GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Scheduling Module Centricity Services

Transcription

1 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Scheduling Module Centricity Services 1

2 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, Imagination at work, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

3 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

4 Table of Contents: Scheduling Workflow... 5 Select Schedule View... 7 Scheduling an Appointment... 8 New Appointment Window...10 Appointment Search...11 Confirm an Appointment...12 Update Patient Registration...13 Printing Patient Profiles...14 Printing Superbills...14 Appointment Check-In...15 Cancel an Appointment...16 Rescheduling an Appointment Using the Clipboard...17 Appointment Sets...18 Appointment Chains...19 Attaching a Recall to an Appointment...20 Case Management...21 Verify Eligibility-Manual and Electronic...23 Using the Waiting List...25 Posting a Co-Pay

5 Scheduling Workflow Possible Worfklow(s) Action Item(s) Confirm Appointment? List View Update Registration Information? Rt Click/Modify Patient Information Printing Profile(s)? File/Profiles for Active Schedule Schedule Appointment Printing Superbill(s)? Check In? File/Superbills for Active Schedule Rt Click/Check In New Patient? Enter Demographic Info in Mini- Registration Cancel Appointment? Reschedule Appointment? Rt Click/Cancel Appt/Reason Click & Drag/Appointment Clipboard Appt Sets? Modify Appointment/Add Set Create/Attach Case? Modify Appointment/Case/New Verify Eligibility? Edit/Verify Insurance Eligibility for Schedule Waiting List? Rt Click/Add Patient Posting Copay? Billing Module/Open Visit/Trans Tab/Pt Pymt 5

6 The Scheduling module maintains schedules for all resources (Doctors, Labs, Nurses, Procedure Rooms, etc.). The Scheduling module of Centricity Practice Solution 10 (CPS) software may be accessed from the Main Menu screen by clicking on the Scheduling button. This window is also accessible by clicking on the Scheduling icon at the top of the Main Menu screen. Likewise, using the tool bar, the Scheduling module can be accessed by clicking on File, Open and Scheduling. 6

7 Select Schedule View When accessing the Scheduling module, selecting a predefined View to display is considered best practice, instead of selecting Facility and Resource each time. Considerations: When creating Schedule views, it is recommended that a Scheduling Manager create views that will be accessed by other users. Allowing users to create and save views can create duplicate and unnecessary views which will become confusing to the users. Each user can have a preference of which Schedule View will display when opening the Scheduling module or the Chart Desktop via Options menu and Preferences. 7

8 Scheduling an Appointment Scenario: Scheduling an appointment for a new or established patient. Typical Staff Responsible for this Process: Scheduling Staff Billing Staff Clinical Staff While there are four different methods to schedule an appointment from the Scheduling component, best practice is to Right Click on an available appointment time slot and select New Patient Appointment. 8

9 When scheduling an appointment, the Select Patient window opens requiring a patient selection. If the patient is new to the practice, a new registration can be completed and the appointment booked for the patient, without exiting the Scheduling module. This is referred to as the Mini Registration and is accessed by selecting the New button. If the patient is an existing patient in your database, simply search for and select the existing patient to continue booking the appointment. Considerations: When entering demographic information for the patient, remember that NO PUNCTUATION is allowed in the fields as this could potentially cause claim rejections. Required fields that are setup in Administration are honored here in the Mini Registration as well as the main Registration module. When considering Required Fields setup, remember that not all information can be easily obtained over the telephone. For this reason, it is recommended that minimal information needed be obtained during this Mini Reigstration process, i.e. Name, Phone Number, Financial Class. This will also save time for the user and decrease the amount of errors when registering your patients. Be cautious not to accidentally select the Enter Key until completely finished with the Mini-Registration. Doing so prematurely will cause the window to save itself, disappear, unable to be retrieved again. If this happens, you will need to access the main Registration module to complete the registration pieces. DO NOT manually enter any information in the Patient ID. The software will autogenerate this when the Mini-Registration is saved. Once the Mini Registration information is saved, the New Appointment window opens to continue booking the appointment. 9

10 New Appointment Window Whether booking a newly registered patient, or an existing patient, the new appointment dialog box remains the same. The New Appointment window has multiple fields that can be used. In a typical appointment, however, the Type of Appointment and Appointment notes are the most commonly used fields. The Appointment note is generally used to indicate the patient s chief complaint, and lives on this appointment only. The Patient Appointment note is used to alert the Scheduler that the patient has special considerations. For example, the patient is in a wheelchair, therefore requiring extra time for the appointment. This Patient Appointment note is displayed on every appointment, as well as in the patient s Registration/Appointments Tab. 10

11 Appointment Search Utilizing the Appointment Search feature is a quick way to find available appointments for Resource(s). Scenario: A patient appointment needs to be scheduled and you are unable to quickly locate an available time slot by viewing each daily schedule. Or, you have multiple appointments on the same day that you need to schedule for the patient and appropriately coordinate time between them. Appointment Search will quickly review the appointment combinations and display all available time slots that meet the criteria you define. From there, you are able to select which appointment(s) best meets the needs of the patient. Typical Staff Responsible for this Process: Scheduling Staff Billing Staff Clinical Staff Considerations: Appointment Search can only be as effective as the Schedule Templates allow. For example, if you would like to search for New Patient time slots, your Schedule template should contain time slots that are specifically allocated to New Patient appointment types. Otherwise, the system can only search ANY available, or unallocated time slot. Appointment search allows searching for multiple resources and multiple appointment types on any given day. For example, a New Patient appointment with Dr + Lab Work appointment + Nurse Visit etc... Using Delay and Rules can help streamline the search process even further. Appointment Search default criteria can be setup as a Preference to eliminate filling these out for each appointment search. Appointment Search criteria can be saved for commonly used appointment searches (i.e. New Patient appointment slots). Appointment search criteria can work in conjunction with appointment chains to find a series of recurring appointments over time. 11

12 Confirm an Appointment Confirming an appointment can be performed from the Daily View or List View of the Scheduling module. Whether confirming from the Daily View or List View, simply Right Click on the desired patient, Modify Appointment Status and select the desired appointment status. Considerations: Using the List View of the Schedule to confirm appointments is considered best practice as the patient s contact information is readily displayed from this view Appointment statuses are created in Administration and are customized to your practice specific needs. Best practice is to use the stoplight approach, whereas Red is an alert that the appointment has not been confirmed, Yellow is a caution that may or may not be confirmed, and Green is Confirmed. Appointment statuses are also utilized if the practice is using a third party vendor for appointment confirmations. 12

13 Update Patient Registration When a patient arrives for their appointment, updating their registration information is a typical workflow for any practice. This can be accomplished by modify the patient s registration information from the Scheduling module. For more information on this workflow, please reference the Registration section of the Companion Guides. 13

14 Printing Patient Profiles Another method to updating patient registration information is to print out patient profiles and have the patient enter their information on that sheet, which will be used later to update the demographic information. Printing profiles can be performed for a single patient by Right Clicking on the patient and selecting Profile/Print or All patients on a current schedule by using the File Menu, Profiles for Active Schedule/Print. Single Patient All Patients for current schedule view OR Considerations: Printing profiles for all patients on a schedule may not be feasible in a larger practice. In this case, printing individual profiles for only New Patients may be a better option. Printing Superbills Printing superbills from the schedule can also be performed for a single patient by Right Clicking on the patient and selecting Superbill/Print or All patients on a current schedule by using the File Menu, Superbills for Active Schedule/Print. Single Patient All Patients for current schedule view OR 14

15 Considerations: Printing all the superbills on the morning of the scheduled appointment will help streamline the workflow activities for the appointment date. However, in practices with a large volume of No- Show patients, printing individual superbills as the patient arrives may be a better option. Once a Superbill is printed or previewed, a ticket number is generated and associated with the visit in the Billing module. Appointment Check-In To check-in a patient, right click and select Check-In. When selecting Check In, the appointment box becomes royal blue with a smaller color bar to the left of the appointment. Considerations: The Check In feature helps to visually assess the schedule at the end of the day to make sure any No-Shows or Cancels have been accounted for. The colors assigned to the appointment status can also help make a quick assessment by viewing the schedule. However, the royal blue color of the Check In status cannot be changed. Regardless of your front desk or check in workflow, the act of selecting Check In should always be the absolutely last action of the workflow. For example, if you post a patient co-pay AFTER selecting Check In, the appointment will automatically change to Checked Out based on the Administration settings for appointment status. 15

16 Cancel an Appointment Cancelling an appointment will help eliminate missing superbills (ticket numbers). When cancelling an appointment, always be sure to select the appropriate reason for the cancellation. An option to attach a note to the Chart for this cancelled appointment is also available, if desired. Considerations: Cancelling an appointment removes the visit from the Billing component as well. A record of the cancellation will remain in the patient s registration, Appointments tab, as long as Delete Appointment is selected as No in Administration. (Please see the Help Guide for additional options). If utilizing the EMR module of CPS10, you will have the additional option of having the cancellation reason appear as an unsigned document in the patient s chart. If this workflow is followed, the appointment resource (doctor) will need to sign the document on their chart desktop. 16

17 Rescheduling an Appointment Using the Clipboard To reschedule an appointment on the same day, simply click, hold and drag the appointment to the new slot then release. The Modify Appointment window will appear to confirm the time change desired. To reschedule an appointment to another day, we will use the Appointment Clipboard: Click on the desired patient, hold and drag the appointment to the Appointment Clipboard, and drop it there. Go to the new appointment time on the schedule date desired and click, drag and drop the patient from the Appointment Clipboard into the new appointment slot. Click OK in the Modify Appointment window to save the new appointment time. Considerations: If your practice has an interface with a stand-alone EMR product, best practice is to cancel the appointment and rebook, rather than using the click and drag method to ensure that the EMR reflects accurate appointments. 17

18 Appointment Sets Scenario: The patient needs to see the doctor, and the Lab Technician for a blood draw. Or, the patient is having a consultation with the orthopedist and then seeing the physical therapist on the same day. There must be at least two appointments on the schedule before they can be linked together. Using appointment sets allows the ability to create only one ticket number (one visit) for the billable resource on that day. Typical Staff Responsible for this Process: Scheduling Staff Billing Staff Clinical Staff Appointment Sets allow linking multiple appointments for the same patient on the same day. This is used for visits that have multiple parts. To create an Appointment Set, schedule the first appointment. Next, schedule the second appointment and link it to the original by double clicking in the Set field of the New Appointment window. Appointments available to link to a set are displayed. Highlight the appointment desired to link these appointments together. Click OK to save the information. Considerations: When using Appointment Sets, always schedule the Responsible Provider s appointment first. This will be the visit that is created first in Billing. When creating Appointment Sets, the Company, Facility, Responsible Provider and Appointment Date MUST be the same for each appointment to ensure that only one visit is created in Billing. If any one of the above four items do not match, the appointment set will still work, however, there will be multiple visits in Billing. In addition to the one visit benefit of using Appointment Sets, you also have the additional benefit of cancelling all of the appointments associated with the Appointment Set at one time. 18

19 Appointment Chains Appointment Chains (sometimes also referred to as recurring appointments) are useful for booking multiple appointments at once for the same patient but on different dates. Scenario: We can use Appointment Chains to book several allergy appointments for the patient using the Appointment Chain feature. Typical Staff Responsible for this Process: Scheduling Staff Billing Staff Clinical Staff Considerations: If you do not need to use the Appointment Search feature to find available appointments, you simply book the first appointment and double click in the Chain field and name this chain. From this point, you will continue adding additional appointments to this chain by repeating this step. If you do not know which future time slots are available, you can use the Appointment Search feature to both schedule and chain those appointments. Unlike Appointment Sets, Appointment Chains have no impact to the Billing module. A separate visit will be created for each booked appointment. When cancelling an appointment that belongs to an Appointment Chain, you have the option to cancel ALL appointments within the chain, or several appointments within the chain. 19

20 Attaching a Recall to an Appointment Scenario: The patient has called to schedule an appointment and while booking the appointment, you notice that the Recall field binoculars are flashing. We will attach a previously created Recall to this current appointment, assuming that this current appointment will resolve this particular Recall. Patient is unable to schedule a future appointment at checkout Patient appointment Recall is created in Registration Patient contacted via mail/phone/ and future appointment is then scheduled During this appointment scheduling, the Recall is attached and Recall is resolved Considerations: The above workflow is appropriate when the Scheduler is actively pursuing patients to schedule the needed Recall appointments, or even when the patient simply calls in themselves to book the Recall appointment. For more information on workflow associated with creating new Recalls, please see the Companion Guide for the Registration module. 20

21 Case Management Scenario: The patient you are scheduling an appointment for has cases built in Case Management. These cases may be related to Worker s Comp and/or Insurance authorizations. You will need to associate the case with the scheduled appointment to ensure that the appropriate Billing workflow is followed. Schedule Appointment/New Case Needed Schedule Appointment/Existing Case Pt Needs Initial Worker s Comp Appointment Pt Needs Worker s Comp Appointment Scheduler Books Appointment pending Worker s Comp Information Scheduler Books Appointment and associates Worker s Comp Case w/appointment Worker s Comp Referral Coordinator obtains patient s information and Builds the Case in Case Management from Registration module Worker s Comp Referral Coordinator returns to Scheduling module and associates new case with the appointment Creating/Attaching cases can be done from the Scheduling module by accessing the Case area in the appointment box. If the patient has existing cases, the binoculars next to the case field will be flashing. Simply review the cases to determine if this visit should be associated with one of the open cases for the patient. (Please review the CBT s or the product Help Guide for further instructions on creating cases). Case Management deals with appointments that need to be associated with: Worker s Compensation claims Insurance Authorizations/Referrals (incoming) Auto Accident, No Fault claims, Third Party Liability claims 21

