
    What it saves you
    The assessment is typed once, and the client and order come from it.
  3. Confirming the assessment builds a draft quotation with ADP and client portions for the rep to review.
    1.3
    • System
    • Sales rep

    Review the quotation built from the assessment

    What happens
    When a quote profile matches the assessment, the draft quotation is filled in for the rep. The rep reviews it, then sends it to the client or finishes without sending.
    What it saves you
    Reps start from a filled-in quotation, and nothing reaches the client before a person checks it.
  4. The Express form can capture the applicant consent and signature for Page 11 during the visit.
    1.4
    • Client
    • Sales rep

    Collect the signed pages

    What happens
    During the assessment the applicant or agent can sign the Page 11 consent on screen, and the system saves it as a PDF. The full assessment screen captures the Page 11 and Page 12 signatures, and Page 11 can also be sent to sign remotely.
    What it saves you
    A page that was not signed on paper can be signed without another visit.
2

Application

The therapist's application comes in through their own portal, the system follows up when it is late, and your office checks it before it moves on.

  1. The therapist uploads the application to the case in their portal instead of emailing it.
    2.1
    • Therapist
    • Office

    Receive documents through the therapist portal

    What happens
    Each therapist signs in to their own portal, sees only their own cases and uploads the application, signed pages or other documents to the case. A new upload keeps the earlier copy as a past revision.
    What it saves you
    Applications and signed pages land on the case instead of in email attachments.
  2. When the application has not arrived, a reminder to the therapist is queued and logged on the case.
    2.2
    • System

    Follow up on a late application

    What happens
    If no application is recorded four days after the assessment, the system emails the therapist, copies the rep and office, and notes it on the case. A second follow-up goes out at eight days. Both delays can be changed.
    What it saves you
    Nobody keeps a list of which therapists still owe an application.
  3. The office records the original application and how Pages 11 and 12 were provided.
    2.3
    • Office

    Process the application in the office

    What happens
    Staff record the application as received, keep the original PDF and note how the signed pages arrived. Before a case can be marked Ready for Submission, the system checks the authorization date, client references, reason for application and signed pages.
    What it saves you
    A case with a missing item cannot be marked ready, and the screen lists what is missing.
3

Submission and approval

Files are checked before they go to ADP, the response is recorded on the case, and the client, rep and therapist hear about approvals.

  1. The submission step refuses a data file that does not have the .xml extension.
    3.1
    • Office
    • System

    Check the files before submission

    What happens
    Submission Verification needs at least one device type, the final application PDF and the XML data file, and refuses a file with the wrong extension, such as an XML file saved as .txt. XML import reports a file it cannot read.
    What it saves you
    A submission missing its final PDF or XML file is caught in the office, before it goes to ADP.
  2. After submission the case keeps the original, signed pages, final application and XML together.
    3.2
    • Office

    Record the submission and ADP's response

    What happens
    Your staff submit on the ADP portal, then record it in Fusion Claims: the devices, final PDF and XML file are stored on the case with its submission history. Accepted, rejected and correction responses are recorded the same way.
    What it saves you
    Anyone can see what was submitted, when, and what ADP said, without asking who sent it.
  3. Staff confirm which devices ADP approved before the case moves on.
    3.3
    • Office
    • System

    Record the approved devices

    What happens
    Staff enter the claim number and approval date, mark each device approved or not, enter any deduction and can attach the approval letter. The ADP and client portions are recalculated, and devices that were not approved move to the client.
    What it saves you
    Partial approvals and deductions reach the portions and invoices without working them out by hand.
  4. Upload the downloaded Invoice and Application Status Reports PDF to read it in the system.
    3.4
    • Office
    • System
    Beta

    Read the ADP status report PDF (optional)

    What happens
    Optionally, upload the Invoice and Application Status Reports PDF downloaded from ADP. The system reads its rows, checks your vendor registration and matches them to cases, an optional AI second read flags any differences, and a Claims Administrator applies the matched results.
    What it saves you
    Approvals on the report reach their cases without keying each one in.
  5. An approval email to the client, with the rep copied and the report attached, waits in the outgoing queue.
    3.5
    • System

    Tell the client and rep about the approval

    What happens
    When a case is approved, the system emails the client, with the rep and office copied, listing the approved devices with the Approved Items Report PDF attached.
    What it saves you
    Clients and reps hear about approvals without a phone call from the office.
  6. One summary email groups a therapist's decided cases instead of one email per case.
    3.6
    • System
    • Therapist

    Send each therapist one summary

    What happens
    A therapist's approvals, deductions and other decisions are gathered into one summary email on Monday mornings instead of one email per case. A therapist can ask for one email per case, and staff can preview a summary first.
    What it saves you
    Therapists get one weekly email instead of a stream of separate ones.
4

Ordering and delivery

Equipment can be ordered before or after approval, and delivery is scheduled and proven on the case.

