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Resolving Revenue Management “Connect, Create, Cancel”

Reconnecting Revenue Management in Medisoft

When attempting to connect to Revenue Management, you may encounter an error like the one shown below.

12

Typically this occurs when the system has lost its connection to the database due to either a reboot of the server or an outage at the office.

If your Revenue Management has been previously configured and connected, but has become disconnected, this video will show you how to reconnect to the database.

Reconnecting Revenue Management when it becomes disconnected in Medisoft

reconnect-revenue

 

Check out our YouTube Channel, for more videos just like this.


Attend Our FREE Medisoft Training Webinars

These webinars are free to everyone and held monthly. You can subscribe to receive notifications by visiting this page.

Eligibility Verification Medisoft

How to Fix Claim Rejections Because of No Procedure Code Description

How to Fix Claim Rejections Because of No Procedure Code Description

If you get rejected claims for not having a procedure code description, sometimes the claim might come back as being rejected for Loop 2400 SV101-7. This video will show you how to handle this, or how to fix this so that you can resubmit the claim along with the procedure code description.

Check out the video here:

Did this video answer your question? Hopefully it did! If not, we have 100’s of more DIY support videos on our YouTube channel and right here on our blog. Just search for what you are looking for and watch as many videos as you have the time for.

Need professional help? Running short on time? Can’t quite get Medisoft to work the way you want it to? AZCOMP provides the most phenomenal support experience in the entire country and you can get them to help you an UNLIMITED amount by becoming a Platinum Member. Plans start as low as $99 per month.

 

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Medisoft ICD-10 Frequently Asked Questions

Medisoft ICD-10 FAQ

October 1, 2015 has come and is now gone and the AZCOMP support department has been busy to say the least. The phone is ringing almost non-stop and we’re getting the same questions over and over. So we’ve put together this list of Frequently Asked Questions.

We’ve compiled this same list on our ICD-10 resource page, so be sure to check there for future updates. If there are more FAQ’s to add, we’ll add them on that page.

Here is a list of the current top 5 most frequently asked questions about ICD-10 and Medisoft.

#1: Why are my codes showing in red in Medisoft transaction entry?

This first video answers a question about why the old ICD-9 codes are showing in red when you try to enter new charges in the Transaction Entry screen as well as give some insight as to why ICD-9 codes still show. This video will also show you how to change the default diagnosis in the patient’s case from ICD-9 to ICD-10. Watch the video above to get help with this.

#2: Why are my old ICD-9 codes showing in transaction entry?

This video builds on the first video. A lot of people have been wondering why the Transaction Entry screen in Medisoft is still showing the old ICD-9 codes instead of the expected ICD-10 codes. This is a very common point of confusion that is addressed in this video. Watch the video above to get the confusion cleared up hopefully.

#3: Why are there no codes to map when I go into the code mapping tool?

This third video covers a question about the ICD-10 mapping utility in Medisoft. Many people have had questions about how it works and why there are no codes displayed or available to map when they go into the tool. Be sure to watch this video if you are having those problems.

#4: Why are my electronic claims getting rejected, and what is an ICD-10 qualifier?

This video is regarding electronic claims rejections. We’ve had many instances of electronic claims being rejected because the ICD-10 qualifier is sending a “BK” or “BF” rather than the needed ICD-10 qualifier of “ABK” or “ABF”. This video will show you how to resolved this common problem. Watch this video to learn how to solve these problems if you are experiencing claims being rejected.

#5: I still can’t send claims. Why can’t I submit my claims?

Video 5 explains why electronic claims are being rejected for users who send claims in “text file” or “print image” format using the CMS11 program. This will be a 2-part answer.

First, watch this short one-minute video to determine if you are sending claims in the old format: https://www.youtu.be/M4fo4VKrt-U.

If it is determined that you are sending claims in “print image” using the CMS11 or CMSFILE, watch this other video (which is the same as the video above at the beginning of this answer) on what this means to you: https://www.youtu.be/YALuP2zR4JE.

