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Friday, September 25, 2015

WHAT'S NEW - TCMS VERSION 4.8.9.5

09/25/2015
 

TCMS VERSION 4.8.9.5 is now available...

The UB-04 form is updated to include:
1.      Policy Number next to patient name

2.      Box 17 fields

3.      Ganging up of up to 8 pair of occurrence codes and dates

4.      Ganging up of up to 12 pair of value codes and amounts

5.      The referring physician (box 78)

6.      The operating and attending physicians (pulls from the master physician list)

7.      Automatic additions of master physicians (in Setup) if the supervising doctor used in existing UB-04 claims (originally drawn from referring doctor list) is not found in the master physician list

Added the option for "Child Health Plus" on the pull-down in the VFC (Vaccines for Children) section

After saving a scanned document, the user will now be prompted to move the newly added document to a queue. The user can select the desired queue or hit cancel.

An open schedule screen will now refresh immediately after an appointment is cancelled.

The unsent claims report now offers the ability to limit results by insurance type and/or carrier.

An appointment’s properties is now utilized to identify the profile to be used to confirm authorizations from the scheduler. This will correct the confusion caused when a patient has multiple active profiles or when personal injury profiles are involved.

The selection field named "Use ICD10 code" in the insurance carrier setup screen is now audited.

The “I actively supervised” option on the worker’s comp form screen will now utilize the billing physician of the master physician (as it already is used with medical claims).

The caption of the “Sync ICD-10” option in the diagnosis code setup screen now reads '1X MAP OF ALL ICD9 TO ICD10' – a preventive confirmation after selecting this option is now also included.

An option to select all (or deselect all) ICD-10 codes shown in the mapping list is now available.

The option to “Add from ICD-9 Master” is no longer available.

Electronic statements now provides an option to preview a list of patients whose statements be generated.

Electronic statements will no longer split by location when these two practice defaults are not selected:
·        "Print Location Name on Per-Se statements instead of Practice Name"

·        "Print Location Address on Per-Se statements instead of Practice Address"

The payment analysis report now offers an option to include services (within the service date span selected) that have no payments

A practice default labeled “Suppress ICD-9 printing on Superbills" now reads "Suppress diagnosis code printing on Superbills"

The “currency” field length on many reports are now extended from 10 characters to 14

The document queue’s displayed order in the drop down box will now reflect the order projected from the queue’s setup screen.
The locations available in the user setup screen are now alphabetized.

Wednesday, September 23, 2015

HOW TO SET UP AND USE ICD-10 IN THE CRITERIONS BROWSER OR TCMS

09/23/2015

Do you need information on setting up and using ICD-10?
Here is some helpful documentation:

This documentation is intended to walk you through the steps of setting up, and the use of, ICD-10 diagnosis coding in your Criterions BROWSER (Note that you must be on Criterions Browser version 3.0.1.15 or higher).
Click Here (Criterions Browser only)


This documentation is intended to walk you through the steps of setting up, and the use of, ICD-10 diagnosis coding in your TCMS.exe (Note that you must be on TCMS version 4.8.9.4 or higher).
Click Here (TCMS.exe only)


This documentation is intended for those who have purchased the ICD-10 "mapping" feature.
Click Here (only if you've purchased "Mapping")

 

Tuesday, September 22, 2015

CMS AND AMA ANNOUNCE EFFORTS TO HELP


09/22/2015

CMS will appoint an Ombudsman (an advocate) that will help triage and address your ICD-10 issues and concerns with representatives in CMS’s regional offices. You can email the ICD-10 Ombudsman at icd10_ombudsman@cms.hhs.gov

Please read through this CMS document for more information:

CLAIMS WITH DOS PERFORMED AFTER OCT 1ST WILL REQUIRE ICD-10 CODING

09/17/2015
 
Are you prepared or making preparations for ICD-10?
Most of our clients have!

Criterions or TCMS will only convert or select an ICD10 Codes set if you have downloaded the latest update and activated the date sensitive settings in your setup.
To enter claims using ICD-10 codes for services performed on or after October 1st, 2015, there are a few things you will need to do on October 1st, 2015.

  1. Make certain that you are using TCMS version 4.8.9.4 or higher.
  2. Enter the ICD10 start date (10/1/2015) located at the bottom of the Practice Information section of setup
  3. Enable the “Use ICD-10 Codes” option in Practice Defaults (middle tab) from within Practice Setup
  4. Insurance carriers will need a checkmark in the option “Use ICD10 Code” in order to send ICD-10 formatted coding.
    • a)  To place the checkmark in all carriers at once, use the option (at the top of the Insurance Setup screen) labeled “Use ICD10 for all carriers”
    • b)  To place the checkmark in carriers individually: Edit the Insurance Carrier(s) to place a checkmark in the option “Use ICD10 Code” at the bottom of each carrier’s edit screen
  5.  Enter the ICD-10 codes you will need in the Diagnosis Code Setup screen.
    • a)  ICD-10 can be entered manually (FREE) or with Automated Diagnosis Code Assistance (FEE)
    • b)  Manual code entry assumes you have access to ICD-10 coding resources to assist with proper coding
For more details related to ICD-10 Readiness, click here 
 

ICD-10 READINESS

09/03/2015

Criterions EHR and TCMS solutions are currently ICD-10 ready and now offer automated functionality to assist practices as they transition to this new coding methodology. 
 
