The Fax Outbox feature allows users to view faxes in the Outbox, as well as to edit and resend faxes.

• Within the EHR, select “Documents” from the bottom blue bar annd then select the “Fax Outbox” tab.

• Filter the faxes displayed by “Status” and “Sent By.”

• View the status of each fax. If the status of a fax is “Failed,” click the question mark to view the reason why the selected fax has failed.

• Click the “Search Faxes” icon to search for specific faxes.
• Enter information and click “Search Faxes.”

• The search results will appear on the next screen.

• To resend or delete a fax, highlight the desired fax and click “Resend” or “Delete.”

• To view the queue, click “View My Fax Queue.”

• Enter Cover Sheet information, and flag as “Normal” or “Urgent.”
• Filter Recipients by using the “Contact Filter.”
• Add a New Recipient if desired.
• Click “Save Fax Queue” to save.
• Click “Clear Fax Queue” to clear the Queue.

The Anesthesia Calculator, located within Charge Entry, is a convenient tool that allows users to conveniently calculate anesthesia units upon entering an anesthesia claim.

• Proceed to Charge Entry in the Practice Management System.
• Upon entering an anesthesia claim, click the Calendar icon.

• Enter Modifiers, Start Time and End Time.
• Click “Apply Units.”

• Once applied, the anesthesia information will be displayed.

Under the Chronic Care Management (CCM) program authorized by CMS, providers can bill $42.60 per 30-day period for 20 minutes of chronic care activity (non-encounter based follow up care). This help section reviews how to document the activity and time spent for CCM billing. For more information on CCM billing see the Chronic Care Management (CCM) Billing page.

CCM Billing

Once permission has been recorded for a patient, MediTouch will begin tracking clinical activities for the patient. A “CCM Billing” module is provided in the EHR to help providers identify which patients have accrued recent activity and may be ready to bill.

• From the EHR Dashboard click the “Documents” button in the bottom navigation menu.
• Click “My Reports” and then “CCM Billing” to continue.

Ready to Bill

The “Ready to Bill” tab consists of patients who have granted CCM Permission to the selected provider, have at least 2 active chronic conditions, and have had recent activity during the 30 day period.

• The Recent Activity column identifies clinical activity recorded in the patient chart within the 30-day period.
• An edit icon is available document the recent activity.

Document the Recent Activity and Time Spent

The “Ready to Bill” tab consists of the recent activity during the 30 day period. The edit icon allows the provider delete recent activity that he or she believes is not relevant to the CCM claim. It also allows the provider to document additional notes and record the time spent per activity.

• Click the edit icon to document the Recent Activity.

• A “Notes” and “Time” field is available per activity.
• Use the Notes field to document any comments necessary to justify the CCM billing.
• Use the Time field to document the time spent performing the activity (in minutes).

• Click the “X” icon to delete any activity that is determined to not be relevant to the CCM claim.
• A confirmation message is provided, click “OK, Delete” to delete the activity.

• Click the “Save” button to close the window and update the recent activity.

This help section outlines the new and improved Patient Portal that is set to release in the coming weeks. The new portal consists of many great new features that will help patients and offices use the platform. Portal usage is vital to a successful Stage 2 Meaningful Use attestation. Patients will immediately notice a difference as the entire layout has been enhanced to allow for easier navigation to the important areas. Two other features to highlight include: a “Responsive Design” that will allow patients to use the portal on any device and the ability to create a custom check-in process. This page highlights the major changes to the portal.

New Look and Feel

• The Home Page now features a set of tiles, offering patients an overview of important information along with links to the most commonly used Patient Portal tools.
• The patient is immediately informed of outstanding balances, new messages, and prompts them to check-in for their next appointment

Designed for Any Device

• The Patient Portal has been redesigned using “Responsive Design” techniques.
• This allows patients to view their health information on any device, including desktops, laptops, tablets, or smartphones.

Premium Portal Enhancements

There are a number of new features and enhancements that are only available in the premium patient portal. These features are aimed at engaging the patient and providing them with greater access to their statements and payment informtation.

Detailed Statements and Payment History

• My Current Charges provides patients with a detailed view of their current balance and includes the same level of detail as the information seen in the paper statement.
• Statement History displays all prior statements in PDF format that have been sent to the portal.
• Payment History allows the patient to see a history of their payments posted in the system. This can be especially helpful for patients who need to reconcile their Health Saving Account (HSA) records.

*Premium Portal Feature. This premium portal feature can be enabled and disabled by the practice.

Custom Check-in Process

• In Admin > Portal Check-in Management provides a drag and drop interface that allows the user to place check-in elements in any order they desire.
• The pages in the current check-in process will be used as the system default.
• All of the current pages will be available, along with the ability to select Custom Forms.

Immunization Records

• The Immunizations module will be formatted to align with the CDC Child and Adult Immunization Records.
• This makes it convenient for patients or parents to generate a printable copy.

Improved Print Page Format

• Printing individual portal pages is presented in a cleaner format.

Document Viewer

• A hindrance of old portal was the inconsistencies of how browsers display documents, especially editable PDFs. The Document Viewer is an embedded PDF viewer that results in a common experience for all users across all browsers.
• Now regardless of the browser settings the patient will have no problem viewing documents and filling in editable PDFs.
• This feature can be used when the patient originally registers for the Portal or during the Custom Check-in process.

