Mid-Release Update v4.4.1

CARC Management & Denial Analysis Reporting

You can now identify which CARC codes you want to report as Denials. The new Denial Analysis Report is located in the A/R Panel on the Reports screen. CARC denials can be designated as Preventable or Non-Preventable and Categorized by root cause.

Example Report: Top 10 Denial Codes

Learn More: CARC Management and Denial Analysis Overview, CARC Denial Rules, Denial Analysis Reporting Criteria, Denial Analysis: Preventable/Non-preventable Denials

Map a Crossover Insurance to an Existing Insurance

When the Primary Insurance pays on an ERA and forwards to a secondary that was not on the Patient’s Insurance Profile, the Remit historically went on Hold with the message: Insurance on Remit does not Exist on Profile. The Secondary Crossover Payer can now be mapped to the correct Insurance, which adds the secondary insurance automatically to the Insurance Profile.

Learn More: Map a Crossover Insurance to an Existing Insurance

Executive Summary Report

The Executive Summary Report provides key Monthly revenue cycle KPIs, over a 12 month reporting period. Including:

• Clearinghouse and Payer Clean Claim Rates
• Time taken to Add, Complete, and Bill Encounters
• Net Collection Rates
• Days in A/R

Learn More: Executive Summary Calculations, Why use the Executive Summary Report?

Cash Flow Report

The Cash Flow/Waterfall Report helps you visualize your revenue cycle. It contains KPIs of Gross and Net Collections and exposes delays in Charges and the flow of Payments over time.  For the selected time span, you will see all posted transactions grouped by the Date of Service month.

• Time to bill: Easily see Charges that are being posted outside of the DOS month.
• Time to collect: Reveals payments not made in a timely manner.
• Calculates remaining A/R for the Date of Service month.

Learn More: Cash Flow Report

Payment Plans

Patient Payment Plans can be established if one of our Merchant Service vendors is being used for credit card processing. These plans can be added from the Patient, Payments, Receipt, or Guarantor Dashboard. The Patient’s credit or debit card is required.

Learn More: Payment Plans

Self-Pay Discount

You can define a Self-Pay discount % on the Statement Profile. The discount will apply to the Charge amount.

• If the First Statement Only checkbox is selected, a discount will only be applied on the First Statement. This gives the Guarantor an incentive to pay in full before the second Statement is generated.

• SPD (Self-Pay Discount) Transaction Code is System delivered to use for the discount. You can change the Transaction Code description (Libraries > Transaction Codes) , or use a different Adjustment Code if preferred.
• If the balance is not paid in full on the first Statement, the discount will be Undone (reversed) with the same Transaction Code, when the second Statement is generated.

• If First Statement Only is unchecked, the discount will be applied on all statements.

Learn More: Apply A Self-Pay Discount using Statement Profiles

Nuggets

Go-Box Tabbing

The tab key now functions the same way as the Enter key when using the Navigation Go-Box to navigate or perform a search.

Browser Tab Options Added

For users with access to a single practice, you will now see the page title in the browser tab. For users with access to multiple practices, you now have the ability to determine the information that appears in the browser tab via “My User Profile” (select your user ID at the top of the screen to access). 

Self Pay Reporting Option Added

Self Pay has been added as an option on the Practice Analysis Report.