Billing

Medicaid - CMS 1450 (UB-92) - Several changes have been made to printing the CMS 1450, including:

• Attending Physician ID number now prints in block 82

• Condition codes now reflect FP condition code when FP services are on the claim.

• Block 84 now prints selected procedures for FP supplies, medications, etc

• Encounter providers and license numbers not print in block 84, in addition to NDC numbers and claim notes.

• A change was made to remove errors when opening claims in Adobe (PDF) after making printing adjustments.

• Supplies can now be grouped and coded on the 1450 claim form.

Medicaid Billing

Changes were made to remove record locking.

Non-posted checks

The program combo box on BL-112 now has alpha sort on programs.

OR Electronic Claims

OR Medicaid ANSI claims are now limited to 4 diagnosis codes.

Partial Payment Entry – Medicaid, Medicare, Private Insurance

Ability to add a ledger record to record future payment is now adding the correct future pay amount instead of the standard fee.

PDF Printing CMS 1500 – all billing ledgers

A change was made to remove errors when opening claims in Adobe (PDF) after making printing adjustments.

Client Register Listing (CR-06)

Credit and Write-Off amounts have been added to the Client Register Listing.

Client Information (CR-23)

New KCI form has been added to Immunization History for Kansas Health Departments.

Client Document Tracker program combo box now has alpha sort on programs.

The account balance display on Client Billing Information (CR-32) has been updated and refreshes automatically after changes have been made using the Payment button.

New Medicaid ID format has been added and changes made to detecting Medicaid and Medicare name and ID changes when billings are created.

Medicaid Type is now required, when the Required Preference is selected, on entering or editing a Medicaid ID.

Client Billing Ledger (BL-02)

Manual ledger transfer screen when transferring to Medicaid has a new format designed for the new Medicaid ID.

Client Payment now alerts the user when the client has a miscellaneous credit with an option to use the credit. When the option to use the credit is selected, the amount of the credit automatically defaults on the Payment Selection screen (BL-09)

The display of the client account balance, miscellaneous credit and write-off on the Payment Selection screen (BL-09) has been updated.

Encounters
 

KS – CVR

Changes have been made to update and correct edits on entry of CVR data.

When 2 CVR’s have been entered for the same encounter, the ability to selectively delete one of the CVR records has been added.

CVR Encounter Totals (SR-120)

Client name now prints with a comma separator.

Receivables Activity (SR-38)

The Receivables Activity report no longer picks up services provided on future dates.

Revenue Detail report (SR-100)

Adjustments from third party billing ledgers now show under the appropriate third party payer instead of adjustments to the client ledger.

Calendar Profile Maintenance

24/7 Clinics are now displaying all times correctly

Import/Export – Kansas Specific Programs

Ability to exclude client name from KS CVR export has been added.

Additional data edits have been added to KS-CVR export.

Import/Export – Washington Specific Programs

Changes have been made to reflect new Medicaid ID format in the MER Match export file.

Changes have also been made to speed up creating of the MER Match export file.

Procedure Menu - Billing Supply Code (CMS 1450 only)

A new button has been added to the Procedure Menu labeled Billing Supply Code. This function will be used for grouping contraceptive supplies under one line detail item on the CMS 1450 (UB-92) claim form for Medicaid Billing in California. A line item detail will be created on the claim based on the billing code entered on the table and Service detail will be printed in block 84.

Procedure Maintenance (SM-32)

Column head sorts have been added to the procedure list.

There is now a column displaying Export Code on Procedure Maintenance

A column displaying Alternate Code is now on the procedure list.

There are now options on the Actions Menu on SM-32 to Create Procedure Masters and Delete Procedure Masters (these options are currently disabled and will be activated in the future for use by Kansas Health Departments).

Procedure Maintenance (Edit) (SM-42)

Changing procedure owner is now easier. Select the new program you wish to make owner of the procedure and save the change.

The CPT field has been relabeled on to Export Code and separated from the Private Insurance Billing Code. The Export Code field should contain the CPT code that will be used for CASA and Immunization Registry export files.

There is now an Alternate Code field on SM-42 that can be used to tie a procedure to a code other than the PHClinic Code or Export Code and will be used for Procedure Maintenance reporting. Kansas Sites need to leave this field blank until further notice.

Medicare/Medicaid Time Frames (SM-52)

There is now a Private Insurance billing code on SM-52 when Private Insurance is selected. This code will be used for Private Insurance billing. If this field is blank, the Export Code will be used for billing.

Provider Maintenance

A field has been added to Provider Maintenance (SM-23) for Nursing License #. The License # is used on the Medicaid CMS 1450 (UB-92) claim form. If you do not print the CMS 1450 claim form, this field can be used to record Nursing License Numbers for reference.

Remote Workstation

Changes have been made to remote workstation import to correct an error that was occurring.

Vaccine Series Maintenance

The Vaccine Series Code has been increased to 8 characters, and can now contain lower case letters as well as upper case and numeric characters.

The ability to change an existing Vaccine Series Code has been added. Select the Vaccine Series you wish to chance the code for on VI-07, click the Change button and enter the code (up to 8 characters) you wish to change the Vaccine Series to.

CASA Export

Ability to export to CoCASA has been added and is currently in Beta testing. The PHClinic Import Template will be added to a future CoCASA release. Contact the KIPHS Help Desk if you have questions about this functionality.