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The Medical Records application area is used to manage a patient’s documentation and prepare visits for billing. Physicians, nurses, and staff are sometimes required to obtain specific information for a patient’s medical record for proper diagnosis and later reimbursement. Medical Records helps manage that process, from maintaining and applying a variety of diagnosis, procedure, and payment codes toRead more

This application area’s workspace has a variety of Quick Actions available. The Quick Actions and their functionality are described in this section. Keep in mind that an individual user or role may not have access to all of the tabs listed. Demand Admit Form The Demand Admit Form Quick Action is used to manually generate an admission form,Read more

The Legal tab is used to add or update legal status information for a visit. Crime and legal requirement information can also be added. This information can be used for facilities that serve patients who are incarcerated for crimes. To add legal status detail, follow these steps: Click the Add  button. A row is added to the list, andRead more

The MSP tab is available when the insurance plan requires the completion of the Medicare Secondary Payer Questionnaire. This is routinely required when Medicare is the secondary insurance. The Person Supplying Information section is required and identifies the person (patient, relative, caregiver, etc.) providing information, and the Medicare Secondary Payer Questions section contains a list of questions that are required by the government.Read more

Disable Method and/or Date Range Rules The rules requiring a utilization review method and approved authorization date range can be disabled using Global Registry keys. Using standard functionality, the Authorizations and Authorization Details tabs require both to be entered before an authorization can be saved. If a visit has multiple authorizations, their approved date spans cannot overlap or haveRead more

The Authorizations tab is used to review and authorize coverage for charges on visits that have an insurance that requires service authorizations, allowing those charges to be included on the insurance claim and for Billing to process the visits. An authorization provides coverage for a defined date range and can cover all charges within a range of days orRead more

Activate Medicare Lifetime Reserve Fields The Lifetime Reserve and Psych Lifetime Reserve fields and authorization options on the Insurance > Coverages tab can be activated by enabling Location Registry keys. These fields allow lifetime reserve information, and the patient’s accompanying authorization or denial to use those reserve days, to be stored in RCM Cloud®. This is informational, and the application does not enforce any limits. TheRead more

The Insurance tab lists all insurances associated with the selected visit and allows the user to add, update, delete or re-rank the insurances assigned to a visit. It allows insurances to be verified, while subscriber, bill code, coverage, and exclusion information can also be managed. A visit can have multiple insurances with the same or different rankings,Read more

Assign Guarantor ID A unique guarantor ID can be assigned to a guarantor for use in guarantor statements by enabling the Global Registry key GUAR_UNIQUE_ID. When enabled, the guarantor ID is assigned to the guarantor upon saving the visit, and the Guar ID field displays in the common Guarantor tab. There is also a Search button enabled to allow the user to searchRead more

The Guarantor tab is used to indicate who is responsible for paying any charges accrued during the visit. The guarantor can be a patient, relative, or company/group. A guarantor is required in order to register a patient. A Payment Plan can be set up for the guarantor through this option as well. To complete guarantor information, follow these steps:Read more