Presentation is loading. Please wait.

Presentation is loading. Please wait.

CySolutions CHC Enhancements Training Thursday, June 12, 2014 CySolutions Presents Functional enhancments for Centricity Practice Solutions Designed specifically.

Similar presentations


Presentation on theme: "CySolutions CHC Enhancements Training Thursday, June 12, 2014 CySolutions Presents Functional enhancments for Centricity Practice Solutions Designed specifically."— Presentation transcript:

1 CySolutions CHC Enhancements Training Thursday, June 12, 2014 CySolutions Presents Functional enhancments for Centricity Practice Solutions Designed specifically for FQHCS, RHCs and Public Health Agencies

2 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Rural Health Clinics created by Congress in 1977 –Created cost-based reimbursement system for clinics located in underserved rural areas –Encouraged the use of mid-level practitioners in rural areas as reimbursement formula paid same amount for services whether done by provider or mid-level –Reimbursements processed through the Medicare/Medicaid systems –Services provided are generally primary care What is an FQHC, RHC, Look-Alike ?

3 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Federally Qualified Health Centers created by Congress in 1989 (Section 330 of Public Health Services Act) –Includes: Federally Qualified Health Centers (FQHC) Community Health Centers (CHC) Migrant Health Centers (MHC) Healthcare for the Homeless Centers (HCH) Public Housing Primary Care Centers (PHPC) FQHC Look-Alikes (FQHCLA) – Same as FQHC without the 330 Grant Outpatient Health Programs operated by tribal organizations under the Indian Healthcare Improvement Act What is an FQHC, RHC, Look-Alike ?

4 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Administered by Bureau of Public Health (BPHC) (http://bphc.hrsa.gov)http://bphc.hrsa.gov Congress created the FQHC program to allow special Medicare and Medicaid payments for CHCs and MHCs thereby ensuring that grant dollars intended for the uninsured were available for that purpose. Approximately 1,500 FQHCs nationwide Approximately 3,500 RHCs nationwide FQHCs are non-profit by definition – governed by a Board of Directors of which 51% of directors must be non-employees of the health center RHCs can be for-profit clinics Annual Grants are administered by BPHC. Prospective Payment System (PPS) reimbursements administered by state Medicaid system. FQHCs and FQHCLAs must file annual reports with BPHC (Uniform Data System (UDS) Reports) What is an FQHC, RHC, Look-Alike ?

5 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Section 330 Grants – FQHC, Homeless (330h), Migrant (330g) – Administered in connection with Sliding Fee Discounts provided to patients (users) under 200% of Federal Poverty Guidelines – Typically 50% of encounters Prospective Payment through Medicare (5%) & Medicaid (35%) Title X grants – Family Planning Services Ryan White – HIV Grant Program State and Local Programs varies by state (examples) –BCCCP – Breast Cancer & Cervical Cancer Prevention Program –Family Pact – California Family Planning Services Program –EAPC – California Early Access to Primary Care –CHDP, KidCare, CHIPS – Pediatric Immunization Programs for Children –Participation in Chronic Disease Collaboratives including Diabetes, Cardiac Care, Depression, Cancer. Private Grant Funding Commercial Insurance – (10%) Payor Sources for CHCs

6 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Priorities for CHCs in selecting a new system –Reporting capabilities Compliance – UDS, Title X, CADR (Ryan White), Grants Financial – –Accrual accounting reconciliation to cash accounting –Production/incentive compensation reporting –Reimbursement Sliding Fee FQHC Medicare and Medicaid Managed Care – Both Capitation and Fee for Service Grants and Special Programs (Indigent, Disease Management) –Automation Table Automation Custom Billing Preparation – Corporate billing Automated Alert Notes – Recalls, Missing information Managing non-billable resources Objectives of a CHC Implementation

7 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Initial Customer Visit includes meeting with: –Financial Department Representative –Clinical Services Manager –Billing Manager –Chief Operating Officer (optional) We ask for the following information: –Copy or list of all compliance reports filed (UDS, CADR,Title X) –Sample of each type of claim (primary AND secondary) filed Medicare A, Medicare B, Each Medicaid program, Grant payers, Dental, Special Plans. –Customer is furnished plugins for Medicare A (UGS), Medicare B, Medicaid (all programs), BCBS/Anthem, Dental CHC Implementation Visit - Checklist

8 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Custom Forms including: –Superbills –Patient Profile and Consents (bi-lingual) –Encounter Reports –Custom HCFA/UB-92/State Medicaid –Eligibility Applications FQHC Requirements for Prospective Payment Reimbursement Managed Care filing rules – wraparound rules Uninsured programs –Sliding Fee programs (Standard, Title X, Ryan White, Homeless) –State/County Indigent or Homeless Programs CHC Implementation Visit – Checklist (more)

