vitera intergy 7.10 new system features

New System Features, Version 7.10Vitera Intergy

Vitera Intergy 7.10 New System Features

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Table of Contents Vitera Intergy Basics ............................................................................................................ 1

Add Mobile Phone Numbers in Patient Registration .......................................................................................... 2 Edit and Delete Added States ..................................................................................................................................... 4 New Pending Charges Icon in the User Toolbar ................................................................................................... 5

Patient Information ............................................................................................................. 6 Patient Information Remembers Last Page Accessed ........................................................................................ 7 Record Patient/Person Information History System Parameter Enhancement .......................................... 8 High Priority Patient and Account Alerts ................................................................................................................ 9 New Verified With Family Option for Advance Directives ............................................................................... 11 Ethnicity Information Added to the Summary Tab in Patient Information ............................................... 13 Canceled and Rescheduled Appointment Date and Time Now Display in Patient Information ........ 15 View Insurance Plan Notes From the Insurance Tab in Patient Information ............................................. 17

Financial ............................................................................................................................. 19 Schedule Collections Automatic Add and Remove to be Run by the Vitera Intergy System .............. 20 Collections Add and Remove Finance Group Options ..................................................................................... 26 Delete Multiple ERA Checks at Once ...................................................................................................................... 29 Charge Posting Warning Message for Duplicate Charge Information ........................................................ 30 Reopen a Closed Journal ............................................................................................................................................ 31 Encounter Can Be Required for Charge Posting ................................................................................................. 32 Journal Management Displays User Who Closed the Journal........................................................................ 33 Patient and Account Alerts Shown When Selecting Pending Charge ........................................................ 34 General Ledger Account Code Maintenance Allows Inactive Codes ........................................................... 35 Turn Off $0 Charge Posting Warning ...................................................................................................................... 37 Refund Check Batch Printing Has Refund Journal Filtering ............................................................................ 38 Journal Close Window Renamed Journal Management .................................................................................. 40 View Who Created an Insurance Card Scan .......................................................................................................... 42 Show Copay Amount if AEV is Unknown .............................................................................................................. 43

Insurance Billing ................................................................................................................ 44 Auto Assign Insurance Serialization Change ....................................................................................................... 45 Create Pending Insurance Policies .......................................................................................................................... 55 Universal Billing Page and Header Information .................................................................................................. 58 Ability to Open System Insurance Plan Maintenance in Vitera Intergy Desktop ..................................... 59

Clinical ................................................................................................................................ 61 Internal Use Only Indicated on Rx Note ................................................................................................................. 62 Editing Lab Order Tasks in Vitera Intergy Work Tasks ....................................................................................... 64 Lab Purge Utility Changes .......................................................................................................................................... 66

Encounters ......................................................................................................................... 70 Select Encounter Date Range in the Pending Charges Window ................................................................... 71

Community Health Care .................................................................................................... 75 Medicare Mental Health Rate Change .................................................................................................................... 76 Preventive Procedures for Medicare Clinic Rates ............................................................................................... 78 Additional Sliding Fee Minimum Amount Options ........................................................................................... 79 Medicaid Clinic Rates for States Enhancements ................................................................................................. 83 OSHPD 2011 Reporting ............................................................................................................................................... 86 CA FPAR Identifies Unassigned Insurance Plans ................................................................................................. 88 Set Patient Age Ranges for CA FPAR Report ........................................................................................................ 89


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CA FPAR Follow-up Encounter Reporting ............................................................................................................. 90 UDS 2011 Reporting ..................................................................................................................................................... 91 UDS Report Table 6B Updates ................................................................................................................................... 92 UDS Report Table 7 Updates ..................................................................................................................................... 96 UDS Report Clinical Audit Worksheet Updates ................................................................................................... 97 Using the UDS Report Clinical Audit Worksheet for Table 6B Reporting ................................................. 100 Using Practice Analytics for Table 6B Reporting ............................................................................................... 102

Transcriptions .................................................................................................................. 113 New Referring Provider Merge Fields ................................................................................................................... 114 Edit Transcription Catalog Entry From Transcription Writer Work List ..................................................... 116

Letters and Labels ........................................................................................................... 119 New Letters/Labels Processing Merge Fields .................................................................................................... 120 New Letters/Labels Processing Merge Fields for Recalls ............................................................................... 125 New Letters/Labels Processing Merge Fields for Appointments ................................................................ 126

Scheduling ....................................................................................................................... 129 Appointment Time Displayed When Printing Referral Information .......................................................... 130 Day of Week Is Displayed with the Date When Making an Appointment ................................................ 132 Prevent New Appointments for Patients in Collections ................................................................................. 133 Appointment Template Color Palette Expanded ............................................................................................. 135 Patient Flow Tracking Window Can Be Resized ................................................................................................ 137

Reports ............................................................................................................................. 138 Exclude Encounters That Have Pending Charges from the Patient Encounters Report ..................... 140 Clinical Activity Audit Reporting ............................................................................................................................ 142 Pending Charge Report ............................................................................................................................................. 143 Procedure Analysis Report Filters by Modifiers ................................................................................................. 145 Appointments by Day Report Can Include Primary Insurance Information ............................................ 147 Patient Report Can Show Deactivated or Deceased Patients Only ............................................................ 149 Additional Displays of Insurance Plan Information in Appointment Worksheet Report .................... 150 Procedure Productivity Report Can Show Modifiers ....................................................................................... 152 Open Item Report Has Procedure Sort and Filter ............................................................................................. 154 Filter the Procedure Analysis Report by Diagnoses and Patient Age Range ........................................... 156 Filter the Referring Provider Analysis Report by Date ..................................................................................... 157 Additional Payment Allocation Report Sorts and Filters ................................................................................ 158 Procedure Reimbursement Report Can Filter by Post Date .......................................................................... 160 Procedure Reimbursement Report Sorts and Filters by Procedure Code ................................................ 161 Account Summary Report Has Additional Filters ............................................................................................. 163 Patient Report Sorts and Filters by Insurance .................................................................................................... 164 Practice Financial Summary Report Provider Sort Change ........................................................................... 166 Option to Remove the Total Payment Amount from the Payment Description in the Open Item Payment History Report ............................................................................................................................................ 167 Stop Scheduled Reports from Being Run ............................................................................................................ 169 Appointments Detail Report and Appointments Exception Report Show Additional Dates and Times ............................................................................................................................................................................... 172 Patient Referral Source Report Filters by Patient Registration Date .......................................................... 174 New Percent of Total Column in the Insurance Ranking Report ................................................................. 176 New Show Patient Detail and Include Event Comments Options in the Patient Flow Analysis Report ........................................................................................................................................................................................... 177 Filter and Sort the Provider Productivity Report by Supervising Provider .............................................. 180 Include Secondary Diagnoses Codes on the Diagnosis Analysis Report .................................................. 181 Primary Insurance Productivity Report Enhancements .................................................................................. 182 Procedure Modifiers Now Display in the Insurance Productivity Report ................................................. 183

