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1.2 Purpose

The PrognoCIS^TM (Build # 40) release has some new features and modules, and it also provides bug list for this release of PrognoCIS^TM.

2 About This Release

This release is provided to customer who would be using Bizmatic’s PrognoCIS^TM product.

3 Feature Summary for PrognoCIS^TM Release

For detailed information regarding full PrognoCIS^TM capabilities, please refer to the on-line help.

3.1 Patient Alerts

3.1.1.1 View Alerts

Provided an option to view alerts for the opened encounter entered by different users. User has an option to hide the alerts by selecting “Hide” check box given under view alert tab. Once Hide alert won’t be available for any user under view alerts tab.

3.1.1.2 My Alerts

My alerts tab displays alerts created by logged in user for different encounters. User has an option to select the screen on which alerts to be displayed viz Appointment, Encounter & Billing. User can also select a date up to which alerts should be displayed to user. By default creation date will be when user will create the alert.

3.2 Self Scheduled Process

Added an option to schedule different processes for monitoring purpose. User can schedule process like Billing Count, Client Usage, and Closed Encounter Progress Notes etc.

To schedule a process go to Settings > Configurations > Clinic > Scheduled Process. User can specify Process name, Time Interval, Frequency, Date & Parameters to schedule a process.

Note: Process can be scheduled with the assistance of Bizmatics support.

3.3 EMR

3.3.1 Switch From EMR to Billing

Added an option to switch from EMR to billing. A button is added on top menu bar to switch to billing.

3.3.2 Home Page

3.3.2.1 Quick Navigation

Provided option to quickly navigate to patient details, patient insurance, patient alert, patient billing notes, encounter details, copay details, patient receipt, claim details, patient statement, & patient a/c from home page.

- Following buttons are added to browse through different details:

o is added to view patient details under Appointment & Encounter tab.

o is added to view patient insurance details under Appointment & Encounter tab.

o is added to view patient alerts under Appointment & Encounter tab.

o is added to view copay details under Appointment & Encounter tab

o is added to view progress notes under Appointment & Encounter tab

o is added to view check out docs under Appointment & Encounter tab

Note: The selected current row on home page shown in Blue background will be reselected if user goes to any other page and then comes back to Home page.

3.3.2.2 Process Status

An option is provided where user can define whether different process status like Process C, Process D, Process S, Process V, Process P, Process L, & Process R to be displayed on the home page or not.

Added a property under Settings > Configuration > Properties > “home.show.process.status” to configure the process status. If the flag value is set to Y then process status will be displayed on Home page. Else, if the flag value is set to N then Process status won’t be displayed on Home page and with nurse, with doc etc status will be shown.

3.3.2.3 Encounter Review

Provision is added to define reviewer for the medic if required. If reviewer is defined for medic and medic is done with the encounter then encounter will be available to reviewers for review.

Medics can define reviewers for their encounters under Settings > Configuration > Medics masters.

Reviewer will get cumulative list of encounters to be reviewed by him and to be worked on. Encounters to be reviewed will have a status “Ready for review”

3.3.2.4 Last Login information

Added a provision to display last login date and time zone information on Home page. Display is according to server’s date and time zone.

3.3.3 Appointment

Added a provision to view patient’s history from Appointment screen.

3.3.4 Print Patient’s History

Added a provision to print patient’s history from appointment schedule popup > history.

3.3.5 Messages

3.3.5.1 Urgent Messages

If sender sends urgent message with an action then receiver will get two check boxes viz "Accept Task" and “Done" to perform action.

- If an urgent message is send without an “action” then it will be displayed to all recipients and on reading the message, it will be marked as READ in the inbox for respective recipients.

- If an urgent message is send with an action then on receive of the urgent message:

o If a recipient selects “Accept Task” then message will be marked as READ in the inbox of all recipients. It means user has accepted the task and will take action.

o If a recipient selects “Done” then message will be marked as READ & DONE in the inbox of all recipients. It indicates task is done.

o If a recipient neither selects “Accept Task” or “Done” and closes the message then other recipients will still receive the pop up till the time someone will explicitly select accept task or Done.

3.3.5.2 Message Deletion

Provided options to:

- Delete READ inbox mails automatically after a specific time interval. User can define number of days duration in Settings > Configurations > Properties > mail.mark.del.days. If 0 is set then application won’t delete the mails automatically.

- Delete DELETED marked mails from the inbox User can define number of days duration in Settings > Configurations > Properties > mail.purge.del.days. If 0 is set then application won’t delete the mails automatically.

