昨天和一个网友聊Billing的项目，俺翻旧文档看到了这个总结

总结

在过去的一年里，我在组织和协调上，通过Skype、电话、邮件、文档、流程图等积极有效地进行交流和沟通，提高了工作的效率，保障了工作的方向。对于每天在工作上的进展和遇到的问题，及时地进行沟通，保障了工作的进度。
    在公司的日常工作中，和BPO部门一起处理Billing、FNSR上遇到的问题。 
    在开发上，完成了206次更新，1000多项的功能改动或增强。具体的工作如下：
 
一、Billing方面：
在Billing方面，结合851、852、853、854、855这些医院的需求和Billing的实际工作，不断完善系统。主要的工作如下：
1、CMS1500相处理：和office ally的数据集成，邮件的打印，第二保险的处理等。
2、Payment的处理：Payment各种数据项的处理，EDI数据的导入等。
3、其他模块：Claim List、统计报表、表格自定义列、Notes、Fee、Dashboard、NDC、Plan等。
4、数据接口：Amazing Charts、eClinicWorks、My SQL、CSV、Text、CCDA、Summary等数据的处理。
5、BPO的常用工具:如PDF、Tiff的切割、转换、缩放工具等。
6、其他工具：Send Fax、 Send EMail等
二、FNSR方面：
1、修改了021医院的模板文件的解析，修改了CDA的生成。
2、模板转换工具SaveCDANormal。
 
三、DTEHR方面：
1、AnyModalFootpedal的设置的处理，MModelReportEditor的Playback的处理、MModelReportEditor的拼写检查 。
 
四、其他方面：
1、架设了wordpress。
2、测试了Google的短语音还有长语音的识别服务。
3、测试了Google的OCR服务。
4、注册了Power BI和Skype 机器人。
 
 
在新的2018年里，我将加倍努力，做好公司的各项工作。
祝新年快乐。
                                                                                      
                                                                                     
另：
翻看了这一年的已发邮件。回顾了每一天的工作。这一年，琐碎的事情比较多，工作节奏比较快，大部分需求都是在1天内完成并更新，总共做了206次更新。主要是细节的处理。这一点和前2年的FNSR开发完全不同，FNSR的开发是那种厚重的，注重结构和算法的。回顾之前的邮件，有三项需要继续跟进。药房的接口、检查的接口、医生常用模块。这三块，对以后完善整个产品线，有着很重要的意义。
 

Billing的部分修改

10/24/2017
1.ERA backend payment post, if the claim is already completed, then when new payment come in, it will add “Revised Payment”, but if the payment is already completed and claim is in partial, then we will need to add new payment even the completed payment does not cover all of the CPT code. We will need to discuss more about multi-CPTs in one ERA, such as the new payment still need to compare the check# before add and maybe add “Remove” button to delete empty CPT line in payment details etc.
2.As we discuss yesterday, we had some further discussion today. What we need to do:
(a). In Patient Payment List, rename “Previous Balance” to “Account Balance” and sum of the patient invoice, deposit, credit together as the final balance for this patient. Move this column to the first column
(b). Rename “Patient Credit” to “Applied Credit”. For Credit/Deposit, inside the database, we can still keep it as negative number for calculation, but when display credit/deposit in list or payment detail, we need to display as positive number (just the display)
(c). We will need to separate patient credit and patient deposit. In patient detail lines, if the type is “Deposit”, don’t auto balance the invoice amount for COPay/CoInsurance etc. Just Sum it as total patient account deposit. Patient credit is for overpaid CoPay CoInsu. (When ERA CoPay is 0, but patient still pay the CoPay amount). 
(d). In patient payment detail, rename “Patient Credit” to “Applied Amount”, and make this textbox read only. In the same line, add “, Remaining Deposit : $xxx”, then “Apply : (textbox)”, then “, Remaining Credit: $xx Apply : (textbox)”, sum these two textbox dollar amount then fill in “Applied Amount”. This “Applied Amount” will be used to cancel the Invoice charge amount (Patient Resp.) for CoPay/Deductible etc. same as we did before. Also once user put amount in “Apply” textbox, reduce the “Available” amount (Total amount for this patient account). Again, the credit/deposit/apply dollar are all positive number but inside database it can be negative
(e). In the new tab MR patient list, first, remove the service date limits (current is half year), so it will display all patient visit records. And also disable the top search button, textbox etc so user can change any search criteria in this tab. Also above the MR list, add new one line section to display patient Account summary info: Account Balance, Remaining Deposit, Renaming Credit, Patient Responsibility. Account Balance= (Patient Resp.- Remaining Deposit + Renaming Credit).
(f). Add two new columns “Remaining Deposit” “Remaining Credit” in the List just before the “Invoice Balance” (The label can be changed later).
(f), Still display yellow if “Account Balance” is negative to remind user that this patient have renaming credit/deposit which can be applied for invoice charge. So we don’t need to send invoice to patient for like CoPay/CoInsur. Charge.
 
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10/21/2017
1.I made some change on one SQL SP, See attached file for Printout CMS 1500 Item 31 signature line.
2.For Patient payment List, add link to each item of “Previous Balance”, once user click the link, one new tab (with tab label as this patient mr#) next to “summary” tab to display all patient payment for this patient order by service date so end-user can quickly see all previous patient payments (invoice) for this patient. Use exact same list. 
3.Check FNSR Normal tool (program) for converting RTF normal to CDA normal. We had two example, one works good, one is not. See separated emails for example.
 
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10/13/2017
1.Today, the biller called Medicare and found out the reason these Lab Service CPT codes were rejected by Medicare because of the CLIA certification number. the CMS 1500 Item 23 CLIA Certification number and qualifier are required for Medicare. In REF01 loop 2300, Instead of “G1”, we need to use “X4” if item 23 number is 10 digits with letter “D” in the third position. Loop 2300 or 2400 depend on another item in CMS 1500 (Outside lab), if outside lab is yes, then use loop 2400. Otherwise use loop 2300. I will talk with you more in detail. See attached pdf.
2.For SQL execute timeout and aspx.cs page timeout, we need to extend the default timeout. Otherwise server side error popup.
3.For CASH patient, see Item 6 in 6/19/2017. We did it before, but in Account 0854, CASH patient MRN: 101683, the balance is not zero, but it does not display “red” color
4.Save “reject” claim reason into “Notes” so user can track it.
5.When user add new Dx in Job Summary, when user save it, then update CPT Dx Points with all of the Dx (ABCD).
 
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10/12/2017
1.I have made a minor change in SQL SP for save payment, Check the attached file.
2.In Denied/partial list, the “Recent Post” checkbox need to include the “Red” payment (Revised)
3.After payment completed (or deleted), the “red” background color need to be removed
4.Double check “CASH Patient” for invoice print red mark.
5.Currently when payment is saved it will call sp_after_save_payment, for ERA payment, need to call this SQL SP too for primary payment to adjust secondary Medi-CAL payment.
 
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10/6/2017
1.Problem of CMS1500 Required modifier checking, SQL SP: net_check_claim_proceure.sql, fix the popup warning CPT code, see attachment. 
2.CMS 1500, Print out/PDF for Item 11d. Yes/No checkboxes. See attached claims.cs file.
3.Payername should be 200 chars long, original is only 50 chars. See attached cs file for the changes.
4.Dashboard, exclude the number of Missing Jobs from Pending Jobs. See attached SQL SP for the modification.
5.For the denied/partial claim list, turn the payment_no cell yellow as long as ERA payment is posted. 
6.FnetEncoder, At the first search page, add option for 2017/2018 same as the Advance Search
7.When Revise payment posted, double check to make sure the Job Status “Completed” is changed to “Billed”.
8.When job is completed or uncompleted, add tracking info to the notes just like claim submit etc.
9.In denied/partial claim list, verify the “Recent Posted” search criteria to make the “yellow” background setting
10.In claim list, display the payment# even the payment with deleted status.
11.Sorting in Payer List especially payer name
12.Sometime, secondary payment will come before the primary payment. So when primary payment is saved, and if secondary payment is already existed, need to call SQL SP: sp_payment_after_import to adjust the secondary payment for medi-Cal etc.
13.Job Summary, CPT page, check unlinked DxPoint, message popup even the DxPoint is linked with CPT code.
 
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9/27/2017
1.In ERA post payment backend program, currently, for “Completed”, “Write-Off”, “Appeal” Claim status, we post “Revised payment”. Remove “Appeal”, means we treat “Appeal” as “Deleted”, “Denied”, still post regular ERA, not “Revise”
2.In ERA post payment, currently, after post payment, the program only change the claim status in “Submitted”, “Transmit’, ‘Accepts’ … to “Partial”. We need to comments out these lines, so all claims as long as post payment, change it to “partial” (NOT for Revised payment) 
3.For “QA-Claim”, after submit another new claim, the program will auto change it to “Partial” or popup message. Do same thing for “Mail” claim (same as submit to officeally)
4.Adjust the job summary Billed info section. See Jun’s email. And also remove the last “referenece” column (The ERA check#). Link the “Payment#” to popup the payment detail page.
 
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9/27/2017
1.I made minor change on invoice SQL SP. See attached file.
2.For Revise Payment, one thing need to be fixed. The Job Status need to be changed to “Billed” (Status=4), not empty. And also don’t “restore” the job back to pending pool. It is billed job waiting to be completed.
3.Dashboard, for 20 lowest CPT code list, don’t including the CPT if count(*)<10.
4.For QA-Claim submit, warning popup message wordings change, see Jun’s email.
 
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9/26/2017
1.I have fixed one special case in ERA post payment see attached SQL SP.
2.For new patient visit/payment column previous balance. After discussing, I rename and reorganize the columns header. See attached JS file. But need to adjust the Previous Sum (balance) to include all manually entered Patient credit (originally named previous balance). I will talk you more by phone
3.When a new claim is submitted (Status changed to submitted), check if there is any other claims with same job_no existed in “QA-Claim” pool. If it does, popup a message asking biller if they want to change that claim from “QA-Claim” status to “Partial” status.
4.In new Message module, if there is unread message in the InBox, have red dot in the menu item, so end-user know there is new message in the inbox.
 
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9/25/2017
1.Since we do not carry over the previous balance for each patient visit/payment, sometimes, the previous “deposit” info. will be missed. After discussing, we need to add a new column in patient visit/patient right after balance column to “sum” of all previous visit balance (the visit has date earlier than current visit date). If the “Sum” is negative display the cell (Not the whole row) with different background. Also if previous sum is negative, popup warning when user click the invoice report.
2.In Denied/Partial Payment, please check the search criteria for “Recent Posted”. It display the claim without payment (It has Deleted Payment under same job for another claim)
3.Double check 9/7 Item 3 for incorrect CTP description. I will discuss with you more.
 
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9/21/2017
 
1.I have changed two SQL SPs please check the attachment.
2.Still for ‘Revise Payment”, See attachment for today’s claim 0852 00001519. At the end of ERA, two payment with same check# and claim#, so after post the first new “revise payment”, then the second payment should “add” to the first “Revised Payment” with same CPT code. I will discuss with you in more detail by phone.
3.In Job Summary, in CPT panel, currently when user enter one code, the program will auto fill in description, make it same for HCPCS. The different between CPT and HCPCS is HCPCS has letter, while CPT are all digits. 
 
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9/20/2017
1.The patient collection with setting in “SystemConfig” works good. However, one more thing need to do. When user check the first three checkboxes in Patient Visit/Payment, should only display the records which is NOT in patient collection.
2.In Insurance Payment detail page, when user manually new a payment, by default, set “allow amount” to blank (Not Zero), just like all other fields. 
3.For ERA payment, when all CPT have payment, the background of the list of cell will become “yellow”. When user verify the payment (complete” then the yellow will be removed. This works fine. However, sometimes, the payment will be deleted, so the yellow background cell still exist. We should make the “Deleted” payment same as “Completed” for this yellow background.
4.For Lowest 20 CPT payment in the dashboard. We need to remove the following CPT codes since these are always “zero” amount. See below Jun’s email
 
Here is a list of CPT codes should be excluded from the “20 CPT/HCPCS codes with lowest payments”. I will study more and update the list.
 
a.Any code with a F at the end, such as 1111F, 1090F
b.Any code with C at the beginning, such as C1771
c.99024, this is a reporting code, usually is not paid
 
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9/19/2017
1.For 9/11/2017 Item 1, the different provider NPI is filled in CMS 1500, but after save or submit, it rollback to default NPI. (NOT save into “claim_procedure” table). 
2.In Dashboard, we have top 20 highest paid CPT code, one doctor want to see the 20 lowest paid CPT code in the dashboard.
3.Once user add new DX in Job Summary, it will auto refresh the Procedure page DX part, we need to check if we can auto refresh the DX Pointer (A,B,C) for CPT panel in the right side. I think it has some side effect, maybe we can popup warning when the procedure page is saved.
 
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9/18/2017
1.I changed SQL SP to retrieve fee structure, see attachment.
2.For “revised payment”, two things need to be changed after I tested (See attachment for testing ERA). First, need to remove “Complete” Job Status beside claim status. Second, don’t change the existing “Complete” payment, leave it as what it was before. Only post new payment (with Revised Status). If there is two payments in one ERA files, combine them first (As we did before), then post it.
3.For the tool converting RTF normal to CDA normal, see Terri’s email below and attached exsmaple.
“check to see why this particular .rtf file is creating the rectangle symbol where the space is supposed to be at.” 
 
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9/17/2017
 
We found a new case today, Sometimes, the insurance company (payer) actually made mistake in issuing the payment. And they corrected it after we “complete” the claim and job. So the backend ERA payment posting program will skip this ERA because the claim is already complete. I checked one this “corrected” payment, and found that for the new payment the payer has different “check#”. Based on this, we need to modify the ERA posting program to skip only the EAR when the claim is already “Complete” and the Check# is exact same (That mean there are duplicated payment). Otherwise, if only claim is completed but check# is different, then still need to post this ERA payment with a new status as “Revise payment” instead of “Processed as Primary”. Make the claim list color as “yellow” (waiting for verify).
 
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9/14/2017
1.In Mail Claim print out, remove Item 31 “SIGNUATURE ON FILE” line for Medi-Cal (MR002) so it can be manually signed the paper claim
2.Keep enhance the new “Message” module
 
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9/13/2017
1.For the payment summary tab, Capitation still need to keep “Yes” No” as before. At the end just count(Yes) as Total Cap. Items. 
2.Add new “Other” checkbox option in Missing Info.
 
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9/12/2017
1.Cap checkmark is only need in Cap. Column not in every column. Also need to add this checkmark in Job Summary section.
2.For new added Search CTP code, in IE, click button, did not popup any page. Also move it to the right, and add “List of DX Pointers” at the top of A, B, C these ICD10 code
3.Display the Rendering Provider entered from the Procedure screen into the Summary screen.
4.From the Payer Management, when adding a New Payer by selecting Payer ID from the global list the payer address does not fill in.
 
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9/11/2017
1.In Job Procedure, currently we did not link the “Provider” field with CMS 1500 CPT NPI entry. Sometimes, one claims contain two CPT with different doctors. So we need to change the “Provider” field to doctor ID with popup selection. Then in CMS 1500, link the selected doctor ID NPI for each CPT. Default is empty with the primary doctor for this patient visit Same as before. 
2.Still in this page, the FnEncoder sometime did not fit into the frame correctly. The words are overlap each other.
3.In FnEncoder Guideline (Downloaded Doc. For ICD10 etc), we need to get newest PDF files and update our site.
4.For ICD10, Oct 1, will start with newer version of year 2018, so we will need to do what we did last year upgrade to 2018 and make 2017 as old version. 
 
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9/7/2017
1.Modified for Patient Invoice and SQL SP to remove the detail dollar amount for I/C/O etc. and also adjusted the printout MS Report format.
2.Bug fix for when end-user login one account while view/print other account patient invoice in payment list
3.I think because of the Internet connection, in a few cases, in Job Summary, the Procedure CPT Code did not match with the description. So in the save, program can double checking the CPT and the description.
4.In Ins. payment list, in Cap. Columns, currently it display cap. Amount, but if cap. Checkbox is checked, display “checkmark” in front of the amount. 
5.In account setting, we need to have new setting for how many times of the patient invoice letter sent out before go to patient collection. By default it is 3 times. 
6.In patient payment detail, when end-user changed “paid amount”, save the login User into “Last Modified By” field for tracking purpose
 
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9/6/2017
1.One most item, In CMS 1500 to EDI 837 Claim Uploading, for the new item 32b, it actually should go to “REF02”, not “CLM05”. See attached pdf and txt files. With Item 32b “Facility ID” in “CLM05”, OfficeAlly rejected the submission especially for Place of Service Code -- POS (31). So leave CLM05 blank and put it into REF02.
2.Second, see attachment filename “451906306_EDI_STATUS_20170903.txt”, I think the Reject Reason description in this returned claim is too long, so the backend “Claim Return” program had error in Column 12. Please increase the variable length.
3.For new enhanced patient invoice, please make the changes based on attached MS Report file See attachment. (I made some minor format changes last month).
4.For patient invoice, as we discussed last night, only “reduction” field need to go to “adjustment”, keep “Cap.” Amount in “Ins. payment”/Second Ins. Payment” amount because Capitation is actually the Insurance payment just with different method.
5.For the new patient Visit Correspondence, only default entries in Visit Correspondence that has a “new” message just like in the InBox with unread message. 
6.For the Visit Correspondence, after the Dr Office user enters a message, the message that was posted is also showing “Green” for the Dr. Office user. These are “Send” message should not display as “Green”. Maybe we should consider separate the list into “InBox”, “Send Items” just like the message module in DTEHR or in regular email. We will discuss it more to see what is the best way.
7.Deng Minpeng, as we discussed on this week Monday, HCPCS is available in CMS website. Please work on the backend program to update HCPCS to 2017 version the CMS website: https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html
 
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9/5/2017
1.IN Patient invoice, “move” reduction amount (only this amount) from “applied” and “Other Ins.” to “adjusted amount” column for each CPT code,
2.Break the Patient Balance column for each CPT into more 4 categories: Copay (C), CoInsurance (I), Deductible (D), and Others (O). Append this letters after each sub amount. At the end of the invoice, display text to explain the means of C, I, D, O.
 
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9/1/2017
1.In the new “Patient Collection”: (After send patient invoice for 3 times), We need to display the patient visit in this menu only until 30 days after the third invoice is sent out. 
2.Patient Correspondence - Dr. Office User type cannot create a message. Don’t have the Post New Message. Also, add the function to allow user to upload files just like in the Notes.
3.When adding local facility the global list needs to display all entries not just the first 20.
4.Also I will discuss with you in Payment List Summary part, at the end of the summary line, for reduction, add it to ‘adjustment” instead of “applied”, or maybe just have new item. Same for patient invoice “Other Ins …” column. 
 