We recommend you call your AZCOMP account representative at (888) 799-4777 to proceed forward with the implementation of Revenue Management. If you are currently using Revenue Management to send claims electronically this video will not apply to you and there may be other issues our support department will need to look at for you.

Need More Help?

If these videos don’t answer your questions, call AZCOMP for technical support and training!

We can help you with Medisoft and ICD-10 challenges with a support agreement starting for as little as $99 per month! We have support plans to fit all different sizes of practices as well, so give us a call to get started on your Platinum Support Membership.

Visit our ICD-10 Resource Page

Be sure to check out our ICD-10 Resource Page for more updates, more videos, more training and more information.

https://www.azcomp.com/medisoft/medisoft-addons/

Medisoft ICD-10 Troubleshooting Tips

Day 1 ICD-10 Troubleshooting Tips in Medisoft

Day 1 of ICD-10 was a busy day at the AZCOMP Support Department. After a full day of helping resolve over 100 different support tickets, we’ve got a pretty good handle on what the struggles are for a lot of different people.

This quick video will give some tips on troubleshooting some problems you might be having so far in Medisoft with the ICD-10 transition. We’ll look at the following items:

  • Dx codes showing red
  • Making sure you have added your ICD-10 codes
  • Changing the ICD version for your various insurance carriers
  • Setting the ICD-10 date
  • Updating codes inside a patients case
  • Updating the settings in Revenue Management

 

If you’re having any other troubles that you need help with, be sure to leave us a comment in the comment section of the video. If you like the video then let us know by giving us a “thumbs up”!

Watch the video now…

icd-10 troubleshooting tips for medisoft

Need More Video Help?

We have more videos you can watch to help you get through the transition. Check out these others if you need…

  1. Options for getting ICD-10 codes into Medisoft
  2. Start to finish how to setup Medisoft for ICD-10

 

Be sure to check out all our other ICD-10 and Medisoft training or support videos and subscribe to our channel!

New Place of Services Code Created by CMS

New Place of Service Code

Ask the Coder

By Lisa A Schroeder, CHC, CPC, CCS-P, Compliance – Academic, Office-based and Multi-specialty Physicians, McKesson Business Performance Services | August 31, 2015

Place of Service Update

The plan to update Place of Service (POS) codes for outpatient hospital services was announced in the CY 2015 Physician Fee Schedule (PFS) Final Rule. In that Final Rule, the Centers for Medicare and Medicaid Services (CMS) noted that with the proliferation of physician practices becoming hospital based, CMS lacked a means to adequately determine the expense incurred by a practice versus the expense incurred by a hospital outpatient department. The Practice Expense (PE) is one of the components of the Relative Value Unit (RVU) and is used to determine the fee schedule amount1. In the CY 2015 PFS Final Rule, CMS was also looking for ways to more accurately value visits within the postoperative period.2 Though the Final Rule decided on new POS codes under Part B to help with the assessments, it did not recommend the new code at the time of publication.

On Aug. 6, 2015, CMS issued details regarding the new and revised POS codes under Part B in MLN Matters MM9231 (PDF, 69 KB). These changes will become effective Jan. 1, 2016. To differentiate between on-campus and off-campus provider-based hospital departments, CMS is creating a new POS code – POS 19 and revising the current POS 22 code description for outpatient hospital. These changes will affect physicians, other providers, and suppliers submitting claims to Medicare Administrative Contractors (MAC), including Durable Medical Equipment Medicare Administrative Contractors (DME MAC) for services provided to Medicare beneficiaries under Part B3.

POS Code Set – Outpatient changes4

place-of-service-update-codes

What does this mean to physicians and practitioners?

