Removed:
Receipts 1.04 6/11/12 K. Sanders Added:
3.2.9 Medical Spell Checker Updated:
2.1.4 Printing Correspondence
2.1.3 Work List Columns
3.1.1 Searching Denials
3.1.4 Default Operator Settings
6.4 HealthTracker: Patient Photo
6.10 Operator Settings
Document Information
Version
Date Changed
Completed
By Description of Changes 1.05 6/29/12 K. Sanders Added:
3.2.7 ToDo Reason Patient Care Management has been added as an option in the ToDo Reason list. Patient Care Management is available as an option when the Category = Support Center and the Type = EHR.
ToDo Replies
Updated:
3.1.3 Denial Details
1.06 7/3/12 K. Sanders Added:
3.2.7 ToDo Reason
Updated:
3.1.1 Searching Denials
Contents
About this Document... v
Purpose... v
Before You Begin... v
Document Conventions ... v
1 Release Overview ... 6
1.1 Optum Rebranding ... 6
2 Financial Module... 7
2.1 Correspondence... 7
2.1.1 Searching & Sorting Correspondence... 7
2.1.2 Correspondence Work List Features... 7
2.1.3 Work List Columns ... 8
2.1.4 Printing Correspondence... 9
2.1.5 Correspondence Settings ... 9
2.1.6 Accessing Correspondence ... 9
3 Home Module ... 11
3.1 Denials... 11
3.1.1 Searching Denials ... 11
3.1.2 Denials Work List... 12
3.1.3 Denial Details ... 13
3.1.4 Default Operator Settings ... 14
3.1.5 Denial Category Maintenance ... 15
3.2 Messages Center ... 15
3.2.1 Event Manager ... 15
3.2.2 Macros ... 16
3.2.3 Using Macros... 16
3.2.4 Creating a Macro ... 17
3.2.5 Templates ... 17
3.2.6 ToDo Defaults... 17
3.2.7 ToDo Reason ... 18
3.2.8 ToDo Replies... 18
3.2.9 Medical Spell Checking ... 18
3.2.10 Fax Cover Sheet... 18
3.3 Electronic Remittances... 19
3.4 Prescription Renewals... 19
3.5 Batch Level Rejections... 19
3.6 New Insurance ... 20
3.7 Patient Search... 20
4 Patient Module ... 21
4.1 Referrals ... 21
4.2 “At a Glance” Patient Information Window ... 21
4.3 Patient Status ... 21
4.4 Family Tab: Relationships ... 21
5 Scheduling Module... 22
5.1 Adding a Chief Complaint to an Appointment ... 22
5.2 Book: Appointment Colors... 22
5.3 Visit: Extended Amount ... 23
5.4 Appointment Detail & Appointment List... 23
6 Administration Module... 24
Contents
6.1 Order Sets... 24
6.2 Appointment Types ... 24
6.3 HealthTracker: Ask the Practice ... 25
6.4 HealthTracker: Patient Photo... 26
6.5 HealthTracker: Billing Address Update... 26
6.6 Chief Complaint Maintenance... 27
6.6.1 Adding a Chief Complaint to an Appointment ... 27
6.6.2 Template Hierarchy... 28
6.7 Linking Templates to Appointment Types... 28
6.8 Combine Duplicate Patients... 29
6.9 Instamed Partial Payments ... 29
6.10 Operator Settings ... 29
6.11 Allowed Schedules... 30
6.12 Contracts... 30
6.13 Patient Data Export... 30
6.14 Quick Picks: Fee Schedules ... 31
6.15 Letter Editor Fields... 31
7 Document Management Module ... 32
7.1 File Types... 32
7.2 Document Audit Log ... 32
7.3 Document Settings... 32
7.4 Document Sub-Type List ... 32
7.5 Refresh Document Work List ... 33
7.6 Expand/Collapse Metadata Pane ... 33
8 Connections Module ... 34
8.1 Template Mappings ... 34
9 Reports Module ... 35
9.1 PQRI Reports... 35
10Transactions Module ... 36
10.1 Open Items... 36
10.2 Procedure Line Item Detail ... 36
10.3 EOB Reports ... 36
11Claims... 37
11.1 North Carolina Medicaid ... 37
11.2 Medicaid of Illinois... 37
11.3 Claim Exception ... 37
12HealthTracker... 38
12.1 Patient Information: Billing Address ... 38
12.2 Quick Links: Ask the Practice ... 39
12.3 Quick Links Removed ... 39
13Enterprises... 40
13.1 Enterprise Patient Search ... 40
13.2 Enterprise Appointments... 40
13.3 Generate Enterprise Claims... 40
14Roles & Security ... 43
Contents
About this Document
Purpose
This document outlines new and updated features for the 7.6 version release of Optum Practice Management 7.0.
