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Practice Management/Billing V3B1 – Part 2, AR/Follow-up
4010 Moorpark Avenue, Suite 222 San Jose, CA 95117
www.prognocis.com [email protected] Copyright 2014 – Bizmatics, Inc.
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Q&A will follow
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Housekeeping Bullets
• User Interface Skin, Navigation, and Scalability • Login/Splash screen • Menu Tabs
• Patient Advance Tracking • Patient Opening Advance Entry
• Collection Agency Workflow • Assign-To Utilities • Denied Screen • Bulk Insurance Write-offs • Write-off Buckets by Type • Custom Report Layout • Billing Filters Setup Master
v3b1 – effective March 2014
Prominent Features
PrognoCIS Login Screen
v3
v2
Multi-browsers supported e.g.: IE
v8 & higher, Safari (Mac & iPad)
Limitations w/Google Chrome (3rd
level pop-ups, editing templates at
encounter level, etc.)
GUI scalable/resizable per multiple
screen resolutions. (For IE users only
property prognocis.resize.applicable
can be set to N to disable it.)
If resized < than 1024 x 768, viewing
area will be reduced
PrognoCIS Login Screen Scrolling billboards to communicate events, news, features, training, etc.
Social Media links (Facebook, Linked-In, Twitter)
Quick links to Browser Settings, Contact Support, & Training Schedule/Webinar Registration page
Scrolling FYI Billboards (up to 3)
Social Media
Webinar Schedule & Registration
Client Resources
Browser Settings
System Skin & Navigation
Upper Left
icon replaces Home tab
icons replace Back / Forward icons; repositioned to the upper left
Upper Right
Icons are redesigned
v3
v2
User Training
issue
Redesigned Icons System Tray
provides a direct link to new version Release Notes
allows user to toggle between EMR & Billing modules per Role designation/property
invokes patient search to open selected patient’s account
allows user to compose a message within PrognoCIS to another user or patient chart
indicates the user has pending system alerts/notifications in the Inbox
opens the Client Resource Center
launches system Help Index per alphabetical TOC
displays System About details
locks current session for the current logged-in user
logs out/exits the system
Patient-level Icons
Case Management
Patient Alerts
Patient Notes
Secure Messaging (N2N)
PM/Billing Menu Tabs • Menu tabs and sub-menus remain accessible via vertical, drop-down menus • The overall look and feel is more contemporary and now reflects EMR side • Sub-menus are identified by the instead of the
v3
v2
New Menu/Sub-menu options: • Remittance Patient Payment Patient Use Advance • Remittance Other Payment Collection • Remittance Write Off Bulk Insurance • AR/Follow-up Send To Collection • Settings Configuration Vendors Collection Agency • Settings Configuration Vendors Pat Opening Adv Entry
Home Page
• The OpeEob # hyperlink now includes/displays patient name w/claim details
• Location button now enabled to allow for user to filter visits on Home Page by specific location (same as already available for providers)
Claim(s) left open in Single-Claim
Edit mode
Patient Appointments Schedule + Copay ( ).
Copay Patient Advance:
New field (mandatory) Comment to be entered for all payments posted directly to Advance
Note: This is required only when posting an Advance (for PM/Billing clients only).
Schedule Patient Info pane
Labels in bold red font will inform when the
patient has been handed over to Collection
Agency. Details can be added to tooltip.
