RANSOMWARE - NETWORK SAFETY MEASURES

You may have already heard of the recent global cyber-attacks affecting over 200,000 organizations in over 150 countries known as ransomware. The “WannaCry” ransomware uses flaws in Microsoft software to spread quickly through networks and locking away files. There is no anti-virus that can fix ransomware.

Exercising caution can help to prevent an attack to your network.

So, what can you do?

Eliminate any computers running operating systems other than Windows, 7, 8 or 10.

Be sure to set Windows updates to automatic.  In this specific instance, we have found it better to also manually check for a Windows update.  Select “Settings, Windows Updates, Check for updates” and install.

Have anti-virus software installed on each PC.  We suggest and use ESET antivirus and www.Malwarebytes.org for ransomware and trojans.  You can go to Malwarebytes.org and download their free version.  Their lifetime subscription is better and we do have both available. 

Do not open unsolicited emails with attachments; especially from unknown or questionable sources, even if they address you by name.

Always type the website out yourself and resist clicking on any links that take you to seemingly authentic but fraudulent websites, or that warn you to change a password. Stay alert and be suspiciously cautious.

If you do become infected, you will need to disconnect the infected PC from your network and re-install Windows as soon as possible.

 

HORIZON BCBS OF NJ - NO LONGER PARTICIPATING PAYER WITH EMDEON/CHANGE HEALTHCARE

Effective March 1, 2017, Horizon BCBS of New Jersey (Payor ID# 22099) is no longer a participating carrier with Change Healthcare (formerly Emdeon). 

As a result, clients who are not enrolled with Change Healthcare's Provider Complete program will generate fees for claims submission, ERA retrievals and/or patient eligibility inquiries.

The following applies only to clients NOT CURRENTLY ENROLLED with Change Healthcare's PROVIDER COMPLETE program:

 

To continue sending electronic submissions to a non-participating carrier, you will not need to do anything; just continue submitting files as usual and you will be charged for them.

To discontinue electronic submissions to a non-participating carrier, you will need to:

a) Remove the Payor ID# from the carrier's "Payer ID#" field in the Insurance Carrier's Setup screen, and

b) Remove the checkmark from the "Send Electronically to" field, also in the carrier's setup screen.

 

To continue receiving Electronic Remittance Advices (ERA's) from a non-participating carrier, you will not need to do anything; you will continue to receive them and you will be charged for them.

To discontinue receiving ERA's from a non-participating carrier, you will need to contact our Support Services office directly, or simply create an e-Track, for our Enrollment and Eligibility Department, and let us know... be sure to include (1) the carrier's name, (2) the payor ID# and (3) the practice's Tax ID#.  We will remove the service and forward a Confirmation of Completeness to you when finalized.  

 

To continue accessing patient eligibility information from a non-participating carrier, you will not need to do anything; just continue eligibility inquiries as usual and you will be charged for them.

To discontinue accessing patient eligibility information from a non-participating carrier, you will need to remove the Payor ID# from the carrier's "Eligibility Payer ID#" field in the Insurance Carrier's Setup screen.

WHAT'S NEW - TCMS VERSION 4.9.1.0

TCMS version 4.9.1.0 is now available to all clients

Bulk Claim Write-off option, “Write-off based on number of statements printed,” now displays a reminder, “Claims that have been printed on a statement within the last 30 days will not be included"

Insurance Payment Posting screen now offers an option to post payments received from a payer-issued credit card.

Digitally locking the last document in Workflow’s Document View will switch to the List View and no longer generate an error for an empty queue.

A new System Default, “Force effective start date for insurance profiles” will, when selected, obligate entry of an effective start date on patient demographics when adding or editing insurance profiles.

A standard HIPAA Privacy & Security disclaimer is now added to all emailed statements, emailed chart, and bulk email.

Electronic statement ledger message, “Patient Statement Printed through Perse” is now a more generic message, "Electronic patient statement created"

The Payment Analysis Export now displays the Due from Insurance name.

The Payment Analysis Export now offers an option to include inactive locations.

The Claim Information export now offers an option to include inactive locations.

In compliance with the Worker’s Compensation Board of NY, the Workers’ Compensation report now offers the latest version of the MD1 form.

 The Schedule Information Export now includes the matching appointment for the services actually written, based on service written in the ESB Queue.

The Schedule Information Export now includes a new column called “CPTSWRITTEN” which identifies the CPT code of a service generated from the ESB Queue as “ESB=(CPT code number)”. If no service is found as written through the ESB Queue, the system will identify a service’s CPT code written for the patient on that appointment date.

The C4 Authorization Form now offers a new Location dropdown field, allowing the user to override the otherwise defaulted practice address/phone for the Master Physician’s information.

The Patients Seen with No Service Written report was not recognizing some services generated from the ESB Queue in bulk when the service contained a date/time stamp.  This problem is now fixed.

