PCC eRx Prescription Favorites
PCC eRx has the ability to keep track of the medications you most commonly prescribe as “favorites”. Selecting from a list of favorites can save you quite a bit of time as you prescribe.
You can add favorites on-the-fly as you prescribe, or you can opt to allow PCC eRx to automatically adjust your list of favorites based on your ongoing prescription activity.
If you want to manage your favorites list, you can do that in the My Settings tab in PCC eRx.
Favorites Are Set By Prescribers: If you are clinical staff or a provider agent, then you will see the ordering provider’s favorites. For more information about prescriber roles, read PCC eRx Prescriber Roles.
Prescribe with Favorites
There are three ways that you can see your favorites within the Prescribe component:
- At the top of search results when you begin a new prescription
- As thumbnail tiles (optional)
- In a drop-down menu (optional)
Favorites always appear first whenever you search for a medication.
If you would like to see some (or all) of your favorites as you prescribe, you can choose to display them as thumbnail tiles or in a drop-down menu.
With thumbnail tiles, you can choose how many favorites to display at one time.
Thumbnail tiles also include the green plus icon, which sends the prescription directly to the Review & Sign component, ready to be sent to the pharmacy.
If you have a long favorites list, using the searchable drop-down menu makes it easy to find the right prescription.
For each favorite prescription, you see the name, dosing statement, quantity, and instructions. When you select a favorite from the drop-down, you will be taken directly to the Edit Prescriptions window, with the dosing statement already filled in.
To see how you can customize your favorites display options, read the section below titled Choose How Favorites Appear in the Prescribe Component.
Add a New Favorite as You Prescribe
You can add new favorites on-the-fly as you prescribe, with one click.
Create a Favorites List All at Once: If you prefer to set up several favorites at one time, you can add favorites manually from the My Settings tab. Weight-based favorites that auto-calculate for you must be added in My Settings.
To create favorites as you prescribe, simply click the gray heart icon next to the drug name, or click the “Add to Favorites” button at the bottom of the Add New Med window.
If you are prescribing something that is already a favorite, the heart will be colored blue. If you make changes to that favorite, the heart will turn gray, indicating that it is no longer a favorite. You can then save this new prescription as a new favorite.
Favorite fields: The following information is saved as part of a favorite: drug name, route, frequency, dosage form, dose, dose max, dose unit of measure, strength, strength max, strength unit of measure, dispense quantity, dispense unit of measure, and refills.
Can I Delete a Favorite?: You cannot remove a favorite while prescribing. To remove something from your favorites list or otherwise manage favorites, go to the My Settings tab in PCC eRx.
Manage Your Favorites from My Settings
Favorites are maintained and managed within the My Settings tab in PCC eRx. Here you can choose how new favorites should be added (automatically or manually), and how favorites will appear when prescribing. The My Settings tab is where weight-based favorites are created, and where you can edit, delete, pin, or exclude existing favorites.
To manage your favorites, click the “My Settings” link on the PCC eRx menu bar, and scroll down to the “Favorites” section.
All of your favorites, whether manually created or automatically generated, display in the table, grouped first by status (pinned, automatic, excluded), and then by drug class (ADHD, Antihistamines, Asthma/COPD, etc).
For each prescription, you can see the name, dosing statement, quantity, and instructions.
Turn Automatic Favorites Off or On
If Automatic favorite management is turned on in My Settings, your most commonly prescribed medications are added as favorites automatically. You can still add favorites manually, if you like.
The Manage Favorites List function can be set to either “Manual” or “Automatic”.
When set to “Automatic”, PCC eRx keeps track of your last six months of prescribing activity and automatically updates your Favorites list as you go. This can be a very helpful feature, but keep in mind that slight differences in details will create more than one version of a drug to appear on your Favorites list.
If you would rather not have PCC eRx “remember” your prescribing activity, select “Manual”. When your favorites list is managed manually, medications are only added as favorites when you intentionally do so.
Need Help Cleaning Up Your Favorites List?: Turning off Automatic Favorites does not remove existing auto favorites from your list. If you find that you have too many favorites for your list to be useful, contact PCC Support for help cleaning up your list.
You can edit, delete, and manage how favorites will appear, whether “Automatic” or “Manual” is selected.
Choose How Favorites Appear in the Prescribe Component
When you prescribe with PCC eRx, you can choose how (or if) you want your favorites list to be displayed. You can choose to display them as thumbnail tiles, in a drop-down menu, both ways, or not at all.
In the “Favorites” section of the My Settings tab, check the box beside whichever favorites display method you want to enable (you can choose both if you like).
If you choose to display favorites as tiles, you can choose how many tiles to display.
Number of Favorites to Display: If you have chosen to see your favorites as tiles, you can select the number of tiles to show with the “Number of Favorites to display in Prescribe section” field. The Favorites drop-down menu will always contain all favorites.
If you would rather not see a Favorites section displayed as you prescribe, and prefer to only see favorites suggested as you search, you can uncheck both favorite display methods.
Add Favorites Manually from My Settings
If you want to set up new favorites outside of your prescribing workflow, go to the My Settings tab, scroll down to the Favorites section, and click “Add New Favorite”.
Find the drug (or supply) and dosing statement for the new favorite.
Enter additional prescription details, if needed, and click “Save”.
Working with Weight-Based Favorites
You can create weight-based prescription favorites that will automatically calculate volume-per-dose based on a patient’s weight. For weight-based favorites, PCC eRx saves the math, not the actual dose; the dose is calculated when you prescribe from the favorite.
From the Favorites section of the My Settings tab, click “Add New Favorite”.
Find the medication and pick a weight-based dosing statement. (Note: You can pick any dosing statement as a template, but selecting a weight-based dosing statement saves a step.)
PCC eRx understands that you want to create a weight-based favorite, and it will display the medication with a “milligram/kilogram/dose” value.
Make any adjustments needed, enter additional prescription details if desired, and click “Save”.
Your new prescription favorite will appear in the Prescribe component.
When you select the favorite to prescribe, PCC eRx will check the patient’s weight and calculate a per-dose value based on the weight of the patient and the strength of the medication.
Edit or Delete an Existing Favorite
If you need to adjust a favorite, or delete it, go to the My Settings tab, scroll down to the Favorites section, and find the favorite within the table.
Click the red pencil icon to edit an existing favorite.
In the above example, we changed the Dispense information for the favorite prescription.
Click “Save”. The changes made will be reflected in the Favorites table.
Delete a Favorite: From the edit window, you can also delete a favorite if you don’t want to see it on the list anymore. Just click “Delete” to remove it.
Pin, Unpin, and Exclude
You can use the icons to the left of each favorite within the table to indicate active and inactive favorites, and (depending on your selected favorites display method) which are your preferred favorites.
There are 3 icons within the favorites table:
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thumbs up: The thumbs-up icon denotes a “pinned” prescription. Pinned prescriptions only matter if you have chosen to see your favorites as tiles. If you have more favorites than space within your tiled favorites section, pinned prescriptions are given display preference. All manually added prescriptions are pinned by default. You can un-pin a favorite by de-selecting the thumbs up icon.
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checkbox: A checked prescription simply means it is an active favorite. Automatically added favorites are checked but unpinned by default. You can choose to pin an automatically added favorite by clicking the thumbs-up icon.
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excluded: The thumbs-down icon denotes an inactive (excluded) favorite. Inactive favorites are not included in your favorites display or when searching for prescriptions. Marking a favorite as “excluded” is relevant if you have Automatic favorites turned on, because it blocks the specific drug and sig from being added to the list again.
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Click on an icon to unpin, pin, or exclude a favorite.
Delete or Exclude?: You can click the red pencil icon to edit a favorite and then click “Delete” to remove it. However, if you prescribe the medication again and you have Automatic management turned on, the prescriptions can show up on your Favorites list again. If it a favorite is “excluded”, you will not see it on your Favorites list.
Administrator Only: Share Favorites Among Prescribers
You can pass favorites back and forth among different prescribers at your practice. For example, one pediatrician could create favorites and then have an eRx administrator share them with other pediatricians.
Only a PCC eRx Administrator can copy favorites between users. For more information, read Set Up PCC eRx User Access.
To copy favorites, go to the “Administration” tab. Within the User Management section, click “Copy Favorites”.
Next, use the first search field to find a user from whom you wish to copy favorites. Use the second search field to find one or more users who will receive the copied favorites.
Review the list of favorites for the “From” user. You can de-select any that you do not wish to copy.
Finally, choose one of the options on the right to either add the copied favorites, or completely replace the destination user’s favorites with the copies from the first user.
Switch to the New Forms Solution in PCC EHR
A new forms solution in PCC EHR empowers you to create and manage your own auto-filling forms, handouts, policies, and letters. With help and guidance from PCC Support, you can switch to the new forms solution when the time is right for your practice. Read more to learn why, when, and how to make the switch.
Early Access Tool: The new forms solution is in an early access testing period in just a few offices. If you are interested in participating in the early access release, please contact PCC Support.
Explore What’s New
Learn about the benefits of the new forms solution in PCC EHR and evaluate your readiness to make the switch.
The Benefits of Switching
Switching to a new way of doing things takes time and preparation, but there are many reasons your practice might want to put in the effort to switch to the new forms solution in PCC EHR.
You should consider switching to the new forms solution if you want:
- More control over the creation and maintenance of your practice’s forms, handouts, policies, and letters in a user-friendly interface
- Fewer back-and-forth emails with PCC Support when you need to make changes to a form
- Smarter functionality for forms that require a signature or include visit-specific data, and
- Better ways to add free text on the fly when generating forms for patients.
Read Create and Manage Forms in PCC EHR to learn more about what you can do in the new forms solution, and speak with PCC Support to learn if the time is right for you to make the switch.
Evaluate Your Readiness
The new forms solution includes early access tools that are still under construction. To learn if the new solution is ready to meet your practice’s needs, contact PCC Support.
PCC Support can explain how the tools work and help you determine whether the time is right for your practice to switch over.
Together, you will explore:
- the functionality of the forms you currently generate in PCC EHR
- whether the new solution can support that existing functionality
- your level of interest in switching to the new solution
- and the amount of time and people power you can devote to the process of switching over.
With these factors in mind, PCC Support will make a recommendation about whether now is the time for your practice to consider switching to the new forms solution.
Make the Switch
Follow these steps when you decide to make the switch to the new forms solution.
Give the Green Light
After the evaluation period, tell PCC Support whether you want to make the switch to the new forms solution. PCC Support will note your interest in activating the new tool and contact you when we are ready to begin your onboarding. When it’s your time to make the switch, PCC Support will actively guide you through the process.
Depending on your current configuration and the amount of time that you and PCC Support have to devote to the transition, the process of switching to the new forms solution can take anywhere from one hour to several months. Work closely with PCC Support to plan the transition at a pace that works for everyone.
Follow PCC’s Pre-Migration Instructions
Based on the evaluation of your current forms configuration and the functionality that is available in the new solution, PCC Support might recommend that you take certain pre-migration steps. Pre-migration steps typically include things like recreating certain forms as PDFs before you migrate to the new tool.
PCC Support Enables Configuration Mode
When the pre-migration steps are complete, PCC Support will enable the new forms solution in Configuration Mode.
In Configuration Mode, PCC Support can migrate your current forms into the new Forms Configuration tool in PCC EHR and you can finish setting them up without interrupting your practice’s existing workflows.
PCC Support Migrates Your Current Forms
After enabling Configuration Mode, PCC Support will migrate your current forms into the Forms Configuration tool. The migration will take into account the functionality that is available in the new solution and might change the appearance or function of some of your forms, all of which PCC Support should make clear to you well before the migration process begins.
Migrated forms retain their protocol mapping, so you can continue to generate them with a single click wherever you have buttons set up for that in PCC EHR. You can learn more about the Forms component and protocol mapping in the article Generate Forms in PCC EHR.
Once PCC Support indicates that your existing forms have been migrated into the new tool, you can set up user access to the Forms Configuration tool and finish configuring your forms.
Set Up User Access
Users need special permission in order to access the Forms Configuration tool. The ability to delete forms within the tool is also protected by a special permission. You can set up these permissions while in Configuration Mode.
Open the User Administration tool in PCC EHR.
On the Roles tab, create a new Forms Configuration role or add the Forms permission to an existing user role.
Follow the same steps to assign the Delete Form permission to users at your practice.
Finish Configuring Your Migrated Forms
After PCC Support migrates your existing forms into the new Forms Configuration tool, it’s up to you to finish configuring them for use.
Open Forms Configuration
Open the Forms Configuration tool.
Check that the Right Forms Were Migrated
Review the list of forms and make sure that those you wanted to migrate are present.
If any of the forms are missing, speak with your contact on PCC Support.
Finish Configuring PDF Forms
Edit the forms that have PDF icons to review and touch up their configuration.
On PDF forms that include user response fields, you can review and edit the prompts that users will see and respond to when they generate the form for patients.
In addition to response prompts, you can configure the names of PDF forms and preview them using real patient data. To learn more about how to work with PDF forms in the Forms Configuration tool, read Create and Manage Forms in PCC EHR.
Recreate Non-PDF Forms Using the Embedded Form Editor
Forms that do not have a PDF icon in the Forms Configuration tool were migrated with only their titles and background protocol mapping and must be recreated in the embedded form editor.
To recreate the forms, edit them in the Forms Configuration tool and use the tools in the form editor to recreate their contents.
At your request, PCC Support can send you copies of the forms that need to be recreated and assist you with the recreation process.
To learn more about how to create and manage forms in the Forms Configuration tool, read Create and Manage Forms in PCC EHR.
Make Your Forms Active
When you have finished configuring your migrated forms, edit them and set their status to active so that other users at your practice will be able to generate them for patients when you finish making the switch to the new forms solution.
You can learn everything there is to know about working in the Forms Configuration tool in the article Create and Manage Forms in PCC EHR.
Complete a Final Check
When you have finished configuring your migrated forms, complete a final check with PCC Support.
The purpose of this check is to make sure that your forms are working properly, that your questions have been answered, and that you are ready to make the final switch to the new forms solution.
PCC Support Enables the New Forms Solution
Tell PCC Support when you are ready to switch your whole practice over to using your newly configured forms.
PCC Support will fully enable the new solution.
Once enabled, the Forms component will stop pointing to your old forms and users at your practice will only be able to generate forms that have been configured in the Forms Configuration tool.
Optionally Revert to the Legacy Solution: If you find that the new forms solution does not work for your practice, PCC Support can disable it and restore your ability to generate forms the old way. This function may also be used to temporarily disable the new forms solution while PCC Support troubleshoots issues that arise with migrated forms.
Configure Claim Holds and Claim Delay
When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans.
You can also configure your practice’s claim delay, which prevents any claim from going out until a certain number of days after the date of service.
Watch a Video: You can watch a video to learn about Claim Holds and Claim Delay.
Review Claim Holds
Open the Claims tool from the Tools menu in PCC EHR and visit the “Holds” tab.
Your practice can use User Roles to specify which users can open the tool. (See Set User Roles for Permissions and Security)
Click on an existing claim hold in the Claim Hold Index to view details.
Create a New Claim Hold
Follow the procedure below to create a new claim hold.
Click “Add”
To create a new claim hold, click “Add”.
Enter a Description and Dates of Service
A claim hold requires a description and a date range for dates of service.
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Description: You can include a lengthy description indicating the purpose of the claim hold.
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Dates of Service: Enter the claim hold date range. Claims for these dates of service, including the start and end date, will be held until the hold is deleted or changed.
Select Billing Providers, Places of Service, and Insurance Plans
Select additional optional criteria for the new claim hold. You can restrict a claim hold to specific billing providers, places of service, and/or a subset of insurance plans to which your practice bills.
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Billing Providers: Click “Edit” to select which providers’ claims will be held. When processing claims, PCC will hold claims with a Billing Provider that matches one of the providers listed in the claim hold.
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Places of Service: Click “Edit” to select which locations’ claims will be held. You can select one or more places of service. When processing claims, PCC will hold claims with a Billing Location that matches places of service listed in the claim hold.
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Insurance Plans: Click “Edit” to select which insurance plans’ claims will be held. You can search and sort by plan name, plan group, or the payor id used for electronic submission.
When making a selection, you can search a list and use “Select All” and “Select None” to quickly pick groups of providers, locations, or plans.
Click “Save”
Click “Save” to finish creating the claim hold.
Holds are immediately active. After you create a hold, any claims that match the specified dates of service, providers, locations, and insurance plans will not be sent out when you process claims.
When Does a Claim Hold Expire? Never: Claim holds are based on dates of service, so they never expire. Any claims that match the indicated dates of service and the other criteria for the hold will never be sent. In order to release held claims, you must either delete the hold or edit the dates of service or other criteria to change which claims are held.
View Which Claims Were Held
Your practice’s claim holds stop claims when they are processed for submission.
You can review which claims were held in the Log tab of the Claims tool in PCC EHR.
To learn more read Submit Claims.
If your practice submits claims with PCC’s previous claims tool, Prepare/Submit Electronic Claims (preptags/ECS
), then no log is created of which claims were held.
Edit or Delete a Claim Hold
Select a claim hold and click “Edit” to make changes.
For example, you may have a claim hold for a new clinician which holds claims for all insurance plans. As they become credentialed with each payor, you can edit the claim hold and make changes to the insurance plan criteria. Doing so will release claims that do not match the new criteria.
Select a claim hold and click “Delete” to delete a claim hold.
The next time you process and submit claims, any claims held by the deleted hold will be processed and sent.
Configure Your Practice’s Claim Delay
Your practice may want to prevent all claims from going out until a day or two after the date of service. This gives billers extra time to complete charge posting or review encounters to make sure all procedures were billed correctly.
When you want to adjust your practice-wide claim delay, open the Claims tool and visit the Delay tab.
Enter your practice’s desired number of days and click “Save”.
Whenever you process and submit claims, the Claims tool will check each date of service and delay any claim that is younger than your claim delay.
Grant User Access to the Claim Holds and Claim Delay Configuration
Your practice can designate which user roles will have access to claim configuration tools.
User the Roles tab on the User Administration tool to edit an appropriate role.
Next, review that appropriate users are assigned that role.
PCC 9.4 Release
In the third quarter of 2022, PCC will release version 9.4 of our electronic charting and practice management software to all PCC practices.
PCC 9.4 is a major advancement in many of PCC’s products and services. You’ll be empowered to create, edit, and generate form letters in a new interface, and PCC EHR’s Payments tool includes new features for reviewing, editing, and applying payments.
Watch a Video Overview and Demoes: Want to see PCC 9.4’s highlights in action? Watch the PCC 9.4 Overview and Video Series.
Implementation: PCC 9.4 includes features that require configuration and user-specific software training. Read about the features below and then review the PCC 9.4 Migration Considerations article.
Read below to learn more about the new features, and contact PCC Support for help with any PCC product or service.
Updates to Payments in PCC EHR
PCC 9.4 includes new features, improvements, and bug fixes for anyone at your practice who works with payments.
Apply Payments to Specific Charges in PCC EHR
When you post a payment in PCC EHR’s Payments tool, or edit a payment, you can now optionally select the charges that the payment will apply towards.
By default, when you enter a payment it automatically applies towards the oldest charges on an account that have a personal amount due.
Click “Distribution” to review and update how the payment will be applied.
PCC EHR will display all charges on the account that have a personal amount due. You can review how the new payment will be applied, and you can optionally update the amounts to change what charges will be paid by the payment.
When you are finished reviewing or changing how the payment amount will be applied, click “Save Payment” to save and post the payment.
Total Distribution Amount Must Equal the Applied Amount of the Payment: You can’t distribute more or less than the original payment amount (or than the amount you designate to apply to previous balances).
If the distribution total doesn’t equal the applied amount of the payment, you will be unable to save the payment.
Distribute a Payment to Charges Already Paid By Unapplied Payments
When you use the Distribution section to apply payments to charges, you may see more charges than you expect. The Distribution list can include charges that are paid off by unapplied payments.
In PCC, unapplied (or “unlinked”) payments on an account are automatically included in personal balance totals. So a charge can be paid off by unapplied money on an account. For example, if a family paid a $25 copay in error, and the copay due was later changed, they may end up with a $25 credit on their account. The $25 will be an unapplied payment. Personal balance totals will automatically consider that $25, and reduce the amount due on personal charges.
When you use Distribution, you will see all personal charges not paid off by an applied payment. The list may include charges that are paid off by unapplied payments, such as an old credit on the account. You can review and clean up unapplied payments on the Payment History tab.
By displaying all charges that are not already paid off by applied payments, your practice can use the Distribution section to control to which charges a payment applies.
Review an Encounter’s Charges and Payments
You can use the Billing History in the patient’s chart to review detailed charge and payment information for any encounter.
The Billing History displays all of the billing-related information for an encounter.
In the Procedures section, you can review charges for the encounter, including the amount charged and a history of all payments.
For each charge, you can see personal payments, insurance payments, and adjustments.
If any unapplied (or “unlinked”) payments on an account are paying off charges, you will see the “Payment (Unapplied)” amount indicated for each charge and in the totals section.
In the Payments section, you can review payments posted on the same date as the encounter. To configure which payment types appear in this section, contact PCC Support.
For each payment, you can review what charges the payment applies towards.
Print an Encounter's Complete Billing History: Select any encounter and click “Print” to print the billing history. It will include all charge, payment, and adjustment information along with details about the claim.
See Bounced Checks and Other Payment Reversals: If a payment has been reversed (such as a returned check or a stopped credit card payment), it will appear along with the reversal procedure. The payment description will be struckthrough to help you identify that it was reversed. (If only part of a payment has been reversed, then the payment is still partly valid and the strikethrough line will not appear.)
Click 'Payments' For More Details and to Make Changes: After you review the charges and payments for an encounter, you may want to work with the billing account’s payment history and make changes. Click the “Payments” button to open the Payments tool.
In the Payments tool, you can edit payments, add notes, print a receipt, or make changes to how a payment is applied.
Review Payment History
Use the Payments tool in PCC EHR to review and edit an account’s full payment history. You can jump to Payments from within a patient’s Billing History, or open it from the Tools menu.
You can search for an account by name or use other search parameters, like an account phone number. The list of matching search results includes a Dependents column to help you confirm that you have the right account.