22 When a case was previously created, the current appointment box will display flashing binoculars to indicate that a current case is open for this patient. When selecting the flashing binoculars, a new window appears displaying all open cases for the patient. Simply select the appropriate case for this appointment. Considerations: Best practice is determined by your workflow. In some practices, cases can be created and attached from the Scheduling module, however, in other practices, staff members other than scheduling personnel are responsible for obtaining the necessary information. For this reason, case creation is most often performed from the Registration module. After the case is created, then it can be associated with the appointment in Scheduling. The Case note field is populated when creating a case. This field can contain valuable information for the Scheduler when booking the appointment. 22

23 Verify Eligibility-Manual and Electronic Eligibility information links to the Details field stored in the Registration module for each insurance record entered, and contains insurance policy information. Access via the Edit menu is a shortcut that prevents having to move to the Patient Registration record to perform this function. You can also Right Click on a single patient s appointment for this same functionality. Verifying eligibility can be performed on a single patient by selecting Verify Insurance Eligibility, or for all patients on a selected schedule by selecting Verify Insurance Eligibility for Schedule. When verifying eligibility for a single patient, manual verification can be tracked by entering the information in the appropriate fields. If verifying a single patient electronically, select the Verify Eligibility button. 23

24 Manual Electronic Considerations: If an eligibility plug-in is being used to verify eligibility electronically, best practice is to perform this task around 2 days prior to the scheduled appointment in case further followup with the patient is needed. Verifying eligibility electronically is best when performed for the entire day s schedule. Use the List View of the scheduling module to view the results of the eligibility verification. Deductible information that is obtained electronically or manually is read-only, helpful information. This does not apply to any formulas or calculations performed in the software (i.e., Allocation Sets, Transfers, etc.). Utilizing the effective and termination dates are helpful and appear as a message in a variety of locations. However, these dates DO NOT activate or inactive a carrier on the patient s registration. Activation or Inactivation of a carrier is triggered by the checkmark beside the carrier on the patient s Registration. 24

25 Using the Waiting List The Waiting List can be used for a variety of reasons. In addition, multiple waiting lists can be created for multiple resources, facilities or workflow needs as desired. Scenario: Don Bassett is booking an appointment with Dr. Winston in December. While booking the appointment, he asks to be placed on Dr. Winston s Waiting List in case an earlier appointment slot opens if another patient cancels. While booking the appointment, double click on the Waiting List binoculars to select and attach Don s appointment to Dr. Winston s waiting list. 25

26 Scenario: Now that Don s appointment is on the waiting list, the next cancellation for Dr. Winston will allow the user to click and drag Don from the waiting list to the earlier appointment slot. Considerations: The Waiting Lists must be maintained manually. Patients will not automatically fall off the waiting list when the appointment date has been passed. Likewise, you will not receive a system warning or alert that an appointment slot suddenly becomes available to use for your Waiting List patients. Waiting Lists are database-specific, meaning that anyone who has access to this CPS database and has access to the Scheduling module, will see all Waiting Lists that have been created. When a future appointment is attached to a waiting list, clicking and dragging the patient from the waiting list to the schedule will remove them from the waiting list. Waiting Lists can be triaged by importance of appointment. Waiting List can also be used for No Show management When patients no show, they can be placed on the No Show waiting list and at end of day, users may contact them and reschedule, especially for those critical followup patients, i.e. Oncology. 26

27 Posting a Co-Pay Collecting and posting a patient s co-pay is sometimes the responsibility of the Front Desk staff. In this case, access to the Billing module is required to actually enter the co-pay on the patient s visit. From the Billing module, search for and open the patients visits for the current day. Considerations: Best practice is to open a billing spreadsheet for all patients for the current day. (As a default, CPS populates today s date in the From and To Dates, so simply selecting OK will open today s appointments (visits). If you are posting co-pays for only one Facility, you may also select the Facility in the criteria to decrease the number of visits that display. This workflow could also be utilized if you are only posting co-pays for a specific Provider or Company. 27

28 From the Billing spreadsheet, double click on the desired patient to open the visit. Once inside the visit, move to the Trans tab to post the co-pay and select the Patient Pmt button. Enter the patient s co-pay amount in the Amount field and select OK. Once a payment is posted to a visit with no charges, the amount posted will remain as a Deposit until such time that charges are entered and this Deposit is applied to the patient s responsibility. Considerations: In order to post payments to the visits, the user must have access to create batches as well. Please reference the Billing Companion Guide for creating batches. If charges are entered and the patient does not have a responsibility, the co-pay will remain on the visit as a Deposit and will need to be conveyed manually to another visit or refunded to the patient. Deposit amounts are included in some reports and not others. For this reason, it is recommended that you consider the pros and cons of having the co-pays posted to the visits as deposits. Ensure that staff have a proper workflow for error correction. Not engaging in the proper correction workflow could result in unapplied funds. Staff who only post copays may not have the necessary knowledge for the Payment Entry module, therefore the ability to correct mistakes is limited. These users may need the support and guidance of Billing or Payment Entry staff for error corrections. 28

29 Notes: 29

30 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Registration Module Centricity Services 1

31 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, Imagination at work, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

32 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

33 Table of Contents: Registration Workflow... 5 Patient Tab... 6 Guarantor Tab... 8 Additional Tab... 9 Insurance Tab...10 Contacts Tab...11 Appointments Tab...12 Financial Tab...13 Payment Plan Tab...14 Historical Data Tab...15 File Menu...16 Edit Menu...17 Recall Case Management Workers Compensation Referral View Menu...20 Options Menu...20 Help Menu

34 Registration Workflow Patient Guarantor Additional Insurance Contacts Appts Financial Enter Required Fields Search/ Enter Required Data Enter Ins Info Update Review Bill Code/ Review Payment Plan Historical Data Registry Create/ Review Review Contact Inside Sales for Interface Options File Menu Edit Menu View Menu Options Menu Help Menu Statement Profile Reports Recall Eligibility Case Mngt Global Period Activity Log Toolbars Preferences Workstn Settings Help Guide 5

35 Patient Tab The Registration component stores demographic, insurance, financial, and appointment details for each patient. The first tab of a patient s registration is the Patient Tab. Scenario: Each time the patient checks into the clinic, whether new or existing, there is an opportunity to review the necessary data fields within Registration to confirm data and ensure its accuracy. Typical Staff Responsible: All staff. From the Patient tab, you will need to enter the required information as determined by your practice s Required Fields settings in Administration as well as any additional workflow needs. 6

36 Considerations: Complete the patient demographics in upper and lower case text for maximum consistency. Employer information is particularly important for workers compensation situations. Note that required fields are marked with an asterisk (*), and must be completed. Users will not be able to save the record until all required fields are completed. Do not use punctuation or special characters in any field! A patient may be entered as their own Guarantor, or will need to be marked with a Guarantor as applicable. Complete the Guarantor Tab when there is a guarantor other than the patient. Statements are generated per Guarantor so it is important not to duplicate Guarantor entries. Users can utilize a Primary and Alternate address for the Patient and Guarantor. This is great for patients with semi-annual residences or practices that are located in resort areas. Avoid using the Title field. Suffix fields should only be used for parts of a legal name, for example Jr, Sr or the III. It is best practice NOT to manually manipulate the Patient ID field and allow the system to automatically assign this ID number. The data field is a read-only data field that has no action within the product. However, if you are using Kryptiq s Secure Messaging, this field will be utilized for that third party product. Changing the patient s status to deceased will open the date of death field and cancel all future appointments. This will automatically create a pop-up alert that will notify the user that the patient is deceased. MRN (Medical Record Number) data field is NOT an auto-generated ID number by the software. This data field is self-designed for customized workflows within the practice (i.e. capturing the hospital ID number, Lab ID number, etc.) You can, however, search for this number via the Patient Search dialog window. Suffix fields should only be used for parts of a legal name, for example Jr, Sr, the III. 7

37 Guarantor Tab Considerations: Before entering data into the fields, first search the database for the Guarantor by clicking on the Select Guarantor button. Patient s Relationship to Guarantor is important to enter, especially if the Insurance policy is owned by the Guarantor. 8

38 Additional Tab Considerations: Source/Signature on File, Release Patient Information & Privacy Policy are REQUIRED fields for ALL patients. Patient Alert Notes can be helpful pop-up warnings, but only if not overused. These notes will appear on the patient s Chart, but will not pop-up. 9

39 Insurance Tab Considerations: When Medicare is a secondary carrier, the Medicare Secondary drop down box MUST be populated with the appropriate selection. Failure to select this will result in Approve Failed visits. Do Not use any punctuation or special characters when completing the information on this tab. When the Insurance policy is owned by someone other than the Patient or Guarantor, (Other), the Patient Relationship to Insured is a required field! A patient can have only one Allocation Set and one Financial Class, regardless of the number of insurance carriers they have. Even though Financial Class can be defaulted based on the Insurance Carrier selection as primary, remember that Financial Class is a PATIENT related data field, NOT an Insurance related data field. When thinking of Financial Class, remember that it is a Financial grouping of your patient population. Furthermore, if you are using Financial Class based reporting, your front desk or registration workflow must ensure that this data element is correct. Allocation Set selection should depend on the patient s responsibility when all insurance carriers are considered. The checkboxes next to the Insurance Carriers are used to Activate or Inactivate an Insurance Carrier. In Registration, this is the ONLY area where this can be accomplished. The Remove button is used only to remove a carrier when it was selected in error. Attempting to Remove a carrier when there are historical transactions attached will result in a warning message. For Insurance Eligibility workflows, please see the Scheduling Companion Guide. 10

40 Contacts Tab Considerations: Provider (Doctor), Referring Provider, and Primary Care Provider are automatically added to the patient s Contacts tab when populated on the Patient Tab. Pharmacy will automatically be added when the first prescription is documented within the Chart module. Since Contacts are part of a table, it is helpful to search the desired table before entering new data. Searching first will avoid entering duplicate data in these tables. When entering Personal Contacts, there is a workflow opportunity to enter an assortment of information such as Emergency Contacts, Daycare Centers, Schools, Individuals who have or do not have HIPAA authorization to discuss the patient s account, etc. 11

41 Appointments Tab Considerations: Patient Appointment Notes will display in all appointments scheduled for the patient. It is useful to put special needs of the patient here, such as Needs Wheelchair. These notes do not print, but display on the New Appointment window and can be entered or revised on the ModifyAppointment window in the Scheduling module as well. A right click on one of the appointments in the Appointment History box will allow some of the features found in the Scheduling module, if needed. The Recall box is a read-only area to display any Recalls that have been created for the patient. A good best practice is to rearrange the columns in the Appointment History box and move Status toward the left so that it is easily viewed. 12

42 Financial Tab Considerations: Billing Notes is an internal field that is displayed in the Billing Note field of all patient visits, as well as Payment Entry, however they do not print anywhere. As an example, entering a note to describe a patient s odd insurance requirements that should be followed for every date of service would be beneficial. Bill Code determines whether the Guarantor receives a statement or not, and whether the patient has a payment plan. By default, if nothing is selected here, the Guarantor will receive a statement if there is a patient balance on a visit. 13

43 Payment Plan Tab Considerations: Only one Payment Plan can be active for a guarantor at one time. Payment Plans are only adequate for tracking an account, not specified visits. Statement Activity is based on the Guarantor, and will be logged here every time, even if there is no payment plan for the guarantor. When the Criteria column is blank, this indicates an on-demand statement. If a Payment Plan is active and the patient accrues an additional balance, the OLD Payment Plan must be inactivated and a NEW Payment Plan must be created in order to include this new balance. 14

44 Historical Data Tab Considerations: Patient historical information shows in bold and italicized font. If there are multiple instances where changes were made to patient demographics, then multiple lines will display in the grid. Changes made through an interface will also show on the grid. Populating a blank patient field is not considered a historical change. For example, if address line 2 is blank and you add Apartment B, there will be no historical information available. However, when changing a previously populated address line 2 to Suite B or deleting the information in address 2, the historical information will be available. 15

45 File Menu From the Registration component the File menu allows access to patient Statements, Profiles and Reports. Considerations: If generating statements from the File menu, the user is still prompted to update the last statement date with today s date. 16

46 Edit Menu The Edit menu allows setting a Default batch, but from the Registration module also allows access to Attachments, Recalls, Verify Eligibility, Case Management and to view Global Periods applicable to the patient. Recall Scenario: During checkout, the patient needs to schedule a followup appointment. However, you and/or the patient are unprepared to schedule this appointment at this time. You choose to create a Recall to place the patient in the Recall workflow that is managed by your practice. Creating the Recall is best managed by accessing the patient s registration and Edit menu. Patient is unable to schedule a future appointment at checkout Patient appointment Recall is created in Registration Patient contacted via mail/phone/ and future appointment is then scheduled During this appointment scheduling, the Recall is attached and Recall is resolved Considerations: Recalls are easily created for the patient from this menu. If a patient needs to schedule a future appointment, a Recall can be created to remind the patient, via , letter or phone call that an appointment needs to be scheduled. Best practice is to create the Recall from here which will cause the Recall binoculars to flash in the Schedule/New Appointment screen, alerting the Scheduler that there is an active Recall. Recall workflows are not an automated process within the product. You must design a manual workflow that will handle the recall appointments appropriately, for example Monthly reports. 17

