Add Button:
Click this button to add and save a new employer in the clinic's database.
Search Button:
Click this button to search for an existing employer's record in the Master.
Employer Details
Employer Name: The Employer Name is a mandatory field. The employer's address can be saved by clicking the 'Address' button next to this field. The Employer Name is an alphanumeric field supporting 50 characters.Address Button: Clicking this button opens the Address popup, which allows the user to add the employer's address. When the Employer Portal is enabled and an email address is entered in the Email field, the Employer Portal credentials are automatically generated upon saving. If an employer record is saved without entering an email address, a warning message states: Email Address of the Employer is required to login to the Employer Portal.
Billing Address: Click this button to invoke the Billing Address for Employer popup. All input fields within the popup adhere to the standard validation rules applied to other address fields within the system.
Nature of Business: This field defines the type of business the employer has, such as Software, Manufacturing, Government, etc. This field supports 255 characters.
DOT Agency: This field allows the association of DOT agencies to the employer and is displayed only for Occ Med-enabled clinics. Click the Search
button to invoke the DOT Agency List popup and select the checkboxes for the required DOT agencies.
The names of all the DOT agencies added under the DE - DOT Agency for Employee Category Group Type are displayed in this popup.
Once selected, the DOT agencies are displayed as a comma-separated list in this field, and their names are also displayed in the tooltip on hovering the cursor over the field.
Selected DOT agencies can be removed from the field by clicking the Clear hyperlink.
Note that this hyperlink is not available if the employer is associated with a patient's record.
If an attempt is made to unselect a DOT agency from the DOT Agency List popup, then a validation message is displayed stating:
Cannot remove DOT Agency selected, as the Employee Category associated to the DOT Agency are linked to the patients on registration screen.
Associated to Organization: If the admin-level property enable.organization.emp is set to On on the Properties Master screen, an Associated to Organization field along with a
Search icon,
Associated to Organization icon, and a Clear link are displayed for Single, Hybrid, and Multi-Location setups in PrognoCIS.
Click the Search icon to invoke the Organization Search List and select an Organization Employer that is already stored in PrognoCIS.
Click the Associated to Organization icon to invoke the Add Organization Employer popup to add a record for a new Organization Employer in PrognoCIS.
The user can enter details with respect to the employer added as an Organization Employer in the provided fields.
The selected Organization Employer is then displayed in the Associated to Organization field.
To edit existing details on the popup, the user can click the hyperlinked Associated to Organization label, which invokes the Add Organization Employer popup with the existing details.
Click the Clear link to remove the selected entry from the Add Organization Employer field.
Associate Clinic Location: This field is displayed along with a multiselect
icon only for a Hybrid Location setup if the admin-level property associate.cl.loc.emp is set to On on the Properties Master screen and a medic for whom the user role HybridLocationAccess is assigned logs into PrognoCIS.
Click the All Locations icon to invoke the Location(s) popup.
All active locations saved in PrognoCIS are displayed in this popup. A vertical scrollbar is present on the popup to scroll and view all the locations available in the popup.
The user can select multiple and an unlimited number of locations from the popup. Selected and saved locations on the popup are seen in the Associate Clinic Location field in a comma-separated manner.
Departments Button: Clicking the Departments button displays the Department's popup, which allows adding multiple departments for an employer. This button is only visible when the Employer Portal is turned 'ON' and the property patient.show.employer.dept is turned 'ON'.
Contacts/Employer Users Button:
Clicking this button displays the Contacts/ Employer Users popup, enabling the addition of multiple users for logging into the Employer Portal.
This button is visible only when the Employer Portal is enabled.
Jobs Button:
Clicking this button displays the Jobs For Employer <Name> popup, which allows adding job details.
Protocols Button:
Clicking this button displays the Protocol popup, which allows adding multiple protocols for the respective employer.
This button is only visible when the property use.employer.protocol is turned 'ON'.
Contact First Name: This is the first name of the contact person of the above-mentioned employer. This field supports 30 characters.
Contact Last Name: This is the last name of the contact person of the above-mentioned employer. This field supports 30 characters.
Designation: This is the designation of the contact person of the employer. This field supports 30 characters.
Medical Review: Medical reviewer details are entered using the Details
button.
Employer Status: The Employer Status field is a configurable field that becomes visible only when the admin-level Boolean property employer.enable.status.rcmstatus.field is enabled (set to On). By default, this property is set to Off, which means the Employer Status field remains hidden from the user interface. When enabled, the field becomes visible and operational, allowing users to manage an employer's status more effectively. The dropdown options for the Employer Status field are defined through the employer.empstatus.field.options property, which accepts values in a pipe-separated format (e.g., |Option1|Option2|Option3|). This property supports up to 1024 characters and does not limit the number of values that can be entered. By default, the system includes "Blank" and "Priority" as dropdown options. If the options property is left blank, these default values will be used. It is important to note that the Employer Status field is only visible and functional if the associated visibility property is enabled.