The Electronic Statements Export now includes the Master Physician’s name.

When creating an electronic claims file, the option to include all locations will also include eligible services from inactive locations.

A new Insurance Type Custom Field called “Bypass DTP Admission date segment in loop 2300” will, when selected, skip Admission Date and Discharge Date data awhile creating a file.

The Practice Default, “'Update all future appointments when patient insurance profile changes,” will now also update existing appointments to a new/changed No Fault profile.

A new Insurance Type Custom Field called “Print CLIA in Box 23 of Form HCFA-1500” will, when selected, print the CLIA number in Box 23 instead of a prior Authorization; however, Medicare Insurance Type will still override and force CLIA in Box 23.

Printing the Medicaid Form can now accommodate diagnosis codes of up to 7 characters.

The Aging Report can now be limited to “Show Patient Totals Only” when the Date Range option is enabled.

In the patient search screen, sorting by any column will now automatically also sort alphabetically by patient name as a secondary sort.

Medications sent to New Crop containing invalid characters, such as “#” are now stripped to only contain numeric values.

Worker’s Compensation claims will now print the Worker’s Compensation Case Number in Box 11 on the HCFA form (CMS 1500).

The Daily Totals report will now exclude debited non-allowed amounts from the non-allowed column. (When a payment is debited, the attached non-allowed amount is also debited).

NYS Medicaid form’s Box 24L will now display the “Received Other” amount of the claim (not the “Total Received”) when NYS Medicaid is the tertiary payer.

The actual date and time of the creation of a claim is now stored and displayed when hovering over the transaction date, identifying when a claim is written even if batch dating is used.

Various other bug fixes

HAVE YOU UPDATED TO TCMS VERSION 4.9.0.1?

DEC 14th
HAVE YOU UPDATED YET?
This is our last chance to remind you to update if you haven't updated yet... or you will be unable to submit claims through Emdeon tomorrow, Dec 15th.

Emdeon has released a new URL for accessing all communications related to claim submissions. ALL TCMS clients must update to TCMS version 4.9.0.1 to use the new Emdeon URL by December 15^th. If you are not utilizing the new URL through the new version, you will be unable to send claims electronically through Emdeon.

Criterions' Support Services offices will be closed on Monday, December 26th, in observance of the Christmas Holiday.

 

How to get Criterions Alerts by email
You can get email alerts from Criterions when a new version is released or whenever we post any other type of notification on Criterions Corner. Simply go to our Criterions Corner BlogSpot >>> http://criterionsblog.blogspot.com/ <<< and enter your email address in the “ENTER YOUR EMAIL ADDRESS HERE TO GET ALERTS DIRECTLY” option located on the front page. You will receive an immediate confirmation email to respond to and complete the registration.

EMDEON HAS MADE A CHANGE THAT AFFECTS YOUR OFFICE

NOV 30th
HAVE YOU UPDATED YET?
This is so important that we just want to remind you to do so if you haven't updated yet...

Emdeon has released a new URL for accessing all communications related to claim submissions. ALL TCMS clients must update to TCMS version 4.9.0.1 to use the new Emdeon URL by December 15^th. If you are not utilizing the new URL through the new version, you will be unable to send claims electronically through Emdeon.

How to get Criterions Alerts by email
You can get email alerts from Criterions when a new version is released or whenever we post any other type of notification on Criterions Corner. Simply go to our Criterions Corner BlogSpot >>> http://criterionsblog.blogspot.com/ <<< and enter your email address in the “ENTER YOUR EMAIL ADDRESS HERE TO GET ALERTS DIRECTLY” option located on the front page. You will receive an immediate confirmation email to respond to and complete the registration.

EMDEON HAS MADE A CHANGE THAT AFFECTS YOUR OFFICE

Emdeon has released a new URL for accessing all communications related to claim submissions. ALL TCMS clients must update to TCMS version 4.9.0.1 to use the new Emdeon URL by December 15^th. If you are not utilizing the new URL through the new version, you will be unable to send claims electronically through Emdeon.

How to get Criterions Alerts by email
You can get email alerts from Criterions when a new version is released or whenever we post any other type of notification on Criterions Corner. Simply go to our Criterions Corner BlogSpot >>> http://criterionsblog.blogspot.com/ <<< and enter your email address in the “ENTER YOUR EMAIL ADDRESS HERE TO GET ALERTS DIRECTLY” option located on the front page. You will receive an immediate confirmation email to respond to and complete the registration.

TRACKS MOVED TO NEXT VERSION

NOTICE -
Due to the need to meet Medicare's mandated usage of the new 2017 ICD-10 Master List, Criterions has pushed all tracks slated for release in TCMS version 4.9.0 to version 4.9.1.