47 Case Management Workers Compensation Scenario: The patient has provided you with the information needed to create a Workers Compensation. Let s access the patient s registration and the Edit Menu to create the new Case. Typical Staff Responsible for this Process: Billing Staff Referral Coordinator Staff Once the Workers Compensation checkbox is selected, it cannot be de-selected. Notice that the 2nd tab changes to Workers Compensation accordingly. Considerations: Review the Worker s Compensation tab to ensure the Date of Injury is correct and enter the Claim Number. Be sure the patient has an Employer and associated Insurance Carrier linked to this case. If none are listed, double click in the Employer Information Name field and attach an Employer. It is helpful to ensure that Employer information is entered on the patient s registration before attempting to create the Worker s Comp claim. Enter Authorization Number and Expiration Dates as appropriate. The Authorization tab may also be used to include any other limitations. Now that the case is created, attaching it to the appropriate appointments or visits is completed via the Scheduling or Billing modules. Visit Info, Filing 1, Filing 2, Filing 3, Filing 4/Dental tabs are only utilized when your workflow warrants autopopulating Visit information during charge entry. If you do NOT need to auto-populate this Visit information, these tabs will not be used. Auto-populating Visit information, however, can be a sufficient workflow to reduce the time and inaccuracy of charge entry staff. 18

48 Referral Scenario: The patient has provided you with the information needed to create a Referral/Authorization case. Let s access the patient s registration and the Edit Menu to create the new Case. Typical Staff Responsible for this Process: Billing Staff Referral Coordinator Staff Whether creating Worker s Compensation/Referral or Accident cases, the Edit menu is accessed in the same manner. The main difference is that the Workers Compensation checkbox will NOT be selected for Referrals or Accident cases. Considerations: When creating cases, best practice is to use a consistent naming structure within your practice. The Insurance Carrier and Authorization tabs are most commonly used to track the case information that will be used for Billing purposes. Information entered on these two tabs will automatically populate the necessary fields in the visit when the Case is attached. IMPORTANT! When creating accident cases, the Insurance Carrier that will be billed needs to be added to the patient s registration BEFORE attempting to create the Case. After the Case is created, simply remove the checkmark from that Insurance Carrier on the patient s registration/insurance tab. 19

49 View Menu The View menu options include Activity Log access (tracking user/system activity) and Toolbars arrangement/customization. Options Menu The Options menu is used to setup Preferences or Workstation Settings. Preferences can be set for many different modules from this same menu. 20

50 Help Menu The Help Menu offers the product Help Guide where the user can search for help items. Alternatively, pressing the F1 key will display context-sensitive Help on the topic for the currently displayed module/screen. Or by pressing F1 on the keyboard from the Patient tab of Registration... 21

51 Notes: 22

52 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Billing Module Centricity Services 1

53 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

54 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

55 Table of Contents Billing Workflow... 5 Billing Module... 6 Working with Batches... 7 Billing Criteria... 9 Billing Window (Spreadsheet)...11 Visit Info Tab...12 Filing (1) Tab...13 Notes Tab...14 Charges Tab...15 Trans. (Transaction) Tab...16 Corr. (Correspondence) Tab...18 Claims Tab...19 Filing Claims Workflow

56 Billing Workflow Create Batch Open Billing Spreadsheet Post Charges Approve Visits Print Paper Claims Batch Electronic Claims Update to Filed Auto- Update to Batched EDI Submission/ Send Auto-Update to Sent Auto-Update to Filed Succeeded or Filed Rejected Work Rejections/Reapprove/ Refile 5

57 Billing Module When a patient appointment is scheduled using the Scheduling module, a corresponding visit entry is created in the Billing module. This module is used to create and edit visit charges for paper filing and electronic submission, as well as to post patient co-pays. It is a powerful tool for managing visit information for workflow as visits can be organized by date, status and a host of other views as desired. Scenario: Your responsibilities in the practice include posting charges and copays in the Billing module. You are also responsible for Printing and Batching/Sending claims for your practice. Let s use the Billing module to complete your daily tasks. Typical Staff Responsible : Billing Staff, Charge Entry, Front Desk 6

58 Working with Batches CPS associates all charges, payments, adjustments and transfers entered with a batch. Every financial transaction is part of a batch. This provides a mechanism to group specific transactions for balancing, reviewing and/or closing procedures. When entering financial data in the Billing module, a batch will be required. First, we will need to create a default batch to post the charges and payments to. To create a new default batch, select Edit on the toolbar and click on Default Batch. Next, click on the binoculars or double click in the white box and on the search screen, click on New. Add a specifying description, if necessary, and mark the box titled Set as Default and click OK. Click OK again. The batch number will appear at the bottom right corner of your screen to identify which batch is open at any given time. 7

59 Considerations: When creating batches, each user can create a prompt to set up a default batch at login under the Options menu. These options are user based, therefore each staff member can set their own preferences. This function will take effect the next time the application is opened for this user. Although CPS requires transactions to be associated with a given Batch, creating Batches allows for an excellent managerial tool. By having policies for the creation/ naming/utilization of Batches in the workflow, management can audit, report, and review specific Batches to ensure that overall business workflows are being followed. In addition, inaccuracies can be quickly identified by having a routine naming structure. A policy should be established that dictates the naming structure of all batches to help identify what the batch contains, i.e. Charges_UserName_100410, InsPymts_UserName_100410, etc. When creating a new Batch, remember that the "Date of Entry" that you enter is similar to a "financial date". All transactions associated with this Batch will be associated with this financial date. This is particularly important when you are in a new month, but still working on data entry from a previous month. For example: Today is Monday, October 4, but you are still working on charges for dates of service in the month of September. When you create a new Batch, the default "Date of Entry" will be October 4. You should reset the "Date of Entry" to September 30. This way, all September-based charges you are entering will be associated with a September batch. Always make sure that the Date of Entry matches the date in the Name field. Corrective transactions (i.e., Void/Clone/Conveyance) that need to be posted should be placed in special corrective batches, not typical daily workflow batches. If the corrective transaction is concerning a transaction that's associated with a Hard Closed Month, this best practice is particularly helpful. This best practice keeps corrective transactions separate from daily workflow transactions and allows for easier management of batches. Special transactions (i.e., Refunds, NSF Check Reversals, Special Adjustments, Massive Adjustments, etc.) that need to be entered should be placed in special batches, not typical daily workflow batches. This best practice keeps special transactions separate from daily workflow transactions and allows for easier management of batches. At the end of the day, after the end user has reconciled his/her Batch, it is best practice to do a Batch Close (aka, Soft Close) on that Batch(es). This policy ensures that Batches are reconciled, and that other users are aware that the Batch is finished for the day. Security should be set to ensure that only a select group of individuals have access to re-open Batches that have been soft closed. The security ability of Batch Closing Override should also be given to only a select group of individuals. When these security options are not selectively given, data contained in Batches is subject to change/deletion without proper security measures in place. 8

60 Billing Criteria To open the Billing module, click Billing on the Main Menu. The Billing Criteria window displays. This screen allows filtering for viewing and working specific visits or a specific group of visits. For this scenario, we will open the current day s visits to begin posting charges. Since this is the default setting for the Billing Criteria, we will just select OK to see a list of patients for the day. 9

61 Considerations: The Billing Criteria can be used to narrow the list of visits, i.e. by Facility, Responsible Provider, etc... if a user is only responsible for some of these entities and not all. Never underestimate the power behind the Billing Critieria Screen. With it, you can "slice and dice" visits in nearly every possible assortment. With all the selection criteria available, you can locate very specific sets of Visits, or you can be very high level and general. Regardless of your need, the Billing Criteria Screen allows you to see nearly every possible configuration of Visits that you could want. Use the Billing Criteria Screen to "watch dog" your Visit Statuses. On a routine schedule (i.e., weekly, monthly), staff should have responsibility for looking at ALL Visits contained in each Visit Status. Doing so will give management great insight into the management of the organization. Once the Visit Statuses are reviewed, Visits needing action items should be immediately triaged to staff for follow up and resolution. Utilizing Visit Owner for this triage is an excellent best practice to follow. 10

62 Billing Window (Spreadsheet) Once search criteria, if any, is entered and OK is selected, a billing window similar to the above is displayed. The display can be customized by rearranging columns by personal preference. Column widths may also be customized. Considerations: If working with multiple visits, it is best practice to alphabetize the list of patients by last name using the Sort Ascending option on the Patient column. In addition, rearranging the columns to best fit the workflow of the user is also helpful. In addition to rearranging columns, customizing the toolbar is also available under View/Toolbars/Customize. For example, adding an "Approve" button to the toolbar is a common practice. For the visits that are displayed in the spreadsheet, the bottom right section of the screen will display Summary Data for the ENTIRE spreadsheet. 11

63 Next, we ll select the patient s visit to post charges to by double clicking on that patient s visit. As you are posting charges, you also need to be aware of all tabs within the visit as they may or may not apply to this visit. Visit Info Tab Once the visit it opened, the user will need to verify the information on the Visit Info tab to ensure that the data is correct for the charges about to be entered. Any changes will need to be made at this time. Considerations: Allocation Set is a typical field that may be changed depending on what is being posted, i.e., changing to Self Pay when posting a CPT code that the patient will be totally responsible for. The information on this Visit Info tab can be modified WITHOUT affecting the Patient s Registration information. Each visit can have its own combination, separate from Patient Registration, if needed. For Filing Type, if the user will NOT be filing this visit to the Insurance Company, the Filing Type will need to be changed to None. For filing Method, If a UB04 is required to print to paper for this claim, and the default Filing Method is HCFA or CMS1500, the Filing Method needs to be changed to Paper. 12

64 Filing (1) Tab The Filing (1) tab contains additional information for filing claims. In some instances, additional information is required for claims, i.e. Date of Illness, etc. Please reference the Help Guide for more information on where this information would populate on claims. The Filing (2), Filing (3), Filing (4), Dental and Ambulance tabs are used for more specialized billing needs, i.e. Institutional claims/ub04. Please reference the Help Guide for more information concerning this type of claim filing and the use of these tabs. 13

65 Notes Tab The Notes tab can be used to add notes to the visit. Notes can be entered to print on the HCFA and receipt or just add general notes for the visit. Considerations: The gray area on the left is system generated, read only, and stores visit approval and batching results. Visit Billing Notes is a field designed for the Billing department to enter notes regarding this visit. These notes do not print, however these notes are also visible in the Payment Entry Distribution screen for this visit. The visit notes entered here apply only to this visit. Receipt Notes entered here would appear on a receipt for this visit only. 14

66 Charges Tab The Charges tab is used to enter the diagnosis and CPT codes for the patient s visit. Cases can be associated with the visit when applicable. Workers Compensation and Referral cases, or Case Management, are covered in the Scheduling and Registration companion guides. Considerations: The Case Set button can be utilized to automatically populate the Diagnosis and CPT codes entered on the Case when created. The Fee Schedule is displayed at the top of the screen to indicate how the Procedure code and Fee Schedule setup for Fees and Allowed amounts will be calculated for this visit. (This is controlled by the Procedure code and Fee Schedule setup and the Responsible Provider setup in Administration). Always enter Diagnosis(es) first to auto-associate with Procedures. If not entered first, each procedure code will need to be manually linked to the applicable diagnosis(es). Best practice is to use the Arrow Down Key on the keyboard after entering a diagnosis or CPT. This allows faster charge entry without opening each code and its details. The arrow keys on the keyboard also allow for movement and entry within the grid. If there is a need to look up or search for a code, using the wildcard, the %, at the beginning of the description will help to limit the results to choose from. The Auto Adjustment button will automatically adjust off the difference between the procedure s Fee and Allowed amounts, as determined by the Procedure code and Fee Schedule setup. This will only be used for specialized billing workflows (i.e., Capitation plans, Sliding Fee Scale, etc.). 15

67 Trans. (Transaction) Tab The Trans Tab, or Transactions, of a patient s visit contains a summary of all transactions applied against a visit, both from the insurance carrier and the patient, and shows any adjustments made against the visit. The lower portion of the window lists all transactions against the visit. Dates, payer, payment amount, adjustments, transfers, batch, the creator, and who modified the transaction, if applicable are also displayed. Patient copays can easily be entered from this window 16

68 Considerations: When entering a patient payment using the Patient Pmt button (e.g., a patient copay), the payer name defaults to the guarantor. Should payment be received from someone other than the guarantor, the information may be entered by clicking in the Payer box and choosing (Other). Enter the name of the person rendering payment in the Other Payer screen. The payer s name will display in the Payer column of the lower Transaction section. o If the patient intends to pay more than what is expected on this visit, proper workflow needs to be determined. Will the user place the full payment on this visit and the remainder conveyed later by other business personnel? Or, will the user post JUST the copay on this visit and utilize Payment Entry to post the remainder? o When utilizing the Patient Pmt button and an error is made, the user must verify that NO transaction is saved for this payment. Failure to ensure this may result in Unapplied Funds. Copays or patient payments made to a visit without any charges posted will result in a Deposit for this visit. When charges are posted, the system will automatically apply this deposit to the patient balance calculated by the allocation set. (If NO patient balance is allocated when posting charges, the deposit will remain on the visit as a Deposit and will need to be MANUALLY conveyed to an applicable patient balance, either on this visit or other visits for this patient). o When the system can automatically apply a deposit to a patient balance, the lower Transaction section will show a 0.00 line denoting this action. The Pending column is used to display the dollar amount that will be adjusted off once the visit is saved. (This action is controlled by the Allocation Set and Fee Schedule setup). The New button will open Payment Entry with Patient as the source. This is commonly overlooked by users when attempting to post an Insurance Payment. The Pmt Entry and Distribution buttons will drill-down into the selected transaction, displaying Payment Entry and Transaction Distribution windows respectively. The Delete button will delete the selected transaction. CAUTION: Proper security must be setup to allow access to the Delete button. In addition, when deleting a transaction, make sure to Answer Yes to both questions regarding payment deletion. Failure to answer Yes to both will result in Unapplied Funds. 17