- Following properties are now removed from application now:

mail.purge.lab.days

mail.purge.rad.days

mail.purge.type.days

mail.purgecount

3.3.6 Error log

An option is provided to view error occurred while importing and exporting data with Advanced MD interface. Error logs can be viewed from Settings > Configurations > Import logs.

3.3.7 Clinic Forms

Provision is added to add insurance details on clinic forms. Insurance drop down is added on clinic forms screen, to assign patient’s insurance. On print/preview of clinic form insurance information will be displayed.

3.3.8 Lab Test Results

Added an option to import some more HL7 segments and information related to segments will be displayed under Remark tab of Lab result screen.

3.3.9 Test

An option is added to mark the status of test as inactive or active when imported from HL7 Lab or Rad test results import.

A property is added under Settings >Configuration >Properties > “test.hl7.add.inactive”. If the flag value is set to Y then test status will be inactive and test won’t be available in encounter. Where as if the flag value is set to N then test status will be active and available in encounter.

3.3.10 Patient Registration

3.3.10.1 Patient’s Age

Added an option to enter patient’s age if patient’s DOB is not known.

A calendar icon is provided on the patient registration screen. When user clicks this icon a pop up appears. On selecting DOB Not Known check box user can enter patient's age in text box.

Note: Maximum age user can enter is 150.

3.3.10.2 Quick registration of responsible person

Added an option to copy patient’s address details in responsible person’s address details if responsible person’s address is same as patient’s address. Option is provided under billing info tab on patient registration screen.

User can select “Same as Patient” option it will automatically populates patient’s address in responsible person’s address details.

3.3.11 Patient’s & Doctor’s Forms

Added an option to provide number of character limits for notes section on patient and doctor form. Warning message will be displayed if number of character limit exceeds in notes section while typing.

3.3.12 Complaints & Test Templates

Added an option to display pertinent complaints & test execution VT, HPI, ROS, PHY, SC templates on encounter screen according to the specialty of attending doctor.

This option allows to list out complaints & test execution templates according to the specialty of attending doctor.

“Specialty” button is added on complaints & test execution template screens. On click of Specialty button user can select “All” Specialist or few specialists pertinent for complaints and test templates.

3.3.13 Lab Order

Added an option to add the ICDs in lab order from the list of ICDs used in past medical history of the same patient.

Button is provided just next to ICD codes on lab order screen. It provides list of ICDs used in past medical history for the same patient. User can select codes from the list and the codes will be added accordingly.

3.3.14 Document List

Provision is added to display Lab/Rad Result Date along with Lab/Rad details under document list.

3.3.15 Electronic Signature

Provided an option to accept patient’s e-signature on documents. Now patient’s signature can be taken on online document using signature pad.

3.3.16 Health Status

Provided an option to select Health Status from Encounter close screen. User can select Health status from encounter close screen before closing the encounter.

Also added an option to select health status from Addendum screen. A property is added under Settings >Configuration >Properties > encounter.addendum.edithealthstatus. If this is set to Y then user will have option to select health status from Addendum screen. If this is set to N then health status won’t be available on Addendum screen.

3.3.17 Change Password

Now user can define whether they want to change the system generated password or not. A property is added under Settings >Configuration >Properties > gen.pswd.change.notmust. If the flag value is set to Y user will not be forced to change system generated password. Where as if the flag value is set to N then user will be forced to change the password.

3.3.18 Patient Workflow

Added an option “Remain on current encounter” on patient’s workflow popup.

3.3.19 Assessment

3.3.19.1 CPT & HCPC cross reference with ICD

An option is added to define mapping between CPTs & ICDs and HCPCs & ICDs.

Above mentioned options is available when:

1) Cross reference value of CPT, HCPC & ICD is saved in database.

2) And If the flag value is set to Y in Settings > Configuration > Properties > assessment.cpt.usecrossreficd.

This implies that associated ICDs should be selected for CPT and HCPC selected in encounter. If ICD is not selected for selected CPT or HCPC then on saving codes on Assessment screen or closing encounter following message is displayed:

“The applicable diagnosis for the [CPT_NAME], [HCPC_NAME] is not selected”

If the flag value is set to N then warning message won’t be displayed.

Note: Works same for billing as well.

3.3.19.2 ICDs

Added a property under Settings > Configuration > Properties > assessment.icd.noprimary to hide or unhide Primary column for ICDs on assessment screen. If the flag is set to Y then mark Primary ICD won’t be available on assessment screen. Else, if the flag value is set to N then user will have an option to mark ICD as Primary in Assessment.

