Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Managing your Eclipsys PAS Bill Edits

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. What are PAS Bill Edits? Errors that have occurred on a registration that will stop an account from being billed May result in Uncollected revenue Cash flow delay Potential lost revenue if timely filing limits are exceeded

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. What is the purpose of working the report? To identify and correct all accounts that have a fatal bill edit so that Kaleida can collect for services rendered in a timely fashion. To identify and correct all accounts that have a fatal bill edit so that Kaleida can collect for services rendered in a timely fashion.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. How should you work the report? You should reference the RE101 PAS Bill Edits report on a daily basis. Updates and corrections are generally removed from the report after each nightly process cycles.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. To Access your PAS Bill Edits through Oracle: Accessing the RE101 Report in Oracle:

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 1. Double click on the “e” on your desktop, to access Kaleidascope

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 2. Click on “Applications”

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 3. Click “Oracle Discoverer” from your menu

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 4. Click on the “Connect” button

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 5. Type in your assigned Oracle User Name and password. Make sure that your pop ups are ENABLED.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 6. Click on “DSCP Reporting”

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 7. Click on the Browse button to get a list of all of the Oracle reports that you have access to.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 8.Select the RE101 Registration Errors Report. Click on Open

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 9. Click Yes to run the query for the RE101 Registration Error Report

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. 10. Your report is now available to work. Your report is now available to work.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Things to Know and Understand: Self Pay Accounts do not have any Bill Edits applied – therefore, you will never see a self pay account on your bill edit report.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Index to Common Bill Edit Fixes : Medicaid Replacement MCD Medicaid NYS…..p.17 Social Security Number …………………………….p.18 Relationship to Guarantor………………………….p.19 Patient Over 18 & Reln No…………………………p.20 Ins Rel Code Invalid………………………………….p.21 Special Characters in Add………………………….p.22 Att/Adm Should not be 8888 Referrring………p.23 Lab without Referring Facility…………………….p.24 Pat DOB Missing……………………………………….p.25 Pat Sex Code Invalid…………………………………p.26 Guarantor State Missing…………………………….p.27 Before Ins Effective Date…………………………..p.28 Carrier Secondary to Medicaid……………………p.29 No Fault or Workers Comp………………………..p.30

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Medicaid Replacement MCD Medicaid NYS – This error means you have added Medicaid secondary to a Medicaid Managed Care Program (i.e. Medisource, Comm Care, Fidelis, Univera Plus Med) To fix this error: Edit Pt Info and view the Ins. Screen. If Medicaid is listed as the 2 nd insurance plan, delete the Medicaid plan. Update visit and view the Ins screen. If Medicaid is listed as the 2 nd insurance plan, delete the Medicaid plan. You must list the Medicaid # in the Second Policy Number field of the Medicaid managed Care insurance.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Social Security Number = this error means that you left in the Social Security Number field. To fix this error – Edit Pt Info and enter the patient’s Social Security Number if available. If not, follow Kaleida’s format rules : for an unknown SS#, for patient who refuses to give their SS# or for a patient who is not a citizen of the U.S. (never had a SS# and never will have a SS#)

