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DisclaimerThis webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some state laws. This should not be used as legal advice. Itentive recognizes that there is not a “one
size fits all” solution for the ideas expressed in this webinar; we invite you to follow up directly with us for more personalized information as it
pertains to your specific practice and issues. Thank you, and enjoy the webinar.
Introductions
Cynthia KincadeVice President,
Consulting Solutions
Sean HarveyImplementation
Consultant
Jeannie LogueDirector,
Managing Consultants
PM Enhancements
• Demographics
• Insurance
• Reporting
• Letters
• SIM Groups
• PM Patient Portal Integration
• Transactions
• Authorizations
• Claims
• Eligibility
• National Drug Codes
• Bad Debt
• Anesthesia Concurrency
Patient Demographics
• Added ability to arrange the order of the Race dropdown for patient demographics in the EHR or in PM
• Added patient notification icons and default preferences for communication Reportable
Changes are tracked in significant events and clinical history/notes
Encounter Insurance Selection• New columns are now available to display patient
insurance information including: Policy number
Insurance card on file
Detail-2 information
Benefit information
Authorizations
Referrals
Eligibility (RTS)
• Added the capability to add, remove, and arrange columns on the insurance selection screen based on user preference
Encounter Insurance Selection
• Right Click Headers to Add or Remove Columns
• Hover Over Push Pins to Display Data
Reporting Tool• New columns have been added to the Unapplied
Report Guarantor name
Birth date
Charge amount
Insurance 1/2/3 amount
Patient amount
Encounter copay
Line item amount
Process date
• Associated column filters have been added
Report SearchingText Search Capability added to Reports• Flashlight icon added to the tool bar to populate
search function
• Searching abilities include: Text field
Find
Next
Previous
Cancel
Stop
Match Case
Report TaskingEnhanced Tasking from reports
Enables user to choose how a task will be created and what data will be encapsulated in the task.
• Encounter tasks will send a task at the encounter level with the encounter-specific detail attached
• Account tasks will send account level tasks with account-specific detail attached.
• The option for Both is available to create tasks at both levels.
Consolidated File Maintenance• Letter Types have been moved under the Letters
option in the Master Files as opposed to two separate locations
• Structure of letter modifications has been made significantly easier to navigate.
Letter Modifications
• Edit name, description, and header without using SQL to modify.
• Single click to add or remove header.• View the creator and last modifier of the letter
highlighted.Smith, Christina
Smith, Christi…
New Look and FeelThe letter editing window has been enhanced to have a more MS Word-like appeal
• Use the toolbar to edit text, paragraph formatting, bullets, etc.
• Right-click to populate formatting window to insert tables, images, and format text frames.
Data RepositoryA new data repository has been added to enhance the macro selection and expand the abilities of letter creation
These macros will change based on the letter that is selected
Letter Conversion UtilityPrior to utilizing the new letter functionality, your existing documents will need to be converted. As a result, NextGen has created a conversion utility
• On the local drive, in the NextGen folder, there is a letter update utility. (c:\Nextgen\NextGen Letter Update Utility.exe)
• A simple blue window will populate, with which users can convert the letters
• This takes a few seconds, but will only need to be ran one time. Once it is complete, simply exit the utility and restart the application
SIM Groups
SIM Group set-up has been changed to allow the following:
Allow single- CPT SIM groups to be created with more than one unit
Allow multiple entries of the same SIM into one group
Patient Portal IndicatorThe Patient Portal icon has been made available in multiple locations:
• Appointment Book (Daily View)
• Add/Edit Appointment Window
• Patient Information Window of the Patient Chart
• Status Bar at the Bottom of the Screen
Patient Lookup and Portal MenuEnhancements in Patient Lookup
• The Patient Lookup has been changed to add a Patient Portal column
Patient Portal Menu – PM
• In PM, Patient Portal Menu has been enhanced to include three different options: enrollment, online forms, and send message
• The rights to this functionality can be added or removed in system administration
Patient Portal Menu
• Enrollment has been expanded into a separate menu to handle enrolling, locking, and unlocking patients
• The Online Forms option has been added to the menu to assist in sending, importing, or revoking forms for the patient
Advanced SIM PricesPrior to UD2 when Advanced SIM was turned on, the user defined boxes would always be present. With the upgrade, these fields will populate only if they are designated with a label and there is a price listed for that label in the SIM library
Charge Discount Feature• The discount feature allows the user to apply a discount to a charge
prior to the releasing the claim
• A discount adjustment code is created and associated with the charge in order to account for the amount removed
A checkbox has been added to the Modify Transaction Code Information screen in File Maintenance to make the code available for discounts
• Discounts can be applied to the encounter as a whole, or to a specific line item on the charge posting screen
Line items can be discounted at different rates
• Discounts can be applied as a percentage of the whole charge, or a specific dollar amount less than the original charge
• Discounts can be reversed by using the Clear Discount button provided on the discount screen
Discount Feature Set UpTurn the Discount Feature on in File Maintenance -> Practice Preferences.