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Phone Tree Report Contains New Fields ............................................................................................................. 184 Enhanced Sorting in Phone Tree Reports ........................................................................................................... 185

HL7 .................................................................................................................................... 186 Search HL7 Queue Using Text String .................................................................................................................... 187 Viewing Unformatted HL7 Text .............................................................................................................................. 188

RIS ..................................................................................................................................... 189 Indicate the RIS Studies That Have a Report Attached ................................................................................... 190 Cloud-based Fax Systems Available for Document Delivery System ........................................................ 191

Practice Setup .................................................................................................................. 195 Warn If Saving a Duplicate Clinician Provider Identifier ................................................................................. 196 Patient, Account, and Charge Notes Security Enhancements ..................................................................... 197 Activity Audit Logs Include Report Duration ..................................................................................................... 198 Copy a Role Definition ............................................................................................................................................... 201

System Setup ................................................................................................................... 208 Century Change Year Calculation .......................................................................................................................... 209 Restrict PHI Access in Administration Windows by User ............................................................................... 211 Access Practice Configuration from Vitera Intergy and Vitera Intergy EHR ............................................. 213 Limit Future Dates that Can be Entered .............................................................................................................. 216 Copying System Users ............................................................................................................................................... 217 Customize Transcription Approval Text .............................................................................................................. 219 System Maintenance Scheduler Shows All Client Connections .................................................................. 221 Meaningful Use Update Utility ................................................................................................................................ 222


Vitera Vitera Intergy 7.10 New System Features 1

itera Intergy Basics

Vitera Intergy Basics This chapter discusses enhancements to basic features in the Vitera Intergy system, such as Patient Registration.

Add Mobile Phone Numbers in Patient Registration

Edit and Delete Added States

New Pending Charges Icon in the User Toolbar


2 Vitera Intergy 7.10 New System Features Vitera

Add Mobile Phone Numbers in Patient Registration

You can now enter mobile phone numbers when you register a patient.

This enables you to record the mobile phone number for a new patient as well as the guarantor, emergency contact person, and parent/guardian for the patient.

Previously, you could enter mobile phone numbers for patients only when you were editing previously recorded patient information for an existing patient in Patient Information and Person Maintenance or adding a new person in Person Maintenance.

Now, you have the ability to add mobile phone numbers at the time of registration.

The new Mobile Phone field has been added to following pages of Patient Registration: Patient Demographics, Guarantor Information, and Contact Information.

Additionally, the following Vitera Intergy system reports have been modified to display mobile phone information in the report.

Appointments Worksheet Report

Appointments Detail Report



Patients With No Activity Report

Quick Patient Registration Report

Recall Report

Appointments Wait List Report

Appointments with Expired Slide Report

Collections Report with Demographics

Health Management Recall Report

Appointments by Patient Report (Note that the Appointments by Patient Report had included mobile phone information prior to this enhancement.)

For example, the Appointments Detail Report now includes the Mobile Phone heading below the Home Phone heading in the same column. The report displays the mobile phone number for each patient included in the report who has a phone number recorded in the new Mobile field in Patient Information.

The Appointments Detail Report has been enhanced to display mobile phone numbers. As a result of the enhancement, if you use the Appointments Detail Report to manually generate the output file for your Phone Tree system, it is necessary to contact Phone Tree to continue this report with your Phone Tree system. It is possible to use the Appointments Phone Tree Report for generating the output file for your Phone Tree system without additional changes.



Edit and Delete Added States

In Zip Code Maintenance, you can now edit or delete a state prior to saving the ZIP code.

This allows you to change or remove a state that was created in error.

The new Edit and Delete buttons have been added to the Select State dialog box in Zip Code Maintenance.

Note that you can edit and delete only those states that were created manually in Zip Code Maintenance. You cannot edit and delete the pre-defined U.S. states.

Additionally, you can edit a manually added state from the State fields in some Vitera Intergy windows, such as Service Center Maintenance and Person Maintenance.



New Pending Charges Icon in the User Toolbar

You can now add a Pending Charges icon to your User Toolbar in the Vitera Intergy Desktop.

After the Pending Charges icon has been added to your User Toolbar, selecting the Pending Charges icon will open the Pending Charges window.



Patient Information

Patient Information This chapter provides information about Patient Information enhancements.

Patient Information Remembers Last Page Accessed

Record Patient/Person Information History System Parameter Enhancement

High Priority Patient and Account Alerts

New Verified With Family Option for Advance Directives

Ethnicity Information Added to the Summary Tab in Patient Information

Canceled and Rescheduled Appointment Date and Time Now Display in Patient Information

View Insurance Plan Notes From the Insurance Tab in Patient Information



Patient Information Remembers Last Page Accessed

The Patient Information window now remembers the last page you accessed.

When you close the Patient Information window and/or logout of Vitera Intergy, Vitera Intergy remembers the last page you accessed. The next time you open the Patient Information window, the last Patient Information page you accessed before closing the Patient Information window will display.



Record Patient/Person Information History System Parameter Enhancement

The Record Patient/Person Information History system parameter has been enhanced in the System Configuration window in System Administration. You now have the option of being prompted to record the previous patient/person information in the Edit Patient Information window or the Person Maintenance window.

The Record Patient/Person Information History system parameter now has the following options:

(Y)es The user will not be prompted to record the previous patient/person information and the previous patient/person information will be automatically recorded.

(N)o The user will not be prompted to record the previous patient/person information and the previous patient/person information will not be automatically recorded.

(P)rompt The user will be prompted to record the previous patient/person information.



High Priority Patient and Account Alerts

Vitera Intergy has been enhanced to show 'High Priority Patient and Account alerts throughout the system.

If patient and account alerts are specified as 'High Priority in the Alert Maintenance window, they display in bold, red text and the 'Yes' indicator displays in the High Priority column of the Patient Alerts and Account Alerts windows.

If you would like to specify an alert as 'High Priority' when assigning a new patient or account alert in Vitera Intergy, you can select the High Priority check box to specify that a patient or account alert should display as high priority.



New Verified With Family Option for Advance Directives

A new option, 'Verified With Family,' is now available for Advance Directives in the Advance Directives tab on the Privacy page in Patient Information.

The Verified With Family check box specifies whether or not the family is aware of the advance directive that determines the care provided in the situations specified in the advance directive.



Note that if the Verify With Family check box is cleared, the Patient Aware check box must be selected if the patient is aware of the advance directive or the name of the party responsible for the advance directive must be entered in the Third Party field.



