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Disclaimer This webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some state laws. This should not be used as legal advice. Itentive recognizes that there is not a “one size fits all” solution for the ideas expressed in this webinar; we invite you to follow up directly with us for more personalized information as it pertains to your specific practice and issues. Thank you, and enjoy the webinar.

Upcoming Webinar

Evaluating Your Practice’s Financial Health

Tuesday April 7th 12:00 EST

Introductions

Cynthia Kincade

Vice President, Consulting Solutions

Sean Harvey

Implementation Consultant

Jeannie Logue

Director, Managing Consultants

NextGen UD2: Sneak Peek

PM Enhancements and Features to be Excited About!

ITENTIVE WEBINAR SERIES

Peek vs. Peak

Agenda

• When
• Why
• What
• Who
• How

UD2

The 5.8 UD2 expected release date is April 22nd 2015!

When?

UD2 offers many enhancements and new features to benefit your billing and front office staff!

Why?

Enhancements to be Expected

What?

PM Enhancements

• Demographics
• Insurance
• Reporting
• Letters
• SIM Groups
• PM Patient Portal

Integration

• Transactions
• Authorizations
• Claims
• Eligibility
• National Drug Codes
• Bad Debt
• Anesthesia Concurrency

Demographics

Patient Demographics

• Added ability to arrange the order of the

Race dropdown for patient demographics in the EHR or in PM

• Added patient notification icons and

default preferences for communication

• Reportable
• Changes are tracked in significant events

and clinical history/notes

Race Selection

(Double Click to Populate Race Box)

Race Reorder

Notification Preferences

Encounter Insurance Selection

• New columns are now available to display patient

insurance information including:

• Policy number
• Insurance card on file
• Detail-2 information
• Benefit information
• Authorizations
• Referrals
• Eligibility (RTS)
• Added the capability to add, remove, and arrange

columns on the insurance selection screen based on user preference

Encounter Insurance Selection

• Right Click Headers to

Add or Remove Columns

• Hover Over Push Pins to

Display Data

Reporting

Reporting Tool

• New columns have been added to the Unapplied

Report

• Guarantor name
• Birth date
• Charge amount
• Insurance 1/2/3 amount
• Patient amount
• Encounter copay
• Line item amount
• Process date
• Associated column filters have been added

Unapplied Report

Report Searching

Text Search Capability added to Reports

• Flashlight icon added to the tool bar to populate

search function

• Searching abilities include:
• Text field
• Find
• Next
• Previous
• Cancel
• Stop
• Match Case

Report Tasking

Enhanced Tasking from reports Enables user to choose how a task will be created and what data will be encapsulated in the task.

• Encounter tasks will send a task at the encounter level with the

encounter-specific detail attached

• Account tasks will send account level tasks with account-specific detail

attached.

• The option for Both is available to create tasks at both levels.

Letters

Consolidated File Maintenance

• Letter Types have been moved under the Letters
• ption in the Master Files as opposed to two separate

locations

• Structure of letter modifications has been made

significantly easier to navigate.

Letter Modifications

• Edit name, description, and header without

using SQL to modify.

• Single click to add or remove header.
• View the creator and last modifier of the letter

highlighted.

Smith, Christina

Smith, Christi…

New Look and Feel

The letter editing window has been enhanced to have a more MS Word-like appeal

• Use the toolbar to edit text,

paragraph formatting, bullets, etc.

• Right-click to populate formatting

window to insert tables, images, and format text frames.

Data Repository

A new data repository has been added to enhance the macro selection and expand the abilities of letter creation

These macros will change based on the letter that is selected

Letter Conversion Utility

Prior to utilizing the new letter functionality, your existing documents will need to be converted. As a result, NextGen has created a conversion utility

• On the local drive, in the NextGen folder, there is a letter update
• utility. (c:\Nextgen\NextGen Letter Update Utility.exe)
• A simple blue window will populate, with which users can convert the

letters

• This takes a few seconds, but will only need to be ran one time. Once

it is complete, simply exit the utility and restart the application

SIM Groups

SIM Groups

SIM Group set-up has been changed to allow the following:

• Allow single- CPT SIM groups to be created with more

than one unit

• Allow multiple entries of the same SIM into one group

PM Patient Portal Integration

Patient Portal Indicator

The Patient Portal icon has been made available in multiple locations:

• Appointment Book (Daily View)
• Add/Edit Appointment Window
• Patient Information Window of the Patient Chart
• Status Bar at the Bottom of the Screen

Patient Lookup and Portal Menu

Enhancements in Patient Lookup

• The Patient Lookup has been changed to add a Patient Portal

column

Patient Portal Menu – PM

• In PM, Patient Portal Menu has been enhanced to include three

different options: enrollment, online forms, and send message

• The rights to this functionality can be added or removed in system

administration

Patient Portal Menu

• Enrollment has been

expanded into a separate menu to handle enrolling, locking, and unlocking patients