Before You Begin
Clear the Cache
Before you login and use a new release of Optum PM and Physician EMR, you must first clear your computer (or iPad) memory cache to ensure proper performance.
Training & Online Help
Please see the following topic in Optum PM and Physician EMR Online Help for instructions on clearing your cache: Support > Support Knowledge Base > How to Clear Cache
Document Conventions
This document uses the following formatting conventions:
Formatting Convention Description
Indicates a note about online help, training or support.
Indicates an important message or warning.
Italics Italics are used to denote paths and cross references.
Bold Denotes the name of an application element, such a module, application or field name.
[Placeholder] Indicates information that is not yet available or a feature that is still in development.
1 Release Overview
This section highlights some of the major enhancements included in this release:
Correspondence – The Correspondence application has been redesigned to streamline the correspondence workflow.See section 2.1 Correspondence on page 7.
Denials Redesign – The Denials application has been redesigned and enhanced to allow bulk transfers and adjustments from the work list and assignment of custom denialcategories.
See section 3.1 Denials on page 11.
Message Center Templates – You can now create custom templates and macros to streamline the fax, mail and ToDo workflows.See section 3.2 Messages Center on page 15.
Appointment Types – You can now link a progress note template to an appointment type, simplifying the process of applying a template to a progress note.See section 6.2 Appointment Types on page 24.
1.1 Optum Rebranding
With the 7.6 release we are unifying our CareTracker products under the Optum brand name.
Ingenix CareTracker Practice Management is now Optum Practice Management
Ingenix CareTracker Electronic Health Record (EHR) is now Optum Physician EMR.
The combined CareTracker product is now Optum PM and Physician EMR.As part of the rebranding, the Health Record module has been renamed Medical Record and the login page has been redesigned to reflect the Optum brand.
Figure 1 Optum PM and Physician EMR login page
2 Financial Module
2.1 Correspondence
This release includes significant enhancements to Optum PM’s Correspondence application, including an updated user interface that reflects the new Optum style.
Figure 2 Patient Correspondence
2.1.1 Searching & Sorting Correspondence
When you launch the application, the work list displays correspondence for the patient in context, by default. The filters allow you to search and sort the work list:
Use Pt in Context – Displays correspondence only for the patient in context. (Deselect the checkbox to view correspondence for all patients.)
Show Unprinted Only – Displays only unprinted correspondence in the work list.
Show Inactive – Displays both active and inactive correspondence in the work list.You can search for correspondence by date range. The options are:
Last Encounter
Past 6 months
Past year
Custom date rangeYou can sort the correspondence work list by clicking on the column headings.
2.1.2 Correspondence Work List Features
In the correspondence work list you can:
Manually add new correspondence from all access points, except when the application is launched from the Corr button on the Name Bar.Financial Module
View letters or documents attached to a correspondence item.
Deactivate and activate correspondence. Deactivating removes the correspondence from the default work list view.
Click the ToDo incident ID in the work list to launch the associated ToDo in the Messages Center.
Print Practice Management correspondence individually or in bulk.
Mark correspondence items as printed individually or in bulk.2.1.3 Work List Columns
Table 1 describes each column in the redesigned correspondence work list.
Table 1 Correspondence work list columns Column Description
Date The date the correspondence was created.
Note: System generated correspondence displays both the date and time the item was created.
Type The correspondence type (letter to patient, ToDo, phone call, etc.)
Notes The content of the Notes column is determined by the correspondence type:
If the correspondence was manually entered, this column displays the values from the Notes field.
If the correspondence is a ToDo or Fax, this column displays the value from the Notes field.
If the correspondence is a Letter or Patient Education, this column displays the title.
If the correspondence type is HealthTracker, this column displays the HealthTracker notification subject line.
If the correspondence type is Patient Visit Summary, this column displays “Patient Visit Summary Printed.”
Encounter The encounter linked to the correspondence.
ToDo ID When a patient receives a ToDo, this column displays the ToDo ID number and a link to the ToDo. The link opens the ToDo in a new window and gives you the option to print the ToDo incident details.
Operator Displays the name of the operator who created the ToDo.
Printed Indicates whether a Practice Management correspondence has been printed.
Click the documents button to launch the attached document in the Document Viewer.
Click the letters button to view attached letters in a new window. Hover over the icon to view the name of the letter.
Click the active button to activate the correspondence.
Click the inactive button to set the correspondence to “inactive.” Deactivating removes the correspondence from the default work list view.
Financial Module
2.1.4 Printing Correspondence
Select the checkbox next to one or more correspondence items in the work list and then select Actions > Print Practice Letters to print the selected items. Tip: Click All to select all of the correspondence items in the work list.