Payment batches are groups of payments that practices collect and process from patients and insurance companies throughout the day. We recommend using the Payment Batches feature to help reconcile your bank account deposits. When posting an insurance payment or patient payment use the drop down box to assign the payment to a batch.

• Hover over Billing on the menu bar, select Payments and then click Payment Batches.

Open a New Payment Batch

• To open a new batch, click Open New Batch.
• Select a location and/or deposit date (optional) and click Create Batch.
• The batch ID is formatted as MMDDYYYY-[location’s first five characters]-nn, where MMDDYYYY is the current date and nn increments by one starting with 01. Example: 04202015-EVERY-01. EVERY is used if no is location selected.

Manage Payment Batches

This section describes the various ways to manage payment batches.

• Batches can be filtered by all batches (default), open batches, and closed batches.
• To view the batch’s associated payments, click the Batch ID’s blue hyperlink

Payment batches can be edited, closed, deleted, or reopened. The following scenarios can occur:

• An open batch with no associated payments can be edited or deleted, but not closed.
• An open batch with one or more associated payments can be edited or closed, but not deleted.
• A closed batch can only be reopened.

View associated payments

• Click the Batch ID’s blue hyperlink.
• For more information on searching payments, go to Billing: Payments – Search Payments.

Associate a payment to a payment batch

You have the option to associate a patient or insurance payment with a payment batch. For information on posting an insurance payment, go to Billing: Post Insurance Payment.

The option to associate an autogenerated payment with a payment batch will be available in a future release. For information on ERA auto-posting, go to Billing: ERA Auto-Posting.

Edit payment batches

• Location or Deposit Date can be edited. Click .
• Make your edits and click Save Changes.

Delete payment batches

• Click and then click Delete Batch.

Close payment batches

• Click and then click Close Batch.

Reopen payment batches

• Click and then click Reopen Batch.

This page describes how to create a tertiary claim. The following conditions must be met before creating a tertiary claim.

• The primary claim has been created and the primary payment has been posted.
• The secondary claim has been created and the COB payment has been posted.
• The tertiary payer has been added to the patient’s chart as a paper payer or electronic payer with a paper mailing address. Tertiary claims cannot be submitted electronically.

• Navigate to the patient’s chart. For a list of recent patients, hover over Patients and select Recent Patients. The list displays on the right.
• To find a patient, enter their name in the search box.

• Click Ledger.

• Write-off the patient responsibility. Click the patient balance dollar amount (blue hyperlink). For instructions, go to How to Write Off a Patient Balance.

• Search for the primary claim. Click Advanced (next to the search box).
• Click Payment Detail.

• To create a claim, click Copy.

• Under Bill To, change payer to the tertiary payer.
• Under Claim Transmission, select Print Locally on CMS-1500.
• Click Create Claim.
• Print the claim on a CMS-1500 form, attach the primary and secondary EOBs, and mail to the payer.
• When payment is received, post the payment as normal.

A new tabbed charge entry feature will be included in an upcoming release, providing streamlined data entry and improved keyboard navigation. We have not changed the overall functionality, but we have enhanced the layout to include tabs to important areas, no longer requiring you to scroll down for all of the information. Two enhancements to highlight are the Patient Insurance tab, which supplies detailed insurance information and the Additional Info tab, which replaces the Advanced Encounter option. A few tab views are displayed below. Look out for this change as well as many others coming soon to the Tabbed Charge Entry screen.

Coming This Summer

• Move service lines up/down
• Resubmit one service line
• Update adjustments during resubmission

Tabbed Charge Entry Coming Soon

• The blue hyperlink to the Advanced Encounter option is no longer available. This option has been replaced by the Additional Info tab.
• The cursor automatically focuses to the first field on each tab.
• Each page is capable of tab navigation.

• The Patient Insurance tab provides greater details about the patient’s insurance.

• The content in the Additional Info tab replaces what was in the Advanced Encounter option.

Hot Keys

Note: The Number Keypad will not work.

Use the Patient Portal Website Setup feature to enable your practice’s website to host the YourHealthFile Patient Portal login form. This feature is accessible from the Practice Management (PM) system.

• From the PM’s menu bar, click Admin and then click Patient Portal Website Setup.

Enter the URL

• Enter the URL for your practice’s website and then click Save.

Login Form

The hosted login requires you to log in through a form hosted on the practice’s website. Upon successful authentication, the patient is directed to YourHealthFile. Unlike co-branding, in which the practice’s logo is displayed on the HealthFusion Practice Management screens, a hosted login does not apply the practice’s logo on the portal pages. All portal screens will continue to display the YourHealthFile logo.

• The login form is displayed on the practice’s website by inserting an IFrame in the HTML code on one of the practice’s existing web pages. Alternatively, practices may create a new page intended specifically for portal information and login, such as the example here.

IFrame

The URL for the HealthFusion login must include “https” instead of the typical “http” to ensure the patient’s login credentials remain encrypted during the login process.

Downtime

• On occasion, the Patient Portal may be unavailable due to scheduled maintenance. Under normal circumstances, this downtime will not be scheduled during normal Monday–Friday business hours.
• If the Patient Portal is taken offline, the login screen will be replaced with a message alerting the patient of the downtime, as shown here.