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8/30/2017
1.In New Visit menu for exchanging message with Dr Office. Don’t need to display current “Notes”, instead, replace the Notes with a new “Message” field which is same as Notes but just for exchanging message with Dr office. Notes is for our own tracking purpose.
2.In Insurance Payment ERA detail page, open the Modifier field just in case the end user want to change the modifier for the payment because sometime the Ins. Company will auto change the modifier and pay the amount based on new modifier.
3.Also in Insurance Payment list, summary section, add one more column (after Applied) for “Cap. Amount” for each Payer.
4.In Patient Visit payment, add two more checkboxes at the top search criteria. One for “SOC” for the item there is any the Coins, Copay, Dedub. Amount in patient payment list is from “payer name/healthplan” contain “medi-cal”. The other is “Patient Paid” to filter out if there is “applied” amount from patient. We need to use “AND” to join all of these checkboxes and search criteria. 
 
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8/29/2017:
1.When copy the Global Facility item to Local account, bring the Seq No in.
2.In Claim list, the EOB/Auth popup window, the close button does not work.
 
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8/28/2017
1.See attached file, for Global/Local facility, I change “Facility ID” label to “POS Code”, and add “C_HMO_ID” back and label it as “Facility ID”. If this field is not empty, need to auto fill in in CMS 1500 item 32(b)
2.In CMS 1500, for NDC dosage (such as ml, mg etc), since there no “mg” in CMS 1500, so when we auto fill in, replace “mg” with “me”
3.In Denied/Partial Claim list, we have yellow cell background to indicate ERA payment is posted and waiting for biller to complete. Add a checkbox at the top search criteria, as “Recent Posted”, once this checkbox is checked, only display these “yellow” claims.
4.When submit CMS1500, if the patient don’t have “primary” insu. checked, popup warning message so biller can always make sure the patient has one primary ins. Checked.
 
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8/25/2017
1.For CMS 1500, secondary insurance claim (ONLY for secondary), for 9(d), auto fill in primary insurance “HealthPlan” info. and for 11(d), auto check “YES” checkbox, don’t check “NO”.
2.As we discussed, we will implement a complete new menu beside “Patvisit/patient payment list” for communication between Dr. office and billers. The list is based on patvisit, and with Job Summary, Insurance Payment, and Patient balance columns. Like Dr. Followup, display the message in different background indicate “unread” message send from the other side.
 
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8/24/2017
1.For Top 20 CPT highest payment, order by average payment amount from highest to lowest
2.For Global/Local Facility list, allow end-user customize the columns
3.Payment Summary section, order by primary insur. Payment secondary insur. Payment, then if there are more than one primary or secondary insur. payments, then order by payment date.
4.For Dr. Followup claim list, display different background color if Dr. office has not read the notes from biller just same as if the biller has not read the notes replied by the Dr. office 
 
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8/23/2017
1.I have changed one SQL SP to exclude the “Deleted” payment after job is completed. See attached file. 
2.In CMS 1500, make sure the QA checkbox is unchecked by default.
3.Before, when end-user check this QA checkbox, the job/claim will be sent to “QA Job” list under “Job Management”. This function actually is not used now, and none of claims are with this status. So we can combine this “QA Job” claim status with “QA Claim” status and all displayed in “QA Claim” list under “Claim Management” menu.
4.For the “QA Job” menu under “Job Management” we will display a new ”QA” JOB STATUS. Make this menu exactly same as “HOLD” Job list. So end-user can send job to “QA” or send job to “Hold”. 
5.Add a new button “QA” (Just like Hold button) at the top of the all of these job list. (Such as To Be Billed, Missing Info,etc.) 
And rearrange these buttons as : “Assign, Reset, QA , Hold, Discard, Delete, Write Off”
6.For Online Billing, move the Missing Info checkbox and selection to the first row, and add QA, Hold etc. these button, so the top will be same as “To Be Billed” list except no “Assign” function.
 
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8/22/2017
 
1.I fixed one bug in DashBoard display and also had minor change in pay.js. Please check into SVN. See attachment.
2.In Dashboard, for the top 20 Billed CPT codes, need to sort by average paid amount from highest to lowest
3.In pay.js, in new added “insurance section”, don’t display the insurance with “Inactive” Status, only display Active Insurance. And also we can remove “Status” column, leave more space for notes and payer name
4.Please adjusted patient insurance detail page as we discussed before, and continue with other unfinished items.
 
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8/17/2017
1.Patient Statement Invoice – If the type is not “copay”, “coinsurance” or “deductible” then display the description from the Payment screen into the Description section on the patient statement invoice. Also display the Date of Service onto the patient statement invoice. 
2.We encounter one case for deb. in primary ins. But secondary has reduction to adjust. So the balance is 0. I checked the “sp_complete_job_pay”, line 112, we need to check if both CoIns. And CoInsAdjust > 0. Also, for this SQL SP, I don’t think we need to consider previous balance to calculate the final @balance line 139. And I moved line 38 to the section after calculate the balance (See attached SQL SP). We will discuss it more.
3.After we have NDC items done (See below), in the insurance payment list, currently we have claim list section and payment summary section. Need to add one section for Insurance at the bottom. For this patient insurance list, we display list with columns: payerID/payername, primary/secondary, healthplan, copay, deb. coIns. Verified date. Also in patient insurance detail page, make the CoIns textbox smaller, currently it covers two columns.
4.Still in this insuracen payment list, for the top claim/payment list, adjust order of the columns, it will be “Billed/Applied/Reduction/Cap.” Then “Copay/Deductible/CoIns./Other PR” 
 
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8/16/2017
1.For yesterday item 2, when “Completed Job”, there is a special case, first, the end-user complete the job with some CoIns/Deb. amount, then program auto insert a record into patient payment because of non-zero patient resp. Then end-user realized there is a mistake in insurance payment posting, and “Uncompleted Job”, adjusted the CoIns/Deb. etc. to make the balance zero. After adjustment, “Completed Job” again. But because of the zero balance, the program did not auto update the “ERA amount” it was inserted before. So we need to modify it even for zero balance, need to check patient payment list for “Copay/CoIns/Deb.” entries. If these entries have: “ERA Amount > 0 and Applied = 0” and IN the notes, it has “JobNo”, then delete this previous inserted entry.
2.In Patient Payment List, some patient visit has “NULL” service date because of the inpatient claims (such as in account 0851). In this case, by default search by “Service Date Form To” can’t find the patient visit. So if the service date is null in “patvisit” table, then “left join (top 1 select dos_date_from claims on job_no order by dos_date_from)”, use the first dos_date_from in claism table as service date for search criteria and also display this date in the patient payment list (Currently the service date are empty for these inpatient visit)
3.NDC List enhancement:
(a). In Global NDC list, when end-user enter new NDC info, set “maxlength” for these “TextBox” such as Drug Name, Desc. etc. So end-user won’t keep typing and can’t save due to length of the fields.
(b). In Default NDC, after user Add a default NDC, it won’t auto refresh, and even not display the items after click the search button. 
(c). In Default NDC, make the popup “Add” windows bigger, and by default, auto check these checkboxes if there is corresponding default NDC item for current account. 
(d). In Default NDC, add more search criteria (same as Global NDC list)
(e). In Default NDC, add “Comments” field to allow user to enter special comments just for current account (The Notes field is for Global NDC).
 
Thanks
 
 
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8/15/2017
1.As we talked before, for CoIns. Patient payment adjustment, we have “applied”+”reduction” auto filled into CoIns. adjustment field, we need to add “Cap. Amount”. Basically the total of “applied”+”reduction”+Cap.” Is like a “payment” from secondary payer. (Currently Invoice and Summary balance are correct, don’t need to change those)
2.When “Completed Job”, if the patient Resp. is already zero (after add primary, secondary etc. ), that means insurance companies already cover all of the charge amount, then don’t need to auto insert any record into patient payment list (Such Copay/CoIns/Deb.). In this way, we can make patient payment a lot clear. If doctor office want to charge any extra money, such as office visit, they can manually create the payment entry.
3.For 8/11 Item 1, the “Denied” payment without detailed CPT info (such as allowed etc.). Currently the program won’t do anything. But two things the program can still do without detail CPT info., one is still put ERA BatchNo into each CPT batchNo field, second put Reason Code/Desc. into the payment description. In this way, the biller can view the ERA and see the reasons to continue the next step. And if the reason code is PR 26 (Patient insurance expired or no coverage), then we can still use the charge amount, auto filled in Other PR amount based on each CPT. All of these can be done in this new SQL SP (Process after payment)
4.If the Medi-Cal as Secondary Insurance, then after post payment (with applied or without applied amount), as long as Medi-Cal does not have additional CoIns/Copay/Deb. then we need to adjust the primary insurance patient resp. means after secondary Medi-Cal, we can’t ask patient to pay any balance. I will discuss with you how to implement this.
5.Later, when we smooth out these Medi-Cal ERA payments, we can enhance the “Summary Tab” in patient payment list.
 
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8/14/2017
1.eClinicWork patient insurance import. If there is no same exited insurance, then need to “insert” a new insurance entry. Also same for the “not verified” insurance, always “update” just like before. Only for “Verified” exited insurance, “Update” ONLY if there is “Update Insurance” in the Notes section.
2.For ERA OA 23, this is a very special ERA adjustment code for secondary payer. I spent a few hours to check/clean up the existed “OA 23” payment records. The criteria should be: “where description like '%OA 23%' and isnull(applied,0) = 0 and allowable = other_pay and allowable > 0 “. But to do the auto adjustment for primary CoIns. We can’t directly put “other_pay” (OA 23 Amount) to “reduction/discount” because most of the time, this “Other_pay” amount > Primary CoIns. Amount, then the final patient balance is negative. So we maybe need to search for primary insurance CoIns field and then insert into secondary payment. We will need to discuss more about this code.
3.When “Completed Job”, currently, the “applied” amount in secondary payment will be auto filled into patient invoice CoIns. Adjustment field. But beside “applied”, need to include “reduction/discount” amount into CoIns adjustment field in patient invoice list. Currently the Patient MS report Invoice and Insu. Payment summary calculate balance correctly. 
4.In Patient Payment List, make sure the sorting works especially for these paid charge amount. Also change the header label from “Charge” to “Total Charge”, “Paid” to “Total Paid”, “Adjustment” to “Total Adjusted”. And add 9 additional columns at the end for “Copay Charge”, “Copay Paid”, “Copay Adjusted” same for “CoIns.” And “Ded.” 
5.For “Completed Job” button, in popup message, don’t need to display PR balance for each payment, only the final patient balance (Just the final balance amount in payment summary section).
6.For “UnComleted Job” button, auto refresh the claim list job status form “Completed” to “Billed”
7.In the patient payment list, currently we have checkbox for “Verified” to list all “Verified” records, need to add a new checkbox “Not Verified” to list all of the patient invoice which has completed + has balance + has not been verified.
8.Account Facility list, allow end-user to delete the record. Also, create a global Facility List to store some common hospital facilities. In each account, when end-user add new facility, they can have choice to copy the facility from the global list or create a complete new one.
 
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8/11/2017
1.Please check the attached ERA (Medi-Cal), Three denied claims, ERA posting payment did not complete (No Allowed Amount, Adjust Group Code etc.)
2.Finish 8/9 Item 4, Don’t’ change the status for “Deleted” Claim when Complete Job.
3.For Insurance. Payment List, add two more columns: “CoIns.” and “Other PR” (Patient Resp). 
4.In Local Payor List, we have “TextArea” (allow multi-lines) for Address2 field, make same for Global Payor List (For all three address sections).
 
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8/10/2017
1.ERA posted payment, if ERA is “Processed as Secondary”, please double check the “HealthPlan” will be copied from patient secondary insurance healthplan field.
2.Insurance payment list, add more cloumns to display such as Copay, Deb. etc.
3.IN Job Summary, Procedures page, after click “Copy from previous items”, the DX Points will auto filled “ABCD”, but if end-user change the CPT code, then the DX point will be removed automatically. Need to keep the DX point.
 
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8/9/2017
1.Attached is the new patient invoice SQL SP I modified to including the “CoInsurance” Applied amount (Not the Adjustment amount). Please double check.
2.For the new “Job Status” column, sorting does not work.
3.More important, current for Job Status we have two fields, one is “Status”, the other is “payment_status”. We need to combine these two fields to display the job status. The Job should be “Completed” only if “payment_status” has date in. Otherwise it is still “Billed”. And also check what the status the “Finalize” button will do when submit the job. And how the status changed to Billed.
4.When “Completed Job” in the payment list, currently it will auto complete payment and claims. But don’t change the claims and payment status if the claims and payment are “Deleted”
5.In “Completed Job”, currently it will popup “save successfully. Copay is xxx”, change this popup to “Save Successfully, Pateint Resp… is ..”
6.For backend ERA posting program, today we found CO 253, and OA 253, CO 253 should go to “Reduction” field, while “OA 253” should still stay in “Adjustment” field. What we talked before only depend on Reason Code look like incorrect. SO in the Payment program setting, in these textbox, instead of just “253”, we should put “CO 253”. 
7.NDC popup is too wider, and also the “notes” column should auto adjust to extend the space.
8.In Claim List, currently the “Yellow” row will be displayed for reminder, but if the claims status is “Completed”, then don’t change the color to yellow.
9.I will discuss with you for “OA 23” for the payment when “applied=other_pay” and applied=0 which means the secondary insur. did not pay anything, but CoIns. Need to be adjusted (Patient don’t need to pay this too)
10.EOB/Auth popup, if there is two or more payments for each claim, it will popup a small window to ask user to select a payment to upload EOB. We can remove this payment selection, then display the EOB for each payment together in one screen.
 
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8/8/2017
1.For backend ERA posting program, eClinicWork, in most of the cases, we don’t auto “overwrite” the patient insurance because the biller already correct the patient insurance. We only update the existing patient insurance only if there is “Update Insurance”/”New Insurance” in the “Note” field.
2.Make NDC popup wider to see more info in the list
3.In “Claim List”, change current “Status” column header label to “Claim Status” and add one more column at the begin of list, put “Job Status” to display job status.
4.Sometimes, biller will make mistake to complete job, then they will uncomplete job and make change for Copay/CoIns./Deb., then complete again. So double check to make sure when they do “Complete Job” again, the patient payment list EAR amount (Copay/CoIns/Deb.) will be updated, especially for zero amount.
5.Still for backend, if there is “OA 18”, means exactly duplicated claims, then we should completely adjusted it, (the Allowed amount should be 0, only adjusted amount) Check example 0854 Job 00001251.
6.Also double check for secondary insurance payment, when complete job, the Applied amount and Reduction Discount amount (add together) will auto put into “Adjustment” for CoIns. To adjust patient final balance. 
7.In Patient invoice, for patient Resp., beside the total amount, need to break it into more detail (Copay, CoIns. Deb.) I will discuss it more with you.
 
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8/7/2017
1.For Global Payor List and Account payor List, beside the primary address, we need to add extra two set of “address1/address2/city/state/zipcode” for “secondary” and for “third”. When user create “Mail Claim”, if it is secondary claim (with secondary insurance), then the address need to be “secondary”. Same for Third
2.When Global Payor address updated (all three set of address), need to go through all active accounts to update account payor list 
3.When submit secondary claim for “secondary Insurance”, we should still use the “Primary Insurance” (Payor ID info.) to calculate the CPT charge amount in CMS 1500 CPT lines. Nothing else need to be changed. 
4.Beside global NCD list, we need to have a local table based on each account. In the global NCD list, one CPT could possible link with multi-NCD codes, but in local table, we need allow end-user to check one default NCD for one CPT. And in Job Summary, procedure page, when popup the selection page of NCD, put mark in front of the default NCD, so biller know which NCD to select based on account.
 
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8/3/2017
1.Popup message in patient payment list for “Verify” checkbox. Currently it popup message when “verify” is checked, and popup same message for Uncheck. The Uncheck message need to be changed.
2.When job is completed in Ins. Payment list, the program will auto insert copay/coins./Deb. to patient payment list. Currently the “method” is default to “Claim#”, change the method to empty, so end-user can select which method the patient paid.
3.Still in patient payment detail page, after “method” is changed, and saved, it did not auto refresh the list record.
4.For patient invoice and ins. Payment summary, if billed amount = 0, applied =0, adjusted =0, only allowed amount is not 0, then still patient balance need to be set to 0. Still check the example 0854 job# 1616, claim# 00001111.
 
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8/2/2017
1.After yesterday change, the secondary payment do replace the primary denied payment in payment summary/invoice. But two things need to do next:
a.In this case, in patient invoice, still keep “Ins. Payment” as 0, while the secondary applied amount in “Other Ins. Payment”
b.Example 0851 job# 428. This Claim has three payments, two payment processed as “primary”, one as “Secondary”. The first primary payment was a denied one (with applied =0, and billed=adjusted), but second “primary” has applied amount. SO we need to replace the first primary payment with second primary first, the move to secondary payment.
2.For “PR 96” (Non-covered CPT code), in the backend ERA posting program, if ERA allowed amount = 0 then put this PR96 into “Adjusted Amount”, if allowed <> 0 then put this PR96 into “other patient Resp.”. Only in this way, the payment can be balance.
3.I will discuss with you for the negative amount posting in the backend EAR posting program by phone
 
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8/1/2017
1.One example in 0851, Job# 213, we have a case when the primary insurance actually denied one of the CPT code. (Adjustment Amount = Billed Amount). However, the secondary insurance paid some if the amount with Allowed Amount and Applied Amount. In this case, (Primary payment Adjustment=billed), in Job Summary and patient invoice, we should use secondary payment billed, applied, adjustment amount instead of primary.
2.Another example in 0854 job# 1616. The insurance company paid, but within same ERA, they “regret” and cancel the payment with negative bill amount and negative applied amount. We will discuss how to handle this kind of “regret” payments in job summary and patient invoice. (One payment with positive amount, and follow by a negative amount) 
3.Example 0852 Job# 2900. For CoInsurance (not CoPay),, the program will auto put “adjustment” into patient payment lst if there is secondary insurance payment. But after yesterday changes, we substract “adjustment” form the final payment due amount for the coinsurance which results double amounts. 
Please check the invoice and payment posted, we will discuss it by phone for how to handle this case.
 
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7/31/2017
1.Inpatient invoice, check the copay Adjustment, the adjustment should be same as Patient payment from the balance, See below screen capture.
2.Please check 0851 account job# 00000914 for third insurance payment. The discount should cancel out the periovus (primary/secondary) insurance patient resp.
3.Check 0851 account job#00000992, in insurance payment list and payment summary, display the payment based on primary/secondary etc..
4.In patient payment list, add column for Patient Visit Notes, so end user can see it quickly.
 
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7/28/2017
 
1. In Patient Visit List, add auto adjust copay
2. Change payment “Complete Job”（sp_complete_job_pay, Auto adjust copay）
 
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7/25/2017
 
1.Change the display order of the CPT code in the insurance payment summary
2.In New Mail Claim, don;’t check the payer list for secondary insurance
 
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7/21/2017
1.Add payment delete function， and in the posted payment, exclude these deleted payment.
 
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7/18/2017
1.The feature to enter a MRN for a new Patient in the Patient Visit/Payment. If the MRN field is left blank then our system can auto generate a MRN. 
2.In CPT page, auto fill in Qty from NDC beside the “ML”.
 
