4Financial Opportunity Is your billing process inefficientDo you have high staff turnoverAre you a new providerWhat priorities do you want to focus on?
5Portland Centricity® User Group Meeting January 29th, 2015
6Who We Are IT/computer consulting firm Established in 1997 12 network consultants (18 staff)66 of 175 clients are small/mid-sized clinicsVast majority use Centricity® via HealthCoHealthCo’s preferred IT partner in OregonLot’s of mutual clients with HePS(she’s a client of ours too )
7Why We’re Different No Long-term Contracts Hourly Billing or Fixed-fee No Mileage/Travel ChargesFeaturing:24/7 Help Desk/End-user SupportHIPAA & Compliance AssistanceEHR / PM Selection & SupportHardware & Software SalesVendor Relations Management24/7 Server Monitoring & AlertsMedical Practice Interfacing: Hospital, Lab, Radiology, EKG Ultrasound, Spirometry, etc.
8Some of Our Clients The Children’s Clinic Longview Orthopedic Pediatric Associates of the NorthwestCascade Eye CenterLongview UrologyHillsboro PediatricsColumbia Pain & Spine InstituteWestside Pediatric ClinicSunset PediatricsPortland Plastic Surgery GroupComprehensive Neurosurgical ConsultantsPortland Pain & SpineMaple Street ClinicMountain View Medical CenterOregon Reproductive MedicineVivid Eye CareWaldorf Center for Plastic Surgery…and many more
12“Guarantor Based” New Options Here we have some new settings for Guarantor based collections. You do have to check the Guarantor based collection letter option in order for these other options to work.There is now a new “Default collection status” for visits newly changed to a visit status of collections. In current versions, the default for a visit that just changed to a Visit Status of Collections is New.The new default looks for the most recent visit for the guarantor in collections based on DOS and sees what Collection status it has, then the system will change all newly turned visits to that same Collection status.You can still set it to New as the default if you want, but this way – if you have a guarantor with visits in Collections, you can have all their visits automatically be the same collection status instead of having some in 120 day delinquent and some in 45 courtesy reminder.We also have a new pop up alert warning for guarantors in collections.
13Billing NotesGE has enhanced the Billing notes. They are now user name and date/time stamped like the Correspondence notes. Notes that are repeatedly used can be created and saved in Administration. The user can select the note from a drop down list within registration.They have added security to this where you can set whether a user can delete, edit or inactivate/reactivate the notesType any notes pertaining to the billing.Add notes1 Click (New). The New Billing Notes window appears.2 Type the Note subject and text.3 Click Done. The new note appears in all Billing Notes windows for this patient throughout the application (reg, Charges tab of the visit and pymt entry).Edit notes1 Select the note from the list in the Billing Notes window.2 Click (Edit). The Edit Billing Notes window appears. 3 Complete your edits and click Done. The updates appear in all Billing Notes windows for this patient throughout the application.Delete notes use when... You want to completely remove the note from the database. Once deleted, the note cannot be retrieved.2 Click (Delete). The Delete Billing Notes query appears. 3 Click Yes to delete. The note no longer appears in all Billing Notes windows for this patient throughout the application.Inactivate/reactivate notes use when... You want to be able to retrieve the note at a later date.Inactivate a note1 Select the note from the list in the Billing Notes window.2Click (Inactivate). The note no longer appears in all Billing Notes windows for this patient throughout the application.Reactivate a note1 Click Display inactive billing notes in the Billing Notes window. Inactive notes display in the list. 2 Select the note from the list in the Billing Notes window.3 Click (Reactivate). The note appears in all Billing Note windows for this patient throughout the application.
14Open a patient’s chart summary from registration Also, when you are looking at a patient’s record in Registration, You can go directly from registration into the patient’s chart summary. In previous versions, the chart component would open in registration at the desktop level and then the user would need to search for the patient. It will now open directly into the chart for the patient that is being viewed in Centricity.
15Configure default Quantity and Type of Unit of Measure for DrugsYou can now configure default Quantity and Type of Unit of Measure for Drugs, from the Information screen on a CPT code (this was actually fixed in CPS version ) Setting this at the CPT code level will fill in the information appropriately when billing with the CPT code in the visit.
16Chart Contributor has been changed to Chart Access In Administration in the in the User table: Chart contributor has been changed to Chart Access. The function remains the same.
