Add button:
Click on this button to add and save a new Employer in the Clinic's database.
Search button:
Click on this button to search an existing Employer's record from the Master.
Employer Details
Employer Name: The Employer name is a mandatory field. Employer's address can be saved by clicking the ‘Address’ button next to this field. Employer Name is provided with alphanumeric field supporting 50 charactersAddress... button: Clicking this button user can add Address of the Employer. When Employer Portal is turned 'ON' and Email address is entered in email field and FTIN is present on Employer Master then on saving, Employer Portal credentials are created.
Nature of Business: This field defines the type of business the employer has, like Software/ Manufacturing/ Government, etc.This field supports 255 characters.
DOT Agency: This field allows the association of DOT Agencies to the Employer. Click on 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 on 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 on the Search icon to invoke the Organization Search List and select Organization Employer that is already stored in PrognoCIS. Click on the Associated to Organization icon to invoke the Add Organization Employer popup to add a record for a new Organization Employer in PrognoCIS. User can enter details with respect to the Employer added as an Organization Employer, in the provided fields. Selected Organization Employer is then displayed in the Associated to Organization field. To edit existing details on the popup, user can click the hyperlinked Associated to Organization label which invokes the Add Organization Employer popup with existing details. Click on 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 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 on the All Locations icon to invoke 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. User can select multiple and 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.
External ID: This is the ID of the external application from where this employer is imported. If the employer is created from PrognoCIS then external ID can remain blank. This field supports 20 characters.
FTIN: Enter the FTIN i.e. Federal Tax ID Number in this field. FTIN field accepts 9 digits.
Departments button: Clicking on the Department button displays Department's pop up, which allows to adding multiple departments for an Employer. This button is only visible when Employer Portal is turned 'ON' and property patient.show.employer.dept is turned 'ON'.
Users button: Clicking on the User button displays User’s pop up, allows adding multiple users for logging into Employer Portal. This button is only visible when Employer Portal is turned 'ON.
Protocols button: Clicking on this button displays Protocol pop up which allows adding multiple Protocols for the respective Employer. This button is only visible when the property, use.employer.protocol is turned 'ON'.
Jobs button: Clicking on this button displays Jobs For Employer <Name> popup which allows adding Job details.
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.
Insurance Details
Insurance: User can select a valid insurance company by either typing the first few characters of the company name or by searching it from 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: User can specify the effective date range from and upto which the selected Insurance is applicable. Dates can either be entered or be selected through the 'Calendar'
icon. Effective Upto date must be greater than Effective From date.
Employer Insurance History: Clicking on 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', 'Effective From and Upto'.Employer Notes: Notes field supports 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 or exported from Employer Master.
Encounter Details
Supported ENC Types: By default, this field displays a keyword as all encounter types supported. A multi – select icon and a clear hyperlink is provided in next to this field. Clicking on the multi – select icon, Supported ENC Type popup gets invoked displaying a list of Encounter Types and their corresponding Names. Clicking on the clear hyperlink, the selected the Encounter types is deselected.Employer Billing Info
Billing & Invoicing Info. button: Clicking on this button invokes the Employer Account popup. On this popup 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 Claims Charges and Employer Writeoff. Employer Account can be configured based on property billing.emp.account.sections.Split Claims
Emp Bill button: Clicking on this button, user can split Claim TPA, Worker Comp Insurance and Patient wherein certain CPT codes are defined for TPA, Insurance, Patient, default (Employer Claim) and then the Claim gets auto split into four claims.
Work Comp button: Clicking on Work Comp button, user can split Employer Claim for Worker Comp Encounter Type and the Claim gets autosplit.
Invoice Parameters
Invoice By Enc Type: When the checkbox is checked then the invoices are generated as per the Encounter Type.Invoice By Department: When this checkbox is checked, department wise invoices will be generated of the Patient on Claims screen.
Invoice By Job No: When the checkbox is checked then invoice are generated as per 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 message popup 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 on this popup, this checkbox becomes checked, and all the other options become unchecked and disabled. If No is clicked, then 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 message popup 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 on this popup, this checkbox becomes checked, and all the other options become unchecked and disabled. If No is clicked, then no changes are made and this checkbox remains unchecked and enabled.
To generate a location-wise Employer Invoice, check 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 6-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 is provided to users with 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 have a distinct group with Claim wise subtotals.
- 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 the numeric order (45378 will be placed above 99214 regardless of the volume or $ amount for charge codes).
