PracticeSuite Release Note
Product Release Version: 19.3.0
EHR Version: EHR-18.0.0
Product Release Date: December 2019
© 2019 PracticeSuite
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Printed December 2019 at 37600 Central Court, Suite# 260, Newark, CA 94560
Part – I Enhancements
1.1 ERA Posting Screen
1.1.1 COB Automation
In ERA, when the claim status code indicated is 19 ( CoB is for a crossover claim) and if the secondary insurance indicated in the ERA is not present in the patient’s record, so as to facilitate the COB posting & to efficiently move the line(s) to secondary responsibility, the system will automatically create the secondary insurance for the patient as part of the auto-posting process. The system will use the secondary insurance name and patient insurance id presented in the electronic remit to create the secondary insurance for the patient. If the secondary insurance is already present in the patient demographics, the system will simply add insurance to the Case.
In the process of adding secondary insurance for the patient, if the insurance company is not present in the insurance master, the system will first auto-create the insurance company with generic information. Please note – users will need to complete any missing secondary insurance information in both the insurance company master and inpatient insurance records.
1.1.2 Negative Payments in ERA
In order to prevent inadvertent auto-posting of negative amounts by users that can result in posting errors, the claim selection checkbox in the ERA screen is disabled when a negative amt is present in the remit. Below are the couple of the negative amount ERA posting scenarios where the system will prevent selection of the claim for auto-posting –
1. If the claims status code is 22 (indicating negative payment or adjustment)
2. If the Paid Amt. or the sum of Adj. Amt. is a negative amt; see Image 1.1.2.
1.2 Collection Manager – Multi-select Option to Edit Multiple Claims.
This enhancement enables a user to select multiple claims in the selected category (through the multi-select option) for adding a collection note and to record the collection activity for all the selected claims; see Image 1.2a.
1.3 Warning in Patient Statement Generation Screen
In the Generate Patient Statement screen a warning will show up for patients if secondary insurance is present for the patient but the insurance is not present in the patient’s case. This flag helps to identify patients who have active secondary insurance but have been inadvertently had their lines in patient responsibility (BILL_to_PT or GR).
Also, now, from the patient listing in the Patient Statement screen, you can click on the patient name link to open the patient information screen or click the ChargeMaster option to view or edit the charge information. Refer to Image 1.3.
1.4 Work Queue Screen to Display the CH and Payer Claim Status Codes
The Work Queue details to include the Claim Status code of the Clearinghouse and Payer as shown in Image 1.4a. The status fields are available for all claims except for the unbilled charges and visits category.
Also, a new tab named – Claim Status Hx is added in the Next Action popup screen. This screen can be accessed by clicking on any claim. The tab lists the selected claim status and any previous submission history. Clicking on icon shows the claim details including rejection/status information such as code, reject reason, etc., refer Image 1.4b.
1.5 X-Superbill Screen to Allow Line Level Edit for HOLD Charges
For any charge in the HOLD bucket, the line edit option has been enabled (see Image 1.5) to make line-level edits for the claim. Previously, the edit option was disabled for lines in HOLD and any line edits had to be made from Charge Master screen.
2.1 J31. Unusual Transactions in Closed period
J31 report that shows the transactions that occurred for a closed month now includes an additional export option to export the report to a detailed excel format; see Image 2.1. The new option includes some additional fields in the report such as – MR #, DOS, CPT, Total Charge, Remaining, INS Payment & Patient Payment with subtotals. The previous export option will continue to be available for export.
2.2 I6. Posting Detail Report
‘Posted On’ column now shows the posted date and time in I6 Report.
2.3 Renamed Accession Report
Accession Report that shows the list of charges imported through the interface from an external system has been renamed to – ‘Daily Imported Charges Report’ and the report is now available in Report Central as ‘E10. Daily Imported Charges Report’.
2.4 Added Timestamp in G3. Collector Productivity Report
Timestamp added to the field Collection Activity Date in G3. Collector Productivity Report (see Image 2.4). The report shows the user wise insurance collection activities made from Collection Manager.
3.1 Adjustment Reason Code and the Amounts not Showing in ERA.
Due to an aberration in the format of some ERA files received into the system, the adjustment reason codes and their corresponding amounts were not displayed in the ERA screen though the amounts applied correctly from the remit. This error is now resolved.
3.2 POS Code 12 (Home) in the EDI Claim file
Going forward, if in an electronic claim the place of service code is 12, the text “HOME” will populate in the service location segment instead of the patient’s name.
3.3 Collection Manager Showed Duplicate Claims and Lines in ‘All Open Lines List’
This error has been resolved. To avoid duplication of claims within the different categories, there is a small change made to the categorization of ‘All Open Lines’. Denied and no response claims are now separately listed under their respective denial and no response categories. Previously, all claims used to be clubbed under the corresponding general payer category in ‘All Open Lines’ listing. The remaining open claims will continue to be shown in the respective payer categories- see Image 3.3.