Ethnicity Information Added to the Summary Tab in Patient Information

A patients ethnicity information has been added to the Summary tab on the Personal page in Patient Information in the Race/Eth field. Previously, you could only view a patients ethnicity information in the Edit Patient Information window.

Now, if a patient has ethnicity information in Vitera Intergy, it will display in the Summary tab on the Personal page in Patient Information in the Race/Eth field.

For example if a patients race is defined as Caucasian and their ethnicity is defined as Other, the patients race and ethnicity will display as C / O.



Canceled and Rescheduled Appointment Date and Time Now Display in Patient Information

When an appointment has been canceled or rescheduled, the date and time that the appointment was canceled or rescheduled now display in the Appointments tab on the Scheduling page in the Patient Information window.

The date of the cancelation or rescheduling now displays next to the Cancelled on or Rescheduled on field in blue text in the lower portion of the Appointments tab.

In addition, both the date and time of cancelation or rescheduling now display in the Notes box in the lower portion of the Appointments tab.



View Insurance Plan Notes From the Insurance Tab in Patient Information

You can now view insurance plan notes from Patient Information by clicking the Notes icon in the Details pane of the Insurance tab.

The Plan Notes window displays in View Only mode.



Financial

Financial This chapter discusses enhancements to financial features, including billing and charge posting features.

Schedule Collections Automatic Add and Remove to be Run by the Vitera Intergy System

Collections Add and Remove Finance Group Options

Delete Multiple ERA Checks at Once

Charge Posting Warning Message for Duplicate Charge Information

Reopen a Closed Journal

Encounter Can Be Required for Charge Posting

Journal Management Displays User Who Closed the Journal

Patient and Account Alerts Shown When Selecting Pending Charge

General Ledger Account Code Maintenance Allows Inactive Codes

Turn Off $0 Charge Posting Warning

Refund Check Batch Printing Has Refund Journal Filtering

Journal Close Window Renamed Journal Management

View Who Created an Insurance Card Scan

Show Copay Amount if AEV is Unknown



Schedule Collections Automatic Add and Remove to be Run by the Sage Intergy System

Schedule Collections Automatic Add and Remove to be Run by the Vitera Intergy System

You can now set up Collections Automatic Add and Remove to be run on a schedule by the Vitera Intergy system.

This enables you to add and/or remove collection accounts and notify assigned users automatically whenever the scheduled run occurs.

Previously, you could add and/or remove collection accounts in your Vitera Intergy system when you performed a Collections Automatic Add and Remove run.

Now, you can add and/or remove collection accounts when scheduled Collections Automatic and Add and Remove runs occur and send a new Vitera Intergy notification about the run to one or more assigned users. The notification includes attached files of the standard reports about the collection accounts that were added and/or removed.

The new Schedule Collections Add/Remove feature has been added to the Vitera Intergy system. The feature can be accessed from Vitera Intergy Practice Administration and from the Collections Automatic Add and Remove window.



Scheduling a Collections Automatic Add and Remove System Job



Scheduling a Collections Automatic Add and Remove System Job

You can schedule a system job to perform a scheduled Collections Automatic Add and Remove run that can add accounts to collections and/or remove accounts from collections in your Vitera Intergy system.

Scheduling a Collections Automatic Add and Remove system job includes setting collections criteria for the job, selecting the practice users who will receive notification about the system job, and specifying the start date, start time, and day(s) of the week for the job to be run.

Follow the steps below for instructions on scheduling a collections automatic add and remove system job.

1. You can open the Schedule Collections Automatic Add/Remove window from the Collections Automatic Add and Remove window by clicking the Schedule link located in the lower portion of the window.

Optionally, you can open the Schedule Collections Automatic Add/Remove window from Vitera Intergy Practice Administration menu bar by selecting the Utilities menu, selecting Schedule, and then selecting Collections Add/Remove.

2. To add accounts and selected responsible parties to Collections, select the Perform Automatic Add check box. If you do not want to add any accounts at this time, clear the check box.

If you selected the Perform Automatic Add check box, verify the default settings in the Perform Automatic Add section for adding accounts and selected responsible parties to Collections. You can add or edit field values, if necessary.

The next action that is specified for guarantors and insurance will be performed when the next scheduled Collections Automatic Add and Remove system job is run.



3. To remove accounts and selected responsible parties from Collections, select the Perform Automatic Remove check box. If you do not want to remove any accounts during this run, clear the Perform Automatic Remove check box.

If you selected the Perform Automatic Remove check box, verify the Responsible Party Type field default setting for removing accounts and selected responsible parties from Collections. You can change the setting, if necessary.

4. In the Notification Users section, you can assign the Vitera Intergy system users who will be notified about the system job run by clicking the Assign Users button and selecting the users.

5. To set the schedule for the Collections Automatic Add and Remove system job, click the Schedule button. The Schedule System Job dialog box displays on the Select Job Run Frequency page. The Weekly radio button is selected to run the job on a weekly frequency.

It is recommended that your practice run the Collections Automatic Add and Remove on a weekly basis to update the accounts that are added to and/or removed from collections. Optionally, you can select a different job run frequency by clicking the radio button for the frequency that you want to use.

6. Click the Next button. The Select Job Run Time page displays.

7. In the System Job Name field, the 'Collections Add/Remove' job name is displayed. You can edit the name of the system job.



8. In the Start Date field, the date for today is displayed. You can change the date on which the job run will be started.

9. In the Start Time field, the current time is displayed. You can change the time of day when the job run will be started.

10. Specify the day(s) of the week on which to run the scheduled Collections Automatic Add and Remove system job by selecting the check box for each day of the week that you want to run the system job to add and/or remove collection accounts in your Vitera Intergy system.

11. Click the Next button. The Activate System Job page displays.

12. To activate the job to be run by the Vitera Intergy system on the specified date and time, select the Activate System Job check box.

13. Click the Finished button to save the scheduled Collections Automatic Add and Remove system job and return to the Schedule Collections Add/Remove window.

The specified users will receive a notification task after the system job run. The task provides the users with information about the system job run and the ability to view the add and/or



remove reports for the system job run. If the system job or the report fails, the task notes indicate that one or more errors occurred. For more information about the user notification task, see the Working an Auto Collection Rpts Notification Task from Work Tasks topic.

You have just completed Step-by-Step Scheduling a Collections Automatic Add and Remove System Job.



Collections Add and Remove Finance Group Options

You can now set the finance group for accounts that have guarantor-responsible parties when the accounts are added to Collections or removed from Collections.

When adding accounts to Collections, this allows you to select a finance group that will replace the current finance group on the accounts that have guarantor-responsible charges for which the accounts and responsible parties are being added into Collections. This can be helpful for stopping statements for the account and guarantor that are based on the original finance group prior to the account entering Collections.

Additionally, when removing accounts from Collections, this allows you to choose whether you want the account finance group to be set to the previous finance group that was set for the collection account or select another finance group.