Click on the “History” tab to see the account’s payment history.
Aged account totals appear at the top, followed by a list of payments. The most recent payments appear at the top of the list.
Click the disclosure arrow next to a payment to see what charges it applies towards.
If any portion of a payment is unapplied, the payment amount appears in bold orange in the Unapplied Amount column. You can click the disclosure arrow to see more details about unapplied payments.
You can use the History tab in the Payments tool to review account balance and payment information. Then you can switch to the Payment tab to post payments, enter account notes, or perform other actions.
Edit a Personal Payment
Double-click on a personal payment in the Payment History tab to make changes.
You can modify the transaction date, payment type, amount, or check number. You can also change how much of a payment applies towards balances on personal charges, and you can use the Distribution section to specify which charges the payment applies towards.
Click “Save” to save any changes to the payment.
In addition to fixing mistakes made during payment entry, your practice can use the Payment History tab to identify unlinked payments, edit them, and apply them towards appropriate charges on an account.
Editing a Payment Updates Your Daysheet and Other PCC Auditing Reports: When you edit a payment, it will update your system’s underlying payment reports. For example, the Daysheet report will display a negative entry and a positive entry, reflecting the removal of the old payment and the addition of the new payment with your saved changes.
Print Receipts for Previously Posted Payments
In PCC EHR, you can print a receipt for any payment on an account.
Select a payment on the History tab in the Payments tool.
You can shift-click or command-click to select multiple payments in the history.
Then click “Print Receipt” to generate a new receipt for the selected payment(s).
The receipt displays each payment, along with details about which charges each payment applies towards.
Different Receipts for Different Needs: The receipt created from the Payments tool’s History tab includes more information about the encounter than a simple payment receipt. You can generate a receipt any time you post a payment, and it may not always be appropriate to share a detailed receipt. Your practice should consider when to provide a basic payment receipt or the more detailed payment history receipt. You can also print an encounter’s complete charge and payment history in the Billing History section of a patient’s chart.
Updates to Insurance Billing and Claims
From claim holds to RARCs, PCC 9.4 includes new and improved features related to insurance billing and claims.
Hold Claims for Specific Dates of Service, Billing Providers, Locations, and Plans
When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans.
Use the Claim Holds tool to create or edit claim holds. Read the procedure below to learn more.
Claim Holds in Place Prior to PCC 9.4: If your practice had PCC place a hold on claims for your system before PCC 9.4, those existing holds will still function. Prior to PCC 9.4, PCC created holds under-the-hood in your practice’s configuration. Those holds will not be visible in the Claim Holds tool. PCC will help you migrate holds into the new Claims Hold tool so your practice can manage them directly.
Open the Claim Holds Tool
Open the Claim Holds tool from the Tools menu in PCC EHR. Your practice can use User Roles to specify which users can open the tool. (See Set User Roles for Permissions and Security)
Review Existing Claim Holds
Click on an existing claim hold in the Claim Hold Index to view details.
Click “Add”
To create a new claim hold, click “Add”.
Enter a Description and Dates of Service
A claim hold requires a description and a date range for dates of service.
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Description: You can include a lengthy description indicating the purpose of the claim hold.
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Dates of Service: Enter the claim hold date range. Claims for these dates of service, including the start and end date, will be held until the hold is deleted or changed.
Select Billing Providers, Places of Service, and Insurance Plans
Select additional criteria for the new claim hold. You can restrict a claim hold to specific billing providers, places of service, and/or a subset of insurance plans to which your practice bills.
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Billing Providers: Click “Edit” to select which providers’ claims will be held. When processing claims, PCC will hold claims with a Billing Provider that matches one of the providers listed in the claim hold.
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Places of Service: Click “Edit” to select which locations’ claims will be held. You can select one or more places of service. When processing claims, PCC will hold claims with a Billing Location that matches places of service listed in the claim hold.
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Insurance Plans: Click “Edit” to select which insurance plans’ claims will be held. You can search and sort by plan name, plan group, or the payor id used for electronic submission.
When making a selection, you can search a list and use “Select All” and “Select None” to quickly pick groups of providers, locations, or plans.
Click “Save”
Click “Save” to finish creating the claim hold.
Holds are immediately active. After you create a hold, any claims that match the specified dates of service, providers, locations, and insurance plans will not be sent out when you process claims.
Optionally, Edit a Claim Hold
Select a claim hold and click “Edit” to make changes.
For example, you may have a claim hold for a new clinician which holds claims for all insurance plans. As they become credentialed with each payor, you can edit the claim hold and make changes to the insurance plan criteria.
Delete a Claim Hold to Release Claims
Select a claim hold and click “Delete” to delete a claim hold.
The next time you process and submit claims, any claims held by the deleted hold will be sent.
When Does a Claim Hold Expire? Never: Claim holds are based on dates of service, so they never expire. Any claims that match the indicated dates of service and the other criteria for the hold will never be sent. In order to release held claims, you must either delete the hold or edit the dates of service or other criteria to change which claims are held.
Improved Visibility of Policies that are Not Yet Active
When you add an insurance policy to a patient’s record with a start date in the future, PCC EHR will display the “Not Yet Active” status.
In the patient’s policies list, future policies will appear above active policies. You can filter that list to review All, Active, Expired, and/or Not Yet Active policies.
Other Billing Improvements
In addition to the features described above, PCC 9.4 includes these under-the-hood improvements.
-
RARCs No Longer Require Manual Attention: PCC’s Autopost Insurance Payments (
autopip
) program can post normal insurance payments and adjustments automatically, setting aside denials and claim responses with unusual adjustment reason codes for your attention. PCC 9.4 improves this process by also allowing Remittance Advice Remark Codes (RARCs) to post automatically. RARCs are typically supplemental information that should not preclude automatic posting. Contact PCC Support to adjust what your system is allowed to post automatically. -
Encounters with Different Places of Service Will Be Submitted On Separate Claims: When your practice processes charges for a patient who has had multiple encounters on the same day with the same provider but in two different places of service, PCC’s claim processor will now create two separate claims. For example, when a patient had a telemedicine encounter and an in-person encounter that occurred on the same day, the encounters can now result in two claims. Only charges with the same patient, date, billing provider, and location will appear on the same claim.
-
Improved Claim Configuration for Encounters With Multiple Providers: PCC 9.4 improves claim configuration options for when an encounter has a different billing and rendering provider. For example, when your practice needs “incident-to” billing, with CPT code modifiers based on the rendering provider, PCC can now more easily customize your setup for each payor to ensure the right codes go out on claims.
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Clearer Unlinking and Relinking of Payments in Correct Mistakes: When you unlink a payment that was linked to multiple charges, the Correct Mistakes (
oops
) program will consolidate the unlinked portions of the payment. This reduces clutter by eliminating multiple unlinked “part of payment” line items in the account history and makes it easier to relink the original payment to charges. -
Fewer Locks When You Work With Account History: When you review an account using Correct Mistakes (
oops
), the program will no longer place a temporary hold on charge, payment, and adjustment posting. Theoops
tool will only create a lock when a user is in the middle of making a change to an account, not when a user is simply viewing the history. Your practice may notice fewer warnings that charge posting will be delayed, and this improvement will also reduce concurrency payment errors that require PCC Support intervention. -
Improved Support for Billing Provider Taxonomy Codes on Claims: Insurance payors increasingly require the billing provider’s taxonomy code on claims. PCC 9.4 improves your system’s claim processing tools so PCC can more easily configure whether or not Loop 2000A includes the billing provider taxonomy code.
New and Updated Billing Interfaces
With each release, PCC expands and updates direct connections, partnerships, and integrations with insurance payors and clearinghouses.
During the PCC 9.4 release cycle, PCC enabled or updated insurance eligibility interfaces with: Community Health Choice, Community Health Plan Inc, Fidelis Care New York, Gilsbar, Health Partners of Philadelphia, Healthscope Benefits, HealthSmart Benefit Solution, Keystone First, Molina Healthcare of Nevada, Sierra Health Services, Trustmark Coresource Ohio, Trustmark Small Business Benefits, Unite Here Health, and West Virginia Highmark.
If your practice would like to take advantage of these connections, or you have other interface needs, contact PCC Support.
Create and Manage Forms in PCC EHR
Move your auto-filling forms, handouts, policies, and letters to a new Forms Configuration tool in PCC EHR where you can edit their settings, preview them with real patient data, and control how, when, and where they show up in the Forms component.
When you switch to the new tool, it becomes easier to generate forms that require a provider signature or visit-specific information. You can also try creating your own forms from scratch in an embedded form editor.
For a complete guide about how to use the Forms Configuration tool, read Create and Manage Forms in PCC EHR. Read on to learn what you have to gain by making the switch to the new Forms Configuration tool.
Enable Forms Configuration
Forms Configuration is an early access tool that can be enabled upon request. There are several steps involved in enabling the new tool.
Speak with PCC Support if you are interested in enabling Forms Configuration. PCC Support will help you assess whether the current version of the tool can support your practice’s needs and guide you through the transition.
To learn more about how to enable Forms Configuration, read Switch to the New Forms Solution in PCC EHR.
Early Access Tool: The new forms solution is in an early access testing period in just a few offices. If you are interested in participating in the early access release, please contact PCC Support.
Manage Your Own Forms
Once the Forms Configuration tool is enabled, you can manage your own forms with little to no intervention from PCC Support.
Access Forms Configuration
Open the Forms Configuration tool from the Configuration menu in PCC EHR.
Users must have the Forms permission in order to access the Forms Configuration tool. Your practice can add the Forms permission to user roles in the User Administration tool in PCC EHR.
Work with PDF Forms
When you enable Forms Configuration, your PCC Client Advocate helps you migrate your existing forms into the new tool. Most existing forms are custom-built PDFs that were uploaded to your system by PCC Support.
PDF forms are marked by a PDF icon in the Forms Configuration tool.
Edit a PDF form to view its contents, modify its settings, preview it with real patient data, and control how it appears in the Forms component.
If you need to edit the contents of a PDF form or add a new one to PCC EHR, contact PCC Support. PCC Support will continue to custom-build PDF forms and upload them to PCC EHR on your behalf.
Expect Fewer PDF Forms Over Time: Your reliance on PDF forms will diminish over time as you begin building your own forms using the form editor embedded within the Forms Configuration tool.
Control How Forms Appear in the Forms Component
The Forms component occurs throughout PCC EHR and contains the list of forms that your practice can generate for patients. You can control its display parameters in the Forms Configuration tool.
Set Forms to Display in the Forms Component
The status of a form determines whether it displays in the Forms component. You can set the status of a form in the Forms Configuration tool.
To set the status of a form, open the Forms Configuration tool and edit the form.
Set the status in the top right corner of the form canvas.
Save your work to apply the status change. Active forms display in the Forms component. Inactive forms do not display in the Forms component and cannot be generated for patients.
Set the Form Display Name
Once a form is active, its name displays in the Forms component and elsewhere on your PCC system that your practice and patients might see. You can customize a form’s display name in the Forms Configuration tool.
To customize a form’s name, edit the form in the Forms Configuration tool.
The text in the Form Name field is what users at your practice will see in the Forms component and elsewhere when the form is active.
Where Can Patients See Form Names?: When you generate forms for patients, their names serve as default document titles that patients can later reference in the patient portal.
Set the Display Order of Forms in the Forms Component
You can set the display order of forms in the Forms component. To get started, click the “Edit Display Order” button on the main page of the Forms Configuration tool.
Drag and drop the forms to rearrange their display order in the Forms component.
You can set the display order of active and inactive forms, but only the active ones appear in the Forms component and can be generated for patients.
Fill Out Complex Forms More Easily
When you switch to the Forms Configuration tool, complex forms become easier for your practice to fill out.
For example, when you generate a form that includes fields for visit-specific data, it prompts you to choose which visit it should reference.
Forms that need a signature prompt you to choose a signing provider.
Finally, forms that prompt you for written responses have text boxes that grow as you type, so you can review your answers as a whole without having to scroll.
As a bonus, forms that were built using the form editor in the Forms Configuration tool have a live preview as you fill them out for patients.
Forms built as custom PDFs do not offer a live preview as you fill them out.
Experiment with Creating Your Own Forms
Pioneers who enable the Forms Configuration tool can begin to make their own forms from scratch using the embedded form editor.
This early access tool has text editing capabilities and a library of auto-filling fields that you can add to your forms. PCC will continue to improve and build upon this tool in upcoming releases.
Patient Portal, pocketPCC, and Communication
Receive Signed Policy Documents from Families
Speed up your check-in process by creating new Patient Portal Messaging templates that include signable documents, so patients can submit your policy documents before they arrive.
Your Patient Portal Messaging Templates tool includes a new “Agreement” field. Documents attached to this field are available for all Portal users to review and sign.
When a portal user selects a messaging template that includes the Agreement field, they can review the document and click “Sign” to attach an electronic signature, along with a time and date stamp.
Once the user has signed the documents and sent the portal message, you’ll find it in the Messages Queue, the patient’s history and documents.
Automatically Close Portal Message Conversations
Prevent users from replying to old messages in the Patient Portal, so that your conversations remain on-topic and fresh in your messaging queue. PCC EHR’s Patient Portal Configuration, Portal Messaging includes the option to prevent replies to a message thread after a selected number of days.
You can select any number of days, from 1 to 99. Keep in mind that selecting too short a date range can prevent users from replying at all, so select a reasonable length of time.
If the portal user does not send a reply within the selected number of days, the conversation will become inactive and additional replies cannot be sent. The countdown resets every time a reply is sent.
Users can create a new message to begin a new conversation.
Conversations awaiting the first response from your practice will not become inactive. Messages must have at least one reply or be marked as “no reply” for the countdown to begin.
Your practice users, replying from within the EHR, can always reply to any thread, even if the conversation is inactive.
CHADIS Results Appear in PocketPCC
CHADIS results now automatically appear in PocketPCC, as they do in PCC EHR.
When your patients, families, and other users complete CHADIS questionnaires, and CHADIS returns the results, those results will appear in PocketPCC, assigned to the order in the visit’s note.
Configure the Other Portal Message Template
Take greater control of your Patient Portal messaging with additional options for customizing your Portal’s Other message type. Find the Other message type in the Messaging Template tool where you can edit or even delete the Other message template alongside all your other templates.
By default, the Other message is designed to function as a simple email message. It has a subject field, a large input box, and an attachments field. From the Portal Messaging Template tool, you can add any additional fields.
By default, the new subject field is enabled for the Other Message and any text entered in the subject field will appear in the subject column of the messaging queue in PCC EHR. All the changes you make to the Other template will be immediately available in your Patient Portal’s messages.
Add a Subject Line to Any Portal Message Template
Quickly review your incoming Portal Messages on the Messaging Queue by adding a subject line option to your Portal Messages.
The new subject field now appears on every Portal Messaging Template. It is disabled by default for all message types aside from the Other template. When the subject field is disabled, the subject line in the Messaging Queue displays the message template title, such as “Appointment Request” or “Referral Request”
By enabling the subject field, a single text line will be available to your users to write their own subject line.
The subject line content will appear in the messaging queue, so you can get more information about each message with a glance at your Messaging Queue.
Identify Missed and Canceled Appointments in pocketPCC
Easily identify missed and canceled appointments in pocketPCC’s visit history, so you can get a complete view of each patient’s history from your mobile device.
Appointments marked as missed or canceled in PCC EHR, are marked as such in pocketPCC alongside the visit reason.
New Titles in pocketPCC
PocketPCC is easier to navigate with the addition of labels on each page, so at a glance, you’ll know what page you’re on, and where you left off.
Manage Unsubscribed and Invalid Email Addresses and Phone Numbers
Take more control over your patient and family messaging by quickly identifying and resolving unsubscribed, invalid, and blacklisted email addresses and phone numbers from the patient demographics in both PCC EHR and pocketPCC.
The icon that previously indicated that an email address or phone number was unsubscribed from Broadcast Messaging now appears for any issue preventing an email or SMS message from being received by that number or email address.
Clicking that icon opens a window explaining the issue with that contact method and how to resolve it.
Unsubscribed Email Addresses
If a user has unsubscribed from receiving email addresses, they’ll receive no messages from PCC. Clicking the icon pops up a window with the option to send an invite email. Clicking the link in that email will resubscribe the email address to your emails.
Invalid Email Address
If the email address is not unsubscribed but still not receiving emails, you’ll find the option to correct any typo in the email address, or mark the email address as correct. Marking the address as correct does not guarantee the next message will send, but it clears the error and attempts to send future messages.
Invalid Phone Numbers
If the phone number is incorrect or formatted incorrectly, such as a missing area code, or it’s a landline and cannot receive SMS messages, you’ll have the opportunity to fix the number. Like the email above, marking the number as correct doesn’t guarantee the next message will go through.
Phone Number is Unsubscribed
If the phone number has opted out of receiving text messages, the only resolution is for that user to text UNSTOP to the number displayed in the window.
Reporting Updates
Track your practice’s COVID-19 vaccination trends in the Practice Vitals Dashboard, tailor the columns on Report Library reports to requester’s specifications, and more in PCC 9.4.
Review COVID Vaccination Trends Among Your Active Patients
You can see how many of your active patients have received one or more, two or more, or three or more doses of the COVID-19 vaccine on the COVID-19 page of your Practice Vitals Dashboard.
A new trend graph illustrates COVID-19 vaccination rates among active patients within an age range over time. Select an age range to see what percentage of active patients in that range received one or more, two or more, or three or more doses of the vaccine since it was initially approved for that group.
The table below the trend graph shows the most recently collected COVID-19 immunization data and the date it was collected.
The number of eligible patients in the data set is equal to the number of active patients in the selected age range. The dose counts in the data set include those administered at your practice and those administered elsewhere that have been entered manually into patients’ charts.
You can compare your COVID-19 vaccination trends to benchmark data from the CDC. Click the link in the Additional Resources section to view the CDC’s benchmark data.
Practices who are new to PCC might note a choppy or downward trend in COVID-19 vaccination rates. This typically indicates that your practice increased its active patient count over time at a greater rate than it vaccinated those patients against COVID-19.
The new vaccination rate graph and table replace the financial and visit productivity data that was designed to show the impact of the COVID-19 pandemic on your practice. While the pandemic continues to have an impact, the financial and visit productivity measures are no longer as relevant as they were in 2020.
Choose How to Represent Patient Names on Reports
In PCC 9.4, you can choose whether to display patient names in one or several columns on reports in the PCC EHR Report Library. With this flexibility, you can customize reports to meet the name formatting requirements of third-party requesters. Customized reports retain their patient name format when printed and exported.
Read on to learn how to change the patient name format on reports in the PCC EHR Report Library.
Customize the Report
In the PCC EHR Report Library, open the report you want to customize and click on the “Customize Report” button.
Select Columns to Include
On the report criteria screen, click the “Edit” button under Select Columns to Include.
Select the patient name columns that you want the option to display on the report results screen.
In a future step, you will be able to define the default patient name columns that display on the report.
Preview the Report
Click on the “Preview” button to view your custom report.
Add Patient Name Columns to the Report Defaults
On the report preview screen, open the Columns drop-down and select the patient name columns that you want to include on the report by default.
Whenever users run this report, it will display the selected columns.
Optionally Change Column Sequence and Sort Order
You can optionally drag and drop the report columns to rearrange them and click on the column headers to change how the report results sort on the screen.
Save the Custom Report
When all appears to your liking, click “Save As” and follow the prompts to name, write a description for, and save the report.
Custom reports appear in the Report Library under the name, description, and categories you ascribe.
Applies to All Reports with Patient Name Columns Except Broadcast Messaging: You can customize the patient name format on all reports that allow for patient name columns to be included, except for the Broadcast Messaging report, which joins multiple patient names into a a single column.
CMS’s Omission of COVID-19 RVUs Affected PCC Reports
CMS’s Relative Value Unit publications have not included COVID-19 vaccines since 2021. Due to this omission, PCC financial reports that are based on RVUs may be incomplete from 2021 through the present. PCC expects CMS to file a correction in June, and we will keep our clients up-to-date on any changes.
Your PCC system automatically retrieves the latest RVU data from CMS in order to keep your practice’s financial reports up-to-date. You can use your Practice Vitals Dashboard or run SRS reports to evaluate your pricing model and find out how the prices you bill compare to Medicare’s published values for each service.
Due to CMS’s omission, if your practice billed for COVID-19 vaccines, RVU-based reports on your system may not fully reflect the services you provided during this period.
PCC discovered this omission and sent a notice to all clients in April of 2022. PCC Support can optionally update your system’s RVUs manually upon request. When CMS files a correction, PCC will ensure that your system is correctly updating from the latest public data.
Clinical Interoperability Updates
PCC’s clinical interoperability tools make it possible to e-prescribe, submit and retrieve records from your local immunization registry, receive electronic lab results, communicate securely with other healthcare providers, and more. Most clinical interoperability updates occur on a rolling basis. Read on to learn what’s new in clinical interoperability since the last PCC release.
Better Response Options for Change Requests in PCC eRx
Since the last PCC release, your practice received an important, non-disruptive background update to change request functionality in PCC eRx. Your practice received this update on Monday, April 18, 2022.
Change requests are electronic messages that pharmacies use to request script clarifications, generic substitutions, therapeutic interchanges, drug use evaluations, or confirmation of the prescribers’ credentials. Pharmacies can also use change requests to notify you when a medication requires prior authorization or is out of stock. Change requests appear on the Rx Queue in PCC EHR alongside pending prescriptions and renewal requests.
The background update introduced five standard response options for change requests:
-
Keep or Edit Original Prescription: Keep or edit the prescription you originally wrote, then send that in response to the change request.
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Approve Requested Substitution: Approve the substitution suggested by the pharmacy, either as written or with edits.
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Replace with New Prescription: Start a new prescription from scratch to replace the original.
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Cancel Original Prescription: Notify the pharmacy that you want to cancel the original prescription.
-
Reassign: Reassign the change request to a different provider at your practice.
