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.
Therapist calls or emails
- 1 Intake and assessment 4 steps
- 2 Application 3 steps
- 3 Submission and approval 6 steps
- 4 Ordering and delivery 2 steps
- 5 Billing and ADP invoicing 6 steps
- 6 Audit and records 3 steps
Case closed, records kept
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.
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A sales rep books the assessment with the therapist, client, time, place and the equipment to bring. The booked meeting shows its details and offers Start Visit or Start Express Assessment. A therapist can request an assessment from their own portal and see which rep will attend. 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.
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The rep records the client, health card details and funding type on the ADP Express form. 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.
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Confirming the assessment builds a draft quotation with ADP and client portions for the rep to review. The quotation PDF lists each device with its ADP code and the ADP and client portions. 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.
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The Express form can capture the applicant consent and signature for Page 11 during the visit. The full assessment flow has its own screen for the Page 11 and Page 12 signatures. A client can sign Page 11 remotely on a page sent by the office. 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.
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.
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The therapist uploads the application to the case in their portal instead of emailing it. The office sees each uploaded revision, who uploaded it and which copy is current. 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.
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When the application has not arrived, a reminder to the therapist is queued and logged on the case. 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.
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The office records the original application and how Pages 11 and 12 were provided. A case cannot be marked ready for submission while a required client reference is missing. 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.
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.
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The submission step refuses a data file that does not have the .xml extension. The XML importer reports a file it cannot read instead of saving bad data. 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.
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After submission the case keeps the original, signed pages, final application and XML together. 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.
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Staff confirm which devices ADP approved before the case moves on. The case shows Application Approved with the approval letter kept on file. 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.
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Upload the downloaded Invoice and Application Status Reports PDF to read it in the system. The statement is read locally into lines and totals for review before anything is applied. 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.
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An approval email to the client, with the rep copied and the report attached, waits in the outgoing queue. The Approved Items Report lists each approved device with its ADP and client portions. 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.
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One summary email groups a therapist's decided cases instead of one email per case. 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.
Ordering and delivery
Equipment can be ordered before or after approval, and delivery is scheduled and proven on the case.
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Create PO groups the case lines by vendor and links the purchase order back to the case. 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.
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The delivery is scheduled as a task with a technician, date and time. The proof of delivery form lists the devices and serial numbers for the client to sign. The case moves to ready to bill once the delivery date and signed proof of delivery are on file. 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.
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.
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A fixed deduction moves that amount from the ADP portion to the client portion. 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.
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The client invoice carries only the client portion of each device. The client invoice PDF shows the client portion alongside the ADP portion for reference. 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.
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Each funded line is linked to the supplier bill that proves it was bought. The supplier invoice PDF is kept on the vendor bill as audit evidence. 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.
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The ADP invoice carries only the ADP portion of each approved device. The ADP invoice PDF shows the claim number, serial numbers and ADP portion. 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.
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Export ADP Claims builds the submission file for the selected invoices. The export confirms the lines written, warns about a repeated file name and saves the file for download. 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.
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Each ADP invoice records its export and its own ADP billing status, separate from its accounting state. 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.
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.
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The order trail shows at a glance which documents and billing steps are in place. An audit sample is matched to cases and any amount difference is flagged for review. 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.
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Every exported file is saved with its date, posting period, total and line count. The saved text file holds one line per device in the comma separated ADP format. 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.
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Before closing, the case is checked for signed pages, final application, proof of delivery and vendor bills. The closed case keeps a note of what was verified and who closed it. 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.
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Ready for submissionSee the step
Authorization date, client references, reason for application and signed pages are in place.
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Submission filesSee the step
A device type, the final application PDF and the XML file are attached, with the right file types.
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Ready to billSee the step
Approval, completed device verification, the delivery date and the proof of delivery PDF.
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Supplier bill matchingSee the step
Each device is matched to a posted supplier bill, and uncertain matches wait for a person.
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Portions and deductionsSee the step
Every exported portion is checked against the ADP device price list, and a mismatch stops the export.
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Closing the caseSee the step
Signed pages, final application, proof of delivery and supplier bills, or a written reason.
Other funding programs
ODSP, March of Dimes and the other programs Fusion Claims handles.
The Fusion Claims module
Features, documents, screens and recent changes of the Odoo module behind this workflow.
The ADP equipment ERP
Sales, service, rentals and accounting around the claims, built for ADP vendors.
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.