Employer Attachment: You can attach employer-related documents through the Attach
button.
Employer RCM Status: The Employer RCM Status field is a configurable field that becomes visible only when the admin-level Boolean property employer.enable.status.rcmstatus.field is enabled (set to On). By default, this property is set to Off, keeping the Employer RCM Status field hidden. Once enabled, the field appears on the screen and becomes operational, allowing users to manage the employer's RCM status more effectively. The dropdown options for the Employer RCM Status field are defined using the employer.emprcmstatus.field.options property. This is an admin-level setting that accepts values in a pipe-separated format (e.g., |Option1|Option2|Option3|) and supports a maximum of 1024 characters. There is no restriction on the number of values that can be configured. By default, the dropdown includes the options "Blank," "Pre-Credit Hold," and "Credit Hold." If no custom values are specified, the system will default to these predefined options. This property only takes effect when the visibility setting employer.enable.status.rcmstatus.field is turned On, ensuring that the Employer RCM Status field is both visible and functional.
FTIN: Enter the FTIN, i.e., Federal Tax ID Number, in this field. The FTIN field accepts 9 digits.
External ID: This is the ID of the external application from which this employer is imported. If the employer is created in PrognoCIS, then the external ID can remain blank. This field supports 20 characters.
Insurance Details
Insurance: The user can select a valid insurance company by either typing the first few characters of the company name or by searching for it using the binocular icon provided next to the field.Insurance Policy: This is the policy number of the group insurance given by the employer. This field supports 30 characters.
Effective From and Upto: The user can specify the effective date range from and up to which the selected insurance is applicable. Dates can either be entered or selected through the 'Calendar'
icon. The Effective Up To date must be greater than the Effective From date.
Employer Insurance History: Clicking the 'Employer Insurance History' icon invokes the 'Employer Insurance History' popup. This popup captures the additions or modifications made to the
fields under the 'Insurance Details' section. These fields include 'Insurance', 'Insurance Policy', and 'Effective From and Up To'.Employer Notes: The notes field supports a character limit of 5000. If more than 5000 characters are entered in the notes field, then a message is displayed: 'Cannot enter more than 5000 characters'. Employer notes cannot be imported from or exported to the Employer Master.
Encounter Details
Supported ENC Types: By default, this field displays the keyword all encounter types supported. A multi-select
icon and a Clear hyperlink are provided next to this field.
Clicking the multi-select icon invokes the Supported Enc Types popup,
displaying a list of encounter types and their corresponding names. Clicking
the Clear hyperlink deselects the selected encounter types.Employer Billing Info
Billing & Invoicing Info
Button: Clicking this button invokes the Employer
Account popup. On this popup, the user can see details related to Employer
Aging, TPA-wise Aging, Job-wise Aging, Employer Invoices, Employer
Invoices By Claims, Employer Invoices By Claim Charges, Employer
Outstanding Invoices, Employer Outstanding Invoices By Claims, Employer
Outstanding Invoices By Claim Charges, and Employer Write-off. The Employer
Account can be configured based on the property billing.emp.account.sections.
Bill No-Show Checkbox: The Bill No-Show checkbox is unchecked by default. When unchecked, the system continues to bill the patient for no-show appointments. When checked for an employer, if the employer is linked to a visit, the system generates a penalty invoice to the employer instead of the patient. This behavior applies even if the associated encounter type has the Do Not Bill No-Show checkbox selected under Settings → Configuration → Clinic column → Encounter Types Master. All changes to the Bill No-Show checkbox are tracked in the Employer History popup.
Split Claims:
Emp Bill
Button: Clicking this button allows the user to split the Claim TPA,
Workers' Comp Insurance, and Patient, wherein certain CPT codes are defined for TPA,
Insurance, Patient, and default (Employer Claim), and the claim then gets automatically
split into four claims.Work Comp
Button: Clicking the Work Comp button allows the user to split the Employer Claim
for a Workers' Comp Encounter Type, and the claim gets automatically split.Invoice Parameters
Invoice By Enc Type: When this checkbox is checked, invoices are generated according to the Encounter Type.Invoice By Department: When this checkbox is checked, department-wise invoices will be generated for patients on the Claims screen.
Invoice By Job No: When this checkbox is checked, invoices are generated according to the Job No.
