工作记录 01-02-2018 至 03-16-2018

03-16-2018
1.   Add new setting in Patient Visit for self-pay visit even the patient has regular insurance, but this particularly visit is “self-pay” visit. Need to generate patient invoice and bill patient without going through claims and wait for insurance payment.
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03-12-2018
1.   For EAR text file breakdown, keep the Check# line info. at the top. Also add “Health Care Claim Payment/Advise” as the page title.
2.   CPT code 2018 Q2 update.

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03-09-2018
1.   If there are multiple Office Visit entries. It only displays the description of the first one.
2.   The Account Balance does not look like it is correct. The problem exists when there is “Other Patient Responsibility” entry. It should be the same as “Copay”, “Coinsurance” , “Deductible” to calculate the Account Balance.
3.   Upload File – allow to save Notes without uploading any files. Also, change the Column name from File to Notes/File
4.   Reorganize and recalculate Patient Invoice Summary page, using PT category with patient balance only (Not include Insurance amount). Put PT deposit at the end as separated section
5.   Rearrange the PT category dropdown list
6.   In Patient Invoice search criteria, add new checkbox “PT Deposit”.

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03-08-2018
1.   In posting ERA payment, since allowable amount is not included in the calculation, so we do not need to set the up limit for Copay/CoIns/Deb/Other (up to allowable amount). Whatever it is in “PR”, we post in payment. Example 854 Job#5980
2.   In Job Complete, if there is secondary payment, only need to consider secondary Copay/CoIns/Deb/Other Resp., then don’t insert into patient visit invoice from primary payment Copay etc. Example 851 Job#2737
3.   Check the DK CLIA Error from Ref Doctor NPI from Office Ally email. Need to add Ref Qualifier (Second field) after “REF” before NPI number. Also put DK (Not DN) if it is DK from CMS 1500.
4.   In Payment Posted Summary and Invoice page, sorting by the number of Claims for each payer, highest number on the top.
5.   Continue for ERA payment text file breakdown (including the tools to breakdown and update previous posted ERA payments), and continue separating all of the functions based on different doctor login.
6.   IN the payment detail page, in the bottom patient insurance section, still need to display “InActive” patient Insurance, but gray out the whole line. So end user can see these inactive insurance records.

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03-06-2018
1.   Please make “payment posted” search criteria at the top same as other two list (All A/R, and pending payment list). So end-user won’t get confused.
2.   For “Revised Payment”, only need to check the Claim status, don’t need to check the payment status, still post as “Process as Primary” even the previous payment is completed.
3.   For “Reversal Previous Payment”, the patient invoice (PDF) looks good, but the ERA payment detail summary need to do same thing. Example, 0855, Job# 0306
4.   For ERA payment posted, we have attached the OfficeAlly Text file for each payment. Currently each text file contains many payment even for different doctors/accounts. (Same payer). We need to break this text file into individual section based on each payment. I will discuss with you more about it.
5.   For “Payment Posted” Summary Tab (Group by Payer ID), we will need to change to group by patient insurance payer ID, not by ERA payment payer ID. “Process by Primary” will link to primary insurance, “Process by Secondary” will link to secondary patient insurance payer ID. ERA posting still need to keep as same wit Tax ID in the payment detail. We do the link ONLY in Summary page.

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03-05-2018
1.   Add “PT Resp.” total amount for “pending payment”, “Posted payment” and “All A/R account” list.
2.   Please check the calculation of the Total Applied Amount for “Posted payment” and “All A/R account” list to make them match each other. There are some old “uncompleted” payment may affect this.
3.   Double check when the ERA payment will be changed to “Revised payment” by backend program. Make sure only when claim is completed. (Not partial).

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03-01-2018
1.   Modify the Patent payment Invoice PT Resp., Adjustment, Allowable calculation, especially for secondary claim with mulit-payments.
2.   Continue working on the problem of “DK”, “CLIA” Officeally return error message for “Referring NPI invalidate format”.
3.   Adjust the display format for Error Message for rejected claims from Officeally.