The update also fixed some bugs, resulting in:
- Fewer calls to Support to delete faulty change requests from the Rx Queue
- The ability to respond to change requests that contain little or no information from the pharmacy
- The ability to process responses to change requests successfully, even when they include notes that exceed the 70 character limit
- Neater display of repeat change and renewal requests on the Rx Queue
- The ability to respond to renewal requests for compounds on the Rx Queue
- Fewer ways to accidentally create duplicate prescriptions when your network lags
- Better handling of Spanish language and other special characters on prescriptions
- Better visibility into prescription errors that are retrying on the Rx Queue
- Fewer “digital signature” errors when sending prescriptions for controlled substances
- The ability to successfully send controlled substance prescriptions that were interrupted while you were entering your two-factor authentication credentials
Stay tuned to PCC Community for information about upcoming background updates and improvements to PCC eRx.
Contact PCC Support to get started, or to let us know that you’re interested in establishing a bidirectional connection with your registry once it’s available in your region.
Updates to Immunization Forecasting
Practices received a behind-the-scenes update to the immunization forecaster on June 7, 2022. The update included the following:
-
COVID-19 Booster Schedule for 12+: This release implemented the ACIP guidance for a booster dose of Pfizer COVID-19 vaccine to persons 12+ years of age who have completed a COVID primary series.
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Change in Interval Between End of Series and Booster: This release also modified the interval between the last dose of COVID vaccine and the booster dose from 6 months to 5 months.
PCC updates the immunization forecaster throughout the release cycle. If you have questions or encounter issues with your immunization forecasting, contact PCC Support.
New and Updated Clinical Interfaces
With each release, PCC expands and updates direct connections, partnerships, and integrations with immunization registries, health information exchanges, clinical information networks, and more. Here are the clinical interoperability updates for PCC 9.4:
-
Bidirectional Immunization Registry Connections: Practices in Delaware, Kansas, Oregon, and Pennsylvania are newly eligible to sign up for bidirectional immunization registry interfaces, joining those who have similar connections in California, Colorado, Connecticut, Florida, Georgia, Indiana, Maryland, New Jersey, North Carolina, Philadelphia, Virginia, and Wyoming. With a bidirectional connection, you can check vaccine records in your local immunization registry and import them into patient charts without ever leaving PCC EHR. To read about how it works, check out Look Up and Import Patient Immunization Records from Your Local Registry.
-
HIEs, CINs, and More: During the PCC 9.4 release cycle, PCC introduced new clinical interfaces with VaxCare, Swell CX, HealthtrackRx, Steward Health Care, and Helix Diagnostics, and deprecated the integration with North Carolina’s CVMS.
If your practice would like to take advantage of these connections, or you have other interface needs, contact PCC Support.
Improvements to Encounter-Level CPT Reporting on C-CDAs
C-CDA is a virtual clinical document type used for health information exchange. C-CDAs communicate encounter-level information. Where available, the C-CDAs generated in PCC EHR will now include the CPT code for the encounter itself, not just the procedures completed during the encounter. Encounter-level CPT data is often requested by health information exchanges, which use it to determine if practices are meeting certain measures. This data may also help practices qualify for optimal Medicaid reimbursement.
Fixes and Improvements in the August 2022 PCC eRx Patch
A nondisruptive background patch to PCC eRx at the end of August 2022 delivers many important fixes and improvements.
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Continue ePrescribing Compounds Past September 1, 2022: Compounds prescribed from PCC eRx will comply with changes to the NCPDP SCRIPT Standard by the September 1, 2022 change deadline, securing your ability to continue prescribing compounds electronically. Read Create Custom Medication Items in PCC eRx to learn more about how to create, manage and prescribe compounds and other custom medication items.
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New EPCS Registrants Can More Reliably Proceed to Video ID-Proofing: In certain rare cases, new registrants who elected to complete EPCS identity verification via video with Exostar experienced session loss as a result of an unstable internet connection. Those providers were unable to enter their video ID-proofing code and had to restart the identity verification process. This issue has been fixed
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Add a New or Replacement EPCS Token After Deactivating All Others: Prescribers who deactivated all of their EPCS tokens and later needed to add new ones were unable to access Exostar Token Management in the My Settings area of PCC eRx, even when they had a backup phone number that they could use to authenticate their access rights. This issue has been fixed.
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Calculate Dose by Weight in Fewer Clicks: In certain cases, the “Calculate Dose By Weight” button for weight-based prescriptions required two presses in order to calculate a dose. This issue has been fixed.
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See Weight-Based Doses for Generic Antibiotics in mLs: In some cases, the weight-based dosing calculations for generic antibiotics such as Bactrim and certain Augmentin formulations resulted in the number of milligrams (mg) per dose rather than milliliters (mL). This issue has been fixed.
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Send Paxlovid, Daytrana, and Onextron Prescriptions Electronically: An issue relating to the complexity of the dose forms for Paxlovid, Daytrana, and Onextron was preventing prescriptions for these medications from being sent electronically to pharmacies. This issue has been fixed. Please note that, due to the nature of the fix, you will not be able to prescribe these medications from your existing favorites list after the update. PCC recommends deleting those favorites and creating new ones from scratch. To learn how to work with favorites, read PCC eRx Prescription Favorites.
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Prescribe Pseudoephedrine without Error: In certain cases, pseudoephedrine prescriptions caused errors when prescribed across state lines with differing DEA schedule classifications. This issue has been fixed.
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Successfully Prescribe Different Variants of the Same Controlled Substance on the Same Day: In certain cases, prescribers who created several prescriptions on the same day for various forms of a controlled substance that were meant to be taken concurrently (e.g., that differed in strength, frequency, or release mechanism) received an error prompting them to choose different dates to fill for these prescriptions. This was particularly notable in the case of Adderall and Adderall XR. This issue has been fixed.
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See All Start Dates for 3-Month Supply Prescriptions on the Rx Queue: 3-month supply prescriptions on the Rx Queue were only displaying the start date of the first prescription in the series. This issue has been fixed.
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Long Pharmacy Names Display Correctly for Renewals on the Rx Queue: In some cases, the length of pharmacy names for prescription renewal requests on the Rx Queue overlapped the provider name. A nondisruptive PCC eRx patch corrects this issue.
Other Updates and PCC News
PCC 9.4 delivers several general improvements and updates that you should know about.
Improved Access to PCC Talk
To ensure that you can reliably access PCC Talk, PCC’s online forum for users, the Help menu in PCC EHR will open PCC Talk in your web browser instead of within PCC EHR.
Update Your Windows 8 and Windows Server 2012 Workstations
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. Microsoft will end support for Windows 8 in January of 2023, and infrastructure support necessitates we end support for Windows Server 2012 at the same time. If your practice uses workstations that run Windows 8 (or prior) or Windows Server 2012 (or prior), you should upgrade those machines.
When a user logs into PCC EHR, it will present a message if they are running older system software. The reminder encourages them to review and update their operating system. Contact PCC Support for recommendations.
Apple does not formally announce the end of software security updates, but similarly your practice should make plans to upgrade any Apple Macintosh workstation running MacOS 10.14 (Mojave) or MacOS 10.15 (Catalina) or prior, as they are approaching end-of-life.
PCC EHR recommends a workstation running on Windows 10 (or higher) or MacOS 11 (or higher). For more information, read Hardware Guide: Your Personal Computer and Equipment.
Continuous Updates to COVID-19 Vaccine Support in PCC
PCC continually updates your system to support COVID-19 vaccines. This includes support for clinical and financial codes, manufacturer and vaccine codes (MVX and CVX), and the index of VIS. During the PCC 9.2 to 9.4 release cycle, PCC rolled out multiple patches to your system.
To learn how to configure your system for COVID-19 vaccine administration, read:
COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill
For other guides and updates related to COVID-19, visit PCC’s COVID-19 Links and Resources page.
January 2022 Support for Third Pfizer Vaccine for Immunocompromised Children 5-11
In early 2022, PCC updated the claim validation lists on all PCC systems to support the newly announced CPT 0073A. Your practice can add this procedure to your Procedures table and use this code to bill a third dose of Pfizer’s pediatric COVID-19 vaccine “for certain immunocompromised children 5 through 11 years of age” (AMA).
March 2022 VIS, CVX, and MVX Update
In March of 2022, PCC patched all practice systems with the latest VIS, MVX, and CVX data. These updates allow your practice to track and record the latest immunization information.
The update included these new or updated VIS document titles:
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet-12 years and older
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet- Pediatric 5 – 11 years
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet- Pediatric <5 yrs
- COVID-19 Moderna Vaccine EUA Recipient-Caregiver Fact Sheet
- COVID-19 Janssen Vaccine EUA Recipient-Caregiver Fact Sheet
- Recombinant Zoster Vaccine VIS
- Pneumococcal Conjugate Vaccine (PCV13_PCV15_PCV20) VIS
The update added support for these new CVX codes:
- 207: COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose
- 217: COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose
- 219: COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose
- 220: HepB recombinant, 3-antigen, Al(OH)3
- 221: COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose
The update added support for one MVX code:
- VBI: VBI Vaccines, Inc
March 2022 Diagnosis Code Update
In March of 2022, PCC patched all practice systems with the CDC’s latest COVID-19 ICD-10 update. The new codes become valid on April 1st, 2022.
The update includes underimmunization for COVID-19:
- Z28.31 Underimmunization for COVID-19 status
- Z28.310 Unvaccinated for COVID-19
- Z28.311 Partially vaccinated for COVID-19
The guidelines specify that these codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the healthcare provider.
The update also includes the “other underimmunization” status, with two additional descriptions:
- Z28.39 Other underimmunization status
- Delinquent immunization status
- Lapsed immunization schedule status
You can read the complete list of new diagnoses in this update on the CDC’s website.
For help linking these new billing codes to the diagnosis descriptions used in a patient’s chart, read Link Chart Diagnoses to ICD-10 Billing Codes.
April 2022 VIS Update
In April of 2022, PCC patched all practice systems with the latest VIS data released by the CDC.
The update included new VIS editions dated March 29, 2022 for two vaccines:
- Moderna COVID-19 vaccine (CVX 207 and 221)
- Pfizer COVID-19 vaccine for patients ages 12 and older (CVX 208 and 217)
May 2022 CVX and NDC Update
In May of 2022, PCC patched all practice systems with the latest CVX and NDC data released by the CDC.
The update added support for two new CVX codes for Moderna pediatric COVID-19 vaccines (pre-EUA):
- 227: COVID-19, mRNA, LNP-S, PF, pediatric 50 mcg/0.5 mL dose
- 228: COVID-19, mRNA, LNP-S, PF, pediatric 25 mcg/0.25 mL dose
The update also added support for new NDC codes associated with the Sanofi COVID-19 booster (pre-EUA):
- Sale NDCs: 49281-618-20, 49281-0618-20
- Use NDCs: 49281-618-20, 49281-0618-78
Finally, the update removed support for several NDC codes associated with FluMist Quadrivalent:
- Sale NDCs: 66019-308-10, 66019-0308-10
- Use NDCs: 66019-308-01, 66019-0308-01
May 2022 Support for 5-11 COVID-19 Boosters
In May of 2022, PCC updated the claim validation lists on PCC systems to support the newly announced CPT 0074A. Your practice can add this procedure to your Procedures table and then use it to bill for administration of the booster dose of Pfizer’s pediatric COVID-19 vaccine to children aged 5 to 11.
For more information about COVID-19 vaccines in PCC EHR, visit learn.pcc.com’s COVID-19 Vaccine page. Please note that the booster administration code is distinct from the 3rd dose administration code (0073A), which is already in use for immunocompromised patients.
June 2022 Support for Moderna and Pfizer COVID-19 Vaccines for Young Children
In June of 2022, PCC updated the claim validation and CVX lists on PCC systems to support the newly announced Moderna and Pfizer vaccines for young children.
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CPT Code Updates: PCC updated the claim validation code list on your system. As is usual with COVID-19 vaccines, the new codes include unique vaccine CPT codes (91322 and 91308), along with distinct codes for each administration. PCC has collected these codes on learn.pcc.com’s COVID-19 vaccine page.
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CVX Updates: PCC added the new vaccine administration CVX entry for Moderna’s 6m to 6yr COVID-19 vaccine to your system, CVX 228. Your system already included 219 (Pfizer’s 6m to 5yr vaccine). The same patch also added CVX codes for Moderna’s 6-12yr COVID-19 vaccine (227) and other less common new CVX and MVX codes, inclusive of all CDC updates up through June 19th.
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VIS Lists: When the CDC announces appropriate EUA Fact Sheet (in lieu of VIS) for each vaccine, PCC will update the lists on your system so the correct entry can be selected when you administer the vaccine.
July 2022 Claim Validation Update
In July of 2022, PCC updated your server’s claim validation lists for newly announced COVID-19 billing codes. The new codes include some additional Moderna vaccine product and administration codes for younger children. PCC updates claim validation when new codes are approved, but many payers will not accept these new codes. Work with your payers to ensure you can bill these and other new codes.
To learn more about configuring COVID-19 vaccines in PCC EHR, visit PCC Learn’s COVID-19 vaccine page. To learn more about new COVID-19 vaccine codes, read the AMA’s announcement and refer to your practice’s CPT manual.
Bug Fixes in PCC 9.4
PCC 9.4 includes some notable squashed bugs.
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Portal Messages With No Incomplete Tasks Appeared on the Messaging Queue: Under certain circumstances, the Messaging queue could continue to display portal message conversations as incomplete with “No Tasks” when they should be considered “Completed”. PCC 9.4 corrects this issue.
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New Type of Relationship Table Entry Did Not Appear: Under certain circumstances, if your practice created a new Type of Relationship, it would not appear in PCC EHR. This has been corrected.
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Referring Provider Appeared Incorrectly in Patient's Billing History: If your practice’s referring provider table had an erroneous entry, it could lead to that entry appearing in a patient’s Billing History, even though the encounter was not assigned a referring provider. This will no longer occur.
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Merging Accounts Could Cause an A/R Discrepancy: Merging duplicate PCC family accounts when one of the accounts had never had a balance due could cause your practice’s A/R totals to report a discrepancy. PCC identified this problem and corrected all PCC practices with a mid-release patch in April which is also included in PCC 9.4.
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Identical Filenames Could Create an ERA Processing Problem: In rare circumstances, when two incoming electronic remittance advice files (ERAs) were given the same filename, the system could fail to see one of the files. PCC 9.4 adds a layer of safety by giving all incoming ERAs a new unique identifier when they arrive on your system.
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Invalid Characters Caused Snap Text Display Issues: If Snap Texts included invalid characters, they could fail to display properly in the Snap Text editor. PCC 9.4 fixes this issue by ignoring invalid characters.
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Daily View Report Was Unavailable: When viewing the Daily View in
autopip
, reports could sometimes fail to appear. This problem was resolved with a patch to affected clients and is included in PCC 9.4. -
Simultaneous Payment Linking Caused an Error: In rare cases, when two users simultaneously tried to link a payment to two different charges, the payment would not be linked. PCC 9.4 resolves this concurrency issue.
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Advanced Find Routines Not Displaying a Result: In rare cases, when using the advanced find routines in the Practice Management system (
findem
), a search would not return results. PCC 9.4 resolves this issue. -
Old Reports Unable to Access Printer Dialog: Some under-the-hood reports from PCC’s early products and services could not open a computer’s printing dialog. PCC patched a fix to this issue upon client request, and PCC 9.4 resolves the issue.
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Appointments Erroneously Included on Provider Hour Reports: Prior to PCC 9.4, appointment reports based on provider hours were including appointments that started at the same time that provider hours ended. This has been fixed.
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Report Erroneously Associated Unlinked Portal Users with Formerly Linked Patients: Prior to PCC 9.4, the Patients with Portal Users report incorrectly associated unlinked portal users with the patients to whom they were previously connected. This has been fixed.
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Visit History Shakiness : When viewing a visit history with certain screen sizes, when enough diagnoses appear, a vertical scrollbar would appear and disappear continuously, causing the text to appear to shake. This has been fixed in PCC 9.4.
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Certain Tasks Not Saving: Prior to PCC 9.4 adding a task to a document from the pocketPCC signing queue would result in the task not being saved. This is corrected and tasks added in this way are now saved.
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PCC EHR Sometimes Crashed when Retrieving Immunization Registry Records: Sometimes PCC EHR crashed when users clicked the “Retrieve Imms” button. This occurred in cases where the patient immunization record sent by the registry contained immunization descriptions that were associated with more than one CVX code. This has been fixed.
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Importing Immunizations from a State Registry Sometimes Created Duplicate Lot Records in PCC EHR: Importing immunizations from a state registry using PCC EHR’s bidirectional immunization functionality sometimes resulted in the creation of duplicate vaccine lot records. The duplicate records were visible where users could select lot numbers in PCC EHR. This issue has been fixed.
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Send EpiPen Prescriptions Electronically on the First Try: An issue with the dispense unit of measure caused new EpiPen prescriptions to default to a state where they could not be sent electronically unless extensively edited. A nondisruptive PCC eRx patch corrected this issue just before PCC 9.4 general deployment and restored your ability to send EpiPen prescriptions electronically on the first try.
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Successfully Prescribe Drugs with Apostrophes in their Names: In certain cases, prescribing a medication with an apostrophe in its name, such as “Children’s Tylenol,” caused save and sync errors in PCC eRx. This has been fixed.
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PCC 9.4 Migration Considerations
The PCC 9.4 release includes new features that may need configuration and for which you may want to do extra planning or training. Read below to learn more, and share relevant details with your physicians and staff.
Read the PCC 9.4 Release article for complete details on these features.
Contact PCC Support for help implementing features in PCC 9.4.
Adjust Account Roles for the New Claim Holds Tool
Your practice can designate which user roles will have access to the new Claim Holds tool in PCC 9.4.
Use the Roles tab on the User Administration tool to edit an appropriate role.
Next, review that appropriate users are assigned that role.
Migrate Your Claim Holds to PCC EHR
PCC 9.4’s new Claim Holds tool provides your practice direct, customizable control when you need to hold claims for specific providers, payers, locations, and dates of service.
After your PCC 9.4 update, you can work with PCC Support to migrate any pre-existing holds into the new tool. Contact PCC Support for assistance.
Adjust Payment Types to Accommodate New Payment Tools
As you use the new Payments tool in PCC EHR and the new Procedures and Payments sections of the Billing History in the patient’s chart, you may find you want to adjust your practice’s Payment Types.
Your practice’s list of Payment Types is found in the under-the-hood Table Editor (ted
), and it includes configuration options that determine which Payment Types appear in different tools.
Contact PCC Support for help adjusting your payment types and payment configuration.
Review And Update Which RARCs and/or CARCs to Hold For Manual Attention
When a payor responds to a claim, they can include Claim Adjustment Reason Codes (CARCs) and Remittance Advice Remark Codes (RARCs).
PCC automatically posts payments and adjustments for most payor responses, and your practice can configure which CARCs and RARCs will indicate a claim needs manual attention. PCC 9.4 adds additional flexibility for configuring RARCs.
If your practice would like to adjust which RARCs or CARCs cause a claim to need manually attention, contact PCC.
Switch to the New Forms Solution in PCC EHR
A new forms solution in PCC EHR empowers you to create and manage your own auto-filling forms, handouts, policies, and letters. With help and guidance from PCC Support, you can switch to the new forms solution when the time is right for your practice. To learn why, when, and how to make the switch, read Switch to the New Forms Solution in PCC EHR.
Early Access Tool: The new forms solution is in an early access testing period in just a few offices. If you are interested in participating in the early access release, please contact PCC Support.
Add Signable Policy Documents to Portal Messaging Templates
Create a new Portal Messaging Template to receive electronically signed policy documents from your patients and families.
Create or Edit a Message Template
Open the Patient Portal Configuration tool from PCC EHR’s Configuration menu and open the Messaging Templates tab. Click “Add” to create a new message template, or “Edit” to add the Agreement field to an existing template.
Add The Agreement Field
From the field drop-down menu, select the Agreement Field and click “Add”.
Upload Documents
Click “Attach Document” to select a file. This file will be available for all Patient Portal users to review and sign when they select this message type. Select a document category for this document to be assigned in the chart’s documents.
Add a Label and Title
Once you’ve uploaded the document, give it a label and a title. The label will appear in the message template to indicate to the user what the document is, and the title will appear as the file name in the patient’s documents.
Add Additional Agreements
You can add multiple agreement fields, so if you need several documents signed, add an agreement field for each one, and upload each document.
Optional: Update Your Policy Documents
If you update or create a new policy document, you can replace the document in your Patient Portal Messaging Template and uploading a new one. To remove the document, edit the message template and click the X icon next to the document, then click “Attach Document” to upload a new version of the document.
Portal Users Sign and Send the Documents
When a portal user selects the new template, they’ll find each document waiting for them. They can review each document and click “Sign” to attach an electronic signature, along with a time and date stamp.
Once the user has signed the documents and sent the portal message, you’ll find it in the Messages Queue, the patient’s history and the patient’s documents.
If there are multiple documents in the message template, and the user elects to sign only one, no signed tag or timestamp will appear on the unsigned documents, but the user can send a new message to sign or resign any document.
Update Your COVID-19 Vaccine Configuration
As described in the PCC 9.4 release article, PCC continually updates your practice’s server with new codes and VIS lists in order to follow the EUA approved COVID-19 vaccines.
Read COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill to learn how to set up these vaccines for use at your practice.
Update Your Windows 8 and Windows Server 2012 Workstations
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. Microsoft will end support for Windows 8 in January of 2023, and infrastructure support necessitates we end support for Windows Server 2012 at the same time. If your practice uses workstations that run Windows 8 (or prior) or Windows Server 2012 (or prior), you should upgrade those machines.
Apple does not formally announce the end of software security updates, but similarly your practice should make plans to update or upgrade any Apple Macintosh workstation running MacOS 10.14 (Mojave) or MacOS 10.15 (Catalina) or prior, as they are approaching end-of-life.
When a user logs into PCC EHR, it will present a message if they are running older system software. The reminder encourages them to review and update their operating system. Contact PCC Support for recommendations.
PCC EHR recommends a workstation running on Windows 10 (or higher) or MacOS 11 (or higher). For more information, read Hardware Guide: Your Personal Computer and Equipment.