Invoice By Patient: When this checkbox is checked, invoices are created patient-wise. Selecting this checkbox disables the EncType, Department, JobNo, and Location checkboxes. If the EncType or Location checkbox is unselected and this checkbox is selected, then a popup message stating: You are selecting "Invoice by Patient" option, any other selected Invoice By options would get reset. Do you want to continue? is displayed. On clicking Yes in this popup, this checkbox becomes checked, and all the other options become unchecked and disabled. If No is clicked, no changes are made and this checkbox remains unchecked and enabled.
Invoice By Location: This checkbox allows the generation of employer invoices by location. Using this checkbox, users can obtain information related to transactions happening across multiple locations on a single employer invoice. Selecting this checkbox disables the EncType, Department, JobNo, and Patient checkboxes. If the EncType or Patient checkbox is deselected while this checkbox is selected, then a popup message stating: You are selecting "Invoice by Location" option, any other selected Invoice By options would get reset. Do you want to continue? is displayed. On clicking Yes in this popup, this checkbox becomes checked, and all the other options become unchecked and disabled. If No is clicked, no changes are made and this checkbox remains unchecked and enabled.
To generate a location-wise employer invoice, select this checkbox and create an invoice from Billing → Claims → Send → Emp Invoice. The generated employer invoice is split into separate location-wise invoices, which are grouped according to the selection made in the Invoice Group By field.
The format of the invoice number for location-wise employer invoices is the location code followed by a hyphen (-) followed by a system-generated six-digit number. For example, if the location code is CL001, the invoice number is CL001-000001. This invoice number is displayed under the Invoice No label in the generated location-wise employer invoice.
Invoice Group By: This dropdown field provides users with the following options: Patient, Charge Codes, Date of Service by Patients, and Date of Service by Charge Codes.
- Patient - When this option is selected, the employer invoice is generated in the following format:
- Invoices are grouped by patients sorted alphabetically.
- Each claim has a distinct group with claim-wise subtotals.
- The invoice total is printed at the end.
- Charge Codes - When this option is selected, the employer invoice is generated in the following format:
- Invoices are grouped by Charge Codes sorted in numeric order (45378 will be placed above 99214 regardless of the volume or dollar amount for charge codes).
- Each charge code has a distinct group with charge-code-wise subtotals.
- The second sort is by Patient Name.
- No patient-level subtotals are presented.
- The invoice total is printed at the end.
- Date of Service by Patients - When this option is selected, the employer invoice is generated in the following format:
- Invoices are grouped by Date of Service in ascending order.
- Each DOS has a distinct block.
- Day totals are printed at the end of each block.
- Invoices are grouped by Date of Service and then by patients. For example, if Patient A was treated on the following DOS: 01/01/2017 and 02/01/2017, and Patient B was treated on the following DOS: 01/15/2017, the invoice lists three separate blocks for individual service dates, where Patient A is listed first, Patient B second, and the third block is for Patient A for DOS 02/01/2017.
- Date of Service by Charge Codes - When this option is selected, the employer invoice is generated in the following format:
- Invoices are grouped by Date of Service in ascending order.
- Each DOS has a distinct block.
- Day totals are printed at the end of each block.
- The invoice total is printed at the end.
- Invoices are grouped by Charge Codes.
- Subtotals are printed for each procedure block.
Schedule Invoice Cycle: The Schedule Invoice Cycle dropdown has three values: Monthly, Weekly, and Daily. This describes how the employer prefers to receive the invoices.
Payment Days: The Payment Days field indicates the normal processing period to process invoices as decided between the practice and the employer. For example, if Medical Practices LLC has a contract with employer "Axion" which mandates that Axion process invoices within 20 days from the invoice date, the practice adds the number 20 in the "Invoice Payment Days" field. When invoices are printed, the due date before which payment is expected from the employer is added to employer invoices using the tag [BLH_EMPLOYER_DUEDATE]. So if the invoices are generated on 01/01/2017 and the Invoice Payment date is set to 20, [BLH_EMPLOYER_DUEDATE] prints 01/21/2017 as the due date for the invoice.
Late Fee _ %: This field is displayed only when the property billing.allow.emp.latefeeinvoice is set to On. Clinics must enter a percentage value that defines the penalty rate to be applied to outstanding employer invoices once the payment period defined in Payment Days lapses. This field accepts decimal values up to two decimal places; if three digits are entered, the system automatically rounds the value to two decimal places. The two radio buttons, Simple and Compound, determine the method of calculation for the penalty amount. If Simple is selected, the penalty is calculated using simple interest. If Compound is selected, the penalty is calculated using compound interest.