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7/14/2017
1.For NDI Dosgae, allow user edit it in detail page
2.Add “Notes” (textbox) in User Detail page
3.Patient invoice when user view the invoice popup message let user know it is view only, not send the real invoice (I will change the wording later after you get it done)
 
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7/11/2017
 
One minor thing:
Change the menu “Biller Management” to “User Management” and add dropdown list for select criteria: “User Type” at the top. BY default, show all users.
And also please go through previous list to check these unfinished items. We will get them done one by one. I believe in the past half year, we finished most of them, especially these important items. 
Thank you for your hard work.
 
 
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7/7/2017
1.In CMS 1500, the “reload” button works for primary insurance, but not for secondary claim. 
2.In Insurance payment list, summary section, and payment posted list, patient invoice, make sure if the claim is deleted (or write-off), then don’t include this 
claim and the related payments for this claims in these list.
3.In Insurance Payment Detail page, make the dropdown list for “Processed as Primary..” wider, so end-user can see the whole string
 
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7/6/2017
1.In Insurance (payer) payment posted list, summary tab, for each payer row, add one column at the end to indicate if this payer has any “Capitation” (Yes/No)
2.Backend ERA payment posted program, post every CPT code payment info. for same CPT/DOS/Modifier within one payment.
3.Wording/label change sin Dashboard.
 
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6/27/2017
1.In the patient payemtn detail list (For Office Visit, Copay, etc.), change the balance at the each line just for the “Sum” of current line, not combine the balance from previous lines. And move Previous Balance Textbox to the right to line up with “Balance” column.
2.In Insurance Summray Section for the CPT lines, sort the CPT based on “item_id” in the payment_detail table, so the CPT sorting will be same as payment detail.
3.Allow end user to Add/Edit NCD list (just like global fee/payer list)
4.For CMS 1500, when there is NCD code, set “NCD Qual” default to “N4” (dropdown list)
5.For supoer bill backedn import (eClinicWork 0854), when post the Copay amount into patient payment, currently, it use this “Charge amount” to auto calculate the balance. Should use ERA amount. But because ERA amount has not posted yet when upload superbill, so keep balance to “0”.
6.When the field “HealthPlan” in “PatInsurance” table contains (%medi-cal%), then in SQL SP get_code_fee use the “Medi-CAL” category for fee structure.
7.For new NDC selection feature in Procedure CPT page, make the popup NCD list windows wider, so end-user can see the full entry.
 
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6/23/2017
 
1.I had modified two SQL SP, one is for get patient invoice to exclude these “Discard” Job. And the other is for “QW” checking the popup warning message for CPT code. And also please double check for get patient invoice statement, we should exclude the “Deleted” Claims too beside the Discard Job.
2.For new ERA amount, currently the program check ERA amount first, if it is empty or zero, then use charge amount to calculate the final balance. We need to change it a little, for “Copay/CoIns./Deb”, always use ERA amount even it is zero amount. And for other patient payment charge type (such as Office Visit etc.) always use “Charge Amount” because there is no ERA amount for these types.
3.In the Ins. Payment list the Summary section, to calculate the final patient resp. we separate the EAR as “Processed as Primary”, and “processed as Secondary” based on the status. But there are some ERA with “Denied” status. Currently it count as “Secondary”. We should treat it as “Primary” to calculate patient resp. Basically, same as patient invoice SQL SP, currently we can have two one is <> “Processed as Secondary”, the other is == “Processed as Secondary”. We will adjust it when we see more different status later.
4.IN account 0852, we have over 50 jobs with same MR, CaseNo, and DOS, but multi-jobs for same day visit. This will bring confusion in submit claims (duplicated), post payment. So when Yoyo team manually upload superbill, program will need to check existing job to see if there same MR, CaseNo, and DOS already existed in job list, if there is, popup warning to avoid such problem. I will talk with you guys more about this.
5.Please continue working on NCD popup selection in Procedure, and auto fill in NCD into CMS 1500. Also add new function to allow user to Add/Edit NCD list (Just like Add/Edit Fee structure List)
6.After above items, we need to enhance the patient payment list. One is in patient payment detail, allow user to upload patient payment PDF/Gif files. Second, in Patient payment list/detail, need to add more date fields: Charge Date, Payment Date, and posted date (read only, and default to today date just like the Insurance payment posted date). Last, based on posted date, need to add Summary Tab in the patient payment list based on this “Posted Date”, so we know how much the patient paid during certain period. And we can charge Dr. office for these paid amount for service fee. Basically, we will make the patient payment list same as Insurance Payment List (The “Payment Posted List” and “Summary/Invoice” tab).
7.In ERA payment post backend program, For CoPay/CoIns/Deb, in the most of the case, the code is “PR 1/2/3”, however, in a few cases, the code is “CO 1/2/3” especially for “CO 3”, so same as other reasons code, for code 1,2,3 don’t need to check Group Code, so as long as Reason Code is 1, 2,3 then put it into CoPay/CoIns/Deb fields.
 
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6/22/2017
 
1.In the PT Payment/Visit do not carry the previous balance to the next visit.
2.Switch what is in the bracket to be what the doctor’s office charge instead of what the insurance charges (For Copay/Coinsurance/Deductible). Also use the amount which from ERA Ins. Payment to calculate the patient balance just exactly same as the patient invoice (statement). Basically the charge the Dr. Office enter in will be “Reference” only, the balance should calculate from ERA Ins. 
3.The Posting Date From To Search criteria in “All A/R Accounts” only check From date Payment, please fix it.
4.Any uploaded images that we click on to open up the image have the function to move the screen outside the Summary page or upload Superbill list.
5.Job Summary in the Hold Pool, add the Send To Pending button.
 
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6/21/2017
For the “Self Pay” Patient Statement, actually it is not the Payment List, it is the patient insurance PatInsurance which contain words “CASH” or “SELFPAY” in the insurance name. I will explain it further. 
And I also modified Patient Invoice (Statement) SQL SP to including the new Capitation Amount, please check the attachment.
Another minor issue is in “Hold Job List”, currently the Job Summary popup is “view” only, change it to normal “edit” just like other job list.
 
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6/20/2017
Today, we encounter a special case in ERA post payment. The “Reversal of Previous Payment”. See attached examples Claim# 085400000668, and 669.
The payer paid the CPT based on the claim (Processed as Primary), then they “Reversal of Payment all negative to cancel the payment they did. Then in same ERA, they paid this claim again with different CPT and of course lower payment (applied amount).
So here two issues, one is when combine the payments (Both are Processed as Primary), I think the program do not add all together, it is “Update”. 
Second, we should treat “Reversal of Previous Payment” as “Process as Primary” to cancel out the all of dollar amount, (Applied, Allowed, Copay, Coinsurance etc.)
 
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6/19/2017
1.In Insurance Payment List, currently the “Complete Job” button will complete job and claims/payment all together. But beside the status field in “Claim” table, also need change “Genedbs.ClaimPool.Status”
2.IN one ERA, it may have same claim# posted multi-times. One for “Process as Primary”, the second is “Process as Secondary”. Before we combined them together and post one payment. But now after we had these multi-claims/multi-payments features, we need to post each ERA record as one separated payment. See attachment Claim#085400000957 as example. If the dollar amount is negative, post it as negative (In most case, OA or PR 187 is negative, should cancel out the previous positive patient deductible.). The reason code is more important. The group code “OA” or “PR” is depend on payer.
3.Please ignore 6/16, item 4 after further discussion today. IN the Payment Summary, don’t need to add “Other Ins. Adj” column. But still the “Applied” should be just the “Applied” (Currently it is Applied+Reduction). The “Adjusted” amount column should including all of the Adjustment (Reduction+Capition+Adjustment). Basically we move this “Reduction+Capitation” from “Applied” to “Adjusted”. But for “Secondary” payment, still add “Applied+Reduction+Capitation” as Total Ins. Payment (balance out the previous CoInsurance)
4.Change the words “PT Responsibility” to “PT Resp.” to make the Summary section shorter. Also In top list part, Add “Cap”, “Other Ins. Payment” “CoInsurance:, “Dedub.” and change “Balance” to “Other PT Resp.” (Make it same as CPT lines in payment details). 
5.In PatVisit, the Facility textbox, display as “Facility ID/Facility Name”
6.Some patients are “Cash” or “SelfPay” patient. For these patients, don’t have Job or Claims associated with them. But still need to send Patient Invoice (Statement) to them. So if in patient insurance. The ins. Name is like “CASH” or “SELFPAY” then, as long as the balance is NOT zero, display the red “New” button in patient payment list.
7.Contiuen work on 6/16 Item 8 and 9 then item 5.
8.Still In payment summary section, Add “(Process as Primary)” after Payer Name or put it in the second line. The original Primary/Secondary change to be used for Ins. Payer. (Mean Primary Ins. Or Secondary Ins.). We encounter the case same primary Ins. Process same claim twice, one payment as “Process as primary” the other payment as “Process as Secondary”. 
9.We can retrieve Payer Claim# from ERA, and in Payment posting program, update this number into Genedbs.ClaimPool.Payer_Claim_no.
 
 
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6/16/2017
1.I changed Patient Statement (invoice) SQL SP a little to handle these NULL case and changed a few words. And these sentences with “hospmas” embedded in this statement look good after you changed yesterday. One more thing we need to further improve is the Dr. Office name/address/phone/fax no in this letter. Before we always pull the info. from “hospmas”, but for some accounts, the Dr. want to the patient to send payment to the different Facilities based on “PatVisit Facility ID” (Just like CMS 1500 Item 32). So in “billing-cfg” add one more checkbox to using the name/address/phone/fax in “Facility” table instead of “HospMas”
2.In Payment Detail page for each CPT code, current, we have “Capitation” check box based on the ERA. We need to add another textbox for the amount of “Capitation”, (replace the word “Capitation” after the checkbox with this textbox). This “Capitation” amount is part of “Ins. Payment” (Different kind of payment just like “Reduction/Discount and Other Ins. Payment”). 
Ins. Payment = Applied+Other. Ins.+Reduction+Capitation, and Patient Resp.=Copay+CoInsu+Deductibile+Other Patient Resp. 
Allowed Amount=Ins.Payment+Patient Resp.
Adjusted Amount = Billed Amount – Allowed Amount
3.In ERA payment posting backend program, these setting for posting different Group Code and different Reason Code work good. But we need to add two more setting: one is “Other Ins Payment”. Current the code is “OA 23”. The second one is “Capitation Amount”. Current the code is “CO 24”. 
4.In payment List Summary section, Beside the “Applied” column, add one more column as “Other Ins. Adj” (the header label can be changed later). So we just keep “Applied” juts for real Applied amount which is the actually money the Dr received. And ”Other Ins. Adj” for “Reduction+Capitation”. If this payment is secondary payment, then “Applied”+”Other Ins. Adj” should “balance” the primary “CoInsurance” amount. I will discuss more with you. The Summary line also need to add this “Other Ins. Adj”
5.When biller submit CMS 1500, if in the “Global Fee Structure List” for the CPT code has one record (One CPT code can have multi-records with/without modifier) contain “QW” in the modifier, and the CMS 1500 don’t have this modifier, popup warning message and don’t allow submit.
6.For the new button you added, please change the label as “ Undo ‘Complete Job’ ”
7.In the Paitent Payment List, don’t link the record for “Discard” Job. Otherwise there will be two same patient visit records for one visit. 
8.As we mentioned before, in Payment Posted which is used for the invoice we generate to bill the Dr. Office, we need to list all of the payments with “Complete” status. Before we use Claim status as “Completed”. But one claim may have multi-payments, one is complete, one is still waiting.
9.In the patient payment list, when the program auto insert CoPay/CoInsurance/Deduciable, may need to add CPT/Modifier (or maybe the payer payment#) because one job has multi-claims, one claims has mutli-payemnt and each CPT may have its own Copay amount. Or maybe just sum them all together. We will discuss it further in detail.
10.In Global Fee Structure Table, we need to add “Dosage” field to store the Dosage info for the injection CPT code. See attached Excel file.
11.IN Dashboard, add two more dashboard, one is same as current key performance, but limit just current month. The another one is same as current Top 20 CPT code, but list the CPT code based on the highest “Applied” amount. 
 
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6/14/2017
1.As in my previous email, when the payer’s “applied amount =0” and “Allowed Amount <> 0 ” and “Allowed < Patient Resp. Amount”, that actually result will be negative balance. After the discussion, please ignore this item now. We will do the following a few things to correct this problem:
(a). In the payment detail list, change the column label “Other” to “Other Ins. Payment”, and “Balance” to “Other Patient Resp.”. And open this field to allow end-user to edit.
(b). Adjust the column order as: “Allowed”,”Applied”,”Other Ins. Payment”,”Reduction/Discount”,”Copay”,”CoInsurance”, “Deductiable”,Other Patient Payment”, “Adjusted”
(c). For “PR” group, based on different reason code, we need to put into different fields. Deductible = Code #1/CoInsurance = Code #2/Copay = Code #3. But for “PR” Code #31, and #204, it should leave it as “Adjusted”. And all other PR codes should leave in “Other Patient Resp.” (The Balance field), not go to “Deductible”. Deductible is only for Code #1. 
(d). if in the ERA, the allowed amount is “null”, then we need to put it as “0”. 
2. In Payment List, after user click “Completed Job”, then auto “Close” this popup page.
3. In the account setting, we need to add a checkbox setting to auto “adjust” the copay.
 
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6/8/2017
1.When biller save the payment, for the “Complete Payment Only” option, currently we change claim status to “Partial” when the claim is in the status of “Pending”, “Transmitted”, “Accepted”, “Rejected”. We need to change the claim to “Partial” just when the status is NOT in “Completed”, “Write-Off”. 
2.In 5/31 items 6: In All A/R Account and other Payment List, in the top search criteria, beside Billed Date, add search From To for “Payment Date”.
3.In Reject Claim List, currently the program will auto fill in “Response” field with the info from OfficeAlly, please add Date in front of the message in this Response so the end-user know when the rejected error message was posted.
4.In manually superbill upload, we have button to “Send to Pending Pool”, add a similar button for “Send to Hold Pool”. Everything is same as “Pending”, just the status changed to “Hold” Job status automatically. 
 
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6/7/2017
1.I have attached most recently Reason Codes (updated on March 2017). The last code currently is “280”. The previous document we had only up to code “164”. Please update the tables for “Reason Code” in payments and in CMS 1500 secondary adjustment line popup windows. (Make this popup windows bigger as we talked last night) 
 
2.There are five “Group Code”: PR/CO/PI/CR/OA. Currently I have seen three PR/CO/OA. Her is the cases:
(a). For “CO”, “OA”, the amount should add to payment “Adjusted Amount”, mostly Reason Code: 45 and 237.
(b). For “CO” Reason Code: 253 (As we had done yesterday), it should go payment “Reduction”. We may have another Reduction reason Code later.
(c). All “PR” should go to Patient Deductible(ReasonCode#1)/CoInsurance(Code#2)/Copay(Code#3). There is one thing we need to do today is there are some other Reason Code with “PR” group, See below screen capture and attached the 835 files. All other “PR” Reason code except 2 and 3 should add together as “Deductible Amount”. For example, this PR “187” code is a $-63.91, and it add to PR Code #1 $63.91, the finial patient “Deductible” should be “0” .
(d). For “PI” and “CR” should go to “Reduction” too. So far I have not see any such cases, but we implement this two group codes for “Reduction” now. 
 
3.The Payment List Summary Section now display correct. But the Patient Invoice (get_invociexxx SQL SP) need to be changed to including the payment CPT with “Same CPT but with different modified”. Currently it sum the all same CPT (Not considering different modifier code) for adjustment amount etc. which is not correct. (See below screen capture for example Account 0854 MR: 100267. The patient Statement (Invoice) should match the new patient summary section we have been working on these days. 
4.For Superbill import, don’t import any “Admit/Discharge” date (from Amazing Chart etc.) even the input file has such info. Only auto input “Service Date”, the biller will fill in Admit/Discharge Date in patient visit info when they need to bill Inpatient. In the most cases, the Amazing Chart gave us wrong admit/discharge date, so we don’t import them in.
5.For patient payment list, beside verified checkbox, we need to add column for “Verified Date” and also the search criteria for this Verified Date.
6.In Insurance payment list, after Summary Section, add two link button to popup “Job Summary” and “Patient Statement (invoice)”.
7.In the patient insurance, for “Insured” section, add one more textbox (new table field) as “Group/Plan”.
8.In the Notes, when biller submit claim, it will auto generate a new notes as “Submitted by … at ..”. If this claim is a “Secondary Claim”, then Change the words to “Submitted Secondary Claim by xx at …”. 
 
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6/6/2017
 
1.See attached the ERA (835) files, I posted a few days ago, and tried again today, the backend program create duplicated CPT lines in payment, one for the real service date, one is for today’s service date. Please track the program to see what cause it.
2.In ERA, I don’t think they have payer ID, they only have payer name, address. Currently the PaymentImport program get the payer zipcode (5 digital+4) and put into payment payer id field which is incorrect. I think we can retrieve payer’s tax ID (See below screen capture, need to reformat it, remove the first 1 and put “-“ after two digitals), then later, we can have use the tax ID to get payer id from our own payer list 
3.Still for PaymentImport, for the adjustment group if the the Grop CODe is “CO” and the reason code is “253” which mean the “Reduction”, so should put the amount into payment reduction field (Same as Copay), otherwise the auto payment will have like $1.26 balance. It should not have any balance. The Balance for any ERA payment should always be zero. Also, fill in the “0” to the CPT balance field for auto ERA, don’t leave it blank.
4.Same as the Secondary payment, for the primary payment, the reduction field should add with applied amount and subtract from PT responsibility. 
5.For manually payment posting, if the payer ID match with the patient insurance primary or secondary payer ID, then in the payment list, it will display as “Secondary” which is correct, but it did not save into payment table “payer_flag”, so the summary section still show as primary, Need to save it to payer_flag. Also I think we should add a dropdown list in the payment detail (Just below the description box, and above Detail CPT to allow biller manually select “Process as Primary”, “Process as Secondary” and display/save it to “payer_flag” field. (Should use the words “Process as Primary”, not just “Primary”)
6.Still for manually payment posting, sometimes there are some additional payment or adjustment amount need to post, so for each CPT line, need to add one extra column before “Balance” as “Other Payment”. This Other Payment amount is only used to calculate the CPT “Balance”, don’t need to be included in any other places. 
7.Yesterday after the changes, we added all of the billed amount/adjusted amount/applied etc for all primary payments if there are resubmit. Actually that will make the total sum of billed amount very large if there are multi-payment or multi-claims. The reason for resubmit is CPT is denied (All go to adjustment). SO I think maybe we can still keep just one billed amount, but reduce the adjustment amount too. I will discuss the detail with you by phone tonight.
 