3.3.20 Confirmation Message

Added a property under Settings > Configuration > Properties > prognocis.dontshow.confirm. If this is set to Y then confirmation message to save the changes won’t be displayed to user if user tries to switch from one screen to another without saving changes. Application will automatically save the changes. If this is set to N then confirmation message to save the changes will be displayed.

3.3.21 My Notes

Provided an option to create my notes from previous encounter's progress note (if the encounter is open) or from generated my notes (for closed encounter) of the same patient.

“From Previous Visit” option is added in my notes Prompt popup. If user selects From Previous Visit then my notes will be generated according to previous encounter's notes.

3.3.22 Specialty

3.3.22.1 Define Procedures

Added an option to define a template (set of tests) as a Procedure in Specialty. “Procedural” check box is added on Specialty template screen to define the templates as Procedure.

3.3.22.2 Procedure DONE

Different options to mark procedure as DONE are:

1) To explicitly mark procedures as DONE

Added a property under Settings > Configuration > Properties >”specialty.showprocdone.checkbox” to display DONE check box after each procedure. If the flag value in is set to Y then user has to explicitly mark all tests as DONE & accordingly status will be changed on Home Page.

2) Or Application will automatically mark procedure as DONE based upon the procedure results. Added a property under Settings > Configuration > Properties > “specialty.autoprocdone.checkbox” to mark procedure automatically DONE and accordingly status will be changed on home page. In this case DONE check box will be disabled and checked.

3.3.23 Reference Doctor’s NPI import

Added an option where NPI of reference doctor can be imported in application using HL7 interface. Now NPI is also available as one of the rules for the HL7 reference doctor import process.

3.3.24 Close Encounter

Added an option where user can define that only attending doctor can close the encounter if required.

Added a property under Settings > Configuration > Properties > “Enc.close.onlybyattdoc”. If the flag is set to Y then only attending doctor can close the encounter.

3.3.25 Diagnostic Codes

Added an option to export diagnostic codes (ICDs) to 3^rd party application using HL7 interface.

3.4 Billing

3.4.1 Switch From Billing to EMR

Following buttons are added on the top menu:

o to switch from billing to EMR.

o . to view patient’s account details.

3.4.2 Home Page

3.4.2.1 Quick Navigation

- Following buttons are added to browse through different details:

o is added to view patient details

o is added to view patient insurance details

o is added to view patient alerts

o is added to view patient billing notes

o is added to view encounter details

o is added to view copay details

o is added to view patient receipt details

o is added to view claim details

o is added to view patient statement

o is added to view patient A/C details

Note: The selected current row on home page shown in Blue background will be reselected if user goes to any other page and then comes back to Home page.

3.4.2.2 Billing Amount Table

Added hyperlinks to browse through the detail information from home page:

o Ready to Send Amount: Is the Sum total of Billing Claims whose status is Ready to Send.

o Not Posted Era: Is the total Remittance Received from Insurance, which is Not yet posted.

o Not Posted Receipt: Is the total Patient Receipt Received (Not the Encounter Copay collected on visit), which is Not yet posted.

o Collection Today CoPay: The Encounter Copay Amount collected on visit today.

o Collection Today Remittance: The Remittance Received from Insurance today.

o Collection Today Receipt: The Patient Receipt collected today.

o Outstanding Claims Insurance: Insurance Outstanding

o Outstanding Claims Patient: Patient Outstanding

o Outstanding Claims Total: Insurance Outstanding plus Patient Outstanding

Note: Many of these amounts are hyperlinked to provide a pop up with a detail break up of the Amount.

3.4.3 New Claims

Following options are added to create new claims

o Added a provision to create a new claim by providing date, patient, providers & location details.

o Added a provision to create a copy of existing claim. If this is selected all other fields need Not be selected on create new claim popup. The generated claim will be a replica of the selected claim, except that the Visit ID will be different.

o Added a provision to create a copy of an existing claim to resend. Claim will be replica of the selected claim with same VisitID.

3.4.4 Edit/New Claims

3.4.4.1 Claims

Added a provision to generate Claim with zero (0) Value. This is typically generated for OB Patients where the Doctors charge them the full amount in the first visit and nothing on the subsequent visits till the delivery. The same principle can be applicable for all doctors dealing with surgical procedures and specified number of post operation follow up visits.

3.4.4.2 CLIA number

If Pre-Authorization number is not available then Clinical Laboratory Improvement Amendments (CLIA) number will be printed in place of Pre-Authorization number on CMS 1500. Added a property under Settings > Configuration > Properties > billing.clia.cpts to define CPT codes for which CLIA number should be printed

Note: Applicable only when in house tests are done or CPT codes are selected.