69 Corr. (Correspondence) Tab Considerations: The Correspondence tab is primarily used for Collections activity. Please reference the Collections section of the Companion Guide for best practices in Collections workflows. In addition to using this tab for Collections workflows, some customers will utilize a workflow that places ALL (patient and insurance related) correspondence activity notes in this tab. These customers utilize this workflow because of the advantages of using the Correspondence Audit Report and the fact that these notes cannot be deleted or modified and displays the user and timestamp of each note. The Correspondence tab of the visit can be accessed via the Billing, Accounts Receivable or Collections modules. Depending on the specific workflow and use of the Correspondence tab, a user may access the visit from any of these three modules to perform their work. For example, the Insurance A/R staff may use the Billing module to enter correspondence notes concerning their conversations with the Insurance payer, whereas the Patient Collections staff may use the Collections module to enter correspondence notes concerning their patient conversations regarding past due balances. 18

70 Claims Tab The Claims tab contains information for all claim submissions for this visit. The top portion contains filing information. There will be multiple entries in this section If the claim has been resubmitted or filed to more than one carrier. The lower list box displays a list of all report files that have been received for this visit if filed electronically. If a visit is rejected by the clearinghouse or insurance carrier, details may be viewed in this section or within an EDI report. To view the full content of the description, double click a report file to launch a notes editor. This box will also display any Clearinghouse report file line items that are Auto-Processed, (i.e., Remittance files, etc.) and apply to this visit. Considerations: Rearranging the columns in the upper box and using Date Transmitted as the first column is helpful when reviewing multiple submissions. Double clicking on one of the line items in the lower box will open the line to view all the details. Claim status is a future use field that will display the response to an inquiry, or 276 file, submitted to the carrier, or a 277 file. In general, Claim Status is to inquire as to the adjudication status of your claim. 19

71 Filing Claims Workflow Now that you have entered charges for all your patients for the day, and have a better understanding of all the parts of a visit, we will Approve, File, Batch and Send the visits to complete the workflow. Approve Visits Print Paper Claims Batch Electronic Claims Update to Filed Auto-Update to Batched EDI Submission/ Send Auto-Update to Sent Auto-Update to Filed Succeeded or Filed Rejected Work Rejections/Reapprove/ Refile 20

72 Considerations: When Approving visits, users have the option to Approve from within the visit, one at a time, or to Approve all visits at once, using the Approve button from the Billing spreadsheet window. When Filing Claims, it is not necessary to choose a Filing Method of Paper and Electronic separately as they both can be filed simultaneously. Best practice is to indicate ALL visits, Status Approved and Current Carrier Primary in the Billing module criteria window. In this way, any visit that needs to be filed initially or refiled will appear on the spreadsheet. As such, no visits will be inadvertantly batched for electronic filing when the current carrier is a secondary and no COB information is entered. Filing secondary claims is typically a workflow of its own and it is best practice not to mix filing secondaries with primaries. If experiencing EDI issues with a particular payer(s), it is best practice to batch visits with like carriers in order to troubleshoot effectively. For example, you are experiencing EDI issues with Medicare. You decide to batch all Medicare visits separate from other payers. In this way, the batch file submitted to Medicare will also generate its own response file that will contain ONLY Medicare responses. When filing secondary claims, the workflow mentioned previously is followed, with the exception of identifying the Current Carrier as Secondary in the Billing criteria window. The workflow for filing primary claims and secondary claims is the same. You will simply retrieve different visits for each workflow, based on the criteria selected. When batching visits, any visit that initially batches will reside in a batch file in EDI Submission Management awaiting submission to the clearinghouse. Any visit that fails the batching process will need to be corrected, reapproved, rebatched and sent separately. o If a batch is deleted in EDI Submission Management, all visits in that batch will return to a status of Approved. Every time you transmit files to the clearinghouse, any available response reports will be downloaded to CPS and may contain newly rejected claims. A workflow will need to be designed to determine by whom and when these rejections will be addressed. Some reports that are downloaded into EDI Response Management may not affect visit status (i.e., Eligibility files and Remittance files) but may affect other workflows in your practice. All staff should be aware of this and how it may impact their various workflows. o o Depending on your clearinghouse, your workflow for rejections must focus on both reports that are downloaded through EDI Response Management (If not automatically processed) and visits that have been automatically updated to Filed Rejected. Best practice is to work the Filed Rejected visits daily in order to quickly refile. Visit Owners can be used to triage the various types of rejections and assign them to the various staff members responsible for that type of rejection. 21

73 Notes: 22

74 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Payment Entry Module Centricity Services 1

75 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

76 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

77 Table of Contents Payment Entry Workflow... 5 Payment Posting Insurance Payments... 6 Posting Payments Secondary Electronic Requirements...10 Posting Payments Patient Payments

78 Payment Entry Workflow The Payment Entry module allows the end user to post payments from insurance companies and patients to individual visits. Other elements of patient accounting (i.e., adjustments, transfers of responsibility, etc.) also occur within this module. It is best practice to come prepared with the information necessary to post (i.e., ticket numbers, patient statements, Insurance EOB s, etc.). The Transaction Distribution screen of Payment Entry is used to distribute transactions to specific line items on the visit. The Payment Entry module is typically not an area used for researching payment information as unintended changes may result. Billing, AR and the Collections modules can be used to review any payment/adjustment/transfer information. Payment Entry Source = Patient Source = Insurance Select Patient or Guarantor Select DOS or Apply Oldest First Enter pertinent information, i.e. Amount/Check # Single Check? Enter Ticket Number Enter pertinent information, i.e. Deposit Date, Amount, Check #, Check Date Bulk Check? If check from family of payers, i.e. Blue Cross, may select Insurance Group Enter Ticket Number Use Auto Apply feature for ease of entry Manually review each Visit Status on a routine basis to avoid lost revenue Run applicable Reports as needed for monitoring purposes Select New to access Transaction Distribution Enter line item information Select OK, then Next (to enter next check) Enter pertinent information, i.e. Deposit Date, Amount, Check #, Check Date Select New to access Transaction Distribution Enter line item information Select OK, then enter next Ticket # and continue posting 5

79 Payment Posting Insurance Payments Scenario: Your responsibilities in the practice include posting Insurance payments and Patient Statement payments. For this scenario, Let s discuss the Payment Entry features available when posting these types of payments. Typical Staff Responsible : Billing Staff, Payment Entry staff, AR Staff Note: A Batch must be created before or at the time of Payment Entry See the Billing Companion Guide for details We ll first discuss posting an Insurance Payment. You will select Source=Insurance and ensure that the correct batch is being used to post payments in. At this point, it should be determined whether this check is a single check or bulk check and whether it should be posted by Insurance Group or if it is acceptable to just enter the ticket #. (If posting a single check, just entering the ticket number is best practice. If posting a bulk check, however, selecting Insurance Group, if applicable, before entering the first ticket number on the EOB will allow for quicker posting and suppress warnings when a different carrier lives on the next patient s visit). 6

80 Considerations: The Deposit Date field is an optional feature. If, for example, your practice utilizes electronic funds transfer and the carrier deposits the money into your account a few days before you receive the check, this field can be used to track the actual Deposit Date, which may be different than the Batch s Date of Entry. Deposit Date can also be used when printing the Deposit Slip report from the Reports module. Entering the Check # (or EOB reference #) and the Date of the check/eob is helpful when trying to locate a specific check # from Transaction Management. Using Auto Apply to apply Insurance payments is not best practice. Insurance carrier payments should be posted directly to the line items from the Transaction Distribution screen. If posting patient payments, using the Apply Oldest First and Auto Apply features will help streamline the payment posting process. When selecting the source, Insurance or Patient, the system will automatically default to display only visits with balances for this source of payment. However, sometimes it is necessary to post overpayments to a visit and selecting the All button (instead of Unpaid) will list ALL visits for the selected patient/guarantor. After selecting All, the dropdown will contain a list of All visits for the selected patient/guarantor and payments can then be applied to a visit that may not have a balance. Sometimes, the secondary payer for a patient will pay before the primary. When this occurs, simply changing the Payer Name after the ticket # has been entered will apply the payment from the secondary payer. It is not necessary to manipulate the visit and Set Carrier. The New button will display the Transaction Distribution screen for line item posting. The Next button will save current payments and prepares this module for the next check. A common mistake is selecting the Next button when the current check is not entirely posted. This may cause unapplied funds. Only use the Next button when you are completely finished posting the current check. (A quick reference is to always check the Amount Remaining field to be sure it is at 0.00 before selecting Next). After entering the pertinent information in the Payment Entry screen, the New button will open the Transaction Distribution window to allow entering line item payments/adjustments/transfers. 7

81 Each line item has multiple columns for posting. The column names and their behaviors are driven by the Transaction Column Set that was created and attached to the insurance carriers. The carrier attached to the current payment is displayed in the top left Summary area, above the procedure codes. (It is a good idea to ensure that the current payment is being applied for the correct carrier). This window has multiple areas with different functionalities. Many of the fields are to provide the Payment Poster with reference items to the overall status and history of the Visit. Other fields, however, contain workflow-specific functionality (i.e., TCS grid, Visit Owner, Billing Note, etc.). With the reference items and the workflow-specific functionality items, the Payment Poster can eliminate the need to go outside of Payment Entry to accomplish many needed tasks. The bottom section of Transaction Distribution will display any previous payments, adjustments or transfers made to this visit. 8

82 Considerations: Using the Quick Pay button is helpful when posting single secondary insurance payments as there are no adjustments to make. As Payments and Adjustments and Transfers are posted, watching the Patient Balance and Insurance Balance columns will help determine if the amounts are being applied correctly. Using the = sign in a column will move the source s balance to the current column as a shortcut. Positive and Negative Transfers have different effects: A Positive Transfer will PUSH monies FROM the current source TO the opposite Source. A Negative Transfer will PULL monies FROM the opposite source TO the current source. In short: Positive = Push Negative = Pull As an example, negative transfers are necessary when the patient s visit has allocated a balance to the patient erroneously. Currently, the insurance carrier is paying that balance, therefore it is necessary to PULL the balance FROM the patient TO the Insurance in order to make payment on it. Medicare crossovers are handled simply by selecting the Status drop down menu and selecting File Next Carrier BEFORE selecting OK. This lets the system know that the secondary carrier is now the current carrier without having to file a secondary claim. Best practice is to use Visit Owner, when necessary, to communicate followup activities to other staff members, i.e. a large write-off has occurred and needs followup. 9

83 Posting Payments Secondary Electronic Requirements When posting primary carrier payments, there are additional requirements in Transaction Distribution needed in order to send the secondary claim electronically. In the above example, the Line Info column box is double clicked (highlighted in red) and the required information is entered. (This information is automatically populated if the primary carrier s payment is posted via Electronic Remittance). Line Information must be populated for EACH line item (CPT). The Adjudication date is the only field required on the left. On the right hand side of Line Info, the Group Codes and Claim Adjustment Reason Codes are entered with their respective amounts for each line. These codes are available at the Washington Publishing website: Considerations: A good formula to use to make sure your claim is balanced for the secondary carrier is this: Fee Adjustments = Total Payment Fee (per CPT) minus the sum of the adjustments (from Line Info) should equal the amount paid for that line (CPT). After entering the Line Info for each CPT, the next requirement is the COB Information. This information is for the TOTAL CLAIM LEVEL amounts, as opposed to the Line Item amounts entered in the Line Info column. After selecting the COB Information button (highlighted in red), enter the TOTAL CLAIM amounts in the appropriate fields. 10

84 Typically, the first 3-4 fields are what are required for the secondary carrier. This may vary depending on the secondary carrier requirements. Once all the necessary information is entered from the primary payer, the secondary claim is ready to be batched and sent electronically. 11

85 Posting Payments Patient Payments Patient payments received via mail, i.e. statement payments, are typically posted from this module. While it is possible to post patient payments from the actual visit, it is more effective to post these payments from Payment Entry as the payment can apply to multiple visits. Scenario: Lisa Chamberlain mails a check for $100 to apply to multiple visit balances. For this scenario, let s discuss the Payment Entry features available for posting patient payments. Typical Staff Responsible : Billing Staff, Payment Entry staff, AR Staff From the Payment Entry screen, we ll first select the source of this payment as Patient. Again, make sure a batch is selected for posting these payments. (Some users find it helpful to separate Insurance payments from Patient payments by using two separate batches). Next, instead of entering a specific ticket number, we will select the patient (or Gaurantor). The system will default to Apply Oldest First as the payment option for this check. (Single visits can be selected from the dropdown as well). Using Apply Oldest First will allow CPS to post the $ to as many visits as possible, starting with the oldest date of service, until all of the $ check is exhausted. 12

86 Next, we ll select the Auto Apply button. Using this feature means that you do not have to enter Transaction Distribution simply to post a payment. CPS will auto-distribute the monies either to a single visit or to multiple visits if using Apply Oldest First feature. Once the Auto Apply selection is made, CPS will confirm that you wish to automatically apply the payment(s). After answering Yes, CPS will then display the visits posted to and the amounts in the bottom section. After confirming that the Amount Remaining is 0.00, select Next and move on to the next check to post. 13