Personalized provider web pages are a great way to build the practice and market it to potential new patients. Use the Local Search Provider Pages feature (accessible from the Practice Management (PM) system) to create a new provider page and have it published and hosted by the YourHealthFile Patient Portal. Local search provider pages are designed and optimized so that new patients can easily search for providers. Each practice provider can create a page and customize its content using the easy-to-use graphical template.

Sample Page

For example, a family medicine physician in Solana Beach, CA creates his local search provider page. When new patients search for “Solana Beach family doctor,” his provider page is included in the search results. A patient can use the patient view of the provider’s calendar to select an appointment time and complete a self-registration form.

• Local search provider pages include:
• Practice name and specialty
• Calendar of available appointment times
• Practice information
• Location address and map
• Testimonials (optional)
• Accepted payers and plans (optional)

Each practice provider can create a local search provider page and customize its content using the easy-to-use graphical template.

• From the Practice Management menu bar, click Admin and then click Local Search Provider Pages.

• The page displays all current local search provider pages.
• Click Create a New Page.

Provider Page Template

We provide a provider page template with sample content to help guide you through the process. The local search provider page is based on the specific location and provider that is going to be featured on the page.

• The practice name is prepopulated, but it may be edited.
• Editing the practice name will only be reflected on the local search provider page.

Set the Location

• Select an office location from the Location list.
• The office address is populated.

Assign a Calendar

• Select a calendar from the Calendar list.
• The selected calendar is where all new appointments are scheduled by new patients visiting the page and requesting an appointment.

Note: The actual schedule is not displayed; only the available time slots as you have configured them. For more information, go to Portal Calendar Management.

Select a Provider

• Select a provider from the Provider list.
• The selected provider’s name is used to populate the Provider Name field.

Note: If the selected calendar is associated with a provider, as opposed to a resource, e.g., room, equipment, etc., the provider populates automatically.

• The provider’s taxonomy code is used in combination with the selected location’s city to populate the Page Title field.
• The selected provider’s specialty is used to populate the Specialties field.
• The specialty is also inserted in the “Benefits of” field.

The YourHealthFile Patient Portal is organized so that patients can quickly and easily find necessary information and tools. Use the navigation tiles on the Patient Portal’s home page, and the navigation menu (available after you click one of the tiles), to find information and links to the most commonly used tools.

More Patient Portal help pages are coming soon. This page will be updated with links as more help pages get created.

Login Page

• On the login page, patients can:
• Activate their account
• Log in to their account
• Retrieve their username and password

Home Page

The home page contains a set of navigation tiles that link to the most frequently used portal tools.

• If the provider has the premium Patient Portal, the home page contains, at the most, the following tiles:
• View Current Charges: Displays the current balance due.
• Schedule an Appointment
• Appointment Check-in: Displays the next appointment that the patient can check in for.
• Request a Medication Refill
• Review Medical Record
• Message a Doctor: Displays how many unread messages the patient has.
• Contact Us
• If the provider has the standard Patient Portal, the home page only contains the last three tiles.

Providers have the option to enable and disable selected premium Patient Portal features.

Patient Summary

The patient summary is located below the navigation tiles. This summary includes the patient’s demographic and medical information. This is the same information that is found at Review Medical Record > Patient Summary. The table of contents lists each medical information category that is provided.

Header

The header on every page after the home page is the same.

• YourHealthFile logo: Returns you to the home page.
• Print Page: Prints the current page.
• Log Out: Logs you out of the Patient Portal.
• Appointment Check-in Process: Providers can customize their check-in process. Note: This only displays in the header when a check-in process has yet to be completed.

Navigation Menu

The patient’s name is displayed above the navigation menu. Some menu items have submenu items (patient account, patient appointments, documents, and review medical record).

Patient Account

• Current Charges: Provides a detailed view of the patient’s current balance and includes the same level of detail as the paper statement.
• Statement History: Displays all prior statements that the provider has sent to the Patient Portal.
• Payment History: Displays the patient’s payment history.
• Patient Credit Cards: Displays saved credit cards. Patients can add credit cards.
• Patient Information: Displays patient information, contact information, emergency contact information, employment information, primary care physician, preferred pharmacy, care team, and family members who are in the practice. Patients can update this information.
• Patient Insurance: Displays the patient’s insurance information. Patients can add insurance information.
• Account Settings: Patients can update their email address, security question, or password.
• Additional Account Access: Displays the individuals who also have access to the patient’s portal account. Patients can grant additional account access.
• Audit Log: Maintains a log of the account’s online activity.

Patient Appointments

• Upcoming Appointments: Displays the patient’s upcoming appointments. The patient can check in for his current appointment.
• Request Appointment: The patient can submit a request for a nonemergency appointment.
• Request e-Visit: The patient can submit a request for a nonemergency e-visit.

Documents

• Displays the documents that the provider has shared with the patient.

Health Maintenance

This menu contains tabs for health maintenance and health logs.

• Health Maintenance: Based on the patient’s current data in the provider’s MediTouch electronic health record (EHR). Displays the health maintenance measure status on the portal (e.g., high blood pressure control – overdue).
• Health Logs: Patients can enter data (e.g., glucose) into a flow sheet to track progress. Flow Sheets are found in the EHR. Note: Requires a flow sheet to be enabled for portal access.