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02-28-2018
1.   I have changed two SQL SPs for ERA, please check into the projects. See attachments. We will keep working on these ERA posting for some special cases.
2.   See attached OfficeAlly Claim Return text file. For the backend claim return status posting program, some Rejected Claims may have multi-lines for just one claim with different status, (starting from bottom to top), currently we only import the first line. We will need to import all lines. Also the Status will change (They could “Accepted” first, then “Rejected”, but sometime, they will “Rejected” first, then “Accepted”. In the second case, our program did not update “Rejected” status to “Accepted”.
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02-27-2018
1.   If end-user click “Claim Check Status” to change or add notes, both notes and user ID will be updated (such as “C0104” for user login ID), but when end-user post a new notes in Claim List/Job List Notes column (Post New Notes), a new notes will be added, but the end-user ID will not be updated. Please update the end-user ID in this case also. See below screen capture.
2.   Sorting by date for “CPT”, “ICD10” list in payment posted/pending payment etc. Also customized columns setting need to be saved.
3.   As we mentioned before, for secondary claim CMS 1500, retrieve the charge amount for each CPT from the primary claim. So the amount will be exactly same.
4.   For OA 23, auto adjustment, I did minor change excluding the primary payment with “Deleted” status. See attachment. But for example, 0855/job#87, one job has multi-primary payment even the first one is completed “empty”, all went to adjustment. So in sp_payment_after_import, for OA 23, we need to add all primary payments together not just retrieve the first one.
5.   Later, we can work on adding new field for “CLIA” for each facility (See separated email)
6.   Add CTP consumer description and display it in patient invoice. Also add link in Job Summary CPT code to display full long CPT description.

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02-26-2018
1.   When end-user “Mail” out the patient PDF invoice, auto add a note same as complete job.
2.   In patient visit invoice detail page, change “Uplaod” function to “Add notes and upload file” same as other claim/job notes function.
3.   Check the patient invoice PDF CPT code description length (See previous email)
4.   In login user page (UserReg), we have field for account access control, we also need to add doctor list access control inside each account. I will discuss it in more detail.
5.   As in “02-23-2018” Item 4, for “Medicare Supplement”, we also have example (0851/Job#2737) with Medi-CAL as health plan. For these cases, we will use secondary Patient Resp. (Copay/Coins/Deb/Other) as final patient resp. (Not from primary payment). And more important, in the payment detail page the summary section, we should not use “Allowable” amount to calculate the patient resp. As we discussed before, different payer/primary/secondary have completely different “Allowable” amount. IN our balance (payment ) calculation, we should ignore the “Allowable” amount and use Billed amount, ERA allied, reduction, PT Resp. and Cap. Amount to balance the “Adjust amount”.

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02-23-2018
1.   Pending payment list, currently it excludes “Completed” payment, need to exclude “Deleted” payment too.
2.   Search by ICD10 code had been added into “Posted Payment list”, need to add it to “Pending payment”, and “All A/R account”
3.   In ERA background payment posting, the program specially break the “OA 23” into “Reduction/Other Ins. In order to writeoff the primary payment Coinsurance. This works good. However, example 0851, job# 00002735, beside CoInsurance, need to include “Ded. And Other Patient Resp.” amount too.
4.   For secondary ERA, if health plan contain “Medicare Supplement”, we need to use secondary CoPay/CoInsurance/Ded./Other Patient Resp.” to overwrite the primary payment. But sometimes the Allowable/Adjustment amount is complete different, so we need to discuss how to balance the payment/invoice in this case. Also still for secondary ERA which contains “Medi-Cal’, all of the patient Resp. should be writeoff, please double check and the SQL SP which handle this.
5.   If the payer did not pay any (Applied =0), all of the billed amount is put into PR (Other Patient Resp.). In this case, we need to bill the patient, current invoice (PDF) and summary page are correct, but the patient invoice list balance column is still zero (No Other Patient Resp entry is inserted after job completed). Example, 0854 job# 00005832.
6.   We also have some cases especially the “Denied” (the payer did not pay any applied amount, only CO, PR OA these adjustments), the Allowable amount is incorrect in ERA, so I think maybe we need to double calculate the Allowable amount by ourselves (Not completely depend on ERA).

