PROGNOCIS™
Release Version # 1.8.1
Release Date Jan 30, 2009
Build #39
Bizmatics Inc®.
4020,
Phone: (408) 873 3031/32. Fax: (408) 873 0304
Email: info@bizmaticsinc.com
EMR :
1.
Co- Payment
Screen :Total Charges field will be visible based on the property
Co – Paymentà copay.hide.total.charges
Remarks length has been increased to
512 characters. Phrases can also be defined for Copayment and can be selected
for Remarks.
2.
Test Execution Screen
: In case of Master search test result type, single ICD, CPT
and HCPC selection will get added in assessment (based on property).
Assessmentà assessment.addicd.from.htest4types
assessment.addcpt.from.htest4types
assessment.addhcpc.from.htest4types
3.
Message Outbox Screen: Now
forwarding mail facility is also available for Outbox.
4.
Message Inbox Screen : Deleted Messages are now available under Inbox , with radio selection ‘Deleted
Mails’.
5.
Encounter Screen : Encounter Patient screen search can be
configured for showing all patients list , which means active , inactive and
expired as well. Other than active patient encounter CANNOT be started.
To make the all (active, inactive or
expired) patient list available in search, do the following steps
Go to the Search section property ‘patientinfo…’ , remove the where
clause PT_STATUS ='AC' and if required add the same column to show the status
as a part of list. DO remember to change respective properties when PT_STATUS column
added for display.
6.
Provider and
Encounter Close Screen : In order to
send Provider specific billing codes for Charge capture. (HL7), provision is
made on Provider screen to define the billing codes (comma separated) and the
same list will be available on encounter close screen as list box. Select one of
the billing code form encounter close list and then close the encounter. Hl7
charge capture will pick up the selected billing code will be send in the
appropriate place in the HL7 file. The place to define codes in provider screen
and as well as the list box in encounter close screen is decided by the Label
property. This property also decides the label to be shown for the place
holders in both the screens. If it is blank then the feature will not be
available.
Medicsàmedics.billingcodes.label
7. Message Inbox Screen : On Inbox screen
Patient Info is added to show the
details for the patient (current row selected). This is based on template from
property Patient Registration: patient.contactinfo.template
8.
Home Screen : In case of multi location set up a link
is provided on right top corner ‘change location’ in order to give flexibility
to the user of changing logged in location without log off.
Providers selection and location selection
(filter) on the home page is now remembered, and used when user logins next
time.
9.
Document List Screen : A property is added in Encounter
TOC parametersà
toc.review.doclist.hidepn4enctypes. The given encounter types defined in
this property will be filtered out from document list.
Under document list, Message option
printing now handles the header information also.
To mark or unmark all list check boxes
is now available.
Zipping Mechanism: Marking the files
for zipping and click on Zip button at the top will internally rename every
file to (Patient's) LastName_First name_Type_X. ext.
where X will be the serial no. Even the folder created will be also named as
(Patient's) LastName_FirstName_X where X will be the
serial no. Windows compressed folder utility can be used for zipping.
10.
Letter Out Screen : Reopen facility is provided for Letter
out. Create a role called ‘Reopenletters’ with No Access check box checked. If this
role is assigned to the user then user will be able to see Reopen button enabled
on the letter out screen so he can reopen the sent status letter do the required
editing.
Document list
option allows going to the letter out screen, earlier we were not allowing
modifying the information, but now it is allowed based on basic rights.
11.
Letter Out , Progress Note Screen: Spell-check
button to be made available on the part viz. letter edit, my note edit etc. It
is property driven Prognocis Parameters: show.spellcheck.4PNLT , this will
decide if button for spell check is available for Progress notes and Letter
edit part.
12.
Patient
Registration Screen: For multi location set up, in Patient registration users are
allowed to edit info as well as attach photos even for patient of other
locations. Added a label "Location : XXXX"
hyper linked and name of the current patient location. By clicking on user can
select and change the patient location.
13.
Message Inbox , Outbox, Import Log Screen: Pagination is
provide on these screens.
14.
Message Compose
/ Forward Screen: Added a “self” checkbox under the To:
options.
Check and uncheck on this will decide if the message will be send to self.
15.
Lab Action Screen : Now it has same Compose like features to send mails to
Medics or Roles. Plus self check box is provided in order to send the message
to self. Inform Patient check box will send the mail to patient.
16.
Lab / Rad Order Screen: Lab And Rad
orders with status as “Ordered” (Printed or sent) are now allowed for editing
to the user , depending on the rights.
E-send: e-send (HL7 Export), for the lab / rad
orders is now available, provided the selected Vendor supports the e-send.
Lab and Rad Vendors can be supported for HL7 (e-send) mechanism, by
clicking the check box ‘Supported For e-Send’.
Billing :
1.
Home Page: New Icon for Patient Level Billing Notes And
Ledger.
