Backlog visits allow you to:
Submit visits for clients that happened before you were credentialed with Loula (up to 60 days before the current date)
Submit visits for which you missed the cycle deadline. In the regular submit visit flow, you are able to submit visits that happened in the current cycle or the previous cycle. If you missed your chance to submit visits within that window, you may request access to the Backlog feature.
Unlike visits submitted on-cycle, we do not guarantee payments for backlog visits on our regular biweekly cycle.
This is why when possible, you should submit visits on-time.
Because backlog visits are off-cycle, they work differently:
Unlike visits submitted on-cycle, we do not guarantee payments for backlog visits on our regular biweekly cycle.
Backlog visits are only paid out when the health plan accepts the claim and pays Loula for the claim.
It usually takes 30-60 days to get a response from health plans, but it may take up to 90 days for us to get an ultimate determination.
You are responsible for ensuring that the client's insurance was active at the time of service. A client must currently have active insurance in order for you to submit visits for the client.
Loula makes sure that the client's insurance is currently active, but you should work with the client and the health plan to make sure the client's insurance was also active at the date the services you want to bill for were provided to ensure payment.
In general, you may backlog as far back as 60 days before the current date, as long as your credentialing documentation (i.e. Medi-Cal enrollment, liability insurance, CPR certificate, etc.) were valid at that time.
This feature is only available for clients with Health Net or Kaiser Permanente as their primary insurance.
How do I get access to this feature?
This feature is turned on on a case-by-case basis, for a limited period of time.
If you want to access the Backlog Visits feature -
Log into the Loula Portal. Click "Help" in the sidebar. In the chat bubble that appears, click the ticket Request backlog visit . Fill out the form, and a member of our Support team will turn on this feature for you.
We will look at your credentialing documentation to determine a backlog period. In general, you'll have access to the feature for two weeks.
How do I submit a backlog visit?
Once you submit the Request backlog visit, a Loula team member will review the request and turn on the feature for you.
You will receive an email that tells you 1) how far back you can backlog visits and 2) when you need to backlog visits by
After your backlog deadline, you will no longer be able to backlog visits.
You will have to submit another Request backlog visit request to access this feature again. It will only be turned on on a case-by-case basis, so we highly encourage doulas to submit visits on cycle.
Once this feature is turned on, you will find an alert that appears on your Home Dashboard.
Click Submit backlog and follow the steps to submit a backlog visit. You'll notice that the flow is almost identical to the regular Submit Visit flow, except the background is blue instead of gray.
What happens once I submit a backlog visit?
You will get updates on the status of your backlog visit via email.
Each backlog visit will go through the following statuses. Whenever there is a status change, you will get an update via email. You may also go to the Visit Details page for the backlog visit to view it's status at any time.
Backlog visits all start out with the status, Backlogged.
When we have sent the claim for the backlog visit to the health plan, the status will be updated to Claim created.
When the claim has been accepted by the health plan, they will be moved to Processing. That means the backlog visit will be paid out at the end of the following cycle.
When the claim has been paid out, the status of the backlog visit will be updated to Paid.
If a claim is denied by the health plan, it will be marked as Denied.
Where do I find a backlog visit after I've created one?
Backlog visits can be found in the same way that regular visits can be found: in a client's Client Profile or the Visits page.
On the Visits page, backlog visits are separated out to its own Backlog tab.
On a client's Client Profile, backlog visits will show up in the same table as the rest of the client's visits.
In general, you can also keep identify a backlog visit because it will be labeled as Backlog in the Cycle field.
Important notes:
1) Backlog visits count towards a client's visit count in the same way regular visits do.
2) Backlog visits are viewable even past the backlog deadline