Centricity PM and EMR Housekeeping: Daily: • • • • • • • • • • • • • • • • • • Resolve any unapplied funds Close batches Run daily reports (What reports do you run?) Charge & appointment reconciliation/reconcile the NEW billing statuses with the NO SHOW appointments on the schedule Retrieve billing charges – or manually enter charges Send Primary and Secondary Insurance claims (electronic and paper) Payment Posting (Insurance and Patient) Work on Rejected Claims Work on Appeals / Denial management follow-up Insurance and Patient Internal and External Collections/Patient and Insurance correspondence, calls/Budget plans/Payment Plans Check Visit Owner Queue/Work other task queues or lists Make any necessary adjustments to visits with capitated insurance plans. Get it off you A/R! Balance payments entered in the system and print a deposit slip report IT Admin: Review System Audit Logs IT Admin: Backup Centricity system database EMR Interface - LinkLogic errors –check 1-2 times daily Go to Billing and check “visits awaiting charge import”. Watch Fax Queue Weekly: • • • • • Send patient statements Credit balances/Refunds Work on Returned mail/Bad address Run “Unsigned EMR” document report Audit desktops for flags, check flag proxy buckets, orders, reports, MU report checking, etc. Monthly: • • • • • • • Run monthly reports (What reports do you run?) Audit all outstanding billing for insurance and patient due Hard close EMR Desktop Audit – check for old documents or unsigned documents that need signed Audit your average A/R days. Audit your charge lag time. IT Admin: audit your backups to be sure your system for backing up is actually working. Quarterly: • • • • • If you do not close monthly, at least hard close quarterly. Clean up custom medication or problem lists that aren’t updated automatically by service pack updates. IT Admin: Security audit IT Admin: EMR Knowledge Base Updates – Read release notes IT Admin: Check GE Website for service pack updates • • • • • • IT Admin: Check to see if the plug-ins are up to date Review Insurance Carriers – make sure all setup to go electronic when possible Review top 10 Rejection Reasons per payor – identify opportunities to fix. Coding and Compliance - Perform a billing audit. – Take a few visits from each provider, and audit the chart for documentation, audit the billing side for CPT codes used and the insurance submission process. Ensure each provider is coding to the highest level available that the documentation supports. You may want to also do a geographic peer evaluation per specialty to compare coding to other providers in the same area. Observe and shadow a couple of patient appointments from beginning to end. You will see the patient flowing through the office and it is a good time to identify bottlenecks, training opportunities, or workflow optimization opportunities. Save backup copies of your EMR forms or key components. Yearly: • • • • • • Update fee schedules IT Admin: Annual Security audit Clean up schedule templates and appointment types Run monthly and yearly reports Hard Close the System Review your system downtime plan Visit Statuses Audit in Centricity: Status Description NEW IN PROGRESS - PRIMARY APPROVED APPROVE FAILED BATCHED FILED Untouched visit (appointment on schedule) Either a copay was entered or charges entered Charges entered – visit passed CPS first edit Charges entered – visit failed CPS first edit (reason on notes tab) Claim is ready to be sent electronically Claim was printed on paper. Assume it was mailed to insurance carrier for adjudication. Visit failed CPS second edit or clearinghouse or payor rejected Claim was sent to the clearinghouse electronically Claim was accepted electronically by the insurance payor for adjudication FILED REJECTED SENT FILED SUCCEEDED IN-PROGRESS SECONDARY WAITING PATIENT PAYMENT COLLECTIONS HOLD VISIT OWNER QUEUE Primary insurance carrier EOB received and claim is ready to be prepped for secondary filing Visit balance in patient responsibility Visit balance in either patient or insurance responsibility and is in the internal collections process User manually put visit on hold (please include notes on the visit) User manually assigned a visit owner. Check queue daily Recommended Days in Status 2 2 1 1 1 45 days from last filed date Work on daily 1 10-30 days from last filed date Work on daily Work on daily Work on daily Work on daily Work on daily
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