  • To file a claim, the outpatient POS must be correctly identified. Either the hospital outpatient location is on campus, (POS 22) or it is off campus (POS 19).
  • Payments for services provided to outpatients who are later admitted as inpatients within three- days (or, in the case of non-IPPS hospitals, one-day) are bundled when the patient is seen in a wholly owned or wholly operated physician practice. For those services that have a technical component (TC) and a professional component (PC) split in the PFS, Medicare will continue to pay the facility rate for the PC when provided within the three-day, (or one-day), window.
  • Claims for covered services rendered in an Off Campus-Outpatient Hospital setting (or in an On Campus-Outpatient Hospital setting, if payable by Medicare) will be paid at the facility rate. This also applies to those services with a professional fee only, that is no PC/TC split.
  • Reporting outpatient hospital POS code 19 or 22 is a minimum requirement to trigger the facility payment amount under the PFS when services are provided to a registered outpatient. Therefore, you should use POS code 19 or POS code 22 when you furnish services to a hospital outpatient regardless of where the face-to-face encounter occurs.

MM9231 also mentions minor corrections to POS codes 17 – Walk-in Retail Health Clinic and 26 – Military Treatment Facility. These two codes have been added back to the POS list in the “Medicare Claims Processing Manual”.

To view the related Change Request (CR) 9231 (Transmittal 3315) which includes the update to CMS Manual System Publication 100-04 Medicare Claims Processing Manual, click here (PDF, 225 KB).

1 Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule, Access to
Identifiable Data for the Center for Medicare and Medicaid Innovation Models & other Revisions to Part B for CY 2015, 79 Fed.
Reg. 67547, 67569 (November 13, 2014) (to be codified at 42 CFR 403, 405, 410, et al.).
2 Ibid.
MLN Matters® Number: MM9231 Related Change Request (CR) #: CR 9231 Related CR Release Date: August 6, 2015 Page 1
Ibid at Page 2.

Notice Regarding Print-Image Files and ICD-10

Are you still submitting claims to your clearinghouse using “Print-Image” files?

If you are still using the print image method for submitting claims, you need to start submitting using the new CMS 1500 02/12 claim form or your cash flow will be negatively impacted.

As October 1, 2015 approaches, the primary concern for all providers is whether or not they will continue to receive revenue as the entire industry makes the biggest transition in healthcare in 35 years! While many practices are finishing off the tail end of their ICD-10 Action Plans, and are well on their way to a smooth transition, we have recently seen a surge in calls from practices that have not yet completed ICD-10 testing with their clearinghouse and payers.

As we are assisting practices with their testing, we are finding a higher than expected number of practices that are sending print image files to their clearinghouses. Most clearinghouses cut off the use of print image files when the industry shifted to the new CMS 1500 02/12 form back on April 1, 2014. However, there are still a few outliers that continued to allow users to submit print image files.

Keep in mind that HIPAA required all electronic transactions to be submitted in the ANSI 5010 format as of January 1, 2012.

In order to comply with this new standard, Medisoft built the capability to submit claims in the 5010 format directly from the program through the Revenue Management module. If you are not using Revenue Management then you are submitting claims in a print image format to your clearinghouse. Then the clearinghouse is converting the print image file for you to the ANSI 5010 format and forwarding it on to the payers.

How You Can Find Out If You Are Sending “Print Image” Text Files

Typically the print image format comes from a file that is formatted based on the HCFA claim form fields. In Medisoft and Lytec the most common method of producing the print image file was by setting up an EDI receiver to launch an executable file called CMS11.exe. Here is a sample of what you may see when you are sending claims that notifies you that you are sending a “print image” text file.

medisoft cms11 text file print image

Or you can watch this short video where we show you in Medisoft how you can find out if you are sending “print image” files.

Don’t Let Your Claims Get DENIED

As of Medisoft v19 and Lytec 2014, Medisoft and Lytec discontinued support of the cms11.exe file. It was never updated to match the new claim form or to handle ICD-10 codes. Therefore, if you are still relying on this method to submit claims there is a very high likelihood that your ICD-10 claims will be DENIED starting October 1, 2015.

While some clearinghouses may continue to support print image file submissions, our understanding is that they will require you to use a print image file that produces a print image of the CMS 1500 02/12 claim form. Please take note that the CMS11.exe file produces the old 08/05 claim format and that print image submission is not supported in Medisoft or Lytec.