Update Your Daytrana, Paxlovid, and Onextron Favorites
When your practice receives the August 2022 background update to PCC eRx, providers will no longer be able to prescribe Daytrana, Paxlovid, and Onextron from their existing favorites lists. PCC recommends removing these favorites and creating new ones from scratch. For information about how to work with prescription favorites in PCC eRx, read PCC eRx Prescription Favorites.
Change the Copay Due on a Charge After Charges are Posted
When you learn that a patient was charged the wrong copay for a visit, how can you change the amount due? You may be trying to manually post an insurance payment and find yourself unable to do so because the copay amount for the office visit procedure is incorrect.
Full Documentation: This is a quick reference guide to a common problem. For more details, read Change the Responsible Party and Copay for Charges.
Change the Copay As You Post Insurance Payments
As you post insurance payments and adjustments, you can change the copay amount if (for example) the payer’s response indicates a different expected amount.
When you save, PCC EHR will automatically unlink personal payments down to the new expected amount, if needed.
Change the Expected Copay for Posted Charges Before You Receive a Response
If you need to change the expected copay after you have posted charges and before you submit a claim, you can change the copay for any charge using the procedure below.
Open the Correct Mistakes (oops) Program for the Patient
If you are trying to post an insurance payment and a copay is wrong, for example, you can jump into oops
by pressing F6 – Correct Mistakes.
Or, you can run Correct Mistakes (oops
) by family or by patient.
Locate the Charge with the Incorrect Copay
The Correct Mistakes (oops
) account history is sorted by encounter date. Page down until you find the correct date, and then identify the charge that has the incorrect copay amount. Typically, copays are associated with office visit billing codes.
Press F4 and Select the Encounter or the Charge(s)
Press F4 – Insurance Status, and then enter the number next to the charge(s) you need to edit. You can also press F3 or F4 to select charges by Claim ID or the encounter’s date of service.
Change the Copay Due for the Visit Procedure
Press the Tab key to move between fields. Update the Copay field to reflect the correct amount due.
Typically, you would not change the pending insurance for the charge at this time. Policies often list a copay amount, and that copay amount may be wrong, but you should fix that in a later change to the patient’s policies unless the claim has not yet been submitted.
Press F1 to Save
Press F1 – Save to save your changes. If you were in the middle of posting an insurance payment, you can press F12 to back out to the Post Manual Insurance Payments (pip
) program.
Review and Update the Patient’s Policies
You’ve fixed the charges for that encounter. However, if that specific charge had the wrong copay, does that mean that the patient has the wrong insurance policy on their account? Maybe an insurance policy is misconfigured, or many patients have the wrong copay assigned.
Review the patient’s policies and double-check that they have the correct copay. If the wrong copay was charged because the policy has an irregular copay rule (like charging a copay for well visits), you could work with PCC Support to adjust your policy configuration settings so the correct amount is charged by default at future encounters. You may also need to update the insurance policy for other patients.
Edit Your Practice’s Procedures, Codes, Adjustments, and Prices
When you need to add a new CPT code to your PCC system, create a new version of a code that includes modifiers, or adjust your practice’s prices for procedures or adjustment types, use the Table Editor found in PCC’s under-the-hood Practice Management window.
Watch a Video: Watch Edit Your Prices and Billing Procedure Codes for a video tutorial of these steps.
Procedure Code Guidance: The procedure codes discussed in this article are intended only as examples. You should consult the AMA’s current CPT Coding Guide and work with your insurance payers to verify what codes you should report. Your practice updates and maintains your procedure list, codes, and prices in the Procedures table in the Table Editor on your PCC system.
Updates Procedure Names, Codes, and Prices
Follow the procedure below to learn how to add or update procedure billing codes, prices, and other procedure information (such as dose amounts for an injection procedure).
Add an Immunization: The procedure below covers how to edit prices and add or update billing codes for any medical procedure. You can also read a specific guide: Add and Configure Immunizations.
Open the Practice Management Window
Click on the Practice Management icon to open the Practice Management window.
Run the Table Editor (ted)
Run the Table Editor (ted
).
Select Table #6, Procedures
Open table #6, the Procedures table, to look at your practices list of procedures.
Review Existing Procedures
Press Page Up and Page Down to review the list of all billing procedures on your PCC system.
For each entry, you can see your practice’s custom procedure name, the default billing code (usually a CPT code), your default price, and the type of service.
Enter the number next to a procedure and press Enter to see details about any procedure.
Clone (or Add) to Create a New Procedure
To create a new procedure, find a similar procedure and press C to clone it. Or press A to start from scratch.
Do Not Overwrite an Existing Entry: Never edit and overwrite an existing procedure entry, as this may affect your billing history. Even if a procedure has been retired and replaced with a new CPT code (for example), always clone and create a new entry.
Update the Procedure Name, Group, and Related Fields
Edit the fields in the upper-left corner of the screen to indicate a procedure’s name, accounting type, procedure group, type of service, and units.
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Procedure Name: You can name a billing procedure anything that will be useful for your practice. Your clinicians, billers, and the patient’s family will see this name in various contexts, such as a receipt or bill. Insurance payers do not generally review or verify a procedure’s name, relying instead on the billing procedure code.
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Accounting Type: Billable procedures you perform in your practice should have an accounting type of “Revenue”. Other Account Types, such as “Receipt” and “Revenue – Non-Service” are used for refunds, insurance write offs, and other less common accounting situations.
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Procedure Group: The Procedure Group field is a customizable value used for reporting purposes; it does not usually affect billing or how a procedure is ordered or completed. Select an appropriate Procedure Group.
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Type of Service: The Type of Service field was originally used to indicate a code on claims, but it is no longer part of the claim standard. For most procedures performed by your practice, use “Medical Care”. If the procedure is a lab, select “Diagnostic Laboratory”. When your PCC system formats claims, it includes an appropriate CLIA identifier for procedures with a type of service “Diagnostic Laboratory”.
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Units: If you always bill a procedure as a set number of multiple units, you could adjust the Units field. Normally, units are selected when your practice bills an encounter, and this field is set to “1”.
Update Drug or Injectable Related Fields
If the procedure is an immunization or another injection, enter the injectable-related information on the right.
Read Add and Configure Immunizations to learn about specific details and tips for filling out the NDC, Dose Amount, and Dose Units fields. Always enter the NDC code found on the smallest administered dose. In other words, use the NDC code from the vial, not the box or carton.
Update the Billing Code
Enter the procedure billing code in the Schedule A “CPT” code field. Then press F4 – Duplicate Codes to copy the code to all schedules.
PCC does not provide or distribute CPT billing codes.
What About Billing Codes for Administrative Fees?: When your practice posts charges, PCC’s software will require a linked diagnosis for any procedure that has five or more characters, such as a “99213”. If you are creating or updating your practice’s administrative fees (or other charges that do not require a diagnosis), use a billing code with fewer than five characters. For example, if you are creating a “Forms Fee” or “Missed Appointment Fee”, you could use a billing code of “X” or “FEE”, or whatever would be clearest for your practice.
Code Modifiers: If your practice needs a code with one or more modifiers, such as the common -25, you should clone an existing procedure table entry and adjust the clone to include the modifier(s) in all code schedules. Common modifiers include -25, -26, and -59, but the CPT standard and payer requirements sometimes use more complex modifiers, such as -Q6, and CMS has developed HCPCS Level II Modifiers, such as -E1, -TC, and -XS. (See AAPC.) When your practice adds a modified version of a code, it becomes available to all users when they Post Charges.
When Would I Use a Different Code Schedule?: Normally, you will enter the same code for all schedules. PCC supports optional schedules due to deprecated “local codes”, which are no longer part of the claim standard used in the U.S. If your practice has a schedule specifically configured for Medicaid billing, and your state Medicaid program requires a modifier, you can enter the full code and the modifier into a CPT field for that schedule. PCC can then help configure which claims will use the custom schedule. Alternatively, your practice could clone a Procedure entry and create a specific version of the procedure for Medicaid billing.
Update Your Price for the Procedure
Enter a price for the procedure in the Schedule A “Price” field. Then press F5 – Duplicate Prices to copy the price to all schedules.
PCC does not provide pricing recommendations. The pediatric benchmark in the U.S. is to charge above 200% of Medicare reimbursement amounts, which are publicly available per-relative value unit for each region. The example above is for illustration only and is not a fee suggestion.
When Would I Use a Different Price Schedule?: A procedure’s price should be identical in all schedule fields, except where your practice uses a different fee schedule. For example, many pediatric practices use a fee schedule for medicaid plans, where they enter a $0 (or a reduced price) for immunizations, ensuring that VFC procedures are billed correctly. Read Add and Configure Immunizations in PCC EHR to learn more. If your practice needs a separate fee schedule, work with PCC Support to ensure that the correct insurance policies are configured to use the custom schedule.
Press F1 to Save
Press F1 – Save and Quit to save any changes to your procedure. Alternatively, press F12 to go back to the list without saving your changes.
Configure Your New Procedure Orders
After you add or update a billing procedure code and price, you may want to create one or more orders and add them to specific chart note protocols (found in Protocol Configuration tool), and link procedure codes directly to orders (in the Billing Configuration tool) so the codes will be added to an encounter whenever an order is created for an encounter. See the sections above to learn more.
Configure Adjustments and Accounting Types
In addition to billable clinical procedures, the Procedures table also includes adjustments. These include accounting adjustments, fees and charges, and other items that result in an increase to an account’s balance.
When you edit these procedures in the Table Editor (ted
), the Accounting Type field indicates their purpose. Various PCC reports include or exclude different accounting types, or put them in special columns, in order to provide your practice with a better understanding of your accounts receivable.
The table below describes different categories of these procedures, their related “Accounting Type” in the table, and how they are used for each accounting operation.
What Are These For?: For examples of how you would use the procedures with these accounting types, see Refund Personal Credits and Reverse a Payment.
Procedures | Accounting Type | Explanation and Usage |
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All clinical procedures performed in a practice | Revenue | Billable procedures you perform in your practice should have an accounting type of “Revenue”. Office visits, immunizations, and more are examples of revenue procedures. You can post these procedures as charges in the Post Charges window. |
Non-Clinical service fees | Revenue – Svc Chg | Tasks you perform for a family that are non-clinical, and have a charge, have an accounting type of “Revenue – Svc Chg”. Examples include record transfer fees, form fees, rebilling fees, and similar. |
Fees or other non-service fees | Revenue Non-Service | When your practice charges a bounced check fee, a forms fee, or some other fee that is not billed to an insurance payer, you use a procedure with an accounting type of “Revenue Non-Service”. The procedure will appear like any other charge on the account. |
Capitation, incentive payment, insurance interest, overpayment, or withhold payment adjustments | Revenue Non-Service | When an insurance company sends you a capitation payment, interest payment, or other type of less-common payment, you post an adjustment procedure with an accounting type of “Revenue Non-Service” to indicate what the payment is for. Then you post the payment. For more information see Post Capitation Checks, Incentive Payments, Interest Payments, Overpayments, and Withhold Payments. |
Write off a credit that you will not refund | Revenue Credit W/O | When you wish to classify a credit on an account as income, you can offset it with an adjustment procedure with an accounting type of “Revenue Credit W/O”. This means you are classifying the credit as income to the practice, and you do not intend to refund it. |
Returned check or other stopped payment adjustment | Receipt – NSF | When a check bounces or another type of payment is stopped, your practice negates the payment by linking it to an adjustment procedure with an accounting type of “Receipt – NSF”. You might also post a fee. |
Credit refunds | Receipt – Refund | When you refund a credit to a family, you post an adjustment procedure to the account with an accounting type of “Receipt – Refund”. |
Insurance takebacks and other insurance refund adjustments | Receipt – Refund | When you need to issue an insurance refund, or an insurance company issues a “takeback” for a payment you already posted, you post an adjustment procedure with an accounting type of “Receipt – Refund”. Then you link the original payment to that adjustment procedure. |
Provide Good Faith Estimates for Pediatric Encounters
If a family does not have insurance, or the family won’t be using insurance for an encounter, then a pediatric practices needs to provide a “Good Faith Estimate” for the cost of care when an encounter is scheduled more than 3 days in advance.
This requirement came into effect on January 1st, 2022 as part of the “No Surprises Act”, and it aims to reduce the likelihood of a family receiving an unexpected medical bill.
Apply the Good Faith Estimate Rules for Pediatrics
Under what circumstances would a pediatric practice need to provide a Good Faith Estimate, and what should the estimate include?
Review the Types of Encounters You Schedule
Your practice schedules a variety of encounters, including physicals or “well visits”, next-day or same-day sick appointments, rechecks, and various consultations.
A typical pediatric practice should be prepared to offer Good Faith Estimates for their well visits, recheck visits, or consults—any appointment that would likely be scheduled more than three days in advance. It is unlikely you will need to provide a GFE for typical “sick” encounters, but you may wish to create one anyway for less-common circumstances.
Develop Estimates That Are Within $400
When you provide a Good Faith Estimate, it should declare the expected cost of services typically performed during the type of encounter, with an accuracy within $400.
For example, your Well Visit Good Faith Estimate might list expected amounts for a well visit and immunization administrations for each age, including amounts for common screenings.
While you are not required to detail the individual costs associated with an encounter, your practice may choose to list common procedures and prices to help the family understand what is included in the GFE.
Always Verify Payment Information When You Schedule
Medical professionals are not required to provide GFEs if the patient or family intends to bill insurance for the encounter, or if the practice will bill an insurance payer on behalf of the family.
Therefore, in addition to developing a GFE form for certain encounter types, your practice should review how you schedule appointments.
Whenever you schedule any encounter, your practice should:
- Ask the patient or family how the encounter’s charges will be paid
- Collect or update the patient’s insurance information
- Provide a GFE if the encounter will not be paid by insurance
PCC software includes customizable tools that can help your practice complete these tasks, such as Clinical Alerts which can appear during scheduling, the customizable Patient Details ribbon, and the ability to check insurance eligibility at any time (including a tool for reviewing eligibility for all scheduled patients). Contact PCC Support for help getting started with any of these tools.
No Insurance, Or Not Using Insurance For a Given Encounter: When a patient or family indicates that they do not have insurance, or that they do not intend to bill insurance for a specific encounter, and the appointment is scheduled three or more days in advance, you should provide a Good Faith Estimate that lists the expected charges with an accuracy within $400.
Develop a Workflow for Sending out GFEs
When your practice knows that a family will not be paying for an encounter with insurance, you should provide them with a Good Faith Estimate within three days of scheduling the appointment.
Your practice could use various methods to accomplish this. You can produce the required form immediately after you schedule the appointment, using the Forms component, and then deliver it using the patient portal.
If the family does not have a portal account, you can generate a PDF and use email or physical mail. You can work with PCC Support to adjust your forms and customize reports to meet this need.
Create Good Faith Estimate Forms
Your practice can develop quick Good Faith Estimate forms to help you provide a Good Faith Estimate whenever it is needed. For example, you could create a form letter that lists your GFEs for each type of encounter, and then send that form to families through the Patient Portal.
VFC and TOS Cash Discounts: If your practice administers VFC or other reduced-rate immunizations, you may wish to account for that difference in your GFEs. Similarly, if your practice offers a discount for payment received at time of service, you can include that information on your GFE forms.
While your practice is not required to provide an itemized charge list, many practices are choosing to do so in order to define the amounts included in the Good Faith Estimate.
Olney Pediatrics in Maryland and North Augusta Pediatrics has shared a sample Well Visit form (charge amounts have been removed for this image), which allows them to quickly create a GFE by checking off the details for a scheduled encounter and entering a total:
You can download a Microsoft Word file version for use at your practice.
The AAP has also created several sample forms:
In order to provide an accurate GFE for lab work that may occur outside of your practice, you may want to contact your lab companies. The AAP created a sample letter:
You can access the above AAP’s materials through the SOAPM website.
Contact PCC Support for help setting up your Good Faith Estimate forms.
Configure the Immunization History in PCC EHR
The Immunization History appears in the History section of patient charts and in the Immunizations section of visits, phone notes, and portal messages.
The Immunization History has two parts: Vaccines and Diseases. The Vaccines section shows patients’ vaccine history, organized by immunization name. The Diseases section shows patients’ history of vaccine-preventable disease.
You can customize the default layout of the Immunization History to optimize it for all users and patients at your practice.
Configure the Vaccines Section
You can configure the layout and default display functionality of immunizations in the Vaccines section of the Immunization History.
Open the Configuration menu in PCC EHR and select the Immunizations option.
On the Immunization History Screen tab, click and drag the immunization rows to reorder them. Immunizations display on the Immunization History in the order you establish here.
To display immunizations by default on the Immunization History, check the “Display” box. Immunizations configured this way display as rows on the Immunization History even when patients have not received them.
Immunizations where the “Display” checkbox is blank remain hidden from the Immunization History until patients have received them.
When you have finished configuring the Vaccines section of the Immunization History screen, click “Save” to commit your changes and exit the tool.
Call PCC Support to Edit Immunizations or Add Combination Vaccines: The list of available immunizations in PCC EHR comes from your Immunization and Diseases table and other configuration under the hood in the Practice Management window. Contact PCC Support for help editing immunizations or adding new combination vaccines.
Configure the Diseases Section
You can customize the layout of diseases on the Immunization History screen.
Open the Configuration menu in PCC EHR and select the Immunizations option. Once in the configuration tool, click the Diseases tab.
On the Diseases tab, you can configure which vaccine-preventable diseases display on the Immunization History and elsewhere in PCC EHR. Vaccine-preventable diseases that are checked off in this configuration pane only display for patients who have received a diagnosis.
Check with PCC Support About Immunization Registry Configuration: Not all registries accept vaccine-preventable disease information for patients. If you would like to learn whether the registry with which you interface accepts this information, contact PCC Support to speak with an immunization registry specialist.
When you have finished configuring the Diseases section of the Immunization History screen, click “Save” to commit your changes and exit the tool.
How to Report on Your Practice’s Use of Provider Relief Funds
If your practice received Provider Relief Fund payments of over $10,000 between July 1st, 2020 and December 31st, 2020, you may need to report on the use of these funds before March 31st, 2022. This is the “Reporting Period 2” requirement from the HRSA. These payments were part of the CARES Act and subsequent relief programs during the COVID-19 pandemic.
For later rounds of funding, you may need to update numbers and verify your practice’s loss of income.
What Numbers Do You Need In Order to Report Your Use of PRF Funds?
How do you report on how your Provider Relief Fund payments were used? For most practices, this money is applied towards “patient care lost revenues.”
From the HRSA:
When reporting lost revenues, providers do not need to account for a specific expense to ‘use’ funding by the deadline. Instead, they need to be able to document that the loss occurred during the relevant time period.
(https://www.hrsa.gov/sites/default/files/hrsa/provider-relief/prf-lost-revenues-guide-rp2.pdf)
PCC has worked with several pediatric practices who are reporting their lost revenue. On the HRSA’s reporting website, they are typically asked to enter “Total Revenue/Net Charges from Patient Care” for each quarter from 2019 through the end of 2021. The HRSA’s tool asks practices for the total amounts from Medicare, Medicaid, Self Pay, and Private Insurance payments.
How Do You Get Quarterly Payment Totals from Your PCC System?
There are many different PCC report tools that can produce quarterly revenue amounts, and you may have already worked with PCC to create visit-based payment reports, daysheet-style reports, and similar. You might retrieve income amounts from your practice’s accounting software.
After learning more about this need in early 2022, PCC created a custom “Quarterly Charges and Payments By Insurance Group” report, which is available on your PCC system as of Thursday, March 24th.
What Income Should Be Included?: When you run this report, or another PCC report or retrieve information from your accounting software, your practice should consider what income to include. The HRSA indicates you should report revenue from patient care, which includes: fee-for-service insurance payments, capitation insurance payments, value-based payments (P4P and bonus money), patient payments/copayments and money from the COVID Uninsured Fund and CAF Fund. Patient care revenue does not include the PRF funds themselves, PPP loans, and other non-patient care revenue such as Meaningful Use money or interest income. If your practice enters non-patient care revenue sources of income into your PCC system, then you should use report criteria to exclude that income. See the example in the procedure below. For more information, see PRF Reporting / Keeping Your Funds.
Follow this procedure to calculate your total quarterly payments for reporting your lost revenue.
Open the Practice Management Window
Click on the Practice Management icon to open PCC’s under-the-hood Practice Management tool.
Open the Smart Report Suite
In the Partner Reports–>Practice Management/Financial Reports window, open the Smart Report Suite.
Run the Quarterly Charges and Payments by Insurance Group Report
In the Billing and Collection Reports section, open the Quarterly Charges and Payments by Insurance Group report.
Enter a Date Range
Enter a Date Range. For Reporting Period 2 for Provider Relief Funds received during the COVID-19 pandemic, enter 1/1/2019 through 12/31/2021.
Press F1 to continue.
Select Procedures that Relate to Revenue for Patient Care
The report will next ask you to select procedures to include on the report. You should select all procedures that are patient revenue.
For example, you could select all procedures by group, and then deselect the Refund procedure group.
If your practice uses procedures to offset and post the PRF funds, or other sources of income that are not patient revenue, you can deselect those procedures. They should not be used when reporting your revenue loss for PRF funds.
After you adjust your procedure selection, press F1 to continue.
Confirm Criteria
On the next screen, press F1 to confirm the report criteria.
You can optionally adjust criteria for specific reporting needs at your practice. For example, you could filter by provider or location.
Select Destination and Review Results
For each insurance group, you can see total charges, amount collected (including adjustments), and then the “Amount Deposited (all pmts)”. Your practice can use the Amount Deposited column to review your income from each insurance group for each quarter.
The “Personal / No Insurance” row displays data for patients who are self-pay, without any assigned insurance plan.
If you have more than one Medicaid insurance group, you should add up the “Amount Deposited” columns for those groups when reporting on Medicaid payments.
Similarly, in order to calculate your Commercial/Private Insurance payment amounts, add the total Amount Deposited for any private insurance groups in the report.
Export and Save Your Report
Press F4 – Send To... to email or print the report. Although you can rerun the report at any time, you may wish to keep the report on file.
You can also export the data for use in a spreadsheet.
Use the Report Amounts to Report Your Revenue Loss
To learn how, visit https://prfreporting.hrsa.gov/s/ .
