Chapter 14: Go Live Process
Chapter Overview
What You'll Learn:
- How full EMR agencies move from Sandbox to Production
- That Billing Service + HIPAA BAA must be signed before Approve (details in Chapter 13)
- What happens to sandbox demo data when you convert
- How billing-only agencies are approved (no sandbox convert)
Time to Complete: 20–30 minutes to understand; actual go-live timing depends on review and signatures
Who Should Read This: Agency Administrators; Betasky staff who process go-live requests
Text-only guide — no screenshots. Follow the exact labels on screen.
14.1 Sandbox vs Production (quick)
| Sandbox | Production | |
|---|---|---|
| Purpose | Learn and configure | Real patient care / real billing |
| Claims / Payment Posting / OASIS export | Blocked or limited | Available (subject to CCN / cert rules) |
| Communications (SMS/Fax) | Not available | Available when provisioned |
| Cost | Free test environment | Paid subscription |
You request go-live from sandbox. Betasky reviews, you sign required agreements, then the agency is converted (or activated for billing-only).
14.2 Full EMR — Request Go Live
Who can request
Only an Agency Administrator sees the Go Live button on the sandbox banner.
Banner text:
Sandbox Mode - Test environment only | Not for official use
Button: Go Live
Steps
- Click Go Live → opens
/dashboard/go-live. - On Ready to Go Live? / Production upgrade, review What changes when you go live?, Features Unlocked, and plan cards under Choose your plan.
- Select a plan.
- Click Request to go live.
- In the Request to go live dialog, confirm your profile if prompted (Update my profile if needed).
- Click Confirm & request go live.
You should see a confirmation that the request was submitted, and the page section Your go-live request with a pending alert (for example Request pending…). Super Admin lists show the chip Pending approval (internally PENDING_APPROVAL).
CCN: Not required to submit a go-live request. You can add CCN later. After production, agencies without CCN may see Pre-Certification Mode (billing features restricted until CCN is assigned).
14.3 Required Agreements (summary)
Before Betasky can Approve, Billing Service Agreement + HIPAA BAA must be SIGNED. W-9 and Ohio EFT do not block approval.
Full detail (where the page lives, statuses, Ohio EFT steps, agency vs Betasky staff): Chapter 13: Agreements & Enrollments.
Agency path during sandbox go-live: sign Dropbox Sign emails sent to Agency Administrator login emails (not the agency company/main email). After production, full EMR uses Settings → Agreements; billing-only uses Setup → Agreements. Full email / expected-steps detail: Chapter 13 (§13.2–13.3).
Betasky staff send agreements from Go-Live Requests / Clients. Agency users never use those screens.
14.4 Super Admin Approval (what happens)
Path: Sidebar → Go-Live Requests → open the agency request.
Tabs/filters include: Pending approval · Pending payment · Approved · Rejected.
On the detail view, under Required agreements, confirm Billing + HIPAA BAA are signed. Then Approve → Approve & activate.
Payment method choices
| Option | Label | Result |
|---|---|---|
| Manual first | Manual first payment (then Stripe later) | Agency converts/activates immediately; first payment recorded as Check / Wire / ACH with notes |
| Stripe | Stripe payment link (agency pays — not you) | Status Pending payment; admin can Email agency, Copy link, or Open in browser (test); after successful Stripe payment the agency converts/activates |
Reject uses Reject when the request should not proceed.
14.5 What Happens to Sandbox Data (important)
When a full EMR sandbox agency is converted to production, the system runs a demo data wipe, then sets the environment to production.
Removed (examples)
- Patients (including intake, medications, wounds, HHA plans)
- Visits, clinical documents, compliance tasks
- Care orders, plans of care, physician orders, communications history
- Claims, payments, remittances, prior authorizations
- OASIS submissions
- Physicians / sources, payers, pharmacies
- Facilities, fee schedules, branches, custom visit types, clinical settings overrides from sandbox play
Kept
- Users, clinicians, roles, and access
- Core agency profile (name, NPI, address, CCN if present, etc.)
- Go-live request and agreement records
- The subscription tier applied at convert
Warning: Treat sandbox as a practice space. Do not enter real PHI you need to keep. After go-live you reconfigure payers, branches, and clinical setup for production.
The Go Live page lists Features Unlocked, Cleared on Convert, and What You Keep to match this wipe behavior.
After convert:
- Sandbox banner disappears; you cannot switch back to sandbox on that agency.
- If CCN is present, standard catalog payers may be recreated for production.
- If CCN is empty → Pre-Certification Mode banner until CCN is assigned (billing limited).
14.6 Billing-Only Path (no sandbox convert)
Billing-only agencies sign up via Billing Only on Get Started (/signup/billing), not the sandbox explorer.
Differences:
| Topic | Full EMR sandbox | Billing-only |
|---|---|---|
| Environment at signup | Sandbox | Production (pending review) |
| Plan picker on Go Live page | Yes | Uses Billing Essentials (signup) |
| Demo wipe / convert | Yes on approve | No wipe — activateBillingOnlyAgency |
| Chip | — | Billing only |
| Agreements page in nav | After production: Settings → Agreements | Setup → Agreements |
| CCN | Optional; affects Pre-Cert after go-live | Not required for Claims Center |
| Default claims entry | Ready for Billing | New Claim |
Approval still requires Billing Service Agreement + HIPAA BAA signed. Same Manual vs Stripe activation choices.
14.7 Optional: W-9 and Ohio EFT
See Chapter 13: Agreements & Enrollments (§13.9–13.10).
Short version for go-live:
- W-9 — recommended; does not block Approve; agency signs Dropbox Sign email and tracks on Agreements & Enrollments.
- Ohio EFT — download packet → upload signed form → upload voided check on Agreements & Enrollments.
14.8 After You Are Live — Checklist
- Confirm sandbox banner is gone
- Re-enter production payers / branches / clinical settings as needed (full EMR)
- Complete W-9 / Ohio EFT if your billing team needs them
- Verify Claims Center / Payment Posting access (production + permissions + CCN rules for full EMR)
- Train staff — sandbox habits should not assume demo patients still exist
14.9 Common Mistakes
- Entering real patients in sandbox expecting to keep them after go-live — they are wiped on convert.
- Thinking CCN must be entered before requesting go-live — it does not; Pre-Cert applies later if missing.
- Expecting approval without both Billing and HIPAA BAA signatures.
- Looking for Setup → Agreements on a full EMR agency — that SideNav item is for billing-only. After go-live, full EMR uses Settings → Agreements.
- Assuming W-9 or Ohio EFT must finish before Approve — they are recommended, not approval blockers.
- Following Clients → Agreements as an agency user — that path is Betasky Super Admin only. Agencies use Agreements & Enrollments / Dropbox Sign email.
14.10 Quick Reference
| Step | Who | Action |
|---|---|---|
| 1 | Agency Admin | Banner Go Live → choose plan → Confirm & request go live |
| 2 | Betasky | Go-Live Requests → send Billing + HIPAA BAA |
| 3 | Agency (+ Betasky) | Sign in Dropbox Sign |
| 4 | Betasky | Approve & activate (Manual or Stripe) |
| 5 | Agency | Rebuild production config; start real work |
Previous: Chapter 13: Agreements & Enrollments
Next: Chapter 15: Patient Intake