Practice / Miscellaneous Tab

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 ___.

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

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

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.

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.

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(Numeric)

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.

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

Defines the type of 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.

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.

Case requires referring physician

Designates the Referring Physician field as required in Back Office.

Coding must be complete to create cases from image sets

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

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

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

Automatically hold statements for new procedures

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)

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

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

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

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 window appears and allows the user to choose an ICD-10 code or codes to map to.

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.