Canceling and Rescheduling CHADIS Appointments and Moving CHADIS Results
When your patients and families complete CHADIS questionnaires,the results are automatically assigned to the patient’s upcoming visit. Canceling a visit will also cancel those orders, making CHADIS results unavailable in the patient’s history or in a newly scheduled visit. Use the following workflow and suggestions to ensure that assigned and completed questionnaires are saved and available in a patient’s chart.
Whenever possible, reschedule an appointment instead of canceling it. Rescheduling maintains the same appointment data, so completed CHADIS questionnaires are moved to the new date along with any other information added to the visit where it was originally scheduled.
If an appointment with CHADIS results needs to be canceled, or will be rescheduled for a future date yet to be determined, cancel the appointment. When the time comes to schedule the replacement appointment, restore the appointment through the patient’s appointment history, and then reschedule it as above.
Rescheduled visits are not counted as canceled visits. If you want to mark a visit as “canceled by patient”, but still move the CHADIS results to a replacement appointment, then reschedule the visit with the CHADIS questionnaire, as above, and then create a new visit for the original time and date, and cancel that one. The canceled and the rescheduled visit will appear in the patient history, with the earlier one marked as canceled.
Other tips
- Any appointment scheduled for the following seven days could include CHADIS results, so be sure to check for results before canceling any appointments in the near future.
- CHADIS results will trigger the orange ball in the patient’s history and the EHR schedule queue, but there’s no way to tell that results have arrived in the Appointment Book, so it’s best to manage cancellations and rescheduling through the Appointment History component in the patient’s Medical Summary.
- If an appointment with CHADIS results is canceled instead of rescheduled, there’s no way to move that data to another appointment. The only option is to print the results to the EHR then attach the document to the new appointment.
- CHADIS will not reassign the same questionnaires to a patient twice within a number of days, (usually 14, though that can be changed through the CHADIS web interface). If an appointment with CHADIS results is canceled, and a new appointment is scheduled outside of that date range, then CHADIS will reassign the questionnaires and the user will need to complete them again.
Move CHADIS Results to a Different Encounter
When a patient misses or cancels an appointment after completing CHADIS questionnaires, you can move those CHADIS results and orders to another encounter, so that no results are lost, and no users need to repeat any questionnaires.
When viewing a visit that includes CHADIS orders and results, select “Move CHADIS Results” from the Edit menu. Move CHADIS Results opens a window with a drop-down menu including the patient’s visits and the option to create a new Unsolicited Chadis Results encounter.
After making your selection and clicking move, you’ll have the opportunity to confirm your choice, or click “Back” to return to the previous visit selection window.
Once you confirm your selection by clicking “Move” the orders and results will appear in the visit you selected.
PCC 9.3 Performance and Supportability Enhancements
In the first quarter of 2022, PCC will release version 9.3 of our electronic charting and practice management software to all PCC practices.
PCC 9.3 is a performance and supportability update. We included many performance improvements into the PCC 9.2 infrastructure update, and PCC 9.3 extends that work with further quality-of-life improvements across our products. You’ll enjoy faster, easier access to the tools you need. During this release we also improved how PCC helps new clients get up-and-running, updated immunization tracking and reporting, and added telemedicine configuration options to support new 2022 requirements.
Read below to learn more about the new features, and contact PCC Support for help with any PCC product or service.
Open and Navigate Charts Even Faster
PCC EHR now loads patient chart data only as it is needed, significantly reducing the amount of time it takes to initially open a chart. Average chart-open times will reduce for all users, in any practice location.
In addition, PCC 9.3 reduces the number of clicks needed when you navigate around a chart. For example, when you finish charting a visit and move to other chart sections, PCC EHR will save your changes automatically. You’ll only need to click “Save” when you leave the chart or switch to another patient.
Support for 2022 Telemedicine Place of Service Codes
PCC 9.3 supports the newly updated place of service codes (02 and 10) that appear on claims for telemedicine encounters. You can schedule a telemedicine encounter in your office location and PCC EHR can select a default telemedicine location, with an appropriate place of service code. Your biller can also select a specific location when they post charges, ensuring the correct place of service code appears on the claim.
For more information, read 2022 Updates to Telehealth (Telemedicine) Place of Service Codes.
Updates to COVID-19 Vaccine Support in PCC
PCC continually updates your system to support COVID-19 vaccines. This includes support for clinical and financial codes, manufacturer and vaccine codes (MVX and CVX), and the index of VIS. During the PCC 9.2 to 9.4 release cycle, PCC rolled out multiple patches to your system.
To learn how to configure your system for COVID-19 vaccine administration, read:
COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill
For other guides and updates related to COVID-19, visit PCC’s COVID-19 Links and Resources page.
March 2022 VIS, CVX, and MVX Update
In March of 2022, PCC patched all practice systems with the latest VIS, MVX, and CVX data. These updates allow your practice to track and record the latest immunization information.
The update included these new or updated VIS document titles:
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet-12 years and older
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet- Pediatric 5 – 11 years
- COVID-19 Pfizer BioNTech EUA Recipient-Caregiver Fact Sheet- Pediatric <5 yrs
- COVID-19 Moderna Vaccine EUA Recipient-Caregiver Fact Sheet
- COVID-19 Janssen Vaccine EUA Recipient-Caregiver Fact Sheet
- Recombinant Zoster Vaccine VIS
- Pneumococcal Conjugate Vaccine (PCV13_PCV15_PCV20) VIS
The update added support for these new CVX codes:
- 207: COVID-19, mRNA, LNP-S, PF, 100 mcg/0.5mL dose or 50 mcg/0.25mL dose
- 217: COVID-19, mRNA, LNP-S, PF, 30 mcg/0.3 mL dose, tris-sucrose
- 219: COVID-19, mRNA, LNP-S, PF, 3 mcg/0.2 mL dose, tris-sucrose
- 220: HepB recombinant, 3-antigen, Al(OH)3
- 221: COVID-19, mRNA, LNP-S, PF, 50 mcg/0.5 mL dose
The update added support for one MVX code:
- VBI: VBI Vaccines, Inc
March 2022 Diagnosis Code Update
In March of 2022, PCC patched all practice systems with the CDC’s latest COVID-19 ICD-10 update. The new codes become valid on April 1st, 2022.
The update includes underimmunization for COVID-19:
- Z28.31 Underimmunization for COVID-19 status
- Z28.310 Unvaccinated for COVID-19
- Z28.311 Partially vaccinated for COVID-19
The guidelines specify that these codes should not be used for individuals who are not eligible for the COVID-19 vaccines, as determined by the healthcare provider.
The update also includes the “other underimmunization” status, with two additional descriptions:
- Z28.39 Other underimmunization status
- Delinquent immunization status
- Lapsed immunization schedule status
You can read the complete list of new diagnoses in this update on the CDC’s website.
For help linking these new billing codes to the diagnosis descriptions used in a patient’s chart, read Link Chart Diagnoses to ICD-10 Billing Codes.
Work with Fewer Interruptions on a Cloud-Hosted PCC Server
In PCC 9.3, practices with cloud-hosted servers can expect PCC EHR to work faster and more efficiently, even over less-than-perfect internet connections.
Faster Performance in the PCC EHR Report Library, Patient Portal, and pocketPCC
PCC 9.3 introduces several changes under-the-hood to improve the operating speed and responsiveness of the PCC EHR Report Library, pocketPCC, and the patient portal. The size and configuration of your practice will affect the extent to which you notice these improvements.
MenQuadfi Added to Adolescent Immunization Dashboard
PCC 9.3 updates the adolescent meningococcal immunization rates on the Practice Vitals Dashboard to include administrations of the MenQuadfi vaccine product (CVX 203, CPT 90619).
Add Patient Race and Ethnicity to the Immunization Administration Details Report
In PCC 9.3, you can include columns for patient race and ethnicity on custom versions of the Immunization Administration Details report in the PCC EHR Report Library. Information about patients’ race and ethnicity is sometimes required by third-party requesters who collect immunization data.
This improvement was delivered ahead of the 9.3 release to practices who specifically requested it, including all practices located in North Carolina. North Carolina practices may use this updated report to meet the submission requirements of the North Carolina Immunization Registry (NCIR).
You can learn how to add columns to custom reports in the article Create a Custom Report.
Continued Pilot Test: Create and Manage Patient Forms in PCC EHR
Continuing in PCC 9.3, you can participate in a pilot test to create your own patient form letters in PCC EHR.
As a pilot tester, you will be able to use the new Forms Configuration tool in PCC EHR to create patient form letters that include variable fields for auto-inserting patient, account, and practice information.
You should consider participating in the pilot test if you want early access to the tools for making your own patient form letters in PCC EHR and to tell PCC what would make them even better.
To learn more, read Pilot Test: Create and Manage Patient Form Letters in PCC EHR.
Generate and Print Forms in a Future Release: Please note that you will not be able to generate and print the forms that you create during the pilot test until a future PCC release.
Look Up and Import Immunization Records from Even More State Registries
Practices in Colorado, Connecticut, Maryland, New Jersey, North Carolina, and Philadelphia are newly eligible to sign up for bidirectional immunization registry interfaces, joining those who have similar connections in California, Wyoming, Indiana, Florida, Georgia, and Virginia.
Special Considerations for North Carolina Practices: As part of the go-live process with the North Carolina Immunization Registry (NCIR), practices currently registered with the COVID Vaccine Management System (CVMS) must take special steps to switch COVID-19 immunization reporting to NCIR. If you are interested in establishing a connection with NCIR, contact PCC Support.
With a bidirectional connection, you can check vaccine records in your local immunization registry and import them into patient charts without ever leaving PCC EHR.
To read about how it works, check out Look Up and Import Patient Immunization Records from Your Local Registry.
Contact PCC Support to get started, or to let us know that you’re interested in establishing a bidirectional connection with your registry once it’s available in your region.
Exchange Patient Records with Hospitals and Other Practices On Demand
When you enable Clinical Document Exchange, you can securely and instantaneously retrieve records from other healthcare providers who participate in CareQuality network without ever leaving your patient’s chart in PCC EHR. Other providers in the CareQuality network can also securely retrieve patient records from your practice without having to call, fax, or email record requests.
To learn how it works and how to sign up, read Securely Retrieve Patient Information from Hospitals and Other Practices.
New and Updated Interfaces Available in PCC 9.3
With each release, PCC expands and updates direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 9.3:
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New Clinical Interfaces: During the PCC 9.3 release cycle, PCC introduced new bidirectional immunization registry interfaces with Connecticut (CTWIZ), New Jersey (NJIIS), North Carolina (NCIR), and Philadelphia (PhilaVax) immunization registries.
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New Insurance Eligibility and Financial Interfaces: During the PCC 9.3 release cycle, PCC enabled or updated insurance eligibility interfaces with Connecticare, Vermont Medicaid, Driscoll Children’s Health Plan, Allied Benefits, Medical Card System of Puerto Rico, Plan de la Menonita, and Molina Healthcare of Washington. PCC 9.3 also improved our claim interface with Meridian Health, BCBS All Kids Alabama, Amerihealth Caritas Health Plan of New Hampshire, and Cook Children’s Health Plan.
If your practice would like to take advantage of these connections, or you have other interface needs, contact PCC Support.
Update Your Windows 8 and Windows Server 2012 Workstations
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. Microsoft will end support for Windows 8 in January of 2023, and infrastructure support necessitates we end support for Windows Server 2012 at the same time. If your practice uses workstations that run Windows 8 (or prior) or Windows Server 2012 (or prior), you should upgrade those machines.
Apple does not formally announce the end of software security updates, but similarly your practice should make plans to upgrade any Apple Macintosh workstation running MacOS 10.14 (Mojave) or MacOS 10.15 (Catalina) or prior, as they are approaching end-of-life.
When a user logs into PCC EHR, it will present a message if they are running older system software. The reminder encourages them to review and update their operating system. Contact PCC Support for recommendations.
PCC EHR recommends a workstation running on Windows 10 (or higher) or MacOS 11 (or higher). For more information, read Hardware Guide: Your Personal Computer and Equipment.
Other Feature Improvements and Bug Fixes in PCC 9.3
In addition to the features described above, PCC 9.3 includes these smaller improvements and squashed bugs.
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Less Confusion When Updating Insurance Plans: PCC 9.3 removes the payer-specific immunization registry fields from the Insurance Table, which could cause confusion when adding new plans to your practice’s table.
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Faster and More Accurate Last Answers: Instead of checking your system’s audit log when you check in or “arrive” an encounter, the Last Answer feature on chart notes now updates directly from the most recent answer from the previous visit.
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Billing Statuses Fix: Under certain circumstances, an encounter could have multiple Billing Statuses, with only one displaying. This could lead to unexpected behavior when filtering the Schedule screen in PCC EHR. PCC 9.3 fixes this issue.
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Deleting an E-lab Result: When one user imported an e-lab result to a patient chart and a different user simultaneously deleted that e-lab result, later viewing of the patient’s history could cause PCC EHR to crash. PCC 9.3 fixes this issue by adding safeguards to the import e-labs process.
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Location-Specific Tax ID on Receipts: Due to a previous feature update, receipts for time-of-service payments could only display the Tax ID stored in your practice’s general configuration. PCC 9.3 restores the ability for a receipt to display the Tax ID of the specific location of the encounter.
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Disabled User Accounts Should Not Appear in Snaptext Configuration: When you disable a user account on your PCC system, the user will no longer appear in the Snaptext drop-down menu.
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Portal Messages With No Subject Appearing as Unread: When a portal message had no subject, it could appear with an “Unread” status in PCC EHR even if it was read. PCC 9.3 corrects this issue.
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Reduced Clutter of Completed E-labs on the Visit Tasks Queue: When a user created a new lab order to link an incoming e-lab request, the order could erroneously appear on the Visit Tasks queue as awaiting results. This led to unnecessary clutter on the Visit Tasks queue. In PCC 9.3, a new lab order with attached e-lab results will be marked as complete, and will only appear when filtering for completed tasks.
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See Full Dose Range for Prescriptions on the Patient Visit Summary: In PCC 9.3, the Patient Visit Summary has been updated to display both the minimum and maximum dose quantities for prescriptions which contain a range. For example, if you write an inhaler prescription where the dose quantity is expressed as “2 to 4 puffs,” the maximum dose quantity of “4” will now appear on the Patient Visit Summary in addition to the minimum dose quantity of “2.” Prior to this fix, only the minimum dose quantity was displayed on the Patient Visit Summary.
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Portal New Document Notification Correction: PCC 9.3 prevents new document notifications from being sent to users who have been deleted from the patient portal.
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Improved Scheduling Template Error Checking: PCC EHR’s Scheduling Templates now prevent an end time of 12:00am from being selected. The latest scheduled end time available is now 11:55pm. This prevents users from selecting an end time before the day’s start time.
Use a Billing Service with PCC
Some pediatric practices use a billing service instead of (or in addition to) in-house billing staff.
PCC maintains an index of billing services that have used PCC in the past, along with a quick “things to consider” Billing Service Shopping List for practices who are looking into using a billing service.
Billing Service List
Not a Recommendation or Endorsement: PCC makes no recommendation for particular billing services. Inclusion on this list means we know that the service has used PCC software at some point, and that they’ve shared their contact information with us.
Name | Contact | Phone | Website | Business Address | |
Altus Pediatric Billing | Emily Floyd | emily@altussolutionsgroup.com | (972) 607-4130 | https://altuspediatricbilling.com/ | 7200 State Highway 161, Suite 350, Irving, TX 75039 |
AM Med Solutions | Sunny Gazahi | sg@ammedsol.com | 888-811-5391 x100, Fax: 1-646-292-5178 |
www.ammedsol.com | 247 Prospect Ave, Suite 4C, Brooklyn, NY 11215; 1368 N US 1, Suite 404, Ormond Beach, FL 32174 |
Bookkeeping & Business Services, LCC (BBS) | Diane Richards | info@bbs1040.com, drichards@bbs1040.com | (978) 794-1919 | Bookkeeping & Business Services, LCC | 302 Broadway, Methuen, MA, 01844 |
IPMSO Remote Biller | Susanne Morgana Brennan | brennan@ipmso.org | (877) 774-7726 (877-771-PRCM) | The Verden Group | 48 Burd St Suite 104 Nyack, NY 10960 |
Medical Solutions | Stephanie Dubert | info@sotxbilling.com | (956) 630-2225 | Medical Solutions | 612 Nolana, Suite 330, McAllen, TX 78504 |
PedsOne | Tim Rushford | tim@pedsone.com | (866) 371-6118 | PedsOne | 10 East Allen Street, Suite 100 Winooski, Vermont 05404 |
Billing Service Shopping List
PCC created a Billing Service Shopping List guide in 2021. It includes questions to ask and things to consider when you research a billing service.
Contact PCC
Get in touch with PCC if you have questions about our policies and procedures for working with billing services. If you begin working with a billing service, let us know!
You can find other PCC clients who use billing services on PCC Community.
2022 Updates to Telehealth (Telemedicine) Place of Service Codes
In October of 2021, the Center for Medicare & Medicaid Services (CMS) announced changes to the Place of Service (POS) codes used on claims for telehealth encounters. If your practice bills for any telehealth (or “telemedicine”) encounters, you should learn about place of service code requirements and discuss them with your payers. You may need to update your PCC configuration.
CMS changed the description of POS 02 to “Telehealth Provided Other than in Patient’s Home”, and introduced POS 10, “Telehealth Provided in Patient’s Home”. The effective date is January 1st, 2022, and the implementation date is April 4th, 2022.
Watch a Video Overview: You can watch an overview video explaining the POS code changes and PCC configuration: Configure Your Telemedicine Place of Service Codes (2022).
Learn the Details of the New and Updated POS Codes
CMS now defines these two telemedicine place of service (POS) codes:
- POS 02: Telehealth Provided Other than in Patient’s Home
Descriptor: The location where health services and health related services are provided or received, through telecommunication technology. Patient is not located in their home when receiving health services or health related services through telecommunication technology.
- POS 10: Telehealth Provided in Patient’s Home
Descriptor: The location where health services and health related services are provided or received through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
For more details, you can review the full CMS Place of Service Code Set.
Configure PCC So the Right Place of Service Code(s) Appear on Your Claims
Prior to the 2022 Update
Prior to this change, payers typically required the Place of Service code 02 on claims for telemedicine encounters.
When PCC helped practices configure their locations for telemedicine billing, we typically recommended cloning an existing in-office location in your PCC configuration tables to create a secondary telemedicine place of service, which would use the 02 code. Your practice can also configure PCC EHR to automatically select a telemedicine location for appointments marked “Telemedicine”, so all of a clinician’s time could be scheduled for a single office location.
See Configure PCC EHR for Telemedicine Encounters, and Set a Default Billing Place of Service for Telemedicine Visits.
POS Claim Configuration For 2022 and Beyond
Depending on what you learn from your payers, your practice may decide to:
- Clone your telemedicine entry in your Place of Service table (see Configure PCC EHR for Telemedicine Encounters) to create a new entry.
- Give the new entry a Place of Service code of 10.
- Adjust the names of your locations for ease of use. For example:
Your practice can then select the appropriate location when you post charges, distinguishing between telemedicine encounters where the patient is at home (POS 10) or located somewhere else (POS 02).
Talk to Your Payers First!: It is not clear how or when payers will expect pediatricians to use these adjusted POS codes. CMS indicates the “effective” and “implementation” dates for their purposes (January 1st and April 4th, 2022, respectively), but we do not know how payers will respond and what POS codes they will require. Your practice should ask your major payers about appropriate coding for telemedicine visits.
Clone, Don't Overwrite: When you edit your location configuration, remember to clone your existing telemedicine location to create a new entry. Do not overwrite your existing location’s POS code (02). When you change an existing location, you may inadvertently be editing claim history and previous claims that may need to be reviewed and/or resubmitted.
Automatically Use Telemedicine Place of Service Code 10 in PCC EHR
Your PCC system understands that locations with both 02 and 10 are possible for telemedicine visits. This supports ease of use when your practice schedules and post charges in PCC EHR.
For example, you can map a practice location’s default telemedicine location to any place of service with an 02 or a 10.
Also, when your practice’s biller posts telemedicine encounters, they will be able to select among all the telemedicine locations (02 or 10) configured on your system.
Charting a Patient's Location: Your practice may wish to begin charting a patient’s location during telemedicine encounters. You can do so by adjusting your telemedicine chart note protocols to include a custom component.
Share and Print Lab Results Through the Patient Portal
Your patients and families can download and print lab results from PCC’s Patient Portal, so there’s no need to upload COVID-19 and other test results manually. Portal users can access test results from their phone or computer, to print and share wherever they’re needed.
When you check “Include on Patient Reports” while ordering a lab in PCC EHR, the lab order automatically appears in the Patient Portal in the patient’s Labs section, and in the lab component of the visit itself.
The Download Lab Orders button generates a PDF file of the lab results. The PDF is very similar to the lab order details view in PCC EHR, though some minor items are changed to make the lab results clearer and easier to read.
Portal users can save the PDF to their phone or computer, or print it and have it in hand for schools, camps, and any other occasion where test results are needed.
PCC 9.2 Infrastructure Release
In January of 2022, PCC will release version 9.2 of our electronic charting and practice management software to all PCC practices.
PCC 9.2 is an infrastructure release that updates PCC EHR’s database, operating system, web technologies, and interface tools. This release will pave the way for future functionality. During the release period, PCC also improved performance and met several urgent needs. We updated COVID-19 vaccine and testing support, improved chart open times, and made it easier to print out of Practice Management.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Families Can Print Their Own Lab Test Results
Patients and families can now download and print lab results from PCC’s Patient Portal, so there’s no longer any need to upload COVID-19 and other test results manually. Your portal users can access test results from their phone or computer, and share them wherever they’re needed.
When you check “Include on Patient Reports” when ordering a lab, the lab order automatically appears in the Patient Portal in the patient’s Labs section, and in the lab component of the visit itself.
The Download Lab Orders button generates a PDF file of the lab results. It looks very similar to the lab order details view in PCC EHR, though some minor items are changed to make the lab results clearer and easier to read.
Portal users can save the PDF, or print it and have it in hand for schools, camps, and any other occasion where test results are needed.