Get On Board With Revenue Management

The good news is Medisoft v19 (and Medisoft v20) and Lytec 2014 (and Lytec 2015) are both equipped with not only the new 02/12 claim forms, but also with Revenue Management. The Revenue Management module in Medisoft and Lytec can be configured to send claims to any clearinghouse or even directly to the payers in the 5010 format.

In addition, Revenue Management has features such as claim scrubbing and ERA posting that your practice can take advantage of to streamline billing processes.

revenue management claim check screen shot

While the Revenue Management application is included with the ICD-10 compatible versions of Medisoft and Lytec, it does require setup and configuration to successfully utilize it. If you need to get setup on Revenue Management please call us at (888) 799-4777 to schedule the configuration with an EDI Professional!

If You Need Revenue Management Configured, Don’t Wait!

Please do not wait to contact us as the backlog of practices that need configuration and training is growing and our availability is based on first come first serve.

We also highly recommend contacting your clearinghouse as soon as possible to discuss this change, and to coordinate the switch from the print image file to the ANSI 5010 format.

Here Is A Clip From A Recent Webinar Explaining The Problem And What You Can Do About It

video play - no print image support

Five Facts about ICD-10 from CMS

quick fix icd-10 conversion team cartoon

The Centers for Medicare & Medicaid Services (CMS) recently talked with providers to identify common misperceptions about the transition to ICD-10 in order to help dispel some of the myths surrounding ICD-10.  Some of the most common questions and concerns about ICD-10 are covered in these five facts written by CMS.

The Five Facts about ICD-10 & CMS comments about them

1. The ICD-10 transition date is October 1, 2015.

The government, payers, and large providers alike have made a substantial investment in ICD-10.  This cost will rise if the transition is delayed, and further ICD-10 delays will lead to an unnecessary rise in health care costs.  Get ready now for ICD-10.

2. You don’t have to use 68,000 codes.

Your practice does not use all 13,000 diagnosis codes available in ICD-9.  Nor will it be required to use the 68,000 codes that ICD-10 offers.  As you do now, your practice will use a very small subset of the codes.

3. You will use a similar process to look up ICD-10 codes that you use with ICD-9.

Increasing the number of diagnosis codes does not necessarily make ICD-10 harder to use.  As with ICD-9, an alphabetic index and electronic tools are available to help you with code selection.

4. Outpatient and office procedure codes aren’t changing.

The transition to ICD-10 for diagnosis coding and inpatient procedure coding does not affect the use of CPT for outpatient and office coding.  Your practice will continue to use CPT.

5. All Medicare fee-for-service providers have the opportunity to conduct testing with CMS before the ICD-10 transition.

Your practice or clearinghouse can conduct acknowledgement testing at any time with your Medicare Administrative Contractor (MAC).  Testing will ensure you can submit claims with ICD-10 codes.  During a special “acknowledgment testing” week to be held on June 2015, you will have access to real-time help desk support.  Contact your MAC for details about testing plans and opportunities.

What this means for smaller independent practices (from our perspective)

First – if you feel you aren’t prepared, there is no time like today to get started.

What do you need to do to get prepared?  That answer is different for each different practice, but we have some resources available for you.  Use the ones that fit best with where you are at.

ICD-10 Planning Tools

ICD-10 Webinar Series – A few months back we hosted a series of ICD-10 webinars.  You can access the recordings now by clicking here.  In these 4 short webinars (each recording is between 30 to 45 minutes) we provide a lot of information to help with planning, to help you learn how to use the ICD-10 tools that are built into Medisoft v20/v19 and Lytec 2015/2014, how to conduct testing with your clearinghouse, and give other tips on how to become ICD-10 ready.

Quick ICD-10 Planning Checklist – This 1 page (front and back) checklist summarizes in simple terms what you need to consider for your practice to get ICD-10 ready.

ICD-10 Impact Summary – This 1 page (front side only) info sheet summarizes how ICD-10 might impact different aspects of your practice to help you understand what changes you might need to make.

Roadto10.org – They have some videos you can watch, a “Build Your Action Plan” tool you can use and many other articles and other resources.

Second – you need to upgrade to the ICD-10 ready version of your software.