• The Online Forms option

has been added to the menu to assist in sending, importing, or revoking forms for the patient

Transactions

Advanced SIM Prices

Prior to UD2 when Advanced SIM was turned on, the user defined boxes would always be present. With the upgrade, these fields will populate only if they are designated with a label and there is a price listed for that label in the SIM library

Charge Discount Feature

• The discount feature allows the user to apply a discount to a charge

prior to the releasing the claim

• A discount adjustment code is created and associated with the

charge in order to account for the amount removed

• A checkbox has been added to the Modify Transaction Code

Information screen in File Maintenance to make the code available for discounts

• Discounts can be applied to the encounter as a whole, or to a

specific line item on the charge posting screen

• Line items can be discounted at different rates
• Discounts can be applied as a percentage of the whole charge, or a

specific dollar amount less than the original charge

• Discounts can be reversed by using the Clear Discount button

provided on the discount screen

Charge Discount Feature

Discount Feature Set Up

Turn the Discount Feature on in File Maintenance -> Practice Preferences.

• Create a discount transaction code to be

used with the Discount Feature

• Check the box that denotes Discount to

make it available for use

• Create blocked users for those that should

not have access to the codes

EHR Crossover

• The charge entry pop up that indicates charges have been

submitted in the EHR has been re-structured to resemble the choices in the holding tank

• Instead of Yes or No, the options have been changed to Process or

Reject, which makes them more descriptive of their actions.

• The buttons in the holding tank have been re-

arranged to reflect this pop up order for consistency

Sub Batch Enhancements

For clients that use the Sub Batch feature, the requirement for number of payments is now an

• ption

Account Receipts

• From the print icon on the transaction screen, an account

receipt option has been added to populate a receipt of payment

• When printing, the number of copies needed and the printer

that will be used for patient receipts can be selected. Users can preview the document and print as needed

Authorizations

Patient Insurance - Encounter

• The Patient Insurance – Encounter window has been enhanced to

allow line item level authorizations/referrals any time prior to submission of the claim

• Prior to UD2, once a charge was entered an authorization could not be

linked to an encounter

• With the upgrade, users can manually link authorizations/referrals to

encounters at either the claim level or line item specific level

Note the change in labels for the authorization/referral numbers, as well as the new boxes for line item specific detail.

File Maintenance

Authorization levels can now be controlled in the Payer Master File in File Maintenance

• In the payer table under system tab Claims-2, there is a dropdown for

Alternate Claim Send Method for Auth/Referrals. Authorizations can be selected at the claim level or the line item level. This dropdown will enable the line item option for the end user

Claims

COB Window

• The COB window has been altered to encompass all adjudications

made on a claim. The data from each payment will carry forward and show the adjudication dates as displayed below

• There are two ways to look at the COB window: COB specific or All

Payers

• This will enable the user to see the claim as whole or dig deeper into
• ne specific payer.
• The single payer screens are completely modifiable.
• Only the ‘Include’ column is modifiable on the All Payers screen

COB Access

• The COB window is accessible through the traditional route
• f opening the transaction detail and selecting the COB

button.

• In addition, by simply right clicking on the transaction

screen, users can populate the COB window. Since there is now one collective COB window, there is no need to go into the specific transaction detail and pull up the ‘last touched’.

Practice Preferences

• Along with the new window, there are new alerts

to be set to ensure the COB has been balanced

• The two new alerts are:
• Warn on COB imbalance with allowed amount
• Warn on COB imbalance with billed amount

Internal Control Numbers

• Internal control numbers are used to keep track of re-submitted or

coordinated benefit claims.

• An enhancement has been made to populate the ICN received from

the payer on all COB claims, resubmitted claims, and paper UB04/CMS 1500 claims.

• The setting to ‘Populate ICN Number’ in FM has been changed to

‘Send ICN on Resubmission’, and will function similarly, without flagging the claims automatically as ‘corrected’.

• This will solve problems with Medicare regarding original vs. corrected

claims issues that clients have come across in the past

• If enabled, the setting will populate the ICN and resubmission codes

that are designated in the Payer Master File. If disabled, the spaces will be available on the header for the claim, but will not automatically populate.

Payer Master Files

File Maintenance

• The Send Medicare ICN on COB Claims setting in the Payer Master

File has been changed to read “Send Prior Payer ICN on COB Claims” and its functionality has been extended to all payers that require this information.

• To ensure that secondary payers receive this information on paper

claims, there has been a change to claim print library under the exceptions tab.

• Box 22 now has an option to populate the Prior Payer Ref #, which will

print the ICN.

Transactions

• The resubmission numbers, prior to UD2, could

be entered on the transaction screen manually if

• necessary. Once the transactions were posted,

however, this number was locked in place.

• With the upgrade, this number can be changed at

any time prior to claim submission from the transactions screen.