To learn more about the features and pricing of ICD-10 Automated Diagnosis Code Assistance, please consult the ICD-10 Readiness document.  In addition, practices opting for our automated ICD-10 solutions can complete the online ICD-10 Agreement

EMDEON AND EMBLEM HEATH INSURANCE HAVE COME TO AN AGREEMENT

3/29/2015

The threat of electronic claim  process redirection or interruption has been avoided.

 

EMBLEM HEALTH STATING THEY WILL NO LONGER ACCEPT EMDEON CLAIMS

March 9th, 2015  - 

Emblem Health is mailing letters to all clients stating “On April 1st EmblemHealth will end its Electronic Data Exchange (EDI) with Emdeon to submit electronic claims”

This notice, from Criterions, is to let you know that we are aware.  This is a contractual argument between the largest clearinghouse in the US and an equally large insurance payer. 

We expect to receive more details in the days to come as they feverishly work to resolve this issue.   We will keep all clients posted through notices, such as these, as we get this information.

ICD-10 IS ALMOST A REALITY

3/8/2015

There are two related items in this alert that will help prepare your office for its use in Criterion’s TCMS and Browser software.

One attachment is a written, detailed 14-page book… the other is an abbreviated movie that focuses on the software setup for ICD-10.

Below are the Documents for you to Download 

 

ALL TCMS CLIENTS (ONLY) NEED TO UPDATE TO TCMS v.4.8.8.2

February 9th, 2015
 
A universal change to the URL used by all TCMS clients to create a claim file occurred this past Friday. As a result, our programming staff create a new version of TCMS (v. 4.8.8.2) with only one enhancement that addresses the change.
Any clients that are using the TCMS browser, or EHR, are not affected by this change at all; however, if you are using TCMS, you will not be able to create an electronic claims file until you perform the update to this new version.
PQRS Deadlines are approaching 
February 28th, 2015 -  If filed using our EHR the 2014 filing deadline. Please note the enrollment with Quality Net (EHR Registry) can take significant time.
March 31st, 2015 - If filed using our recommended registry however registry may have cutoff by March 15th 2015
PQRS Measure filings are performed in 1 of 3 ways:
  1. Claim based filing for the entire year submitted along with routine claim entries  (Free)
  2. Filing through a certified registry service using a small sample population  (Service fee)
  3. Filing through our certified EHR (Free)
Since 2007 many providers filed PQRS measures allowing them to receive an annual incentive bonus for their participation.
In 2013 a penalty began when data was not filed.
In 2014 (Filing now) the number of required measures to avoid the penalty is 3 and if you file 9 you will get a .5% bonus
In 2015 you will be required to report 9 measures to avoid the payment penalty.
 
Criterions has two offerings for clients who did not do claims based reporting throughout the 2014 year.
1. Meaningful Use EHR Clients
For clients who are using the latest Criterions EHR in a meaningful way (collecting clinical data), Quality Net has said clients may export a file (QRDA file) from their EHR and import it into the Quality Net registry system*.
a.   There is no charge from Criterions for the production this QRDA files.
b.   This method for reporting is new, untried and agency verbiage is confusing or contradictory.  All of our communications with the registry indicate a provider only need to submit one measure to qualify for the incentive.  We do not make any warranty to this claim and are not responsible for any untoward outcome.  Their description is below:
1. Using a direct EHR product that is Certified EHR Technology (CEHRT) or EHR data submission vendor that is CEHRT, report on at least 9 measures covering 3 National Quality Strategy (NQS) domains.   If the EP’s CEHRT does not contain patient data for at least 9 measures covering at least 3 domains, then the EP must report the measures for which there is Medicare patient data.  An EP must report on at least 1 measure for which there is Medicare patient data.
Please note:
We have found the registration process to be time consuming (18+ steps) so please begin immediately.
Also the Quality Net Site seems to work best in the Google Chrome browser.
EHR Version 3.0.1.10 or our EHR is required to produce this file.  You version number can be found in the lower right portion of your browser’s Criterions login screen. 
 
2. Registry Based Reporting
Criterions will produce a file for clients who did not use the certified Criterions EHR in a meaningful way which will contain data on measures pertaining to most specialties.
a.   The cost, charged by the registry is $350 per doctor for file production and registry submission.
b.   Depending on the data available in your system, providers may be required to manually enter or select some data into the files to be submitted to the registry.