October 2009 Practice Insight Software Release Notes

Change Logs

·  When a Payor Name Match is made, and multiple claims are updated, a change will be reflected for each claim.

·  Claim Activity is now included in the Change Log for a selected claim including original claim tester messages.

·  The Payer Name Match change can be viewed in Search Tools, Payer Name Matches Search. These can be viewed by right clicking and selecting “View Changes” or by pressing “v”.

·  The Staff Change Log is now viewable by right clicking on “Staff Member” from the Staff List and selecting “View Changes for Selected Staff” or by pressing “v”.

·  The User Class Change Log is viewable by right clicking on a User Class and selecting “View Changes to selected User Class” or by pressing “v”.

·  The Rules Change Log is now viewable by right-clicking on a Rule and selecting “View Changes to Selected Rule” or by pressing “v”.

·  Updates to tasks are now being stored in the Task Change Log. The Task Change Log can be accessed by highlighting a task and right-clicking on “View Changes to Selected Task” or by pressing “v”.

Eligibility

·  The Provider column will display correctly for both Person and Non-Person providers.

·  Added Provider prompt to Eligibility Selection Criteria.

Statement Manager

·  Customer can now change the status of individual statements from PRINTEDMV or PRINTEDNST to PRINTED as they work the statements. This option can be accessed by pressing “p” or by right-clicking and selecting the option “Change MV/NST to PRINTED”.

·  In Transfer Files, the Staff column will list the user that uploaded the statement file. The Error Message column will list any errors that occur when the file is uploaded.

·  Practice Insight can now accept statement files via SFTP. Practice Insight will use either of the following conventions to identify the file as a statement file;

o  File Name starts with STMT or ends with .STMT

o  The contents of the file start with STATEMENT (standard PI format)

Claim Status Messages (ERA Manager, Claim Manager)

·  Warn Messages will now display in yellow instead of red. This will apply to all Warning Level Edits; Clinical Claim Scrubbing and Tester.

·  User memos will now display in a blue font color instead of black.

·  User memos not created today will be “View Only” and cannot be edited.

Claim Manager

·  NPI column has been added to Doctor Search from the Billing Provider and Rendering Provider selection prompt in the Claim Manager.

·  Added Pay to Provider, Other Insurance 1, and Other Insurance 2 columns to the end of the selected claims list. Scroll to the far right of the selected claims list section to view the new fields.

·  Added the ability to delete Professional Transactions greater than $.00 from claims. Currently the user can delete $0.00 transactions on Professional claims if they have the “Add Prof/Inst Transaction” permission set to Delete. In order to use the new functionality user will also need “Modify Claim Total” permission set to Delete. This new functionality is NOT recommended for all users and should be granted with caution.

·  Revenue Codes have been added to the EDIinsight code database. The Revenue Code field, on Institutional Claims, is now a searchable field and users can click F4 or the drop-down for a list of Revenue Codes. The Revenue Code description will display on the UB form if there is no HCPCS associated with the transaction.

·  Added Description to EPSDT Condition Field on The Claim EPSDT Referral Screen.

Transfer Files

·  In the Response Message section of the Transfer Files screen the Filter List button has been modified to include additional file types. The INTIAL File Type Choice now includes EDI997 responses. The RSP File Type now includes INS responses.

Search Tools

Diagnosis Code Search

·  Diagnosis Procedures have been added to the Diagnosis Code Search.

Procedures/ HCPCS code Search

·  Procedures/ HCPCS code search will now have Revenue Codes.

Report Manager

Data Miner Reports

·  Response Message ID has been added to the Claim Rejection Analysis Report.

·  EDI Claim number will display in the EDI ID Column of the Change Log in Report Manager.

Customer Record

·  The Note field in the Customer Record will now accepts a full text box of information.

Clinical Claim Scrubbing

·  Added an option for CLINICAL SCRUB Filters to Customer Record Setup. This filter will allow the user to select the type of claims they wish to be sent to MEGAS for Clinical Claim Scrubbing. Claims can be filtered based upon; Claim Format, Responsible Payer, Claim Type, Payor Type, selected Payor list, Place of Service, and UB Place of Service. These fields should only be modified if the customers does not want to send all claims to MEGAS. Customers can still use the provider field to limit the provider’s claims being sent to MEGAS.

Staff Records

·  Once a Staff Record has been saved the login name can no longer be edited. If a login name needs to be changed the current staff record set the staff record to inactive by pressing the delete key. A new staff record can be created with the correct login name.

Support Manager

·  In Support Manager all HOT issues will be yellow instead of red to differentiate between NEW issues.

·  Issues in Support Manager with a status of RFI or RFIC will now display in blue.

·  Added Email Issue Option to Support Manager. This option will allow the user the option to send an email to another user within their customer/CBO/ vendor.

Task Manager

·  Added a Copy Task button to Task Manager. User must have Task Manager ADD level permission to copy their own task. If Task need to be copied between users or customers (CBO, Vendor only) then user must have Task Manager Admin ADD level permissions.

·  When assigning a task to a user, inactive staff records will no longer be listed.

Eligibility Tasks

·  Added “Print List” and “Print Detail” option to Eligibility Tasks. The Print Detail will display The detailed Eligibility and Benefit Information Report for each patient selected in the Task. If the Status of the Eligibility Request is Rejected, Invalid, or Error the error will be listed. The Print List button will displayed the Eligibility Request List Report. The Eligibility Request List Report will display the Patient, Eligibility Status, and co-pay amounts.

·  Added Customer ID column to Eligibility selected for Vendor mode only.


Issue Tasks

·  When a vendor edits a support issue from a Issue Task, Support Manager will display the vendor view. Previously it was displaying the customer view to the vendors.

·  Added Category and Process to Issue Task Selections.

·  Priority and Date Recall field columns to Selected Items window.

Claim Tasks

·  Added the option to select professional claims by Discharge Date in the Age of Claims in Days.

·  Added Filters for Warning Errors to CLAIM Task.

·  Added UB Type of Bill Filter to CLAIM Task. This field will only be applied to institutional claims.

·  Added Secondary Ready to CLAIM Task. When Include or Only are Marked this will display claims that have both a Primary and Secondary Insurance and have a ERA Payment as of a certain date. This will allow users, who need to file secondary claims in EDIinsighht, to select the claims that have not been forwarded to the secondary payer by the primary payer.


ERA Manager

ERA Manager Screen

·  Renamed Denial Status prompt to ERA Status (also renamed in the ERA Task).

·  Added Expect ID to ERA Selection Criteria and Selected ERA Transaction List.

·  Added Print ERA List button to ERA Manager.

Manage Expects

·  Customers can now add a new expect to the Manage Expect Table.

·  Customer can now edit the allowed and payment amount in an Expect Record. Once this field is edited, the program will no longer update the Expect Record automatically when a new ERA file is loaded. If the Expect Record is not manually updated, the program will automatically update the allowed and payment if it is higher based on Payor, Provider, Procedure code with the same modifiers.

·  The Expect Records are being stored with the expected amounts for a single unit even if the payment was made for multiple units.

Fixes

Task Manager

·  Vendor users would go into the Customer View of Support Manager when looking at a Issue Task in Task Manager

·  Task totals did not recalculate when user clicked the Refresh button in the Selected Task Window

Report Manager

·  Reports with Staff prompt would not allow user to select a Staff Record

·  Load ERA utility was causing blank file out records in Transfer Files screen

Admin Tools

·  Response Manager window closed when user edited Resp Message 999

·  Problem creating users under customers that have an apostrophe in customer name

October Software Release Notes | Page 1