Review Medical Record

• Patient Summary: Provides the same information that is on the home page. Patients can download a copy of their medical record.
• Allergies: Lists the patient’s allergies and their associated symptoms. Patients can add an allergy that is not already in the EHR.
• Immunizations: Lists the patient’s immunizations. Patients can add an immunization that is not already in the EHR. Patients can download a copy their record.
• Medical History: Includes conditions that the patient has been diagnosed with during their lifetime. Some providers use Problem List for active conditions. Patients can update their medical history.
• Medications: Lists the medications that the patient is currently taking. Patients can add medications that are not already in the EHR. Patients can request prescription refills.
• Office Visits: Provides information about the patient’s encounter.
• Orders: Lists the orders (lab, radiology, consults, and office tests) and the results that the provider has made available to the patient.
• Problem List: Lists the patient’s active health issues recorded in the EHR.
• Social History: Lists the patient’s cigarette and alcohol consumption history and their active use during pregnancy (including illicit drug use during pregnancy). Patients can update this information.

Message a Doctor

Patients can communicate with their providers using the secure messaging system.

Store

The store is the practice’s personalized Amazon store. The practice can promote specific products or product categories and earn sales commissions.

Contact Us

Practices provide their location(s) and contact information, including a map and a link to get directions.

Patients can conveniently check in for their current appointment through the Patient Portal.

Start Check In

• From the home page, click the Appointment Check-in navigation tile.

• After the appointment check-in process has begun, the Appointment Check-in Process wizard displays in the header on every page until you complete the check-in process. Use the wizard to quickly step through the entire process.
• Use the select menu to navigate to a particular step or click PREV or NEXT to go to the previous or next step in the process.
• Practices can customize the check-in process using the Custom Check-in Setup feature.
• To begin, click Start Check-in Process.

Check In to Current Appointment

If the patient has already entered the Patient Portal through one of the navigation tiles, she can access the check-in process by going to Patient Appointments > Upcoming Appointments on the navigation menu.

• To check in to the current appointment, click CHECK IN.
• The patient is taken to the beginning of the check-in process.

Complete Check In

• After all of the information in the check-in process has been completed or confirmed, click Complete Check-in Process.

Providers have a responsibility to maintain their patients’ privacy. In some situations, providers may deem it necessary to withhold sensitive information from the patient’s family. For example, in the case of a minor being prescribed birth control, a provider may choose not to disclose that information to the patient’s parents. MediTouch now provides an option for providers to identify clinical records as Portal Private. Setting an encounter or an individual record as private prevents them from displaying on the Patient Portal. These private encounters and records are excluded from the portal entirely regardless of who logs into the portal account – the patient or the proxy user (parent).

Set an Encounter as Private

• The Portal Private feature is only accessible to rendering providers and super users.
• To mark an encounter as private, select the Portal Private checkbox.
• The checkbox to enable the clinical summary on the Patient Portal before signing is disabled and cannot be selected unless you deselect the Portal Private option.
• To disable portal privacy, you must be a super user or a rendering provider; however, you do not have to be the same person who enabled the privacy.

• When viewing the table of encounters, indicates that the encounter is private. indicates that the encounter is not private and can be viewed on the Patient Portal.
• You cannot enable or disable the encounter’s privacy by clicking this icon (whether it is red or grey). When you click this icon, you are navigated to the encounter summary where you can mark the encounter as private or not by using the Portal Private checkbox.

When you enable an encounter as private, this privacy setting automatically applies to the records that are created as part of the encounter, (e.g., medications prescribed during a private encounter inherit the privacy and, therefore, are also private). The following types of records inherit privacy when an encounter is marked as private:

• Documents
• Medication List
• Problem List
• Orders
• Medical History
• Social History
• Surgical History

Set Individual Records as Private

Individual records in a chart can be cleared of the privacy setting even if the associated encounter is marked as private. Conversely, an individual record can be marked as private even if the associated encounter is not marked as private. The same types of records that inherit privacy from the associated encounter can be individually marked or unmarked as private.

• Unlike encounters, you can click to clear the portal privacy setting.
• Click to change the icon color to red, which indicates that the record is private.

• Social History is the exception. It has its own Portal Private checkbox. When selected, everything on the page is marked as private.
• Deselect the checkbox to disable portal privacy.

Exporting Patient Records

• Any clinical or CCDA information that you print or download from the EHR contains all of the patient’s records regardless of whether certain encounters or records are marked private.
• Remove any sensitive information that you do not want to share with the patient’s family before providing print or electronic records to them.

• The Print Wizard includes a warning message indicating that printing the patient’s clinical information includes all records, including private ones.

The C-CDA file is a Meaningful Use Stage 2-related document that contains all import-structured data of a patient’s chart (e.g., allergies, medications, problems).

The following can be imported into MediTouch’s data structure:

• Allergies
• Medications
• Problems

Use the existing C-CDA file in the Administrative tab of the patient’s chart to import the allergies, medications, and problems.

• Navigate to the patient’s chart from the EHR Dashboard.
• Select the Administrative tab
• Click Import from File.

• Select the C-CDA file from the drop-down menu.
• You can also click Browse to upload a file.
• Click Proceed.

• Confirm the patient’s information.
• To preview the imported file prior to continuing, click Preview Imported File.
• Indicate if this import is a data migration or a transition of care by clicking one of the buttons.
• Click Proceed.

• If allergies, medications, or problems are present in the C-CDA file, the Allergies, Medication List, and Problem List tabs turn red.