The following enhancements have been added to the Collections Automatic Add and Remove window:

The new Set Finance Group (Guarantor only) check box and field for entering a finance group have been added to the Perform Automatic Add section.

You can select the Set Finance Group (Guarantor only) check box and specify a finance group in the field on the right side of the check box to assign a finance group to replace the current finance group.



Clearing the check box prevents a different finance group from being specified for the accounts and guarantor-responsible parties that are being added to Collections. The account has the same finance group as prior to entering Collections

The new Set Finance Group (Guarantor only) check box, radio buttons, and field for entering a finance group have been added to the Perform Automatic Remove section.

You can select the Set Finance Group (Guarantor only) check box and use the radio buttons to specify whether to use the previous finance group that was set when the account was added to Collections or to select a different finance group to replace the previous one for the collection accounts. If you are selecting a different finance group, you can enter the finance group in the field on the right side of the radio buttons.

Clearing the check box prevents a different finance group from being specified for the accounts and guarantor-responsible parties that are being removed from Collections.

The same enhancements have been added to the Schedule Collections Add/Remove window. This allows you to specify the finance groups that will be assigned when scheduled Collections add/remove run is performed by the Vitera Intergy system.



The finance group cannot be replaced for accounts with insurance-responsible parties that are being added to Collections or removed from Collections.



Delete Multiple ERA Checks at Once

You can now delete multiple ERA remittance checks at the same time.

This allows you to select more than one ERA check in the Check Posting tab and delete all of the checks at once.

Previously, you could select and delete only one remittance check.

Now, you can select one or more remittance checks and delete all of the selected checks.

The Delete Selected Check item on the Utilities menu has been modified to Delete Selected Checks. The menu item is enabled when more than one ERA check is selected in the Check Posting tab list of checks.

If you select more than one check and attempt to delete, the warning dialog box for the deletion displays the number of checks that are about to be deleted.



Charge Posting Warning Message for Duplicate Charge Information

You can now receive a warning message when you attempt to add a charge that may be a possible duplicate charge.

This allows you to be notified when you enter a provider, procedure, and service date that are the same as another charge for the same patient and attempt to add the charge.

Previously, you could add the charge and not have an indication that the charge may be a duplicate of an existing charge.

Now, you can be notified about the duplicate charge information and select whether to continue or stop adding the charge.

The new warning message about duplicate charge information has been added to Charge Posting. The warning message will display when you click the Add button to add the charge and a duplicate procedure, date of service, and provider are detected on a previous charge for the patient.



Reopen a Closed Journal

You can now reopen a closed journal.

This allows you to apply corrections or changes to a journal that had been closed previously without having to call and use support services.

Previously, when a journal was closed for a post date, the journal could not be reopened by the site.

Now, after a journal has been closed, the journal can be reopened by a practice administrator until a daily close is performed for that journals post date. Once a daily close for a post date is performed, no journals can be reopened.

The new Reopen Journals window has been added to Vitera Intergy Practice Administration.



Encounter Can Be Required for Charge Posting

You can now specify whether an encounter number is required in the Encounter field when you are adding and posting charges in Charge Posting.

This can ensure that users will associate an encounter with a charge for a patient.

Previously, you could add a charge whether an encounter for the charge was entered or no encounter was entered.

Now, you have the option to specify whether an encounter is required information for a charge.

The new Encounter Required for Charge Posting practice parameter has been added to Practice Configuration. You can select one of the following choices:

Yes The encounter code is required to post a charge.

No The encounter code is not required to post a charge.

The parameter is shipped with a default value of '(N)o'.



Journal Management Displays User Who Closed the Journal

You can now the view the logon ID of the user who closed a journal.

This allows you to identify the user who closed a journal in Journal Management.

Previously, the user who closed a journal was not displayed.

Now, the logon ID of the user who closed a journal is displayed for each closed journal.

The new By User column has been added to the list of closed journals in the Closed tab of the Journal management window.



Patient and Account Alerts Shown When Selecting Pending Charge

Patient and account alerts are now displayed in the Select Pending Charge dialog box.

This allows you to view the existing patient and account alerts that are associated with the pending charge patient and account for which you are posting charges.

Previously, you did not have the chance to view the patient and account alerts when you selected a pending charge for a patient.

The new alerts list now displays in the Select Pending Charge dialog box. Any existing patient and/or account alerts associated with the pending charge patient and account are listed in the lower portion of the dialog box. The alert type and description are displayed. The alerts list displays only when one or more alerts exist.



General Ledger Account Code Maintenance Allows Inactive Codes

You can now deactivate practice-defined Adjustment and Refund type general ledger account codes when your practice is using a standard general ledger processor. Additionally, you can reactivate a general ledger account code that was deactivated.

Deactivating a general ledger account code allows you to prevent a practice-defined Adjustment or Refund general ledger account from being used. A deactivated general ledger account is not displayed in the GL Accounts page in Provider Maintenance and is not available in selection lists. Reactivating a general ledger account allows you to set an inactive account to be available for use again.

Previously, the ability to deactivate a general ledger account was not available. To prevent a practice-defined Adjustment or refund general ledger account from being used, you could delete the account, but only if the account had not been assigned to transactions in the system.

The following enhancements have been added to the General Ledger Account Code Maintenance window:

The new Deactivate button now displays when an active practice-defined Adjustment or Refund general ledger account code is selected.

The new Activate button now displays when a deactivated practice-defined Adjustment or Refund general ledger account code is selected.



General ledger account codes that have been deactivated now display in the GL Account Codes list in gray text.

The new label Inactive in blue text now displays when a deactivated general ledger account code is selected.



Turn Off $0 Charge Posting Warning

You can now select whether a warning message will display when you attempt to post a charge amount of $0.00.

This provides you with the ability to prevent the warning message from displaying if your practice typically works with posting $0.00 charges.

Previously, a warning message displayed whenever you attempted to post a $0.00 charge amount.

Now, you have the option to display the warning message or prevent the message from displaying.

The new Warn When Posting $0 Charges system/practice parameter has been added to System Configuration in Vitera Intergy System Administration and Practice Configuration in Vitera Intergy Practice Administration. You can select the following options:

(Y)es The warning message will display.

(N)o The warning message will not display.

The parameter is shipped with a default value of '(Y)es'.



Refund Check Batch Printing Has Refund Journal Filtering

When choosing which journals to filter refunds by in Refund Check Batch Print, only those journals that have refunds in them are now displayed.

This provides you with the ability to view and filter a smaller set of journals that includes only those journals that could possibly be in the batch of refunds.

Previously, journals were displayed in the list of journals for filtering regardless of whether the journals contained refunds in them and could have been included in the refund batch.