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Relationship to Guarantor – this error means that you did not enter a Relationship code on the Guarantor screen. To fix this error: Edit Pt Info, the Guar Tab and enter the correct Reln code. Update visit, click on the Guar Tab and enter the correct Reln code.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Patient over 18 & Reln No- This error means you did not list the patient (who is over 18 years of age) as the guarantor. To fix this error – The Guarantor is determined by age. If the patient is 18 or older, they will be their own guarantor. If the patient is 18 or older and of unsound mind, they should still be listed as their own guarantor. However, the patients representative should be indicated at the registration level on the Privacy Tab in the Personal Representative field. The system defaults the patient to be the guarantor Privacy, no matter how old the patient is. If the patient is under 18, the guarantor must be the legally responsible adult. When creating a registration/visit for a child, make sure you change the guarantor to the parent or responsible adult by clicking the CHANGE GUAR/INS button the the lower right. Be sure to verify that this is a changed on both the registration and visit level.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Ins rel code invalid – this error means there was a problem with the Subscriber relationship code. To fix this error – Edit Pt Info,click on the Ins. Tab. Edit the insurance and click OK on the screen with the Ins ID#. Click the Chg Guar/Ins button on the Insured Information screen and reenter the subscriber. Be sure to select the correct relationship of the subscriber to the patient. Click OK. Update Visit, click on the Ins Tab. Edit the insurance and click OK on the screen with the Ins ID#. Click the Chg Guar/Ins button on the Insured Information screen and reenter the subscriber. Be sure to select the correct relationship to the patient. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Special Characters in Add – this error usually means that the address has a # in it. Kaleida edits do not permit you to enter a # sign in the address. To fix this error – Edit Pt Info. Look at the address line and remove the # sign from the address (even if you aren’t the one who put it there!). Click OK. If there is no # in the address, examine address for other special characters such of - etc. and replace with appropriate alpha or numeric characters.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Att/Adm Should Not be 888 Referring, D – this error means no one entered the attending physician in Eclipsys or in Cerner. In Cerner when you do your KH Check-In you must verify the correct attending physician is listed in the attending Physician field. The attending physician is the physician listed on the script or the attending physician of the day. If referring Doc remains in the attending Physician field than a bill will not drop. After you make your changes click on the Save button. To fix this error In Eclipsys ( if process not completed in KH check-in)– Update Visit, click on the Phys Tab, tab to the Att Phys field and enter the attending the patient saw or the attending of the clinic if the patient was seen by a resident. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Lab without Referring Fac – this error means that the registrar used the wrong service area on the visit. To Fix this error – Update Visit, tab to the service area field on the basic screen and enter LOP. Tab off of the service area field and click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Pat DOB missing – this error means that the Date of Birth is not on the Registration To fix this error – Edit Patient Info, enter the patient’s date of birth and click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Pat sex code invalid – this error means that the sex code is listed as U for Unknown. To fix this error – Edit Patient Info, enter the correct sec code (F/Female or M/Male) and click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Guarantor state missing – this error means that there is no state listed on the Guarantor screen. To fix this error – Edit Pt Info, click on the Guar Tab, tab to the State field and enter the correct 2 letter abbreviation for the guarantor’s state, click OK. Update Visit, click on the Guar Tab, tab to the State field and enter the correct 2 letter abbreviation for the guarntor’s state. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys Before ins effective date – this error means that the effective date was entered on the Insurance screen and that the effective date is after the date of service. To fix this error – Edit Pt Info, click the Ins Tab, Edit the insurance and delete the effective date. Click OK. Update Visit, click the Ins Tab, Edit the insurance and delete the effective date. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them In Eclipsys Carrier Secondary to Medi- this error means an insurance is listed secondary to Medicaid. To Fix this error – Edit Pt. Info, click on the Ins Tab. Enter Sort in the Option field. Tab. Type the number in front of the insurances in the order they should be billed (in the Item field – separate the numbers with a comma), click Process. Medicaid cannot be primary over another insurance. Click OK. Update Visit, click on the Ins Tab. Enter Sort in the Option field. Tab. Type the number in front of the insurance in the order they should be billed (in the Item field). Click Process. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys No Fault or Workers Comp- This error means that you entered No Fault or Workers Comp to the visit but did not COB them correctly. To fix this error – Update Visit, click on the Ins Tab, enter Sort in the Option field. Tab. Type the number in front of the insurances in the order they should be billed (in the Item field separate the numbers with a comma). Click Process. No fault or Workers Comp CANNOT be secondary to another insurance. Click Process. Click OK.

Click the arrows to advance forward and backward. Click the Next link below to advance to the assessment. Common Billing Edits and How to Fix Them in Eclipsys After Ins Expiration Date – this error means that you have added an expiration date to the insurance while using the function “Change Ins – And”. When using the Change Ins-And function, you should not enter an expiration date. To fix this error – Update Visit and click on the Ins tab. There will be an E in the right column of the Insurance that you added an expiration date to on the Patient Insurance Information screen. Edit the insurance you added an expiration date to. Remove the expiration date from the insurance. Click OK until you are able to view the Billing Errors Display screen. The error will be gone.