9 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Discussion of Services Delivered –Primary medical care (including labs, pharmacy) –Immunizations – funded/unfunded, in-clinic/out-clinic –Hospital/Skilled Nursing Facilities –OB/Prenatal (Table 7 UDS, CPSP) –Pediatric care –Behavioral Health –Substance Abuse –Case Management – Social Services –Dental –School based health CHC Implementation Visit – Checklist (more)

10 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Workflow discussion –Patient Registration – New/Established Documentation required – Missing information/Required Fields/Mini-Reg Financial Interviewers used? Alias Tracking Custom Demographics –Family Billing –Scheduling – Clinic Based, Resource Based Open Access Forward Scheduling Time Study Requirements Resource Based/Non-Billing Resource Appointments CHC Implementation Visit – Checklist (more)

11 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Workflow discussion (continued) –Patient Registration – New/Established Documentation required – Missing information/Required Fields/Mini-Reg Financial Interviewers used? Alias Tracking Custom Demographics –Family Billing –Scheduling – Clinic Based, Resource Based Open Access Forward Scheduling Time Study Requirements Resource Based/Non-Billing Resource Appointments CHC Implementation Visit – Checklist (more)

12 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Workflow discussion (continued) –Billing Uninsured Patient Processing Check-in and Checkout process –Re-registration »Insurance Eligibility »Pending Medicaid vs. Presumptive Eligibility –Copay collection –Front desk Checkout vs. completion by Billing Department Organize transition to direct filing of claims for Medicare, Medicaid, Blues, Dental. Obtain submitter numbers OB Case management, Dental Case Management Medicare A/Medicare B split visit Title X – Confidential visits Patient Liability – Billing, Statements, Collections CHC Implementation Visit – Checklist (more)

13 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Workflow discussion (continued) –Reporting Daily Close process Monthly Close process – Financial reconciliation and outcome/production reporting Year-end financial audit process Compliance reporting – UDS, OSHPD, Title X, Homeless, CADR, etc. –Data Conversion System in use Discuss items to be converted including: –Demographics, Patient, Guarantor –Extended Demographics (Ethnicity, Language, Family Size, Income, multiple chart numbers including tie back to existing system –Balance Forward – Usually Patient only at beginning. Insurance worked off in old system and balances remaining after days transferred to Centrcity –Mid-Year implementations convert visit information for current year (for compliance reports) CHC Implementation Visit – Checklist (more)

14 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Workflow discussion (continued) –Data Conversion (continued) Timing for first pass conversion – prior to admin training if possible, enables building of master tables out of converted data. Determine desire to convert future appointments –Training matrix and timelines Number of users by classification, number of locations Training classes limited to 8 users per class per trainer General guidelines for training per class of 8: –2-3 Days Admin –1.5 Days Scheduling, Registration, Front Desk Checkout –1.5 Days Billing (prior to go-live) –2 Days Billing, Claim Submission (Primary/Secondary), Payment Posting, Reports Training (post go-live) CHC Implementation Visit – Checklist (more)

15 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training –Admin Master table creation, Company, Facility, Doctor, OP, Resource Setup of Payer information –Insurance Carriers –Fee Schedules –Sliding Fee Functionality »Allocation Sets »Sliding Fee Schedules »Custom Allocation Sets –FQHC claims setup, primary, wraparound, quarterly settle up –FQHC Approval Plugin setup –Non-traditional payment sources – Managed care carve-outs, capitation, grants, insurance carrier/corporate billing –Insurance Policy Type vs. Financial Class discussion CHC Implementation

16 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training (continued) –Admin (continued) CHC List Editor settings –Sliding Fee Schedules, Custom Allocation Sets –Automated processing, Sliding Fee Notification –Required fields, Missing information Schedule Admin – Appointment types, Appointment Statuses, Schedule Templates Resource setup – Determine non-billable resources and visit processing for them Review of custom forms and/or reports for processing (superbills, profiles, chart check out slips, appointment reports, daily productivity) Security Setup All Setup done in Live Database As much setup as possible is done through scripting, active reports and through data conversion CHC Implementation

17 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training (continued) –Super-user/End User Training Patient Registration –Selection of CHC Screen –Mini-Reg vs. Full Registration –Family Registration –Custom Fields –Missing Information –Sliding Fee and Homeless History – Auto Update Allocation Set –Confidential Visits –Document Management Integration of Alias Tracking Wait Status Screen Setup of Short-Cuts on Schedule Processing of Profiles – Bi-lingual Custom reports – Labels, forms CHC Implementation

