August 11, 2016 Presenter: Nicole Beulah. 15 most commonly logged Allscripts EDI support cases

Size: px

Start display at page:

Download "August 11, 2016 Presenter: Nicole Beulah. 15 most commonly logged Allscripts EDI support cases"

Aleesha Blake
5 years ago
Views:

1 August 11, 2016 Presenter: Nicole Beulah 15 most commonly logged Allscripts EDI support cases

4 Agenda Cover 15 most common Payerpath support questions Detail the solution(s) and/or possible workarounds for these common issues Discuss Allscripts Payerpath Knowledge Base Articles and how client s can locate/search for them Copyright 2016 Allscripts Healthcare Solutions, Inc. 4

5 August 11, 2016 Payerpath Access

Payerpath Username / Passwords Our most commonly logged case origin I need my

KnowledgeBase Article 000099313 How to Reset Your Payerpath Password Password Criteria: Minimum of six characters One uppercase

7 KnowledgeBase Article How to Reset Your Payerpath Password Password Criteria: Minimum of six characters One uppercase character One lowercase character One numeric digit One special character Copyright 2016 Allscripts Healthcare Solutions, Inc. 7

8 Payerpath Username / Passwords Payerpath - New user logins for address of the new user is needed. Once the new user is added, the user will need to select Forgot your Password? to generate a new password. Password Criteria: Minimum of six characters One uppercase character One lowercase character One numeric digit One special character (!,@,#,$,*) Copyright 2016 Allscripts Healthcare Solutions, Inc. 8

9 August 11, 2016 Payerpath Claims and Reports

10 Payerpath Rejections Failed Claims in Payerpath Numerous reasons and scenarios for failed claims Field help provides information to correct claim within the application Rejections on Carrier Report Enrollment/Credentialing related issues Payer Rejects Report Workflow Guide Secondary Claims Rejections Primary Payment information was not posted correctly within the Allscripts ProPM application. Formula for success!!! Payment + Adjustment + Patient Responsibility = Charge Amount Copyright 2016 Allscripts Healthcare Solutions, Inc. 10

Application Field Help While working claims in Payerpath users can click on blue field names to gather valuable information that can be used in working claim rejections.

11 Application Field Help While working claims in Payerpath users can click on blue field names to gather valuable information that can be used in working claim rejections. The Application Field Mapping provides guidance on correcting information in the practice management system. 1 Field Description 1 2 Payer Edits 3 Application Reference 2 3 Copyright 2016 Allscripts Healthcare Solutions, Inc. 11

12 Payer Rejections I have called the payer and my claims are not on file? Review Reconcile by Batch for the date the claims were submitted. If Payerpath was able to reconcile this payer s report then the rejected claim would appear in the Rejected column shown below: Copyright 2016 Allscripts Healthcare Solutions, Inc

Payer Rejections Payerpath holds Payer Reports for 2 years!

Reports Payer report Filter 1 2 3 Payer Exclude RCM Matched Rpts

14 Payer Rejections If the claim was submitted to a payer that Payerpath does not reconcile then review Payer Reports under Reports Payer report Filter Payer Exclude RCM Matched Rpts Apply Filter Copyright 2016 Allscripts Healthcare Solutions, Inc

15 Payer Rejections Payer Reports with a Y in the Matched column are included in the reconcile by batch view. Payer Reports with a Blank in the Matched column are not reconciled by Payerpath. These reports need to be reviewed individually for rejections. Copyright 2016 Allscripts Healthcare Solutions, Inc. 15

17 Secondary Claim Rejections Majority of incoming Payerpath claim rejections surround Secondary Claims. These claims can be easily viewed/corrected by using the COB/EOB functionality. Secondary Claim Rejection Example: Payment + Adjustment + Patient Responsibility = Charge Amount Copyright 2016 Allscripts Healthcare Solutions, Inc. 17

Secondary Claim Rejections 1 1 2 Claim Level COB/EOB Service Line

19 August 11, 2016 Insurance Follow-up Process to avoid timely filing issues

21 Insurance Follow-up Process/Timely Filing I have called the payer and my claims are not on file? Review Reconcile by Batch for the date the claims were submitted. If Payerpath was able to reconcile this payer s report then the rejected claim would appear in the Rejected column shown below: Copyright 2016 Allscripts Healthcare Solutions, Inc

22 Insurance Follow-up Process/Timely Filing Print Reports from Payerpath to prove timely filing Locate the report by using the search criteria under Reports Payer report Filter Click on the View to the right of the selected report When the report is displayed, select Print at the top of the screen Select the desired printer and click on Print Copyright 2016 Allscripts Healthcare Solutions, Inc. 22

23 Insurance Follow-up Process/Timely Filing Download Reports from Payerpath to prove timely filing Locate the report by using the search criteria under Reports Payer report Filter Right Click on the diskette icon to the right of the selected report Select Save Target As from the drop-down menu Save to the desired location on your PC Copyright 2016 Allscripts Healthcare Solutions, Inc. 23

24 August 11, 2016 Missing or Duplicate claimfiles in Payerpath

25 Are you missing claimfiles or see duplicate claimfiles? Missing Claims Claimfiles were created and transmitted electronically, but the file isn't listed in Payerpath Claimfile with.txt file extension is still listed in the NtierFiles folder Duplicate Claims Preliminary Listing Only option was selected in IBI prepared claims tab User is creating multiple files at once If an error occurred for a file, the other files create, but the Billed Date doesn t stamp on the claims If user exits out of the job status screen prior to completion Copyright 2016 Allscripts Healthcare Solutions, Inc. 25