- Each Charge Code have a distinct group with Charge Code wise subtotals.
- Second sort is by Patient Name.
- No patient level subotals are presented.
- 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 the ascending order.
- Each DOS would have a distinct block.
- Day totals will get printed at end of each block.
- Invoices will be grouped by Date of Service and then by Patients. For e.g. if Patient A was treated on following DOS 1/01/2017, 02/01/2017 and Patient B was treated on followign DOS 01/15/2017; The invoice would list 3 separate blocks for individual service dates with Patient A would get listed first, Patient B second and Third block would be 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 the ascending order.
- Each DOS would have a distinct block.
- Day totals will get printed at end of each block.
- Invoice total is printed at the end.
- Invoices will be grouped by Charge Codes.
- Subtotals are printed for Each Procedure Block.
Schedule Invoice Cycle: Schedule Invoice cycle drop down has three values Monthly, Weekly and Daily. This describes how the employer would prefer to receive the invoices.
Payment Days: Payment days field indicates the Normal Processing Period to process invoices as decided between the Practice and the Employer.For e.g: If Medical Practices LLC has a contract with Employer “Axion” which mandates Axion to process invoices in 20 days from the invoice date, Practice would add the number 20 in the field “Invoice Payment Days”. When Invoices are printed the Due date on before the payment is expected from the Employer is added on Employer invoices using the tag [BLH_EMPLOYER_DUEDATE]. So if the invoices are generated on 01/01/2017 and Invoice Payment date is set as 20, [BLH_EMPLOYER_DUEDATE] would print 01/21/2017 as due date for the Invoice.
Purchase Order No: Enter the purchase order no in this field.The character limit supported in this field is 20.New tag BLH_EMPLOYER_PO has been added to display PO number on Employer Invoice.FTUX mesage has been added. The message displayed is 'User now can add Purchase Order number to be printed on Employer Invoice. A tag BLH_EMPLOYER_PO could be added on Employer Invoice template to populate Purchase Order details' to the user.
Employer Invoice Template: The template for invoice can be selected from the binocular icon present next to the field. This Template will be considered when 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 are required to be filled out 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 is required to be filled out 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 while sending the Employer Invoice via fax. If this property is left blank, then no coversheet is faxed to the recipient when Employer Invoices are sent to recipients via fax.
Invoice Email: Generated invoices are sent to the email ID entered in this field when the Email checkbox is selected in the Send Invoice By field. This email ID is also imported when an Employer record is imported into PrognoCIS via 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. Alphabets and special characters are not accepted in this field.
Note:
The fax number entered in the this field must not be the same as that entered in the Fax field on the Address for <Employer> popup invoked via the Address button.
Employer Fee Schedule
Fee Schedule Type: Appropriate Fee Schedule can be defined for Employer Claims from the dropdown. Multiple Fee Schedules can also be defined and associated to each Employer seperately. On adding a new Employer, the Fee Schedule saved in the property, employer.fee.schedule.type is seen to be selected by default in the Fee Schedule Type dropdown. If a Fee Schedule which 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 set to 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 to which the Employer was associated for the first time is displayed.Note: Employer Billing
supports only Billable Fee Schedule.
Employer Fee Schedule icon: This icon is available only on the Billing side of Employer Master screen. Click on 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 to them.
Percentage: Enter the % of the amount for which the user would like to bill to that particular employer. The charge codes will get calculated based on the Percentage of fee schedule defined on Employer Master. Default Percentage value is 100.
Active: By default the checkbox remains checked, so that the employer added remains active. On unchecking this checkbox, the employer becomes inactive.
Print Profile button: Click on this button to invoke the Employer Profile popup and view and print 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 on this button user can save the Employer
's details in Employer
Master.
delete button: Clicking on this button deletes the added Employer's details. Once Employer is associated with Patient, user cannot delete an Employer.
reset button: Clicking this button resets all the fields in the screen. Clicking this button resets all the fields in the screen.
history button: Clicking this button invokes Employer History popup to check the last modified details of the Logged in user for the selected Employer record.
export button: When ‘export’ button is clicked, it exports all Employer related records
to .xls. The file format of the file is as EmployerExport.xls on server
under datafiles/importxml folder and the same file is shown downloaded
locally on user machine in default downloads folder.
Note: Button
'export' is visible to Admin login and is enabled when Employer is added.
import button: Import button is used to import
Employers record in Employer Master of PrognoCIS.
Note: Button 'import' is visible to
Admin login and is enabled when Employer is added.