CAS Segments

Behavioral Health Billing Library

• A new tab has been created fro the BH Billing Library to help

balance CAS Segments (line adjudication).

• Typically, when a new charge is entered, the claim no longer

balances with the prior payer’s billed amounts. This new tab allows users to create an adjustment reason code for this purpose.

• With this in place, the COB window will automatically balance for

the user.

Encounter Rate Billing Library

• Similar to BH, encounter rate billing has a new feature in its library

to account for the CAS Segment. This setting will also allow the COBs to automatically balance and prevent the need to manually update.

Behavioral Health Library

Reason code used to justify balancing adjudication.

Encounter Rate Billing Library

Reason code used to justify balancing adjudication.

Eligibility

CPT Code Inclusion

This new feature will allow clients to attach one or multiple CPT codes to an eligibility request re retrieve benefit data for specific procedures. Eligibility Inquiry Eligibility Response

National Drug Codes

NDC Input

• The NDC Library and functionality in the application has been

altered to allow the user to change the unit and/or basis measure per patient.

• Ultimately, this means that clients will not have to have more than
• ne entry per NDC code. The code can be entered into the library
• nce, and then altered on the charge posting screen for how many

units are actually given to the patient.

• If the NDC code is attached to the charge in the library, it will

automatically attach to the charge. If the units are not applied in the library, the window will populate automatically for the user to enter to correct information.

Bad Debt

Bad Debt Status

Bad debt has an optional new status that can be set in Practice Preferences that will keep patients that have fallen into that category labeled as such for reporting purposes

• Currently, patient encounters in Bad Debt are moved to a

history status once they are paid. The following checkbox in File Maintenance (Practice Preferences) will stop this from happening Instead of moving to a history status, these patients will remain in a Bad Debt status on the encounter screen

Note: Clicking the above checkbox will not act retroactively on patient accounts. This will only apply to future encounters. Also, once un-checked, any patient with a balance of zero on a Previous Bad Debt encounter will be moved to a history status.

Bad Debt Encounter Status Display

Encounters that are currently closed have a history status as shown below: If the checkbox to is selected, the encounter history status will display as follows:

Bad Debt Notifications

There are also new alerts that can be automatically generated for patients that have previously been placed in bad debt. If previously in Bad Debt, the following alert will appear: In addition to the alert an update will be created to the Bad Debt Encounter Note. A separate line item will be added as follows

Anesthesia Concurrency

Contract Libraries

• Prior to UD2, anesthetics could not be billed

through a contract due to the nature of anesthesia concurrency billing

• The Anesthesia Libraries have been updated

to include a contract option. This can be done in two ways:

• Overall anesthetics can have a unit price and

adjustment in place by payer

• Anesthetic unit prices and adjustments can be

made by particular SIMs for the same payer

Contract Libraries

Contractual adjustment taken for the entire anesthesia library Contractual adjustment taken for just the 00100- 00999 SIM code range

Anesthesia Process Dates

Process dates for anesthesia billing can be changed upon moving the claim from an In Progress status to an Unbilled

• status. This would occur after the anesthesia audit is run and

the window populates to allow the user to release the encounters for billing.

The process date will automatically be the system date that the charge is entered (unless manually overwritten or altered in File Maintenance). This box allows the user to change the process date from the date the charge was entered, to the date it is actually processed.

Anesthesia Gantt Charts

Ability to print the Gantt Charts has been added to the reporting tool so that the chart can be attached to any audit generated.

• The printer icon populates a window

where the user can select to print the report itself, or the report with the Gantt chart as well

• The Gantt Chart Report can either be

printed for all encounters, as shown,

• r errors only

Who Does UD2 Affect?

Who?

ALL PM USERS

• Set Up Team – File

Maintenance, System Practice Templates, etc. will need to be configured

• Billing and Office Staff -

need to determine and understand the changes that will impact their workflow

• Management- Training of

the new features and enhancements will be necessary for practice management users

With A Plan

How?

Basic Steps to Upgrade

• Validate Features
• Develop Project Plan
• Determine Requirements
• Test Upgrade
• Set Up
• Test…test….test….
• Train…train…train…
• Go Live

And we can help….

Itentive can help by providing an EHR Workflow assessment with an onsite consultation. We can review your processes along with providing assessments of your EHR workflow, EHR challenges and assist with an upgrade plan. We are currently offering a 3 day onsite assessment that includes:

• Workflow Analysis
• Planning
• Written Report of Findings and Recommendations
• All Travel Expenses

If You Feel Uncertain about Next Steps

Questions

• Cynthia Kincade
• Vice President, Client Solutions
• ckincade@Itentive.com
• 224-220-5575
• Keith Justus
• Director, Business Development
• kjustus@itentive.com
• 224-220-5551

Upcoming Webinar

Evaluating Your Practice’s Financial Health

Tuesday April 7th 12:00 EST

Thank you