If the field is left blank, the system calculates the penalty amount using the charge code amount defined in the employer's Fee Schedule and the percentage specified in the Employer Fee Schedule section. This logic applies to both the Simple and Compound methods. If the fee schedule amount is set to 0, no penalty invoice is generated. All modifications made to this field or the selected calculation method are recorded and can be reviewed by clicking the History button.
Purchase Order No: Enter the Purchase Order No. in this field. The character limit supported in this field is 20. A new tag, BLH_EMPLOYER_PO, has been added to display the PO number on the Employer Invoice. An FTUX message has been added. The message displayed to the user is: 'Users can now add a Purchase Order number to be printed on the Employer Invoice. A tag, BLH_EMPLOYER_PO, can be added to the Employer Invoice template to populate Purchase Order details.'
Employer Invoice Template: The template for the invoice can be selected using the binocular
icon next to the field. This
template will be considered when the Employer Invoice is generated.
Send Invoice By: Generated invoices can be sent via email or fax to the selected employer by selecting the Email or Fax checkbox, respectively. When the Email checkbox is selected, the FTIN and Invoice Email fields are prefixed with a red asterisk *, indicating that they must be completed for invoices to be sent via email. When the Fax checkbox is selected, the Invoice Fax field is prefixed with a red asterisk *, indicating that it must be completed for invoices to be sent via fax.
The admin-level property bizfax.emptpa.coversheet.template can be used to select the template to be used in the coversheet when sending the Employer Invoice via fax. If this property is left blank, then no coversheet is faxed when Employer Invoices are sent via fax.
Note:
Sending invoice emails to Organization Employers is independently controlled by the Send Invoice by Email checkbox on the Add Organization Employer popup.
Invoice Email: Generated invoices are sent to the email address entered in this field when the Email checkbox is selected in the Send Invoice By field. This email address is also imported when an employer record is imported into PrognoCIS by clicking the Import button.
Invoice Fax: Generated invoices are sent to the fax number entered in this field when the Fax checkbox is selected in the Send Invoice By field. This field accepts only numeric values and has a character limit of 35. Alphabetic and special characters are not accepted in this field.
Note:
The fax number entered in this field must not be the same as the one entered in the Fax field on the Address for <Employer> popup invoked by clicking the Address button.
Employer Fee Schedule
Fee Schedule Type: An appropriate Fee Schedule can be defined for Employer Claims from the dropdown. Multiple Fee Schedules can also be defined and associated with each employer separately. On adding a new employer, the Fee Schedule saved in the property employer.fee.schedule.type is selected by default in the Fee Schedule Type dropdown. If a Fee Schedule that is not part of the Non-System Group Type, Billing Schedule (B6) is saved in the property employer.fee.schedule.type, or if the property is left blank, then the default Fee Schedule selected from the Fee Schedule Type dropdown for the newly added employer is U&C. Below the Fee Schedule Type dropdown, the name of the active Fee Schedule on the Employer Fee Schedule popup with which the employer was first associated is displayed.Note: Employer Billing
supports only a Billable Fee Schedule.
Employer Fee Schedule Icon: This icon is available only on the Billing side of the Employer Master screen. Click the Employer Fee Schedule Search button to invoke the Employer Fee Schedule popup. This popup shows a list of all Employer Fee Schedules that have the selected employer associated with them.
Percentage: Enter the percentage of the amount that the user would like to bill to that particular employer. The charge codes are calculated based on the percentage of the Fee Schedule defined in the Employer Master. The default percentage value is 100.
Active: By default, the checkbox remains checked so that the added employer remains active. When this checkbox is unchecked, the employer becomes inactive.
Print Profile Button: Click this button to invoke the Employer Profile popup to view and print the employer details. Employer-related information is displayed in this popup in the following sections:
- Organization Details
- Employer Details
- Protocols
- Workers Comp Insurance
- Invoice Parameters
- Employer wise AR
- Split Claims
Save Button: Clicking this button allows the user to save the employer's details in the Employer Master.
Delete Button: Clicking this button deletes the added employer's details. Once an employer is associated with a patient, the user cannot delete the employer..
Reset Button: Clicking this button resets all the fields on the screen.
History Button: Clicking this button invokes the Employer History popup to check the last modified details of the logged-in user for the selected employer record.
Export Button: Clicking the Export button exports all employer-related records
to an .xls file. The file is saved as EmployerExport.xls on the server
under the datafiles/importxml folder, and the same file is downloaded
locally to the user's machine in the default downloads folder.
Note: The Export
button is visible to the Admin login and is enabled once an employer is added.
Import Button: The Import button is used to import
employer records into the Employer Master of PrognoCIS.
Note: The Import button is visible to the
Admin login and is enabled once an employer is added.