PracticeSuite Release Note

Product Release Version: 20.1.0
EHR Version: EHR-18.0.0

        Product Release Date: Mar 2022

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Printed Mar 2022 at PracticeSuite, Inc.3206 Cove Bend Dr Suite A Tampa FL 33613

Part – 1 Enhancements

1.1 Claims Scrubbing

PracticeSuite has rolled out real-time CCI claims scrubbing feature integrated with CMS Pricer tool. The stringent edits available with the integrated scrubbing tool ensure a better first-pass rate and higher claims accuracy and increased reimbursements for Medicare, Medicare Advantage, and other healthcare plans.

This is an add-on feature and interested customers can contact the sales team for pricing and for other information related to this service. CMS Pricer scrubbing can be enabled on all charge screens – Charge Entry, Charge Master, Claims Workbench, and XSuperbill. Image 1.1 shows the Practice Option screen from where the scrubbing option is enabled for all or select screens.

Image 1.1

1.1.1. Claim Scrubbing in Charge Entry & Charge Master

The method for validating claims in Charge Entry and Charge Master remains the same, with the pop-up screen showing the results of the validated claims. Claims with errors or warnings are shown in the pop-up screen with the error description.

1.1.2. Claim Scrubbing in Claims Workbench (Submit Claims Screen)

A new worklist named “CCI Errors” (see Image 1.1.2) is added to the Claims Workbench screen and all claims that fail the CMS price validation are automatically moved to this worklist.

Image 1.1.2

         Users can follow the steps below to validate the claims at the time of batching the claims:

A. Click on the “Generate Batches” with the “Run Claims Validation” option and a pop-up shows the warning/errors for the claims validated with CMS Pricer (Image 1.1.2a).

Image 1.1.2a

B. If “Move Charges with error to CCI-Error” is checked when generating the claims all the errored claims will be automatically moved to CCI error bucket and the remaining claims that passed the validation and have no errors are successfully batched for submission. Claims moved to CCI error worklist will have the line status – ‘HOLD’ and line sub status – ‘CCI Error’.

C. If “Move Charges with error to CCI-Error” is unchecked, then all validated claims are moved for submission even if they have errors.

1.1.3. Claim Scrubbing in XSuperbill

 XSuperbill has a new option to run the CMS Pricer integrated CCI validation. Users can select the claims and hit “Run claim validation” option and any claims that have errors are moved to the CCI_ERROR list. Note that to quickly locate the errored claims, the errored count is displayed in red. Please see Image 1.1.3.

Image 1.1.3

1.1.3.A. On the validation popup screen, click on the “Move Error Charges to CCI-Error Bucket” to move all charges with error to the CCI_ERROR list in Claims Workbench (Submit Claims); see Image 1.1.3a.

Image 1.1.3a

1.1.3.B. Click on the CCI_ERROR bucket to list the validated claims with errors. The besides the Provider Name in the charge listing will show the errors on mouseover (refer to Image1.1.3b).

Image 1.1.3b

1.2 XSuperbill- Change in Error Icons

On the XSuperbill screen, claims that failed CCI validation are shown with  (refer to Image 1.2). Claims with billing errors are indicated with .

Image 1.2

1.3 ERA

1.3.1 Refund of Unposted Payments from PLB Section

Unapplied amounts indicated in the PLB segment can now be refunded when auto-posting the ERA. The steps to refund unapplied payments are explained below:

A. Unapplied Payments can be selected from the PLB matching pop-up screen. If unapplied money is in the PLB, users can search and select the payment to process the refund. Previously, there was no method to pull up unapplied payments for refunds. The user merely needs to enter the payment # in the PLB Matching pop-up to search and list both the applied and unapplied payments associated with the entered payment #.

B. In Image 1.3.1 below, there are two entries corresponding to the payment number. The first entry displays the claim # and patient details indicating an applied payment. However, the second entry is the unapplied balance for the payment and users can select this entry if the unapplied part is to be used for the refund.

Image 1.3.1

1.3.2 Excluding Prior Payments

In ERA, if the checkbox “Exclude Prior PR. Payments and Adjustments” is selected before posting the ERA, the primary payment amount corresponding to the adj. code CO-23 is excluded and not added to the paid or adjustments amts.

1.4 Six New Clinical Quality Measures Added

Quality ID & Description Measure # NQF ID
143P1  Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy in which pain intensity is quantified
143P2 Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving radiation therapy in which pain intensity is quantified
157 0384
12 Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
143 0086
191 Percentage of patients aged 18 years and older with a diagnosis of uncomplicated cataract who had cataract surgery and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved within 90 days following the cataract surgery
133 0565
102 Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy, OR cryotherapy who did not have a bone scan performed at any time since diagnosis of prostate cancer
129 0389
370P1 Population Criteria1:Percentage of adolescent patients (aged 12-17 years) with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) PHQ-9 or PHQ-9M score of less than 5
370P2 Percentage of adult patients (aged 18 years or older) with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9M score greater than nine during the index event who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) PHQ-9 or PHQ-9M score of less than 5
159 0710
281 Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period
149 None

1.5 Payments

1.5.1 Accounting of Payment Refunds Permitted Only for Open Period

Refund entries can no longer have a closed accounting date. If a user attempts to change the accounting date to a date that falls in a closed accounting period, an error is shown to the user as in Image 1.5.1 and the accounting date reverts to the current date.

Image 1.5.1

1.5.2 Fully/Partially Applied Payments

For fully and partially applied a few payment fields have now been made editable.  Most fields for entering check info are made editable. Users can also modify payment methods (Cash, Check, Credit card, EFT) for both partially/fully applied payments. 