26 August 11, 2016 Carrier Remittances

27 Show me the money remits that is Missing Remits What s needed NPI Tax ID PTAN for Medicare carriers Check number Check amount Check total Carrier Name/TSPID Copyright 2016 Allscripts Healthcare Solutions, Inc. 27

error when retrieving remits electronically (ERM) 2

Electronic Remittance Style is missing or invalid for

29 Show me the money remits that is cont. Unpostable payments on the Import Remittance Listing Electronic Remittance Style is missing or invalid for Claim's Remitting Carrier Copyright 2016 Allscripts Healthcare Solutions, Inc. 29

ESM/Reason Options needs to be checked or

31 August 11, 2016 Paper Claims

32 Paper Claims Missing information on a paper claim Claims rejecting at the carrier for missing information Incorrect Paper Claim Format is being used Custom Crystal Report needs to be created Copyright 2016 Allscripts Healthcare Solutions, Inc. 32

33 August 11, 2016 Enrollment Forms and Payer IDs

Are you authorized to send claims or receive remits?

I need a Payer ID to send claims electronically

ID Help > Knowledge Center > Payer Listings

37 August 11, 2016 PP Call (formerly iremind)

38 Update the Voice Print Worksheet We get several calls a day from clients requesting an update to their Voice Print Worksheet (VPW) to add, update or delete a Resource, Location, and Appointment type. What is needed A complete copy of the VPW with the Resource, Location, and/or Appointment type highlighted and dated. This form can be uploaded to the actual case or ed to an EDI Support analyst. Televox is notified of the request via . Typically, the request is completed within hours and the EDI Support analyst will inform the client when the request has been completed. Copyright 2016 Allscripts Healthcare Solutions, Inc. 38

39 Find Call Confirmation Reports Output Path = \\<Server Name>\NtierFiles\<Practice Name>\iRemind or EDI Reports. from about 2 hours or so from the time the PP Call file was transmitted, there should be a confirmation report displaying in itool. This report will contain AN and iremind in the file name. The client needs to hit the send/receive button to retrieve this file, which will then show in their shortcut to EDI Reports folder. The AN file will be named: iremind.an.date.client#.co1.######.htm.gz For example: iremind.an co htm.gz This report from the clearinghouse contains the following information the number of Total Reminders received. The report also lets the client know that the file was successfully received. This can take longer than two hours at high traffic time with the clearinghouse. Copyright 2016 Allscripts Healthcare Solutions, Inc. 39

40 Find Call Confirmation Reports The next business day, the client will receive a second report from the clearinghouse which tells them how many reminders were processed. It will give a total of how many patients cancelled their apts, how many apt reminders were delivered, and how many apt reminders were not delivered. The report will then show each patient and their apt, and the result of the iremind (for example, delivered accepted; delivered answering machine; cancelled, etc). The file will be named: iremind.ap.date.client#.co1.######.edi.gz For example: iremind.ap co htm.gz Find results in Payerpath Copyright 2016 Allscripts Healthcare Solutions, Inc. 40

Payerpath call results now in Payerpath!! 11.

42 Requesting a recorded call /.wav file WAV FILE REQUEST Analysts/Clients will sometimes ask for a WAV file which is a mp3 recording of the message the patient received regarding their future appointment. This is a pre-recorded recorded WAV file, not the actual recording with the patient or voic answering and the appointment options selected. If the Resource, Location, and Appointment type were added to the VPW prior to the appointment and the call occurred less than two weeks prior to today s date then we can ask for WAV file. A secure with the attached.wav file will be sent if sending PHI. Copyright 2016 Allscripts Healthcare Solutions, Inc. 42

43 August 11, 2016 Payerpath Patient Statements (ibill)

44 Payerpath Patient Statements (ibill) I sent a statement file, but I haven t received my Statement Notification (SN) report. Can you confirm the file was received? When creating the statement file, a box will appear and ask what to save the file as. It will default to: statementexport.txt Some clients like to change this to the date of the file. That is fine but you always NEED to leave the word "port" in the file name. That is what the send/receive icon looks for when you transmit. My recommendation is to leave the file name as is. Copyright 2016 Allscripts Healthcare Solutions, Inc. 44

47 Payerpath Education Track TIME TOPIC PRESENTER Tuesday August 9 th 1:30 2:30 Keep your finger on the pulse using Practice Performance Wednesday August 10th Amber Civitarese, RemitData 8:30 9:30 Patient Responsibility Solutions - Maximize Patient Payment Revenue Opportunities Lisa Temporale 9:45 10:45 Allscripts Payerpath: Roadmap to a Healthy Financial Core Steve Mueller 1:30 2:30 Optimize Electronic Remittance Posting Anne Havlina Nicole Beulah 2:45 3:45 Integrating Allscripts Payerpath using Office Manager Paola Turchi 4:00 5:00 Payerpath Pre-visit solutions: A Healthy Revenue Cycle before Patient Visits Anne Havlina Thursday August 11th 1:30 2:30 Payerpath Tools and Techniques for Effectively Reconciling and Tracking Claims Carrie Murphy 2:45 3:45 The 15 Most Common Allscripts EDI Support Questions Nicole Beulah Copyright 2016 Allscripts Healthcare Solutions, Inc. 47

48 This presentation has been sponsored by our partners at To learn more about Contract Audit & Recovery and MCAG s unique revenue generating solutions visit the HUB, or go to Copyright 2015 Allscripts Healthcare Solutions, Inc. 48

Infinedi, LLC. Frequently Asked Questions

Infinedi, LLC. Frequently Asked Questions Infinedi, LLC Frequently Asked Questions Who are we? Infinedi has been helping medical providers better manage their practices since 1986 by providing the finest EDI services available. Infinedi is a privately