v2 v3
Apportion To fields rearranged
Copay Advance Comment NEW Feature
Patient Advance Tracking • Displays all transactions related to patient credits; including payments, adjustments, or transfers;
regardless of the source for the original payment • Sources include Copay Advance, Patient Receipt Moved to Advance, EOB Unapplied but paid
for Patient Responsibility, etc. • Accessed from:
• Patient Account Unapplied Advance
• Patient Receipt Advance
New Feature: Patient Advance Tracking
Patient Advance Tracking Table - Summary • Displays a summary of a patient’s credits and how each one has been applied throughout the system
(If applicable) and how much is remaining • Indicates the Source (DocNo) of the credit; i.e.: where the patient made the payment or from which
previous payment the credit was adjusted or transferred
Summary view
Patient Advance Tracking Summary
Doc No (“Source”) • Number w/o prefix = Copay payment under $ icon • PTREC = Patient Receipt payment under Remittance Patient Payment • ERA = Patient apportioned-to amounts not actually used per posted EOB
Patient Advance Tracking Table - Detailed
Patient Advance Tracking Detailed
• Displays a breakdown each patient credit from its origin and how its value is applied • This enables you to see exact amounts from any original payment that was a surplus in some way
and how those dollars are apportioned across other balances
------ Patient Credit (payment or unused apportioned-as copay/deductibles) ------
--- Adjustments (movement of the credit) --- (Balances Due from Patient)
Patient Account AdjAdv Button • Button will only show as enabled ( ) when there is a patient balance • If only insurance balances are applicable, the button will show disabled ( ) • Upon saving this adjustment, a Patient Receipt is generated to log the credit in the G/L properly
Remarks aid user in applying the $
Patient Account AdjAdv… button
Current Feature
Patient Use Advance AdjAdv Button • Patient Use Advance provides a screen that lists all unapplied patient credits • lets you allocate the credit across other outstanding balances rather than refunding • Upon access, the screen is auto-populated with qualifying patients (A-Z); hence, you now have a
place to identify patient credits all at once rather than individually
Do the data entry
here…
Remittance Patient Payment Patient Use Advance
NEW Feature
AdjAdv Patient Receipt • A $0.00 Patient Receipt voucher is auto-generated for the transaction, • Such transactions show as a PTREC entry on the Patient Account Remittances/Receipts table • The adjustment associated to the receipt can be seen via (see next slide)
Remittance Patient Payment Receipts
See the net result
here…
Notes: • These transactions are not literal/physical payments • Vouchers are created when these credits are transferred so they can be
tracked as to their movement within the G/L • The Receipt No. represents the fact that it is patient credit being applied
and that it actually originated as a Copay or a Patient Receipt
Current Feature
AdjAdv Patient Receipt (cont’d)
Remittance Patient Payment Receipts
• The adjustment associated to the receipt can be seen via , which displays the precise balances that the credit was applied to (see previous slide)
Patient Advance Tracking Detailed
AdjAdv Patient Receipt (cont’d) • The Adjust from Advance transaction audit trail can be viewed from the Patient Account screen
using the Advance Tracking Table (via )
Patient Opening Advance Entry • Incoming Balance forward from old EMR • During conversion to v3, this master will be automatically created from your existing v2 patients
who have any advance transactions; including: • Copays • Patient Receipts
Settings Configuration Vendors Patient Opening Advance Entry
Conversion Alert! Be sure there are NO UNPOSTED Patient Receipts or EOB/ELEs.
During conversion, we will move all unapplied Copay/Deduct/Visit Balances into Advance as a single-line entry
as shown here “Created on V3B1”. After conversion, you will want to confirm these entries
prior to next statement run.
• Unapplied Advances • Apportioned-to amounts (CoIns, Deduct, Visit) not yet applied via EOB
Patient Opening Advance Entry (cont’d) • Single-line entry in Advance Tracking Table to show opening balance from V2 • Existing patients with unmatched advances will be converted in this manner to v3 • After conversion, no transaction associated with these patients can be reopened or modified
Patient Advances Summary
Conversion Alert! “Created on V3B1” balance-forward limitations:
• Remittance Reopen will be disabled • Patient Receipt Reopen will be available but restricted • Single Claim Edit will be allowed if there is no Copay associated • Copay screen save/delete will be disabled • All Credit screens will be impacted
Patient Opening Advance Entry - Specs • Incoming A/R from existing (old) PMS if applicable (for new clients) • Using these standard layout specifications, there is no charge for the import • Requesting custom layout, there will be a customization charge to be approved in
advance of the import being executed
Internal Use only
Settings Configuration Patient Opening Balance Export/Import
You can create a sample file like this by exporting a POB
Collection Agency Workflow
Settings Configuration Vendors Collection Agency
• Collection Agency master must be setup prior to being able to assign bad debt balances • Code is unique per agency; up to 10-digits alpha-numeric & cannot be changed once saved • Use Address button to define address, phone, fax, and email address as applicable
Fee Percent – define negotiated rate of
payment per Agency
Collection Agency Workflow (cont’d) • Applies only to patient balances in conjunction with user-defined parameters/properties*
• Collection Agency Params dialog allows you to modify the default parameters* as needed • Qualified patients based on your definitions will display in the Collection Agency Hand Over screen
AR/Follow-up Send To Collection collection.agency.default.x.days collection.agency.patient.statement.count
# of days since last receipt
# of statements in same period
Hide patients w/Advance $
# of days since DOS
Hide claims referred already
Hide claims w/Insurance $ due
Patient-level criteria: Claim-level criteria:
List can be printed or sent
to Excel
AR/Follow-up Send To Collection Params
Collection Agency Handover To refer a patient to be handed over:
• Select the check box ( ) of the patient; the row will highlight in yellow • Select the desired Collection Agency from the pick list • Click process (system will prompt that it processes in background)
Not all check boxes may be
enabled to select
Bill Amt $ – total charges of the original claim Ins Bal $– total balance due from insurance (if chosen; will display in bold red) Pat Bal $ – total balance due from patient (i.e.: amount being handed over) Claim Bal – current claim balance, which may include Insurance + Patient due • dollar amount displays as a blue hyperlink, which invokes the Claim Ledger Table
Pat Bal $ and Claim Bal $ will typically represent the amount handed over to the Agency; based upon flags included under Params.
