Presenter(s): Jackie Lopez George Hurgeton Kyle Evans Topic Real Time Services - Best Practices, Troubleshooting and The Future of RTS Level 200
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Agenda How will RTS work for me What do these errors mean! Integration Matters RTS Mitigates Claim Denials Maximize RTS (Best Practices) What s New in UD3 Get in the Know Questions
How Will RTS Work for Me? Streamline office efficiency Improve Patient Care RTS Improve Cash Flow Pinpoint potential problems
What Do These Errors Mean
What Do These Errors Mean
What Do These Errors Mean Error 33 Cause: practice has not completed RTS implementation. Solution: Contact NG Support
What Do These Errors Mean Error 13 Cause: Payer is mapped to the wrong clearinghouse or there are no Credentials in the AdminUtility for clearinghouse Solution: contact Support for Assistance
What Do These Errors Mean Error 23 Cause: Payer is enabled for RTS but not mapped in our AdminUtility Solution: Access AdminUtility to map payer to RTS payer
What Do These Errors Mean Error 1 Cause: RTS has not been setup or has been disable to RTS server. Or the URL needs to be whitelisted for user to access. Solution: Open Support ticket for new RTS escalation.
What Do These Errors Mean Error 52 Cause: User desktop icon for PM is corrupt or pointing wrong directory. Solution: Create text file and give user full access for the Domain Users.
Eligibility Submit Report
Maximize Best Practices
Integration Matters Access Points Chart Encounter Ins Maintenance Patient Lookup Appointment List Appointment Book Insurance Listing Historical Content Clinical History/Notes Ins Maintenance
Maximize RTS Tool Tips Tasking Auto Flow Claim Status Alternate Search options Multiple Service Types Best Practices BBP Reports
Optimizing Services Type Codes? On Demand Batch Automation
Search Options Search Options Member ID Name/DOB Name/DOB/MID (default) Name/MID
CPT- ICD10 Search Option Patient Eligibility Search CPT ICD 10
Adding Eligibility to your Auto flow
Appointment Tool Tip The Tooltip: User preference option Customize view of preselected items Provides an at a glance view
Tool Tip Display
Tool Tips Clicking here Opens Eligibility
Task Types Pinpoint potential problems early so you can address them before the patient visit Eligibility Task Appointment Chart Level Claim Status Task Encounter Referral Task Chart
Eligibility Tasks Appointment level Eligibility Tasks Source Type must be Appointment Eligibility Check is needed Eligibility Check resulted in a status
Claim Status Tasks
Referral Tasks
Claim Status Claim Status Transaction enables a Practice to identify the status of a claim in real time. Get insight into anticipated revenue, reduce claim turnaround time, and improve cash flow. Use NextGen RTS to verify that claims are accurate and reimbursable before payment and check the status in real time. Easily manage claim denials for quick resubmission.
Claim Status Request
Claim Status Report
Claim Status Quick Note Chart Encounter Claim Number Status Payment Amount
RTS Background Business Processor (BBP)
Business Background Processor The Background Business Processor (BBP) is an application that enables you to automate EPM Process such as: Reports Statements Billing Encounters Claims Generation RTS Eligibility Request and Response Claim Status request
Benefits of the BBP Increases office efficiency BBP Eligibility Relieves database traffic Reallocate resources to Claims Status
RTS BBP Best Practices- Eligibility Request 2-3 days out from appointment Select specified locations Select appt event and status type
Claim Status 2-3 weeks post claim submission Aged Days without payment. RTS BBP Claim Status
What s New in UD3 Live RTS Demo
Helpful Hints
Eligibility Submit Report Errors Error Description Insurance Not Setup for eligibility transactions Payer not found in cross-reference table Unable to determine Insurance Information not found for provider in elig_ref_scp_mstr Unable to find profile values Provider Not Found Error Definition Verify payer is RTS Supported enable the payer in file maintenance eligibility Payer needs to be mapped in the AdminUtility to RTS payer Error occurs when there is no insurance attached to the patients chart. Payer is not sync under to provider in File Maintenance>Provider>Elig/Ref> under receiver (eligibility) No Eligibility Profile attached to the payer in File Maintenance>payer>library Provider license is not activated for RTS transactions Confidential Proprietary Information For use by authorized NextGen clients and employees only. Not for public distribution. Copyright 2014
Common Rejection Definitions
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