2.
Added provision to accept Ref Doc on Claims New Pop up (As requested)
3.
Claim Screen Search displays ALL Claims in reverse chronological order.
In other words this is equivalent to the Tool Bar List Box with All selection
(Non Billed / Billed / All), earlier it was Non Billed
by default. Now to search for a specific claim will be easier and faster.
4.
Claim screen Navigation Buttons Next Prev, now
go by Claim Date.
5.
Claim Status Level Notes (upto 5000 chars)
provided. Adds User name and Date Time Stamp. All added comments / notes
for a claim are displayed in reverse chronological order. The Button is
displayed after Ready to Send Check Box. This is Yellow in color when there are
No comments saved. It becomes Red in color when there are comments. While the
claim is Not editable after it is Ready to Send, the
Claim Level Notes are always available for entry.
6.
Patient Level Billing Notes (upto 5000 chars)
provided. Adds User name and Date Time Stamp. All added comments / notes
for a claim are displayed in reverse chronological order. The Button is
displayed before Patient Name. While the claim is Not
editable after it is Ready to Send, the Claim Level Notes are always available
for entry. This button is displayed also on the following screens:
Home page
Claims > Unprocessed
Claims > Returned
Remittance > Entry
Remittance > Receipts (Patient)
Encounter CoPay
Appointment Scheduling >
Pat Info Area.
7.
Sales tax on Items – using Special code. Now it is possible for User to
define Special Charge Codes (in Group Master) OR Item Codes for Sales Tax e.g.
SALESTAXA ( for say 4.25%), SALESTAXB (for 8%) etc. When any of these codes (or
similar having a prefix SALESTAX) are selected on the
Claim page, the program computes the total Value of Item Costs in the Claim,
applies the Tax, computes the Sales Tax amount and adds the charge accordingly.
Note that the Code must begin with SALESTAX so that this special handling
becomes applicable. Note that if the Code is used as part of Groups only
Integral values are accepted, not a fraction like 4.25%. If the Code is used as
part of Item Master there are No constraints.
8. Claim Info Button now
allows the user to
change the Referring Provider. The change will be reflected in the encounter.
9. Patient Insurance Master
now accepts the No of Visits along with the Pre Authorization No and Date. The
Claims screen Info Button, now displays these PreAuthorized
Visits # along with Actual No of Visits.
10.
Insurance Master. Many a times the Submitter / Billing Provider / Pay To
provider Types are Insurance Company dependent. Now we have additional fields
to provide for these settings at the Insurance level. By default DO NOT set
them in the Insurance Master, they must be set Only by
exception. The claim generated will have these three fields populated from the
Primary Insurance Master OR from the properties (as at present). Of course the
user retains the option of editing these fields on the claims screen as
required.
11.
Business Unit Master Now accepts the EDIN Code and the Taxonomy Code.
12.
Doc Ins EDI and Clinic Edi Codes masters now have a third dimension of
Business Unit.
13.
Patient Invoice for Patient Responsibility based on Insurance ERA (P2,
P3) now should use a new template, which will print the Insurance Billed Amt,
Insurance Paid Amt(Adjust + paid + write off) and Patient Responsibility Amt.
14.
Remittance / Patient Receipt / Insurance write off / Patient write off
Screen Search displays ALL remittances in reverse chronological order. In other
words this is equivalent to the Tool Bar List Box with All selection (Entered /
Posted / All), earlier it was Entered by default. Now to search for a specific
Remittance / Patient Receipt / Insurance write off / Patient write
off will be easier and faster.
15.
Remittance / Patient Receipt screen
Navigation Buttons Next Prev, now go by Remittance
Date.
16.
Remittance screen, Claims Frame. User needs to select a claim row by
scrolling. The screen is then refreshed.
The claims rows will scroll, so that current
selected Row (Blue background color) is always visible.
17.
Remittance Comments – like Claim
Comments
18.
Remittance.
Money can be collected from Third Party Payer (On behalf of multiple Insurance
Companies). User can now enter the name of the third party payer. If he selects
the Insurance co, its name is populated instead. After saving the header, user
can select one or more claims from search. The search displays claims of all
Insurance companies. Earlier user could select only one claim. The Insurance co
from selected claim would go to header and there after claims of only that
insurance co could be selected. This constraint is removed.
On selecting multiple claims, note that the
corresponding Insurance Company name is also displayed along with other claim
details on the same line.
19.
On Post of Remittance – we create a Patient Responsibility Invoice, and
adjust the CoPay Amt and Deductible Amount collected
in Encounter CoPay with corresponding amounts in
Remittance. If there is a Balance user had to explicitly go to Remittance >
Advance option and Xfer it to Advance. Now on post of
Remittance, the program Automatically xfers any surplus / unadjusted CoPay
/ Deductible from Encounter CoPay to Advance.
