The latest Connect release is 22.3. Highlights of this release include the following:

Claims

• Modified functionality for claims with Place of Service of 51, 52, 56, or 61 to automatically add the Admit Date from the case to the claim and generate an Error if the Admit Date is missing from case.

Code Updates

• Completed Q1/Q2 WPC code updates: Taxonomy, Claim Adjustment Reason Codes, Denial Codes, Claim Status, and Remittance Advice Remark Codes which includes new codes relating to the No Surprises Act.

Eligibility

• A Provider/Practice NPI column was added to the Check Eligibility
  • The enhancement allows you to now check eligibility without first having to enter provider details on a case. 
• Eligibility Check logic updates include:
  • Accounts having more than one insurance tied to it will only perform and return details for the insurance(s) selected on the case.
  • Amount is no longer displayed in the Charge Batches / Eligibility / Benefits tab if the amount was not included in the 271 response.
  • Payer specific eligibility requirements.
• The Error Report button was temporarily removed from the Check Eligibility window since the new logic no longer fits with the report.
  • If you have rows with red text, that means there is something missing from the case preventing you from submitting that row. Please revisit the case and check for the following:
    • Is the insurance tied to the person selected in the case (only ranked insurances will appear).
    • Does the person have a member ID?
    • Is the insurance tied to a TPS Payer ID?
  • Updated the Charge Batches / Eligibility tab:
    • Added View Inquiry button to view the 270 attached to the Eligibility Request
    • Added new Benefit filter to the Benefits tab
    • Added new Limitations column to the Benefits tab
    • Plan Name field to display the name of the plan from the Benefits tab if provided by the Payer
    • Removed the Facility column
    • Added Date/Time to the Response column (when the response received)
    • Added a Status column (values are: Active, Inactive, Rejected)

• Added a Status filter to the Filters options

• Modified submission functionality for Eligibility Requests to MediCal to accommodate requirement of a provider’s UPIN to be included on all Eligibility transactions to CA Medicaid.
  • You must use the Provider NPI for these rows, and they will display with red text if the provider does not have a UPIN found in Admin > Providers.

Facilities

• Updated system Place of Service (POS) codes to meet NUCC/CMS standards.

General

• A new Health Dashboard, accessible from the Help menu has been added to Connect. It can be used to diagnose the health of your computer requirements and provide information to the Support Team if experiencing issues in Connect. 
• Deployed updated Launcher (v1.2.0) to clients in support of latest JRE file structure; update required for users to access Connect following Release 22.3. 
• REMINDER: See emails with instructions for updating your Launcher version.

Payers & Plans / Payments

• To accommodate the No Surprise Act:

• • Added a new Plan / Practices tab to Connect to designate (by practice) whether a plan is “In-Network” or “Out-of-Network”, plus added the Contract Effective Date.
  • Network Status field to the Distribution page to designate whether a claim is “In-Network” or “Out-of-Network”. Note:'Out-of-Network' will appear in red
  • Network Status column added to Payment / Service Lines

Payment Batches

• The Override Payer ID window was renamed Additional Payer IDs and now allows up to 6 additional Payer IDs to be added to this list of plans included in the processing of an ERA.

• Payment Batch Search Criteria window updated to include Payer, Plan, Batch Amount, and Guarantor search options.

Reports

• Created new Back Office/Portal reports: Charge Analysis Summary, Coding Auditing.

• Added new fields (columns) to the following reports:
• AR Aging Analysis Detail: Patient DOB, Patient Gender, Patient Member ID, Claim ID, Case Reporting Type
• Collection Trend Analysis Summary: Primary/Secondary/Tertiary Group By
• Insurance Collection Actions Detail: Rendering Provider, Claim ID, and Case Reporting Type
• Insurance Payment Denial Detail: Pseudo Code
• Plan Detail: Practice, Clearinghouse, Billing Provider Type, Network Status, Contract Effective Date, Extreme Age/Emergency, Billed Fee Schedule, Expected Fee Schedule
• Practice Performance Summary: CPT Short Description

• Added new search parameters to the following reports:
• AR Aging Analysis Detail: Responsible Party (All, Insurance, or Guarantor), Payer, Plan
• Collection Trend Analysis Summary: Primary/Secondary/Tertiary Group By
• Plan Detail: Practices

• Made additional modifications to the following reports:
• Case Analysis Detail: updated the Status filter to default to All 
• Collection Trend Analysis Summary: Case Type option added to the Group By dropdowns
• Insurance Collection Actions Detail and Insurance Payment Denial Detail: Patient's Middle Name added to the Patient column display
• Insurance Payment Denial Detail: Provider's Middle Name added to the Rendering Provider column display
• Plan Detail: Updated logic to only display fee schedules in the report that have Status = Active and an unexpired Expiration Date

• Fixed issue causing the Claim ID to not populate on the Insurance Collections report after a Rebill 2.

• Fixed issue causing the Plan Detail report to display with no data if no filters are selected.

Security

• Social Security Number (SSN) displays in Connect Back Office updated to mask the first 5 digits and display only the last 4 digits (e.g., *****1234). 

• A new 'Unmask SSN' permission was added to the Role: Security topic. Having this right assigned to a role allows users with that role to click the icon to unmask and view full SSNs in certain scenarios, e.g., creating/updating Person, reviewing Charge Batches / EDC Files tab

To view the full release notes for the current Connect release, click here.