Collection Agency Display
• Memo will display throughout the system on various screens in Red bold font; including • Claim screen • Patient Account • Patient Register Billing Tab • Schedule Patient Info pane
• EOB claims pane for selected claim • Schedule Patient Info pane for selected appointment
• There are 2 levels of tooltips on this screen, which are not currently customizable • Tooltips display details as per the specific scenario and display by hovering the mouse over the field
• Disabled check box – tooltip displays why the patient cannot be referred yet • Patient name – tooltip displays the patient details (e.g.: Chart #, DOB, Advance $, Pay Plan, etc.)
• Auto-generated patient alert will also notify users as per current settings (both EMR & PM/Billing)
Collection Agency Receipt • Collection Agency payment (sort of a hybrid between patient receipt and EOB entry functionally)
Remittance Other Payment Collection
Search all claims referred to the
selected Agency
Collection Agency Receipt (cont’d) • Payments received from the agency will reflect patient balance + their collection fee % • Net cash received will be offset by write-off adjustments as applicable to balance to bank deposits
Col Fee $ will calculate per Pat. Paid x % defined under Collection Agency Master for the agency. Net Amount allocated across all claims should balance to the Received Amount of the check. Non-zero balance remaining will prompt an alert.
*Settings Configuration Groups Group Types B8 WriteOff Reason
Bal. can be explicitly W/Off* or it will carry forward.
Collection Agency – Billing Report
Report Billing Layout Collection Agency Handover Claims
• Patients who have been turned over to a Collections Agency can be printed into 1 report
Collection Agency – Collection Report
Report Billing Layout Collection Agency Handover Claims
Be sure to set the Filter to record Voucher by Collection Agency; otherwise, the report will include ALL patient payments rather than just payments made through the Collection Agency
Useful in determining Accounts Payable to
the Agency
Collection Agency – Aging
Report Aging Pat Aging or Col Aging *billing.hide.statement.financialclass
CA workflow provides an alternate to the
previous Financial Class logic*
Collection Aging reports balances stored in
(CA) bucket (moved out of Patient Resp.)
Those who are using the Financial Class*
logic can continue to do so or they can
switch to Collection Agency Handover
Patient Account Charge Next/Write Off • Button will only show as enabled ( ) when there are pending balances due • If there are no balances outstanding, the button will show disabled ( ) • This allows you to easily process balances to the next responsible person or to write them off
Patient Account WoCn… button
Lists all balances due (Pat & Insur)
Current Feature
• Assigned Tasks lets you filter to view multiple balances beyond just an individual level • lets you adjudicate the balances by doing a write off or charging the next responsible bucket • Previously, this function existed only at an individual patient level under Patient Account; now you
can filter by need (i.e.: Insurance Company) which will help in managing trends, etc.
AR/Follow-up Assigned Tasks
Assign To Write Off/Charge Next
Balances are still handled at the patient level
NEW Feature
Assign To Forward
AR/Follow-up Assigned Tasks Forward
Click the Forward button
Forward task to another user
Marks existing one as Done & creates
a dupe (with all details of the original)
to be assigned as needed
Assignment Tracking will record the
details of the entry as being
forwarded
Assign To Notify Others
AR/Follow-up Assigned Tasks Send Message
Create the task as usual
Select Send Message check box
Click the binocular icon to search for
and selected desired user(s)
Upon save, the message will be sent to
the designated user(s) PrognoCIS Inbox
Recipient can view the task by clicking
the Zoom icon on the message
Remittance EOB Remittance Header • Ability to attach to remittances even after they are Posted
*showalert.for.menus
• Assign Task icon ( ) now available for cashier to assign during posting if needed • Financial Class added to tooltip of Claim ID • Ability to Retain Responsibility for secondary and tertiary balances now • Denied charge code in Single Claim Edit, W/O & Excess icons will be disabled • Search will Include Zero Amounts option will include balances referred to Collection Agency
(Note: All entries will be marked as Duplicate.)