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02-20-2018
1.   After end-user complete the job, “Other patient Resp.” will be inserted into patient invoice list with new type as “Other Pat. Resp.” (Not “Other” type). And this “Other Pat. Resp.” type should be same as “CoInsurance”, only ERA amount, no Dr Office Charge. And also in the patient invoice, need to treat this new Pat. Resp. type same as CoInsurance, otherwise the amount will double in the invoice. See the separated email for the details and example.
2.   Patient SelfPay, after changing payment status, still can’t display the patient invoice.
3.   Revise payment, primary/secondary check, example 854, job#1945
4.   Payment posted is based on payment status (Completed), the pending payment list is still based on Claim status. Need to change the pending payment list based on payment status. List all of the claim if there is payment has not been completed.
5.   Some denied ERA payment, the allowed amount is 0, when the reason code is CO (adjustment), then we can keep allowed as 0, but if reason code is PR (Other patient resp.), then in order to balance the ERA payment, need to fill in allowed amount.
6.   In payment posted, currently it has search by CPT code function, add one more search criteria for ICD10.
7.   In CMS 1500, the program will check the CPT code based on service date to see if it is validated, please double check if the program will check for ICD 10 codes or not based on service date. Example 854 job 4199 code N63.10
8.   In ERA with primary/secondary payments, example 855/Job# 00000012, Primary payment has “PR” amount, while the secondary payment has different “PR” or “CO” amount. (In this example, it only has CO adjustment). We are discussing how to handle this case because sometimes we should use primary payment PR as final PR amount, sometimes we need to use secondary payment to override the primary payment.
9.   FnEncoder search in Advance function does not display any result. Please check.
10.   In CMS 1500, when check insurance expired date with patient visit service date, don’t check these “InActive” Insurance, only “Active” insurance.

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02-12-2018
1. Need to add one more field “Other Adjustment”. This field is almost same “Other Patient Resp.” with minor different, current we treat it as Other Patient resp. (See the detail info in separate email)

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02-10-2018
1. In Payment Posted Summary, group the info. by doctor (“Facility Doctor”)
2. For account with multi-doctors, when doctor login, the end-user should only can see their own info. Job List, claim List, payment, patient invoice etc,

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02-06-2018
1.   In Patient Payment List (invoice), for discard job, it shows empty even it has discard job. There is a small bug when there is multi-patient visit. (should use OR Not AND)
2.   Change the wording “Verified” in ERA payment page to “Invoice Verified”.
3.   In patient invoice, after we keep a copy of mailed invoice, now the PDF page popup, and close right after it. Need to stay open to allow user to print.
4.   See attached billing.js file. Only displaying different background color for Missing Info Job Pool. And also same as “Dr Follow Up’, change color based on login user type if user add notes beside checking status.
5.   In Doctor Roster, we need to add check box for “Facility Doctor”. When create new doctor, default is checked. So In the Payment Posted Summary for Health Plan, only displays the summary of the health plan info for these doctors who has “Facility Doctor” checkbox checked.

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02-01-2018
1.   In ERA payment detail page, add new checkbox “Verified” next to “Uncompleted Job”.
2.   Once end-user Confirm Credit, Then if “Verified” is uncheck, then check the “Verified” too.
3.   Modified SQL SP “sp_get_pay_summary_payer” for the counting of Invoice Sent. Can’t link the invoice sent with payer, it will provide duplicated record.

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01-31-2018
1.   I made a minor problem fixed for Patient Invoice printout “adjustment” field. See attached SQL SP.
2.   For eClinicWork text superbill import, the doctor info in the superbill is incorrect, so we always need to default to primary doctor in this case. In DocMas, we can add a checkbox for “Default Doctor”, if this checkbox checked, then eClinicWork import will set ATnd_Dr (ptavisit) always to this doctor
3.   In Claim List, currently we have search dropdown list for “Status”, Label it as “Claim Status” and Add new dropdown list search for “Job Status” the dropdown list should be: All, Completed, Billed, Discarded, Uncompleted (all of the jobs except completed and discarded)
4.   As in 1/25 email, add new functions in FNEHRDataTool to import/update “ Clinical Laboratory (18CLAB), For C-status fee, (Area 18 code) For DMEPOS fees”. See separated email for the details.
5.   Sometimes, same patient will be created with different MRN (Duplicated records), so we need to provide a simple function to merge two MRN.

