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Overview

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The Practice: New and Practices: [name] pages are comprised of fourteen tabs:

The Miscellaneous tab includes miscellaneous options for processing case information, payments, and other pertinent information in Connect Back Office and Connect Front Office.

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titleHow to Get Here?

To open the Miscellaneous tab for new practice:

From the Home Page:
From the Menus:
Via Shortcut Keys: 
  1. Click Practices from the Admin list 
  2. Click Create
  3. Click the Miscellaneous tab
  1. Open the Admin menu and select Practices
  2. Click Create
  3. Click the Miscellaneous tab
  1. From the Practices page, press [Alt] + [C]
  2. Click the Miscellaneous tab

 

To open the Miscellaneous tab for existing practice:

From the Home Page:
From the Menus:
Via Shortcut Keys: 
  1. Click Practices from the Admin list 
  2. Select the practice to be modified
  3. Click Update*
  4. Click the Miscellaneous tab

*Alternate Navigation: Double-click the practice from the list

  1. Open the Admin menu and select Practices

  2. Select the practice to be modified

  3. Click Update*

  4. Click the Miscellaneous tab

*Alternate Navigation: Double-click the practice from the list

  1. From the Practices page, select the practice to be modified
  2. Press [Alt] + [U]
  3. Click the Miscellaneous tab

 

(Click an image below to enlarge.)

Practice: New Page / Miscellaneous Tab

 

 

 Practice: [name] Page / Miscellaneous Tab

 


 

Field Definitions

Field

Type

Required

Description

Small Balance Writeoff Section   
Enable mass writeoff of small balance procedures  Checkbox  No 

Specifies criteria for automatically writing off small balances that originated from a procedure. A small balance must meet all of the following criteria to be eligible for writeoff:

  • Minimum number of days at guarantor responsibility - The the balance must have been in guarantor responsibility for the indicated number of days.

  • Write off guarantor responsible procedures when their balance is less than $XXX.XX ___, but only if current balance on the account is less than $XXX.XX ___.

The drop down box specifies what Transaction CodeDrop Down No

Specifies what transaction code the small balance writeoff is posted under.

Minimum number of days at guarantor responsibility    
Write off guarantor responsible procedures when their balance is less than    
But only if current balance on the account is less than    
Transaction CodeDrop Down   

Required if Enable mass writeoff of small balance procedures is selected.

Payment Entry / Collections Section   
Disallow posting individual payments  Checkbox No 

Prevents the posting of individual payments within a payment batch. When this option is selected, payments may only be posted from the Payment Batches page. This option is available only when the Payment Batch: [ID] > Expected Count and Expected Total values match what was entered during payment entry.

Re-age service fees when re-billed (with no change in responsibility)  Checkbox No 

Resets the responsible balance date to the rebill date, given that responsibility remains the same (guarantor to guarantor, primary to primary, etc.). Unchecking the option will continue to recognize the original If unchecked, the original bill date is recognized as the responsible balance date.

Only option Option is checked by default.

Expected Allowed Tolerance 

Free Text

(Numeric)

No 

Specifies the over-under criteria the that the Actual Allowed amount from an EOB must exceed beyond the exceed the Expected Allowed meet  amount for inclusion in the Payment Exceptions Report, which is generated from the Payment Batch [ID] page in Back Office.

If an Actual Allowed amount from an EOB either exceeds the set thresholds, the amounts entered in these fields will determine if the payment is included in the report. You may enter either a dollar amount or a percentage (of the total expected allowed amount). If both values are entered, the inclusion in the report will be is decided based on the lesser amount.

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Example: Tolerance is set to $5.00 or 1%.

Expected allowed for procedure

The Expected Allowed amount for Procedure 99213 is $100.00.

We would return two values as

Two values returned as a tolerance for the above: $5.00 and $1.00 (

100 x

$100 * .01), so

we would return

this is returned on the report if the actual allowed entered is $98.99 or $101.01, because the percentage is the lesser of the two.

 

  

Force service to internal collections if expected does not match allowed  Checkbox No

Forces service fee lines that are outside of the Expected Allowed Tolerance range to internal insurance collections and the action type assigned via the drop-down box is initiated. This functionality is similar to checking the Collections check box in the current payment entry environment.Examples (given that the allowed amount is outside of assigned Action Type assigned is initiated.

Examples:

  • Assumption: Allowed Amount is outside the Expected Allowed Tolerance limits
)
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Example 1:

1. The practice
  • Practice expects $1,000 from Primary Payer 1 for Service X.
  • Primary Payer 1 allows $800.

Service (fee line) X is automatically moved to internal insurance collections and the default Action Type indicated on the Miscellaneous tab is initiated for Primary Payer 1.

2. The practice
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Example 2:

  • Practice expects $1,000 from Primary Payer 1 for service X.
The primary
  • Primary payer allows $1,500.

Service (fee line) X is automatically moved to internal insurance collections and the default Action Type indicated on the Miscellaneous tab is initiated for Primary Payer 1. Since $1,500 pays the practice more than expected, sending the service fee line to internal insurance collections is a means to notify the practice that the allowance should be investigated.

 

Action TypeDrop DownNo

Defines the type of action initiated if the services fee lines are outside the Expected Allowed Tolerance range and sent to internal insurance collections.