Denied Screen
• If you reopen a claim directly, the system will look through EOB transactions to see if it has been set as “Denied - No Action” and if so, will reset it to “Denied - Reopen Claim for ReSend” and remove it from the Denied Claims screen
• Notes icon ( ) reflects EOB reason codes carried over from 835 as per new Group – DR Denial Reason Code*
Also available on Disputed and
Outstanding screens
Settings Configuration Groups Group Types DR-Denial Reason Code*
Bulk Insurance Write-offs
Remittance Write-off Bulk Insurance
Doing the W/O
• Select the check box ( ) of the patient whose balance is to be written off • Select the appropriate reason from the Options pick list • Click process
Filter by Payer, DOS, CPT, Provider, etc. to create a custom list to review & write-off
Do the write-off
here…
Settings Configuration Groups Group Types B8 WriteOff Reason*
Viewing Insurance Write-offs • An Insurance Write-off voucher is auto-generated for each insurance selected • Such transactions show as a INSWO entry on the Patient Account Ins Wo link • Comment references “Auto Created” with date & time stamp
Remittance Write-off Insurance
See the write-off
here…
Current Feature
Write-off Buckets by Type • All 5 types now have own its own bucket, which enables reporting & tracking per write-off type • During conversion existing entries will be interpreted into the respective buckets behind the scenes • No UI change still a single transaction entry with each type designated as applicable
Remittance EOB/ERA Charge Detail W/Off icon
New standard reports added @ conversion
Report Changes
• Output tags relevant to Case Management have been modified to be available at the report level; previously these tags required an Encounter
• Data will pull from the case which case number is assigned to the appointment
New Tabular Reports
Case Management Tags for Appointment Reports (Shared with EMR)
Reports Menu
• Trouble-shooting tool based upon new property* • Inconsistent balance details will print in footer when applicable to aid in trouble-shooting when
certain reports do not balance as expected
*Property billing.reports.print.inconsistent.amts
• Claim is reopened but there is an EOB, Receipt, or W/O present • Claims Unprocessed status E R (for reopen)
• EOB is reopened while subsequent ones are posted • Applicable to all buckets in respective order of responsibilities • EOB screen does not indicate reopened status E R as claims do • Diagnostics #077 can be executed behind-the-scenes as needed
• EOB Single Claim Edit has reopened (Unapplied) all transactions • Home Page EobOpen link shows details
• EOB marked as Secondary on Hold
Report Changes Report Inconsistencies – Billing and Collection Reports
Report Changes (cont’d) • Buckets have been consolidated and condensed
into fewer categories • FinancialSummary – excludes “Other” amounts
(e.g.: NonPrognoCIS amounts) • FinancialSummaryBrief – older version w/some
modification & limitations as regards Grouping
Summary
Reports Summary
Report Changes (cont’d)
• New Layouts for grouping by Category or by AR Group
Financial Analysis
Reports Management Financial Analysis
v3
v2 Custom Reports Layout
Report Billing / Collections Layout Save As
Design is now horizontal to
reflect output view
New field values are available
such as Enc Type & Collection
Agency data
Navigation is now left/right
instead of up/down using
System Reports can be modified
(save as then changed as needed
via the )
Patient Account • Collection Agency labels wherever applicable throughout the system in bold red font • CA Bal added to display Collection Agency bucket (which represents patient outstanding) • Advance hyperlink in Unapplied table as applicable to open new Advance Tracking Table
• $ Tags accommodate Attorney and Case Management details • Remittance screens now include Collection Agency Rcpt as a filter for Processed & Unallocated
• When generating Outstanding Letters, the job will now run in the background and send you a
message when it is available for downloading • New categories (Letters, Collection Agency) under Download Files and corresponding Scheduled
Processes to execute the jobs in the background • New options added to Audit Trail to capture system-level activity not otherwise captured in the
audit trail per Admin Audit Trail setup.
Etcetera…
Remember…. 7-days advance notice of scheduled upgrade Browser settings may be impacted with any technical upgrade Temporary Internet Files/Cookies may have to be cleared Some features may require Administrator access to activate/modify Contact Technical Support for guidance
Home Page Client Resource Center (408) 873-3032 or Live Chat
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