Improved Support for COVID-19 Vaccines
In November of 2021, PCC proactively updated all client systems for the 5-11 COVID-19 vaccines and updated support for other COVID-19 vaccines. We added the new CVX and NDC codes to your system, and we updated the VIS list to include the newest Pfizer EUA Fact Sheets.
Immediately following the FDA’s authorization of a 5-11 COVID-19 vaccine, PCC updated the billing code validation lists for all practices so your system’s claim processor can handle the new COVID-19 vaccine and administration codes. As a side benefit, PCC 9.2 improves the code validation update process so it will be quicker in the future and will better support unusual and state-specific code validation needs.
Get Started with COVID-19 Vaccination at Your Practice: For information on how your practice can start administering COVID-19 vaccines, including all the codes you’ll need and helpful configuration tips, read COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill.
Improved Vaccine Tracking Dashboards
PCC 9.2 improves the downloadable childhood and adolescent immunization rate reports in the Practice Vitals Dashboard, breaking out the number and percentage of patients who are up-to-date with their immunizations by primary care provider and vaccine.
You can download these reports from the “Immunization Rates – Patients 2 Years Old” and “Immunization Rates – Adolescents” clinical measures pages in the Dashboard.
This information can help you identify providers who are immunizing most or all of their patients on time, and those who could benefit from a little extra support.
PCC 9.2 also introduces more complete and accurate reporting of current and last season trends in influenza vaccine administration.
Practice Vitals Dashboard reports are updated on the Tuesday or Wednesday following the first Saturday of each month.
Choose a Local Printer on the Fly when Printing from Practice Management
When you work in the Practice Management window in PCC EHR, you can now print directly to any printer on your workstation without having to contact PCC for configuration.
In PCC EHR, open a new Practice Management window.
When prompted to set a default printer, type ‘X’ next to “Local Print Dialog”, then press F1 to save.
With this default, print jobs initiated from the Practice Management window (except for encounter forms and paper HCFAs) call up your workstation’s local print dialog.
You can send your job to any printer that is available from your workstation.
After you select a printer, click the “Print” button to finish printing your job.
The output prints from the selected device.
Not All Practice Management Jobs Can Be Printed Locally: Certain kinds of print jobs, such as paper HCFA forms and encounter forms, are configured at the practice level and do not pay attention to users’ personal printer settings. Contact PCC Support if you are having difficulty printing one particular type of job to your local printer.
Only for Onsite Users Working in Practice Management in PCC EHR: This new printing feature is only available to users working in the Practice Management window in PCC EHR while at the physical office. If you are connecting to your office remotely over SecureConnect, you must use the remote printing option to print from Practice Management. If you use AniTa, PuTTy, or a MacOS Terminal window to access your Partner practice management system, PCC Support must configure printers before you can print to them.
Manually Set Your Default Printer
If you are not automatically prompted to select a default printer when you open the Practice Management window in PCC EHR, you can open the Pick a Default Printer (pickaprinter)
program from your main menu in Practice Management and choose the “Local Print Dialog” option there.
If you do not see the Pick a Default Printer (pickaprinter)
on your main menu screen in Practice Management, contact PCC Support to have it added.
Plan Your Day with Total Appointments in pocketPCC
The pocketPCC schedule now displays the number of appointments for each provider’s daily schedule, so at a glance your providers can see exactly how many appointments they have for the day.
Access the Updated AAP Educational Materials Site
In the fourth quarter of 2021, the AAP updated their free educational materials website. PCC patched all practice systems to support the new online library.
Use the Patient Education tool in PCC EHR to browse and search the AAP’s resources (or NLM’s MedlinePlus library). You can also access the AAP’s Pediatric Coding Newsletter and Red Book. For more information, read Find and Share Educational Materials and Handouts.
Open Charts Faster
During PCC’s 9.2 infrastructure update, PCC improved database access, accelerating chart open times. You’ll especially notice this improvement if you are a larger practice or you have charts with a large amount of information.
And We're Not Done: PCC is dedicating our next release, PCC 9.3, to performance and supportability improvements. We’ve found even more ways to improve how PCC EHR loads information onto your screen. While PCC can’t improve your internet network speed (or your laptop), the PCC 9.2 and PCC 9.3 updates to the PCC EHR application will save you time and reduce the aggravation of waiting for a chart to open.
Open eRx Faster
During PCC’s 9.2 infrastructure update, PCC revamped how we load the eRx module in the patient’s chart in order to create a smoother, more efficient user experience. This improvement was delivered in November 2021.
The under-the-hood performance update consolidated background queries associated with the new favorites drop-down, reduced the number of background calls made to common database tables in creating prescriptions, and streamlined the way the eRx prescribing page draws on the screen. The update did not introduce any new features or functionality.
Many practices reported improvements to the prescribing experience as a result of the update, but it did not exhaustively address all performance-related concerns. Please notify PCC Support of ongoing latency issues while prescribing in PCC eRx, and let us know if you have questions about any of the performance improvements that were introduced in the latest update.
Pilot Test: Create and Manage Patient Forms in PCC EHR
Continuing in PCC 9.2, you can participate in a pilot test to create your own patient form letters in PCC EHR.
As a pilot tester, you will be able to use the new Forms Configuration tool in PCC EHR to create patient form letters that include variable fields for auto-inserting patient, account, and practice information.
You should consider participating in the pilot test if you want early access to the tools for making your own patient form letters in PCC EHR and to tell PCC what would make them even better.
Please note that you will not be able to generate the forms that you create during the pilot test until a future PCC release.
To learn more, read Pilot Test: Create and Manage Patient Form Letters in PCC EHR.
Import Immunizations from Connecticut, Georgia, New Jersey, and Virginia State Registries
Practices in Connecticut, Georgia, New Jersey, and Virginia are newly eligible to sign up for bidirectional interfaces with their state immunization registries, joining those who have bidirectional registry connections in California, Wyoming, Indiana, and Florida.
With a bidirectional connection, you can check vaccine records in your local immunization registry and import them into patient charts without ever leaving PCC EHR.
To read about how it works, check out Look Up and Import Patient Immunization Records from Your Local Registry.
Contact PCC Support to get started, or to let us know that you’re interested in establishing a bidirectional connection with your registry once it’s available in your region.
Exchange Patient Records with Hospitals and Other Practices On-Demand
When you enable Clinical Document Exchange, you can securely and instantaneously retrieve records without leaving your patient’s chart from other healthcare providers who participate in CareQuality network. Other providers in the CareQuality network can also retrieve patient records from your practice without having to call, fax, or email in a record request.
To learn how it works and how to sign up, read Securely Retrieve Patient Information from Hospitals and Other Practices.
Use New Test Descriptions in the LOINC 2.71 Update
During the PCC 9.2 release cycle, PCC updated your practice’s system with LOINC 2.71, an update to the standard list of labs used to make tests interoperable between different healthcare systems.
PCC reviewed the updates in LOINC 2.7.1 before the update: there are no disruptive changes to labs that your practice currently orders, and you do not need to take any action to see the effects of the patch.
The update includes over a thousand new terms and updates, including six new COVID-19 related lab tests involving both saliva and respirator specimen testing. You can read more details on the LOINC Release Notes website. LOINC also maintains a dedicated SARS-CoV-2 and COVID-19 related LOINC terms page.
Your practice can configure the tests for each of your lab orders in the Lab Configuration tool. For a quick guide on how to add a COVID-19 test or other lab order, read Create a COVID-19 Test Lab Order.
New and Updated Interfaces Available in PCC 9.2
With each release, PCC expands and updates direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 9.2:
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New and Updated Clinical Interfaces: During the PCC 9.2 release cycle, PCC introduced new bidirectional immunization registry interfaces with Connecticut (CTWIZ), Georgia (GRITS), New Jersey (NJIIS) and Virginia (VIIS) state immunization registries, allowing you to look up and import patient records from those registries without ever leaving PCC EHR.
If your practice would like to take advantage of these connections, or you have other interface needs, contact PCC Support.
Updates to Immunization Forecasting
On Thursday, January 13, 2022, practices received a behind-the-scenes update to the immunization forecaster. These are the immunization forecasting updates for PCC 9.2:
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COVID Booster for Patients 16 Years and Older: The immunization forecaster will recommend a COVID-19 booster dose for patients at least 16 years of age six months after completion of the primary series.
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COVID Immunization for Patients 5-11 Years of Age: The immunization forecaster will recommend a COVID-19 immunization series for patients ages 5 through 11. Pfizer tris-sucrose vaccine for 5 through 11 years of age (CVX 218) will be considered valid when administered under 18 years of age with a 21-day interval between doses 1 and 2. No booster dose will be recommended for children ages 5 through 11.
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Forecasting for Off-Label Administration of Moderna COVID Immunization to Patients 12-17 Years of Age: The immunization forecaster will recommend a second dose of the Moderna COVID-19 vaccine for patients ages 12 through 17 if a first dose has been administered off-label. The second, off-label Moderna dose will be recommended 21 days after the first dose is administered, as is the case with the approved Pfizer vaccine schedule.
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Support for Additional COVID-19 and Other Vaccine Products: The immunization forecaster will make appropriate recommendations for the following COVID-19 vaccine products: CVX 207, 210, 211, 212, 217, 218, and 219. It will also make appropriate recommendations following administration of Pneumococcal conjugate PCV15 vaccine (CVX 215), Pneumococcal conjugate PCV20 vaccine (CVX 216), and Ebola Zaire vaccine (CVX 204).
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Support for Vaccine Product and Manufacturer Codes for Non-US COVID-19 Vaccines:
The immunization forecaster will recognize administrations of unknown, non-US COVID-19 vaccine (CVX 500), QAZCOVID-IN (CVX 501), COVAXIN (CVX 502), COVIVAC (CVX 503), Sputnik Light (CVX 504), Sputnik V (CVX 505), CanSino Biological Inc./Beijing Institute of Biotechnology vaccine (CVX 506), Anhui Zhifei Longcom Biopharmaceutical + Institute of Microbiology, Chinese Academy of Sciences vaccine (CVX 507), Jiangsu Province Centers for Disease Control and Prevention vaccine (CVX 508), EpiVacCorona (CVX 509), BIBP/Sinopharm vaccine (CVX 510), and CoronaVac/Sinovac (CVX 511). The forecaster will also support vaccine manufacturer codes for MSP Vaccine Company (MSP), Sinopharm-Biotech (SPH), Sinovac (SNV), and Emergent Travel Health, Inc (PAX, formerly PaxVax).
- improved the error messages that appear on the Rx Queue when e-prescriptions do not make it to the pharmacy,
- fixed an issue with the Days Supply field when prescribing from favorites,
- improved the responsiveness of Retail Prescription History queries,
- allowed eRx accounts to be properly re-enabled from the User Administration tool in PCC EHR,
- introduced auditing for renewal and change requests that have been reassigned to other providers by office staff,
- fixed an issue where PRN refills were incorrectly transmitted as zero refills,
- prevented users from printing an original prescription for a controlled substance that was sent electronically (per DEA requirements),
- resolved several reasons for unexpected duplication of prescriptions,
- restored the missing NDC for lidocaine-prilocaine (generic Emla cream) prescriptions,
- corrected the background issue resulting in the N0052S error code on the Rx Queue, and
- improved the accuracy of error messages on the Rx Queue pertaining to electronic prescribing of controlled substances (EPCS).
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Improved Eligibility Responses: PCC can now more accurately identify “active vs inactive vs unknown” eligibility responses from payers. When a payer responds with a list of service types, PCC will be able to understand that list and display an “Active” indicator more often (instead of “Unknown”). You’ll be able to complete your eligibility review for upcoming visits more quickly.
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VIS Updates for Hep A, Hep B, Rotavirus, and Multi-Vaccine: In addition to COVID-19 updates, PCC 9.2 includes updates to the VIS lists for Hepatitis A, Hepatitis B, Rotavirus, and Multi-vaccine. Your practice can indicate that you provided VIS and EUA Fact Sheets in the immunization order component. You can obtain VISs from the CDC or the Vaccine Information Statements page on immunize.org.
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HCFA Printing Bug Fix: After posting charges for an encounter with a prior authorization number, printing a paper time-of-service HCFA could sometimes cause a program crash. This has been fixed.
PCC updates the immunization forecaster throughout the release cycle. If you have questions or encounter issues with your immunization forecasting, contact PCC Support.
Additional Background Improvements to PCC eRx
Since the last PCC release, your practice has received several important, non-disruptive background updates to PCC eRx. These updates introduced the following fixes and improvements:
Stay tuned to PCC Community for information about upcoming background updates and improvements to PCC eRx.
Other Feature Improvements and Bug Fixes in PCC 9.2
In addition to the features described above, PCC 9.2 includes these smaller improvements and squashed bugs.
Create and Manage Forms in PCC EHR
A new forms solution in PCC EHR empowers you to create and manage your own auto-filling forms, handouts, policies, and letters, and generate them more easily for patients.
Switch to the New Forms Solution: Contact PCC Support if you want to switch to the new forms solution.
Enable the Forms Configuration Tool
PCC must enable the Forms Configuration tool at your practice before you can create and manage your own auto-filling forms, handouts, policies, and letters in PCC EHR.
Learn how to enable the Forms Configuration tool.
Access the Forms Configuration Tool
Once PCC has enabled the Forms Configuration tool at your practice, you can access it from the Configuration menu in PCC EHR.
You must have the Forms permission in order to access the Forms Configuration tool.
You can add the Forms permission to user accounts in the User Administration tool.
Configure Standard Forms
Use the form editor in the Forms Configuration tool to build, preview, and publish your own auto-filling forms, handouts, policies, and letters.
Form Editor Still Under Active Development: The form editor is an early access tool that is still under active development. Some things might not work exactly as expected. Please report unusual behaviors to PCC Support so that PCC can improve your experience in this tool.
Create a New Form
Click the “Add” button to start a new form.
The new form canvas is an 8.5 x 11-inch page with 1-inch margins.
Name the Form
Give the form a unique name.
Other users at your practice will see this name when you make the form available in the Forms component. The name will also be used as the default document title when you generate the form for patients.
Compose Text
Click on the form canvas and type to add text.
Use the style options in the toolbar to customize the font size, weight, and color, as well as the text alignment and list style. Only one font is available at this time.
Text Style Options Still Under Active Development: The form editor is an early access tool that is still under active development. Some text style options might not work exactly as expected. Please report unusual text styling behaviors to PCC Support so that PCC can improve your experience in this tool.
Insert Variables
You can insert fields onto the form that will auto-fill with patient data or prompt staff and providers for input when the form is generated. These fields are called variables.
Use the pane to the right of the form canvas to find and insert variables.
Double-click on any variable to insert it onto the form. You can also insert variables by selecting them and clicking the “Insert” button.
The variable inserts where your cursor is placed on the form.
You can also quick-insert a variable while you are typing in your form. When you get to a spot in the text where you would like to insert a variable, type “<” to call up the quick-insert variable list. The quick-insert variable list is identical to the list in the Variables pane.
Narrow down the list by typing a few letters of the variable you want to insert.
Use your arrow keys or mouse cursor to select the variable you want from the list, then press the enter key or click to insert it onto the form.
Variables replace the quick-insert text and insert where your cursor is placed on the form.
Configure Variables
Once inserted, some variables have options that you may or must configure.
Click on an inserted variable to open its configuration options in the pane to the right of the form canvas.
Certain variables have no options.
Other variables have a format option. For example, you can customize the date format for date variables.
Variables that turn orange as soon as you insert them require configuration.
Click on the orange variable then fill out the required field in the options pane. The required field is also highlighted in orange.
Once configured, the orange highlight goes away and the variable name updates to reflect the settings you chose.
You must configure all orange variables in order for the form to work properly.
Configure Response Variables
A special kind of variable that requires configuration is the Response variable. The Response variable allows you to prompt anyone who generates the form for a free text response. That response populates onto the generated version of the form.
Add Response variables wherever you want providers and staff to be able to contribute free text responses to the form.
Configure each Response variable with a prompt. The prompt should tell the person filling out the form what kind of information to include in their response.
You can add as many Response variables to the form as you want.
Add Provider Signature
Signature variables can be added to your form, allowing users who generate the form to select a provider signature to appear on it. In addition to the provider’s signature, there are several Signature variables that add related information, such as their printed name, NPI, and Tax ID, among others. A users ability to add a provider’s signature is controlled by the settings in Signature Image Configuration.
Add Signature variables wherever you want the selected provider’s information to display.
Multiple Signature variables can be added to a form, however only one provider signature can be selected at time of form generation.
Preview the Form
You can preview the form as you build it to see how it will look and feel when generated for patients.
Click the eye icon in the top right corner of the form to preview it.
The form renders in real time. Variables auto-fill with real data. Where there is no data to auto-fill, the variable renders as blank.
The data comes from the patient who is selected in the Preview Settings pane. Anyone using the Forms Configuration tool can change that patient at any time. Preview remembers the patient who was most recently selected by any user in the Forms Configuration tool.
If the form includes Response variables, you can test out how providers and staff will interact with them. Read and respond to the prompts in the Preview Settings pane.
As you type responses, the text appears inline on the form.
The response boxes and the form itself grow to accommodate the response text.
When you have finished previewing the form, click the pencil and paper icon in the top right corner of the form to return to edit mode.
You can switch between preview and edit modes as often as needed.
Make the Form Active
When the form is complete and ready to be added to the Forms component in PCC EHR, change its status to Active in the top right corner of the form editor window.
New forms start out as Inactive by default to prevent other users at your practice from generating them before they are ready.
Save the Form
Click the “Save” button to save your work and remain in the form editor.
A “Last Saved” timestamp at the bottom of the form editor tells you the last time the form was saved.
To save your work and close the form editor, click the “Save + Exit” button.
If you want to discard all changes to the form since the last time it was saved, click the “Cancel” button.
“Save + Exit” and the “Cancel” buttons return you to the main page of the Forms Configuration tool.
Edit, Clone, or Delete Saved Forms
Saved forms appear in a list on the main page of the Forms Configuration tool with information about their status and when they were last saved.
You can use the Search Filter to narrow down the list or click the column headers to change how the list is sorted.
To edit a saved form, double-click it or select it and click the “Edit” button.
To make a copy of a saved form, select it and click the “Clone” button.
The copy opens in the form editor, where you can start making changes right away without affecting the original form.
Save the copy as you would a new form. This adds it to the list of saved forms on the main page of the Forms Configuration tool.
To delete a saved form, select it and click the “Delete” button. This action is protected by a special user permission in the User Administration tool.
Deleted forms get removed from both the Forms Configuration tool and the Forms component. If you need to restore a form that was deleted by accident, contact PCC Support.
Add a Header
Add your letterhead, logo, practice contact info, or other information to a header on your standard PCC EHR Form Letters.
Open the Header Configuration tab.
Header Configuration includes a text field similar to the form editor. Add and edit your header text and insert variables from the list to the right.
If you have a letterhead image or a logo, click the picture icon to upload it from your computer or enter the URL of the image.
Adjust the size or text wrapping by clicking the image and selecting from the menu.
Once you’ve completed editing your header, click save.
Add the Header to a Form
To add the header to any standard form, edit your selected form and click the header button.
To edit the header, click back into the Header Configuration tab, any changes will be applied to all forms including the header.
Adjust Form Margins
You can adjust the margins on your standard forms and practice letterhead to improve their appearance and make better use of space.
Adjust Standard Form Margins
In the Forms Configuration tool, select a form and click the “Edit” button.
Check the current margin size using the Body Margin icon in the toolbar. Hover over it to see how the margins are set.
Click the icon to view the margin size choices and, optionally, adjust the margins.
When you select a different margin size, the form updates in real time.
Click “Save + Exit” to save your work and close the form.
Adjust Header and Footer Margins
You can use the Letterhead tab in the Forms Configuration tool to independently adjust the margins for your practice header and footer.
Dotted lines let you know where the margins are set. If you adjust your header or footer margins, the changes will apply to all forms that use the header and footer elements.
Configure PDF Forms
Some forms come to your practice pre-formatted or are too complex to build in the standard form editor in PCC EHR. PCC Support can upload PDF versions of these forms into the Forms Configuration tool, where you can view, configure, and manage many aspects of them yourself.
Upload a PDF Form
Contact PCC Support if you think you need to upload a PDF form into PCC EHR.
PCC Support will request a copy of the form by email and ask you to identify which fields on the form should auto-fill with patient data, where to insert free text response fields, and whether the form needs to be able to be signed by more than one provider.
PCC Support will use the information you provide to build a smart version of the form that can be saved as a PDF and added to the Forms Configuration tool.
Once the PDF form is available in the Forms Configuration tool, you can view, configure, and manage many aspects of it on your own.
Copyright Protected Forms: If you want to upload a form created or owned by a third party, ensure that you have permission to use the form beforehand. PCC assumes no responsibility for verifying you have permission to use a form.
View and Configure a PDF Form
PDF forms are marked by a PDF icon on the main page of the Forms Configuration tool.
Double-click on a PDF form to open it in edit mode. You can also select it and click the “Edit” button.
In edit mode, you can:
- view the form contents and any smart configuration that PCC Support built in
- rename the form
- configure prompts that tell providers and staff how to fill out the free text response fields on the form
- preview the form using real data from any patient on your PCC system, and
- set the status of the form to Active or Inactive, which controls whether providers and staff can find it in the Forms component and generate it for patients.
You cannot edit the body of PDF forms in the Forms Configuration tool. Contact PCC Support to request changes to the body contents of PDF forms.
Preview PDF Forms
When you edit a PDF form in the Forms Configuration tool, click the eye icon in the top right corner of the form canvas to preview it.
The auto-filling variables on the form render with real data from the patient selected in the Preview Settings pane. Where there is no data to auto-fill, variables render as blank.
You can change the preview patient to any patient on your PCC system, and fill out the user response fields to test out the experience of generating the form.
Click the “Refresh Preview” button to test out the form with the new data you entered into the Preview Settings pane.
The form preview updates to reflect the information you entered in the Preview Settings pane.
Delete PDF Forms
You can remove the PDF forms your practice no longer needs from PCC EHR.