To enable the Action Type drop down, check the

Only enabled and required if

Force service to internal collections if expected does not match allowed

box.
Action Type   

is checked.

Front Office Section   
Use freeform procedure entry Checkbox NoIf checked, allows Allows freeform typing in the Procedure field, which is located on the New Patient/Provider Appointment window in Front Office. Checking this option prevents the Procedure drop-down list from appearing.
Auto populate provider asDrop Down  Yes

The options include:

  • Anesthesiologist - causes
Choosing Anesthesiologist will cause
  • the Anesthesiologist field in the New Provider Appointment window to auto-populate with a list of practice providers and can-schedule providers. The Primary Surgeon field will auto-populate with a list of referring physicians.
Choosing
  • Primary Surgeon
will cause
  • - causes the Primary Surgeon field in the New Provider Appointment window to auto-populate with the list of practice providers and can-schedule providers. The Anesthesiologist field will auto-populate with the list of referring physicians
.This option was previously located in Front Office
  • .
Charge Entry Section   

Case requires referring physician

 Checkbox No 

Designates the Referring Physician field as required in Back Office.

Coding must be complete to create cases from image sets

 Checkbox No

Blocks the creation of a case from an image set in Back Office before the Coding form is completed in Image Batches of Back Office. By default, this option is not selected. To restrict cases from being created from image sets before the Coding status is complete, check the box. To allow cases from image sets regardless of the Coding status, leave the check box checkbox blank.

Allow excluding provider time from concurrency checking

 Checkbox No 

Allows users of Connect Back Office to check the " Exclude (provider time segment) from concurrency checking option when using the Add/Update Provider Time form in charge entry. Excluded minutes will continue to be considered in total case time and start/stop time. When a time segment is excluded, a pop-up alert appears.

Use directed minutes as billed minutes

 Checkbox No 

Uses the directed provider's minutes as the billed minutes for the purpose of calculating directed provider billed minutes and time units.

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Example Case:

  • Directing Provider: 09:15 – 09:45
-
  • Excluded Directing Provider: 09:46 – 11:15
  • Directed Provider: 09:46 – 11:15
  • Case should display the following:
    • Directing Minutes – 120
    • Directed Minutes – 90
    • Anesthesia Start – 09:15
    • Anesthesia Stop – 11:15
    • Concurrency Checked for – 09:46 to 11:15

Assuming a 100/100/100 split, 15 mins = 1 Time Unit and we

Round

round up to next unit on the fee schedule,

we will calculate the

following is calculated for each provider type:

  • 5 Base Procedure @ $100 per unit
.
  • Dr (Directing) Minutes – 120
,
  • Time Units – 8
,
  • Billing Fee - $1,300.00
  • CRNA (Directed) Minutes – 90
,
  • Time Units – 6
,
  • Billing Fee - $1,100.00

Automatically hold statements for new procedures

 

 Checkbox No 

Hold statements for all new cases and procedures at the practice level. Once this box is checked, Connect Back Office will automatically check checks the Hold Statement box checkbox in charge entry on all new procedures. The charge entry Hold Statement option will also automatically become becomes unavailable to the user until the box is unchecked. When held procedures are highlighted in charge entry, an indicator appears in the Procedure Details area (click the link to the left to view an example) section.

Enable CPT/ASA to ICD-9 GEMs (General Equivalence Mappings)

 Checkbox No 

Populates ICD-9 Code line in Back Office Charge Entry charge entry (Add/Update Procedure dialog boxwindow) with potential diagnosis code matches based on the CPT code(s) entered. By default, this option is not checked.

Enable ICD-10

 Checkbox  No

Enables the ICD-10 fields and drop downs in Back Office Charge Entry charge entry (Add/Update Procedure dialog box). By default, this option is not checked. window). 

Enable ICD-9 to ICD-10 GEMs (General Equivalence Mappings) Checkbox  No

Populates mapping options between ICD-9 and ICD-10 diagnosis codes.

By default, this option is not checked. This functionality works both ways (ICD-9 to ICD-10 and ICD-10 to ICD-9), depending on the Primary diagnosis format selected (see below). For example, if ICD-9 is selected as the Primary diagnosis format and an ICD-9 Code is selected, the GEM Scenario and Choice Selection dialog box window appears and allows the user to choose an ICD-10 code or codes to map to.

If the Enable CPT to ICD-9 GEMs is unchecked and the ICD-9 code entered is not associated with the Procedure (CPT) code, an error will advise advises the user that the ICD-9 code is not associated with the CPT.

If ICD-10 is set a as the Primary primary diagnosis format, the Enable CPT to ICD-9 GEMs option does not function, regardless of  whether whether it is checked. The system will instead identify only ICD-9 Code code crosswalks for the selected ICD-10 Codecode.

Primary diagnosis format  Radio Selection No Determines the ICD code set (9 or 10) that displays in the primary position (left side of the ICD code area). It also determines how the Enable ICD-9 to ICD-10 GEMs and Enable CPT to ICD-9 GEMs behave (see above).
Apply Hawaii General Excise Tax  Checkbox NoIf checked, the Hawaii General Excise Tax is applied to claim totals in charge entry.