• To accept these into the chart as structured data, navigate to one of the tabs.
• Deselect any items that you do not want imported.
• Click Import Selected.

The purpose of a month end close is to lock down financial transactions for the month, thus preserving the charge and payment data, and to establish static, reportable monthly accounts receivable (AR) totals. This results in an ending AR for the current month and a starting AR for the following month.

MediTouch will automatically perform a month end close for all clients on the last day of the month at 11:59 PM PST. To establish a customized closing date, e.g., close the month on the 5th of the following month, use the AR Month End Close feature to establish your practice’s monthly closing schedule.

Restrictions

• Only a super user can set up or edit a closing schedule.
• The month end closing date can only be extended to the 15th day of the following month.
• The system will not calculate the AR for the month until the month end closing date has passed.

• On the menu bar, click Admin and then click AR Month End Close.

Set Up the Closing Schedule

Set up your practice’s closing date by creating a recurring schedule. The following selections are available:

• Last day of the month (this is the default if you do not set up a schedule)
• The 1st to 15th day of the next month
• First or second Sunday to Saturday of the next month

• To set up your closing schedule for the first time, click the edit icon.

• Select the radio button that corresponds to the desired schedule.
• If you are selecting a closing date other than the last day of the month, you must also select the recurrence from the drop-down menu.
• Click Save Schedule.

• An example of a closing schedule set up for the first Friday of the next month.
• The right side of the screen displays what the next closing date will be.

Edit the Month End Closing Schedule

• The page displays the current closing schedule and the next month’s scheduled closing date with options to:
• Edit the closing schedule.
• Edit the next closing date.

Edit the Closing Schedule

• To edit the closing schedule’s recurrence, click the edit icon.
• Make your changes and then click Save Schedule.
• Your change will be reflected on the right side.

Edit the Next Closing Date

• To edit next month’s closing date, click the edit icon.
• To select a new date, click the calendar box and then click Update.
• The closing date cannot be prior to the last day of the open month or after the 15th of the next month.
• Note: Changing this date does not change the established closing schedule.

We implemented accounts receivable (AR) enhancements to the billing and reporting modules of the Practice Management system. The goal of these improvements is to provide you with balanced and reportable AR totals. If your practice does not plan to use the AR balancing report, you do not have to use the Ledger Date and AR Month End Close features. All current reports available in Reports > Custom Reports are not affected.

This help page presents information on recently introduced new features and the improvements we have made to existing features.

Define AR

AR is the money (in the form of charges) owed to your practice by your patients and third-party payers (Medicare, Medicaid, other government services, and private insurance companies) for medical services. Billers are responsible for collecting the balances owed and applying those funds to the medical claims.

Calculate AR

For the formulas presented here, the following definitions apply.

• Charge = Amount that the provider charges for the medical service
• Payment = Amount paid by the patient or third-party payer
• Adjustment = Adjustment made to the charges by the third-party payer
• Patient responsibility = Balances moved to the patient by the third-party payer

AR Balancing Formulas

Total AR = Insurance Balance + Patient Balance

• Insurance Balance = Charges – Payments – Adjustments – Patient Responsibility
• Patient Balance = Patient Responsibility – Patient Payments – Write-Offs

Starting AR + Change in AR = Ending AR

• Starting AR = Total AR at the beginning of the month
  (Charges + Payments + Adjustments + Write-offs that are present on the ledger as of current month) + ledger date transactions backdated for current month
• Change in AR = Charges – Payments – Adjustments – Patient Responsibility
• Ending AR = Total AR at month end close

AR Ledger

• The AR ledger is a collection of debit and credit transactions applied to the charge. These debits and credits, e.g., payments and adjustments, result in a change in the AR.
• When a claim is created from a patient encounter, a charge is established in the patient’s ledger.
• The AR is established from the charge balances.
• Whether you resubmit a claim or create a secondary claim, there is still only a single charge for the encounter.

Ledger Date

Use the ledger date to accurately date the transactions that affect AR. In the past, transactions were recorded using the date when they were entered. In many cases, the current date is accurate; however, in the cases where you are entering transactions that actually occurred days or weeks ago, the ledger date allows you to document when the transaction truly occurred.

• By default, this field populates the current date, but can be backdated when necessary. Example: It is September 1 and you are still entering charges for August. You must select a ledger date in August before August’s month end close date.
• The ledger date cannot be changed after the transaction has been posted and cannot be dated for a closed month.
• If you do not need to balance your AR, leave the ledger date as is.

Month End Close and AR Totals

Example:

Any August transactions must be backdated by August’s month end close date.

If August’s month end close date is set for September 5, and you have transactions that need to be backdated to August, you must backdate those transactions by September 5 for them to report in the starting AR for September.

(Charges + Payments + Adjustments + Write-offs that are present on the ledger as of August 31) + ledger date transactions backdated for August = September’s starting AR.

Any ledger dates dated for September, entered in before the August month end close date, will be reported in September’s month end close.

Post Payments

To achieve a balanced AR, we made the payment posting process more flexible and improved the way we record each transaction that affects AR.

• Service lines no longer have to balance to $0.00. As a result, we removed the in-progress payment.
• Posting a payment has one restriction: Insurance Payment + Patient Responsibility cannot be greater than the charge amount at each service line or at the claim level.
• Out-of-balance adjustments will be reversed (an example is below).