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6/5/2017
1.Because we have denied claim and denied payment for primary, biller has to resubmit the claim and second payment for resubmit will be posted again. So there will have two primary payments or two secondary payments. In patient payment summary section in payment list especially for the “PT Responsibility” balance, we need to calculate two primary payments with billed amount, allowed, applied, adjusted etc. sum two payments, then we need to calculate two secondary payment together, (Only Applied, and Reduction), then use the total of secondary payments to balance (subtract) from the total of primary payments. It is kind confusion, I will work with you together for it.
2.Then please continue working on 6/2/2017 -Part 2 (especially the item#2), see below list , the reduction as part of secondary “applied” amount. 
3.IN Detail payment CPT lines, the adjusted or balance amount will be auto calculated when the textboxes are changed by “keyup” (Keyboard input), if possible, can we catch the mouse click “paste” windows event and auto calculate the balance. 
4.For the Item 4 in 6/2/2017 -Part 1, The CMS 1500 Secondary claim “Lines Items Information”, as you suggested, you should pull in these info. directly from primary ERA payment into here to save biller time to manually fill in.
 
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6/2/2017 – Part 2
1.When a job is completed, currently, we insert CoInsurance for primary payment into patient payment, and also insert “Applied Amount” in secondary payment to “Adjustment” field to balance it out. But sometimes, the primary payment the coinsurance is empty but only has balance, in this case, should not insert “Adjustment” amount only. It will because negative in total balance. I will talk to you in more detail about it.
2.In Insurance Payment List page, the new summary section looks good, just need a few minor change, first, if the secondary payment has “Reduction”, need to take out from final “PT Responsibility”, but just don’t count secondary payment adjustment and secondary payment Allowable amount. Second, move the summary line at the end of the section, and put total of “PT Responsibility” in the second line, also use different color so user can see it. Last, add link to patient payment and invoice here.
3.Still in this Insurance payment list page, when user click “Complete Job” sometimes, the claims are still in “partial” status (They forget to complete it), then if the claims for this job are in “Partial”, change it to “Complete” (Just for Partial status, if the claim in other status, then don’t change it)
4.Still in this page, currently, after Job is Completed, the job status is changed and the button is grayed out. We need to add another button next to it for “Undo Complete Job”. Popup confirm, then change job status back to “Billed”.
 
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6/2/2017 -Part 1
1.For Claim Status “CPL02”, currently we process “1” – as “Process As Primary”, “2”- as “Process as Secondary”. But need to process all other status, especially 4, 19 and 20. Check the attached 5010_835_ERA_Guide.PDF and below screen capture. For 19, you can just use wording “Process AS Primary, Forwarded”
2.In ERA 835, we have one LOOP “NM1*TT*2*forward payer name”, This NM1*TT mean “Crossover Carrier” (The forwarded payer). Please check attached pdf Claim Payment-Advice..” page 114, See below screen capture. The field NM103 is the forwarded payer name. We will need to extract this forwarded payer name from 835 and insert into payment table (description fields) 
3.In payment list, if the status has “Forwarded”, make the cell background as yellow, so the biller can see it easier. Also, inside the payment detail, for these explanation of adjustment group and code, change the wording color (Not black), so the biller can pay attention to these detail reasons. Last, at the “Detail” line (See below screen capture), add the claim status “Process as Primary ..” after the word “Detail”, show this also in different color so the biller can see it very clearly. 
4.In CMS 1500, for secondary claim, inside the popup window for adjustment for line Item … please make the small icon to popup “Group Code” and “Reason Code” (These the codes we retrieve from ERA 835 CAS fields). See attachment for the list of Group Code (only 5 codes) and list of Reason Code 
 
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6/1/2017
1.In patient payment list, add search criteria “Mailed Date From To”
2.In new summary section in insurance payment list, “Patient Responsibility” is misspelled.
3.Still in this section, For “PT Responsibility”, currently we have “Copay+CoInsurance+Deductible”. If the payment still have “Balance”, that Balance is PT responsibility too. So add balance dollar amount to PT Responsibility column.
4.In Job Summary the claim section, originally it displays claim payerID/Name, recently, we change it to payment payerID/Name. We need to add Claim payer ID/Name back, but still keep payment payerID/Name. So we have two columns “Claim Payer” (combine ID and name in one column), and “Payment Payer”.
5.When biller save the payment, currently we have three options, for the “Complete Payment Only” option, currently we did not change claim status. But if the claim is in the status of “Pending”, “Transmitted”, “Accepted”, “Rejected” then we can still change the claim to “Partial” status (NOT completed).
6.Currently, in Partial/Denied” claim list, if all of the CPT in the payment have the ERA, the background color for this cell will turn to yellow. This is correct. One thing needs to be improved, once this payment is completed but the claim is still in the “Partial” status waiting for the secondary payment, then don’t show the yellow cell background. So check the status of the payment “Completed” for the background color.
 
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05/31/2017
1.ERA payment post program, currently for same Claim, if CPT/Modifier is same, then the program won’t post it again. Actually for 0851 (example job 00000590), there are multi-CPT entries with same CPT code but different service date (Inpatient) in one claim, so we need to change the program to add service date as unique criteria beside CPT code.
2.Payment detail page, since we have mutli-service date (From To) in one claim, so for each CPT code line, before CPT code, add two columns “DOS From”, “DOS To”, so the biller knows where to put the paid amount. Also make this payment detail wider, and for CPT lines section, when there is many CPT lines (46 lines), the biller can scroll up/down, but need to fix the list header so they know which column is for what.
3.Patient Invoice, I changed the report and SQL SP (See attachment), so the “Ins. Payment” is the “Primary Ins. Applied Amount”, while “Other Ins. Payment” is the “Secondary Ins. Applied Amount”, the Adjustment should be “Adjustment”+”Reduction”. Etc. The “CoInsurance” is actually what the Secondary Ins. should pay. What we need to do next is currently when primary ins. Payment completed, if the “CoInsurance” has dollar amount, then the patient payment will be auto inserted a new record for this “CoInsurance”. This is correct. However, when Secondary Ins. Payment is completed, then we need to copy the applied amount from secondary ins. To the patient payment “CoInsurance” “Adjustment” part, so the patient don’t have to pay the “CoInsurance” by themselves.
4.For the new Insurance payment, change current wording “Summary” line to “Total”, then move the Summary line from the List after this section. In this Summary, we need to display Billed Amount (Same as Total line), Allowed Amount (Only from the primary Ins.) Applied Amount (From both Ins. Primary/Secondary), Adjusted Amount (Only from Primary Ins.), and Patient Responsivity (Calculate it).
5.Still for this new section page, the page is kind too height, make it a little shorter, but can make it wider. Also more important, if payment is saved, then this summary section need to be auto refreshed.
6.In All A/R Account and other Payment List, in the top search criteria, beside Billed Date, add search From To for “Payment Date”.
7.In PT payment list, besid eteh checkbox for “Check Mail”, add two checkboxes as search criteria, one for Verified, One for “Invoice Sent”.
 
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5/30/2017
1.Error popup when click “Export” button in “All A/R Account” for 0854, please check the reason.
2.CM1500, for secondary claim, insured name/address/policy# should be retrieved from patient secondary insurance, not from primary insurance.
3.In Job Summary, When end-user change the DX page, and click “save”, save the DX pages and at the same time, reload the opened Procedure page DX section.
4.In EOB upload list, need to have dropdown to filter only ERA or only EOB (manually uploaded PDF/Image) or “ALL”
5.Please continue the payment summary section in payment list page as we discussed before. And also for current Total sum line, don’t need to add “Total Billed Amount”.
6.In Job/Claim List, the “Check Status” column, in the check status popup windows, add additional link to allow end-user to view all notes. 
7.In the payment detail page, change the label “Reduction” to “Reduction/Discount” (both list and top part). 
Thanks 
 
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5/26/2017
 
1.We had added new “verified” checkbox column in the patient payment list, so the Dr. office/Biller can check that to indicate they already verified the payment, then we can send mail letter out. It works good. Just need to change the popup confirmation message to: “Are you sure you want to verify the patient’s invoice ” also change the checkbox “Send Mail” to: “Check Invoice.”
2.The “payment due date” in Invoice should be set to the 30 days (Not 20 days) from the “Statement Date” which is the day we generate and mail out the invoice letter. Also we need to change the “red” background color for “Send Mail” criteria back to the original way (Don’t check claim_date in Billing\Visit.cs line 325 and line 432). 
3.For DxPointer in Procedure, auto fill in the first four letters “ABC..” for DX, or if there are only 2 Dx, then just fill in “AB”. It works good, But also for backend “BillingJobPost”, when import Dx/CPT, need to auto fill in this DxPointer when there is Dx and CPT codes in superbill.
4.In Job Summary the Billed Claim section, the Payer#, Payer Name should get from the database “payment” table not from “Claim” table as the example below, One claim has two payments from Primary and Secondary Payers.
 
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5/24/2017
 
1.The Missing Info Job List need to display all jobs, don’t exclude the jobs which have been assigned. Not like “To Be Billed”
2.Patient Invoice modifications
3.The bottom part (FnEncoder) will look overlap the two sections especially when go to another page and come back or Min/Max
4.In payment detail, in some cases, the balance will be “-0.00” then the red warning will still display. Not sure how the calculation will get -0.00. Please check.
5.For “BillingJobPost”, 0854 account, we had one patient superbill stopped the whole program yesterday, See the attached text file, the 5th patient, the patient name is “Mc Daniel, Claudette”. I think the problem may cause by injection lines “Delestrongen”, “depo estradiol”, they don’t have CPT code in these two lines. Please check.
 
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5/22/2017
1.Dashboard, for key performance, please check the attached SQL SP. And the “Billed Amount” need to display the “cent” don’t round to dollar. Also for Top 20 CPT, if average payment is 0, then display $0.00, don’t leave it blank.
2.Facility# default to 11 for 0851/0852 AmazingChart beside eClinicWork.
3.Payment Posted, also change the bottom summary line to Total encounter, not Total Claims.
4.Since we need to add more fields for job summary procedures panel for each CPT line such as NCD box, So we need to reorganize the page , put DX on the left top section (about 1/3 of width), and CPT panel on the right top section (2/3 of width), and put current FnetEncoder at the bottom section (half of the height, 100% of width.
5.When biller select “Secondary” dropdown list in job summary, when create a new CMS 1500, auto check the “Seconary Claim Checkbox” at the top of CMS 1500, and also auto fill in Item 4-7 (the secondary insurance insured person name/address), and also auto fill in “Primary Insured name/address and policy#. At the bottom, auto fill in primary payer name/ID, and link the popup payer selection same as the payer selection at the top.
 
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5/19/2017
1.The new design of payment list is what we need to implement next, it will help everyone to get whole picture of different payment for the particular job. After discussing with the team: 
a.Put this Summary Of Insurance Payment at the second section of current “Payment List”
b.The “Billed” column go with CPT so each CPT has one Total Billed amount, while the “Allowable” go with each payment. 
c.Change the “Primary Payment” to “Primary Payer”, “Secondary Payment” to “Secondary Payer”. So the column will group by payers (Not by claims) first. But we need to display the claim# for each payer just as in current design. If multi-claims for one payer, just need to list all claim# and billed date (Exclude the deleted ones).
d.(d). For payment column, just need to display total payment results for this “payer”, just list the all payment# (Same as Claim#). The columns for payment: Allowable, Applied, PT Responsibility (Here add Copay+CoIns+Deb together), Adjusted (Add Adjusted+Reduction), Balance.
2.For “BillingJobPost”, if Facility is null, default to “11”
3.For Dashboard, Key performance, Change “Accounting” to “Total Billed” and display the amount in this line. Also add “Capitation” After “Pending” to display the total Billed Amount of all of these CPT which Cap checkbox.
4.One more thing about the Unit Qty and Price in CMS 1500. The price for each CPT line is the total charge amount not the unit price, so it = Unit Price x Qty.
 
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5/18/2017
1.In the payment details CPT lines, add “Balance” column after “Adjusted” amount. The Adjusted amount = Billed Amount-Allowed Amount. While Balance = Allowed Amount-Applied-Copay-CoIns-Reduct-Dedub. The whole payment balance = sum of all CPT balances.
2.In the payment List, at the bottom, add one line to show the Summary of each columns dollars such as balance, Billed amount etc.
3.In the payment List, for the title of Secondary/Third claims, add PayName in the title and also add “Submitted on: ” at the end to display the billed date of claim. If no claim just display “Submitted on: “ .
4.For the new add A/R Total Encounter”, remove the label “(Job#)”.
 
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5/17/2017
1.I have changed a few small things, please see the attachment.
2.In patient visit payment list, currently we changed the background cell color to red when the patient invoice is ready to send out. But we need to sort by this column so these red item can be displayed at the top together.
3.The “Copy Last Code” and “Dx Pointers”, etc these new features in Procedure page work good. Just one minro thing, at the top of the page, when display these Dx codes ,A, B, C, please lines up the description. The max length of Dx code is 7.
4.In payment detail when the payer is reselected, please copy the “healthplan” from the patinsurance if it already existed.
5.We will continue verifiying the Facility=12 (Home) in CMS item 32 address.
6.In A/R account payment list, replace the Total Claims with Total encounters: xxx (Job#) to match with the Dashboard at the bottom of the page.
7.In the Dashboard top 20 CPT code ave payment, currently we use “applied” amount, need to change it to “applied”+”Copay”+”coinsurance”+”deducible” So this Ave. payment for each CPT will look much better.
 
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5/15/2017
1.“BillingJobPost” bug after Last week update for “Admt_DT”, please double check when removing the “Admt_DT”, error popup when import 0854 superbill txt file.
2.“BillingJobPost”, when insert CPT code, default the QTY to 1 if there is no QTY in superbill. The biller will change this QTY in Job Summary “Procedure” page if needed.
3.In Dashboard the Top 20 CPT Ave. payment, need to exclude the CPT item with “0” payment. Otherwise the Ave. payment is not accurately reflect the real payment for this CPT.
4.In Payer popup List, for the top search criteria, we have search by PayerID and PayerName. Currently the default cursor is in payerID textbox, but in tehmost case, the biller will need to search by payername, so default to payername textbox (You can switch PayerID and PayerName so, the PayerName text box will be the first and default textbox in this page)
5.IN Job Summary, Beside the “New Claim” “Mail Claim” button, add dropdown list to display “Primary Insurance”, “Secondary Insuracne”…, by default, it will set to “Primary”. But when biller change to “Secondary” and click “New Claim”, the CMS 1500 will bring the secondary insurance payerID and payer name into CMS 1500.
6.In Job Summary “Procedure” page, when there is a new “duplicated” CPT code entered, curently it will popup warning message, move this warning message when biller click “save” button. Sometimes, same CPT code need to be added many time with different modifier. One warning message at the “Save” is good enough.
7.Still in this “Procedure” page, after search a CPT code (Such as N39.0), the MCC/CC will auto fill in the left panel which is good. But when type the code in the panel, it will auto fill in description, but not CC/MCC. Same for the “Advance Search”.
8.Still in this “procedure” page, at he left panel, display DX info line by line at the top of the CPT code items with A. .. B.. C.. D.. Limited this display in an fixed area with scroll bar if there are many DX code. Also replace the “Allowed Amount” column for each CPT item with “DX Points” (Textbox), by default, it will auto fill in “ABCD”. The biller can look at the Dx description at the top while make change to this DX Point fields. Then these DX points will be auto filled in CMS 1500 CPT item line. 
9.Patient Insurance List, allow end-user auto save the customized column setting same as Pending Job and claim job list. 
 
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5/11/2017
1.In patient payment detail, for item list (Copay etc.), in “Charge Amount” column, beside display current Copy charge amount, put “()” to display the total “Copay” amount from the insurance payment detail. So biller can see what is the Copay amount the Dr. Clerk or Insurance should charge, and what is Copay amount from payer ERA.
2.One patient visit (One service date) is one job, and one job can have multi-claims (For primary payer, secondary payer, resubmit etc), and one claim can have multi-payments (Primary, Secondary payments). Currently, for job, we have different status (such as Completed), and for claim, we have different status too. We need to add “Status” to payment to indicate one payment is completed but the whole claim (Partial) still waiting for the secondary payment. So in payment list, change the list header label as “Payment Status” and display the new payment status (Now it display claim status). Second, when one payment is “saved”, currently it popup up message asking if biller want to complete the claim or not, change this popup to “Do you want to ..” then provide three buttons “Complete Payment Only”, “Complete Payment and Claim”, “Cancel”. Third, for the payment invoice under payment reports, we need to list the payments based on payment status (Completed) not based on claim status. Last, provide me a SQL to update the status for all payments with “completed” claims to “Completed”.
 
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5/10/2017
1.I modified the patient Invoice MS report viewer template file to fit the envelop. Please see attachment. Also in Invoice Mail List, beside “Invoice Mail” (change it to Mail Invoice) add new button for “View Invoice” which is just for viewing and print invoice PDF, not create a new record.
2.In payment posted list, currently we have only “Completed” claims, add “Write-Off” claims
3.In “BillingJobPost” for 0854, check if the Admit date is updated or not. Only Service date should be inserted, not Admit date.
4.Change words for third, fourth patinsurance, and also add oen line for third/fourth insurance line in payment list (just like for secondary insurance (as reminder). And also add patinsurance payerID/payername and policy# in the line. 
5.After AmazeChart recent upgrade, they actually change the “sa” pwd for SQL server, need to find out what is the new PWD if possible.
6.If patinsurance the insurance “Start Date” or “End Date” are filled in, popup warning when CMS 1500 is created and Service date is not between “Start” , End” insurance date.
 
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5/8/2017
1.In “PatInsurance”, allow user add same payer again. The Unique ID can append 1,2 etc.
2.In “BillingJobPost”, 0854 account, for posting superbill, if the pateinrt insurance has Copay, no matter if the copay is “paid” or not, need to create a Patvisitpayemnt for copay. And later we can depend on the wording such as “APX” to put adjustment amount beside charge amount.
3.In “PT Visit/Paym,ent” list, if the balance is not zero and “Complete Job” is clicked in “Payment List”, that means we have to send the patient invoice out. Then need to change that cell background color to “red”, once the invoice is print out or some other mark, then change the color back to normal. After waiting for like 30 days, the color will change to “red” again to alert biller to send the second invoice. Also add (1), (2), (3) for how many times the invoice letter was sent out. 
 
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5/5/2017
1.I had modified a few SQL SPs for CMS1500 fetch data, dashboard etc, please check the attachment.
2.The dashboard, in the key performance, “Billed Amount”, the result from SQL SP is correct, however, during display, (convert to dollar), the cent is round up. Don’t round the cents. We need exact amount.
3.In manually posting “Superbill” through uploaded file, when auto generate caaseno, add “X” in front of service date.
4.In the payment list, beside what you fixed yesterday, there is one more thing, when the payment is “completed” in payment detail, the status in the payment list is still shows old status, should auto refresh the status in payment list to avoid the confusion.
5.In patient visit page for these CMS 1500 Items, rearrange them based on Item number, and also limit the max length input for Item 19 textbox to 80 characters.
6.In CMS 1500, reload function, it is better to check if the biller uncheck certain CPT codes in Job Summary page before reload (just like New claim). I will discuss it more how this can be implemented.
 