Click Print Correspondence Log at the top of the work list to print a log of all patient correspondence.Note
The PDF generated when printing patient correspondence now includes the ToDo incident ID number and the Attachment ID has been replaced with the document name.
2.1.5 Correspondence Settings
You can customize which correspondence items are displayed in your default view when Correspondence is accessed from the Medical Record. Click the configure icon to display the Correspondence Settings dialog box. You can choose to either display all of the patient’s correspondence or just the patient’s clinical correspondence (omitting practice management ToDos and letters). The default view is specific to the operator and applies to all of the operator’s groups.
Figure 3 Correspondence Settings
2.1.6 Accessing Correspondence
With this release, the Correspondence application has been added to the Documents tab in the Patient Information window. The Patient Information window is launched from the Info button on the Name Bar.
Correspondence and Unprinted Correspondence is accessed from the following locations:
Name Bar > Patient Info Window > Documents tab > Correspondence
Financial Module > Correspondence tab
Name Bar > Corr button
Health Record > Correspondence paneFinancial Module
Home Module > Practice Dashboard > Unprinted Correspondence You must have the Demographics - Correspondence or Medical Records –Correspondence security privilege included in your operator profile to access this application.
Note: The Demographics – Correspondence security was previously named Financial – Corresp.
Online Help
For more information, see the following topics in Optum PM and Physician EMR Online Help:
-Name Bar > Viewing Unprinted Correspondence -Name Bar > Patient Info
-Home Module > Practice Dashboard > Front Office > Unprinted Correspondence -Financial Module > Adding Correspondence
3 Home Module
3.1 Denials
The Denials application has been redesigned and the workflow has been enhanced to allow bulk transfers and adjustments from the work list and assignment of custom denial categories.
When the application is accessed from the Practice Dashboard, Optum PM and Physician EMR displays two numbers below the application link:
Unworked: The total number of denials that still need to be worked
Month Total: The cumulative total of denials for the current monthFigure 4 Practice Dashboard: Denials
Clicking the Unworked or Month Total links launches the Denials work list.
3.1.1 Searching Denials
You can perform a basic or advanced search for denials.
Basic Denial Search
Table 2 lists the basic search filters displayed at the top of the denials work list.
Table 2 Basic Search Filters
Search Filter Description
Group Search for denials in one or more of the operator’s groups.
Note: If “All” groups are selected, Optum PM and Physician EMR will limit the search to the last 3 months.
Posted Date Range Search for a denial posted during a specific date range.
Note: If “All” is selected in the Groups field, Optum PM and Physician EMR will limit the posted dates included in the search to the last 3 months.
Financial Class Search for a denial in one or more global or company specific financial classes.
Category Search for a denial by one or more global or company specific denial categories.
Note: Denial categories are created in the Denial Category maintenance application on the Setup tab in the Administration module.
See 3.1.5 Denial Category Maintenance on page 15.
Fiscal Period Search for a denial by fiscal month.
Home Module
Search Filter Description
Fiscal Year Search for a denial by fiscal year.
The selected fiscal period displays in the header of the work list to show the date range of the denials in the search results. The work list footer displays the total procedure count and total procedure balance.
Figure 5 Denial: Fiscal period display
Advanced Search
Click the Advanced Search link to access additional search filters. The options are described in Table 3.
Table 3 Advanced Search Filters
Search Filter Description
Batch Search for denials in a specific batch Show Unbilled Claims Select Yes to display only unbilled claims
Select No to display only billed claims
Select Show All to display billed and unbilled claims
Procedure Paid Select Yes to display only denials without a procedure balance
Select No to display only denials with a procedure balance Recent Activity Displays denials that have had activity within 30 days
3.1.2 Denials Work List
Search results are displayed in the denials work list. Click the column headings to sort the denials in the list by Group, Financial Class, Denial reason, Procedure Count or Balance. Place your cursor over the info icon to display the full denial description.
Home Module
Figure 6 Denials work list
3.1.3 Denial Details
Clicking on a denial in the work list displays the Denial Details. From the details screen you can:
Click the denial to display the Procedure Line Item Details in a new window
Adjust denials individually or in bulk. When adjusting denials individually, you can select an amount to adjust. When adjusting multiple denials, all procedures will be adjusted to zero.
Transfer one or more denial balances to private pay
Launch the Open Items application for a denial
View the Claim Summary for the denial
Click the Microsoft Excel icon at the bottom of the work list to export the denial details to a Microsoft Excel file.Figure 7 Denial Details
Table 4 describes the information displayed in the Denial Details work list columns.
Home Module
Table 4 Denial Details
Column Description
Patient The patient linked to the denial Insurance The insurance on the procedure denial Provider The provider on the procedure denial Svc Date The date of the procedure service
Posted The date the denial transaction was posted Location The location linked to the denial
POS The place of service code
CPT The procedure codes associated with the denial Diagnosis The diagnosis codes associated with the denial Balance The denial balance
Charge The denial charges
(Payment) Click the payment button to launch the Open Items application.