• Create a discount transaction code to be used with the Discount Feature
• Check the box that denotes Discount to make it available for use
• Create blocked users for those that should not have access to the codes
EHR Crossover• The charge entry pop up that indicates charges have been
submitted in the EHR has been re-structured to resemble the choices in the holding tank
• Instead of Yes or No, the options have been changed to Process or Reject, which makes them more descriptive of their actions.
• The buttons in the holding tank have been re-arranged to reflect this pop up order for consistency
Sub Batch Enhancements
For clients that use the Sub Batch feature, the requirement for number of payments is now an
option
Account Receipts• From the print icon on the transaction screen, an account
receipt option has been added to populate a receipt of payment
• When printing, the number of copies needed and the printer that will be used for patient receipts can be selected. Users can preview the document and print as needed
Patient Insurance - Encounter• The Patient Insurance – Encounter window has been enhanced to
allow line item level authorizations/referrals any time prior to submission of the claim
Prior to UD2, once a charge was entered an authorization could not be linked to an encounter
With the upgrade, users can manually link authorizations/referrals to encounters at either the claim level or line item specific level
Note the change in labels for the authorization/referral numbers, as well as the new boxes for line item specific detail.
File MaintenanceAuthorization levels can now be controlled in the Payer Master File in File Maintenance
• In the payer table under system tab Claims-2, there is a dropdown for Alternate Claim Send Method for Auth/Referrals. Authorizations can be selected at the claim level or the line item level. This dropdown will enable the line item option for the end user
COB Window• The COB window has been altered to encompass all adjudications
made on a claim. The data from each payment will carry forward and show the adjudication dates as displayed below
• There are two ways to look at the COB window: COB specific or All Payers This will enable the user to see the claim as whole or dig deeper into
one specific payer.
The single payer screens are completely modifiable.
Only the ‘Include’ column is modifiable on the All Payers screen
COB Access• The COB window is accessible through the traditional route
of opening the transaction detail and selecting the COB button.
• In addition, by simply right clicking on the transaction screen, users can populate the COB window. Since there is now one collective COB window, there is no need to go into the specific transaction detail and pull up the ‘last touched’.
Practice Preferences• Along with the new window, there are new alerts
to be set to ensure the COB has been balanced• The two new alerts are:
Warn on COB imbalance with allowed amount
Warn on COB imbalance with billed amount
Internal Control Numbers• Internal control numbers are used to keep track of re-submitted or
coordinated benefit claims.
• An enhancement has been made to populate the ICN received from the payer on all COB claims, resubmitted claims, and paper UB04/CMS 1500 claims.
• The setting to ‘Populate ICN Number’ in FM has been changed to ‘Send ICN on Resubmission’, and will function similarly, without flagging the claims automatically as ‘corrected’.
This will solve problems with Medicare regarding original vs. corrected claims issues that clients have come across in the past
• If enabled, the setting will populate the ICN and resubmission codes that are designated in the Payer Master File. If disabled, the spaces will be available on the header for the claim, but will not automatically populate.
File Maintenance• The Send Medicare ICN on COB Claims setting in the Payer Master
File has been changed to read “Send Prior Payer ICN on COB Claims” and its functionality has been extended to all payers that require this information.
• To ensure that secondary payers receive this information on paper claims, there has been a change to claim print library under the exceptions tab.
Box 22 now has an option to populate the Prior Payer Ref #, which will print the ICN.
Transactions• The resubmission numbers, prior to UD2, could
be entered on the transaction screen manually if necessary. Once the transactions were posted, however, this number was locked in place.
• With the upgrade, this number can be changed at any time prior to claim submission from the transactions screen.