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5/3/2017
1.For “PaymentImport”, I spent some time to check the ERA for the case when within ONE ‘CAS”, there are multi-reasons codes. for example, for “CO” (CONTRACTUAL OBLIGATIONS), under One CAS, it has three reason codes (45, 237,253) with three different amount ($40.65, $2.44,$1.26) , Same for “PR”, it may have two reasons too, currently, when payment import, the second deductible $72.68 did imported in. See below screen capture. So in the “PaymentImport” program, line 482, we need to loop within “CAS” note to retrieve second/third etc. reason codes. 
2.Still in “PaymentImport”, for line 135 (EDI.cs), please change it to only skip the claim with status “Appeal”, “Write-Off”, “Completed”, Post ERA payment for all other status. While in line 362, change claim status to “Partial” ONLY for “Submitted”, “Transmitted”, “Accepted”, “Pending”, “Rejected”, “Processing”. Don’t change the status for all other claim status. 
3.In PT Payment/Visit, the new “Job Summary” popup, make it “Ready only” page (same as in Payment Posted list). The new “Payment Info”, change the header to “Ins. Payment”, and the popup payment list, make it “read only” too (Remove the new payment, Save etc. button in the list and inside the detail). Also change the “Balance” header to “Patient Balance”.
4.The patient Invoice can be launched in Google Chrome, but have problem in IE. (Keep loading …)
5.When doctor login, in “Payment Posted list”, the “payment” link popup display empty page, while STAF user login, can see the detail payment info. Please fix it.
6.In “Payment posted list” and “All A/R list”, first, for “Export” “Detail List”, use different Excel file name, so end-user can open both at the same time, second, in Exported Excel file, add new column at the end for “Adjustment Codes” which is for these codes/reasons for each CPT in the payment detail when we import ERA.
7.For this log in “BillingJobPost”, if the patient and visit is not exist in patvisit, then for each line of the log, write “Insert 04/27/2017 Mc Elvain Kelly”, if the patvisit (superbill) already exist, the write log as “Update 04/27/2017 Mc Elvain Kelly”, so we know how many patient visit are created (new), and how many are updated (merge) with existing visit.
 
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5/1/2017
1.I had a minor change in sp_get_code_fee to add new facility code 21. See attachment.
2.For the patient invoice, I modified the MS report layout and also changed the “sp_get_invoice” for the patient payment etc. A few days ago, I also found a minor issue in netSearchVisitList. See attachment, and please check into SVN code. One thing for this patient invoice is when download as PDF for printing, it always has the second blank page, please check.
3.For “PaymentImport”, Currently we skipped the claim with the status “QA Claim”, still need to post the payment for this claim, but don’t change the status to “Partial Payment”. 
4.For “PaymentImport”, if there is Copay amount (such as $25) in the imported txt file for 0854, currently the program will create an entry in PatVisitPayment. Please double check this amount should go to “Paid” not go to “Adjustment”
5.For “PaymentImport”, need to process the “note” for “0854” txt file. Under the Notes section, if there’s anything typed in this section put it into our Visit Notes section:
6.In payment Detail, allow biller re-select the payer just in case the payer is not the payer the claim billed such as for secondary payment. 
7.Also, in the payment list, the last column is “Primary”, if it is secondary insurance (or not same as claim payer), then out it as “Secondary”. 
8.For new added “Complete payment” in payment list, change the label to “Complete Job”, popup a confirmation Yes/No. And also if user already “complete” this job, then “gray out” this button.
9.Finish 4/26 Item 0 links in PT Visit/Payment list for job summary/payment info. 
10.For “BillingJobPoster”, as we talked yesterday 5/1/2017 item 4, if in same service date, same patient has two entry, after discuss with team, still just one job but merge all of the DX/CPT/Copay amount into this jobs. More important, write the detail log for billing job poster (just like PaymentImport program) to have service date and patient mrn/name and if skip any patient/merge any patient, write the log too. 
11.Finish 4/18 list Item 17
12.For “PaymentImport”, the txt file show the status as “Process as Primary FWDED”, please check if in 835, there is any field for “”FWDED” mark.
 
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5/1/2017
1.Currently, after payment posting, if the balance is zero, then the program will auto set the claim as “Completed” status. We need to change it to popup a message to confirm with biller if they want to complete this claim. If not, then don’t change the status to “Completed”
2.Error popup for Payment Posted “Export”, “Detail List”. 
3.After above two items, please continue finish the 4/26/2017 (see below list), Item 10 - Primary/Secondary payment from different payer even we only submit one claim, and Item 15 – when all of the payments are completed, auto insert corresponding Copay/Coinsurance/Deductible items into patient self payment list. One thing is one visit can have multi-claims, one claims can have multi-payment, so one payment or one claim is completed, not mean all of the payments for this job have been completed. So we need to have checkbox in the Payment List (at the end) to indicate all of the insurance payer payment are completed (received), then we can auto insert the total “Copay” “CoInsurance” “Deductible” into patient payment, and also can generate patient invoice. By the way, have a link link to patient invoice in this payment list.
4.In Superbill upload (For example for 0854), sometimes, the patient will visit the Dr. Office twice, currently we have server date as CaseNo, in this case, we need to add “-1”, “-2” to the caseno field after X+ServiceDate for second/Third visit in same day. But I need to check further which field to identity the different visit during same service date.
 
patient invoice part:
1.I have modified some layout for MS report Viewer. See attached file.
2.Please make sure the SVN source code is updated for this module. Currently I can’t find the code. So I can’t modify it or check it.
3.See blow screen capture, 
(a). Need to remove the space between CA .. Zipcode, 
(b). Second, see the example is in account 0854, MRN# 100004. In payment detail, need add one new columns in this invoice one is “Other Ins. Payment”=”Reduction”, And remove “copay”, “deductible” these lines, only put the total the “Patient Payment” (retrieve from patient payment module) into “Total for this claim” line, but don’t put “-20”, put “$20”. Actually need to add “$” for all of the dollar amount. 
(c). Also remove the “Total Amount Due” line inside the list (we already have one at the end of the List.
(d). Move “Contact Us” as page “footer” (at the bottom of the page), also where to fill the Phone#, Fax# (currently both of them are empty) in this Invoice.
 
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4/27/2017
1.Payment Import: If the Co-Pay Paid shows the $$$ and then cc. cc means that it is “Credit Card”. It imported as “Check”
It needs to look like the scenario below:
At the Payment, when I click on Edit and changed the Method from Check to Credit Card, it doesn’t reflect it on the Edit Visit page. It still shows Check. We need the Edit Visit page to show the Method as Credit Card before we save it. 
2.In Partial/Denied claim list where the ERA payment posted, sometimes, a first CPT payment come while still waiting for other CPTs. Currently we had “batch#” link to each CPT payment, so if all of the CPT line has “Batch#”, then we can change the background color for this “partial” claim in the list so the biller know the payment is all posted and they can check and complete the claim.
3.Also, as Yoyo checked, need to import patient sex info, and if the rei sonly one doctor in DocMas, then default to this doctor in patient visit/CPT etc. related field. But don’t change the “IVF part”, current way is good.
4.Last, the Dashboard looks good after the change, just need to add “$” for the Top 20 CPT “Average Paid” column.
 
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4/26/2017
0.Regarding auto creating patient responsibility payment entry after the payment is set to completed, please also add two links in PT Visit/Payment list after the balance column, one is with column Job# linked to job summary popup (view only), and second is “Ins. Payment” (Total Applied Amount) linked to insurance payment list popup for this visit. So Dr. office clerk can view all of these info. from one place (one menu). 
 
1.In CMS 1500, for a few claims, we found the patient account number was still “0852”+JobNo, it should be always “0852”+ClaimNo+”C”. I spent sometimes to check the reason, and found the problem was caused mostly by “Rejected” claims. When biller resubmit these claims, occasionally, they will click the “Reload” button at the end of CMS 1500, then after reload, the “patient account #” change to jobno.
2.In CMS 1500, Item 17 referring doctor, before, the form does not allow “DK”, so we worked around it. But actually I found that OfficeAlly can’t even process the “DK”, so it only allow to select “DN”. So we need to change it back to what it was before, don’t allow DK
3.For ERA payment posting program, for the Copay part, please see below:
Copay in the insurance area should go to the Charged Amount of the patient payment besides the “PatInsurance” table.
The Co-Pay Paid amount goes into the Paid Amount. Also can the check # go to the Reference # area. If they enter cc(xxx) or cc/, those are credit card payments.
4.Still for ERA payment posting program, for patient insurance, currently their payer name can’t match with the standard payer name, so always create duplicated insurance entry. Currently, if the patient already exists (0854) account, the existing insurance should be verified. In this case, the program can check the “Policy#”, don’t insert/update if the “policy#” is same.
5.ERA payment posting program, now we process the payment with patient account# as claim#. We can keep this way, but if there are any other patient account such as job#, when we skip it, need to write log in the log file so we know what is wrong with this payment.
6.Dashboard, for “Payment for Top 20 payers” change “payers” to “Payers”, change “Number” to “Claim#”, “Applied” to “Paid”
7.Dashboard, for “Payment for Top 20 CPT”, add 1,2,3 .. as the first column, CPT code as second column, number of Jobs which contains this CPT as third column, and Average paid amount as fourth column. Have Title for each column. 
8.Dashboard, for “Payment for Top 20 Diagnosis”, Change this to “Top 20 Diagnosis Code” add 1,2,3 .. as the first column, DX code as second column, number of Jobs which contains this DX as third column, Don’t need to show payment. 
9.In CMS 1500, for each CPT line, the (E) – Diagnosis Pointer, only display “ABCD”4 letters even though there are more than 4 Diagnosis codes for the claim
10.In ERA payment posting program, see below screen and attached the zip file (both ERA 835 and text file), for some claims, especially what they called “Medi-Medi” (both Medicare/Medical), the ERA will come with the status as “Processed as Primary”, “Processed as Secondary”, “Denied”. Please check if the ERA 835 has such status info. or not. If it does, then we will post the payment as secondary insurance payment. I will discuss with you in detail by phone.
 
11.Capitalize the patient demographics information (name, address, City, etc.)
12.On the Visit Page default the Facility field to 11
13.Description is missing from 96372
14.Change the top labels “Top 20 Payer..” use only one word for each column, not two words. And also add the number for the Total Claims in “Performant Indictor”
15.When Auto post ERA or when biller save the payer payment (make it completed status), check if there is corresponding “Copay”, “Deductible”, “CoInsurance”in payer payment, if there are, and patient payment has no such charge, then auto insert new entry into patient payment with the charge amount but no paid amount.
16.We will need to modify the ALL A/R accounts list based on new patient payment for Copay/Deductible/CoInsurance and Other patient payment to calculate the final account balance.
 
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4/25/2017
1.When doctor login (with user type DOC), only display “Ready” job status in “To Be Billed” List, don’t display the “Assigned” Job to the doctors
2.CMS 1500, Item 17, Referring doctor selection block the submit or save, error popup for 837 format.
3.For new patient payment list, please set the default Service date range as 6 months just like other list.
4.for the “Key Performance Indictors” check the “balance part” in this Indictors (such as in 0852 account)
5.One more minor thing is for top payer, CPT, DX code, please select top 20 instead of top 10.
 
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4/24/2017
 
1.I changed the “SP_get_code_fee” to retrieve fee structure, please integrate into your side.
2.For PaymentImport program, beside “Submitted”, “Accepted” etc., please add two more status “Pending” and “Rejected”. 
3.Currently, the “Notes” in the claim/Job list displays all claims notes under this job which is good. Just need to add a horizontal line to separate the notes for each claim to make it more clear.
4.In patient Insurance, beside the checkbox for “Primary/Secondary” insurance, we will need add additional dropdown list for “Third Insurance”, “Fourth Insurance”, “Fifth Insurance”. 
 
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4/21/2017
 
Attached is the superbill we “copy/paste” from Account 0854 eClinicWorks for 4/19/2017. This is the file they printout first, scan the print papers into computer, then ftp to us and Yoyo team upload, enter patient insurance, generate superbill etc.
This text file format is same for each patient (Separate by ---- line), so we can add a module into DataImport program to import these patient superbill data just like we import what we already have for SAMS/AmazingChart/CCDA/CCD/CSV format. Of course, we need to spend sometimes to analysis this text format. I will discuss the details with you by phone.
 
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4/20/2017
 
1.For PaymentImport, some time, the Adjustment group become huge (more than 200 characters) and caused auto posting failed. So I changed it to “Text” field.
2.For PaymentImport, since each payment may have different ERA for CPTs so the txt file will be different. Now this batch# will be overwrite. So we need to link the batch# with each CPT. See below screen capture.
3.As we discussed yesterday, the new Notes (message) for both Job List and Claim List does not show all notes for all claims under this jobs. It only shows current claim. Need to list all claims notes and separate them into different claims sort by date.
4.CMS 1500, for printout, we need to change the first line at the top of the address part to use the “Payer Name” (Not from InsuranceMas) in CMS 1500 because sometimes, the biller need to change the payer name for letter mailing purpose. 
5.For patient invoice, there is a small bug in netSearchVisit, please see the attachment,
6.In the patient invoice, a few things need to be changed:
a.At the top, which fields are for the Dr Office Address, DocMas. 
b.The “REMIT THIS PAYMENT STUB TO” should be same as Dr office Address. 
c.The CPT Description is too long, one sentence (no more than 3 lines) is enough.
d.Make “Total Amount Due” as new section at the end, so patient can see it clearly (Just like the invoice PDF I sent early)
e.Change “Copay” as “Patient Payment” which including Copay/Deductible etc. all of the patient payments for this claim
f.Add new column “Patient Balance” at the end of each line. Do not need to display each CPT line. Only on the Total line displays the balance.
g.After all CPT lines, put a new line for total of each Column and also the “Balance” column. 
h.At the bottom left corner, like the pdf that I sent you before, put CONTACT US: section which includes doctor’s phone number and fax number. 
 
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4/19/2017
 
1.For PaymentImport, combining same ClaimNo in one ERA 835 first, then importing into system works fine. This covers a lot cases. However, as we talked last night, there are some cases especially for MediCare, the CPT codes in same Claim will be separated into different 835 and in different days. So still we need to use ClaimNo+CPT code to identity one CPT payment either update or insert new. 
2.For PaymentImport, currently it excludes “Deleted”, ”Write-Off”, “Completed”. But actually we should just update the claim with the status as “Submitted”, “Accepted”, “Partial”. We don’t touch claims with any other statuses.
3.Still in PaymentImport, for example, one ERA file contains 2 CPT codes but this claim has 3 CPT codes, when this ERA imported, the program only insert 2 CPT codes for this payment, actually we need to insert all 3 CPT codes into this payment, and leave the third CPT code unfilled (partial payment), so a few days later, when the payer sent another ERA with third CPT code payment, the program can update the exitsed payment for the third CPT code. Or sometimes the biller can manually fill in the third CPT from payer website then they can change the claim status for “Partial” to “Completed”.
4.For the “Notes” in Job list, currently it displays all notes for this Job which is good. For the “Notes” in the Claim List, we need to display all notes for this job too. If there is a claim# for this notes, just put claim# in each message title. In this way, end-user can view all of the related notes for this job together. Before we kind focus on the claim, but actually each job (visit) is what the Dr. office concerns.
 
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4/18/2017
1.When the “Secondary Insurance” checkbox in the patient insurance is checked, then in the payment list page, after “payment for current claim” and before “payment for other claim”, add a new section to display the “Payment for Secondary Claims”. If the claim does not exists, then just display this section title, so biller know they need to submit a new claim for secondary insurance. If another claim exists for this secondary insurance, then display the claim list with (or without payment) just like primary claim list. 
2.ERA posting payment, currently if the claim already have payment, it won’t post any new payments. However, sometimes, even in on ERA, the payment for different CPT code are separated, so the second CPT won’t post. So we need to change payment posting backend program to base on Claim#+CPT code. Also, for the “Completed” claim, don’t post any new payments or change status.
3.Complete the MS Report Viewer for patient visit invoice and make sure the existing MS reports (such as in payment posted) still works.
4.Auto adjust the layout for FnetRecorder inside the DX/CPT page.
5.For Service date “From” and “To” in CPT code, when end-user add new CPT, auto fill in from patient visit page. 
6.In this new Patient payment posting part, besides “Self pay”, add payment method “Deposit” “Co-Insurance”.
7.In the payment list page, popup a new window for the payment detail, not replace the payment list.
8.Data Import/Export backend program for Amazing Chart, sometime, Dr. Office will update patient insurance after patient visit. So when we retrieve superbill every week, we need to retrieve all of the patient insurance (images) with the modified date (within the date period for superbill).
9.Dashboard “Key Performance Indicates” improvement: Separate into three section (with Title), and for all jobs not limit to recent 6 months
(1). Total Claim: 
(a). Pending Submission: The number of jobs (not claims) in To be billed, Missing Info, QA, Hold 
(b). Submitted: The number of jobs (not claims) in Submitted, Rejected, Processing, QA, Partial/Denied, and Followup list
(c). Write Off: The number of jobs in write off claim list
(d). Completed: The number of jobs in completed status. 
(2). Accounting:
(a). Billed Amount: $ 
(b). Paid Amount: $ (Current Applied+CoInsurance+Copay+Deduable)
(c). Adjusted Amount: $ (Adjusted + Reduction)
(d). Balance Amount: $ 
 (3). Average Days in A/R: 
10.For patient payment, need to have function to print out a simple patient receipt. We will get receipt format later.
11.Still Dashboard, change the Title for “Payment ..” to “Payment for Top 10 payers”, and add two new dashboard one for Top 10 CPT code with billing/paid amount, one for Top 10 Diagnosis Code with billing/paid amount.
12.In Patient Visit page, add “Visit Type” dropdown list (As visit purpose), currently we can have these items: “Office Visit”, “Annual Physical Exam”, “Vaccination”, “Routine Checkup”, “Followup”. Later, we will add this “Visit Type” in search criteria in the all of the Job List and Claim List. 
13.Add new status as “Hold” in the Job Status to indicate this job (visit) need to be hold for billing (Not submit claim). Have a separated menu for Hold Job Queue beside “Missing Info”
14.Add “Guarantor” checkbox in patient insurance page “Insured person” section to indicate this Insured person is the guarantor. We will use this guarantor later on.
15.Need to add dropdown list for Sex/Marriage fields, not textbox.
16.Add WebURL and addresses field for Global Payer List, and allow end-user to edit these fields. So when a new Local payer list is added from Global payer list, then these addresses and URL link will be copied over.
17.In patient Visit, besides CMS 1500 Item 19 textbox, Add new “Date” field and “QUAL” field for Item 14, 15. For Item 17, need to auto fill in Referring Dr. name and 17b. NPI (from DocMas and PatVisit). Ignore 17a now. For item 18, auto fill in Admin date into “From”, and Discharge date into “To”
18.Add “Date of Death” in patient demographic. When this field is filled, then all of the patient self-pay balance will be write-off.
 