On the main page of the Forms Configuration tool, select the PDF form you want to remove and click the “Delete” button.
The “Delete” button is protected by a special user permission in the User Administration tool.
Special Notes About PDF Forms
Some PDF forms might prompt you to delete unneeded response prompts when you first edit them. This happens when the PDF form contains fewer response fields than it used to and it no longer requires the same number of prompts. Typically, PCC Support will adjust this for you, but you might encounter it yourself from time to time.
If you do encounter the prompt to delete unneeded response prompts when you open a PDF form, either contact the person on PCC Support who helped you with that form, or read through the original list of prompts associated with the form and delete those that are no longer needed.
Reasons for Unneeded Prompts: Before now, PDF forms used response fields to achieve what can be done in a different way in the new forms solution. When PCC Support helps you migrate your PDF forms into the new solution, they will adjust your forms to take advantage of that new functionality. In the process, some of the response fields on your PDF forms might go away. The step of deleting unneeded prompts when you first open a migrated PDF form is the final step of adjusting the form to take advantage of new functionality in the new forms solution.
If a PDF form is migrated with more user response fields than it used to have, additional response prompt lines will automatically appear in the “Configure Response Prompts” pane when you edit the PDF.
Reasons for Extra Prompts: Response fields are a versatile tool for creating forms that optimally serve your practice and patients. In the process of migrating your PDF forms to the new forms solution, PCC Support might realize that additional response fields are needed to improve the form’s function for your practice. These additional fields should not come as a surprise to you, and you should be sure to write prompts that help users understand how to fill them out when they generate the form for patients.
Manage How Forms Appear in the Forms Component
Providers and staff use the Forms component in PCC EHR to find and generate forms for patients. You can control which forms appear in the Forms component, the order in which they are listed, and their names.
Make Forms Active or Inactive
The status of a form determines whether it appears in the Forms component in PCC EHR. Active forms appear in the Forms component; inactive forms do not.
You can change the status of a form by editing it in the Forms Configuration tool and selecting a different status in the top right corner of the window.
The new status takes effect as soon as you save the form.
Set the Display Order of Forms
You can control the order in which forms display in the Forms component.
Open the Forms Configuration tool, then click on the “Edit Display Order” button.
Drag and drop the forms to rearrange the list order.
The list includes both active and inactive forms, but only active forms display in the Forms component.
Click “Save and Exit” to save your work and return to the main page of the Forms Configuration tool.
Rename Forms
You can control the names under which forms appear in the Forms component.
Open the Forms Configuration tool, then edit any form to rename it.
Rename the form in the Form Name field.
Click “Save” or “Save and Exit” to update the form name across PCC EHR, including in the Forms component. The form name is used as the default document title in patient charts and the portal.
Forms Need Unique Names: In order to save a form, you must give it a unique name. The form editor prevents you from saving forms that do not have unique names.
Set Up Forms for Single-Click Generation
You can add buttons to your visit protocols that let you generate forms with a single click.
To learn more about how to set up forms for single-click generation in PCC EHR, read the “Configure the Forms Component” section of the article Generate Forms in PCC EHR.
Generate Forms for Patients
Use the Forms component in PCC EHR to generate forms for a particular patient. The Forms component can be added to any protocol or ribbon in PCC EHR.
Select a form from the Forms component to generate it for the patient whose record you are accessing.
If the form contains free text fields, respond to the prompts.
Some forms require additional input. If needed, select the visit, phone note, or portal message that contains the data you want to use to fill out the form, or select a provider to sign the form.
Signature Permissions: Some providers may restrict which users can generate their signature on forms. When a user doesn’t have permission for a provider’s signature, all variables tied to the selected provider will auto-fill, with the exception of the signature image itself. This will remain blank to accommodate a wet signature.
If the form was built as a PDF, you must finish generating it in order to see it filled out.
If the form was built using the standard form editor, you can preview it in real time as you fill it out.
Once fully generated, you can save the form to the patient’s chart, share it through the patient portal, print out a hard copy, add tasks, sign it, and more.
If you need to make changes to the generated form, click the “Back” button. To discard the form without saving it, click the “Discard” button.
Once you are happy with the generated form, you can take the same actions with it as you would any other document in PCC EHR. To learn more about how to work with documents, read the article Work with Documents in a Patient’s Chart.
Tell PCC What You Think
If you decide to switch to using the Forms Configuration tool in PCC EHR, tell PCC Support what you like about it and what would make it more useful for your practice.
Your feedback will guide the development of the new forms solution.
Set Up a Brother ADS-2800W Scanner
Read the procedures below to set up and configure a Brother ADS-2800W scanner.
Prepare for Setup
You will need to take the following actions before you can set up your scanner.
Contact PCC Support to Set Up Scanner Bucket
If you do not have an existing scanner bucket, call or email PCC Support at (800)722-7708 or support@pcc.com to request a new scanner bucket.
Replacing an existing scanner?: If you are replacing an existing scanner you can use your old scanner’s bucket. To find your existing bucket number, log in to PCC EHR, select Documents from the Configuration menu, visit the Import Documents tab, and choose a bucket from the “File Source” column.
Find Your Wireless Information
Ask your Office Manager, Managing Provider, or local IT person for the name of your office wireless network and password.
Connect Your Scanner to Your Wireless Network
Follow the steps outlined here to connect your scanner to your wireless network.
Find Your Scanner’s IP address
Turn on your scanner and use your scanner’s control panel to follow the steps in this image. Choose WLAN for step 3 if you are using a wireless internet connection.
Find Your Scanner’s Default Login Password
The default password is either “initpass” or the password located on the back or bottom of the machine after “Pwd”.
Configure Your Scanner Settings
Access Your Scanner in a Browser Window
Open a web browser and type the IP address of your scanner. (Example: https://12.345.6.7) Log in with your Login Password if prompted.
Set Status
Select the “General” tab, then select “Status” and check the following:
- Device status is set to “Sleep”.
- Automatic Refresh is set to “Off”.
- Web Language is set to “Auto”.
- Device Location is blank.
Set Network to “Both”
Select the “Network” tab, then select “Interface” and check the following:
- Interface is set to “Auto Switching (Enable Both Interfaces)”.
- Wi-Fi Direct is Disabled.
Submit Network Selections
Click “Submit”.
Configure Wireless Settings
Open Wireless Setup Wizard
Select the “Network” tab and then select “Wireless (SetupWizard)”. Click “Start Wizard”.
Connect to Your Wireless Network
Choose your office’s wireless network from the dropdown. Enter your wireless password in the Network Key field, and click “Next”.
Enable Wireless Interface
Click “Yes”.
Configure Profile Settings
Set Profile to Network
Click on the “Scan” tab. Then click “Scan to FTP/SFTP/Network/SharePoint”. Set Profile 1 to “Network”.
Save Profile Settings
Click “Save” at the bottom of the page.
Confirm Profile Settings
Click on the “Scan” tab. Then click “Scan to FTP/SFTP/Network/SharePoint Profile” and confirm that Profile 1 is set to “Network”.
Set Profile Path
Click on “Profile 1” and set the following:
- Profile Name: PCC EHR
- Network Folder Path: \\acro\scanning\bucket### (Example: \\gkp\scanning\bucket001)
- File Name: Use default
- Quality: Color 200 dpi
- File Type: PDF Multi-Page
- Document Size: Letter
Continue Setting Profile Path
Scroll down and set the following:
- Use PIN for Authentication: Off
- Pin Code: 0000
- Auth. Method: Auto
- Enter the scanning username: nobody
- Enter the scanning password: nobody
- Reenter the scanning password: nobody
Click “Submit”.
Sync Date and Time With Server
Select the “Administrator” tab and then select “Date & Time”. Enter your current date, time, and time zone. Set Auto Daylight to “On”. Select Synchronize with SNTP server.
Click “Submit” or “Save” if prompted.
Test Your Scanner
Your scanner is now configured. Follow the instructions in your manual to run a test page. Upon completing a scan, your scanned document will appear in the Import Documents tool in PCC EHR. For more information, review this article: Import and Attach a Document to a Patient’s Chart
Downloadable versions of Brother manuals and user guides can be found here.
Virtual Advanced Training Sessions
PCC offers online Virtual Advanced Training on topics designed to help your practice take better advantage of PCC’s features and tools. You’ve been using PCC EHR for a little while, and now you’re ready for a deep dive into how PCC can best intersect with your practice’s day-to-day workflow.
PCC hosts VAT sessions monthly, providing instruction followed by live discussion where you can ask questions, hear about what other practices are doing, and discuss implementation with PCC experts.
You can catch up on the recorded, instructional parts of these sessions any time using the links in the list below:
- Front Desk Essentials
- PCC EHR Tips & Tricks (Advanced Training Session)
- Personal Billing (Advanced Training Session)
- Insurance Billing (Advanced Training Session)
- Post Personal Payments and Write Off Charges
- Review Payment History and Edit Personal Payments
- Autopost ERAs in PCC EHR
- Manually Post Insurance Payments and Adjustments
- Reverse an Insurance Payment (Post a Takeback)
For more information, or to find out how to attend a live session, contact PCC Support at 802-846-8177 or 800-722-7708.
Also, for a self-guided overview based on roles, see Training for New PCC Users.
UC 2021 Videos and Course Materials
Our second-ever virtual Users’ Conference took place the week of June 8th in 2021. Our theme this year, echoed by our logo, was connections. Like a spider’s web, a computer network, or an airline route map, you are not all by yourself — you are connected. Every time PCC adds a new practice, or you add a new employee or new patient, our web grows a little larger, and we all get to make new connections. Connected together, we are all stronger, and remember: You’ve Got a Friend in PCC!
574 attendees logged in and joined 42 courses, sessions, and round tables on coding and clinical practice to the business impact of COVID-19 on pediatric practices.
Sessions were recorded, and where possible we’ve made them available on a PCC UC 2021 playlist, and using the links below. (Some sessions will become unavailable in 2022 as PCC’s permissions with the presenters will expire.)
Learn more on PCC.com’s UC2021 wrap-up page.
Course Descriptions, Slides, and Videos
Course Title | Course Description | Materials |
Welcome & Opening Session | Welcome to UC 2021! Chip Hart will kick off the conference with a welcome message and opening remarks. Presented By: Chip Hart | |
What’s New at PCC | A retrospective review of products and services PCC worked on since UC 2020. Presented By: Scott Ploof | |
Roadmap – Look Ahead | Join PCC’s Product development community for a tour of PCC’s upcoming Roadmap: What we are developing for you right now, and our plans for the second half of 2021. We will look at progress towards touchless check-in and other Patient Engagement features, learn about upcoming Payments functionality in PCC EHR as well as Eligibility enhancements, and we’ll review where we are in the continuing integration of Practice Management functionality. We can’t wait to share with you the all-new Forms Solution and show you what’s next for Reporting, including the Dashboard. We will take a peek inside the big PCC eRx 9.0 package heading your way this summer, and see what else is in store for ePrescribing. And of course we’ll check in on upcoming Interoperability features, exploring opportunities for delivering improved patient care. Facilitated by: Paula VanDeventer Presented By: Kristen Ryan, Tim Proctor, Dan Gillette, Morgan Ellixson Boyea, Jen Marsala, Michael Stein, Amanda Smith, Paula VanDeventer | |
Integrating CHADIS with Your PCC EHR System: Practical Tips from Your Peers | This session will offer PCC practices insights from their peers on ways to adjust configuration, workflows, and office processes to smoothly integrate CHADIS into their day-to-day work. Presented By: Jim Leahy, Roger Hovis, Dr. Melissa Schwartz, Dr. Robin Warner | |
Documenting for Complex Behavioral Health Patients | In this session you will learn how to document complex behavioral health encounters using PCC protocols and industry best practices to demonstrate integrated behavioral health specifically for NCQA’s Behavioral Health Distinction. In addition, we will discuss different collaboration techniques between PCPs and BH specialists. Presented By: Amanda Ciadella, Jim Leahy | |
Suicide Screening for Pediatric Practices | Suicide rates are escalating and pediatricians need to include this screening in all visits. Learn how to use these screens as well as what to do if screen is positive. Most suicide patients have seen a health care worker in the 30 days prior to their suicide. New screening tool is now recommended as PHQ9 does not pick up suicide in children under 18. Presented By: Dr. Jeanne Marconi | |
Impact of COVID on Preventive Care | 2020 was the first time in decades of measurement that most pediatric clinical benchmarks declined – well visit coverage, depression screening, even vaccines. What does the data tell us about the impact of COVID on the services pediatricians provided in 2020 and what should we be doing about it? Presented By: Chip Hart | |
Ask Chip | Bring your practice management questions and PCC’s resident practice management expert, Chip Hart, will answer them live. Presented By: Chip Hart | |
Morning Announcements | We’ll start the day off with morning announcements and Grace Levy will give an update on the points leader board. Presented By: Grace Levy | |
What’s Next for PCC eRx | Join PCC’s Morgan Ellixson-Boyea, CPhT, CSM for an in-depth review of upcoming changes to PCC’s eRx, scheduled to arrive in August 2021. In addition, you’ll hear about recent bug fixes and improvements, learn new tips & tricks, as well as cast your vote for future enhancements of PCC eRx! Session will also include open Q&A. Presented By: Morgan Ellixson Boyea | |
Practice Oversight Reporting | As a managing physician or practice administrator, have you ever wondered which reports you should be monitoring regularly to ensure the practice is operating successfully? This session will highlight PCC’s robust Dashboard and practice management reporting capabilities, focusing on reports that will allow you to keep your finger on the pulse of your practice. Discover the numbers that really matter and how to find and track the information you need most. Presented By: Tim Proctor | |
Client Feedback Session: Billing | PCC is designing a fast, powerful billing tool inside PCC EHR. We need your insights and experience around billing. Come and chat with our development team! Presented By: Kristen Ryan, Michael Stein | |
7 Billing Pitfalls and How to Correct and Avoid Them | This session details certain all too common hazards of revenue cycle management along with specific corrective action to take in order to quickly resolve these problems. Preventative measures are then outlined in order to avoid these vulnerabilities in the future. Presented By: Heidi Chamberlin | |
Liability Risks in Pediatric Practice | Discuss areas of interaction with patients/families which can lead to liability exposure–both medical liability and general liability. Special emphasis on virtual care/telehealth. Information will be provided on ways to safeguard your practice, and how to respond should an event occur. Presented By: Dr. Jesse Hackell | |
Maintaining PCMH Recognition | This session will be for practices who are interested in utilizing PCC for patient-centered medical home transformation. We’ll identify PCC reports and functionality that can be used for population health management and quality improvement with a particular focus on how to identify and manage your most complex patients. Discover how to use PCC tools to meet NCQA’s Patient Centered Medical Home program. Presented By: Tim Proctor, Amanda Ciadella | |
Choosing the Vendors That Are Right for You | Using examples of different types of vendors, I will show how PCC’s reports can help you choose the right vendors for your practice. Presented By: Dr. Hiral Lavania | |
Optimizing PCC EHR: Workflow and Configuration Improvements You Can Use Today | Take advantage of the new features in the EHR which can streamline your workflow, providing your clinicians and staff with more time to focus on delivering healthcare. This course will highlight the most useful enhancements and demonstrate how to take advantage of them in your office. Presented By: Jim Leahy | |
What Every Pediatrician Needs to Know about Prescribing Oral Contraceptives | This session will help Pediatricians feel confident prescribing OCP’s for acne, menstrual health problems, or for contraception. They will walk away with formulary’s that work best with individual situations. Presented By: Dr. Melisa Holmes, Trish Hutchison (MD, FAAP) | |
How Much Should I Pay An Employed Clinician? | Hiring a new physician or nurse practitioner and wondering not only what you should pay, but what you can AFFORD to pay? This simple exercise will walk you through determining the maximum salary of your employed clinicians and review the non-salary drivers that motivate clinicians. Presented By: Chip Hart | |
Jan’s Coding (and Billing) Course | PCC’s Jan Blanchard will share her coding and auditing experience. There will be ample time for Q&A, so bring your questions! Presented By: Jan Blanchard | |
Effective Vaccine Management | From storage solutions to inventory management, purchasing patterns and rebate opportunities, understanding how to most effectively run your vaccine ‘business’ can ensure healthy margins and easier workflows. Presented By: Susanne Madden, MBA | |
Next Generation of QI as Practice Innovation | Quality improvement (QI) methodologies are now well-established in primary care with QI required to maintain pediatric board certification. The COVID-19 pandemic forced many primary care practices to not only optimize existing approaches, but create new ones. Innovation frameworks and strategies exist to guide such work, but are not well known. To address this gap, the proposed session will help participants to (1) understand how an innovation framework can be used to identify, test and scale opportunities that drive improved healthcare, (2) identify challenges in driving innovation in primary care, (3) recognize the value of multidisciplinary collaboration and consultation, including data analytics and practice improvement efforts, in the context of innovation. Examples from practice will guide discussion. Presented By: Alexander Fiks (MD, MSCE) | |
Front Desk Best Practices: What does a pandemic change? | PCC’s Lynne Gratton, CPPM, explores front desk best practices related to scheduling, check-in, insurance verification and copay collection and what has changed as offices work within the pandemic. Understand the importance of the front desk when it comes to your practice’s workflow and collection process. Presented By: Lynne Gratton CPPM, Kate Taylor | |
Morning Announcements | We’ll start the day off with morning announcements and Kate Taylor will give an update on the points leader board. Presented By: Kate Taylor, Grace Levy | |
Revenue Cycle Roundtable | Bring your billing questions, problems and struggles to this session and get helpful advice from revenue cycle management experts. Presented By: Jan Blanchard, Jaimie Metivier | |
Client Feedback Session: Form Letter Configuration | Come preview the new form letter generation solution currently under development. Your feedback and input will help guide its future direction. Presented By: Dan Gillette | |
21st Century Cures Act and Adolescent Confidentiality | PCC’s Regulatory Expert, Megan Maddocks, and Dr. Jesse Hackell discuss the Cures Act, Open Notes, and the impact on confidentiality for adolescents. Develop an understanding of the impact of these policies on EHR notes/charting. This session will also include updates regarding penalties structure, a report out from the ONC annual meeting sessions, and compliance guidance. Presented By: Megan Maddocks, Dr. Jesse Hackell, Jim Smith | |
2021 Evaluation and Management Changes! | Review the recent 2021 E/M changes with examples specific to Pediatrics. Presented By: Donelle Holle | |
Redesigning the Pediatric Office for a Post-Pandemic World | This talk will focus on how to reconfigure traditional office layouts, workflows, and use of technology to better meet the needs of patients, staff and providers in a post-pandemic environment Presented By: Susanne Madden, MBA | |
Beyond Insurance–New Ways to Practice Pediatrics | Panel discussion on DPC, Concierge, Cash Pay and Blended practices (yearly fee plus insurance) Presented By: Dr. Tanya Altmann, Rosana Lastra (MD, MS, FAAP), Dr. Lauren Hughes | |
Set Your Prices Fairly And Easily | Learn the simple rules that govern the RBRVS system for pediatricians and how to calculate your prices fairly and effectively with just a few keystrokes. Includes a spreadsheet tool that allows any practice to examine both pricing and payments in the context of RVUs. Presented By: Chip Hart | |
Managing HR During a Pandemic | An overview of HR during the pandemic. We’ll explore what’s allowed and what’s not as we all navigate new situations and different scenarios. Presented By: Michelle Ann Richards BSHA, CPC, CPCO, SHRM-SCP, CPMA | |
Everybody could use a little more Screen Time | Everybody could use a little more “Screen Time” In this talk, we will explore the “dots and stars,” and screening/surveillance outlined on the Bright Futures Periodicity Schedule, and how to perform these screens electronically, prior to well visits. In addition, we will explore other electronic screens that can be used for behavioral health visits. Not sure how to get buy-in from your staff or families? We will address that as well. And, finally, we will discuss how PCC’s integration with CHADIS will make this process even more seamless. Presented By: Dr. Robin Warner | |
Communicate to Vaccinate | Your practice has great access to vaccines but vaccines don’t stop disease nor meet HEDIS measures… vaccinations do! Does your practice have the communications training, support and platforms to perform optimally in 2021 and beyond? Presented By: Dr. Todd Wolynn | |
How to become a Culturally Competent and Diverse Practice | Pelican Pediatrics is a small practice yet it is known in the area for its diversity and multiculturality. I will to offer tips on how to become a culturally competent and diverse practice where people of different nationalities, ethnicities, and religions feel welcome. Not only is this good medicine to practice culturally competent care, it also opens up your practice to a larger patient panel you may otherwise be missing out on. Presented By: Dr. Eliza Varadi | |
Tried and True Policies and Procedures for Personal AR Management | Proven strategies to effectively manage your personal accounts receivables- financial policies, pre-collection process, ways to talk to patients about their past due balance, increasing payment options, coordinating efforts throughout the practice, coordination of benefits management. Presented By: Rebecca Lamb | |
Understanding & Maximizing Your Merchant Services | Bring your questions! We’ll talk about different areas of merchant services like contactless payments, including credit card on file (CCOF), online and PCC portal payments, and PCI compliance knowledge. We will have plenty of time for Q&A. Presented By: James & Sarah Estes | |
Chip and Paulie Webinar (Click Through to Join the Stream) | Join Chip Hart and Paul Vanchiere for the next installment of their COVID-19 Webinar series. Presented By: Paul Vanchiere MBA, Chip Hart | |
Morning Announcements | We’ll start the day off with morning announcements and Kate Taylor will give an update on the points leader board. Presented By: Kate Taylor, Grace Levy, Calvin Taylor | |
Technology and Addressing Bias and Health Disparities in Children | This session will explore technology and current applications that could address bias and health disparities. As many of these products are built on a foundation of Artificial Intelligence and Machine Learning, these concepts will be explained in the context of how new technology is built and used. Guardrails and continued need for advocacy will round out the session. Presented By: Dr. Colleen Kraft | |
Dashboard Awards Presentation | The dashboard awards are back! Come see who led the PCC pack, who improved the most, and which new members of the PCC family excelled through the crazy year that was 2020. Presented By: Tim Proctor, Chip Hart | |
Closing Session: Practice Management During COVID and Beyond – What Have We Learned? | What did we learn from the impact COVID on the business and culture of pediatrics? What predictions can we make about the future, what changes do we need to make? Chip Hart will take you through the watershed moments of the last year and summarize some of the results, saying some things out loud that many haven’t dared to say. Presented By: Chip Hart |
Update Your PCC Email Preferences
PCC reaches out to one or more folks at your office via email, and PCC services (like the online PCC Community) have optional email notifications.