1.5.2.A Check related fields that are now editable for fully/partially applied payments are the following: Check#, Account#, Bank Name, Account Holder; and these fields are highlighted in Image 1.5.2a.

Image 1.5.2a

1.5.2.B Changing Payment Method

Payment Method can be changed for fully/partially applied payments of pay type cash, check, EFT, and for credit card payments where payment gateway is not enabled. In accounts where the payment gateway is enabled, the option to change payment method from credit card will be unavailable.

1.6 View Narration (Clinical Note) in Charge Master

Customers on our PM and EHR can access the clinical note directly from the Charge Master screen. Previously, in the PM system, this was only available on the Charge Entry screen. 

Icons akin to those present in the EHR screen     depicting the status of the note are now made available in Charge Master screen. Image 1.6 shows a Pending Chart. 

Image 1.6

1.7 New Resubmission Code Added

A new claim resubmission code “6” is added with the label “Corrected Claim”. Please see Image 1.7.

Image 1.7 

1.8 Rank WorkQueue- Changed Default Thresholds

After introducing the rank-based work queue in the last release, an update has been made to the default thresholds for the DOS time Limit and Remit time Limit.

If the “Untimely Filing Limit” field in the insurance master is empty, the system will use the default date of service time limit as 45 days and if the “Response Limit Threshold” field is left empty, the remit time limit to be taken as 30 days.

DOS Time Limit -> Untimely filing limit; if no value is specified, it is 45 days

Remit Time Limit -> Response Limit Threshold. if no value is specified, it is 30 days

1.9 New Tag for Guarantor Salutation

PracticeSuite has introduced a new format for Guarantor salutation which can be used while sending statements. The newly introduced tag is #@GUARANTOR_FULLNAME_FIRSTLAST#@ to display guarantor name with the format ‘FirstName MiddleName LastName’.

1.10 Patient Demographics- Communication Preference to Default to Cell Phone

When adding new patients into the system if the cellphone# is entered, the communication preference for the first reminder will default automatically to the cellphone. The second preference defaults to email. Practice can always change the preferences if needed.

1.11 E-statements- QuickPay Option is Disabled for Non-Payment Gateway Accounts

The quick pay link will not be included in the e-statements for Practices that have opted out of the e-payment solution/payment gateway service.

1.12 New EDI Rule for Institutional Claims

A new rule to populate Rendering Provider (Qualifier 82) in Institutional (UB04) claims has been made available.  The rule when enabled will force populate the provider selected in the “Other Provider” field (FL 78) in the UB04 Charge Entry screen as the Rendering Provider (2310). Note that as this is an EDI rule, the changes are isolated to the electronic files and cannot be seen either in the front-end fields of the system or the paper claim.


Part – 2 Reports

2.1 ‘H4.Billing Dashboard Report’- Excel Export Provided in SSO Screen

Billing Dashboard Report now has the excel export option added to the single sign-on screen (refer to Image 2.1). 

Image 2.1

2.2 ‘D15. Aging Report As of Accounting Date’

A new excel output is added to the D15 report with fields the same as ‘D6. A/R Aging Summary Report‘. Practices can see the breakup of the A/R for the entered “as of” date. A sample excel output is shown in Image 2.2.

Image 2.2

2.3 Offline Report Added to G1 report

Offline report feature is added for G1. Claim Detail Report.

2.4 ‘J23. Service Location Wise Month End Close Report’

J23 report is modified to use the same month-end reporting and accounting logic that is in place for J1, J9, and other month-end reports. To learn more about the accounting logic, please click here.

2.5 ‘Batch Reports’ Renamed

‘Batch Reports’ under the Favorite Tab of Report Central that lists all the offline reports has been renamed to “Batch Reports (Background Reports)”; see Image 2.5.

Image 2.5

2.6 ‘A9. Appointment Reminder Report’- Two New Search Filters Added

The A9 report has two new search parameters – Appointment Status and Appointment Type; refer to Image 2.6.

Image 2.6

Part – 3 Bug Fixes

3.1 Trizetto CH Claim Response Codes

Trizetto may return two response codes for a submitted claim and if any one of the responses has a rejection code, the system will flag the claim as rejected and have it in the rejections worklist for it to be worked.

3.2 Fee Schedule Screen Freezes on Update

The fee schedule screen occasionally freezes when updating the procedure code. This has been resolved.

3.3 Voided Payments

Voided payments will no longer show up in the patient or insurance balance.

3.4 On-Account Amount Incorrectly Displayed in Patient Portal

Refunds were being shown as on-account in Patient Portal and this distorted the patient’s balance displaying the incorrect due amount. This has been corrected.

3.5 PDF Export in Scheduler History of Patient Demographics

If the Scheduler History report was run with a Provider selected in the filter, the pdf export of the report displayed no records even when there was data to be displayed. This is now resolved.

3.6 Amount Display in PDF of I6. Posting Detail Report

If large numbers were in the fields that contained the totals the amounts were getting trimmed due to inadequate column width. The column width in the PDF has been adjusted to address the issue.

3.7 Print Option in the Insurance Card Screen

The print option was not working for the insurance card uploads in pdf format. This has been resolved.

3.8 D2. Detailed Insurance Aging Report

HTML tags were showing up in the payer remarks field of the report. This is now resolved.

3.9 Patient Name Reversed in Pre-Collection Letter

The patient’s name tag in the pre-collection template (“#@PATIENT_FULLNAME_FIRSTLAST#@”) displayed the name in the reverse order. This has been addressed.

3.10 Missing Procedure Code Description in Patient Statements

Certain procedure code descriptions were not populating in the patient statements, and this has been corrected.