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4/14/2017
1.For any dollar amount, if it is negative, don’t display “-$10”, display “($10)” 
2.For the balance in each line (each payment), the balance is not the balance for this payment, it should carry over the previous one, so this column is actually the “Total Balance” for all payments in this visit.
3.Line up the “Total …” with each column, so end-user can easily see it.
4.Move “Previous Balance” to the new line (It did not display now), and the add “Current Balance” after it. So the “Current Balance” will be the final balance.
5.Also, if there is only one doctor in the docmas then default the Attending Doctor field to this doctor.
6.And as mentioned yesterday, in the Upload superbill when the team create the patient visit info they can also enter in the copay amount received for that visit exactly like the doctor office clerk would post the copay amount.
7.We need a place to enter a previous balance under PT Payment/Visit for a visit if we never had this patient in our system before. 
8.Also for payment method add one more “Self Pay” method. List the Methods in alphabetical order. 
 
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4/13/2017
1.In payment section, change “Amount” to “Charged Amount”, “Applied” to “Paid Amount”, and “Adjust” to “Adjustment”, and need to add “Balance” for each line. Auto calculate Balance amount.
2.In payment section, at the end, add Totals for each columns. And add “Previous Balance” (auto calculate balance from all previous visits) field, + charges - payment from this visit = Current Balance
3.For payment method, besides “Copay” “Deduction”, add “Other”. For this “Other” payment mean the patient could just pay for previous balance. So the charge amount can be empty in this payment. 
4.For a new visit, when end-user select an existing patient, need to auto fill in fields such as Sex, DOB etc besides the patient name.
5.We changed the menu to “Patient Visit/Payment” for this list, so in this list, we will need to remove patient DOB, Sex, address, phone these info. and add “Prev. Balance”, “Charge Amount”, “Paid Amount”, “Adjustment”, “Current Balance”.
6.In all patient Visit including this one, display the doctor’s name in the Attending, Admitting and Referring field. The Doctor ID does not mean anything to the end user. Also, if there is only one doctor in the docmas then default the Attending Doctor field to this doctor.
7.At the beginning, we can just “duplicate” the patient invoice as attached file, and we will adjust it based on feedback later.
8.Also after we the above items done, in the Upload superbill when the team create the patient visit info they can also enter in the copay amount received for that visit exactly like the doctor office clerk would post the copay amount.
9.Next step, We have new “Patient A/R List” to combined above “Cash Register” with claim billed amount and payer applied adjustment, coinsurance etc for a complete “A/R” (Account Receivable) List 
10.One minor thing regarding auto generated “CaseNo”, I found some CaseNo in 0854 accounts only have Service Date, the standard “CaseNo” should be “X”+Service Date, so all of patient visit caseno info look same.
 
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4/6/2017
1.Program to Break large tif to jpg for each page and auto generate MRN etc.:
2.For the ERA posted description, currently we put them all into one big “Description” textbox, It is better if we add new “Adjustment Groups” textbox under each CPT code line, and put corresponding CAS info over there not into “Description” . Also in the Excel Export, add new column for this new field for each CPT code line. 
3.Currently, when ERA is posted, we set claim status to “Partial” and wait for biller to verify and change it to “Complete” maybe a few days later. The payment “Posted Date” is still the old date, not the date when claim “Completed”. We need to auto update the “Posted Date” to today’s date when biller change the claim from “Partial” to “Completed” for invoice purpose.
4.Currently, the program auto calculate the patient “Age” from DOB to today’s day. But the patient age at the date of service is what the biller need to check especially for the baby. We need to change the label “Age” to “Age at DOS” and calculate the age from DOB to DOS.
5.For a new pending job, currently, after biller submit a new claim, they need to click “Finalize” button to finish this job and remove it from “Online Billing” list. Sometimes, biller will forget to do it and cause some confusion. So after biller submit the new claim, if this job is still in “pending” status, popup a message asking if they want to “Finalize” current job, if Yes, then auto finalize it. 
 
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4/5/2017
 
1.For the backend ERA import program, three things, first, don’t pull the allowable amount from our own fee structure, we need to retrieve it from ERA (See the attached file for Claim 08510000069C, the allowable amount is $81.82). Second, sometimes, one CPT code, has two “CAS” for example Claim: 085200001442C, it has Copayment and it has Capitation “CAS*CO*24”. The payment above it has 4 adjustment group. We need to retrieve all of these adjustment groups and display in the corresponding fields and put the code description into “Description” fields. Third, as in each download zip, it has two files with same file name but different with extension “.835” and “.txt”. Please import the txt file as “Upload EOB file” and link the “EOB” file with the payment in “Batch #” field. 
2.Yesterday, we added Service Date From To in Patient Visit, in “Procedure” (CPT) code page, currently, for each CPT, we have one “date” field, please add one more as “Date To” just same as Patient Visit. By default, these two date fields will auto fill in the date from Patient Visit, and when a new CMS 1500 is created, pull in the date for each CPT from this “Procedure” page.
3.In Patient Insurance page, for “Insured” section, we had added a new button “Copy From Demographic” to copy the “address/city/state/zip/phone”, but don’ t copy last/first name/dob/sex, the patient and the insured person are different person but they have same address.
4.Move the “CMS 1500 Item 19” at new section of the page, later, we may need to add more such text box for other items.
5.In the “Upload superbill” to create a new billing job (then send to pending billing job pool), sometimes, we don’t have patient MR#, only have patient name/dob etc. In this case, if the end-user leave MR# black, the system will need to generate our own MR# (have a field with start MR#). 
6.Also in “Upload superbill”, sometimes, the end-user don’t have any image/pdf file to upload but need to create a new billing job. In this case, add new button to allow user create a job without upload any image.
 
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4/4/2017
 
1.In Patient Visit page, add new textbox as “CMS 1500 Item 19”, then if biller put something here, auto fill in CMS 1500 Item 19 from this field.
2.In Patient Visit page, change the Label “Service Date” to “Service Date From”, and add new field as “Service Date To”. By default, The Service Date To will be empty, and CMS 1500 will fill in both “From” “To” with current “Service Date” just as what we do now. But if biller put a date in this new “Service Date To” then in CMS 1500 the Service Date “To” field need to use this new field.
3.Add new column for “Allowable” in the Pending Payment, Payment Posted, All A/R Account list and also the Export Excel file just before “Applied Amount”.
4.Add new textbox (make it 250 varchar) in Patient Insurance for “Coinsurance” info.
5.Currently, in payment detail page, when new payment, the “allowable” is auto filled in from fee structure. Please comment it out, we will ask biller to fill in this field when they post payment.
6.I fixed two small issues, one is the payment Excel export file, in the SQL SP, the description field is too short, I increased it to 1000 varchar. Second is “Rejected Claim” list, missing “()” for “or” statement. See attachment.
 
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3/31/2017
1.Online Billing, there are two reset buttons at the top, the second “Reset” next to the “Search” should reset the search criteria, now it mixed with the first “Reset” button.
2.In CMS1500 Popup warning message, beside the current message, add one line as “Click Yes to continue submit the claim, or No to change the claim”, so end-user know what the Yes/No will do. (The exactly message will be changed later)
3.In CMS1500, Currently, it popup message asking if end-user want to submit CMS1500 or not first, then go through the NCCI or other checking, popup warning message, we need to change it, so it go through these checking first, popup warning message then confirm if end-user want to submit the claim or not.
4.As we discussed yesterday, the “Appeal Claim” workflow actually more complicated than Collection Letter. For Appeal, we need to have two parts, one is “Appeal Claim List” to display all of the appeal claims with new column to view Appeal Letter and Attachment. The second part is the New Appeal launched from Payment Detail (Same as the Collection Letter), with selection of CTP code (and other info copy from current claim) auto fill in new Appeal Claim CMS 1500. After biller verify the CMS 1500, then launch the appeal templates to allow biller to edit the appear letter, finally attachment a PDF (EOB) or the EOB with this payment (By radio box for the attachment or EOB). The printout will print CMS1500, Appeal Letter and Attachment (EOB). 
5.By default, in CMS1500, the NDC code only allow 11 digits because NDC code is 11 digits long. But sometimes, end-user will copy/paste the NDC from CMS website which has two ‘-‘. So we need to increase the allow textbox length to 13 and auto remove the ‘-‘ when save or paste.
6.In Patient Insurance, for the insured address/city/state/zip/phone, please add a button to allow user to copy these fields from Patient’ info. And also auto fill in insured info (including sex) into CMS 1500 when new a claim. 
 
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3/30/2017
Beside the major “Appeal/Collection Letter” feature (We will work on the templates), here are three minor items:
1.Move the claim with “pending” status into “Rejected Claim” list. We treat “pending” status from Office Ally as one kind of “rejected” which need to be followed up closely.
2.As we discussed last night, in payment detail page, add sum lines under CTP lines for total amount for each columns.
3.In CMS 1500 submission, current we have some blocks (don’t allow submit such as zero amount for each CPT Code), and we have some warnings popup message (such as 2016 DX code or NCCI warning), change all “block” to “warning” message. And also change the warning style to “Confirmation” style (Have OK/Cancel or Yes/No choice), so the biller can click “OK” to continue the submission (don’t go back to CMS 1500) just like normal process), and if they click “Cancel”, then go back to CMS1500 without submit.
 
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3/28/2017
1.In the attached SQL SP, I changed the length of “insured_id_number” to 20 since we have patient with policy# as 16 characters. Please double check.
2.See below screen capture for the table “FireDir”, I will discuss with you by phone to see how the img path is generated in this table once it reached the 2000 limits (Check the Loc_type for Image/Report file path). 
 
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3/27/2017
1.In Job Summary, besid eth Patient DOB, calculate patient Age, if patient is under 2 years old, put xx months, if over 2 years old, put it as xx years xx months.
2.For payment detail, if adjustment amount > billing amount, don’t allow save.
3.Add checkbox in DocMas profile as “Use SSN as Fed Tax ID”. Once this checkbox checked, in CMS 1500, the radio box should be set to “SSN” (NOT “EIN”) See below screen capture.
4.Allow end-user to add/edit/delete the “Global Health Plan List” directly.
 
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3/24/2017
1.In the claim list, the “payment #”, keep the original way, if there is payment for this claim, then display the payment no, if no, then display “new”. Don’t need to display “New” and “PaymentNo” together. Move the “New” button into the Payment List as “New Payment”. So biller can always click this button to create a new payment inside the list. Also for “New” link, still link to the payment list, not to popup the payment detail. So biller can check other claims payment before post new payment for this claim.
2.In the payment list, don’t display the claim with status of “Deleted”. And Change “Select” to “Payment List for Job: xxx” then add “New Payment” button. Also change the label “Current Claim” to “Payments for Current Claim”, and change “Other Claim” to “Payments for Other Claims under this Job”. Last, add new column for “Primary”, ”Secondary” if the insurance has such checkbox checked.
3.For “Fee Structure List”, after user input some search criteria, when they click “enter’ default to “Search” function. We can do this for all other pages, default to “search” button for Enter key.
 
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3/23/2017
 
After the Patient Scheduling/Appointment modules, as we discussed by phone and Jun’s email, we start to integrate the “NCCI” Medicare tool to help the coding/billing of the possible under-coding/under-billing. This is kind important to us. But we are all new to this area, we will do more research and see what we can do. https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/index.html redirect=/nationalcorrectcodinited/ 
 
after all of these items especially the ERA835 importing program, we still have a lot of new items and a few unfinished items as follow:
1.For the payment, currently we link each payment with each claim. But sometimes, one job has multi-claims, and maybe one claim has two payments from two payers. We still link payment with claim, but we need to restore the “payment list” we had before to display all payments for the whole job (Not just one claim). In the list, for each payment, beside what is the on there now, we can add job_no, claim_no, claim_status columns with each payment. And also restore the New Payment button at the top as we had before.
2.In this payment list, the first section display list of payments for this job as in item 1, but add new the second section to display the list of patient collection letters for this whole job (With templates selection etc.) as we discussed these days. 
3.In patient insurance, beside the “primary” checkbox, add another checkbox as “Secondary”. And we will link this secondary insurance info. with payment list. We will discuss how to implement it in more detail by phone later.
4.Add new submenu as “Appeal” (beside WriteOff etc.) under “Denied Claim Management” display the claims with “Appeal” status. And in this appeal claim list, add new column to popup a new “Appeal Letter List” to create/track these Appeal letters for each claim. Same as this collection letters with templates selection.
5.For all of these upload files list (such as EOB, Capitation etc.) , add search criteria to allow search by Batch ID, and also in the payment the popup list for these upload files, add search criteria for Batch ID too.
6.One small bug, Creating New Users when you enter the User Init it does not save the Initials when the profile is created. 
7.Keep improving “Account Specification”, “Help Center”, “Message” these tools when end-users start to use them.
 
After I went through all of the previous items, only 4 items left out of these hundreds items we finished during past 6 months, we will do these later after we finish above more important items 
 
1. We will need to add a new menu as “To Do List” for the biller. When biller login, it will default to this page, not the dashboard. These are the reminder jobs/claims that changed to a light orange so they know they need to work on them. So they know what they need to do first every morning once they login in. This “To Do List” currently can contain three sections (Lists), one is for reminder jobs, the second is for reminder claims, the third is for payment (we will design it later). This is kind of a major item, I will discuss with you in details on how to implement it by phone later.
2. Remove the Status dropdown list at the top search criteria part if the list only has ONE status. And if there are two or more status in one list, only display these status in the dropdown list and the status dropdown list in “Claim Check Status” need to limited to possible status. For example, “Rejected” Claim don’t allow user to change to “Denied” because Denied is from payer.
3. Add small notes textbox in the right panel for “Dx” “CPT” Coding page (with FnEncoder at the left panel).
4. Dashboard enhancement.
 
 
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3/14/2017
 
Add two columns into “claim list” : The “Claim#” column (the ID OfficeAlly generated) in “Clearinghouse Status” list and “Payer Ref#” (The ID payer generated) in “Payer Response” list.
We will need to add two extra fields in claim list to store this two IDs and when update the status, update these two fields in the backend posting program. Display these two new columns at the end of the calim lists and name them as “OA Claim#”, “Payer Claim#”.
 
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3/9/2017
1.The dropdown and search while typing in Health Plan field is very user friendly. But the search only for top 20 items, please fix it. Also, put this feature in Patient Insurance HealthPlan textbox.
2.I have modified the SQL SP for getting fee a little. So now all of the fee in the fee structure (Global or local) are all “Allowable” amount. (xBilling_ratio). See the attachment, and please double check.
3.IN the payment detail, when biller create a new payment, need to put into these fee from fee structure into “Allowable Amount”, so biller can compare the allowable with the applied amount. Create another SQL SP just like the “sp_get_code_fee” to retrieve corresponding allow amount (same method just don’t need to *1.5)
4.In Patient Insurance, add insurance, and Payer Management, inside the popup Payer ID search list, for PayerID, PayerName search field, same as Health Plan, do the “Auto Search” when user input characters into the search textbox.
5. Please double check the Detail Excel file export under “Payment Reports” (All three reports, especially the pending payment report). The problem maybe cause by extra criteria. 
 
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3/8/2017
1.We can’t replace the CPT fee in the backend when biller save the CMS 1500. Sometime, biller need to manually change the charge amount. So for saving, just save whatever in the CMS 1500 form, don’t change anything. What we talked before is when biller reselect the “payer” (at the top of the CMS 1500), then refresh (retrieve) the CPT charge amount at the time.
2.Inside each account, make the table structure for “fee structure list” and “category list” same as global table. Inside the account the “modifier” is also import for specified CPT rate. Some of other fields we may not use now, but may will use them in the future. 
3.Changing the label “Type” to “Facility Type”. So we have “Facility Type” and “Proc Type” (Procedure)
4.When importing medicare list, please just keep “#” or “” for “Note” field (Facility Type), sorry, don’t use 1 or 0. So the list will look exactly same as the original XLS.
5.Last, I have changed the SQL SP “sp_get_code_fee”, please double check, I did not have time to test it today. But I will upgrade the system tomorrow for these two days modifications.
 
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3/7/2017
1.For Medi-CAL the payerID is: MC051 For Medicare the payerID is: MR002 Medi-CAL is California State Government Health Plan, Medicare is Federal Government Health Plan
2.The “Notes” field in Medicare is a different field with the Medi-CAL “Type” Use two fields inside the “Fee List” table.
3.Same for these “Global Fee list”, add new menu for “Global Payer List” and Global Health Plan List”
 
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3/6/2017
1.Two fields need to be added into the Global Fee Structure List (Not the category). The Modifier and Notes (In table, we can use “Type” field).
2.In Job List/Claim List, when reminder days is reached, currently the program will change the background color for these items which is very useful. But now we have so many items, so by default, please display these items at the top of the list, then display other items. 
3.ll payment reports, add “Reset” button.
 
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3/5/2017
As we just discussed by phone, here are a few items we need to improve for fee structure:
1.Just like the global payerlist, we will need to have a global fee structure and fee category list to store the “Allowed Amount” for each category (for example the government “Publish fee” for medi-cal, medicare and standard fee for other payers) . 
2.Add “PayerID” and “Billing Ratio” (such as 1.5) two fields to each fee structure category within doctor account. So each account can have its own specified billing ratio for each payerID. 
3.Keep current “Charge Amount” for some very special CPT codes within each account only when these particular CPT codes for this doctor are not “Allowed Amount”x”Billing Ratio”. In this way, we can provide the all kind of customization rate or contract rate based on doctor and each payer.
4.When an new CMS 1500 is created, first check the fee structure within each account for corresponding PayerID/CPT, if a matched record is found, then use this specified “Charge amount”. If the “Charge Amount” is empty or no specified record is found, then use global “Allowed Amount” x Account “Billing Ratio” for this payer. Actually this is what Kareo does.
5.If “PayerID” can’t be found in the category, then use the “standard” rate (default rate for all other payerID)
6.When a payerid is changed in CMS 1500 by biller, recheck corresponding PayerID/CPT and modify the bill amount for each CPT line.
7.If “payerID” is found, however, the CPT is not listed under this “PayerID”, then set amount to zero. Don’t allow submit CMS1500 if there is any such zero amount. Then biller will find the allowed amount and bill amount for this CPT code.
8.Double check/correct the display/statistical report to use the CPT bill amount in “claim_procedure” table, not use “JobListxx” table.
 
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3/3/2017
1.Payment Posted, the list did not cleanup (refresh) if the search result is empty (payment pending and all A/R are fine)
2.Add payment descript field into Excel File in Payment Reports. (At the end of the list)
3.Add Payment method at the beginning of the “referenece#”, such as “Check : xxx” or “ETF:xxx”. Put this in Payment posted (ALL A/R account) list and Excel file, and alos Job Summary. Change “Check#” to “Reference” to make the name consistence.
4.Minor change for NDC print out (Start with D. Procedure column). Will discuss with you in more detail.
5.In payment posted (A/R Report), currently, if the capitation checkbox is checked, the Excel export file Check# will display word “Capitation”. This works good. However, in the list itself, in the ”Reference#” column, if there is any “capitation” checkbox is checked for this payment (claim), then append “CAP” to current text. 
 