CAS SegmentsBehavioral Health Billing Library
• A new tab has been created fro the BH Billing Library to help balance CAS Segments (line adjudication).
• Typically, when a new charge is entered, the claim no longer balances with the prior payer’s billed amounts. This new tab allows users to create an adjustment reason code for this purpose.
• With this in place, the COB window will automatically balance for the user.
Encounter Rate Billing Library
• Similar to BH, encounter rate billing has a new feature in its library to account for the CAS Segment. This setting will also allow the COBs to automatically balance and prevent the need to manually update.
CPT Code Inclusion
This new feature will allow clients to attach one or multiple CPT codes to an eligibility request re retrieve benefit data for specific procedures.
Eligibility Inquiry Eligibility Response
NDC Input• The NDC Library and functionality in the application has been
altered to allow the user to change the unit and/or basis measure per patient.
• Ultimately, this means that clients will not have to have more than one entry per NDC code. The code can be entered into the library once, and then altered on the charge posting screen for how many units are actually given to the patient.
• If the NDC code is attached to the charge in the library, it will automatically attach to the charge. If the units are not applied in the library, the window will populate automatically for the user to enter to correct information.
Bad Debt StatusBad debt has an optional new status that can be set in Practice Preferences that will keep patients that have fallen into that category labeled as such for reporting purposes
• Currently, patient encounters in Bad Debt are moved to a history status once they are paid. The following checkbox in File Maintenance (Practice Preferences) will stop this from happening
Instead of moving to a history status, these patients will remain in a Bad Debt status on the encounter screen
Note: Clicking the above checkbox will not act retroactively on patient accounts. This will only apply to future encounters. Also, once un-checked, any patient with a balance of zero on a Previous Bad Debt encounter will be moved to a history status.
Bad Debt Encounter Status DisplayEncounters that are currently closed have a history status as shown below:
If the checkbox to is selected, the encounter history status will display as follows:
Bad Debt NotificationsThere are also new alerts that can be automatically generated for patients that have previously been placed in bad debt. If previously in Bad Debt, the following alert will appear:
In addition to the alert an update will be created to the Bad Debt Encounter Note. A separate line item will be added as follows
Contract Libraries
• Prior to UD2, anesthetics could not be billed through a contract due to the nature of anesthesia concurrency billing
• The Anesthesia Libraries have been updated to include a contract option. This can be done in two ways: Overall anesthetics can have a unit price and
adjustment in place by payer
Anesthetic unit prices and adjustments can be made by particular SIMs for the same payer
Contract Libraries
Contractual adjustment taken for the entire anesthesia library
Contractual adjustment taken for just the 00100-00999 SIM code range
Anesthesia Process Dates
Process dates for anesthesia billing can be changed upon moving the claim from an In Progress status to an Unbilled status. This would occur after the anesthesia audit is run and the window populates to allow the user to release the encounters for billing.
The process date will automatically be the system date that the charge is entered (unless manually overwritten or altered in File Maintenance). This box allows the user to change the process date from the date the charge was entered, to the date it is actually processed.
Anesthesia Gantt Charts
Ability to print the Gantt Charts has been added to the reporting tool so that the chart can be attached to any audit generated.
• The printer icon populates a window where the user can select to print the report itself, or the report with the Gantt chart as well
• The Gantt Chart Report can either be printed for all encounters, as shown, or errors only
ALL PM USERS• Set Up Team – File
Maintenance, System Practice Templates, etc. will need to be configured
• Billing and Office Staff -need to determine and understand the changes that will impact their workflow
• Management- Training of the new features and enhancements will be necessary for practice management users
Basic Steps to Upgrade
• Validate Features
• Develop Project Plan
• Determine Requirements
• Test Upgrade
• Set Up
• Test…test….test….
• Train…train…train…
• Go Live
Itentive can help by providing an EHR Workflow assessment with an onsite consultation. We can review your processes along with providing assessments of your EHR workflow, EHR challenges and assist with an upgrade plan. We are currently offering a 3 day onsite assessment that includes:
Workflow Analysis
Planning
Written Report of Findings and Recommendations
All Travel Expenses
If You Feel Uncertain about Next Steps
Questions
• Cynthia Kincade Vice President, Client Solutions
224-220-5575
• Keith Justus Director, Business Development
224-220-5551