(Claim Summary) Click the button to launch the Claim Summary in a new window.
3.1.4 Default Operator Settings
The operator can set defaults for how Optum PM and Physician EMR displays denials. Click the configure icon to launch the Default Operator Settings window. The default settings are specific to the company and only apply when the application is initially launched. Table 5 describes the default setting options.
Table 5 Denials: Default Operator Settings
Filter Description
Group Displays denials for the selected groups
Financial Class Displays denials for one or more financial classes Category Displays denials for one or more denial categories Use Current Fiscal Month Shows denials for the current fiscal month by default Show Unbilled Claims Select Yes to show only unbilled claims
Select No to show only billed claims
Select Show All to display both billed and unbilled claims Procedure Paid Displays the balance for the procedure for all insurances Recent Activity Displays only the denials that have had activity within 30 days
Support & Online Help
You must have the Denials security privilege included in your operator profile to access this application.
Home Module
For more information, see the following topic in Optum PM and Physician EMR Online Help:
Home module > Practice Dashboard > Billing > Denials
3.1.5 Denial Category Maintenance
You can now organize denials by assigning custom denial categories. Each category is linked to one or more denial transaction types. Company specific Denial Categories are created and maintained in the Denial Category maintenance application on the Setup tab in the Administration module.
There are 3 levels of denial categories:
CareTracker Global – Available to all users across all companies.
Channel Partner Global – Available to all Channel Partner companies.
Company Specific – Only available in the specific company to which it was assigned.In the work list:
Click the column headings to sort the list of denial categories by Channel Partner, Company, Denial Category or Level.
Click the transactions button to view the transactions linked to the denial category.
Click the audit log button to view a history of changes made to the denial category, including the fields changed, a description of the activity and the name of the operator who made the change.
Click the edit button to edit a denial category.Support & Online Help
You must have the Denial Categories security privilege included in your operator profile to access this application.
For more information, see the following topic in Optum PM and Physician EMR Online Help:
Administration module > Setup > Financial > Denial Categories
3.2 Messages Center
This release includes significant enhancements to the Messages Center workflow, including the addition of pre-formatted templates for mail messages, ToDos and faxes.
3.2.1 Event Manager
The new Event Manager application allows operators to create templates and assign them to macros that run when certain “events” are triggered throughout Optum PM and Physician EMR.
A Macro is a grouping of one or more templates. Macros are assigned to a specific group and Event Type.Home Module
A Template is a pre-formatted body of text. Templates are assigned to a specific group and a single macro.
An Event Type is an action that is triggered by a macro such as a ToDo, fax, or mail message.3.2.2 Macros
Macros will trigger one of the following event types:
Send a fax
Send a ToDo
Send a mail message3.2.3 Using Macros
On screens that have not been updated to the new Optum style, a shortcut menu has been added to the Fax, Mail and ToDo buttons, allowing you to select from a list of macros created for the event.
On screens that have been updated to the Optum style, the ToDo, Fax and Mail buttons have been replaced with a single Msg Center button. Clicking the arrow next to the button launches a menu of available macros. You also have the option to create a ToDo, fax or mail message without a macro.
Figure 8 Accessing Macros on updated screens
For screens that use radio buttons or Actions menus (Figure 9) to launch message center events, you must launch the ToDo, Fax or Mail Message first and then select the macro from inside the Message Center.
Figure 9 Accessing Macros on updated screens
Home Module
3.2.4 Creating a Macro
Message Center templates and macros are created and maintained in the Event Manager application in the Administration module.
Macros can be group-specific or available to all groups in a company.
You can assign multiple templates to a macro.
You can specify whether a macro is available in both Practice Management and the Medical Record or only from one of those access points.3.2.5 Templates
Templates are used to pre-format text for commonly used content. For example, you can create a standard mail message for outgoing referrals. Any time that template is selected, the mail message is automatically populated with the text in the template.
Note
Templates are limited to 2,000 characters.
The Event Manager application is accessed on the Setup tab in the Administration module.
This application replaces the Events application.
Support & Online Help
You must have the Event Manager security privilege included in your operator profile to access this application.
For more information, see the following topic in Optum PM and Physician EMR Online Help:
Administration module > Setup > System > Even Manager
3.2.6 ToDo Defaults
The ToDo workflow has been enhanced with default settings for the Category, Type and Reason based on where you are in Practice Management when the ToDo is launched. Table 6
The ToDo workflow has been enhanced with default settings for the Category, Type and Reason based on where you are in Practice Management when the ToDo is launched. Table 6