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3/2/2017
1.CMS1500 printout, need to print out these “NDC Price Qty etc.” the line above CPT code line
2.Claim List (including Follow up list) the change the background color just like in Job list if the “check claim status” ID starts with “M” or “D”
3.Add weblink for the payer in “Payer Name” Column in “To Be Billed/Online Billing/Payment Reports” just like the payer link in Claim List.
4.In Job List, just like “Missing Info” popup list (checkboxes and Change button), we will need to add a similar function for “Pending Issues”, popup a list of checkboxes with list such as “Coding” (More items will be added later). Also same as “Missing Info”, add new menu for this “Pending Issues”. Basically it is just another missing info list. 
5.We had one item left from a while ago, For FnEncoder inside billing platform, the regular search (Not advance search), we have “Select” button to paste the CPT code to right panel, but no “Select” button for HCPCS
6.In Payment Report, add search criteria for “Payer ID” and “Payer Name”.
7.In payment report export excel files, add “Claim#” column next to Job#, (especially the detail excel file)
8.For Health Plan, currently it is a popup window for user to select from in payment and patient insurance. A good suggestion is just like in FnEncoder, when user key in one or two letter, it dropdown a list to show the suggested Health Plan from Health Plan List. The list won’t be that large, it usually is less than hundred items. We can implement this later when we get other important item finished
 
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2/28/2017
1.Change the words “Insurance Management” to “Payer Management”, and change the button name “New HealthPlan” to “New Payer”.
2.In the “new insurance” (change it to “New Payer”), make the payerID and PayerName textbox read only, so the end-user has to select a payer from the Global payer’s list. User can change other fields such as Insurance name etc.
3.In the Job Summary, patient insurance list, move the “delete” function from List to the inside Detailed page.
4.In Job Summary, the Insurance List section, put PayerName first, then PayerID, then Status, Primary etc … rest of the list.
5.Add Batch ID in all upload File List (Currently the ID shows in selection list, this is good)
6.In “To Be Billed” “Online Billing” Change the column header name from “Insurance name” to “Payer Name”.
7.In patient insurance detail page, start from the relationship, and all other fields related to the Insured Person put all of fields in a new line (separate section). Name this section as “Insured Person”, then under this section, display Relationship, Last Name, First Name, Gender, DOB etc, In this way, the patient’s insurance page will be clearer. And also put “Start Date and End Date together in one line (make the textbox for startdate end date smaller)
8.When post payment, as long as the balance is 0 then auto set it to “Completed” even the adjustment amount is 0
9.When “DOC” user type login, only allow DOC to see the “Dr-Followup” claim in “FollowUp Claim List”
10.When user post Note in “Notes” column, update the UserID/Date in “Claim Check Status” column for BOTH Job List and Claim List
 
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2/23/2017
 
1.In Payment Posted, pending payment, the search criteria section, put search textbox for patient LastName, FirstName in same line (Second line)
2.In Pending Payment List, double check the “Detail” button work for exporting the detail Excel file out. Especially with search criteria.
3.In Payment Posted/All A/R Accounts, in the detail excel export sheet, if the CPT has “capitation” checkbox checked, in Export Excel Reference column, instead of what the biller put into the reference textbox in payment detail, just put the word “Capitation” in this column.
4.Increase the Max length for these notes in upload file list “Sign-in” sheet etc.
5.For Job List/Claim List, if the biller set the “reminder”, currently when the reminder days reached, it will display different background color which is very useful. Need to make this different background color for “Online Billing” list and all other Job and Claim lists too. 
6.If the reminder days is NOT zero, then in all Job/Claim list, Online Billing list, display different background color like light gray (Only need very small different with regular item for the BK color). Don’t need to have “bell” icon as we mentioned before, the new icon is kind complicated. Simple BK color change should be fine.
7.In the “Check Status” popup, after Reminder … Days, add a label (text) after this to display how many days left for reminder days.
8.If the reminder days is set in Check Status, then when post the message into “notes”, put the reminder days info. into notes too.
9.In payment detail, after the “Capitation” checkbox, add “batch #” selection box (Same for Big EOB file selection) to allow the biller link the uploaded Capitation file.
10.Move “Capitation Report” menu under “Upload Files”. And for all of these uploaded file list, display the Batch#, (the unique ID in the table)
11.In “Online Billing” list, make current “Missing Info” selection same as “To Be Billed” (popup with multi-checboxes)
12.“Notes” popup windows, change it to a separated windows (Not inside current windows), so user can move it in another screen.
13.In all Job List, Claim List, Online Billing, display the payer name (replace current insurance name). And display these payer name with primary, active, inactive order
14.Add “Delete” function in patient insurance list. Currently, user can only set the existing patient insurance to “InActive”
15.In Job List, rename the column name “Check” to “Job Check Status” (make it similar with “Claim Check Status”), and in Patient Insuracne, rename the “Insured Sex” to “Insured Person Gender” 
16.Add a new status in Claim list “Coder-Followup”, so we have Dr. Payer and Coder followup. All in Claim Followup list
17.In Online Billing, allow end-user (Only STAF, and QASC, billing supervisor) to reassign the jobs to another biller. (Same as To Be Billed)
18.Display Job Notes and Claim Notes together in both Job List and Claim list.
19.Add search criteria for patient last name, first name in Job List, Claim List, Online Billing at the end of the second line of the search criteria section. 
20.When the claims are submitted to OfficeAlly, currently the transmit pool will change status, but need to change the claim status from “Submitted” to “Transmitted” (A new claim status)
21.If The claim still in transmit pool with “Ready” status, then if biller change the status in claim to rejected, delete, missing info, QA or any other status, then delete it from transmit pool. 
22.One more thing after discussing with the team, just like in DTEHR, we need to have tracking logs for the changes the biller made. First, when have two tracking logs need to record, one is when the biller changes the patient demographics (patmas/patvisit), the second is the patient insurance detail. We will add more categories step by step. We can build a Billing_Logs table with different “type” inside. Need to track the detail of changes of fields, such as “Policy#: from … to … on date/time by who”. One time change (when biller click save) one record for one category (One category mean one action). When displaying the logs, we can have button in Job Summary to display the related changes log for current job (patient/encounter). 
23.ERA/EDI 835 process. I will provide you sample later.
24.Dashboard enhancement.
 
I have gone through all of the previous items and reorganize these unfinished items and list here again to work on later. 
 
Only 5 items left out of these hundreds items. 
 
5. CMS 1500, Tricare payer ID TDDIR check the Tricare radio box for Item 1 just like Medicare and Medi-cal.
6. We will need to add a new menu as “To Do List” for the biller. When biller login, it will default to this page, not the dashboard. These are the reminder jobs/claims that changed to a light orange so they know they need to work on them. So they know what they need to do first every morning once they login in. This “To Do List” currently can contain three sections (Lists), one is for reminder jobs, the second is for reminder claims, the third is for payment (we will design it later). This is kind of a major item, I will discuss with you in details on how to implement it by phone later.
7. For FnEncoder inside billing platform, the regular search (Not advance search), we have “Select” button to paste the CPT code to right panel, but no “Select” button for HCPCS.
8. Remove the Status dropdown list at the top search criteria part if the list only has ONE status. And if there are two or more status in one list, only display these status in the dropdown list and the status dropdown list in “Claim Check Status” need to limited to possible status. For example, “Rejected” Claim don’t allow user to change to “Denied” because Denied is from payer.
9. Add small notes textbox in the right panel for “Dx” “CPT” Coding page (with FnEncoder at the left panel).
 
 
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2/22/2017
1.As in Office Ally, and Amazing Chart, Create a new PayerList in GeneDBS which can be used by all of the accounts. (See attached list we downloaded from Office Ally). This table should have Unique ID, EDI_Payer_no, EDI_Payer_Name, address1, address2,city, state, zipcode,phone,email, fax, website, notes. Basically it will be part of current “InsuranceMas”. This payer list can be used for all of the accounts. 
2.Add HealthPlanList in Genedbs with a unique ID, and Health_Plan, this could be a simple list to prefill some Health Plan name such as Blue Cross etc.
3.In current Hospxxx “InsuranceMas” as link between what Other ID from Dr. Office EHR system (insur_plan_name--OtherID) and the payerList (office Ally)we have in GeneDbs. Basically the InsuranceMas is a small “copy” of the big “PayerList” in Genedbs which is used by this account only. Allow end-user to changes the Insurance Name (insur_plan_prvd) as a description, and Other ID (insur_plan_name) and address. Only field we won’t continue use is the “HealthPlan” field in this table. When biller can’t find a new payer from the InsuranceMas, they can only select from the big “PayerList” in GeneDbs, and “copy” over to the InsuranceMas table. 
4.In each patient Insurance detail, we need to add a new field “HealthPlan”. So for each patient insurance, we will have three fields “HealthPlan”, “GroupName”, “GroupNo”. The BillingJobPost will auto fill in GroupName and GroupNo, while the payment detail and other place such as Job Summary will display all of these three fields.
5.In Job Summary Insurance section, display the list as “Status,Primary,Verified,File,PayerID,PayerName,Policy#,Health Plan,Insurance Name,GroupName,Group#,StartDate,Deductible,Insured Relationship, Insured Last Name, Insured First Name”. Don’t need other fields now. 
6.In patient insurance detail, we need to rearrange the fields too. And also the “insured” field is duplicated with “Insured Last name”, etc. so change “Insured” to “Insured Sex”. 
7.In Payment detail list, Display “Health Plan” “Group_Name”, “GroupNo” from PatInsurance table. In this way, the “Health Plan” go with each patient insurance record, not binded with “InsuranceMas”. The popup list for “Health Plan” popup the “HealthPlanList” in Genedbs to allow biller to select, or biller can type it in “Health Plan” field, then check if the health plan (after replace the spaces and ‘\’) already exist in the “HealthPlanList” in Genedbs, if not, then insert this new Health Plan. Health Plan, Group Name, Group No are all textboxes, so they won’t overwrite each other. 
8.Change all other related places such as Posted Payment, All AR, Excel files etc. for Health Plan field.
 
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2/21/2017
1.In backend BillingJobPost, don’t update the existing Facility table record. (Just like DocMas, only insert or do nothing)
2.In the CMS1500, Item 31, instead of “Facility Name” just put “SIGNATURE ON FILE”
3.In the CMS1500, Don’t allow submit the claim if the payerID or payername is empty.
4.For insurance “verified” checkbox, beside the UserID, please add “Date” (No time) after the UserID.
5.As 2/14/2017, item 5 list, currently the PayerID and error message is displayed in Notes when resubmit, but missing payername. Please have the format as “error message (PayerID/PayerName)” in Notes. (Also in Claims error fields too). Please read previous item list.
6.As in item 5, in 2/6/2017 list, currently when user change a QA-Job to Missing Info Job, the claim was changed to “Draft” which is correct, but the job was not restored back to Missing Info Job List for Historical Job List. 
7.In Job Summary, Patient Insurance List, display the primary insurance first, then Active Insurance, then InActive Insurance as first order by, then the second order by is by PayerName ASC. When fill in CSM 1500, pick the first item from this insurance list too. 
 
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2/16/2017
1.Change “validated” to “Verified”. Change “PreAuthorization” to “Prior Auth#”
2.I have tested the resubmit (for rejected), the error message still did not post into Notes. I will discuss with you in detail.
3.Restore Job fro Historical Job back to To Be Biled pool, missing “Service Date”.
4.In the insurance detail page, rollback the payer name length, actually we need to increase the wider of column of “payer name” in Job List, Claim List.
5.In Job Summary, in Procedure, there are two “PreAuth…#”
6.Rollback the Dx/CPT column size in the list. But add Dx/CPT into Claim List and Payment Report List
7.In Job List/Claim List/Payment Reprot List, add search criteria for CPT code
8.In Payment report, for All A/R account and pending payment,add “Detail” Excel export file button same as “Posted Payment”.
 
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2/14/2017
1.I reorganized the main menu, please check the GeneDbs tables in FNEHR1.
2.Disable the auto refresh functions for “To Be Billed” and “Online Billing”. It causes some confusion during the auto refresh.
3.Upload EOB, Upload Sign-in sheet, need to have the upload date/time. And also make sure the “Delete” function work. 
4.For Upload EOB, display Batch# (FileID in the database table). And also as we discussed before, in payment detail page, next to the “Batch#” textbox, add an icon so biller can popup the list of uploaded EOB (order by upload date DESC), after selection, the Batch# will fill in. Also, once biller click the “view” button next to it, if there is corresponding “batch#” exists in Uploaded EOB, popup the pdf/image.
5.As we discussed last night, when biller resubmit (especially for rejected), copy the “error message” to the Notes. Also, for PayerID, PayerName, I think when we posted to the ClearingHouse/Payer response, we will copy the error message from “billing return” to “claims” table, at this point, we can append “PayerID/PayerName” at the front of the error message and save into claims error field, so during resubmit, the payerID/Payername will be copied to notes too.
6.Add Dx and CPT columns into History Job List. And make the Dx column wider by default (Both in To Be Billed, Online Billing) too.
7.As in “Post New Notes”, end-user can upload file now, please add same “upload file” function to “Status Check” part.
8.As listed in 12/27/2016, we will spend a few days to work on “customized column list” for Job List/Claim List so end users can set which column fields they want to see and in which orders (just like in DTEHR)
 
After above items, here are a few extra items put in the future list:
9.For Job List/Claim List, if the biller set the “reminder”, currently when the reminder days reached, it will display different background color which is very useful. And as we discussed, we will work on “To Do List” later to display these jobs/claims. We will add one more minor thing if the reminder days is NOT zero. Currently we have colorful icon (red/green etc) at the beginning of each item in To Be Billed List to indicate the job status. So if the reminder days is set, we can change this icon to an icon of a “bell” to indicate this job/claim already has reminder set. 
 
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2/13/2017
1.I have added a new status “CAP/EOB”. (See the attached file), please integrate it in, and check if there is any other places needed to be changed (such as claim.cs). This new “CAP/EOB” is one of the pending claim status (same as Accepted/Submitted/Pending).
2.Wording/Labels change:
a.The claim cannot be submitted. E78 is not a billable code. Do you still want to submit the claim to the Clearinghouse 
b.The charge for 99215 is ‘0.00’.
c.Change “Upload PreAut Info” to “Upload Auth Info.”
d.Change column name “EOB” to “EOB/Auth” in Claim List
e.Change “Deactive” to “Inactive” in patient insurance (Dropdown list in the detail), and the words (Deactrive) in the “Job Summary” insurance section.
3.In the Notes (both for job and for claim), add new feature to allow end user to upload/view a file (PDF/Image). So when end user post a new notes, they can actually upload an image file (Just like email attachment)
4.Same as the ‘Big” EOB upload file list, add new menu to allow end user to upload Dr. office “Sign-in Sheet” image files (PDF/Image). So we can put all of these “Sign-in” sheets received from Dr. office into our system to be checked/viewed anytime by anyone.
5.In the new Capitation Details, allow end-user to upload the received Capitation image file.
6.When the last Check ID (In Check Status column) is starting with “M” or “D”, that means the Dr. office people have wrote some notes/upload files, then change the background color for this Job/Claim item to “light green”. Then once the biller see this color, then they will follow up this job/claim.
7.In payment posted/Paid Claim, for the Reduction/Deductible/Copay/CoInsurance (these 4 columns), if the amount dollars is 0.0, then don’t need to display it in the list and in the Export Excel sheet. So the list will look much clear.
8.We will need to add a new menu as “To Do List” for the biller. When biller login, it will default to this page, not the dashboard. These are the reminder jobs/claims that changed to a light orange so they know they need to work on them. So they know what they need to do first every morning once they login in. This “To Do List” currently can contain three sections (Lists), one is for reminder jobs, the second is for reminder claims, the third is for payment (we will design it later). This is kind of a major item, I will discuss with you in details on how to implement it by phone later.
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2/9/2017
1.DataExport, we will need to change the XML file (setting) to only retrieve insurance data from ListPayor, and remove ListPmInsurance setting (back to before), but when we retrieve ListPayor, don’t need to retrieve these old data, only retrieve item which has either DateLastTouched or DateRowAdded (Active needs = 1) within the Service Date range we set in the DataExport. These are new or updated insurance info. to avoid the duplication.
2.For the images, as we discussed before, we need to retrieve only the items for insurance in ImportItems table, only retrieve item which has “DateImported” within the Service Date range we set in the DataExport and also “where Typeofitem='Other' and ((ItemRE like 'Demographics' or ItemRE like 'id%' or ItemRE like '%Ins%' or ItemRE like '%Intake Forms%') and (ItemRE not like '%Inst%')) 
3.For Images, we need to have a function to retrieve ALL patient insurance images or can retrieve just one patient by MRNO.
4.DataExport, for Demographic export, need to export the patient demographic and insurance info (all insurance item from ListPayor table). It can be done for all patient or by MRNO (just like the Superbill retrieve)
5.In Payment Posted list, currently we display all claims with payments, need to just display claims with payment and status=’Completed’. The status <> ‘Completed” even with payment, need to display in “Pending payment List”. The Excel export file needs to be change too.
6.The new “Reminder … “ feature need to display as “Reminder … Days”.
7.Make the “Status Check” function in “To Be Billed” same as “Claim List” ->“Status Check” 
 
However, I have been thinking about this Med Group/IPA and Health Plan database structure in our platform, based on what we learned from Amazing Chart and Office Ally, 
 
9.As in Office Ally, and Amazing Chart, Create a new PayerList in GeneDBS which can be used by all of the accounts. (See attached list we downloaded from Office Ally). This table should have Unique ID, EDI_Payer_no, EDI_Payer_Name, address1, address2,city, state, zipcode,phone,email, fax, website,notes (See the notes in attached xlsx file). Basically it will be part of current “InsuranceMas”. This payer list can be used for all of the accounts. 
10.Add HealthPlanList in Genedbs with a unique ID, and Health_Plan, this could be a simple list to prefill some Health Plan name such as Blue Cross etc.
11.In current Hospxxx “InsuranceMas” as link between what Other ID from Dr. Office EHR system (insur_plan_name) and the payerList we have in GeneDbs. 
12.While in Payment detail list, The “Health Plan” field should map to “Group_Name” in PatInsurance, not to “InsuranceMas” Health_Plan field. In this way, the “Health Plan” go with each patient insurance record, not binder with “InsuranceMas”. The popup list for “Health Plan” popup the “HealthPlanList” in Genedbs to allow biller to select, or biller can type it in if the health plan (Group_Name) is empty. But we need to consider how we link payment with PatInsurance if patient has multi-insurance info. So we need to discuss it more.
13.Add Group No (PatInsurance) in payment detail after “Health Plan”. 
In general, Health plan (Group Name) and Group No (Health Plan#) do not directly link with CMS1500, only payerID and PayerName are in CMS1500. So health Plan and Payer are two separate fields for one patient insurance as we talked about before. So let us discuss more about how to implement it in our database.
 