Your software is not ICD-10 ready if you are not on Medisoft v20/v19, or Lytec 2015/2014.  Medisoft v18 or any other earlier model is not ICD-10 ready.  Lytec 2013 or any other earlier model is not ICD-10 ready.

Call us today at (888) 799-4777 to get your ICD-10 ready software.

Third – consider additional software solutions to help make the transition easier.

In addition to upgrading to Medisoft v20 or Lytec 2015, there are additional tools that can help make things easier.  Fact number 3 above provided by CMS states that electronic tools are available to help you with code selection.  Here are the tools that we have to offer.

Codes on Disk

If your time is valuable then you are going to truly appreciate this simple tool.  Import the latest CPT-4, ICD-10, and HCPCS codes for your specialty into Medisoft or Lytec to assist you with implementing the standard code set requirement for HIPAA.  Save yourself hours of manual labor entering all those procedure and diagnosis codes.  This tool can be used by existing Lytec and Medisoft users alike.  It will not erase your existing codes.

Encoder Pro

Encoder pro enables users to simultaneously search across ICD-10, CPT, and HCPCS codes to get integrated search results, code details, and descriptions.  This will save so much time compared to searching a physical code book by hand.  If you have Google or Bing at your fingertips, would you ever go pick up a phone book or encyclopedia or dictionary?  Take advantage of Encoder Pro the way you use Google to find things out.

EMR

Has your practice implemented an EMR yet?  If you are not using EMR yet, let ICD-10 be another reason to consider it.

How can EMR help with ICD-10?  The short answer is that we cover 5 ways an EMR can help make the transition to ICD-10 easier in our webinar series mentioned above.  Feel free to watch the webinar recordings.

Still not really a direct answer, but here are two questions to consider to get you started thinking about it.

Question 1: What is your paper superbill going to look like with the expanded list of codes you will use in your practice?

Question 2: With an increased need for documentation, how are you going to retrain yourself or your staff to be better at documentation?

With the transition to ICD-10, even though you won’t need to use all 68,000 codes, you will definitely see an increase in the number of codes you are using on a regular basis.  This could significantly increase the size of your superbill.  If you are seeing patients with a four or eight page superbill, how fun will that be to manage?

By implementing an EMR, you will make the switch to an electronic superbill which will be so much better for managing all those codes.  Additionally, the documentation needed with your ICD-10 claims will be taken care of for you while using the EMR program.

There are several other ways an EMR can help with ICD-10, which are covered in our webinar replay you can watch.  And of course EMR helps in many other aspects with amazing tools like e-prescribing, lab-interfaces, eliminating paper charts and helping to improve patient care to name just a few.  To learn more about our Medisoft and Lytec EMR options or to schedule a demo, just give us a call!

Lastly – practice using ICD-10 codes starting ASAP!

Practice!  Practice!  Practice!

Even if you have all of the tools that you need, if you wait until October 1 to start using everything, then it will be a rough transition.  If you haven’t worked out your own kinks, then you could see significant delays in getting your claims paid and you will be frustrated with the process.  Don’t do that to yourself.  You can start practicing today!

Here are a couple tips to help you start practicing.

Our second webinar recording shows you how to put your software (either Lytec or Medisoft) into “testing mode” so that you can submit test claims.  In our third webinar, we outline how you can test your ICD-10 claims with your clearinghouse.  We provide specific information from Relay Health because that is our preferred clearinghouse, but we give you the info you need so you can enquire with your own.

There is also a feature in your ICD-10 version of the program that allows you to just start coding everything in ICD-10 right now, but your claims will still be submitted in ICD-9 right up until September 30th!  In the program, you can set a date for when to start submitting your ICD-10 claims.  Set that date right now so you don’t need to worry about making any changes on the morning of October 1.  

Doing all this will allow you to practice coding in ICD-10 now and so that you and your staff can get comfortable with the changes, but without the added stress of potentially delayed payments.

That’s it for now.

If you’ve been working on getting ICD-10 ready at your practice – feel free to share your successes or your failures with the community so we can learn from each other.  Share with us in the comments below!

