Release Notes v4.4

Contents

Account Lock and New Login Notifications

Timely Filing Management

Stop Unbalanced Claims From Batching

Visibility for Case/Authorization on Incomplete Charge Review

Easier Entry of Appointment Durations    Watch the Video

Additional Criteria added to Appointment Rules    Watch the Video

Merge Guarantors

Insurance Mappings for Crossover Remits

Additional filters on ERA List

Control Default State of Re-Bill Checkbox on the Modify Charge Screen   Watch the Video

Appointment Shells  Watch the Video

Additional Release Nuggets

Updated Insurance Billing Group Add/Modify Screen

"Past Due Only" checkbox for Tasks

ERA Search in the Navigation Box: No Space Required

User Has Concurrent Sessions

New Copay Popup on the Post/Modify Charge Screen

Show/Hide Option in Filter Criteria

Custom Query Reports: Option to add to My Favorites and Period End Reports

User Maintenance: Default Current DB in the DB Filter

Patients and Non-Patients Designation

Two New System Permissions for Charge Reversals

Dollar Amount Filters added to the Denial Worklist

Employer Include/Exclude Filter on Reports

Invoices: Consistent Employer ID on Related Screens

Release Notes Version 4.4

Account Lock and New Login Notifications

If a User has too many login attempts and has locked their account, or is logging in for the first time on a new computer, they will now receive the following emails.

• When an account is locked:

You are receiving this email because your account has been locked due to an excess number of unsuccessful attempts to log in with your User ID.

• The first time a user logs in from a new computer:

A new device was recently used to sign in to your account at (url address).

If this was not you, please reset your password.

Operating System

Windows

Near

Ashburn, Virginia

When

04/18/2022 11:32 AM ET

IP

3.220.129.232

Note that this feature will become active sometime after the feature is released to allow the system to ‘learn’ what device you are using.

Timely Filing Management

Capabilities have been added to help protect against Timely Filing limits.

Timely Filing Submission has been added to the Add/Modify Insurance screen (Libraries > Insurances > Edit > Timely Filing Submission panel). The Timely Filing field defines the Timely Filing Limit (in Days) for Primary, Secondary, and Tertiary.

Timely Filing Setup

System Settings: Sets the Practice Defaults which can be overridden at the Insurance level and Insurance Billing Group level.

• Admin > System Settings > General, 2 settings have been added.

• TIMELYLIMIT - System delivered as 365 days. 
• TIMELYREVIEW - System delivered as 180 days.

On the Add/Modify Insurance screen, add Timely Filing Limit Days (Overrides the System Settings)

• Use From: System Setting, Insurance, or Billing Group
• Primary/Secondary/Tertiary Limit Days fields are Day values, such as 90 days, 180 days, 365 days, etc. Set Limits for specific Payers.
• Primary/Secondary/Tertiary Review Days fields: For Primary, Secondary, and Tertiary, enter the number of days at which point you’d want to look at claims before the Timely Filing Limit is reached.

Finding Claims that have met or are are close to their Filing Limits

Interactive Aging Report (IA) Report

• A Total By filter has been added to Interactive Aging with these Timely Filing Type results:

• (Timely Filing) Limit
• (Timely Filing) Review
• None

Custom Encounter Query (CEQ)

• On the Add/Modify Columns/Filters screen, the Timely Filing fields are located under the Policy panel.

Stop Unbalanced Claims From Batching

To address a common Clearinghouse rejection, before sending a Claim to the next Responsible Insurance, the adjudication from the previous Responsible Party must balance. If an Encounter is unbalanced or missing the Primary Insurance adjudication, the Claim will not batch.

• A Message will be displayed on the Encounter Dashboard in the Balance panel above the Transactions stating why it is unbalanced.
• The line item that is unbalanced will be highlighted on the Encounter Dashboard.
• It will be listed in the Claims Submission Queue as Adjudication Unbalanced.

Visibility for Case/Authorization on Incomplete Charge Review

Visibility has been added to the Incomplete Charge Review screen for Cases and Authorizations. This makes reviewing the Case and Authorization simpler before completing the Encounter.  These icons are displayed in the Encounters Column

• No icon: The Encounter does not have a Case or an Authorization.
• C Icon: A Case is assigned to the Encounter.

• Click the C icon to open the Case Dashboard.

• A Icon: An Authorization is assigned to the Encounter.

• Click the A icon to open the Add/Modify Authorization screen.

Easier Entry of Appointment Durations       

Instead of strictly entering minutes for the Duration of an Appointment, a Block, or an Appointment Type, hours and minutes can be used.

• For example, to block a Resource’s schedule for a day, 8h 30m can be entered instead of 510 minutes.

Additional Criteria added to Appointment Rules       

• A new Appointment Slot option has been added.
• Days of the week can be specified to determine when the rule should apply.

Merge Guarantors

The ability to Merge Guarantors is now available. (Admin > Merge Guarantors) The following items will be merged: Statement Batch Items / Charges / Receipts / Additional Addresses / Scanned/Uploaded Documents / Notifications / Payment Plans.

The following items for the Guarantor being “merged into” will be retained: Guarantor’s Payment Rules, Notification Settings, Contact, Employment, Personal information.

Insurance Mappings for Crossover Remits

Background: Insurance Plans like Medicare know the patient’s secondary coverage, but for a multitude of reasons, the secondary information isn’t on the insurance profile. The primary insurance crosses the claim to the secondary, but when the Medicare remit is applied, the balance can’t be moved since the system doesn’t have the secondary insurance on file. These Remits have historically gone on Hold with the message: Insurance on Remit does not Exist on Profile.