 
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2/8/2017
1.Currently the biller post payment and also upload EOB (images) for just this claim/payment. But sometimes, we will get a “big” EOB from Dr. Office or from Web Site, or especially later when we receive ERA 835 (EOB) from OfficeAlly, One such “big” EOB contains many claims/payments together, not just one. So we will need to add new menu next to the “Payer Response” to allow biller to upload this big EOB (image or pdf) with a unique sequence number (batch no), a short description, Date/Time of upload. And later this upload list can be used to store the ERA 835 file we download from OfficeAlly. After the EOB file is uploaded, the biller will go to each claim/payment to post the payment based on this EOB file, but instead of upload individual EOB image file, the biller can select one corresponding EOB file from the list of uploaded EOB (sorted by upload date DESC), and link this claim/ payment with one existing EOB. In this case, biller just need to upload once, then linked it with many claims/payments. After the link, user can still click the “EOB” link to view this “big” file just like they upload individual EOB file. Later, when we have ERA, then program will process ERA and auto post the payments for each claims inside the ERA 835.
In a short word, one EOB/ERA match many Claims/Payments.
 
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2/7/2017
1.Under payment reports, add “CoInsurance” in the lists (Same as the Excel Export file) after “CoPay” column.
2.CMS 1500, after check the ICD10 codes, and popup confirm message (Yes/No) to allow biller submit the claim if biller answer “Yes” to continue
3.CMS 1500, when submit the claim, don’t allow submit if any amount is zero for CPT code (line). 
4.For “resubmit” claim list, only display the claims with “Accepted”, “Submitted”, “Pending” status. Don’t display these Completed/Denied etc.
5.In Job Summary, Visit section, File “View” link. Don’t display the “View” link if there is no uploaded image associated with this visit (not this patmas). Example, MRN 2893 in 0852 accounts, two visits (two services date, one with upload image, one without, but both have “View” link in the Job Summary). 
6.For the Faxout list, only need “Address” (Street field in the database table), please remove “City,State,Zip” from the web page list (Still keep it in database now)
7.In payment detail, for each CPT lines, at the end, add a checkbox “Capitation”, when biller post the payment, they can check this checkbox to indicate this CPT has “Capitation” applied.
8.In “Check Status”, currently the note is only one line, please make it three lines, so it is easy to view and user can write more notes into it
9.Still in “Check Status”, besides Date/Notes, please add a “Reminder” field with a small textbox and after text box put “days”. Default is empty. User can set like 10 days, or 5 days. When 10 days passed, (From today date to the last checked date), then turn this claim line to different color (such as light green) to remind the biller it is time to check the status of this claim again. It will be useful for these Followup claim, Denied claims etc. Just like the TAT time out in Transcription.
10.For FnEncoder inside billing platform, the regular search (Not advance search), we have “Select” button to paste the CPT code to right panel, but no “Select” button for HCPCS.
11.CMS 1500, Tricare payer ID TDDIR check the Tricare radio box for Item 1 just like Medicare and Medi-cal.
12.Add a new menu under “Payment Reports” as “Capitation Report”. A simple list first, Six columns, Date Period (Text Box), Status (Active/Deleted), Payer ID, Payer Name, Capitation Amount, Enter Date, with Add/Edit popup small detail page to add/edit the list. 
 
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2/6/2017: 
1.The word “Price” spelling wrong
2.Under Payment Reports, for all Export Excel sheet, we had “Deductible, Reduction, Copay”, Need to add one more column “CoInsurance”
3.Error message when click “Payment Posted”, ”Detail List”
4.Add new “Reload” button in CMS 1500, (Already done, need more testing)
5.For “QA -Job”, Add “Missing Info, textbox, change button” at the top of the search criteria, and add checkbox for each list item (Make it exactly same as “To Be Billed” list. So end-user move this job from “Historical Job List” back to “Missing Info” Job list, and change the Claim status from “QA-Job” to “Draft”. I will discuss more in detail by phone with you. 
 
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2/2/2017
1.Please change all of the wording “Insurance Name” to “IPA/Group Name”. As in my separated email, the “Health Plan” is these big health care organization with different plans such as Blue Cross, Blue Cross/HMO, Blue Cross/Medi-Cal, LA Care, LA Care/HMO, LA Care/Medi-Cal etc. While these health care organizations do not want the Doctor directly bill them, so these “IPA/Group” are the “agency” between doctor and health plan. Such as “CVPG” (Citrus Valley Medical Group) can be “agency” for “Blue Cross”, or for “LA Care”. “Alta Med” is another “agency”. When we submit the claim, in the most cases, should submit to “agency” first, then if “agency” reject it, then submit directly to Health Plan.
2.DataExport and BillingJobPost need to be modified a little for “Amazing Chart” database. For account 0852, I found out the new insurance data was stored in a new table “ListPmInsurance” due to their new PM system merged into Amazing Chart. The data in “ListPayor” is only up to 6/8/2016. So DataExport need to retrieve insurance from ListPMInsurance NOT from “List_payor”. For BillingJobPost, things are a little complicated, The “PlanName” should match with InsuranceMas “OtherID”. In Other ID, I have put multi “PlanName” separated by “;” so multi PlanName can match into one record in InsuranceMas. While “GroupNo” or “GroupName” should match with InsuranceMas “Health_plan” field. But because all of these fields in Amazing Chart are manually typed by Dr. Office clerks, so there are a lot of misspelling. When we do the matching, we should remove space, ‘\’, ‘-‘ first. And match using GroupName first, if GroupName is empty, then use GroupNo. If there is no Health plan matched, use the one with empty health plan in InsuranceMas. Insert new one if even the “OtherID’ can’t be matched. If Expiration Date is not empty, then set it as “Deactivate” in PatInsurance table. 
3.As you can see in “ListPmInsurance”, In our PatInsurance, we need to add more fields for “PatientRelToSubscriber”, Subscriber Last/First Name/DOB” etc. Display these in Job Summary page. And auto fill in CMS 1500 for these subscribers info. including the Relationship if these fields are not empty.
4.Besides matching the “InsuranceMas” table, directly import GroupNo, GroupName from “ListPmInsurance” into “PatInsurance. Group_No” and new field “PatInsurance.Group_Name”, so biller can go to check when “match” is incorrect, then biller can reselect the correct one based on GroupName.
5.In Patient Insurance detail page, with these new added fields “Group Name”, “Insured Name DOB” etc. field, we need to reorganize the page, move “Insurance Name” etc. these read only field to (IPA/Group Name) to the top, and move down these editable fields such as insured last name/dob/address. Most of these editable fields will be empty now. And also currently Insurance Plan display our own ID and with selection icon. So we can make this Insurance Plan textbox smaller, and change the selection icon to a bigger button as “Select Insurance/Plan” (See below screen capture)
6.In Patient Insurance detail page, add new textbox for “Capitation”. Allow end-user to enter dollar amount. This field will be used later for billing doctor for service fee.
7.In Payment posted detail page, in the CPT detail part, we need to add “Units”, “Units Price” before “Billed Amount” because for one CPT code, the unit price can be $30, with 3 Units, so the total billed amount is $90. (CMS 1500 is doing this way already) Of course, in most case, Units will be just 1 (by default)
8.In Payment posted detailed page, make the page wider, so we can replace “Other Amount” into four columns “Deductible”, “Reduction”,“Copay”,”CoInsurance”. Use current existed “OtherAmount” as “Copay”, and add three new fields into payment_detail table. Same as “Applied Amount” field, once biller enter dollar in these columns in CPT detail, auto sum together and fill in the top part corresponding field. 
9.In Job Summary page, the Claim List section, need to replace “Other Amount” with these four columns for each CPT lines. And same as in Payment Detail CTP lines, add Units, and Unit Price before billed amount column.
10.Same in all Export Excel sheet, for each CPT line, the link of these four columns (Copay, CoInsurance, Deductible, Reduction) need to link to “payment_details” new fields, NOT link to “payment” table. (Currently, since it link to payment table, we have duplicated “CoPay” amount for each CPT line under one claim. So replace “OtherAmount” field in payment_detail with four fields and link export excel and job summary to payment_detail.
11.In Job Summary page, the ClaimList section, add “Billed Date” and “Biller” (Biller Init) columns after “Status” column. 
12.One minor bug, in Payment Posted, EOB column, it still show “New” even there is EOB file. 
13.As suggested by Yoyo, for these uploaded images files, allow name the label, add notes, sorting, and view images together one by one without close the popup image windows. 
14.Need to have a list of new tables and SQL SP for billing platform in both GeneDbs and Hospxxxx 
15.Same as before, after above items, continue with the previous remaining items.
 
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1/24/2017
1.BillingJobPost for posting patient “Demographic.csv”. The last name last, first name reversed in patmas, (It is correct in “To Be Billed”). This needs to be fixed. Actually it caused quiet confusion today, and I have switched last/first name in database already.
2.For “InsuranceMas”, “DocMas”, “Facility”, these three tables, we are using “OtherID’ to match between our list and Dr. office imported info. But since Dr. office has a lot of “spelling error” especially for Insurance companies, so the BillingJobPost will insert a new record if there is no match, but don’t update the existing InsuranceMas or DocMas or Facility IF there is a match in “OtherID”. In a short word, insert only not update.
3.The “DataExport.exe” is a powerful and good tool to retrieve info directly. Currently we can retrieve info (XML) by set a service data range. Please add new option to retrieve MRNO+Service date. In this case, if there is any info missing for particular billing job, I can just get that info. for that patient and service date.
4.Currently, only need to fill in “atnd_dr” in patient visit. Don’t need to fill in Admit/Refr Dr. etc. We will add these later when we have such request. 
5.We will copy back all of these images (scanned pdf/jpg files for insurance card etc.). These images are stored based on patient MRNO (same as us). So we may need to have small function to search all of the file names under “MRNO” folder and insert corresponding fielpath into “upload_eob” table (as “Other” file type). I will discuss with you in more details by phone.
6.“To Be Billed”, “Online Billing”, “Missing Info” and “Historical Job List”, the column “Payer Name” should display “Insurance Name” and not “OtherID, and also change the column title form “Payer Name” to “Insurance”.
7.Doctor’s office user log in should be able to create Notes using Check Status in “Missing Info” (Job Management), Denied Claims List and Followup List menus (Only these three menus now). Once they click on New under Check, make the Notes box bigger so the user can see what they are typing.
8.In “historical Job list” change Biller Name to the Biller’s Initials. 
9.In Login Screen, hidden the radiobox selection for Doctor/Other. For billing/Coding, all of the users including Dr. Office user are by default is “Other”. So don’t need to show this selection in login screen.
 
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1/23/2017
1.We will still utilize EDI 837 importing, and Patient Demographic CSV importing in the future. These are standard file exchange methods, especially EDI 837 importing, when we deal with other EHR system. After all, Amazing Chart is just one of the EHR vendors in the market. 
2.For BillingJobPost, as what you did, by default, importing all “BillingICD” (sort by the field “SortOrder”, 1, 2,3 .., if the Dr. input correctly, the Record 1 such as Z00.00 should be the primary ICD10 code) for this patient/visit (based on Date Of Service). But we can add new setting in BillingJobPost.exe. The setting will be based on Account to completely ignore the “BillingICD” (the ICD10 codes inside PatMas\PatVisit\BillingJobInfo\BillingJobList\ICD). With this checkbox, we can config the importing based on 0851 or 0852 accounts. 
3.When one visit has multi-CPT code, Sort CPT code by “Sequence” field.
4.For “ListProblemForEncounter”, (PatMas\PatVisit\BillingJobInfo\ProblemList), it is better to import all of the problem ICD10 codes for this visit into “PatVisitProbList” table (the “DateActive” in XML file is kind confused, when we display this date in our system, should label it as “First Occurred On: “). And all of the problems in this list are still for current Visit/Encounter. When display this problem list under each Patient Visit, need to clearly display the MRNO, Patient Name and Service Date on the top of the list. 
5.If “ignore the BillingICD” checkbox is checked for this account, then auto select the top 4 ICD10 codes into Job Summary for CPT code. Order by “DateRowAdded” DESC (Not ASC), so the recent ones will be selected. (Or ListProblemForEnconterID DESC). Also, the set “Deleted =FALSE”(See below screen capture)
6.“ListProblem” table is for all of the problems for this patient together. we can retrieve it into XML, but don’t need to import into our system now because the “ListProblemForEncounter” is enough for current visit (one Billing Job). 
7.For 0852 (Dr. Moya) account, based on the Database I sent to you, please help generate a complete Demographic.csv (They have around 3000 patient these years), then I can use current BillingJobPost.exe function to import all of the patient/insurance info. for this Dr., then the future info will be retrieved by “DataExport.exe”
8.Make sure “CC” field is imported and displayed in Patient Visit page as “Reason of Visit”. And display it in “Job Summary page” in the “Visit” section.
 
 
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1/22/2017
1.For Item23, Pre-Auth field, I tested it again, please change it to “REF*G1*….”, (Not REF*9F*..). I found out OfficeAlly only accept G1, not 9F even both of them are for Pre-Auth.
2.For these rejected claims, the biller will correct and resubmit them. In the “Notes”, the program recorder who and when submit it. There are two things, one is don’t use biller name inside the notes, use biller init, second is for these resubmit (rejected list), if there is error message, then program auto “copy” the error message inside the submit notes before who and when submit it, so other people know why biller resubmit the claims and what is the previous error.
3.For “Send Fax”, please add some extra fields: groupno, address (will contain street, city, state, zip all together), officename, phoneno. Display these fields in the list too. I will fill in these fields.
4.For “send Fax”, add 5 “prefaxdate”, when we refax, it will move current faxdate to these previous faxdate fields, so we can tracking. (Just like the password in UserReg table). Display these previous fax date in the send fax list too.
 
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01/13/2017:
1.The new CMS 1500 Address printout (Top) part is exactly what we need, but just need to move the whole thing two lines up, and also for “Address2”, we may need add “\n” in the address2 field, so the program will replace carriage return during printout to print two lines. (So the total address will have four lines instead of three lines).
2.The new “Not Completed” claim list need to be auto refresh after end-user change the status in “Check Status” column just like others.
3.Add “Notes” column in “Historical Job List” same as other job list.
4.When end-user fill in the missing patient DOB in demography page, it won’t display in “To Be Billed” list
5.Add Claims “Status” column in Payment Reports list (three lists) after jobno column.
6.Auto calculate the Balance (Set it to 0) when biller post the payment and save it. Don’t leave balance as NULL.
7.In Job Summary page, the Claim section, it is very useful to display these claims. Just need to improve one thing, need to display the CPT code (ICD10 code is displayed already) even there is no payment for this claim.
8.Days in A/R is calculated wrong in all of the claims lists for completed claims. Should be from “Billed Date” to “payment date” (Not current date), just like in Payment posted list. Also we will need to save the first claim billing date in to the “historical job list”. And if there is second or third claim, then the “Days in AR” will be calculated from the first claim billing date to payment date. Anotehr thing is for the Average days in AR in dashboard, need to calculate the AR in payment posted list only, not every claim. I will discuss with you more in detail by phone.
9.I made a minor change for Claim.cs to popup “Full” job summary in all of the “claims list”. (See attachment) But please modify it further so when “DR Office” user type login, then the job summary in all of these claim list and all job list should be “view only”. (the simple one page). Other user type (biller, staff) still use the “Edit_billing” function.
 
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01/12/2017:
1. For importing EDI837 for account 0851. Some of these 15 patients which missing from pending list caused by two reasons: Dr. did not enter CPT at all, so for course NO “superbill” can be created, second, the Dr. even forgot to enter service date (NO encounter at all). For these two cases, we can’t do anything to auto generate pending job list. But maybe we can move them to “Uplaod File “ part waiting for more info. to be uploaded.
2. In all Notes part, where “posted by…” use Biller Init NOT biller full name (same as in the list)
3. Payment Posted List in Summary Tab, make “PayerID/PayerName” corrected.
4. Add new top level menu “Claim Status”, move “All Claims”, “Completed with Payment” under this menu, and add new item as “Not Completed” (The name will be change later) to include all claim status<> “completed” and not in “Deleted”, “write-off”.
5. CMS 1500 address print out at the top. The first line using “Address2”, if “Address2” is empty, then use “Insurance Name”, the second line using “Address1”, then third line City/State/ZIpCode. See the image I capture from OffcieAlly I sent to you before.
6. In Dashboard, change the wording “pending Claim” to “Submitted Claim”. 
 
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01/11/2017:
1. For FaxMonitor.exe, we need to add one minor feature to process the feedback from FAX. (Same output fax directory). The file name actually is same as INF, but with XML. The content is exactly same as INF. The IFAX program will “input” the INF file, and start the faxing, then output the “XML” file once it success or fail. So we need to get the Fax_Document field and status. And then match the “faxoutpool” with Fax_Document and update the status (just the number) into a new field “Error”. (0, or 7 or 256 actually 0 Error code means successfully. After process XML file, then delete this XML file. See attachment for example of XML.
2. For account 0851 (or any other accounts with AmazingChart or EHR system), we will upload CCDA for each Visit (See some examples of such CCDA file in the attachment). This CCDA is for each visit (encounter), under Encounter, doctor put a list of ICD10 codes (Assessment). However, these codes are displayed in SONMED-CT format, our biller can’t convert to ICD10 codes. SO when end-user upload CCDA in patient “Visit” page or “Demography” page, please have the program just process the Encounter section to extract these ICD10 codes and update to the “Job Summary” Diagnosis list (skip if it is already exist and insert new if not) based on Service Date in this Encounter section. See below screen capture. (or at this point, we can consider a small backend program to process CCDA The BillingJobPoster )
3. I attached a EDI837 file for importing, can you help to check how many CMS1500 in this file. I expected around 76 “superbill”, but it actually 60. So just want to verify with you.
4. The “Upload/View File” in patient demography/Visit page works good in Google Chrome, but somehow the popup windows for upload/view file is blocked by IE
5. In Diagnosis page, in the left pane, currently we have arrow to move ICD10 code up/down. We learn from AmazringChart that in each line of ICD10 code, there is small icon, after click, it popup to allow end-user to enter a number, for example 2, then this ICD10 code can jump to Item2, then the rest of items will move to 3, 4 etc.
6. Please let me know where to buy CPT code for 2017. We did last year maybe around $50 per year. After we got the newest 2017 CPT library, then we can update our FneEncoder and Billing.
 
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01/10/2017
1.I did a minor change in CLiams.js around line 256, so in “Followup Claim List”, the click on job_no will popup full “Job Summary” just like “Deined Claim list”. Please make the change on your side.
2.I made minor change in three SQL SP to export Excel files under Payment Reports. Please change the lists: Pending payment (with export list), Cliam Payment, and All A/R account to exclude the “Deleted/Write-Off” claims. We don’t need to show these deleted/writeoff claims under “payment reports” (for doctor to view) and Excel file.
3.When end-user change the status of the claim in “Check Status”, Genedbs..ClaimPool.status is changed, but make sure the hospxxx.CLiams.status is changed too. Now they inconsistence.
4.for fax, the whole workflow works fine, two minor changes, one is changing filename “Fax…XML” to “Fax…INF” (INF, not XML), inside file is exactly same. Second, the tif file header has problem when there is NO “replacement for doctor name/faxno’. SO in this case, if the “setting” in the fax_templete is empty, just directly copy the tif file over. (Attached is the tif file)
5.Please change the file location for fax_template file form “CodingFS” to “MedI”+”Fax_template”. (We will use MedI in the most case in Billing for image/templates etc )