The following enhancements have been applied to the Select Refund Check Filters dialog box in Refund Check Batch Print:

In the Options section, the label of the Journals button was 'All Journals' and is now 'All Refund Journals'.

When you click the Journals button, the dialog box that displays was 'Select Journal' and is now 'Select Refund Journal'. In the dialog box, the 'All Journals' list is now 'All Refund Journals'. The 'Selected Journals' list is now 'Selected Refund Journals'.



Journal Close Window Renamed Journal Management

The Journal Close window in Vitera Intergy Desktop and Vitera Intergy Enterprise has been renamed Journal Management.

To open Journal Management from the Vitera Intergy Desktop or Vitera Intergy Enterprise menu bar, select the Financial menu, and then select Journal Management.

In addition, the security override for the Journal Management feature has also been renamed Journal Management.



View Who Created an Insurance Card Scan

You can now view who created an insurance card scan in Vitera Intergy.

The user logon of the user that scanned the insurance card and the date and time when the insurance card was scanned is displayed in Scanned By and On fields in the lower-right corner of the Insurance Card Window for both the Front and Back images of the insurance card.



Show Copay Amount if AEV is Unknown

A patient's copay amount now displays in the patient flow work list of the Patient Work Flow window, and in the Patient Check In list of the Patient Check In window if the patient's AEV status is 'Unknown.'

The Copay column displays a copay amount associated with the visit type. The amount is determined by the following conditions:

If the AEV status is Active and a copay value has been reported from the eligibility check, this copay amount will be displayed. Note that multiple copays can be reported from AEV for different categories of copays such as an office visit or a specialist. If multiple copays are reported, the highest copay amount is displayed by the system.

If the AEV status is Active and a copay value has not been reported from the eligibility check, the copay amount defined at the system level for the primary plan will be displayed. Note that this amount is displayed in brackets in this field and the following message is displayed in blue text at the bottom of the window: 'Not AEV'.

If the AEV Status field is blank because an eligibility check was not run or information was not received from AEV, the copay amount defined at the system level for the primary plan will be displayed. Note that this amount is displayed in brackets in this field and the following message is displayed in blue text at the bottom of the window: 'Not AEV'.

Note that a blank field indicates that an eligibility check was run, but the patients status is Inactive.



Insurance Billing

Insurance Billing This chapter provides information about enhancements to the Insurance Billing feature in the Vitera Intergy system.

Auto Assign Insurance Serialization Change

Create Pending Insurance Policies

Universal Billing Page and Header Information

Ability to Open System Insurance Plan Maintenance in Vitera Intergy Desktop





You can now use Auto Assign Insurance Rule Maintenance regardless of whether your practice is serialized for the optional Community Health Care (CHC) subsystem.

Previously, Auto Assign Insurance Rule Maintenance was a feature of the optional CHC subsystem. If your practice was not serialized for the CHC subsystem, the menu items and windows associated with Auto Assign Insurance Rule Maintenance were not available.

Now, Auto Assign Insurance Rule Maintenance is no longer a feature of the serialized CHC subsystem. The menu items and windows associated with Auto Assign Insurance Rule Maintenance are available with the base Vitera Intergy system.

This enables you to set up rules for specific procedures or procedure classes to automatically add an alternate insurance plan to a patients coverage list during charge posting, and then post the charges to the alternate plan. This feature is useful when a patient receives services that require more than one plan to be billed, but a single plan was added during patient registration. The user posting the charges does not have to change the policy to correctly post the charges.

For example, Medicare B is listed as a patients insurance coverage, but the provider saw the patient while at the hospital, and hospital visits are covered under Medicare A. If Medicare A is set up as an alternate plan for hospital visits for the master plan Medicare B. The alternate plan Medicare A can be added automatically to the patients insurance plans when the charge for the hospital visit procedure is posted, and during the daily close, the charge is posted to Medicare A insurance.

Adding an Auto Assign Insurance Rule

Working with Auto Assign Insurance Rules



Adding an Auto Assign Insurance Rule

You can now add an auto assign insurance rule to specify that certain procedure classes or procedures are billed automatically to an assigned alternate insurance policy. An auto assign insurance rule enables you to post charges to an alternate insurance policy for a patient without having to add the policy for the patient.

Follow the steps below for instructions on adding an auto assign insurance rule.

1. If you are not already in the Auto Assign Insurance Rule Maintenance window, from the Vitera Intergy Desktop menu bar, select the Setup menu, select Procedures and Profiles, and then select Auto Assign Insurance Rules.

2. Add a master plan for the auto assign insurance rule by clicking the New button and entering an insurance plan in the Master field of the New Auto Assign Insurance Rule dialog box. The master plan is the parent insurance plan that provides the main patient coverage for the payer source.

In the following example, Medicare will be the master plan for the auto assign insurance rule.



3. Click the Edit button. The Alternate Plans section of the window becomes available for editing.



4. Click the Add button. The Select Plan dialog box displays. Select the plan to be used as the alternate plan and click OK. An alternate plan will be used instead of the master plan for specific procedure codes or procedure classes.

In the following example, Medicare A will be the alternate plan.

5. In the Charges section, select the specific procedure classes and/or procedures that will be billed to the alternate plan.

To Select: Do this: Specific procedure classes Select the Proc. Classes button and then select

the procedure class(es). Specific procedures Select the Procedures button and then select

the procedure(s).

In the following example, procedure class Out-of-Office Services (OUT) is the class of procedures that will be billed to the alternate insurance plan.



6. Click the Save button.

The alternate plan and the procedure class of the new auto assign insurance rule for the master plan are displayed.



An insurance plan can be used as a master plan only once, however you can add multiple rules to a master plan.

A master plan cannot be used as an alternate plan.

You have just completed Step-by-Step Adding an Auto Assign Insurance Rule.



Working with Auto Assign Insurance Rules

After you have added an auto assign insurance rule, the rule will be applied when posting a charge that uses the insurance plans and a procedure (or procedure class) of the rule.

In the following example, an auto assign insurance rule is applied when a charge is posted.

The auto assign insurance rule for master plan Medicare (MEDG), alternate plan Medicare A (MEDA), and procedure class Out-of-Office Services (OUT) has been added for the practice.

The patient Claire League has the master plan Medicare (MEDG) as the primary insurance in her coverage list.



Charges for the procedure 93010 Electrocardiogram - In Hospital that was performed for the patient Claire League are being added. Note that procedure 90310 has procedure class OUT for which the alternate plan Medicare A (MEDA) was assigned.



The charge is added. The charge information is displayed in the lower portion of the window.

The charge is posted.

The posted charge for procedure 93010 is displayed for the patient in Patient Information (Financial page, Charges tab). The alternate insurance plan Medicare A (MEDA) that was applied for the charge is displayed in the Responsibility column.

The charge history of posting the charge to the alternate insurance plan is displayed.