• Charge = $100
• Insurance payment ($6) + patient responsibility ($6) + and insurance adjustment ($6) = $18.00
• An additional $100.00 payment is applied to the claim so our system automatically reverses $18.00 and categorizes the payment as an HF-96.

You can continue to apply insurance payments and patient responsibility until their sum becomes greater than the charge amount. The claim’s insurance balance will become negative. At this point, the biller must apply negative adjustments to correct the balance.

• We updated the payment posting screen to display a view of the total charge. This provides you a better understanding of what needs to be applied to the claim to balance the AR ledger.

Post an Insurance Payment

• We removed the Save My Work and Post Partial Payment options. You can now post a partial insurance payment by clicking Post Payment.

Corrections and Reversals

• Correction and reversals can now be auto-posted. Auto-post the negative rows first and then auto-post the positive rows.

• Multirow balancing ERAs can now be auto-posted. Select the checkbox(es) in each row that you want queued to auto-post.

Void a Transaction

• To void a transaction from the activity log, you must individually void each transaction.
• If a number of transactions need to be updated, we recommend voiding everything from View Applied Payments.

Resubmit Claims

We made the claim resubmission process more efficient. You now control the reversal of previously posted adjustments.

Service Line Options

You no longer have to resubmit all service lines. You can now select which service lines to resubmit. If a service line is present in the charge, but not on the resubmitted claim, you have the option to submit that service line with the new claim.

To make room for these added features, when you are on the Service Lines tab of the Charge Entry page, the screen will dynamically size to the width of your monitor.

• We added two new options to the service line table:
  • Select a service line to resubmit.

    Note: You must resubmit service lines with insurance balances greater than $0.00.

  • Delete a service line from the charge.

    Note: Service lines with payments cannot be deleted.

More Resubmission Options

1. Claim frequency code
2. Reverse all adjustments from the prior claim when resubmitting
3. View/edit adjustments

Claim Frequency Code

The claim frequency code now displays at the bottom of the Charge Entry page, but only when you are resubmitting a claim.

Reverse All Adjustments from the Prior Claim When Resubmitting

This checkbox is selected by default. When the claim is resubmitted, all prior adjustments will automatically be reversed. You can deselect this checkbox if necessary.

View/Edit Adjustments

In some cases you may not want all adjustments to be reversed. Use this option to view the adjustments for the service lines that are being resubmitted. The pop-up will allow you to control the reversal of adjustments.

1. Use the Reverse button to reverse all adjustments for the service line.
2. Alternatively, you can use the inputs to manually update the individual Copay, Coinsurance, Other PR, or Insurance Adjustment amounts.
3. Click the Edit Adj button if you wish to modify the Group and Reason code for each reversed adjustment.

1. The prior adjustments are displayed for reference and cannot be edited.
2. The reversed adjustment displays as a negative amount and is categorized with the original Group and Reason code.
3. Use the Edit icon to modify the Group and Reason code if necessary. Use the Delete icon to undo the reversal.

• All transactions that result from the updates made in the Resubmission Adjustments widget are applied to the newly created claim.

• These transactions are notated in the activity log.

AR Reports

Every action that is taken on a claim or charge is now registered on a new table. This table helps us produce the following AR reports. When the month closes, we automatically generate these reports.

• Summary AR roll-forward report
• The summary report is comparable to the monthly financial summary with the addition of a starting AR that balances to the ending AR.

• AR roll-forward details report
• The detailed report supplies the details of the charges, payments, adjustments, and write-offs reported in the summary report.

Close the Month

The purpose of closing the month is to produce AR balancing reports (above) with static values. Closing the month locks down the financial transactions for the month and results in an ending AR for the current month and a starting AR for the following month. The ledger date is used to accurately report transactions in the proper month. To set up your practice’s month end closing schedule, use the AR Month End Close feature.

We recently implemented accounts receivable (AR) enhancements to the billing and reporting modules of the MediTouch Practice Management system. These enhancements are based on years of user feedback. The goal of these improvements is to provide you with balanced and reportable AR totals that will feed data to our new Business Intelligence (BI) Reporting tool that will be launched later this year.

During the transition, new workflows must be adopted. The suggested changes featured in this help page will contribute to workflow efficiency and enable historical data to conform to the new AR enhancements.

To begin, we ask that you review the Accounts Receivable Enhancements help page mentioned in the July 30, 2015 Release Notes. Some of the important topics from Accounts Receivable Enhancements help page are referenced here.

We appreciate all of the great requests and feedback from our clients. All requests should be submitted using the MediTouch Feature Requests link.

Key terminology used in this help page:

• Adjudication: The history of applied payments and adjustments for a service line or claim.
• Charge: The complete set of service lines attributed to a patient encounter.
• Claim: A set of service lines billed and submitted to a payer.

AR Ledgers and Balancing

Expanding on the structure of the MediTouch AR Ledger, it is important to understand charge versus claim adjudication.

• Charge adjudication is the end result of one or more claims.
• To uphold our exceptional clearinghouse structure, ERAs/payments are applied to claims.
• Based on the information applied to the claim, values are established in the ledger and the charge is properly balanced.
• The following sections describe the areas that currently display charge-based versus claim-based balancing. This knowledge will help prevent confusion caused by unexpected balancing behavior.

Claims-Based Adjudication

Claim Details

• The Claim Details view displays adjudication information that was applied to the individual claim.