87 Considerations: Posting by Guarantor is helpful when multiple patients belong to a single guarantor, i.e. Dad. Once the Patient or Guarantor is selected, the Payer field will automatically populate with that name. It is possible to change the payer to the actual payer (i.e., Uncle John or Aunt Sally) and continue to post the payment to the patient s balance. In addition, this field is a searchable criteria field from Transaction Management. Auto Apply feature cannot be used to enter Refunds. After entering the Amount as a negative amount i.e., , the Transaction Distribution screen will need to be used to enter the negative payment, and the type of Payment in this case will be Refund (as set up in your Administration Payment Type table) for tracking purposes. When performing a conveyance (moving money from one visit to another), always make sure to change the Method on this screen to Conveyance. When making only adjustments or transfers on a visit, the Amount field will remain 0.00 and New will be selected to access Transaction Distribution and amounts will be posted in the columns available there for the adjustment or transfer amounts. After posting all payments for the day, use Transaction Management to balance on-screen or preview/print the Daily Balance report for end of day activities i.e., Balance, Soft Close all batches for current day. If there is a discrepancy when balancing, Transaction Management is a useful tool in reconciling the payments that are incorrect. Unapplied funds is a common error and can be easily identified through this module. Please see the Transaction Management Companion Guide for further instructions on correcting Unapplied Funds. 14

88 Notes: 15

89 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Reports Module Centricity Services 1

90 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

91 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

92 Table of Contents: Reports Workflow... 5 Standard Reports... 7 Help Features: F1,? or Help Guide... 8 Assigning Security... 9 Creating a New Folder Creating Saved Criteria Exporting Report to Excel Printing Reports Centricity Reports and Hard Close How the Closing Date affects Reports Statements Workflow Setting Up Statement Options Printing Individual Statements Statements-Bulk (Batch) Updating Last Statement Run Date EDI Submission Management

93 Reports Workflow The workflow below describes the typical workflow for utilizing reports. Any report can be added to this workflow or removed from it to best meet your needs. The Help Guide within the product is available with information for additional reports that may be needed. Also, the F1 keyboard shortcut delivers context sensitive help by displaying helpful information depending on where you are in the product. In addition, the Reports component itself contains information for EACH report available with the question mark icon on the toolbar, if needed. Daily Weekly Monthly Yearly Daily Balance Billing Status Monthly Production & Revenue Analyses Monthly Financial Summary Deposit Slip Daily Financial Summary Outstanding Insurance Case List New Patient Analysis Reminders & Recalls Missing Tickets Monthly Financial Summary Reimbursement Analysis Reimbursement Summary by DOS Insurance Reimbursement Summary Aging Reports Monthly Revenue Analysis Referring Physician Analysis Net Charges by Dr Aging Reports 5

94 Scenario: You have just been informed by your practice administrator that managing the practice s reports has become your responsibility. You need to familiarize yourself with the functionality of the Reports component and decide on which reports you, and others, will utilize to accomplish this. Typical Staff Responsible for this Process? Billing Staff, Practice Managers, Billing Mangers, Scheduling Staff The Reports component houses the many reports shipped with the Centricity Practice Solution product. These are the typical or standard reports already designed. Access the Reports component by clicking the Reports button, clicking the Reports Icon on the tool bar, or go to File/Open/Reports. 6

95 Standard Reports When the Reports component is opened, a folder called Reports will display. Click the + sign next to the folder to see report folders contained in Reports. Each folder contains specific types of reports: You decide to learn more about the reports by viewing the information available on the question mark on the toolbar. 7

96 Help Features: F1,? or Help Guide When highlighting a report, click on the?, press F1 (Help), or click the Help drop down menu to get a detailed description of the report. 8

97 Assigning Security Note: In a new Centricity Practice Solution product, Security will need to be assigned before attempting to create/produce any reports. Assign Security to Folders and Specific Reports To determine who can access specific reports To determine who can access specific sets of reports To determine who can generate reports for specific sets of criteria Report Security is broken into the capability of Execute, Modify, Delete, and Create: Execute is the ability to preview or print the report. Modify and Delete only refer to report access related to the Crystal ability to copy then modify standard reports. Create is to create new reports completely. You decide to create a folder for yourself that will house your daily reports (Daily Balance and Deposit Slip) that you can print with one click. Let s first create a new folder for these reports and name it Billing Office Daily... 9

98 Creating a New Folder 10

99 Once created, the folder will drop to the bottom of the current folder open. When printing from a custom report folder ALL reports can be printed within the folder with ONE print command. But use **CAUTION** when utilizing this feature. Depending on the existing saved criteria of those reports, or the lack of criteria, reports may print more information than desired. There may be situations where groups of staff find it helpful to have 1 or 2 custom folders where their daily or routine reports are housed. Create one of these special folders (i.e., Billing Office Daily) by clicking the New Report folder on the toolbar, and then copy any of the standard reports (with or without saved criteria) into the special folder. Additionally, report security can be made easier by having all reports for this particular group of staff in one area. A green folder indicates a custom folder. An orange folder indicates a shipped folder. Now let s highlight the Daily Balance and enter the word today in both From and To dates, then select Save As on the toolbar. Name your New Criteria with a unique name, i.e. Daily Balance Today. 11

100 Creating Saved Criteria Considerations: To use the one-click print command, the criteria used in the report will need to be static data, i.e. Today, Today-1, Month, Month-1 etc... These criteria options can be used with MANY reports at any time. However, using this criteria in your saved report criteria is what allows for one-click printing when saving these reports into a custom folder. (Additional information on static dates for reports can be found under the Help Guide menu). 12

101 Once the report has been saved, the new report will show a teal outline to the left of the name indicating a custom report. 13

102 Next, you will drag and drop and Move this saved criteria to your newly created folder (Billing Office Daily). Now you will repeat the same process for the Deposit Slip. Once both reports live in the Billing Office Daily folder, you can highlight that folder and select the Print Icon on the toolbar to print both reports at once. 14

103 Now let s preview a report and use the Export feature to explore its functionality. We ll preview the Payments report first... 15

104 Previewing Reports 16

105 Exporting Report to Excel Exporting reports to Excel can be a helpful way to analyze your financial data by omitting those items that you do not wish to see and apply formulas to numerical data. After previewing a report, click on the export Icon on the toolbar. 17

106 Next, select the Format and Destination for exporting: Considerations: To simply save the file to a specific location without opening the associated application, i.e. Excel, use the destination of Disk File option. Next, you are prompted with some formatting options for the exported report and can select your desired options: 18

107 Now that the report is displayed in Excel, any calculations or reformatting can be performed from here utilizing Excel s standard functionality. 19

108 Printing Reports A report can be printed by clicking the Print icon on the toolbar. This will only print one report at a time. However to print multiple reports at once, create a new folder with the saved criteria for the selected reports and print them all using one print command. Congratulations! You have explored the functionality of Reports and have gained the knowledge necessary to determine which reports will work best for your practice! Please see below for some helpful information regarding Batches and Soft Close versus Hard Close... 20

109 Centricity Reports and Hard Close There are specific reports that balance to one another, and some reports are dependent on a closing date (Hard close). It is important to note that reports affected by the closing date in your system may not balance to other reports that do not consider the closing date when performing financial calculations. When creating a new batch, the date of entry is the financial date that all your transactions will be linked to on this batch. Remember you should be engaging in a daily batch closing, aka Soft Close or Batch Closing process after reconciliation of each batch has been performed. The Closing Date Hard Close for the month should be done after you have performed your Hard Closing process(es), i.e. are all charges for the month posted? Are all payments posted for the month, have all unapplied funds been accounted for? etc... The closing date should always be the last day of the month. Reports that Balance to Each Other Daily Balance = Daily Financial Summary (Date of Entry) Daily Financial Summary = Daily Transaction Summary (Date of Entry) Monthly Financial Summary = Monthly Transactions Summary (Date of Entry) Ending AR (Monthly Summaries) = Procedure Date Aging Reports that are Close Date Dependent Statements Reimbursement Analysis by Financial Class Reimbursement Analysis by Insurance How the Closing Date affects Reports Hard closing "locks down" any data that was posted (based upon the date of entry of the batch containing this data) to a date of entry that is closed. In the case of patient statements, unclosed data for a specific date may appear on one statement then "disappear" on the next. This may cause your patients some difficulty in understanding the statements, resulting in increased phone calls to your billing department. 21

110 Statements Workflow Setup Statement Options Printing Individual Statements? Printing/Sending Electronic Statements Registration Reports Component Billing Batch Print Payment Entry Collections EDI Submission Management Mail Send 22

111 Setting Up Statement Options Scenario: You have just been given the responsibility of generating statements for your practice and also working with patients when they have a question on their statement. You decide to take this opportunity to review the Statement Options setup and batch/send an electronic statement file. Typical Staff Responsible for this Process?: Practice Managers, Billing Managers, Billing staff In Centricity Practice Solution, you need to setup the Statement Options in the Administration component. To open the Administration component, click the Administration button in the main page of Centricity Practice Solution, click on the Administration icon located on the Component Toolbar, found in any component in Centricity Practice Solution, or select File/Open and choose Administration from the toolbar. 23

112 To set up statement criteria, click on the Systems Folder>Application in the List Editor of Administration. Then, click on the Statement Options button. 24

113 The first tab, Options, defines the information to be included on statements. The below screenshot is typically the recommended setup for most practices. For additional information on these options, please reference the Help Guide. Considerations: For some specialties that have multiple routine or repeat patient visits (i.e. Oncology), you may want to consider a balance forward statement, which only prints the details of each visit once, and the balance ONLY thereafter. To some healthcare management experts, including aging information on statements and receipts may lead to patients purposefully delaying payment until the balance reaches the critical aging buckets. For this reason, you may want to consider NOT marking these options. 25

114 Considerations: Remember: These messages will only appear on Individual Statements. The oldest balance s dunning message will be the only message that prints. 26

115 Printing Individual Statements Printing individual statements can be accomplished from 4 different components: Patient Registration, Payment Entry, Billing and Collections from the File menu. (These workflows can also be found in those corresponding workbooks). Patient Registration: Payment Entry: Billing: Collections: 27

116 Statements-Bulk (Batch) Your manager wants you to create new statement criteria to print all patient statements with an interval of 7 days and a minimum number of days between guarantor statements set at 28. Let s look at the steps involved in creating this new criteria. Typical Staff Responsible for this process?: Practice Managers, Billing Managers After Statement Options have been set up in the Administration component, proceed to the Reports component to set up Statement Criteria for bulk (or batch) statements. To open the Reports component click on the Reports button in the main page of Centricity Practice Solution, or use the File/Open Reports command on the tool bar. Within the Reports Component, select File/Statements to open the Statement Criteria window. 28

117 Then select New to create the criteria. 29

118 The below screenshot is the typical recommended setup for printing weekly statements. Please see the Help Guide for additional options. Considerations: Minimum Pt Balance and Minimum Total Balance work together as an AND statement, not OR statement. Statement Type can be paper if Statements are printed in-house and not sent electronically. In this case, Clearinghouse would remain blank as well. Interval Days set at 7 and Minimum Days Between Statements at 28 means: You will comb the database weekly from A-Z and only generate statements for guarantors that have NOT had a statement in 28 days. If your workflow does not want to generate statements for guarantors in Collection, you can use the option Suppress Guarantors in Collection. Additional new statement criteria can be created on a case-by-case need. Example: Dr. Smith will be leaving the practice. You want to generate statements in hopes of collecting those patient balances as soon as possible, and provide information on where Dr. Smith will be relocating. Creating and generating statements using this criteria can be used as many times as needed. 30

119 Next, you will enter your appropriate dunning messages on the Messages tab and Select OK. Considerations: These dunning messages are created per statement criteria. As such, statement criteria created for special purposes can have their own unique dunning messages. A maximum of 3 lines print at the bottom of paper statements. Information exceeding the specified parameters do not print. 31

120 To batch Electronic statements for the criteria you just created, place a checkmark on the Weekly batch criteria. Click on Electronic- This produces the statement file batch that is transmitted via the EDI Submission Management component. This does not actually transmit statements electronically at this time. Considerations: If you desire to print or preview statements at this time, you can simply select the Print or Preview buttons. Previewing statements is an option that allows you to view statements for accuracy before printing and allows you to make any necessary changes to the criteria before printing. 32

121 Updating Last Statement Run Date After choosing Electronic (or Print/Preview), a popup window will open stating that the system is generating the patient statements. Once the statements have been generated on paper, a second popup will open asking Would you like to update the last statement date for all the statements that were generated? For Electronic statements, this second popup will not appear and the last statement date will be updated automatically. By selecting Yes, the Last Run Date is updated in the Batch Statements Window and the Statement Dates are updated on the Financial Tab of Registration for all patients that had a statement generated for paper statements only. By selecting NO last run date is not updated in the batch statements window and last statement date is not updated on the Financial tab of Patient Registration for paper statements only. This process is creating the batched file that will be present in EDI Submission Management and is transmitted from that component. 33

122 EDI Submission Management Now, let s move to the EDI Submission Management component to select the batch file of statements just generated and submit the file to the clearinghouse. Typical Staff Responsible for this Process?: Billing Staff, Patient A/R Staff Utilize the criteria to search for ONLY statement files, using a date range if desired. Then Select OK. 34

123 In EDI Submission Management, note the window is divided into two parts. The top portion contains the batched statement files, while the bottom displays the patients receiving statements within the highlighted batch. Place a checkmark on the statement batch just generated and then click on the Send button. Congratulations! You have successfully submitted your new statement criteria file to your desired clearinghouse and fulfilled your manager s request. 35

124 Notes: 36

125 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide AR and Collections Modules Centricity Services 1

126 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

127 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

128 Table of Contents Accounts Receivable Workflow... 5 Module Comparison... 6 Working Accounts Receivable with the AR Module... 7 Working Accounts Receivable with the Collections Module