17Security (if upgrading from CPS95) There are new security settings to reflect the changes to the product:Account Summary- a new component for which security will need to be set. We will talk about this feature later in the presentation.Transaction Management – now can set security so that users can see the information, but can be restricted from moving and/or deleting transactions in the batch.Billing Notes now have security for adding new notes, editing, deleting, inactivating and reactivating. To se this go to Administration – Notes – Patient Billing NotesAccount SummaryAdministration – Notes – Patient Billing Notes
18Security – Increased Granularity If you are upgrading from Centricity Practice Solution 9.5 or later, Change patient contacts, Change patient home location of care, and Change patient photo permissions are automatically set for all users already granted Change Registration permission.If you are upgrading from a pre-9.5 version these permissions must be set manually after the application is updated.
19Account SummaryThe Account Summary component is another new feature in CPS v11. It is so exciting that we’ve created an entire section of this presentation on it!Good morning everyone!
20Account Summary is a new component in CPSv11 or later versions This component was created as a centralized place to review account information and troubleshoot patient account status.The module 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.What is Account Summary? It creates a centralized place to review account information and troubleshoot patient account status. This module 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.The account summary basically takes the AR window and the Registration component Patient, Insurance and Financial tabs and displays it in in View only, but much more user friendly format. This makes it much easier for viewing the AR to discuss it with a patient/guarantor.
21Set Up:Users must first be given access to Account Summary in Security before being able to view the component.In Administration > User and Resource Management > Users > Security > Account Summary. Either you have access to it or not.
22So here is a screen shot of the Account Summary component So here is a screen shot of the Account Summary component. Notice the left side navigation area, a blue “banner” or demographics information across the top and then the information in the panes. There are also 2 action icons Comparison View and Find patient which are your action buttons.
23Here is the Account Summary view side by side with the EMR chart Here is the Account Summary view side by side with the EMR chart. Notice the similarities in the left navigation panes and the layout is similar to EMR
24Demographics Area:The Find Patient button allows users to search for a patient or guarantor.In the demographics area, any patients linked to the guarantor will display.By highlighting each patient, you would see their individual insurance information.Here is a closer view of the Guarantor’s demographics banner. Notice the guarantor information on the left, in the middle we see alerts regarding any patients that are linked to that guarantor and to the right of that – a display of any patients that are linked to the guarantor.Note that by highlighting each patient, users can see their individual insurance information = also, users can quickly go directly into the registration record of whichever patient is highlighted by clicking the Go to Registration link.
25If you wanted to view the same information displayed in the Demographics section now, you would have to open up multiple registration windows and go back and forth between the Patient and Insurance tabs.
26Don’t forget your Patient Alert Notes messages… For those patients with Alerts messages like the patient has Visit in Collections, you have to close the pop up warning window that everyone always takes the time to stop and read and evaluate that information… right?
27Account Summary Demographics Area – is a helping hand! Having it all right there in one place without having to navigate through multiple windows or tabs is a great thing!Having the majority of the information right in one window is definitely a great thing!
28Financial Summary:Both the Financial Summary and Transaction History sections display data regarding all visits of all patients associated with the Guarantor.The Financial summary gives a quick snapshot of the balance aging and last patient payment receivedOur next section is the Financial Summary. The Financial summary gives a quick snapshot of the balance aging and last patient payment received,much like the information displayed under the Get Financial Information button in the Registration component
29If you wanted to view this same information now, you would need to: Open the Guarantor’s record in the Registration componentClick on the Get Financial History button
30Then view the information regarding each patient under the Guarantor Granted, this isn’t so bad – but you still don’t have access to all of the information needed to discuss an account with the patient/guarantor. The Account Summary puts access to everything you need in one place!
31Transaction History:The Transaction Summary shows an individual summary for all visits for the patients associated with the guarantor.If needed, users can drill down into a visit to examine it by clicking on the ticket # and it will open the visit in the Billing component.The next section is the Transaction History. Like the Financial Summary, the Transaction History displays data regarding all visits of all patients associated with the Guarantor.Like in the Account Receivable component, clicking on the + next to the ticket number will display detailed information regarding the visit.
32If you wanted to view this same information now, you would need to: Open the Patient’s record in the Registration componentClick on the Get Patient History button
34Go to the Billing Component to view the Visits related to the Guarantor to see the Visit Statues for each visit.And THEN to get the visit status information either go to the Billing or AR Component – as you can see, Account Summary makes this so much easier by having access to all of the information right there.
