2015 User Conference Fixing Patient Accounts April 23 & 24, 2015 Presented by: Kim Gingras and Becky Lynch EHR Training Specialist - RCM Manager PM Session

2015 Office Practicum User Conference Objectives Identify the most common errors and their causes Acquire the tools necessary to correct the issues Learn about tools to document corrections made in accounts Identify strategies to decrease the number of occurrences

2015 Office Practicum User Conference Fixing Patient Accounts Lets take a look at the usual suspects….

2015 Office Practicum User Conference Incorrect Insurance Responsibility #1 We have posted a charge for a Well Visit and allocated $25 to patient responsibility. We realize our mistake and need to transfer the money to insurance responsibility. Example

2015 Office Practicum User Conference Incorrect Insurance Responsibility #1 Lets Review the Claim in the Account

2015 Office Practicum User Conference Insurance Responsibility Keep in mind….this is about responsibility not balance PATIENTINSURANCE

2015 Office Practicum User Conference Correcting Insurance Responsibility Revert Patient Responsibility Revert Pat Resp Claim and Line Ability ●Highlight the Claim or Charge line ●Click Revert Pat Resp button ●Responsibility has been transferred from the patient to insurance.

2015 Office Practicum User Conference Let’s Try It!

2015 Office Practicum User Conference Incorrect Insurance Responsibility #2 We posted an adjudication from UHC, noticing we were underpaid. We corrected and resubmitted, resulting in an additional payment and reduced adjustment. How should we post it? Example

2015 Office Practicum User Conference

Steps to Fix ●Highlight the Adjustment Line ●Click on Void button to Void the original Adjustment ●Post Additional insurance payment with reduced adjustment

2015 Office Practicum User Conference Let’s Try It!

2015 Office Practicum User Conference Transferring Patient Responsibility No more transferring money to patient from the Edit Pencil in Claims window

2015 Office Practicum User Conference Transferring Patient Responsibility Go to Add Payments and Adjustment window Select Adjustment Only in the Payment Method dropdown Post $0 in pay amount, $0 in the insurance adjustment and the amount of patient responsibility in patient adjustment

2015 Office Practicum User Conference Transferring Patient Responsibility Why do we have this new workflow? To provide an Audit log of changes made to the patient account.

2015 Office Practicum User Conference Let’s Try It!

2015 Office Practicum User Conference Over Adjustments on Patient Accounts Have you seen these “Reverse overpayments”?

2015 Office Practicum User Conference Over Adjustments on Patient Accounts Why do these Reverse Overpayments occur? ●Posting Additional payments on a previously paid claim due to resubmission for additional money. ●Posting Duplicate claim adjustments from ERA ●Posting Secondary Claim payments and adjustments

2015 Office Practicum User Conference Correcting Over Adjustments ●Ensure you have the paper EOB for these payments. ●Void the payments/adjustments in the Claims tab, which will place money into the credits tab ●Go and post payment using Payer credit and reduce the adjustment amount.

2015 Office Practicum User Conference Let’s Try It!

2015 Office Practicum User Conference Out of Proof Patient Accounts ●Highlight the claim in question ●Click the Rebuild button to fix the account.

2015 Office Practicum User Conference Out of Proof Patient Accounts ● How does it happen? ○ Excessive voiding ○ Deleting a claim with payments (Ins or Pt) attached. ● When to call Support? ○ When rebuild doesn’t work, or if rebuild does work, but after running a daysheet, the discrepancy comes back. ● When not to call Support? ○ When rebuild works

2015 Office Practicum User Conference Tools for documenting corrections/changes in OP Accounts ●Billing Notes ●Claim Notes ●Tasks ●Messages What are some of the tools we can use to document the patient account after making corrections.

2015 Office Practicum User Conference Resources OP Help: Correcting Patient Claim Errors 40/Correcting+Patient+Claim+Errors

2015 Office Practicum User Conference Questions ?

2015 Office Practicum User Conference We want your feedback!