WHAT'S NEW - TCMS VERSION 4.9.0.0

TCMS version 4.9.0.0 is now available to all clients

THE NEW 2017 ICD10 Master List file is now available - in compliance with Medicare Mandate, effective October 1^st 2016.

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NOTICE:
This version is released with only one content... the addition of a new ICD-10 Master List. All clients using TCMS should update to this version to obtain the new list issued by Medicare this week and, subsequently, add the desired new codes from the Master List to the Practice's working list in the Diagnosis Code Setup screen.  If you have any questions related to this process, please feel free to call us at 516-466-1942, and select prompt# 2 for the Criterions Support Team.

Also, if you are a cloud-based client of our software, there is no need to update because the ICD-1 Master List is already on the server. Cloud-based clients only need to update the ICD10 Master List in from the Setup screen to make these additional codes available.

2017 FEE SCHEDULES

Remember, you cannot write a claim for a service in 2017 unless there is an existing fee schedule for the CPT code, the location and the specialty. There is a feature that can assist in copying your current 2016 fee schedules to 2017. If you have any questions related to this process, please feel free to call us at 516-466-1942, and select prompt# 2 for the Criterions Support Team.

WHAT'S NEW - TCMS VERSION 4.8.9.9

TCMS version 4.8.9.9 is now available to all clients

A new Practice Default, "Hide annotations on printed labs," prevents annotations added to Labs from printing. The user can still see annotations on the documents annotation screen. This will not affect labs already converted to PDFs

The Patient's balance (not total balance - only the balance due from the patient) will now be displayed in the mouse-over hint for an appointment in the daily schedule. This functionality already existed in the browser.  Now it exists in TCMS as well.

Claim export now has diagnosis selection to handle ICD9/ICD10.

Added option to bulk email dependent on Master Physician tied to patient and/or the gender of patient

While going to New Crop, for user type: staff, role type is now 'Nurse Read Only'

New practice default: "Send Group/Individual Taxonomy code in electronic claim file" to send taxonomy code in 2000A*PRV segment always, if this default is selected.

Patient Information Export. Added field Active on export to represent patient being active

Patient list by diagnosis codes now allows you to choose ICD9 or ICD10 depending on how the claim was written is all the system needs to know

When printing Medicaid forms for a particular patient, the grid will now display the physician's name as one of the columns just as they see in the HCFA printing view

Added “Receive Bulk Emails” to the selection criteria to Patient Export

The Payment Analysis report is automatically generated by account number. We added the ability to sort this by Insurance Carrier and by Insurance Type (and provide a total for each Carrier/Type)

The NDC number will now print on the CMS-1500. Added NDC to HCFA Report.

There was an issue with some clients’ printers and the internal memory that would cause the notes not to print in the same order as Worker’s Compensation forms if there was a large batch. Changes were made to the database to accommodate these printers during large batch runs

The printed Superbill will now allow for longer names of Practices. The font was also changed to Arial Narrow for this reason and for better readability

Added physician Title on the provider name and supervised provider name on the bottom of forms. C4 (10-15), C4.2 (10-15), C4.3 (10-15), C4AMR (10-15)

Increased the Diagnosis Description field length on UB04 form.

A checkbox is now available to allow for the override of fee schedule overwrite warning. If Unchecked, the user will not be notified that they are overwriting an existing Fee Schedule

On edit service, the Medicaid tab shows 'corrected claims' instead of the 'Medicaid' tab if there are no active Medicaid insurance profiles.  This is a problem if the actual claim is a Medicaid claim.  The system now checks the claim along with the profile to fix this.

We have resolved the error (not enough values) when adding a new recall document from the recall document setup

I forced the clients ICD9/10 check to default to ICD10 if no insurance is found

There is a weird quirk that happened here. Primary Insurance code was not being defaulted to -1 (self) because the patient has WC profiles and no medical profile. When creating a medical claim, the system did not set the insurance to -1, it defaulted to 0

Now "Electronically sent WC' claims are considered as Sent Claims So they will not appear on unsent claims report.

Added Resource and Tied To Physician on claims export for claims that were generated via ESB

Bulk Email. Fix diagnosis selection to handle ICD9/ICD10

When a document is made inactive, it will be removed from any queue if it is in one and write make a history record of the removal.

When a patient is marked deceased, the system does make all future recalls inactive.  However, if there are past recalls the system does to make those inactive as those dates would have already passed.  In theory, if the date range was changed to an earlier date a user would be able to print a letter or label for an old recall date for a deceased patient.

PDF Document types will now be available to choose from when creating document favorites

The totals for Procedure Financial Analysis Report on multiple practice option has been corrected to reflect accurate numbers

Added grand total for units and # of patients to Multi Practice option to Daily Transaction Summary Report

We added the ability for an Insurance Prac ID and Insurance Site ID to be added, and is printed on Box 33B on the CMS-1500 form

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