35Account Summary Financial Summary and Transaction History helps you see a Patient’s Account from Head to Toe!Another nice feature of the Transaction history is if the expanded view of the ticket isn’t enough information and the user needed to open up the visit in the Billing component, they simply need to click on the ticket number to open it up.
36Comparison Views:The Comparison Views button allows users to look at 2 account summaries side by sideUsers can also have several Account Summaries open for different patients at a time if needed, and you can also have a side by side view of 2 account summaries(for example if you wanted to view a husband and wife’s accounts as they are each their own guarantor).
37Dock/UnDock/Close:There are 3 icons located in the upper right portion of the Patient’s Account Summary window.The icon that looks like a partially unbent paperclip is the undock icon so you can undock this account summary and move it around your window.The open square is the dock icon.The X icon closes the account summary for the patient you are looking at, not the Account summary component.Additional icons in the upper right section of a guarantor’s summary – undock, dock, close.To Sum it up, this is a great tool to help your staff to answer patient questions about their account!Now let’s go into the product and check it out – let’s look for William Duff = see all patients.Comparison view: Joyce and Scott Davenport
42Ability to add custom HTML links to your left navigation pane that open within CentricityAdd custom links and commandsWith Administration > Custom Module Extensibility permissions you can createcustom HTML links in the left navigation pane and custom commands in the ribbonmenu that execute batch or system commands.
43Ability to add a URL using Set Up a Command function to open a new Web Page outside of Centricity
48Ability to minimize the ribbon Administration Edit items and frequently used features moved to Ribbon. LikeMicrosoft Outlook®, the ribbon Home menu offers easy to use visual groupings ofcommonly used features for Administration and Chart.
58New Immunization Management Form With this new HTML form you are able to set series and icons will display as a guide to determine if needed. Once you click on the icon you will now be able to administer the immunization. Dropdown fields can be predefined from Administration.
59New Immunization Management Form With this new HTML form you are able to set series and icons will display as a guide to determine if needed. Once you click on the icon you will now be able to administer the immunization. Dropdown fields can be predefined from Administration.
60New Immunization Management Form With this new HTML form you are able to set series and icons will display as a guide to determine if needed. Once you click on the icon you will now be able to administer the immunization. Dropdown fields can be predefined from Administration.
61New Immunization Management Form With this new HTML form you are able to set series and icons will display as a guide to determine if needed. Once you click on the icon you will now be able to administer the immunization. Dropdown fields can be predefined from Administration.
77HealthCo provides consulting services to assist in upgrade training as well as Meaningful UseConsulting.Please Contact:Andrea CunninghamDirector, Professional Services
78Managing Reimbursements Easy Money Managing Reimbursements Easy Money? Women’s Healthcare Associates Lana Giacomelli Business Office Manager & Jennifer Santos Reimbursement Supervisor
79Payment Options for Patient Balances (hint- make it easy for your patients to pay you!) Use of your portal for one time payments and/or setting up payment plansAbility for a guarantor to make a one time payment from your websiteCCOF (credit card on file) (we don’t use this – YET, but are considering it!) A CCOF program facilitates the collection of a credit or debit card from each patient and requires that this card be used for copayments, coinsurance and deductibles. You may collect an estimate of what is due at time of service and/or charge the credit card when the payer pays the claim.Overview of patient balances - Discussion about the increase in patient balances, and the trend is still ticking upward– are we paying attention to this, and how can we raise the issue to stakeholders to make informed decisions around policies and procedures we utilize to collect from our patients.Centricity vendor Kryptiq (in our area) provides portal access for patients, and provides options for you to set up your payment criteria to make it as easy as possible for patients to pay their balances.Options:Discount for paying in full within a certain timeframe.Make a one time payment.Set up a payment plan for specified period of time (you can set up a perimeter for a patient to set up their own plan) or provide a number for them to call in to set up an automatic plan with a representative from your organization.CCOF (credit card on file) programs - describe this program – ask if anyone is currently utilizing it, and their experience good or bad…
80Utilizing GE Centricity Technology to Streamline Workflows EDI services and website – offers good visibility of the claims processEFT – the key to eliminating the use of ‘virtual credit cards’ERA – automatically posting your insurance paymentsEstablish a team to manage the projectBe prepared for frustrations in setting up each carrier transaction column set (lessons learned - questions to ask to save time)ERA can be ‘turned on’ by carrier. We started with smaller payers to get used to the workflow change. Now at 85% of all carriers on ERA.Lana will start the discussion and outline what WHA is currently utilizing in Centricity to streamline workflows. Utilizing GE EDI services, we have access to the EDI website. The website offers a dashboard (default to last 7 days) that has robust reporting capabilities (available in claim number or claim $ options) and drill down capabilities that allows users to figure out the cause of a claim rejection quickly. WHA recently combined the reimbursement and collection teams into one department (a direct effect of utilizing Centricity EDI, EFT and ERA services to streamline the manual posting process)The focus of our learning opportunity today will be to dig into Task Management (available with our current version 12)Lana will introduce Jenn Santos, the Reimbursement Supervisor at WHA to take the group through the process of utilizing Task Management for assignment and monitoring of the A/R balances and team.