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01-30-2018
1.   Change the background for new “Confirm Credit for ….” Inside the payment detail to white.
2.   In patient payment list, change the column header “Applied Amount” to “Applied Credit”
3.   In patient invoice printout PDF, for description, please consider the special word “eg.” (Not end of sentence)
4.   Example, 0854, job 4878. ERA payment posting, when only partial CPT come back, for the rest of the CPT code, default the “Billed Amount” to 0, only fill in “Charged Amount” from Claims. Billed Amount should always from ERA or EOB (manually post the payment)
5.   Example, 0854, job 3565, ERA payment posting, in some cases, especially for MediCare/MediCal, the payment info does not go with CPT code, it is for whole payment such as “CO 97 …”. Currently we do not post this CPT code instead we put notes in payment. In this case, actually, we found there is only one CPT. So we can continue post the Billed Amount, Applied Amount, Adjustment Amount etc. to the first CPT code.

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01-29-2018
1.   I modified one SQL SP for CMS1500 CPT order by (See attachment). Need to keep the order same as the CPT in Job Summary Procedure page. Please do same for Patient Invoice CPT order.
2.   We have Payer ID for example “MC051”, but when ERA come back, there is no such payer ID existed in 835, only the payer’s TaxID. This a TaxID is unique ID for each payer. Actually payer ID is not unique. Payer ID with payer name are unique. SO we need to add TaxID field in Payer List. In this way, when ERA come back, we can use Tax ID to search for payer then for primary/secondary insurance.
3.   In Production also in Demo system, the Payment Posted Summary page, we group by PayerID and payername. Sometimes, there are same payer ID with one payer name is empty. Please check which field is for PayerName in this summary page, so we can manually change it.

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01-26-2018
1.   Patient Invoice List, After adding new checkbox for “check credit”, the combined checkboxes of “Check Invoice” and “Not Verify” do not display any items.
2.   Patient Invoice List, currently if the is discarded (or write off) especially for self pay patient visit, the job summary column is empty. We need to still display the job no, but change the cell background as “gray”. Once user click it, still popup job summary page. But before popup summary page, popup a message tell user this is a discharged job or write off job. We treat these discarded job are “Completed Job” for “Check Invoice” and “Check Credit”
3.   Change the “Apply Credit” checkbox (Label) back to “Confirm Credit”. And inside payment detail, move the checkbox to above the payment items, and label it as “Confirm credit to be used for further patient statement/invoices”
4.   Move yellow background cell from negative invoice balance column to “Apply Credit” column, so the cell will be red if invoice is positive, yellow if negative (credit)
5.   For eClinicWork import patient superbill, for SELF PAY/Paid, need to change Payment Type to “SELF PAY”. See separated email for detail.
6.   When end-user view patient invoice, if there is reminding credit, it will popup message as “Do you want to apply…”, give selection as Yes or No, if Yes, then redirect to payment detail page where the user can apply the reminding credit.
7.   Patient Invoice List, currently, New/Invoice and Confirm Credit are combined into one column which works good. But we need to add same function for invoice list for just one MRN.
8.   For EAR payment, the patient Resp. part contains four fields “Copay”, “CoIns.”, “Ded.” And “Other Patient Resp.”. Currently once the job is completed, a item will be inserted into patient invoice items for Copay, CoIns. Deb. three fields, We need to add one more payment Type as “Other Patient Resp”. Change current “Other” type to “Other Misc.” This new type is same as “Copay” for Invoice calculation. I will discuss by Skype in more details.

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01-25-2018
1.   PDF invoice printing works good inside the payment detail, need to change to PDF for Patient Invoice List.
2.   Dashboard Top 20 payer sort by “claim#” desc. The largest “claim#’ on the top.
3.   Add more import/update features in FNEHRDataTool for different formats and contents.

