Requests for Medical Records - how does Zaya handle this?

Summary 

You can now offload the submission of medical records entirely to Zaya by providing us with EMR access. If not, you are able to upload medical records directly through the Zaya portal. This article explains these different options, and answers common questions.

EMR Access 

EMR access helps us retrieve records more efficiently and respond to payer requests faster. Zaya has in-house release of information specialists who have years of experience doing this! We hope to expand this to all of our practices as soon as possible. 

When Zaya has EMR access:

You remain responsible for maintaining complete and accurate documentation.

Documentation must be finalized and signed in your EMR in a timely manner.

Records must clearly support medical necessity and skilled care.

If Zaya does not have access to your EMR:

You must upload medical records directly through the Zaya portal (follow the steps below)

INTERESTED IN EMR ACCESS?? - Please contact Samantha@zayacare.com to learn more!

Step-by-step instructions for how to upload medical records

Step 1: Navigate to Claims Page

Step 2: Search for the claim by patient name (Select the correct date of service)

Step 3: Click on the claim

Step 4: Click 'Submit Medical Records' (Uploading records to the wrong claim will delay payment. Make sure the documentation is uploaded under the correct patient and date of service.)

Step 5: Choose the files from your computer and confirm the upload

Common Questions

Which claims can I upload medical records for?

• From the Claims page, you can use the Medical Records column to see which claims allow you to upload medical records.

    Records successfully uploaded to Zaya.

   Records cannot be uploaded yet. Option will be available shortly.

    No records on file.

Records for this claim must be submitted via this form. 

How to view uploaded medical records

• If a claim has a checkmark under the Medical records column on the Claims page, you can click into the row to view the uploaded records. 

  1. Navigate to the Claims page

  2. Search for the claim by patient name and ensure you select the correct date of service

  3. Select 'View Medical Records'. If there are multiple attachments, you can click into each one individually 

What should I include in the medical records

• For successful reimbursements ensure your clinical documentation clearly outlines the following

• One-on-one skilled care

• Medical necessity for the service provided

• Objective clinical findings

• Provider's active involvement (not general or non-skilled care)

• In case of a denial, review your documentation and add any missing details such as

• Specific goals addresses

• patient progress notes

• Functional impairments addressed with skilled intervention

Do I need to submit documentation for each date of service

• Yes. You are required to to submit the documentation per date of service, not combined.