18 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training (continued) –Super-user/End User Training Superbill, route slip, checkout form printing in accordance with workflow established in implementation or admin training. Checkout process –Payment Posting –Charge entry and Patient Determination including Visit Approval process –Receipt printing –Payment on account –On-demand statement printing Front desk administration –Appointment reports –End of day batch closing reports Activity Log and Appointment Activiity List Review CHC Implementation

19 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training (continued) –Billing Training Charge Entry –Medicare FQHC Primary Split to Medicare B –Medicaid FQHC/Non-FQHC –Family Planning Visit special processing »Confidential Visits »EPSDT –Multiple Encounter processing (if applicable) –Managed Care processing –Medicaid Pending (Including Reports) –Dental Billing - Cases –OB Case Management –Third Party billing interfaces (Lab Billing) –Visit Approval Process, Auto Adjustment CHC Implementation

20 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Review of Training (continued) –Billing Training (continued) Claims Submission – Electronic, Paper Payment Posting Secondary Processing – Paper/Electronic –FQHC Wraparound Processing –Custom HCFA/UB-92 requirements Case Management Encounter Billing (if applicable) Group Visit Billing (if applicable) Insurance Carrier/Corporate Billing (if applicable) Additional Visit Information, Immunizations, Dental –Reports End of Day Billing Audit Reports – Billing Status Analysis Periodic Financial Reports – CHC Electronic Statement Processing – FQHC Collections & Bad Debt Processing Month end processing Year end reports – year end accrual computations Productivity Reporting Disease Management, Collaborative, Grant reporting CHC Implementation

21 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Community Health Enhancements

22 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Complete CHC Demographics

23 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Single Form Navigation

24 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Single Form Navigation

25 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Single Form Navigation

26 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Single Form Navigation

27 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Single Form Navigation

28 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Theres More!

29 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – Expanded Contacts

30 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – User Defined

31 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Registration – User Defined

32 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Alias Tracking and Demographic History

33 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Dashboard Schedule Managment

34 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Referrals and Authorizations

35 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Referrals and Authorizations - History

36 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Referrals and Authorizations - Detail

37 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Includes Registry Export

38 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Includes Registry Export

39 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Includes Clinical Details

40 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Includes Clinical Details

41 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Track All IZs or Import!

42 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Track All IZs or Import!

43 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Immunizations – Immunizations Logs

44 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Dental Billing and Scheduling

45 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Dental Billing and Documentation

46 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Dental Billing and Documentation

47 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Dental Billing

48 CySolutions CHC Enhancements Training Thursday, June 12, 2014 ADA Paper and Electronic 837D

49 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Track Incomplete Registration Information!

50 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Track Incomplete Registration Information!

51 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Show All Tracked Information – User Configurable

52 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Expanded Document Management

53 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Single Click Document Retrieval

54 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Perinatal Case Management

55 CySolutions CHC Enhancements Training Thursday, June 12, 2014 UDS Table 7 Required Information and More!

56 CySolutions CHC Enhancements Training Thursday, June 12, 2014 UDS Table 7 Required Information and More!

57 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Electronic Lab Import and Lab History

58 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Electronic Lab Import and Lab History

59 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Abnormals Highlighted

60 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Ability to annotate lab findings

61 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Flowsheet Display Available

62 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Flowsheet Display Available

63 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Flowsheet Graph Also Available

64 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Flowsheet Graph Also Available

65 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Title X Reporting and Tracking

66 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Global Management of Title X, Immunizations, Perinatal, Referrals

67 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Complete Sliding Fee Functionality

68 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Patient Portion Automatically Computed from Schedules

69 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Medicaid and Medicare FQHC Visits Automatically Processed

70 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Unparalleled UDS, Title X and Grant Reporting

71 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Including Perinatal Table 7 and Tables 9(c) & 9(d)

72 CySolutions CHC Enhancements Training Thursday, June 12, 2014 What else do you get with all of this? Premium support Peace of mind – Over 70 satisfied FQHCs use our products in 32 states Smooth transition – We convert data from your existing system(s) We are experts in the FQHC compliance arena All products are maintained with updates no less than semi-annually At GE Healthcare, our FQHC experts provide regular forums and user group meetings to enable customers to realize the maximum from their investment

73 CySolutions CHC Enhancements Training Thursday, June 12, 2014 Contact information CySolutions Support (866) x234 7:00am – 7:00pm Central Time Weekends & Evenings on call


Download ppt "CySolutions CHC Enhancements Training Thursday, June 12, 2014 CySolutions Presents Functional enhancments for Centricity Practice Solutions Designed specifically."

Similar presentations


Ads by Google