PracticeSuite Release Note

Product Release Version : 18.5.0
EHR Version : EHR-18.0.0

© 2018 PracticeSuite

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Printed June 2018 at 37600 Central Court, Suite# 260, Newark, CA 94560

Part I – UI Enhancements

    As part of our new User Interface (UI) module upgrades, PracticeSuite has introduced a brand-new Claims Workbench module. The new Claims Workbench seamlessly integrates with our clearinghouse providing greater visibility to claims status and improved claims tracking mechanism & claim management capability. The module gives you the ability to review, resolve &rebill claim errors and rejections from the screen.
    The new Claims Workbench has a tabbed UI with separate tabs for – Claims Dashboard, Claims History, and Print/Rebill.

1. Claims Dashboard

    Claims get categorized into different buckets based on their submission type and status (Claim Batch Type and Claim Status).
    The dashboard plots a pie chart of the various status & the left side menu shows the claims count represented in each status. Clicking a status in the chart displays all the claims listed in the selected status.

    The Claims are categorized under dashboard as follows:

1. Ready to Submit Claims –

Lists all insurance claims waiting to be batched. The new posted claims and claims in rebill status are the ones that show up in this screen. Hit the button to have them batched for submission.

1) The Batch Claims are classified as follows:

a. Unsubmitted Batch –

Shows the batched & generated files in this screen. Clicking on the ‘Send’ option submits the file to our partnered clearinghouse. Users can also download the raw 837 files to their computer by hitting the download icon. Submitted files would not show in the default search listing.

b. Error Batch –

Any files with syntactical errors & rejected files get shown in this screen.

2) Electronic Claims:

All electronic claims flow into the following buckets based on the response status received from our partnered clearinghouse –

i) Accepted –

The claims accepted by the Clearing House and Payer appear under this bucket.

ii) Clearing House Rejects –

Clearinghouse rejected claims are listed in this bucket. Users can click on the Rejected Claim and make corrections and rebill.

iii) Payer Rejects –

Claims rejected by payers are listed here. Users can resolve the rejections and rebill from this screen.

iv) Pending Responses –

Claims not acknowledged by the clearinghouse or payer over a certain time get dropped into this bucket. The system uses the individual ‘Claim Response Limit’ threshold criteria setup in the insurance master or the global parameter in billing options to show any unacknowledged claims.

v) Downloaded –

All downloaded electronic claims are shown in this list. These claims were not sent to the clearinghouse using the direct ‘Send’ option

3) Paper Claims :

All paper claims get grouped in the following buckets:

a) New Paper –

All unprinted paper claims are listed in this section. Users can print using the CMS 1500 Claim Formats and/or NYWC OTPT form option. Once printed they get removed from this list.

b) Printed –

Printed paper claims are listed in this screen.

4) Clearing House:

Provides direct auto sign on access to your clearinghouse

Claims History –

This screen lists all the claims batched in the system for a specific date period. You have multiple search parameters to find previous batched claims. The encounter activity or the history of each claim can be viewed by clicking on the Activity icon against each Claim.
The following search parameters are available on the Claims History tab to search for a claim(s)-

Print or Rebill

Print or Rebill screen provides an option to search specific claims or group of claims and either reprint or rebill the claim(s). You can filter either Professional or Institutional claims. Additional options to include closed lines while printing or to print EoB are also available.

The following print options are available for Professional Claims –
a. CMS 1500 Form
b. CMS 1500 Data
c. NYWC OTPT04 Form

The following print options are available for Institutional Claims –
d. UB04 Form
e. UB04 Data

2. Multiple Insurance Add

Users now can add multiple insurances from the Insurance search screen. The clearinghouse payer list is populated in the screen and you can search for payers with multiple filters such as payer name, payer id, state (for state specific payers), Claim Type etc. Please note: claim address is not stored in the repository and has to be manually added, hence, the system defaults the address stored in the Practice screen when adding a new payer.

3. Columns Filter

As highlighted below, users will have the ability to configure table columns. Click on the arrow icon for the More Filter and uncheck the columns that the user does not require to be displayed. The changes are saved on the Local Storage of the Browser.To reset this back to default settings, clear the Local Storage that can be accessed from the Developer Tools.

4. Security –>User Module

A new redesigned and intuitive Security module is the latest enhancement in the system. Here are the new robust features of the new Security module:
i) A listing page to show all users with the options to configure Remote Access and Menu.
ii) The ability to authorize Admin, Legal, and Accounting attributes for a specific user.

iii) Access Configuration –Access Configuration popup screen now allows an admin user to setup Remote Access, Emergency Access etc.
iv) Send Password Reset Link – Administrators can reset passwords either using the Set Password option or by clicking on Send Password Reset Link option, to email a password reset link to the user. The reset link expires in 24 hours.

Security –> Preference

Added a field named ‘Security PIN’ in the new Security Preferences screen. An Administrator can now reset the 4-digit security PIN (Passcode) from here. The Security PIN is validated by our Customer Service and Support teams to authenticate users who contact them for assistance or access to the database. To safeguard your information and prevent unauthorized access to your database, it is recommended to reset the PIN occasionally.

Logged in users can see the Pin by clicking on Security Pin under the profile menu.

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