• This is not necessarily an accurate view of the charge because more than one claim could be involved in the billing of the charge (e.g., resubmitted claims, secondary claims).
• If there is a single claim billed for the charge, the claim and charge adjudication would be identical.

Charge-Based Adjudication

Apply Payment Screen

• The summary information above the service line details is charge-based.

• The insurance balance in service lines is charge-based.
• When applying a payment, if the service line has too much adjudication information (i.e., insurance balance is negative) the service line turns red.

We will make our best effort to automatically balance the charge based on the historical data that we have, but, at times, you must manually balance the charge to $0.00.

Resubmission Adjustments Widget

• When resubmitting a claim, you have the option to manually update prior adjustments. The information provided is charge-based.

AR Ledger

• Ledger totals are charge-based.

Workflow Suggestions

The following best practices will help eliminate unnecessary steps and ensure historical data will accurately conform to the AR enhancements.

Do Not Void Prior Claim Adjudication

Use the void functionality when a transaction has been erroneously created (e.g., void a payment that was entered by mistake). Voiding transactions to balance an account is discouraged and must be avoided whenever possible.

If the ledger is ever out of balance and your intention is to update the balance, a new adjudication transaction should be entered to reverse the information that is already present. In the past, these types of transactions were not possible since we forced you to balance to $0.00 any time adjudication information was applied.

Warning: If you attempt to void transactions on resubmitted claims and/or primary/secondary claim combinations originally applied before July 31, 2015, the ledger may not accurately update. However, void transactions that occurred after July 31, 2015 will not result in any balancing issues.

• Manually enter a negative transaction to the most recent claim rather than voiding (unapplying) the payment.

We understand that clients sometimes unapply a payment from a resubmitted claim and then reapply the payment to the new claim. Our efforts are to address the reasons why users currently perform this unnecessary step. We are already in the process of updating our secondary creation logic to always complete the required fields regardless of which claim the payment(s) are applied to. If there are other reasons why this action is being taken, we would like to hear from you. All requests should be submitted using the MediTouch Feature Requests link.

Balance to the Charge

• Example: A claim was resubmitted and the insurance adjustment and patient responsibility from 98941 was reversed.

• The adjustment and patient responsibility are now $0.00 and the insurance balance is $70.00.

• When applying payments to the new created claim, only $70.00 in adjudication information needs to be entered to balance the charge to $0.00 and finalize the claim.

When applying payments, the old system forced you to balance to $0.00. This restriction was removed based on years of client requests. The flexibility to apply partial transactions requires you to manually balance the charge.

Understand Reverse Adjustments

Insurance adjustments and patient responsibility will be reversed by default (on the Charge Entry page) when resubmitting a claim. This default selection matches the old AR logic.

• In the old workflow, adjustments and patient responsibility were removed from the ledger. The new AR logic creates a new transaction to track the event.

• In this example, the claim was submitted and an ERA was auto-posted. The user identified an underpayment using the expected amount fee schedule underpayment report.

• During resubmission, the adjustments were reversed using the default option.

Know When to Reverse

• If you reverse adjustments during resubmission and then void the original payment on the resubmitted claim, this results in negative adjustments on the charge. You must only perform one of these transactions.
• If a correction and reversal ERA is received, the payer will reverse these transactions.
• If the correction and reversal is fully posted, this may result in a ledger that is not balanced to $0.00. The new AR logic manually reverses adjustments, when possible, to help the charge’s insurance balance to $0.00 when these correction and reversals are posted.

Note: Applying payments to claims that were applied on or before July 31, 2015 is the most common way for automatic system balancing issues to occur, depending on the situation. The primary situations to be aware of are posting to resubmitted primary claims with payments and primary and secondary claims for the same charge. In these situations, we recommended you only apply the necessary positive and/or negative transactions to balance the charge to $0.00. Full postings may cause balancing issues that will need to be corrected manually.

Use the Delete Option to Remove Service Lines

• When resubmitting claims, use the Delete option to remove service lines that you do not intend to leave on the charge.

Post to Restored Secondary Claims

• In isolated cases, the restored charge data displays patient responsibility amounts that were originally transferred to the secondary insurance balance. When this occurs, you need to manually reverse the patient responsibility.

Reverse Historical Write-offs

• In the old workflow, write-offs would be included in the Adjustment column in the ledger.

• Historical write-offs still display this way in the new workflow. When reversing a historical write-off, that service line may not correctly balance.
• Applying a patient payment after performing a reverse write-off is causing Ledger Discrepancies. We are working to update this logic.
• If any balancing issues occur, navigate to the Apply Payment screen and enter the necessary transactions to balance the service lines to $0.00.

Applied to Claims without Insurance Payment

• This logic was updated for future occurrences only.
• Historical data will not be updated as we are removing this section in the near future.
• This section will be removed when logic is added to reduce the balance in the A/R Aging Days

Patient Aging

• This logic was updated for future occurrences only.
• We are researching the possibility of a mass update for affected records.

Use the Diagnosis Panels feature to set up diagnosis panels for the most commonly used ICD-10 codes, enabling you to more efficiently move through the diagnosis coding portion of an encounter. Create customized diagnosis panels using our user-friendly drag‑and‑drop interface, which includes system-defined specialty-based panels, Medicare hierarchical defined code categories, and user-defined search results.

