2010 Second Quarter EDIinsight Hotfix by 7Vl7vc


									2010 Final Release

We are very excited about this release and all that it entails. Along with our normal software
enhancements we are also updating our databases to a newer version of PostgreSQL. Due to the
extensive nature of this release, it will be our last release of the year. The release will take place
throughout the months of November and December. Each of our servers will have a dedicated release
date to ensure proper migration to the new database version.
Additional database changes have been made to data tables in preparation for 5010. The Claim table has
been split into two tables: Claim table and Claim Data table. This change should result in faster queries
and better overall performance. Fields that the application uses as search criteria in Claim Manager will
remain in the Claim table. This change will not affect the way that data is reported back in the Change
Log for integrated customers. This change will affect Custom Rules as the correct table will need to be
selected when creating a rule. Practice Insight will run a utility to update any existing customer rules
during the upgrade.

Entire Application
       Throughout the application we have updated the Provider Selection window so that by default
        sorts by Provider Last Name, First Name or Practice Name.

Admin Tools
       A new option called Communication Manager has been added to the Task Manager main
        screen. Communication Manager allows vendors to send notifications to a customer. When a
        user logs in to Task Manager, notifications will display on the bottom of the screen in the new
        Communication Center section. A user must have Task Manager in order to receive notifications.
        A separate document will be available to walk you through creating notifications.
       In Rule Manager the Message and REASON FOR RULE fields have been increased to
        accommodate more characters.

Claim Manager
       Unit Price field on the Transaction Drug Identification window has been converted to a money
       The claim Change Log will now log when an EDI receiver on a claim has been reset.
       Create Secondary Claim feature has been corrected to include all line level adjudication
        information. An issue was occurring for charges less than a whole dollar amount.
       Appeal Letter will always print Reason for Appeal. Reason for Appeal was not printing if the user
        did not click MARK APPEALED prior to printing.
       Insured Last and Patient Last search fields have been enhanced to include up to a 3 alpha letter
        range in the patient name search. Users can now search by a-b, aa-br, or aaa-brz. For example if
        you specifically wanted the range of Jones – Madison you could use a search of jon-mad.
       Added the CMS-847/DME 04.04C Osteogenesis Stimulators form to Supporting Documents.
       DME Forms have been updated to show the correct provider information in the Physician and
        Supplier boxes. The Supplier box now shows the Billing Provider. The Physician box shows the

2010 Final Release-11/17/2010                                                                 Page |1
       Ordering Provider. If no Ordering Provider is sent on the claim, then the Physician Box displays
       the Rendering Provider.
      DME Forms will now populate Section A: Certification Type/Date.
      NDC Information has been added to the View CMS/UB04.
           o   CMS-1500 form: NDC code sent in Loop 2410 LIN03 will display in Box 24A shaded with
               NA qualifier. Box 24D will display NDC Unit of Measurement and Quantity.
           o   UB04 form: NDC code sent in Loop 2410 LIN03 will be in FL43 description. The qualifier
               N4 will precede the 11-digit drug code.
      The ANSI file viewer has been enhanced in preparation for the transition to 5010. One of the
       noticeable changes is the Loop Headers are now displayed in bold font.
      The ANSI file viewer for ANSI 275 (Electronic Attachments) will no longer duplicate each
       segment line.
      The MREP EOB View will always show the EOB View header. There were instances that when an
       ERA came back that had all payment reversals and negative payments, the EOB View header was
      The MREP EOB View had a duplicate header between the totals line and the glossary; this has
       been removed.
      Updated the format of the Real-Time Claim Status Response.
           o   Moved Claim Amount, Paid Amount, Payer Reference, Claim Date, Pay Date, Patient,
               Adjudication Date, Payment Method, and Medical Record # to the Status Grid.
           o   Display transaction payment level adjudication information if available.
           o   If the payer returns multiple statuses, all statuses will display in the grid with the most
               recent first.

2010 Final Release-11/17/2010                                                                    Page |2
Claim Loaders and Builders
      Both Professional and Institutional claim builders have been updated to strip the ‘$’ symbol
       from dollar amounts that were entered by users with thinwin v1.38 or higher. This problem was
       occurring with the unit price field in the CTP segment.
      The NSF loader has been enhanced to accurately pull information from the GX0 and GU0 lines
       and map them to the corresponding DME Forms.
      Both Professional and Institutional builders have been updated with logic to insure that Loop
       2320 (Other Subscriber Information) is built in the correct order in outbound batches.

Customer Record
      Modified Customer Record Tabs to include more options.
           o   Customer Information Tab

                      Removed Audit Details and Claim Clerk.
           o   Setup Specifications Tab

                      Added CLAIMS LOADING and RESPONSE DELIVERY section headings.
                      Added Claim Clerk to the CLAIMS FILING section.
                      Added Scrub Response to the RESPONSE DELIVERY section. This allows SFTP
                       users to receive the MEGAS Scrub responses in their SFTP response directory.
                       Select ‘XML’ or ‘HTML’ or both.
                      Added Change Log to the RESPONSE DELIVERY section. You can check ‘Yes’ if
                       you would like to receive the Change Log in your SFTP response directory. If you
                       are requesting Change Logs via HTTPS in Real-Time, this option does not need to
                       be checked.
                      Added the AUDIT Details button. AUDIT Details will be utilized on Dashboard
                       Reports and the new Message Center in Task Manager.