3.4.4.3 Claim Search

Added an option to search claim by Patient name, DOS, Claim id & Insurance/Self pay field.

3.4.4.4 Preview

Added a “Preview” button on edit / new claim screen to preview claims before printing.

Provides an option to preview

o Primary CMS - If Insurance is present and some charges are billed to Insurance

o Secondary CMS – If Other Insurance is present and some charges are billed to Insurance

o Primary EDI - If Insurance is present and some charges are billed to Insurance and Supported by Clearing house option is selected in Insurance Master

o Patient CMS - Many times patient has an Insurance which is Not recognized by the clinic. In such a case although the Insurance details are entered, the patient is billed and is expected to settle the amount completely. However the clinic prints the CMS with the Insurance name and gives it to Patient. Patient is then supposed to follow up with them and get the applicable refund / reimbursement from his Insurance.

3.4.4.5 Claim ID

Claim ID is now displayed in place of Visit ID on edit / new claim screen.

3.4.4.6 Insurance

If Insurance List Box selection is changed by user, then Other Insurance information will automatically turn Blank.

3.4.4.7 Copy Codes

“Copy Claim” button is renamed as “Copy Codes” on edit / new claim page. Copy codes allow to copy codes from previous claims of same patients.

3.4.4.8 Assign Flag

Added discount (%) option on assign flag popup to give a % discount and apply the discount to all charge rows.

3.4.4.8.1 Sync EMR

Added a property under Settings > Configuration > Billing Parameters > billing.sync.with.emr to reflect billing changes on EMR side.

o If the flag is set to N then changes won’t be reflected on EMR side

o If the flag is set to Y then changes made in CPT/HCPC/ITEM and their modifiers in Billing Charge Entry will get reflected in EMR even if the encounter is closed

o If the flag is set to L then changes made to CPT/HCPC/ITEM and their modifiers in Billing Charge Entry will get reflected in EMR, only when the Encounter is Live (Open)

Note: If property was set to L and Encounter was closed, then on Add / Del of ICD / CPT/ HCPC a comment line will be generated and added to Claim Notes.

3.4.4.9 Claim Information

Added a provision to display “Attending Provider” and “Rendering Provider” information on claim information popup.

3.4.5 Patient Insurance

3.4.5.1 Card Image

Once the insurance card image is attached to patient’s insurance details, the tool tip for the attach button changes to Detach . So that user can detach or clear the insurance card image from insurance details .

3.4.5.2 Effective From Date

Now user can enter today’s date in “Effective from” date field on insurance screen .

3.4.6 CoPay

Added properties to configure fields to be displayed on CoPay screen:

Co-Payment > copay.copay.label=CoPay

Co-Payment > copay.deductible.label=Deductible

Co-Payment > copay.visit.label=Visit

Note: Co Pay and Advance bucket will always be present on Copay screen.

3.4.7 NDC Code

Added a provision to print NDC Code under 24A and Units Under 24D on Gray band . NDC Code is printed with prefix as N4. It can also have a Unit, in which case it will have a suffix of UN99. The Unit can be part of the same NDC Code.

Note: Code with Prefix of N4 and Unit together can not exceed 20 characters. Such a code can be defined in In-House Master.

3.4.8 Remittance

3.4.8.1 Carrier

If remittance is received from carrier then user can enter the carrier name on remittance screen under Insurance label. On save, insurance label will be changed to “Carrier” on remittance screen.

3.4.8.2 Batch Number

Added a provision to create a Batch No. with Date Time, And close the Batch. Authorized Users will have access to this option. At a time there can be only one batch open for each Authorized user. On accept (Post) of Encounter ERA / Receipts it will save the open Batch No.

o Added a property Billing Parameters > billing.use.receipt.batchno if set to Y, receipt cannot be posted without a Batch No assigned to it.

o Added a property Billing Parameters > billing.autoassign.batchno if set to Y, new batch no will be generated if there is no open batch.

o Added a property Billing Parameters > billing.userwise.batchno if set to N, then Batch No will always be created for only Admin

3.4.8.3 EOB from Secondary Insurance

Now user can define whether the remittance is from secondary insurance or primary insurance. Added a check box to select if remittance is from secondary insurance

3.4.8.4 Remittance Balance Amount

Added a property under Settings > Properties > Billing > era.charge.balanceamt.mustbezero

If the flag value in is set to Y then user can not save the remittance information having +ve Balance (which is Not Written off). If flag is set to N then user can save the remittance information having +ve Balance (which is Not Written off). By default property is set to Y.

