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Estimates

Billing checks

Catch what a carrier or TPA would send back before the estimate goes out. Wave checks your estimate against the program you confirm and flags the lines that need attention.

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Check any estimate against the carrier or TPA program that applies, whether you're writing it or reviewing it. Wave flags the lines that need attention and quotes the program's own words beside the facts that triggered each flag.

When your company has uploaded a carrier or TPA program, Wave checks the estimate against that program's terms while you build it. Lines that don't fit are flagged before the estimate goes out, so you can fix them early.

Choose the program for a job

Programs come from your company's guideline library. See Set up carrier guidelines.

  1. Open the job and tell Wave the carrier in the job's chat, or ask for that carrier's guidelines.
  2. Wave asks which of your uploaded programs applies. Tap the program, or tap None of these. You can also type your answer.
  3. If the program has separate assignments, Wave may ask one more question about which applies to this job.

Wave attaches a program when you confirm it. Naming a carrier records it on the job without attaching anything. When a newer version of a program is ready, name the program again in chat to move the estimate onto it.

Read the findings

Go to Jobs, open the job and select the Estimates tab. Checks run and refresh as the estimate changes, so you can review findings while you build.

  • The guidelines band. Above the estimate, a one-line summary reads "Using program name guidelines" with the number of findings. It also shows status text such as Checking… while Wave works. Click it to open the drawer.
  • Amber lines. A flagged line shows a short "Billing check:" excerpt under its description. Click it to jump to that finding.
  • Findings without a single line appear under Grand total.

The Billing checks drawer

The Billing checks drawer holds one card per flagged clause of the program. Each card shows:

  • Triggered by: the estimate facts and the lines that set off the check
  • Needs: what's still missing, when the check depends on a fact you haven't given yet
  • Guideline from program name: the program's own words, quoted

A summary at the bottom of the drawer shows how much of the program Wave could check. Many program rules depend on facts outside the estimate, so use it as a guide to what was covered, and review the rest of the program yourself.

If the program refers to a companion document Wave doesn't have, or one of its PDFs is a scanned image, the drawer says so, and rules in that document aren't checked. Add or replace the PDF in Settings > Guidelines.

Act on a finding

Close out each flag in one click, and your team can see what was handled and why. Each open card has two actions:

  • Handled: you dealt with it.
  • Doesn't apply: you add a short reason why it doesn't fit this job.

From there:

  • Mark handled from the line. On a flagged line, the check mark at the right end of the row marks that check handled without opening the drawer.
  • Reopen. A closed card shows Reopen if you change your mind.
  • Fix the estimate. Edit the line or tell Wave in chat. Handled and Doesn't apply change only the finding.
  • Add a line note. If you want a justification to travel with the estimate, write it as a line note. See Add a note to a line item.

You can also ask Wave about the program in the job's chat: which findings are open, why a line was flagged, or what the program says about a topic. Wave cites the uploaded document and page.

Checks stay current

Wave re-checks as the estimate changes, and fixed issues clear on their own. A finding you marked Handled or Doesn't apply stays that way unless whatever triggered it changes, and then it can open again. If a refresh doesn't complete, the band says Billing checks may be out of date, and Wave tries again when the estimate next changes.

Private to your team

Findings are working notes for your team. They are not included on exported PDFs, share links, printouts or other exports. What can go out is a line note: one you write, or one Wave adds while it builds because the program asks for that documentation.

Wave checks your estimates against the programs you upload and attach. Your guidelines stay private to your company. Wave is not trained on carrier guidelines, yours or anyone's. Uploaded guidelines are never used to improve Wave.

Billing checks help you tidy an estimate before it goes out. Coverage decisions rest with the carrier. When you ask Wave a coverage question, it recommends a reading and points to the section it rests on. See Coverage and industry standards questions.

Availability

Billing checks come with Pro and Enterprise, with Custom plans at higher volumes, and with the free trial. On other plans, the band, the amber flags and the drawer are hidden, and naming a carrier in chat still records it on the job. See Plans and limits.

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