  1. Create PO groups the case lines by vendor and links the purchase order back to the case.
    4.1
    • Office

    Order the equipment

    What happens
    From the quotation, staff assign lines to vendors and create purchase orders grouped by vendor, each linked to the client's order. This works before or after approval.
    What it saves you
    Every purchase order shows which client it is for.
  2. The delivery is scheduled as a task with a technician, date and time.
    4.2
    • Office
    • Technician

    Deliver and keep the proof of delivery

    What happens
    Staff assign the delivery technicians and a date, with an early delivery option. Ready to Bill needs the approval, completed device verification, the delivery date and the signed proof of delivery as a PDF.
    What it saves you
    A case cannot move to billing without its proof of delivery on file.
5

Billing and ADP invoicing

The client's portion and ADP's portion go on separate invoices, and supplier bills and prices are checked before ADP is billed.

  1. A fixed deduction moves that amount from the ADP portion to the client portion.
    5.1
    • Office
    • System

    Apply the deduction

    What happens
    When ADP approves a device with a deduction, staff choose Percentage or Amount and enter the value. The ADP and client portions are recalculated from the client type and the device's ADP price.
    What it saves you
    The deduction is entered once, on the device, and the invoices are built from it.
  2. The client invoice carries only the client portion of each device.
    5.2
    • Office

    Invoice the client's portion

    What happens
    For regular (REG) clients, the client invoice holds only the client's portion and in most cases can be created before approval. Devices ADP does not fund or did not approve can go fully on the client invoice.
    What it saves you
    The client's share is billed when it suits you, without waiting for ADP.
  3. Each funded line is linked to the supplier bill that proves it was bought.
    5.3
    • System
    • Office

    Match supplier bills to the case

    What happens
    The system matches each device to posted supplier bills using serial numbers, purchase order links and other rules. Strong matches are confirmed on their own, and uncertain ones wait for a person to confirm or reject.
    What it saves you
    The supplier bill behind each device is already linked when billing or an audit needs it.
  4. The ADP invoice carries only the ADP portion of each approved device.
    5.4
    • Office
    • System

    Create the ADP invoice

    What happens
    The ADP invoice holds only ADP's portion. It can be created once the proof of delivery, device verification, an approved device and supplier bill evidence are in place, or a manager records an override.
    What it saves you
    ADP is not billed for a case that is missing the paperwork behind it.
  5. Export ADP Claims builds the submission file for the selected invoices.
    5.5
    • Office
    • System

    Export the claim file for ADP

    What happens
    Export ADP Claims builds the .txt claim file from the ADP invoices, one row per unit, and checks every portion against the ADP device price list. A mismatch stops the export. Your staff then upload the file on the ADP portal.
    What it saves you
    No hand-built billing file, and a price mismatch is caught before ADP sees it.
  6. Each ADP invoice records its export and its own ADP billing status, separate from its accounting state.
    5.6
    • Office
    • System

    Follow up on corrections and payment

    What happens
    Each ADP invoice shows its billing status: Waiting, Submitted, Need Correction or Payment Issued. Correction reminders go to the people you choose, and the status changes to Payment Issued once the invoice is paid.
    What it saves you
    A claim that needs correcting stays on someone's list until it is fixed.
6

Audit and records

Each case keeps its audit trail as it moves, every claim file stays on record, and closing a case checks its paperwork.

  1. The order trail shows at a glance which documents and billing steps are in place.
    6.1
    • System
    • Office

    Keep the audit trail on the case

    What happens
    The ADP Order Trail on each case is a checklist of assessment dates, authorization, application, signed pages, XML, approval, proof of delivery, supplier bills and posted invoices. For an ADP audit, the audit workbench imports the appendix, checks the evidence line by line and builds the evidence pack.
    What it saves you
    An audit request starts from evidence already on the cases, not a search through folders.
  2. Every exported file is saved with its date, posting period, total and line count.
    6.2
    • System

    Keep every claim file

    What happens
    Each export is saved under Claim Submission Files with the file, a text preview, who exported it and when, the posting period and the invoices it contains.
    What it saves you
    You can reopen exactly what was sent to ADP for any posting period.
  3. Before closing, the case is checked for signed pages, final application, proof of delivery and vendor bills.
    6.3
    • Office
    • System

    Close the case

    What happens
    Before closing, the system checks the signed pages, final application, proof of delivery and supplier bills. Closing with something missing needs a written reason, which is kept. Billed cases close on their own 30 days after billing.
    What it saves you
    Finished cases leave the work queues, and any gap at closing is on record.

What the system checks for you

These checks run inside Fusion Claims before a case can move on.

  • Ready for submission

    Authorization date, client references, reason for application and signed pages are in place.

    See the step
  • Submission files

    A device type, the final application PDF and the XML file are attached, with the right file types.

    See the step
  • Ready to bill

    Approval, completed device verification, the delivery date and the proof of delivery PDF.

    See the step
  • Supplier bill matching

    Each device is matched to a posted supplier bill, and uncertain matches wait for a person.

    See the step
  • Portions and deductions

    Every exported portion is checked against the ADP device price list, and a mismatch stops the export.

    See the step
  • Closing the case

    Signed pages, final application, proof of delivery and supplier bills, or a written reason.

    See the step

Walk through this workflow with us.

Book a call and we'll show each step on a demo system and talk through how your office runs ADP today. Prefer the phone? Call 905-792-0000.