In Patient Information (Personal page, Insurance tab), the Policies list for the patient displays the alternate plan Medicare A (MEDA) below the #1 (primary coverage) plan Medicare with the alternate plan selected. Note the Details text below the Policies for the selected alternate plan that indicates that an alternate plan was used.



You have just completed Tell Me More Working with Auto Assign Insurance Rules.



Create Pending Insurance Policies

You can now request a new insurance plan while creating an insurance policy for a new or existing patient.

This feature can be helpful when a user enters the insurance policy information for a patient, the plan for the policy does not exist, and the user is not allowed to enter plan information. The user can now enter basic information to request a plan and continue adding policy information, including the ability to scan the patient's insurance card. The policy information is saved as a pending policy. An insurance specialist can then work with the pending policy to fully add the new insurance plan in the Vitera Intergy system. The original user can then finalize the pending policy as a normal policy for the patient that can be used for insurance coverage.

Previously, you could add an insurance policy for a patient only when the plan for the policy was already existing in the Vitera Intergy system.

Now, when you are adding a policy for a patient and the plan does not exist, you can request a new plan and enter information to create a pending policy.

The following new features and enhancements have now been added in the Vitera Intergy Desktop:

The new Request button has been added to the Select Plan window.

The New Plan Request window has been added.



The New Patient Policy window and Edit Patient Policy window have been modified.

The Use Existing Plan link has been added to the New Patient Policy window when an insurance plan has been requested for a policy that is being added.

The Set Patient Default Coverage Order dialog box has been modified to display and identify a pending insurance policy that has been added for a patient when a plan was requested.

Messages to warn you that a pending policy exists for a patient now display when you are performing tasks such as viewing patient insurance coverage information and posting a charge.

The new Plan Request task type has been added to the Task Setup window.

The new Plan Request tasks now display in Work Tasks and Task Administration.



Universal Billing Page and Header Information

The Universal Billing page and Universal Billing Header information are now available for all Vitera Intergy systems. Previously, all Universal Billing functions of the Ailments page in the Patient Information interface required separate serialization.

The claim collapse capability and the use of revenue codes still require the Universal Billing serialization option. Contact your Sales/Support office for more information.



Ability to Open System Insurance Plan Maintenance in Vitera Intergy Desktop

You can now open the System Insurance Plan Maintenance window from the Insurance Plan Maintenance window in Vitera Intergy Desktop without having to login to System Administration.

With the proper security settings, you can open the System Insurance Plan Maintenance window from the Insurance Plan Maintenance window in Vitera Intergy Desktop by selecting the Utilities menu and then selecting System Insurance Plan Maintenance.



In addition, the Insurance Plan Maintenance window in System Administration has been renamed System Insurance Plan Maintenance window.



Clinical

Clinical Enhancements This chapter discusses enhancements to the clinical areas of the Vitera Intergy software. All of the windows in this chapter are optional features available for the Vitera Intergy system.

Internal Use Only Indicated on Rx Note

Editing a Lab Order Task in Work Tasks

Lab Purge Utility Changes



Internal Use Only Indicated on Rx Note

In previous versions of Vitera Intergy, there was no indication that notes entered for a prescription are for internal use only. They are not transmitted to the pharmacy and do not display on prescription printouts. To make this information more apparent, Vitera Intergy has been enhanced as follows:

In Vitera Intergy on the New Prescription window (also known as the Rx Pad), the label Internal Note Only has been added to the button for adding a note.

In Vitera Intergy on the New Patient Reported Prescription window, the label Internal Note Only has been added to the button for adding a note.



In Vitera Intergy on the Patient Information window (Clinical page, Prescriptions tab), the label Internal Note Only has been added to the button for adding a note.



Editing Lab Order Tasks in Sage Intergy Work Tasks

Editing Lab Order Tasks in Vitera Intergy Work Tasks

Vitera Intergy has been enhanced to allow you to edit a Lab Orders (Lab-O) task from Work Tasks. A Lab Order task is generated when lab order request is entered in Vitera Intergy or in Vitera Intergy EHR. The task is typically for a practice user to complete the lab requisitions for the requested lab tests. However, there are cases when a Lab Order task is completed without entering a lab requisition in the system.

The ability to edit a Lab Order task in Work Tasks allows you to modify the lab order request, and it also allows you to complete the task without having to enter a lab requisition in the system.

When a Lab Order task is opened in the Lab Order viewer window, two new options are available for editing the task.

On the toolbar, an Edit Order button is available. It displays with a paper and pencil icon.

From the window menu, an Edit command displays on the Action menu.

Selecting either of these options opens the Lab Order Header Details dialog box. This dialog box displays the details of the lab order request. You can edit the available information in the dialog box. It is important to note that changing the When Save Order option to anything other than Requested will result in the task being completed. The Work Task window will be updated to display a status of Completed.





You can edit a Lab Orders (Lab-O) task from Work Tasks. A Lab Order task is generated when lab order request is entered in Vitera Intergy or in Vitera Intergy EHR. The task is typically for a practice user to complete the lab requisitions for the requested lab tests. However, there are cases when a Lab Order task needs to be completed without entering a lab requisition in the system. Editing a Lab Order task allows you to modify the lab order request, and it also allows you to complete the task without having to enter a lab requisition in the system.

1. If you are not already in the Work Tasks window, open it. 2. From the list of tasks, select the lab order task (LAB-O) that you want to edit. 3. Click the Work button. The Lab Order viewer display. 4. Click the Edit Order button (paper and pencil icon) on the toolbar.

- OR -

From the Actions menu, select Edit.

5. The Lab Order Header Details dialog box displays, from which you can edit the lab order request. For help on a specific field, select the field and press F1.

6. Note that changing the When Save Order option to anything other than Requested completes the task. The Work Task window will be updated to display a status of Completed.

You have just completed Step-By-Step Editing a Lab Order Task in Work Tasks.



Lab Purge Utility Changes

The Lab Purge Utility in Vitera Intergy can be run to identify and permanently delete large numbers of old, outstanding lab records that no longer need to be tracked, including lab results and lab orders. It is accessible from the Labs Information window by selecting the Tools menu from the window menu bar, and then selecting Lab Test Purge Utility. The Lab Purge Utility has been enhanced with the following changes:

Ability to Purge Unsent Lab Orders

You can now use the Lab Purge Utility to purge unsent Lab Orders. Unsent lab orders are lab orders for which a requisition has been created but has not been sent. In the Test Results section, an Unsent option is now available to select for purging unsent lab orders.

For instance, your practice may want to use this option to delete lab orders for tests that are no longer needed or that the lab no longer supports. Some examples of unsent lab orders that you might want to delete are lab orders for tests that the patient later refused, lab orders for tests that the lab no longer performs, and lab orders that were created in error.