129 Accounts Receivable Workflow Insurance and Patient accounts receivables can be worked through the Billing, Accounts Receivable or Collections modules, depending on your practice workflow demands. Insurance receivables are typically handled through the Billing and Accounts Receivable modules. Patient receivables are typically handled through the Collections module. Billing Module AR Module Collections Module Use Billing Criteria to openvisit(s) needing followup Use Correspondence Tab or Visit Billing Notes to enter documentation per visit Refile Claims as necessary Use AR Criteria to openvisit(s) needing followup Use + /- sign to quickly review visit transactions Use Correspondence Tab or Visit Billing Notes to enter documentation per visit Visit status has automatically updated to Collection by system parameters or manually by staff Use Collections Criteria to openvisit(s) needing followup Use Correspondence Tab to enter Notes Manually review each Visit Status on a routine basis to avoid lost revenue Change Collection Status as necessary Print Letter (Single or Bulk by Collection status) Run applicable Reports as needed for monitoring purposes Auto-Update additional visits as necessary Run applicable Reports as needed for monitoring purposes 5

130 Module Comparison Depending on your workflow and the module you choose to work your accounts receivables, the below grid compares each module and attributes available. Item Billing A/R Collections Visit Based X X X Select Multiple Visits X X Retrieve Visits by Owner X X X Drill Down into Visit X X X Use Next Contact Date X Minimum Balance Search X X X Search by Last Filed Date X X Scenario: Your responsibilities in the practice include working your accounts receivables by Insurance Carrier. You will utilize the Billing or Accounts Receivable modules to accomplish this. Advantages to using the Billing module are that you can refile a visit or several visits quickly and that you can preview a receipt to review multiple visits at once. (Please reference the Billing section of the Companion Guide for further details). For this scenario, Let s discuss the AR module and its features for completing your daily tasks. Typical Staff Responsible : Billing Staff, Charge Entry, AR Staff 6

131 Working Accounts Receivable with the AR Module The Accounts Receivable spreadsheet is very similar to the Billing spreadsheet. The primary difference is the plus sign in the left column. The plus sign indicates that a visit can be expanded to view any payments, adjustments, or transfers that have been posted to the visit. This is helpful to gain a quick glimpse of transactions that have occurred on this visit. If a plus sign is not populated next to a visit, this indicates that no payments, adjustments, or transfers have been posted to the visit. Clicking on the Plus Sign will expand the details of the transactions for the selected visit. Considerations: When selecting a visit, the guarantor balances appear at the bottom of the spreadsheet. The correspondence tab can also be used in the AR module to enter notes pertaining to insurance carrier conversations. The AR module is very similar to the Billing module. Best practice is to use the Billing module to work accounts receivable visits for the Insurance carrier balances. 7

132 Scenario: Your responsibilities in the practice include working your accounts receivables by Patient and/or Guarantor. You will utilize the Collections module to accomplish this. Advantages to using the Collections module are the ability to generate template letters from the product based on the Collection status of the visit, the ability to track and manage visits via Next Contact Date, and Collection visits can be limited based on criteria specified in the Collections criteria window. For this scenario, Let s discuss the Collections module and its features for completing your daily tasks. Typical Staff Responsible : Billing Staff, Charge Entry, AR staff Working Accounts Receivable with the Collections Module Collections criteria can be used in a variety of ways to limit the results in your spreadsheet. 8

133 Considerations: Status refers to the Collection Status of the visit (i.e., New, Sent First Notice, Sent Final Demand, etc.). Collection statuses are setup in Administration and should represent the journey that a visit will take from the point of becoming labeled Collection to the point of write-off or payment. Each Collection Status is like a mile marker in that journey. o Do not forget to include Collection statuses for those visits that are being o handled internally only under special orders from the Doctors or Administrators. Creating statuses in verb form will help other users to understand the point in the journey the guarantor is in (i.e., Made First Phone Call, Waiting Approval for Outside Collection Write-Off, Sent Final Demand, etc.). Collection letters setup in Administration can have a contact period assigned to them. When that collection status is assigned to a visit, the system will automatically update the next contact date to the corresponding number of days attached to that collection status. Please reference the product Help Guide and the Administration Companion Guide for details on the collection status, collection letter and contact period days. In addition, reference the product Help Guide or Reports Companion Guide for details on creating customized collection letters. Visits that meet the defined criteria will appear on the spreadsheet and can be opened and managed accordingly. 9

134 Considerations: Only visits in a Visit Status of Collection will appear on the spreadsheet. The totals at the bottom of the spreadsheet are for ALL the listed visits, not per patient/guarantor. Using the Visit Description field can be a way to track which visits were worked in the current month. For example, when opening the visit and entering Correspondence notes, entering 8/10 in the Visit Description field will allow this information to display on the spreadsheet. In this way, the user will know that they have worked this visit in the current month and can move on to other visits in the spreadsheet. This is a manual entry, so each month the date would need to reflect the current month that the visit was worked. From the Correspondence tab, collection status and collection letters can be managed. In addition, any updates to Notes, Collection status and Next Contact Date can be copied to other visits for this guarantor. This eliminates the need to open every individual visit and enter the same note repeatedly. It is crucial to have a collection workflow so that all types of collection visits are dealt with routinely. For example, on Mondays, you may review all visits that are New to Collections. Then on Tuesday, you may review high dollar visits in Collections (visits over $ ). Then on Wednesday, you may review all visits that need followup this week based on the Next Contact Date. Etc. In the Collections module you will not be forced to utilize ONE workflow. You will need to customize your OWN workflow that works best and meets the needs of your practice. 10

135 Notes: 11

136 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide EDI Submission & Response Modules Centricity Services 1

137 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

138 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

139 Table of Contents EDI Submission and Response Management Workflow... 5 EDI Submission Management... 6 EDI Response Management

140 EDI Submission and Response Management Workflow Enter Daily Charges EDI Submission Management EDI Response Management Send batched claim files to clearinghouse Review active reports as necessary Retrieve reports as necessary Process active reports as necessary Archive active reports as necessary 5

141 EDI Submission Management In Centricity Practice Solution, EDI Submission Management is used to send claim files to the clearinghouse(s). If using a supported clearinghouse, claim files are sent first to the clearinghouse and then on to the payer. The clearinghouse will return reports to notify the user of the claim files succession or rejection. In addition, the clearinghouse will return payer responses to your claim files as to acceptance or denial. Continually monitoring the visit status for Filed Succeeded or Filed Rejected is crucial to the success of your practice. Scenario: It is your responsibility to submit claim files to your clearinghouse on a daily basis. These claim files are created by the Billing staff after posting charges and batching the visits. For this scenario, let s discuss submitting your claim files to the clearinghouse and managing the responses from the clearinghouse/payer via EDI Response Management. Typical Staff Responsible : Billing Staff, AR Staff In Centricity Practice Solution, you will open the EDI Submission Management module and select appropriate criteria for the claim files you wish to send to the clearinghouse. 6

142 Typically, the Clearinghouse is the only selection that needs to be made here. However, if sending both claim files and Eligibility and/or Statement files on a regular basis, it may be necessary to uncheck the boxes that do not apply. In this scenario, we will use a sample clearinghouse so will select All and OK. In the resulting screen that displays, all visits currently in a Batched status will display in the top window. You will simply place a checkmark on the claim file checkboxes and select Send. This will open the existing connection between your database and the clearinghouse and submit your claim files. The bottom section of the window will display all visits that are contained in the currently selected batch file. Considerations: After transmitting claims to the clearinghouse, it is important to ensure that the transmission status of the claim file is Transmitted. This action is what will change your visit statuses to Sent. After submission is complete, CPS will automatically download any new reports from your mailbox at the clearinghouse. (These reports appear in the EDI Response Management component, discussed later in this guide). Because reports are automatically retrieved from the clearinghouse and automatically processed against visits in the database, the result may be that previously submitted visits have been rejected (either from the clearinghouse or the payer). While it is not necessary to review these reports via EDI Response Management, it is EXTREMELY important to utilize the Billing module to followup on your visit statuses for successful revenue capture. If an error is discovered in the batch file, it is possible to delete the file. This will, in effect, unbatch those visits and place them back in Approved status. 7

143 EDI Response Management Once claim files have been submitted to the clearinghouse, EDI Response Management can be used to review any new Active reports that have just been downloaded. To review these reports, the EDI Response Management criteria is accessed and appropriate criteria entered. For this scenario, we will simply leave the criteria at (all). This criteria will display all active reports from the clearinghouse. Considerations: Multiple criteria fields are available in this module, however, the default criteria will display only Active reports. Sometimes it is necessary to review reports that have been Archived, either automatically by Centricity, or manually by a user. When this is necessary, the Include Archived checkbox can be used. If this option is selected, ensure that a reasonable timeframe is used in the Date Received to limit the displayed results. The Search for files containing the following text area can be used to search responses for patient name, ticket number, dollar amounts, etc. The percent sign can be used as a wild card, if needed. This is sometimes helpful when researching payer acceptance reports for proof of timely filing. The Short Description field can be used to limit responses of like types, for example Typically, only Eligibility, Statement or Remittance Advice reports should appear in this module. This is Remittance Advice Report, Eligibility Response, etc. because reports that should update the visit statuses 8

144 Once the responses are displayed, determine which, if any, reports will need to be Archived, Processed or Reviewed. Technical reports from the clearinghouse that update visit statuses should not appear as an Active report. The status of these reports should read Processed Without Errors. When the reports are downloaded to Centricity (either automatically at the same time claims were transmitted, or manually with the Retrieve function), these reports should automatically process themselves, which in turn will automatically update visit statuses accordingly (Filed Rejected or Filed Succeeded). Once these reports automatically process, they should also automatically Archive. If any of these technical reports appear as Active, you will need to consult Centricity Support for further instructions. Other reports, such as Remittance Advice Reports, will need to be manually processed by selecting the Process button. Corresponding remittance reports will also need to be manually Archived by the user. Considerations: A workflow process for EDI Response Management should include reviewing any Active reports on a daily basis. This will ensure that reports are being addressed in a timely manner, as well as identify any potential errors. The file name that appears in the first column will also display on the patient s visit on the Claims tab. This is useful when researching rejections, as you can input part of the file name in the EDI Response Management criteria screen to view that report only. Remittance Advice Reports may also download a corresponding human readable generic EOB. This report is designed to mimic the actual payer s EOB for those occasions when the payer does not send a paper EOB to your practice. 9

145 Notes: 10

146 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Charge & Transaction Management Modules Centricity Services 1

147 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

148 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

149 Table of Contents Charge and Transaction Management Workflow... 5 Charge Management... 6 Charge Management Criteria... 7 Charge Management Moving Charges... 9 Transaction Management

150 Charge and Transaction Management Workflow Enter Daily Charges, Payments, Adjustments, Transfers Charge Management Transaction Management Review Daily charges entered Review Daily Payments/Adjustments/ Transfers Compare Total Charges to Batch(es) Total Charges Compare Total Payments to Batch(es) Total Payments Correct any errors Correct any errors 5

151 Charge Management This component is optional, but can be used daily to review/search/manage charge balancing processes at the end of the day. Scenario: You have just entered all charges and payments/adjustments/transfers for the day and need to balance them against a paper source, such as superbills, patient statement payments and EOB s. Typical Staff Responsible for this Process?: Practice Managers, Billing Managers, Billing staff In Centricity Practice Solution, you will open the Charge Management module and select appropriate criteria for the charges you wish to balance. Charge Management allows you to balance your batches and, at a glance, view all charges, diagnoses and units and balance against these totals. If the charges do not balance, you can open the visit directly and make corrections. 6

152 Charge Management Criteria The Charge Management Criteria window provides several options for filtering charges that display in the Charge Management window. These filters may be used singly, or together, to further narrow selections. Charge Management allows you to search for and work with charges independent of the visit to which they belong. To balance a particular batch, select the batch to balance in the Batch field (double click in field, or click on the binoculars to the right, and search for batch), then click OK. Considerations: Other criteria can be used in Charge Management to review data. Date of Entry can be used to view all charges entered for a particular day, or a date range, for ALL users, regardless of batch. A patient name can be entered, as well as dates of service, to view all charges for a particular patient during a specific timeframe. Charge Management is often used in practices that utilize the EMR module of CPS to review the charges imported from the EMR module (or any other interfaced EMR product). Reviewing charges in this way allows the user to quickly determine if appropriate modifiers, units, diagnoses, etc. have been entered on the procedures. 7

153 After accessing the Charge Management spreadsheet, the bottom row will display totals for the criteria previously entered. A quick look at these totals will determine whether or not the total charges listed here balance to what was calculated on the superbills Hash Total Charges Total Considerations: Balancing charges is an important element that too many practices overlook. This simple process will ensure that all services rendered are properly posted and revenue is not lost. Using hash totals to balance, instead of total dollars, is a more accurate way to ensure that all charges have been posted. (Hash total is a numeric value that is calculated by adding all CPT s on a superbill, instead of the total dollars. In this way, each CPT entered on the superbill is accounted for, rather than using a total charge field on the superbill). 8

154 Charge Management Moving Charges If the totals do not balance and the error is identified, Charge Management offers the ability to move these charges from one batch to another. This occurs when a user selects the wrong batch or default batch to post charges in. Instead of deleting and reposting the charge, CPS allows moving that charge to the correct batch. Moving the charge to the correct batch will resolve the problem. When this move is complete, the Batch name will change to the new Batch for these visits, however, the screen must be refreshed (refresh button on the toolbar) to see and balance the current batch with these visits removed. When charges are balanced, the user can proceed to Transaction Management to balance payments entered for the day. 9

155 Transaction Management As with Charge Management, Transaction Management is an optional module that can be used to review the payments, adjustments and transfers that are posted to CPS. Using Transaction Management to balance payments posted for the day is an alternative to using the Daily Balance Report to balance. In this way, any corrections that need to be made can be accomplished directly from this module. Once desired criteria is entered, the Transaction Management screen will display all transactions associated. 10