Emdeon (Capario) Clearinghouse EMF Migration Instructions

This is a required update in Revenue Management if you are using the Emdeon (Capario) clearinghouse

Emdeon has notified AZCOMP that there is a critical update that users of their clearinghouse need to perform inside of Revenue Management by May 31, 2015.  If you are using the Emdeon clearinghouse to process your electronic claims, all mailboxes will be suspended from using the old EMF on June 1, 2015.  This means that you will no longer be able to upload or download any files (claim files & reports) from Emdeon using the old EMF.

In order to avoid problems with Emdeon in your Revenue Management feature of Medisoft or Lytec, this update needs to be performed on every workstation that does work in Revenue Management.

If your clearinghouse is Emdeon, then you need to perform this update.

In order to perform this update, please visit our website for writen instructions and for a video showing you how to do this.  It is very simple and should take you less than 10 or 15 minutes to complete.

Click Here To Perform The EMF Update for Emdeon in Revenue Management

Emdeon EMF update video

Relay Health ICD-10 Testing Information

Learn Here How To Test Your ICD-10 Claims With Relay Health

icd-10

Relay Health is an electronic claims clearinghouse that is integrated with the Revenue Management feature of Medisoft and Lytec.  Relay Health’s seamless integration is awesome for you because it allows you to manage the entire claims process from within the program (Medisoft or Lytec), it provides you with real-time information about claim rejections or approvals, it speeds up the payment process, and reduces the time you spend on the claims process.

If you are not using the Relay Health clearinghouse, give AZCOMP a call to find out more about how Relay Health can save you time and get you paid quicker.

ICD-10 Testing

Earlier this year, AZCOMP produced and hosted 4 webinars designed to help small practices get ready for ICD-10.  In these webinars we discussed things like:

  • The ICD-10 billing challenges and the solutions that are available to you in Medisoft version 20 (or 19) and Lytec 2015 (or 2014)
  • How to put Medisoft or Lytec into “testing mode” so that you can test sending claims
  • How to set the date for the ICD-10 transition so that you can start using ICD-10 codes today and still be submitting your claims using ICD-9 codes
  • How to begin testing with your clearinghouse (including how to do this with Relay Health)
  • Problems your practice will face switching to ICD-10 outside of submitting claims and the solutions to these problems.

There was a lot more discussed in the 4-part webinar series but those are the highlights.

Click Here To Get Access To The Webinar Recordings!

Relay Health’s ICD-10 Testing Update

AZCOMP is a partner with Relay Health and they recently sent us this information about conducting ICD-10 testing with them.  Everything that you read below here is the information that we received from them.

ICD-10 Testing – It’s Easier Than You Think!

By now you’ve heard the warnings. If you’re not already conducting ICD-10 testing, you’re late. So why are you waiting? It’s easier than you think!

There are three types of testing available to RelayHealth customers:  End-to-End Testing, Validation Testing, and Self-Supported Payer Testing. 

Here’s how to get started:

1. End-to-End Payer Testing (Available Through July 31, 2015)
RelayHealth customers can send ICD-10 test claims to the 300+ core payers that are part of the RelayHealth testing program. Test claims will be processed through RelayHealth and sent to payers following the same process as ICD-9 claims.

  • Determine if you have been selected by your payers to conduct ICD-10 testing. Most payers are indicating they will test with a limited number of providers. 
  • View the training course for the RelayHealth ICD-10 testing program. This training course should be viewed prior to attempting any ICD-10 testing with your payers.
  • Review the “RelayHealth Reports – Test” section of the RelayHealth Reference Guide for information on RelayHealth generated test reports returned for test claims.  
  • Access the Payer Testing Readiness Dashboard from ConnectCenter or Collaboration Compass to determine if your payers are ready to conduct end-to-end ICD-10 testing.

Hundreds of RelayHealth customers have used our end-to-end ICD-10 testing platform to submit thousands of ICD-10 test claims to their payers and receive test claim remittances back from their payers. 