Ability to Enter a Purge Date Range

When setting up a lab test purge, you can now specify a range of dates for lab tests to be purged based on the specified criteria. In previous versions, you were only able to specify an end date, which effectively creates a date range that had an open-ended start date (that is, it included all dates prior to the end date) and ended with the specified date.

The new date range now allows you to enter the Start and End date.



For example, the current date is July 17, 2011 and you want to purge all outstanding lab test results in June 2011. In the Transmit Date section, you would select Outstanding. In the Transmit Date section, you would enter 6/1/2011 in the Start field and 6/30/2011 in the End field. Select the Run button to begin the purge.

When entering the date range, if you want the start date to be open ended (that is, to include all dates prior to the end date), leave the Start field blank. If you want the end date to be the current system date, leave the End field blank.

Section Label for Date Range Indicates Date Type

The section that contains the purge date range has been modified so that the section label indicates the type of date range you are entering. Depending on the type of lab test results you have selected to purge, the date type differs, as follows:

If Final or Unmatched is selected in the Test Results section, the label of the date range section is Reported Date.



If Outstanding or Unsent is selected in the Test Results section, the label of the date range section is Ordered Date.

In previous versions, the section label from the date entry was always Report Dates.



Encounters

Encounters This chapter discusses enhancements to the Encounters feature of the Vitera Intergy software.

Select Encounter Date Range in the Pending Charges Window





You can now set the date range for which you want to filter pending charges by encounter date in the Pending Charges window. Selecting a date range for pending charges reduces the amount of pending charges that display and makes it easier to choose the pending charge you wish to post.

Selecting an Encounter Date Range in the Pending Charges Window



Selecting an Encounter Date Range in the Pending Charges Window

You can now set the date range for which you want to filter pending charges by encounter date in the Pending Charges window.

Follow the steps below for instructions on selecting an Encounter date range in the Pending Charges window.

1. If you are not already in the Pending Charge Report window, open it by selecting the Financial menu in the Vitera Intergy Desktop menu bar, selecting Charges, and then selecting Pending Charges.

2. From the Pending Charges window menu bar, select the Display menu and then select Select Date Range.... The Select Encounter Date Range dialog box displays.



3. Specify a range of dates by using the From and To fields.

4. Click the OK button.



The Pending Charges window displays pending charges by encounter date in the selected date range. In addition, the selected date range displays in blue text at the top-right of the Pending Charge window.

You have just completed Step-by-Step Selecting an Encounter Date Range in the Pending Charges Window.



Community Health Care

Community Health Care This chapter provides information about the new Vitera Intergy Community Health Care features. Community Health Care features are optional features available for the Vitera Intergy system.

Medicare Mental Health Rate Change

Preventive Procedures for Medicare Clinic Rates

Additional Sliding Fee Minimum Amount Options

Medicaid Clinic Rates for States Enhancements

OSHPD 2011 Reporting

CA FPAR Identifies Unassigned Insurance Plans

Set Patient Age Ranges for CA FPAR Report

CA FPAR Follow-up Encounter Reporting

UDS 2011 Reporting



Medicare Mental Health Rate Change

Medicare Clinic Rate can now calculate the Mental Health payment amounts based on the service date of a Mental Health clinic rate visit.

This enables you to comply with regulatory changes for Federally Qualified Health Centers (FQHC) that require different Medicare Mental Health payment percentages for the calendar years 2010 - 2011, 2012, 2013, and 2014.

The following Medicare Mental Health payment percentages can be applied:

If the Service Date is from : The patient coinsurance percentage is:

January 1, 2010 through December 31, 2011 45% January 1, 2012 through December 31, 2012 40% January 1, 2013 through December 31, 2013 35% January 1, 2014 and after 20%

For example, if a Mental Health visit has the service date June 10, 2011, the patient co-insurance amount will be 45% of the amount entered for the total charge on the date. A Mental Health visit that has the service date March 2, 2012 will have a patient co-insurance amount that is 40% of the total charge amount.

Previously, the Medicare Mental Health payment amounts were calculated based on a single percentage, regardless of the service date.

Now, the Mental Health payment amounts are calculated for multiple percentages by using the service date of the Mental Health clinic rate visit to determine the correct percentage for the payment amount.

The Medicare Clinic Rate feature has been enhanced to calculate patient co-insurance amounts and insurance payment amounts based on the service date. When the Co-Insurance Method field is set to Mental Health, Medicare Clinic Rate now calculates the patient coinsurance amount using the percentage that is based on the year in which the service date occurred.



Preventive Procedures for Medicare Clinic Rates

You can now select and assign specific procedures that are preventive procedures.

A preventive procedure is a health care service that is provided to maintain health or prevent illness, disease, disability, or other conditions. Preventive procedures can include services such as exams, shots, lab tests, and screenings, as well as programs for health monitoring, counseling, and education. For example, a flu shot, a screening mammogram, and smoking cessation counseling may be considered preventive procedures. According to Medicare rules, coinsurance is waived for preventive procedures.

This enhancement enables you to exclude preventive procedures from the visit coinsurance calculation when a procedure that has been specified as a preventive procedure is included in a visit. The charge for a preventive procedure is not included in the total charge amounts to which the Medicare clinic rate will be applied for the visit. When charges are posted, preventive procedures are not included in the calculation of the patient coinsurance amount.

Previously, procedures could not be specified as preventive procedures in Medicare Clinic Rate Maintenance for Medicare clinic rate calculations.

The new Preventive Charges section and Procedures button have been added to the Details page of the Medicare Clinic Rate Maintenance window.



Additional Sliding Fee Minimum Amount Options

You can now set sliding fee visit and charge amounts by service center and department.

The new override options enable you to vary visit minimum amounts and charge minimum amounts for a sliding fee schedule by service center and department, as well as by slide level. You can set a visit minimum amount and/or a charge minimum amount, and then set overrides to the amount for one or more specific levels, service centers, and/or departments as needed for your practice. The new options provide you with additional flexibility for setting the visit and charge minimum amounts for your sliding fee schedules.

The following enhancements have been added to the Sliding Fee Schedule Maintenance window:

In the Details section, the new Slide Level, Service Center, and Department check boxes have been added. The check boxes allow the user to indicate how charge and visit minimum visit amounts may vary: by slide level, service center, and/or department. If visit minimum fee amounts do not vary by Level, then an amount field is provided for entering the default visit minimum amount for the Type.

In the lower portion of the window, the new Visit Minimum Overrides tab has been added. The Visit Minimum Overrides tab displays visit minimum amounts that have been set up for specific service centers and/or departments for which the Visit



Minimum Overrides override the sliding fee type and slide level visit minimum amounts.