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01-24-2018
1.   Combine new “Apply Credit” column with “Send Invoice” column based on Invoice balance (positive/negative)
2.   For Importing superbill form eClinic, program default Doctor ID (Attend Dr in Patvisit) is incorrect if ther eis multi-doctors in the Docmas.
3.   For Claim reminder days background color, currently if passing the reminder days, the color will change until the status of claim is completed. Need to add new criteria not change the color if any of the payment status is changed.
4.   For ERA/Charge Amount in payment details, changing wordings, and also for job complete, copay/coinsurance etc just need to post ERA amount, don’t change charge amount.
5.   Please help update the dates in the database in demo system account 0003
6.   For secondary claim the print out Payer address, please check what the “address2” field for.
7.   Same for secondary claim, we will need to “copy” all of ERA info. from primary payer to the bottom of the CMS 1500 and also using the primary ERA charge amount for each CPT first.

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01-23-2018
1.   Change “Confirm Credit” wording and background cell colors.
2.   Change the Dr. Follow Claim List background to different color when Dr. sent us notes and when we sent Dr. office notes.
3.   In patient ERA payment, “Revise” payment need to be calculated based on primary/secondary payer.
4.   Still in patient EAR payment posting, if there are two payment from same payer all primary, then need to overwrite the payment with zero applied amount for each CPT.
5.   MS Report for invoice launches slow, will fine a method to improve the speed.

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01-22-2018
1. Patient Visit Payment List, the Ins. Payment amount column should excludes the deleted payment same as other balance amount.
2. When end-user mail the patient invoice, make copy of current invoice (pdf) so it can be tracked later for what has been sent to the patient.

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01-19-2018
1.   ImportWav for doctor ID, limit the length as 6 digits.
2.   The new “check credit” combined with “Not Verify” do not display any items. Please check
3.   Patient Collection menu do not display any items. It was ok before. We need to check.
4.   In patient invoice list, add checkbox inside the invoice detail and also add new column for the checkbox as “Confirm Credit” . So doctor office can confirm the negative balance as patient credit. Once this patient is confirmed, then “check credit” won’t display this record anymore. Same as positive Invoice (marked as red), the negative “invoice balance” without “Confirm Credit” checkbox checked will be highlighted (background cell) as yellow.
5.   Secondary payment ERA has incorrect pay amount posted, see previous email for detail
6.   When patient invoice is mailed out, we will need to keep a copy of current MS report invoice file for records to be tracked later.
7.   When job is completed, the program will auto insert entries into patient invoice detail such as copay etc. For these records, in Modified By field, put “System” so end-user can see where the record come from.

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01-18-2018
1. ImportWav for ASP Account 101, for MR number, remove the <> if there are these special characters enclosed in MRN.
2. In Patient Visit Payment List, add “Check Credit” checkbox to search the patient invoice with negative number (credit)

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01-17-2018
1. In Patient Visit detail page, add Item 11 textbox for CMS 1500
2. Improve the Patient Responsibility calculation, example 0854: 00000591, 000000753

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01-16-2018
1. Import RARC data (code/descriptions) into our system.
2. In payment detail, link the RARC code (such as LQ: MA83 …) to the descriptions in popup windows, so the billers can view these info. and process with next step (resubmit etc.)

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01-15-2018
1.   Just for “reversal of payment”, we need to specially deal with this case (All negative number because the payer take back the payment). Keep the normal ERA payment as what we do currently.
2.   As you mentioned, please summarize current payment posting workflow so everyone can be in the same page and know what to expect. This will be very useful.
3.   For some special cases, we will handle them when we have such examples.

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01-09-2018
1.   Add export excel sheet for “Missing Info” list
2.   In Global Payer, add old payer setting including the change date, old payer ID/Name etc.
3.   In CMS 1500, based on service date, select correct payer info (ID/Name), new payer/old payer. comparing payer change date with service date.

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01-05-2018
1.   Payment posted list improvement, remove “payer Id”, add “invoice sent”,
2.   Modify the payment posted printing summary, fix the problem of next page
3.   Modification of Dashboard top 20 payer list

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01-04-2018
1.   FNEHRDataTools for importing/updating data such as Crosswalk, Medi-Cal etc.
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01-02-2018
1.   Eligibility Request 270/271 batch process
2.   Tools for NDC import and update
3.   Tools for Fee structure, MPFS import and update

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