3.4.8.5 Secondary Insurance

Added an option to select Patient’s secondary insurance on remittance screen to charge remaining claim amount to secondary insurance. This is required in case secondary insurance information has been added after claim already sent to primary insurance. This option is available if

o Remittance is from Primary Insurance

o Remittance is NOT from third Party (Carrier)

o Claim selected has only one Insurance assigned

o Patient has more than One Insurance defined.

3.4.8.6 Enter key

Added an option where “Enter” key can be used to navigate through amount details on remittance screen.

3.4.8.7 Search Claim

o Added an option to search claims based upon Insurance & Provider selected on remittance screen.

o Added a provision to search claim which is fully paid.

3.4.8.8 Remittance for Secondary Insurance

Allows to create remittance for Secondary Insurance before receiving Primary Insurance remittance details.

3.4.8.9 Remittance

Added an option to by default highlight the last selected current claim row on remittance screen every time user logs in.

3.4.8.10 Remittance Date

Added an option to edit remittance date on remittance screen.

3.4.8.11 Insurance Write Off

Enhanced the Insurance W/O feature to allow balance amount to be written off partially as well.

3.4.9 Patient w/off

Enhanced the Patient W/O feature to allow balance amount to be written off partially as well.

3.4.10 Patient A/C

3.4.10.1 Adjust Advance

Provided an option to adjust the Patient’s Outstanding amount against Advance Collected. This option is only available when there is some advance collected from patient as copay.

3.4.10.2 WO Balance

Provided an option to write off Patient’s Balance amount which is due from more than some number of days.

3.4.11 Patient Receipt

o Removed mandatory “*” mark for all Credit card fields removed.

o User can now print Receipt before posting.

o Provided easy Access to go to Patient receipt. Receipt Pop up can be invoked from Appointment > Schedule > Patient Receipt. User can enter only the Received Amount and details. User won’t be able to Post it. It will be done later by the Biller.

o Removed list Box for Advance Move/from/etc and Adv Amt field. On Save If received amount & adjusted amount do not match then system will prompt a message “Balance amount is moved to advance or taken from advance”. Now user can edit the patient name once patient is selected.

3.4.12 Report

3.4.12.1 Ledger Report

Removed mandatory mark from Ledger From and Upto Dates on Ledger print popup.

Note: If date is not specified by the user then report will be generated from earliest patient transaction date to till date.

3.4.12.2 Statements

Added 3 different templates to generate statement:

STPIB: Prints statement chronologically.

STPIB2. Prints bills & remittance details according to Visit ID. Not chronologically.

STPIB3: Prints details of charge lines for a visit with the amount paid / balance due from primary insurance, secondary insurance & patient.

3.4.12.3 Claim

Provided an option to filter patient’s information to be displayed on report. Added “Filter button” to select the different filter criteria using Boolean operators.

3.4.12.4 Patient Aging

Added a provision to print

o Patient wise Aging

o Patient wise Aging With Percentage

o Patient wise Aging with Claim wise breakup

3.4.12.5 Insurance Aging

Added a provision to print

o Insurance wise Aging

o Insurance wise Aging With Percentage

o Insurance wise Aging with Claim wise breakup

4 Installation for PrognoCIS^TM Release

PrognoCIS^TM setup has its own set of installers, please refer to the PrognoCIS^TM Installation Guide.

5 Software/Hardware Requirements

Please refer to the PrognoCIS^TM Installation Guide.

6 Known Bugs

Key	Summary	Comments
Issue 1	When user opens Patient’s notes from document list screen and tries to use back button it goes to Face sheet screen.	Fixed, on click of back button from patient’s notes now user goes to document list screen.
Issue 2	When user reopens the encounter Addend Notes template gets appended to My Notes multiple times	Fixed, now after reopening the encounter addend notes wont be appended to My notes until user explicitly include
Issue 3	User can not define % more than 100 on Insurance master	Fixed, % more than 100 can be defined
Issue 4	If CPT is billed to Insurance & patient both then on patient’s receipt total of both is displayed	Fixed, patient receipt only shows the charge for CPT billed to the patient
Issue 5	If user deletes In-house Lab/Rad results from CPOE > Lab/Rad results screen then Inbox mail for the same deleted lab/rad results show error when user clicks on zoom button to see the results.	If user deletes In-house Lab/Rad results from CPOE > Lab/Rad results screen then Inbox mail for the same deleted lab/rad will be automatically deleted from Inbox.