156 For daily balancing, use the total of the Payments column to match the checks and cash collected. The Unapplied Funds column is also important. Monies in this column were entered into the database but not posted to a specific date. (Batches that contain unapplied funds cannot be closed). Double clicking on a line item opens Payment Entry and allows the user to modify/finish posting the payment. Considerations: Occasionally, unapplied funds will occur and using Transaction Management is the best way to resolve these. The transaction type can be used to search for payments via check number for researching purposes. Like Charge Management, Transaction Management can be used to balance payments and move any payments that were erroneously applied to the wrong batch. 11

157 Notes: 12

158 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Administration Module Centricity Services 1

159 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

160 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

161 Table of Contents Administration Setup Process Map... 5 List Editor Items... 6 Visit Owner... 6 Allocation Types... 7 Setting Up Collection Status Parameters... 8 Security/User Management... 9 Ribbon Menu Items...10 Allocation Sets Company Fee Schedules Insurance Carriers Procedures Referring Providers Responsible Providers Schedule Templates Statement Criteria...18 End of Day Processes...20 End of Month Processes

162 Administration Setup Process Map Use this general setup process map as a guide as you plan and implement the application in your clinic or enterprise. This Companion Guide will focus on the areas that are highlighted below. Scenario: Your practice has just purchased CPS and needs to setup Administration items to customize the software for your needs. Let s review the various areas of Administration that may need further explanation and/or special attention. Typical Staff Responsible : Administrative Staff, Billing Administrative Staff, Schedule Administrative Staff 5

163 List Editor Items Visit Owner The first item to review is Visit Owner. Visit Owner allows you to create a category identification that you can then assign to a visit for sorting purposes in addition to other criteria. The Billing, Payment Entry/Transaction Distribution, Accounts Receivable, and Collections modules use this information. Considerations: Visit Owners can be created to match staff names or reasons for follow-up. For example, a Visit Owner could be created for Sally (your billing staff member who may be responsible for following up on large write offs that occur during payment entry). On the other hand, a Visit Owner could be created named Large Write Off-Needs Review. Regardless, the staff member who is responsible for the visit can use Visit Owner in the search criteria to display only those visits that have the specified Visit Owner attached. Once a Visit Owner is assigned to a visit, the Visit Owner must be MANUALLY modified/removed as the visit progresses through the normal follow-up activities. Failure to remove/edit the Visit Owner accordingly will result in multiple visits that have an erroneous or non-applicable visit owner. When you first begin to set up visit owners, the first item on the list should be unknown. Once you create the owners, you may need to re-order the listing to be sure that Unknown remains FIRST on the list. The application will then assign this owner to all new visits by default. Closing date rules do not restrict the visit owner. You can change the visit owner designation at any time and in any location in which it appears in the application. 6

164 Allocation Types Allocation types identify the breakdown of charges between the patient and the insurance carrier responsibility, and are the required building blocks for allocation sets (discussed later in this guide). Once created, the application uses allocation types to create allocation sets, which are then required for patient visits. Considerations: When creating allocation types, keep in mind that percentages (80/20, 70/30, etc.) can only work well if your practice is diligent on maintaining the carrier s fee schedules within your database. As an example, if you assign an 80/20 allocation to a patient that has Cigna, the patient can/will be charged 20% of the Allowed amount for that procedure code. This would work as long as every code has Cigna s Allowed amount attached in the Procedure table. Multiply this across your entire procedure table to determine if it will be feasible to maintain that many procedure code Allowed amounts. You would also multiply this effort times the number of Fee Schedules (carrier Allowed amounts) that you maintain. For this reason, typical setup is to use only Co-pay amounts, Private Pay or 100% Insurance as an allocation assignment to the patients. Once an Allocation Type is created, it cannot be deleted. For this reason, exercise caution when creating them! 7

165 Setting Up Collection Status Parameters You can set up how the application determines when a visit is in collection status due to an overdue insurance payment, an overdue insurance balance, or a total of both. In addition, you can indicate if you want a warning to display when accessing a patient who has one or more visits in collections. The application also allows you to define the criteria for moving patient visits to collections status. Considerations: Collection statuses are used for in-house collection activities BEFORE the account would be placed with an outside collection agency. Once a visit has been placed in a collection status, either automatically by the collection parameters or manually by a user, this visit must be manually manipulated to move the visit out of collection status. Best practice is to set collection criteria for patient balances only. Insurance balances should be managed on a daily basis through the normal A/R process within your practice. Best practice is to use the Guarantor-based collection letter option available here. Enabling this feature will allow multiple patient visits for the Guarantor to be included in any collection letter sent, as well as the ability to manage/update multiple visits while working within one visit. Bad Debt warning notification is considered best practice. Bad Debt write-offs can be used when inhouse attempts to collect the debt have not been successful and the balance must be placed with an outside agency. If a Bad Debt write-off is used, Bad Debt is assigned to the visit status and users are alerted when accessing a patient with a Bad Debt visit status. 8

166 Security/User Management If your practice authenticates users in Active Directory, you will need Administration rights on the database server. To set up users in Administration, you need all Administration rights. Assigning security rights to individual users allows you to assign users to security groups, and allow or deny explicit (override) permissions that supersede security group settings. Considerations: It is best practice to use security groups as your primary method for assigning rights to users. Avoid managing security permissions on individual users whenever possible. Any security changes performed on an individual user are considered explicit permissions, or an override. Explicit permissions override all security group settings and must be manually removed from the user, or from the selected permission. Checking a component node assigns all permissions beneath that node. Use the Shift or Ctrl key to select multiple permissions. Security rights in Centricity Practice Solution can be classified into 2 groups: o o Inherited rights rights granted to users by security groups. Explicit or Override rights rights granted or denied to users on the user level that override all other security settings. 9

167 Ribbon Menu Items Allocation Sets Allocation sets expand the functionality of allocation types so that a procedure s responsibility can be automatically allocated to patient or insurance, either by fee or allowed amount for all procedures used. Also, allocation sets allow you to specify allocation type by a single procedure or a range of procedures. Considerations: When creating allocation sets, you will be using the Allocation Type(s) previously created from the List Editor. One Allocation Set can use multiple Allocation Types. o For example, a Co-pay Allocation Set can use the Co-pay Allocation type for any E & M codes ( ) but use the 100% Insurance Allocation type for all other codes. This is what s known as a carve-out, whereby you are carving out procedure codes to assign a separate allocation type to. When posting procedure codes on the visit, the will assign the Co-pay amount to the patient s responsibility. Any other procedure code fees will be assigned to the Insurance carrier responsibility. The Insurance carrier will still be billed for the entire amount of the claim, however, the patient will be immediately responsible for the Co-pay portion. If the patient chooses not to pay at the time of service, a statement will be generated on the next statement run instead of having to wait for the insurance carrier to respond and transfer the Copay amount at that time. 10

168 Company A Company is typically created based on Tax ID. The Company information will be sent in your claims and, if filing claims as part of a group, the NPI of your Company will be sent as the Billing Provider Number. This is how the insurance carrier will recognize your practice, along with the Tax ID sent. Considerations: The NPI and Tax ID should be placed on the Information tab. Use the PayTo address field when the Pay To address is different than the Billing Provider address. The Identification Tab should only contain a default All row with NO NUMBERS entered here. As a default, the NPI and Tax ID will be generated from the Information tab, which is why NO NUMBERS are required on this default row. In rare cases, an insurance carrier may require the Legacy number be submitted in the claims as well. If this occurs, an Exception row will need to be created here with THAT carrier s legacy number in the GRP and EMC fields. 11

169 Fee Schedules Fee schedules are designed to set up the general rules for calculating charges for procedures. A fee schedule tracks fees, RVUs, costs, and allowed amounts for a procedure. These items can be associated with the responsible provider, facility, company, and financial class of a patient. Fee schedules can be stored within the application for access throughout the system. You can create multiple fee schedules based on carrier reimbursements. The application allows you the flexibility to set up fee schedules using either a flat fee or RVU (Relative Value Unit). With the application, you have the ability to increase an entire fee schedule by a percentage (%) amount, copy and rename an existing fee schedule and set effective dates for fee schedules. Considerations: Best practice is to set up Fee Schedules for only those carriers that can be maintained on an ongoing basis. For example, you may wish to create Fee Schedules for all carriers, but maintaining the Allowed amounts for ALL carriers may not be practical. For this reason, typical practice setup is to enter Allowed amounts for the top 5 payers in your practice, as long as those 5 can be maintained. At least one Fee Schedule must be created. Typically, a Standard Fee Schedule is created to reflect the usual and customary Fees for each procedure code. It is also recommended that the base fee be included as the Allowed amount on this fee schedule, from the Fee Schedules tab of the procedure code. Placing the base fee in the Allowed amount field will allow calculating patient portions from this Allowed amount. For example, if your practice decides to offer a cash discount for self-pay patients, the Standard Fee Schedule would be copied and the Allowed amount could be adjusted to 80% (giving the patient a 20% discount). If the Allowed amount field is blank, the Copy feature for Fee Schedules would not be available and each procedure code would need to be manually edited. Naming the Fee Schedule with the year included in the name is best practice. This will help manage your fee schedules from year to year with regard to effective and expiration dates. Modifiers can be used in determining the fee for a performed service. For example, if a modifier 50 is posted, (bilateral procedure), the Fee Schedule could automatically reduce the fee and/or allowed amount by 50% for this procedure code when posted. If creating a Fee Schedule based on RVU, remember that conversion factors can ONLY be setup on the Department of the procedure code. In addition, the RVU itself must be manually entered for each procedure code in the procedure code table. 12

170 Insurance Carriers While most databases installed will have insurance carriers preloaded, it is still sometimes necessary to add insurance carriers to the database. Insurance carriers have required fields in order to be able to file electronically and/or on paper. (Insurance Carriers are not preloaded with addresses. If mailing addresses are needed, these will need to be added). Considerations: When creating insurance carriers, the following items are REQUIRED for EVERY carrier: o Information tab: Name, Carrier Type, Transaction Column Set, Policy Type and Filing Method (2 parts-type and method). o Identification Tab: Required for ALL payers (paper AND electronic) Default All row with Payer ID only, no other criteria entered here. EDI tab is required ONLY if Information tab states Electronic for the filing type. Default All row including Clearinghouse/Payer ID/Plug-In for the File Creators It is NOT necessary to create a carrier for Medicare Secondary, as long as Policy Type for Medicare carrier is set to Other. Further, it is best practice to set Policy Type to Other for ALL carriers, with the exception of Worker s Compensation. Optional setup on the insurance carriers that may be helpful include Financial Class, Allocation Set, Insurance Group and Collections Group. Caution! If the Allocation Set attached to the carrier will NOT be the allocation set for ALL patients that have this insurance, it is best practice NOT to select the Allocation Set on the insurance carrier. The allocation set would be selected at the time the patient is registered, according to their specific plan s requirements. Caution! It is NOT recommended to change the Insurance Carrier ID that is automatically assigned. The original ID is needed when setting up Remittance Processing. 13

171 Procedures Although your database will most likely come pre-loaded with the procedure codes specified on your spreadsheets, some modification may be necessary and new codes added. Considerations: When adding procedure codes, the Code field will be used during charge entry. The CPT code field will be billed to the insurance carrier. In-house codes, i.e. NSF check fees, Postoperative visit codes (99024) can be created as well. If a code will never be billed to any insurance carrier, leaving the CPT code field blank will remove the checkmark from the code when it is posted in Billing. In addition, any Fee associated with the code will automatically default to the patient s responsibility. Examples of when this setup would be beneficial: NSF fees, Retail products sold in your office, i.e. Dermatology products, etc. Required fields for the procedure codes are Code, HCFA qualifier, Description, Department, Specialty and Fee. CAUTION! If the visit Doctor s specialty is not attached to the procedure code, the procedure code will not display when posting charges! Place of Service should be left blank as some procedure codes could be performed in multiple places of services. The Facility used on the visit when this procedure code is posted will determine the Place of Service Code sent. Type of Service Code can be left blank, UNLESS it is required on a PAPER claim. Electronically, this field is NOT used. On the Fee Schedule setup, there are multiple optional fields available per procedure code and fee schedule combination, as well as overrides available. Some of the most commonly used options are: o o o Laboratory is marked for all Laboratory procedure codes (this will send a CLIA #, if applicable) Use Responsible Provider as Referring (used when a referring doctor is required, BUT can also be the same Doctor listed as the Responsible Provider on the Visit. Typically used for Medicare when there is a Laboratory, Procedure or X-ray performed in the Office that requires a referring, but the Responsible Doctor can be sent as the Referring Doctor as well). Referring Provider Required (Typically used for Consult codes and when the Responsible Doctor CANNOT also be the Referring Doctor). 14

172 Referring Providers The referring provider table should contain all providers that refer patients to your practice. Reports can also be generated by Referring Provider for statistical data. Considerations: A BLANK default row is required for every Referring Provider. DO NOT enter your practice s Responsible Providers in this table. They will not appear in this table, however, when your own Responsible Provider can also be the Referring Provider, he/she WILL appear in the Referring Provider table search on the Visit Info tab of the visit. Specialties and Organization are not required for the Referring Providers, but may be entered, if desired. 15

