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Overview

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Info

The Practice: New and Practices: [name] pages are comprised of eight 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 balance must have been in guarantor responsibility for the indicated number of days

  • 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 No

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

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

Payment Entry / Collections Section


Disallow posting individual payments CheckboxNo 

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) CheckboxNo 

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

Option is checked by default.

Expected Allowed Tolerance

Free Text

(Numeric)

No

Specifies the over-under criteria that the Actual Allowed amount from an EOB must exceed the Expected Allowed 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 exceeds the set thresholds, the amounts entered in these fields 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 is decided based on the lesser amount.

Info

Example: Tolerance is set to $5.00 or 1%. The Expected Allowed amount for Procedure 99213 is $100.00. Two values returned as a tolerance for the above: $5.00 and $1.00 ($100 * .01), so 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 CheckboxNo

Forces service fee lines outside of the Expected Allowed Tolerance range to internal insurance collections and the assigned Action Type assigned is initiated.

Examples:

  • Assumption: Allowed Amount is outside the Expected Allowed Tolerance limits
Info

Example 1:

  • 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.


Info

Example 2:

  • Practice expects $1,000 from Primary Payer 1 for service X.
  • 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.


Note

If the result of the payment is a zero balance, a task is not created.


ActionDrop DownNo

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

Only enabled and required if Force service to internal collections if expected does not match allowed is checked.

Reporting Section


AQI Reports Sub-section

Facilitates customization of data sent to AQI.
Anesthesia Record IDDrop DownYes

The entity selected in the drop down determines the value pulled from the Connect database and reported in the Anesthesia Record ID field of a generated AQI XML file.

Options include: Case ID, External Case ID, Facility Case ID, any custom-created fields.

Patient IDDrop DownYes

The entity selected in the drop down determines the value pulled from the Connect database and reported in the Patient ID field of a generated AQI XML file.

Options include: Case ID, External Case ID, Facility Case ID, any custom-created fields.

Procedure IDDrop DownYes

The entity selected in the drop down determines the value pulled from the Connect database and reported in the Procedure ID field of a generated AQI XML file.

Options include: Case ID, External Case ID, Facility Case ID, any custom-created fields.

Staff IDDrop DownYes

The entity selected in the drop down determines the value pulled from the Connect database and reported in the Staff ID field of a generated AQI XML file.

Options include: Provider ID, Tax ID_NPI.

Anesthesia Practice IDFree TextNoAllows the entry of an alphanumeric value. The value represents the Practice ID for AQI reporting purposes.
AQI XML VersionDrop DownYes

Used to identify the XML version used by the practice.

QI Number (Fides)Drop DownYes

Designates the QI to include with the Fides extract report.

Front Office Section


Use freeform procedure entryCheckboxNoIf checked, allows freeform typing in the Procedure field, which is located on the New Patient/Provider Appointment window in Front Office.
Auto populate provider asDrop Down Yes

The options include:

  • Anesthesiologist - causes 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.
  • Primary Surgeon - 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.
Charge Entry Section


Case requires referring physician

CheckboxNo 

Designates the Referring Physician field as required in Back Office.

Coding must be complete to create cases from image sets

CheckboxNo

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. 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 checkbox blank.

Allow excluding provider time from concurrency checking

CheckboxNo 

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

CheckboxNo 

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

Info

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 up to next unit on the fee schedule, 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


CheckboxNo 

Hold statements for all new cases and procedures at the practice level. Once this box is checked, Connect Back Office automatically checks the Hold Statement checkbox in charge entry on all new procedures. The charge entry Hold Statement option also automatically 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 section.

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

CheckboxNo 

Populates ICD-9 Code line in Back Office charge entry (Add/Update Procedure window) with potential diagnosis code matches based on the CPT code(s) entered.

Enable ICD-10

Checkbox No

Enables the ICD-10 fields and drop downs in Back Office charge entry (Add/Update Procedure window). 

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

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

This functionality maps ICD-9 codes to ICD-10 codes only. 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 window appears and allows the user to choose an ICD-10 code to map the codes.

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

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

Primary diagnosis format Radio SelectionNo 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 CheckboxNoIf checked, the Hawaii General Excise Tax is applied to claim totals in charge entry.