Billing

Electronic Media Claims Set-up BL-51
Changes have been made to EMC Set-up to allow for routing changes made by Noridian. Changes will apply to ND Medicaid, Medicare B and Blue Shield claims, as well as UT and WA Medicare B claims. The EMC record Receiver screen now has a separate field for entry of Application Receivers Code for Loop GS03 and Loop 1000B, NM109. Note: ISA08 (33477) will continue to be entered into the Receiver ID field. The payer screen now has a separate field for entry of Loop 2000BB, NM109, which at this time may be the same as 1000B, NM109. Claims in billings will need to be returned to the main ledger and attached to the EMC record after the changes are made to pick up the new routing change format.

All Ledgers
The column order has been changed on the browser for screen BL-102: Payment Ledger Detail. It now shows the client id after the billing number and before the client name and the HD Charge is before the reimbursement.

Changed the ‘Exit’ message to be clearer on BL-102: Payment Ledger Detail. The message now better explains your options when you exit.

Client Billing Ledger
Default Receipts by date and added column sorting options to BL-06: View Receipts.

Actions Menu option to “Show Ledgers” has been added to Client Billing Ledger BL-02. When selected Client Ledgers BL-122 screen displays third party ledgers for the client on BL-02. There are multiple sort options available for viewing the status of third party ledger records.

Contract Billing Ledger
When contract services are set to use standard fees, the fees will not display in the column as they may change over time. A fee will only show when they are charged different than the standard fee.

Medicaid Billing
Editing the rendering provider in MD Claims changes the HCFA field 24k value.

CA Only - Electronic claim creation for 837 Institutional claims has been added – set up Institutional EMC record to attach to claims for 837I format (BL-59, Actions, Create Institutional).

Medicare Billing – Flu/Pneumonia Diagnosis
An option has been added to the Billing Menu that allows you to set up your Influenza and Pneumococcal procedures so the system will prompt if you want to automatically use diagnosis code V06.6 on Medicare claims when both procedures are on the claim.

If Medicare name is blank when entering the card information, the ledger now uses the client name.

Client Billing Statements
Now have the ability to run statements by last payment date on or before. This will only show services before this time and should not pick up services after this date even if run at a later date.
 

Client Register

Client Information (CR-23)
Spokane Regional Health District - Program Enrollment has additional data fields for conversion of records room data.

Fixed the tab order on program enrollment (PE-03). Also, moved Next Cert field if additional fields in preferences are marked as active.

Client MOGE status not updating when services are given has been fixed.

Display confidential flag on IM-04: Immunization history and CR-42: Procedure History.

Labels
The system will not print labels for clients with bad address marked.

Client Register Listing (CR-06)
Client listing was showing ‘OVP’ detail amounts in client balances. This is fixed so it would not do this anymore.

Client Data Verification (CR-37)
Changed spacing on the client data verification print.

If more than one private insurance policy is marked as primary, you will not get a pop up screen so you can choose the correct policy for billing information.

Address
The Census button on the address update screen (CR-20) has been disabled until Census Tract section is complete.

Now allowed to have the same zip code for more than one city and city was changed to a combo box. This can now be saved on the zip code table.

Private Insurance Policy Information (CR-01)
Changed the subscriber DOB field to a character field so it could be deleted if need be. Buttons were added so you could switch between policies without having to exit the screen. There is also a notes field and an end date now. You can now attach an end date to a policy so you can still bill with these policies when they are no longer active. This will keep you from having to mark them as primary if there is still billing that needs to be done and a new insurance policy. Also, this will allow you to have more than one insurance policy marked as primary. If you do have more than one, you will get a pop up screen at check-in so you can choose the correct policy.

Alert Information (CR-21)
Changed the label ‘Alert Printable’ to be more specific, it now says ‘Print on Encounter.’

Immunization History (IM-04)
Added a create date and time to IM-01.

When a history and an encounter were done on the same day for the same multi-antigen vaccine and you deleted one set to correct it, it deleted all sets of the vaccine. This has been fixed to only delete one.

Lot numbers will now display when multiple multi-antigens are given.
 

Encounters

Encounter Detail (EP-01)
Display confidential flag on EP-01 and EP-06.