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                      Added the CUSTOM Files button. Click on this button to see logo files,
                       postloaders, CMS/UB04 print image mapping spec files, and default settings.
                      Added the ANSI format option to the Claim Response field in the RESPONSE
                       DELIVERY section. Select this option to receive responses in a 997 and 277
                       format instead of PI flat file format responses.
                      Removed the CLINICAL SCRUB and STATEMENTS sections.
           o   Additional Services Tab

                      CLINICAL SCRUB Settings have been moved to this new tab.
                      SCRUB Dates have been added to Customer Record. Registration Date will show
                       the date the customer was registered. Accepted Date will show the date the
                       customer accepted the clinical claim scrubbing agreement. Termination Date
                       will show the date the customer terminated clinical claim scrubbing service.
                      STATEMENT Settings have been moved to this new tab.

Eligibility Manager
      The 270 builder will no longer create an INS segment if the patient relationship is not set.
      Eligibility requests will now be resent up to 5 times instead of 2 when a payer doesn’t respond.
      The Notes Column will now display the coverage status of the patient. In some instances it was
       showing the coverage status of the subscriber.

ERA Manager
      Insured Last and Patient Last fields have been enhanced to include up to a 3 alpha letter range
       in the patient name search. Users can now search by a-b, aa-br, or aaa-brz. For example if you
       were looking for Jones – Madison you could use a search of jon-mad.
      Fixed the ERA Print List. It will no longer print the same ERA Transaction multiple times.

MEGAS/Claim Scrubbing
      The registration process has been updated to prevent users from including an underscore
       character ‘_’ in submitter ids. This caused problems in the registration process.

Search Tools
      Updated Clinical Claim button to point to the new Claim Staker URL: https://www.alphaii.net/.
       This was added back in September but was not documented in the Q2 2010 Release.

2010 Final Release-11/17/2010                                                                  Page |4
Report Manager
      Claim Status by Payer Report has been enhanced.
           o   Report header now features blue shading.
           o   Subtotals have been added to the Payer Type. The Payer Type has also been highlighted
               in gray.

      We have added a new Dataminer report: the Transaction Analysis Report. This report will
       analyze procedures that have been submitted on claims. The Date selections allow you to select
       procedures submitted in a certain date range for a customer. Vendor and CBO level users can
       leave the customer selection blank and see submitted procedures for all customers. When the
       report first launches it will display Procedure codes, Quantity submitted, and Dollar Amount.
       Data blades can be used to drill down further into the claim data or transaction level data.
       Some available data blades are: Provider, Facility, Modifiers, and Payers. This report is different
       from the Claim Analysis Report in that the Claim Analysis report shows you information about
       the claims you submitted while the Transaction Analysis Report allows you to see information
       about the procedures you submitted.

2010 Final Release-11/17/2010                                                                 Page |5
      Added Dashboard as a new class. Dashboard Reports can be run from Report Manager or from
       the new Dashboard.

      ERA Manager Reports have been added to Report Manager so that customers have more places
       within the application to access their reports. Customers will still have to have a fee setup for
       ERA Manager and at least VIEW Level permissions for ERA Manager to view and run the ERA
       type reports. If a customer does not have ERA Manager View Level permissions the ERA
       Manager reports will not display in the report list.
      Claim Status Summary Report, Claim Status by Date Report, and Claim Status by Payer Report
       now have an option to exclude test claims.

Task Manager
      The Task Manager Window has been modified to include our new Communications Center and
       our new Dashboard reports. The Communications Center is at the bottom of the Task manager
       screen and replaces the location of the old Dashboard reports. The new full screen Dashboard
       Reports can be accessed by clicking on the MY DASHBOARD button.

      The new Communications Center replaces the old Dashboard reports on the bottom portion of
       the screen. This list will display all unread notifications from the user's vendor. The vendor can
       create the notification from within Admin Tools, using the new Communication Manager.
       Please refer to document 2010 Final Release-Communication Manager for more information.

2010 Final Release-11/17/2010                                                                 Page |6
      All current Dashboard Reports have been updated and new reports have been added. Reports
       are available to configure in the new MY DASHBOARD section of Task Manager. Dashboard
       reports can also be accessed by going to Report Manager and selecting the report class of
       Dashboard. Additional documentation will be sent out to discuss the purpose of each report.
      Patient Range field has been enhanced to include up to a 3 alpha letter range in the patient
       name. Users can now search by a-b, aa-br, or aaa-brz. For example if you were looking for Jones
       – Madison you could use a search of jon-mad.
      Rearranged the CLAIM Task screen. The Rule ID List, Response ID List, Scrub Type List, Scrubbing
       Errors, Warning Errors, and Secondary Ready filters were moved to the third column.
      Added an Include/Exclude option to the following list filters in Claim task types:
          o Rule ID List
          o Response ID List
          o Scrub Type List
      Added an Include/Exclude/Only option to Staff Assigned.

      The Staff Assigned feature has become a multi select field.

      Moved the Task Description to the Task title bar in the Items window. This was done for Claim
       and Bill task types only.

      Fixed an issue that occurred when vendor level users filtered tasks by a customer. It sometimes
       showed tasks for multiple customers.
      Fixed an issue that was occuring in the Print List for ERA tasks. It will now Include/Exclude Status
       Messages based upon what you select.

2010 Final Release-11/17/2010                                                                   Page |7
      Tasks assigned to vendor level users will be hidden from customer level users when filtering
      Added the ‘Check RT for all selected records (r)’ option to the right click menu on the Eligibility
       Selected Items window.

User Class
      Added a new menu option to User Class, USER 85: TASK_ELIG_SRCH_SUP. This menu will give
       customers access to Task Manager, Eligibility Manager, Search Tools, and Support Manager.

2010 Final Release-11/17/2010                                                                   Page |8

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