Connecting ERAs to the Date of Service?

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drk
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Connecting ERAs to the Date of Service?

Post by drk » Mon Jan 12, 2015 4:30 pm

We have mostly got the system up and running, thanks to this informative forum. There are a couple of questions I am hoping someone knows the answers to:

1. Walk out receipt - when a patient pays the copay and wants a receipt, it takes forever to generate a receipt. What do you use for this transaction?

2. ERA posting - Is there any way to connect the claim DOS to the ERA? Although Medisoft parses the file cleanly, there is no way to tell which line of the ERA goes with which DOS. Date From: and Date To: are the ERA's dates, date of service is not one of the columns I can expose on the payments/adjustments section of the Transaction screen. The medisoft claim number is not coming back from the payer either. Since a case can contain multiple dates of service, the case number is of limited use. Any suggestions on how to connect the top section (service charges) to the bottom (payments and adjustments)

It would be amazing if you are able to highlight a service line and all associated ERA lines get highlighted. Maybe in a future release?

Thanks.

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Gavin Walker
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Re: Connecting ERAs to the Date of Service?

Post by Gavin Walker » Tue Jan 13, 2015 4:35 pm

1. In Program Options -> Billing tab -> Receipt you can select the Walk Out Receipt template that you want to use for your walk-out receipts. This will then by your Quick Receipt button which prints a receipt of just today's charges and payments. If you set this up, you can save yourself a few button clicks.

2. In Revenue Management -> Configure -> Receivers edit the receiver record you are billing for and select Chart Number + XX + Claim Number in the Claim Number Format column (the default is just Chart Number). Once you have done this, then the claim number will go out on any claim that you submit for this receiver. The claim number should then come from the payer on the remittance file for Revenue Management to match when posting remittances. Any claims you already submitted will have the remittance file come back in the format that was specified when the claim was submitted. Another thing to watch out for is Revenue Management matches by procedure code AND modifier codes. Some payers only send back the first 2 modifier codes or they don't send back modifiers at all or they even send back a different set of modifier codes which can cause a mis-match.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

drk
Posts: 155
Joined: Sat Oct 11, 2014 11:40 am
Location: Boston, MA

Re: Connecting ERAs to the Date of Service?

Post by drk » Wed Jan 14, 2015 1:01 pm

That should work for RM at least, thanks.

bocpg
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Re: Connecting ERAs to the Date of Service?

Post by bocpg » Thu Jul 23, 2015 2:23 pm

You wrote in a previous post...
"Another thing to watch out for is Revenue Management matches by procedure code AND modifier codes. Some payers only send back the first 2 modifier codes or they don't send back modifiers at all or they even send back a different set of modifier codes which can cause a mis-match"

This is my problem... RM does not see the 3rd modifier because it's not on the remit, therefore can not post. Is there a way to have RM post without looking at the modifiers, say date and CPT code only? I spend a lot of time manually selecting to post these codes. Also RM will not post to any patient that has Jr or Sr, I'm having to manually select every code billed in order for RM to work. Another time consuming process. Any help greatly appreciated!!!

Thanks Bo

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Gavin Walker
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Re: Connecting ERAs to the Date of Service?

Post by Gavin Walker » Fri Jul 24, 2015 9:52 am

1. If you setup the Quick Receipt in Program Options, then that will save you a couple of steps.

2. Did you select the Claim Number Format on the Receiver in Revenue Management like I suggested above? Claim # should be coming back on the remittance then.

bocpg
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Re: Connecting ERAs to the Date of Service?

Post by bocpg » Mon Jul 27, 2015 4:16 pm

Thank you... I just changed it!!

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Gavin Walker
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Re: Connecting ERAs to the Date of Service?

Post by Gavin Walker » Tue Jul 28, 2015 9:19 am

Now, you need to wait until some claims you submitted with this option come back as remittances.

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