This end-to-end testing platform is only available until July 31, 2015. This aligns with the Centers for Medicare and Medicaid Services’ (CMS) recommendation to complete all ICD-10 testing by July 31 – to focus on final go-live preparations and mitigations (if any) during the last 60 days before the compliance deadline.  

2. Validation Testing (Available throughout the ICD-10 transition)
Validation testing allows customers to verify that their ICD-10 test claims have been successfully transmitted to RelayHealth – but it does not include the transmission to the payer component of end-to-end testing. 

Customers can send ICD-10 test claims to RelayHealth for code set validation of ICD-10-CM (Clinical Modification) for diagnosis and ICD-10-PCS (Procedure Coding System) for inpatient hospital procedures.

3. Self-Supported Payer Testing (Available throughout the ICD-10 transition)
If you were not selected by your payers to participate in end-to-end testing, you should ask your payers if they will enable you to submit passive ICD-10 test transactions. RelayHealth provides the means to conduct passive testing by enabling you to deliver an 837 test file to providers. This allows you to test directly with any of your payers, whether you’ve been selected to test or not.

WHY IS TESTING CRITICAL?

If your organization is not ready for the ICD-10 transition, you may experience significant backlogs, claim denials, and negative impacts on revenue. 

Read One Customer’s ICD-10 Testing Success Story
From the start, Tampa General Hospital understood the importance of payer-provider collaboration in ICD-10 readiness – particularly when it came to testing. They knew that this testing would be different than anything the industry had done before and in order for it to be meaningful, there had to be open and transparent collaboration between providers and payers. Learn how Tampa General validated its ICD-10 readiness and also helped identify some potentially problematic claim issues.

Action Required: If you haven’t started ICD-10 testing yet, we recommend you choose one – or more – of the testing options offered through RelayHealth and get started as soon as possible.

If this information was useful to you, please share the information by clicking below!

Electronic Claims Video – Create Shortcut for Explanations Of Loop And Segment Rejections

Don’t Have All Those Loop & Segment References Memorized?  No Problem – This Might Help

When you have electronic claims rejections, the clearinghouse often includes these Loop and Segment references.  If you don’t know what these loop and segment references mean, don’t feel too badly because we don’t know what they mean either.  Luckily though there is a reference guide that can help explain.

In this short video, learn how to create a desktop shortcut for yourself so that you can quickly access the information and look up these references.  This way the explanations you are looking for are now at your fingertips.

Watch the video here…

video thumbnail - loop and segments shortcut

 Video Transcript:

In this video we’re going to show you how to set up a shortcut on your desktop that’s going to explain what all those loop and segments are. So when you get a rejection in Revenue Management or from your clearing else or even from the insurance company. Most of the time they’re going to include that was a rejected for a certain loop and segment number. This is going to help you make heads or tails and how to actually fix it.

First thing we want to do is on the desktop we go to an empty spot where there are no icons and right click and choose New, Shortcut, and then we’re going to browse into this PC. We’re going to go to our Medisoft folder and the Bin, and we’re going to scroll down until we get to that one file. It’s one of those files that’s kind of hard to find unless you know what you’re looking for. We’re going to look for MedisoftHelpAIIANSI. Then we click on next, we’re going to name this just to make it easier, Loops and click finish. There’s our desktop shortcut to those loop and segments.

When we get a rejection and let’s say that it was going to be on loop, here we go let’s just go click one out of random, Loop 2000B Segment HL. We click on that and it’s going to tell you everything about where that loop and segment is. If it’s right here, if it’s loop and segment HL01 it tells you all that stuff. The most common one is 2010AB Pay-to Provider Name, it tells you here again where it all is. If it’s Loop2010AB Segment N2 tells you right here, segments not used; For segment N3 it tells you where it’s point from practice information.

Same here if it was rejected because of Loop2010AB Segment N3 then we’re going to know that it’s probably the Pay to Address 1 and this is where you find it, it’s going to be in the Practice information, Practice Pay To tab, Street 1. It tells you exactly where that loop and the segment is pulling from so you can repair it, re-submit the claim and get that claim paid.