20.
Two Additional buttons to REPRINT the CMS 1500 for Secondary Insurance
AND Invoice for patient Responsibility are provided on the Remittance screen.
From the claim screen a user could reprint the Pri
CMS 1500 and Direct Patient Invoice. The secondary CMS 1500 and Invoice for
Patient responsibility are printed from the Claims > Send Claims option. But
after printing the entries go off the list, so it was impossible to reprint
them. Since both get generated based on the Insurance Remittance, the provision
has been made on this screen. The document will be printed only if the
Remittance is Posted and the Document was already printed from Claims > Send
Claims option.
21.
Pagination like Home Page is also provided on these screens:
Claims > Unprocessed
Claims > Returned (Edi failed)
Claims > Unpaid
Remittance > Unallocated
Remittance > Processed
Remittance > Denied
22.
Statement / Ledger - Template/Program
rationalized. (Removed Visit name from Statement). Both Statement and Ledger
were Not considering the From and Upto Date entered.
It would print them for all the available data. Now they do consider the dates
and if necessary print the Opening balances. In the process of this
rationalization, many statement sections based on template have been made hard
coded like Ledger. As such the new Statement will work only if the new template
is available.
23.
Print button provided on Ledger and Statement Pop up.
24.
Bulk Printing of Statements for a range of patients.
Presently this is possible as a scheduled process.
The process does a few things:
a)
It adds an entry in the table TRN_PAT_BILL_STATEMENTS for each Patient
Statement
b)
It creates a Pdf for each Patient Statement
and saves it to datafiles/patbillstatements with the
filename same as the index of corresponding record above.
c)
Creates a single consolidated pdf from all
individual Patient Statements generated under datafiles/bulkstatements
with the filename as the DateTime when it was
generated.
d)
User will need to set up ftp, so that this generated consolidated file
is moved (copy and then delete) from this folder to the users
local machine.
25.
Patient MIS - New option to see for selected patient on one page all
Claims, Invoices, Remittance / Receipts, Bulk statements generated with hyper
links for corresponding documents besides Ledger and Statement. Documents can
be attached from Messages >
26.
To provide From and Upto LastName for OS
Letters for Patient/Responsible Person/Insurance
27.
Patient Wise Aging template and Insurance wise Aging template modified.
28.
NO SHOW
New property Billing
Parameters > billing.splcode.noshow=NSC
This must be set to the NO SHOW Special Charge code
as defined in the Billing Charges Group Master (type BC)
We have setting in EMR, so that all scheduled
appointment more than X days old get marked as No Show. In case of Billing it
will do the additional tasks of
a) creating a Dummy
Encounter
b) creating a
corresponding claim
c) Adding the Special charge code as per the
property above. The claim is Not posted.,
Further any appointment can be explicitly marked as
No Show from Appointment Scheduler page. On doing so, the No Show claim will be
created.
Likewise any appointment can be explicitly marked
as Cancelled by Patient from Appointment Scheduler page. On doing so, the a
claim will be created using the property Billing
Parameters > billing.splcode.cancelled
This must be set to the Cancellation Special Change
code as defined in the Billing Charges Group Master.
29.
EDI Returned
To facilitate better tracking this screen has the
following changes:
Pagination provided
Status is Now a Number.
The tool tip shows the detail name.
0 Not
Sent
11 Sent
12 Hide - Supress
13 AutoBill
14 Resent
15 To be Rebill
16 Is
Corrected. To be resent
21 997
Success
22 997 Fail
23 Batch
Failed Although Not because of this Claim
31 Insurance
Success
32 Insurance
Fail
41 Billed
from Web Site
42 ETS_INS_AGREED_2PAY
51
Recevied Remittance
Billing
Parameters > billing.edi.sendclaim.offset=15
If a Claim has been sent by EDI and there is No
response in 15 days, AND there is No Remittance against this, it will also
appear in this List.
EDI Error is too big and complex to be understood
by end user. It could be in terms of Segment 2010BA and some field. In simple
English it could mean Subscriber Id is NOT present. User is now able to type in
“Subscriber Id is NOT present” in a separate Error Comments field. Click on the
Error message to get a Pop up with
Actual EDI Error in a Non editable Text Area
Error Comments. A single
line edit control.
For a current selected Row (Blue background), two
buttons are provided at the Top Left for Claim Level Notes, and EDI Tracking Status.
EDI Tracking Status displays a
tabular information of Date / Comments / Person when the Tracking Status
is changed for that Claim.
Count is displayed before Total Amount.
30.
Fee Schedule
Fee Schedule Can have Upto
Date as Open ended.
31.
Location Master
User can define Tax Id for each Location, and print
it on CMS 1500 in cell 32 if required.
32.
Unprocessed Claims
Charges are displayed in Red if the complete amount
is Outstanding.