173 Responsible Providers When creating Responsible Providers, there are several aspects to this process. In addition to creating the Identification numbers for this provider, Fee Schedules, Schedule templates and Chart Access may need to be created. Three types of providers can be created: Responsible Provider, Billing Resource and Referring Provider. Referring Provider is a separate table (discussed previously). The Responsible Provider and Billing Resource will both be accessed from the Edit menu and applicable attributes set for each. Considerations: The NPI and Specialty are the only numbers required on the Basic Info tab. The additional fields for license numbers, etc. can be used as placeholders for those numbers. Attributes for the type of provider being created should be set on the Basic Info tab using the checkboxes. A Billing provider is defined as: A non-user resource who can be scheduled and billed using the application, but who does not log into the application, nor has access to patient charts managed by the application. The Billing Identification tab should contain the Tax ID and MUST have a default All row. This all row will determine if the provider files as Part of a Group or an individual. No other numbers are required on this default all row. Billing Fee Schedules must be attached for this provider. If this provider will need a schedule for booking patient appointments, the Schedule Templates tab must also be used. (Please see below for creating Schedule Templates). 16

174 Schedule Templates Whether creating schedule templates for Responsible Providers or Schedule Resources, the steps are exactly the same. It is recommended that Appointment Types be created first and assigned to all applicable schedule resources and responsible providers BEFORE creating the schedule templates. Sometimes, allocating a specific appointment type to a specific time slot is needed and this can only be accomplished when appointment types are created first. Considerations: Schedule templates can be copied from and to Responsible Providers and Schedule Resources by using the Copy feature of the Schedule template. This may help eliminate some of the setup process. When naming the schedule templates, be specific so that other users will understand what the template is used for. For example: Bailey M-W-F 9-5 Main means: Dr Bailey, every Monday, Wednesday and Friday from 9:00 am to 5:00 pm at the Main Office. If this template is copied, it can be renamed for the specific Resource or Provider that will be using it. 17

175 Statement Criteria Statement criteria setup is accomplished in two different sections; One is the Administration module/system folder/application menu/statement Options (1). The second step is in the Reports module/file menu (2). When creating the statement setup, remember that statements are generated by the Guarantor, not the patient. 1 Then from the Reports Module, File menu/statements: 2 18

176 Considerations: Statements can be generated by Company, Doctor or Database. Typical setup is to generate statements by Company. For Statement Options, it is not recommended to select Include patients with transactions since their last statement date. This option will override the minimum balance criteria and send 0.00 statements when the patient makes a full payment from the previous statement. For Statement Criteria, best practice is to use the Weekly A-Z setup, using Interval days of 7 and Days Between statements at 28. This means that each week, the guarantors will be checked for any minimum balance set. If this guarantor has NOT had a statement within 28 days, CPS will generate a statement at this time. This setup helps to streamline the process and generate statements for guarantors that may have had a large transfer within the past 7 days. 19

177 End of Day Processes Balancing all financial data at the end of each day should be performed. The usual method for accomplishing this task is to use an adding machine to run a tape of the charges, payments, and/or adjustments totaled on the Superbills. Next, compare these figures against the Daily Balance and Deposit Slip reports. These numbers should balance. If the numbers do not balance, compare each individual Superbill s total against the reports. Locate any discrepancies. Correct the necessary visits in the Billing module. Re-run the reports. Verify your figures again. Repeat these steps until you balance. (Another method to balancing Charges is to use Charge Management and hash totals. This is a more accurate way to balance charges). The Daily Balance and Deposit Slip reports (See the Reports and Statements Companion Guide) are the recommended reports for your daily activities, however, other reports can be generated for your practice specific needs, if desired. After all batches have been balanced, closing the batch(es) should be a daily activity as well. This is accomplished from the Administration Module/Edit menu/batch Closing. Considerations: The Daily Balance report can be generated by each user, however, it can also be generated for the practice as a whole. For example, running the Daily Balance for today s date and grouping by User will provide an overall daily total for the practice by User data entered. Using this method, each user can simply preview the Daily Balance for their own totals to balance. The practice Administrator can then print one Daily Balance for all users for the day. Creating static dates can also help to streamline the end of day activities. For example, a copy of the Daily Balance and Deposit Slip reports can be created with today in the From and To Dates. These reports can then be placed into a new folder named Daily Reports. All reports that live in a folder can then be printed with one click instead of running each report separately. (Please see the Reports Companion Guide for additional instructions). Closing the batch(es) (soft close) is HIGHLY recommended as a DAILY activity. This step helps to eliminate adding/deleting transactions in error. 20

178 End of Month Processes The first step in balancing your monthly financial data is to perform a Hard Close of the system (Closing Date). This step is CRUCIAL to retain the financial data s integrity in your database. Failure to set the Closing Date each month can result in mismatched financial data from month to month. Since some of the reports depend on a Hard Close, this step must NOT be avoided. Once the system closing date is set, the financial data up to that date cannot be manipulated without tracking. This is the sole purpose of setting the Closing Date. It is recommended that the system s Closing Date be set at LEAST ONCE PER MONTH. After the Closing Date is set to last day of the prior month, monthly reports can be generated. Some of the recommended monthly reports include Daily Financial Summary, Monthly Financial Summary, Monthly Transaction Summary, Monthly Production Analysis, Aging Summary by Financial Class, Aging Summary by Responsible Provider, Aging Totals by Patient, and Practice Aging. Of course, other reports can be generated according to your practice specific needs. 21

179 Notes: 22

180 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Task Management Module Centricity Services 1

181 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

182 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

183 Table of Contents Task Management Workflow... 5 Using Task Management... 6 Enabling Task Management and Assigning Security... 7 Building Queues... 9 Queue Productivity Reports

184 Task Management Workflow The Task Management module allows the end user to identify visits that require some form of followup. These visits are identified by inclusion into a queue, built by the administrator. Queue: Selected Criteria used to identify visits, i.e. Insurance Balance, Company, Current Insurance Carrier, etc. determined by the administrator. Tasks: Visits that have met the criteria in a queue. Assigned: The visits that meet the queue s criteria can be assigned to a user by the administrator of the queue, or the user can self-assign, as determined by your practice s workflow requirements and setup. Complete: Once the visits (Tasks) have been worked, the user can change the status of the Task to Complete, Follow-up, Hold, In Progress or Manager Review. Archived: Only visits that have reached Paid or Bad Debt visit status will be archived from the queue. Open Task Management Module Option 1 Option 2 Select My Tasks Select appropriate Queue Open each visit and perform follow-up work Assign visit to your Tasks Select My Tasks Rt Click and Change Task Status accordingly Open each visit to perform follow-up work Rt Click and Change Task Status 5

185 Using Task Management Scenario: Your responsibilities in the practice include insurance follow-up activities to expedite the payment process. For this scenario, let s discuss the Task Management features available that will aid you in this process. Your administrator has determined what criteria will be used and has assigned visits to your tasks. Typical Staff Responsible : Billing Staff, Payment Entry staff, AR Staff Open task management and select My Tasks. Open each visit (task) and complete your follow-up work, i.e. call the insurance carrier, change visit information and refile, etc. Once your follow-up work has been performed on the visit, return here and Change Status of the task with a right click. Proceed to the next visit (task) and repeat these steps. Considerations: Tasks may be assigned to other users for additional follow-up work, as long as you are given security permission to do so. When a task is Complete, the task disappears from your My Task list. However, the task will return to the Queue area in the Completed Tasks queue. This queue is only accessible with security permission. From this Completed Tasks queue, visits may be reassigned to other users tasks, if necessary. Queues can be created for Large Insurance Balances, Visits with Ins Balance but last filing date is over 60 days, for example. The administrator can create queues and users can assign them to themselves from the Queue list. This ensures that the most important tasks can be accomplished first. The Column sort feature can be utilized to move large balances to the top and work them first, or move oldest date of service to the top and work them first. 6

186 Enabling Task Management and Assigning Security Before Task Management is utilized in your database, it must be enabled. This is accomplished through Administration/System/Advanced Features/Enable. 7

187 After enabling Task Management, Security permissions must be assigned to those users that will utilize the module. Security can be assigned by Group, User or Permission. Considerations: The Administrator of the queues must be given permissions as well. It is not recommended that all users be given access to View completed tasks. This queue is inherent to the product and is used by administrators to ensure that tasks marked as Completed are accurate and can be reassigned from here, if necessary. 8

188 Building Queues Before attempting to build queues, the administrator will consider the size of your practice, number of staff available to work the queues and types of data to include in the queues. For example, if only one user is responsible for working the queues, that user would have no need to assign tasks to other users. On the other hand, if there are multiple users that will work the same type of queues, the administrator can decide to simply create the queue and let the users self-assign the visits to their own Task list. To build queues, return to the Task Management module and select Queue Administration/Build Queues. Considerations: Use Shift and select to select multiple lines and assign to users. When you remove queues, they become inactive and no longer appear in the Queue list. However, removed queues still exist in the database to maintain the history, so queue names must be unique and cannot be reused. When building queues, the administrator MUST be added to the queue users area in order to access it. Utilizing Automatically exit tasks will help keep the queues manageable. After adding queue criteria, clicking Preview Queue will allow previewing the number of tasks in the queue for consideration. Clicking Run Queue will immediately update the content of the queue. However, a synchronizer process runs nightly that will automatically update the content of the queues. 9

189 Queue Productivity Reports Several reports are available for the administrator to review queue productivity for users. 10

190 Notes: 11

191 GE Healthcare IT Centricity Practice Solution CPS 12 Companion Guide Account Summary Module Centricity Services 1

192 Proprietary Rights and Limitations and Conditions of Use This document is the property of GE Healthcare, a division of General Electric Company ( GE Healthcare ) and is furnished to you, a current GE Healthcare customer, pursuant to an agreement between you and GE Healthcare. If you are not (i) a current GE Healthcare customer, and (ii) subject to a non disclosure obligations pursuant to an agreement with GE Healthcare, you are not authorized to access this document. No part of this document may be reproduced in any form, by photostat, microfilm, xerography, or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of GE Healthcare. Contact your GE Healthcare representative with any inquiries regarding copying and/or using the materials contained in this document outside of the limited scope described herein. GE Healthcare reminds you that there may be legal, ethical, and moral obligations for medical care providers to protect sensitive patient information when dealing with vendors such as GE Healthcare. You should obtain explicit written consent from both the patient and GE Healthcare before you disclose sensitive patient information to GE Healthcare. Trademarks GE, the GE Monogram, and Centricity are trademarks of General Electric Company. All other product names and logos are trademarks or registered trademarks of their respective companies Copyright Notice Disclaimers Any information related to clinical functionality is intended for clinical professionals. Clinical professionals are expected to know the medical procedures, practices and terminology required to monitor patients. Operation of the product should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health. General Electric Company reserves the right to make changes in specifications and features shown herein, or discontinue the products described at any time without notice or obligation. This does not constitute a representation or warranty regarding the product or service featured. All illustrations or examples are provided for informational or reference purposes and/or as fictional examples only. Your product features and configuration may be different than those shown. GE Healthcare IT 540 West Northwest Highway Barrington, IL U.S.A. 2

193 How to Use This Companion Guide: This Companion Guide is provided as an ancillary instructional guide to be used in conjunction with the CPS Computer Based Tutorials (CBT's), CPS Help Guides (F1), and CPS New Version What s New Guide and Release Notes available to you with the purchase of the CPS product(s). Additionally, during your CPS Implementation or Upgrade, you will have GE Healthcare professionals available to assist you as designed by your purchase. For field-by-field explanation of the product or for point-and-click functionality explanation, please reference the CBTs, Help Guides, and/or New Version What s New Guide and Release Notes. This Companion Guide is a compilation of best practices obtained from multiple healthcare practice workflows, which are combined with the functionality of the CPS software, to provide the most commonly used workflows within an ambulatory physician office. The workflows described in this Companion Guide are recommendations ONLY and do not necessarily reflect mandatory setup/settings. The Companion Guide should be used as a reference in determining the best workflow designs for your specific medical practice needs. The Companion Guide is divided into sections that represent major functionality areas and/or workflows of the CPS product. Please note that topics affecting more than one area of functionality may be cross-referenced. Also, at the end of each section, you will find a Notes area available for your own customized notes. For more information on customer education services and tools concerning the CPS products, please visit the Centricity Customer Portal, and/or the Customer Education website: 3

194 Table of Contents Account Summary Overview

195 Account Summary Overview Centricity Practice Solution Account Summary provides financial summary information for a guarantor account (total balances and aging) and transaction history with detailed ledger information for each visit within a guarantor s responsibility. Scenario: Your responsibilities in the practice include patient collections, which requires telephoning patients and/or guarantors to request payment and review their account information, if necessary. For this scenario, let s discuss the Account Summary features available that will aid you in this process. Typical Staff Responsible : Billing Staff, AR Staff 5

196 Account Summary can be accessed from Patient Registration or the main menu of CPS. 6

197 After accessing Account Summary, some of the features available inside the module will help in your follow-up activities when discussing account information. Banner displays guarantor information, alerts related to the guarantor, and patients for whom the guarantor is responsible. Aging section displays aging ranges for guarantor s outstanding balances Financial Summary Balance section displays sum of all balances, insurance, patient, and deposit breakdown for all visits with a balance Transaction History displays all visits for all patients associated with the selected guarantor Tabs allow quick access to guarantor information 7

198 View visit information, procedure, and transaction level detail in the Transaction History Click the toggle icon to expand/collapse all row details. Click + to expand or collapse a single row. The Panel buttons let you undock, dock, and close views. The Autohide button hides the panel. The hidden panel appears as a tab. Simply select the tab to unhide the panel. Dock, undock, or close panels to view multiple records or compare transactions 8

199 Use the new icons to assist you in finding the help you need. Considerations: When reviewing accounts with patients in the office, this module provides a summary view without navigating separately to Billing, AR, etc. Account Summary can be used in place of the detailed patient ledger report. 9