When trying to commit an encounter with a vaccine on it that has the same date and vaccine as a history service on the IM pod, it will now message you letting you know that the history already exists.

Added the ability to edit or add diagnosis codes to nurse encounters. Also, now shows if there is already a default diagnosis code with the ability to change it as well.

Encounter Detail Maintenance (EP-06)
When exiting the pre-commit screen, reset the quantity to 1 on the encounter detail screen. Also, now on the edit of procedures we detect adjustments/ledger transfers. If there adjustments/ledger transfers we don't allow changing quantity. You will receive a message telling you that you will need to delete the services, transfer the procedure back to the client billing ledger, adjust the amounts and reenter them with the correct quantity. If there are no adjustments/ledger transfers we now allow change, and change amounts as needed.

KS CVR (EP-05)
Ethnic origins on CVRs were being erased if coded as any ethnicity other than ‘H’.

CA CVR (EP-05)
Expanded the monthly income to 5 digits, removed the age validation on CVR entry.

All States with CVR Entry (EP-01)
A check-box "CVR Not Required" added to Encounter Detail (EP-01). If this is selected, the system will not include the CVR on the CVR encounter totals report section detailing encounters with no cvr.
 

Preferences

Billing - Client statement and receipts with BOLD option are now print only.
 

Reporting

Client Write Off Balances (SR-69)
This report was rewritten to reflect client current balances.

Appointment/Immunization Reminders and Labels (SR-13)
These are now fixed to be addressed to the HOH instead of the client. An error log is now created for those with bad address marked

Encounters by Disposition (SR-33)
Increased the field size for the client name so it will no longer truncate the name and added the client ID. This report is now also available in CSV format. Also, changed this report so it will only show those appointments with a disposition when it is left blank on the trigger screen. It will now also sort by disposition code.

Active Enrollments/Referrals (SR-53) and MCH Pregnancy Data Reports
Added enrollment date to trigger screen and reports.

Aged Receivables (SR-50) and Revenue Detail (SR-100)
Updates have been made to both reports to better match receivables reporting.

Two new reports added:
CA CVR Demographic Detail (SR-137)
CA CVR Services/Education Detail (SR-138)
 

Vaccine Inventory

Vaccine on hand report (SR-61) and Physical Inventory Worksheet
Added the vaccine expiration date to both reports.

Lot Detail Accounting (VI-03) – Vaccine Labels
Problem with a single page and 2 blank pages of vaccine labels printing has been corrected. Now the first page leaves the last row of labels blank. This is intentional. This is still being worked on by programming, but it will not leave the blank pages now.
 

System Maintenance

Procedure Maintenance (SM-32)
Now allow procedures with future deactivation dates to still be in procedure groups.

The IM Pod was not available when adding a new procedure code. This is now available when saved.

Removed the auto cap feature from the fields abbr., alt. codes and description.

Site Maintenance
CA Only - New field on Site Maintenance (SM-49) “Location Code” for CA Blue Shield claims. If the location code is on the site record for the encounter, the code will print after the Tax ID number on the CMS 1500 claim form. It will be included in the ANSI 837P claim in Loop 2010AA REF02.

Tables Menu, Clinical Data Forms
The system automatically adds any new forms and elements without having to do it manually when you enter the screen. We removed the menu options to do this manually.

Import/Export Menu
Added program age validation to KS CVR Export.

Added program and clinic combo to CA CVR export and allowed the creation of export file by program and clinic.

Data Clean up and Reporting (SM-107)
Check Merged Ledgers-This procedure will prompt for what ledgers you would like to choose, and then examine all of the Ledger Records that have merge information, and check that the merge information is still correct. If the merge information is no longer correct, then the Ledger Record will be unmerged, and will show on the main ledger.
 

Remote

Added a new check to detect Server User IDs being used to log in on the remote workstations. If you log in with a server ID instead of a Remote ID, a message will now pop up letting you know.

Archive – Sedgwick County, KS only

Add the functionality to view shot record information from the archive database.
Recover Program enrollment data for Healthy Babies clients from archive.

A print button was added on the archive search that gives you IM History of client in archive database. Also now able to print the KCI.