October 1, 2015 is the mandatory compliance date to use ICD-10 codes in place of ICD-9 codes for diagnosis coding.

• From the Practice Management (PM) menu bar, click Admin and then under EHR Setup, click Diagnosis Panels (ICD10).

Practice Default Settings

• Practice Default Settings is a set of common diagnosis panels supplied by MediTouch to be used throughout the EHR.
• To create a diagnosis panel, click New Diagnosis Panel.

Create a New Diagnosis Panel

There are four options to create a new ICD-10 panel:

• Manually create a panel.
• Import an existing ICD-9 panel from the PM and map it to ICD-10.
• Import an existing ICD-9 panel from the EHR and map it to ICD-10.
• Import an existing ICD-10 panel from the EHR.

• To manually create a new panel, select the New Panel radio button.
• To import an existing ICD-9 panel from the PM, select the Import ICD9 (PM) radio button. Select a panel from the menu.
• To import an existing ICD-9 panel from the EHR, select the Import ICD9 (EHR) radio button. Select a practice and then a panel from the menus.
• To import an existing ICD-10 panel from the EHR, select the Import ICD10 radio button. Select a practice and then a panel from the menus.
• Enter a Panel Name.
• Click Create Diagnosis Panel.

Add, Edit, and Delete Folders and Codes

After you click Create Diagnosis Panel, you are navigated to the Administration: Diagnosis Panels (ICD10) page.

• Diagnosis panels may contain folders, subfolders, and codes.
• Add codes using user-defined searches, from MediTouch specialty panels, or from Medicare panels.
• To create a new folder, grab Drag to make a new folder and drag it down to the right pane. To edit the folder’s name, click the New Folder title.
• Drag and drop a code from an existing panel or a search result and customize the description.
• Descriptions are editable when they are on the right pane. To edit the title, click in the description field.
• To delete a folder or code, click .

ICD-9-to-ICD-10 Mapping and Drag-and-Drop Interface

• Using the ICD-9 search as the example, click ICD9 Search.
• After you enter the search criteria, the search results display on the left pane.
• To view the mapped ICD-10 code, click . The EHR uses the Medicare-provided General Equivalency Mappings (GEMs) to help you select the appropriate ICD-9-to-ICD-10 mapped code.
• Drag and drop all or part of a panel or a search result from the left pane to the right pane.

• If one of these codes is suitable, drag and drop it to the right pane.
• To view related ICD-10 codes, click . MediTouch’s ICD-10 code expansion logic displays codes related to the selected code, enabling you to choose the most appropriate code to record the patient’s diagnosis.

• If one of these codes is suitable, drag and drop it to the right pane.

Add Codes from ICD-10 Search

• Click ICD10 Search.
• Enter the search criteria. The search result displays on the left pane.
• If one of these codes is suitable, drag and drop it to the right pane.
• To view related ICD-10 codes, click .
• Click Update Diagnosis Panel.

Add Codes from MediTouch Panels

• Click MediTouch Panels.
• Select a MediTouch specialty panel from the menu.
• The selected panel displays on the left pane.
• Drag and drop all or part of a panel from the left pane to the right pane.
• Click Update Diagnosis Panel.

Add Codes from Medicare Panels

• Click Medicare Panels.
• Select a Medicare chapter and then a Medicare block from the menus.
• The selected panel displays on the left pane.
• Drag and drop all or part of a panel from the left pane to the right pane.
• Click Update Diagnosis Panel.

Edit, Delete, or Archive a Practice Panel

• To customize the default panels, click a panel and then click Edit.
• To edit a custom panel, click the panel and then click Edit.
• To delete a custom panel, click the panel and then click Delete.
• You cannot delete a practice default panel, but you can archive it so it is not displayed. To archive a default panel, click Archive.

• To restore a panel that was archived, click Restore.

Provider Custom Settings

The provider custom settings is the customized set of diagnosis panels for a specific provider. Each provider may have her own tailored set of panels. When adding diagnoses to an encounter, these custom-defined diagnosis panels are displayed instead of the practice default settings.

Create a New Provider Diagnosis Panel

• To create a customized diagnosis panel for a specific provider, select the provider’s name from the menu and then click Create Provider Panels.

• All practice default and custom panels are copied and saved to the provider’s profile.
• To delete all custom panels for the provider, click Delete.
• To create a new diagnosis panel, click Add New Panel.
• To customize the default panels, click a panel and then click Edit.
• To edit a custom panel, click the panel and then click Edit.
• To delete a custom panel, click the panel and then click Delete.
• You cannot delete a provider default panel, but you can archive it so it is not displayed. To archive a default panel, click Archive.

• To restore a panel that was archived, click Restore.

This help page describes how to balance a charge to $0.00. We have implemented additional logic on the Apply Payment screen to help you know which adjudication information needs to be applied to balance the charge to $0.00.

Charge Ledger Balance

• This example charge shows two service lines with a $400.00 insurance balance in the ledger.
• To finalize the claim, the ledger’s insurance balance must be $0.00.
• Apply only the necessary payments, adjustments, and patient responsibility to balance the service line to $0.00.

Apply the Payment

• The insurance balance in service lines is charge-based.
• When applying a payment, if the service line has too much adjudication information (i.e., insurance balance is negative) the service line turns red.

We will make our best effort to automatically balance the charge based on the historical data that we have, but, at times, you must manually balance the charge to $0.00.