The new Visit Minimum Override page has been added. The Visit Minimum Override page is available when the 'Visit Minimum Amounts Vary By Department' or the Visit Minimum Amounts Vary By Service Center' check box on the Details page is selected. The visit minimum amounts overridden by slide level, service center, and/or department are displayed for the selected type. When a visit minimum override is selected, the visit minimum override details can be edited. The visit minimum amount for a slide level, service center, and/or department is applied when charges are posted and the assigned slide level, service center, and/or department is on a charge included in the visit. You can add, edit, and delete visit minimum overrides.



The new Charge Minimum Override page has been added. The Charge Minimum Override page is available when one or more Charge Minimum Amounts Vary By check boxes on the Details page are selected for a sliding fee schedule type. For a specific type of services, the charge minimum override amounts defined by slide level, service center, and/or department are displayed. When a charge minimum override is selected, the charge minimum override details for the override can be viewed or edited. The charge minimum override amount for a slide level, service center, or department is applied when charges are posted for those procedures that are assigned a charge minimum override and the slide level, service center, and/or department specified for the override is used on the charge. You can add, edit, and delete charge minimum overrides.



Additionally, the Sliding Fee Schedule Report has been enhanced to display charge minimum amount and visit minimum amount overrides.



Medicaid Clinic Rates for States Enhancements

You can now set additional rules to maintain Medicaid clinic rates for specific state programs.

The enhancements enable you to set individual state specifications for T-code billing and how billed amounts should be calculated for Medicaid clinic rate billing.

The following enhancements have been applied to the Medicaid Rate State Maintenance window:

The Add T-Code Charge To Claim field options have been modified. The field allows you to specify whether a state Medicaid program requires a T-code procedure to be reported on Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) Medicaid clinic rate claims, and if so, how the T-code procedure is displayed on the claim. If you are reporting T-codes, you can specify whether the T-code procedure is placed as the first procedure or the last procedure on the claim. You also have the option to specify that only the T-code procedure is reported on the claim. You can now select one of the following choices:

(F)irst The T-code procedure will be sorted to the position as the first procedure on the Medicaid claim. Additionally, the T-Code List field will display on the Medicaid Clinic Rate Maintenance window when the state program is selected. This field enables you to select the alternate code list that will be used to specify the procedure code for which the T-code procedure will be applied.

(L)ast The T-code procedure will be sorted to position as the last procedure on the Medicaid claim. Additionally, the T-Code List field displays on the Medicaid Clinic Rate Maintenance window when the state program is selected. This field enables you to select the alternate code list that will be used to specify the procedure code for which the T-code procedure will be applied.

(N)o The state Medicaid program does not require a T-code procedure on the Medicaid claim.

(S)ingle T-Code The T-code procedure will be the only procedure displayed on the Medicaid claim. The T-code procedure will replace the visit procedure for the claim. Additionally, the T-Code List field displays on the Medicaid Clinic Rate Maintenance window when the state program is selected. This field enables you to select the alternate code list that will be used to determine the procedure code for which the T-code procedure will be applied. When the Single T-Code option is selected, the T-code will also be displayed in insurance pre-bill analysis, EMC billing, and ERA remittance reports.

The T-Code Billed Amounts field has been added. The field allows you to specify how the billed amount of the T-code procedure charge should be calculated when a T-code charge is included on Medicaid claims for a Medicaid rate state. You can select one of the following choices:



(G)ross visit charge The billed amount of the T-code charge will be the gross amount of the visit procedure charge amount.

(N)et visit charge (clinic rate) The billed amount of the T-code charge will be the adjusted clinic rate amount (visit charge amount) for the claim.

(T)otal gross charges The billed amount of the T-code charge will be the total of all procedure gross charge amounts on the claim.

(Z)ero The billed amount of the T-code charge will be zero ('0') on the claim.

The Visit Billed Amounts field has been added. The field allows you to specify how the billed amount of a visit procedure charge should be calculated when a T-code procedure charge is included on Medicaid claims for a Medicaid rate state.

The T-code procedure may be displayed as the either the first procedure or the last procedure on a Medicaid claim based on the setting of the Add T-Code Charge to Claim field. You can select one of the following choices:

(G)ross visit charge The billed amount for the visit procedure charge will be the gross charge amount of the visit procedure charge on the claim.

(N)et visit charge (clinic rate) The billed amount for the visit procedure charge will be the clinic rate adjusted amount for the claim.

(T)otal gross charges The billed amount for the visit procedure charge will be the total of all procedure gross charge amounts on the claim.

(Z)ero The billed amount for the visit procedure charge will be zero ('0') on the claim.

The Ancillary Billed Amounts field has been added. The field allows you to specify how the billed amounts of ancillary procedure charges should be calculated when a T-code procedure charge is included on Medicaid claims for a Medicaid rate state.

The T-code procedure may be displayed as the either the first procedure or the last procedure on a Medicaid claim based on the setting of the Add T-Code Charge to Claim field. You can select one of the following choices:

(G)ross charge The billed amount of an ancillary procedure charge will be the gross charge amount of the procedure.

(N)et charge The billed amount of the an ancillary procedure charge will be the net amount of the procedure gross charge amount based on clinic rate adjustments.

(Z)ero The billed amount of an ancillary procedure charge will will be zero ('0').



OSHPD 2011 Reporting

The federal requirements for OSHPD reporting of Section 5 - Encounters By Principal Service and Section 6 - Revenue and Utilization By Payer have been changed for 2011 annual reporting.

Section 5 - Encounters By Principal Service

The following code range changes have been specified by the Office of Statewide Health Planning and Development (OSHPD) for Section 5:

Line 2010 Procedure Code Range 2011 Procedure Code Range 3 Hospital Related Services 99217 - 99223 99217 - 99226 13 Musculoskeletal System 20000 - 29999 20005 - 29999 33 CPT Category III Codes 0016T - 9999T 0001T - 9999T

For 2011 annual reporting, you need to use OSHPD Report Maintenance to change the procedure code ranges for Section 5. This will enable your site to report the OSHPD Report Section 5 data in compliance with the OSHPD 2011 specifications for OSHPD reporting.

The procedure code ranges for OSHPD Report Section 5 lines 3, 13, and 33 can be edited. This allows any qualified charges posted within the OSHPD report date range that have the defined procedure codes to display on the correct lines in the OSHPD Report Section 5.

In the following example, the procedure code ranges for Line 3 Hospital Related Services are displayed. You can change the procedure code range of 99217 - 99223 to 99217 - 99226 by editing the range.



Section 6 - Revenue and Utilization By Payer

Because the Expanded Access to Primary Care ( EAPC) program was not funded for 2011, OSHPD does not require or allow reporting of EAPC data for the 2011 reporting year. If the OSHPD Report still includes data relevant to EAPC in Column (12) of Section 6 - Revenue and Utilization By Payer that your practice needs to report to another payer category, you can add the EAPC data to the appr

vitera intergy 7.10 new system features

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