Insurance mappings for crossover remits have been introduced to nicely address this issue.

When a remit from the primary insurance shows a crossover claim, the crossover payer will need to be mapped to an insurance in the Library. This only needs to be done one time for each crossover payer. Here is the process:

• ERA is applied w/ a crossover, a CM will show in the Status Column 

• Select the Mappings button. The screen (below) shows each Payer that has a Claim that crossed to a non-existent Secondary or Tertiary Payer, with an option to map to an existing Insurance in the Insurance Library or select the Do Not Map checkbox.

• Choosing Do Not Map will put the remit(s) on Hold

• When you Save, the Remit automatically Applies after mapping.
• A policy number of “UNKNOWN” will be added with a note showing the involved ERA number.

• When the subsequent ERA is applied, the policy number will automatically update from UNKNOWN to the number in the ERA.

• Future remits crossed to the same insurance will automatically create a policy on the profile.

Additional filters on ERA List

The following filters were added to the ERA List Filter Criteria to improve search capabilities for ERAs that have been Applied. Change the Status filter to All, Posted, or Archived to utilize these filters. (Payments > All ERAs)

• DOS From and DOS To
• On Hold Remits
• Denial Worklist Remits
• Custom Worklist Remits
• Old System Remits
• Unbalanced
• Crossover Mapping Remits
• Applied By
  

Check Number filter: Spaces at the beginning or the end of the Check Number will be removed automatically.

Control Default State of Re-Bill Checkbox on the Modify Charge Screen

A “Re-Bill Encounter” checkbox has been added to the Claim Status screen in the Claim Status Library (Libraries > Claim Status > Modify Claim Status). This controls when re-billing should be automatically triggered.

• When the Re-Bill Encounter checkbox is selected, the system will automatically select the Re-Bill checkbox on the Modify Charge screen. 

• This will change the Claim Status to Ready to Submit/Resubmit when the Charge is saved.
• The Re-Bill checkbox on the Modify Charge screen will ONLY be selected automatically if ALL Insurances on the Encounter have a Status where Re-Bill Encounter is checked, and the Encounter has a balance.

• When adding a new Claim Status to the Library, the Re-Bill Encounter checkbox is checked by default.

Appointment Shells

Appointment Shells is a Calendar option that opens a view of the types of Appointment Slots that are available. The User has the ability to Add/Modify/View Concurrent Appointments and identify the number of Appointments and duration. The Appointment Shells reflect your Slots, Build, and Rules Setup.

1. Make the Appointment Shells visible by selecting the Show Appt Shells checkbox on the Settings tab.
2. Select one of the Shells to add an Appointment.
3. The Appointment replaces the Shell.

Additional Release Nuggets

Updated Insurance Billing Group Add/Modify Screen

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New columns were added to the Insurance Billing Group table with links to Provider IDs / Insurance IDs / Insurances (Libraries > Insurance Billing Groups).

"Past Due Only" checkbox for Tasks

A Past Due Only checkbox has been added to the Tasks screen. This gives greater flexibility in working and performing mass actions on Past Due Tasks.

ERA Search in the Navigation Box: No Space Required

When using the Navigation Box to search for an ERA, a space is no longer needed between ERA and the ERA number. The search can be entered either way. For example: ERA123 or ERA 123.

User Has Concurrent Sessions

A Warning will display on the Home Dashboard when a User logs in if they are already logged in with a different IP address.

New Copay Popup on the Post/Modify Charge Screen

When collecting a Credit Card Transaction for a Patient Copay on the Post/Modify Charge screen, the “process” popup will now display if POS (signifying a ‘point of service’ payment) is “Yes”. This only applies when using integrated merchant services.

Show/Hide Option in Filter Criteria

The verbiage Show or Hide has been added to the left of the Filter Criteria label to give better visibility when the Filter Criteria is hidden. If there are less than 10 items in a results list, the Filter Criteria will automatically be hidden. Click the word Show to display the Filters. If the results contain 10 items or more, the Filter Criteria will show by default. Click the Hide link to hide the filters.

Custom Query Reports: Option to add to My Favorites and Period End Reports

Checkboxes have been added to the Custom Query Reports to add them to My Favorites and Period End Reports. These are located above the Title bar.

User Maintenance: Default Current DB in the DB Filter

For Billing Services

When opening User Maintenance, it will default to the Database you are in currently.

• The Database number can be removed from the DB filter to see all Users for the Databases where you have access.
• A different Database number can be entered in the DB List filter.

Patients and Non-Patients Designation

On the Find Patient/Guarantor screen, Patients and Non-Patients have been separated and are labeled with a green bar before each section.

Two New System Permissions for Charge Reversals

You can now control whether a User or Role can Reverse a Charge for Modification and/or Reverse for Deletion.

Admin > User Maintenance > Charges > Encounter Dashboard > Actions > Charge Reversal

Dollar Amount Filters added to the Denial Worklist

New filters have been added to make it easier to search for dollar amounts greater, less than or equal to a specific amount: Pat Bal / Ins Bal / Charge / Paid / Applied / Unapplied (Home Dashboard > Denial button)

Employer Include/Exclude Filter on Reports

An Employer filter has been added to the following Reports with Include/Exclude/Only. You will only have this option if Invoices have been activated in System Settings.

• Practice Analysis 
• Interactive Aging
• AR Analysis
• AR Management
• Incomplete Charge Review

Invoices: Consistent Employer ID on Related Screens

The Employer ID (from the Employer Library)is now used consistently across all related screens (Policy, Responsible Party, Guarantor, Patient/Encounter Dashboards).