81Managing your team with Centricity Task Management Assigning SecurityA/R DistributionBuilding QueuesAdding CriteriaAssigning TasksFollow Up and MonitoringQuestionsShifting our focus now to the tools available in Centricity for management of A/R - Jenn Santos will take you through the steps to utilize Task Management effectively by showing you the step by step building blocks in Centricity.Jenn will review this outline, the take us through the individual steps…
82Assigning SecurityTask Management: Assign all users that will be using this moduleEverything else should be the person building and assigning tasks.Review that you have to assign users in security to view and use task manager.What should be assigned to users vs. Admin
83AR DistributionDescribe how our AR Department is divided out by insurance company then by alpha.
84Building Queues How to build a queue Go over the buttons at the top Review that it lists how many tasks meet the criteria next to the queue name
85Name your Queue Assign Users Name must be unique and not include any previous queue namesAssign UsersInclude anyone who will be working the queue along with the user who will be assigning tasks and anyone else you want to be able to view it.Explain the importance of removing the task once it no longer meets the criteriaAssigning users
86Adding Criteria Company Current Insurance Carrier Current Insurance GroupDays Since Last FiledDays Since ProcedureDepartmentFacilityPatient Last NameProcedure BalanceProviderResourceVisit Deposit BalanceVisit Insurance BalanceVisit OwnerVisit Patient BalanceVisit StatusCriteria optionsCompany – if you do billing for more than one companyCurrent Insurance Carrier – One specific insurance carrierCurrent Insurance Group – A whole group of many individual insurance carriersDays Since Last Filed – Days since the claim went out the doorDays since procedure – Days since the service was performedDepartment – Breakdown by department; office visit, mammogram, surgery etc.Facility – If you want to look at a specific sitePatient last name – if you work your AR by alphaProcedure balance – if you want to work tasks over a certain dollar amountProvider – Breakdown by providerResource – Breakdown by resources you have setup in the systemVisit Deposit Balance – If there is a deposit sitting on a ticket (you can put in a dollar amount range)Visit Insurance Balance – Work claims with a certain insurance balanceVisit owner – claims in a certain visit owner or excluded from a certain visit ownerVisit Patient Balance – working patient balancesVisit Status – If the claim is on hold, in progress, filed succeeded; we use it to exclude filed rejected claims
87How you run your department will determine the way you setup your queues. **Make sure to Save your queue!This is how I have our queues setup for my department. Depending on what data you want to look at will depend on how you setup the queue. Make sure that you save the queue!
88Queues Each queue updates every night How to manually run a queue Open Task ManagementBuild QueuesSelect the Queue you want to runRun QueueShow how to manually run queues.
89Assigning Tasks Select multiple lines at once Right click option Assign Task Button**User must have access to queue to view assigned claims**How I assign tasks.Assign them weeklyBy alpha by insuranceOne at a time or a large amount at once.
90Follow up and Monitoring Once claim has been worked the AR Specialist puts the claim in their visit owner along with a visit description. They also complete the task.**<date> <brief description>**1/20/15 Corrected ClaimOnce it is in the visit owner it will no longer meet the queue criteria and drop off the list the next day.Explain the follow up procedures.
92Future Decisions & Challenges Discussion Electronic Eligibility through GE?Phreesia or similar product compatible with Centricity?Patient balances – how to manage payment plans that make sense for your practice, and how to get meaningful reports on payment plan performance.Getting what you need for reporting and managing purposes from your vendors.Lana will thank Jenn for her presentation, then if time permits have more open discussion about future decisions and challenges…
93Thank you!We appreciate the opportunity to share ideas about the ever changing and challenging processes for managing the Revenue Cycle puzzle!Thank Jill Arena for the invitation to present to the group.