If your practice has a new Office Manager, or you get a new email address, how do you update the ways that PCC contacts you? How do you set your preferences for different kinds of email communication from PCC?
Set Email Preferences for PCC Updates and Announcements
PCC sends information about software updates, disruptions to services, news about important issues facing pediatricians, and more to an email mailing list.
PCC recommends that at least one person at your practice sign up for these emails, such as an Office Manager or managing provider. We are careful to limit how many emails we send, and you can set which types of email messages you receive. These emails are sent from the pccmarketing@pcc.com address.
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Subscribe: To subscribe to PCC updates and announcements, call 802-846-8177 or 800-722-7708 or send an email to support@pcc.com.
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Change Your Email Address: To change the email address you use to read PCC communication, send an email to support@pcc.com to subscribe your new email address. Then, in your old email address account, use the Unsubscribe link from the bottom of an email from PCC.
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Unsubscribe or Change What Messages You Receive: To change your email preferences or the address that you use, click on a link to “Manage Preferences” or “Update your email preferences” found at the bottom of an email from PCC.
You can find links to unsubscribe or change email preferences at the bottom of emails from PCC.
When you click a link to manage preferences, you can indicate whether you would still like to receive emails about PCC EHR and Company News, Pediatric Resources, the Pediatric Insights Blog, The Independent Pediatrician, Job Notifications, and emails from PCC Sales.
Click the “Update email preferences” button at the bottom to save your changes.
Set Email Preferences for PCC Community and PCC Talk
PCC Community is an online forum where you can ask questions of other pediatric practices and learn about important issues in pediatrics. It’s also a place where you can get caught up on PCC news, blogs, and announcements. Learn more by reading the PCC Community help article.
PCC Community can automatically send you email notifications about new posts, or digests collecting the new posts since you last visited.
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Sign Up: To sign up for PCC Community, which can include email updates, see the instructions in the PCC Community help article.
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Unsubscribe, Change Email Address or Change What Messages You Receive: To change your email preferences for PCC Community, see the instructions in the “How do I adjust my email settings and other user preferences?” and “Can I redirect PCC Community messages to a different email address?” questions in the PCC Community help article.
Change Email and Contact Information for Individual Communication from PCC
PCC Support sometimes needs to email your practice directly about support issues, software update migration, and other issues.
PCC keeps a list of contacts for your practice, with corresponding emails and phone numbers.
To change who PCC should contact, or to change the email address or phone number they should use, call 802-846-8177 or 800-722-7708 or email support@pcc.com.
PCC 9.1 Release
In the fourth quarter of 2021, PCC will release version 9.1 of our electronic charting and practice management software to all PCC users.
PCC 9.1 brings personal payment posting to PCC EHR, dramatically improving several tools for billers. PCC 9.1 also introduces a pilot test of a new forms configuration tool, allowing you to create new forms quickly and easily in PCC EHR.
Watch a Video Series: Want to see PCC 9.1’s highlights in action? Watch the PCC 9.1 Release Video Series.
Implementation: PCC 9.1 includes features that require configuration and user-specific software training. Read about the features below and then review the PCC 9.1 Migration Considerations article.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Post Personal Payments in PCC EHR
When you want to post a payment from a family, or a stack of personal payments, use the Payments tool in PCC EHR.
Open Payments
Open the Payments tool from the Tools menu in PCC EHR.
Find an Account
Find the billing account for the payment.
You can search by account name or use other search parameters, like an account phone number. The list of matching search results includes a Dependents column, to help you confirm that you have the right account.
Optionally Review and Update Account Information
Before you enter payment information in the Payments component, you can optionally review and update account information.
The Payments tool includes Payments, Account Balances, Account Demographics, and the Account Notes component so you can review balance details, update account information, and add notes about any billing issue with the family.
Enter Payment Information
Next, review and adjust the transaction date, select a payment type, and enter a payment amount.
Enter a check number if applicable.
Save the Payment
Click “Save Payment” to save the payment and update the account’s balance.
Review Results and Optionally Add Another Payment
After you save a payment, you can see it in the ledger. Click the disclosure arrow to see how the payment was applied.
You can enter additional payments if (for example) the family used two different checks.
Print a Reciept
Click “Print Receipt” to print a receipt for the payment(s) you posted this session.
The receipt displays all payment information, along with helpful charge information for the family.
Save Changes and Continue to the Next Payment
Click “Save + Exit” to close the Payments window and save any additional changes you’ve made for the account. If you are posting a stack of personal payments, you can then immediately find the next account.
Review all Payments Posted
At the end of the day, run the Payment Reconciliation report in the PCC EHR Report Library to review all payments.
Optionally Indicate a Payment Should Not Be Linked
By default, a payment will link to the account’s oldest charges with a personal balance. You can optionally specify that only a portion (or none) of the payment amount should be applied.
If you change the amount of a payment to apply to charges (and therefore leave some or all of it unapplied), you can select a provider for reporting purposes.
Payments are normally linked to charges, which have an associated provider. If a payment is not linked to charges, you can indicate a provider manually.
Write Off a Charge in PCC EHR
When you want to write off a charge on an account in PCC EHR, use the Payments tool.
Open Payments
Open the Payments tool from the Tools menu in PCC EHR
Find an Account
Find the billing account for the charges you need to write off.
You can search by account name or use other search parameters, like an account phone number.
Optionally Review Account Information
In the Payments tool, you can review Account Balances, Account Demographics, and the Account Notes component so you can understand the charges and what you may need to write off.
For an explanation of all outstanding personal balances, click the disclosure arrow below Aged Balances.
Enter Adjustment Information and Click “Save Adjustment”
Select your practice’s preferred Adjustment type for a write off in the Payment Type drop-down menu. Then enter an amount and click “Save Adjustment”.
Optionally Review Results
PCC will automatically apply the adjustment to the oldest unpaid charge(s) on the account. Use the ledger to see the charges that the adjustment is applied towards.
In an upcoming PCC release, you will be able to select specific charges when (for example) an older charge should remain due and the adjustment should apply to more recent charges.
Enter an Account Note Explaining What You Did
It’s a good idea to add an account note explaining what balances were written off.
Enter and Review Account Notes in PCC EHR
When you wish to record details about an account or billing situation with a family, you can add an account note.
First, open the Payments tool and find the account.
Next, scroll down to the Account Notes component. It appears underneath Account Demographics.
Click “New Note” to create a new note.
Click the checkbox to save your note.
If you want to add something to your note later, click the pencil icon to edit a note.
Do you have follow-up information about an existing note? Click the plus symbol (+) to add a follow-up note to an existing note.
You can have multiple follow-up notes to track a billing issue as it continues.
Account Notes in PCC EHR vs. Partner: If your practice used the Account Notes features in the Partner Practice Management system, found in the Family Editor (fame
), you may notice slight differences. For more details about transitioning between the two interfaces, read the PCC 9.1 Migration article.
Understand and Respond to Eligibility Errors
When automated insurance eligibility checking fails, PCC 9.1 explains precisely why, and gives you action steps to fix the problem.
If the underlying issue is missing patient or policy information, you can quickly correct the problem and try again. If eligibility isn’t working due to underlying configuration, PCC EHR will provide you with useful information so you can contact PCC Support.
PCC EHR’s Insurance Eligibility tool summarizes errors, but it also provides access to the full payer response, when available. You can review the payer response to learn more.
Experience Fewer Eligibility “False Positives”
PCC 9.1 improves the underlying intelligence of automated eligibility in PCC EHR. The Insurance Eligibility tool will more accurately indicate whether a patient’s policy status is Active, Inactive, or Unknown.
Prior to PCC 9.1, the default Insurance Eligibility result was Active. This worked well when a payer’s eligibility response followed a straightforward logic. However, eligibility responses can include both a status and a variety of additional codes. PCC’s automated eligibility now displays Unknown, or “Eligibility Undetermined” by default, which will increase eligibility accuracy, and provides details in the Full Report.
Do You Trust Eligibility in PCC EHR, or Do You Visit the Payer's Web Site?: PCC wants automated eligibility to be 100% reliable, the perfect tool to give your billers a heads up about upcoming encounters. If you encounter an eligibility status in PCC EHR that doesn’t match a patient’s status on a payer’s web site, please let us know so we can track down and correct the issue.
Configure Your Locations to Reduce Service Facility Claim Errors
If your practice bills for several facilities, such as when you have a multiple locations across town, you can now designate that a location is a subpart of your main billing location.
To make the change, edit the location in the Places of Service table in the Table Editor (ted
) in your Practice Management window. Or, get PCC Support to make the change for you.
PCC will then automatically use the correct logic to include (or leave out) service facility location information based on electronic claim standards and your practice configuration.
See Both Codes When a Payer Downcodes
When an insurance payment can’t be posted automatically because of a rejection or other issue, your practice’s billers review the 835 ERA to find out what’s wrong and resolve the issue.
When PCC 9.1 displays an 835, you’ll now be able to see both the adjudicated code and the submitted code. That means that if a payer includes information about both the code you submitted and the code they paid on, you’ll see both. Payers sometimes reply to a charge by erroneously including the NDC code instead of the CPT code you used on the claim. When that occurs, the NDC code will appear in the Submitted column, as shown in the example above.
By reviewing both columns, billers can better understand what happened and take action to resolve the issue and post the payments and adjustments.
Notify Portal Users When a New Document is Available
Automatically notify your patients and families when you share a new document to the Patient Portal, to keep them informed and updated in real time.
When you add a new document to a patient’s chart, check the “Display in Portal Documents” box to automatically send a portal notification to the users associated with the patient you selected. If the patient has multiple portal users associated with their account, each portal user will receive the notification.
When the user signs into their patient portal, they’ll find the new document waiting.
One Notification Per Patient, Per Hour: To avoid inundating your users with emails, a notification will only be sent for the first document uploaded to a patient in a 60 minute period. So if you upload multiple documents for one patient, that patient’s portal users will only receive one notification for the batch.
Pilot Test: Create and Manage Patient Forms in PCC EHR
Starting in PCC 9.1, you can optionally participate in a pilot test to create your own patient form letters in PCC EHR.
In the new Forms Configuration tool, you can create patient form letters that include variable fields for auto-inserting patient, account, and practice information.
The form letters you create during the pilot test will not replace your existing patient forms in PCC EHR until a time of your choosing in a future PCC release.
You should consider participating in the pilot test if you want early access to the tools for making your own patient form letters in PCC EHR and to tell PCC what would make them even better.
Get Started with Forms in PCC EHR
Notify your Client Advocate if you want to participate in the pilot test to create your own patient form letters in PCC EHR. Your Client Advocate will enable the Forms Configuration tool and help you prepare to use it as a pilot tester.
You can read more about how to get started with Forms Configuration in PCC EHR in the Migration and Implementation Considerations.
Create a Basic Text Form
Once your Client Advocate enables the Forms Configuration tool, you can start creating your own patient form letters in PCC EHR.
Open Forms Configuration
Click on “Forms” in the Configuration menu in PCC EHR to open the Forms Configuration tool.
Access Forms Configuration by Permission Only: Users can only access the Forms Configuration tool if they have permission to do so. You can grant users forms configuration access in the User Administration tool in PCC EHR.
Add a New Form
In Forms Configuration, click the “Add” button to create a new form.
A blank form template opens in the window.
Give the Form a Name
Create a name for your form. In a future PCC release, this will be the name that users see in the Forms component in PCC EHR.
Pick a Unique Name: The form name must be unique. You cannot save a new form if it has the same name as another form in the Forms Configuration tool.
Compose Text
Compose the text of your form in the blank document template.
The document template represents a standard 8.5 x 11-inch page with 1-inch margins.
Automatic Page Breaks: When the content of your form exceeds the amount of space available on the page, the extra text automatically flows onto a new page.
Customize the Style of the Text
Use the style options in the toolbar at the top of the window to customize the font, size, weight, color, and alignment of your text, or to insert a bulleted or numbered list.
Save Your Work
Click the “Save” button to save your new form.
A “Last Saved” timestamp appears beneath your form in the editor window. The timestamp updates each time you save your form.
Close Your Form
When you have finished working, click “Save + Exit” to save and close the form.
You can also click the “Back” button if you wish to discard your changes instead of saving them.
When you close a form, you return to the main screen of the Forms Configuration tool.
Work with Variables
You can include fields on your forms for auto-inserting patient, account, and practice information. These fields are called variables.
You can use variables to create generic form templates that will auto-complete with relevant details when you generate them for patients. You will be able to generate your new form letters for patients in a future PCC release.
Get to Know the List of Variables
Edit a form in the Forms Configuration tool and locate the Variables pane to the right of the document canvas.
Review the list of variable names and descriptions to learn which kinds of information you can auto-insert onto forms.
In PCC 9.1, you can auto-insert:
- patients’ demographics, insurance policy details, last vaccination date, and allergies
- patients’ billing and home account addresses, demographics, and contact information
- patients’ next appointment details
- patients’ primary care provider details
- your practice’s physical and Web address, contact information, and tax ID
- today’s date
More variables will be added in future PCC releases.
Search the Variable List: You can search for specific terms within the Variables pane. As you type a search term, the list narrows to include just the variables with names or descriptions that match your search.
Variables Use Your Practice’s Naming Conventions: The variables available to you in the Forms Configuration tool reflect your practice’s unique names for phone numbers and custom demographics fields. For example, if your practice has a custom field for emergency contact information in patient demographics, you will see a corresponding variable for that custom field in the Forms Configuration tool.
Find a Variable to Insert
To insert a variable onto your form, first select it in the Variables pane.
Place Your Cursor Where You Want to Insert the Variable
Position your cursor in the body of the form where you want to insert the selected variable.
Insert the Variable
With your cursor in position, double-click the selected variable to insert it, or click the “Insert” button at the bottom of the Variables pane.
The variable appears on your form where the cursor was positioned.
Configure the Variable Options
Click on the variable in the body of your form to view and configure its options. Once selected, the variable’s options appear in the Variables pane.
Some variables have formatting options. For example, you can choose how to format dates.
Other variables require you to make a decision before they can work. These variables turn orange as soon as you insert them onto your form, letting you know there is an action for you to take.
Click on the variable in the body of your form, then select one of the options from the orange-highlighted drop down list within the Variables pane.
Once you take the required action, the orange highlight goes away and the name of the variable on your form updates to reflect your choice.
The way you configure each variable determines what kind of information it auto-inserts onto your form upon generation and the manner in which the information is formatted.
Coming Soon: Edit the Font Style of Variables: In a future PCC Release, you will be able to edit the font style of variables to match the surrounding text.
Work with Saved Forms
You can edit, delete, and clone saved forms on the main screen of the Forms Configuration tool. To work with a saved form, select it, then click the button for the action you want to take.
Edit
The “Edit” button allows you to make changes to a saved form. You can also double-click a form to open it for editing.
Clone
The “Clone” button makes a copy of a saved form and allows you to make changes to the copy. When you save a cloned form, the original form remains intact and the cloned version gets added to the Forms Configuration tool with the changes you implemented.
Delete
The “Delete” button allows you to permanently remove a form from the Forms Configuration tool.
Delete by Permission Only: Users can delete forms by permission only. You can set up user permissions in the User Administration tool in PCC EHR.
Work with PDFs
With help from PCC Support, you can upload PDF forms into the Forms Configuration tool.
You might need to do this if your state or local school district requires that you complete a particular form for patients at the beginning of a new school year.
PDF forms appear in Forms Configuration with an icon.
You can rename them without intervention from PCC Support.
Users with the right permissions can also delete PDFs from the Forms Configuration tool.
In a future PCC release, you will be able to view the contents of PDFs in the Forms Configuration tool, control which PDFs are visible in the Forms component in PCC EHR, and decide where PDFs appear in the Forms component list order.
What to Look Forward To
PCC 9.1 is the first of many PCC releases that puts the power to create and manage patient forms into your hands. In upcoming PCC releases, you will be able to:
- Preview your form letters as you build them to see what they will look like when you generate them for patients
- Generate your form letters for patients in PCC EHR
- Include images on forms
- Auto-insert provider signatures
- Auto-insert details from patient encounters, such as vitals
- Auto-insert complete address blocks
- Auto-insert patients’ siblings
- Create questions for users to answer while generating a form, and auto-insert their answers
- Set custom margins and page sizes
- Check spelling
- Recreate your letterhead in Forms Configuration
- Control which forms appear in the Forms component and in what order
…and more! Pilot tester feedback will steer the future development of the Forms Configuration tool in PCC EHR.
Tell PCC What You Think
If you decide to become a pilot tester, tell your PCC Client Advocate what you like about the Forms Configuration tool and what would make it more useful for your practice.
Your feedback will guide the development of the Forms Configuration tool in PCC EHR.
Look Up and Import Immunization Records from Your State’s Registry
Practices in California, Wyoming, Indiana, and Florida are now eligible to sign up for bidirectional connections with their state immunization registries.
With a bidirectional connection, you can look up vaccine records from your local immunization registry and import them into patients’ charts without ever leaving PCC EHR.
To read about how it works, check out Look Up and Import Patient Immunization Records from Your Local Registry.
Contact PCC Support to get started, or to let us know that you’re interested in establishing a bidirectional connection with your registry once it’s available in your region.
Securely Retrieve Patient Information from Hospitals and Other Practices
When you enable Clinical Document Exchange, you can exchange patient records securely and on-demand with other healthcare organizations right within PCC EHR.
Learn how it works and how to sign up in Securely Retrieve Patient Information from Hospitals and Other Practices.
Use 2022 ICD-10 Diagnosis Billing Codes in PCC EHR
During the PCC 9.1 release cycle, PCC updated your practice’s system with 2022 ICD-10 diagnosis billing codes.
The 2022 ICD-10 update includes additions and expansions to sections for neonatal screening findings (P09*), cough (R05*), pediatric feeding disorder (R633*), cannabis/cannabinoid related codes (T407*), and Social Determinants of Health (Z5*). The update also includes a new “Post COVID-19 condition, unspecified” code (U099).
The new codes and guidelines take effect for dates of service starting on 10/1/2021.
Here are some resources to help you learn about 2022 ICD-10:
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CMS: You can review the complete, updated guidelines in the CDC’s 2022 ICD-10-CM Official Guidelines for Coding and Reporting.
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Attend a Billing Drop-In Event: You can learn about the updates that are of most interest to pediatric practices by attending Monthly Billing Drop-In events hosted by PCC’s billing specialists. September’s Drop-In included a Code Updates presentation.
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New and Updated ICD-10 Codes of Interest to Pediatricians: You can also review a list of new codes highlighted by PCC’s Jan Blanchard (CPC, CPEDC).
Chart Diagnoses Mapped to Deprecated ICD-10 Billing Codes: Were there any 2022 code changes for items that your practice frequently bills? After your update, you can review your system configuration using the snomedmap program in Partner. You can set what charted diagnoses (SNOMED-CT) map to your billing codes in the Billing Configuration tool in PCC EHR. While there were no major disruptions in the 2022 ICD-10 update, it’s always worth reviewing your code mapping to head off any billing challenges.
Use New Test Descriptions in the LOINC 2.70 Update
During the PCC 9.1 release cycle, PCC updated your practice’s system with LOINC 2.70, an update to the standard list of labs used to make tests interoperable between different systems.
PCC reviewed the updates to LOINC before the update: there will not be any disruption to labs your practice currently orders, and you shouldn’t need to take any action to see the effects of the patch.
The update includes over a thousand new terms and updates, including COVID-19 related issues and new lab tests such as LOINC Code 76098-2 (Respiratory Syncytial Virus RNA by isothermal nucleic acid amplification technology (NAAT)). You can read more details on the LOINC Release Notes web site.
Your practice can configure the tests for each of your lab orders in the Lab Configuration tool. For a quick guide on how to add a COVID-19 test or other lab order to your system, you can read Create a COVID-19 Test Lab Order.
New and Updated Reports in PCC 9.1
With each release, PCC improves upon the reports you can generate in PCC EHR. Here are the reporting updates for PCC 9.1:
Find Portal Users Who Have Unknown Relationships to Their Linked Patients
Use the new Portal Users by Relationship report in PCC 9.1 to generate a list of portal users who have undefined relationships to their linked patients. Then, fix the undefined relationships to ensure that your patients and their family members get the right portal communications at the right times. This is especially important for practices who send CHADIS questionnaires to portal users ahead of patient visits.
In the Report Library in PCC EHR, open the Portal Users by Relationship report from the Appointment or Patient Portal category.
The default settings for the report will help you find patients with upcoming appointments who have an unknown relationship to their linked portal users.
Once the report generates, you can use your findings to correct the undefined relationships in the Patient Portal Administration tool.
Open Patient Portal Administration from the Tools menu, then click on the Manage Portal User tab.
Search for the portal users on your list, then set up their relationships to their linked patients.
If the Portal User by Relationships report does not meet your needs by default, you can customize it to include different default filter settings (such as a date range that looks further into the future), more or fewer columns, or different criteria.
Filter by CHADIS Visit Type: Because the Portal Users by Relationship report is primarily intended for use in practices where CHADIS is enabled, it includes a filter for CHADIS Visit Type that allows you to limit the report results to patients who are scheduled for certain kinds of visits associated with CHADIS questionnaires. If you run the report to include “All CHADIS Visit Types”, the results will include all patients with unknown portal user relationships irrespective of CHADIS visit type.
Customize Lab Test Reports to Meet Third-Party Requirements
PCC 9.1 introduces the ability to generate, customize, and schedule test result reports from the PCC EHR Report Library.
The Test Result report in the Report Library improves upon the Lab Test Report, which is located in the Reports menu in PCC EHR. You can use the new Test Results report to share COVID test results and contact tracing information with your regional health agency.
Open the Test Results report from the Clinical category within the Report Library.
By default, the report includes lab test and facility information, patient and account contact information, and insurance policy details. Tests will display a CLIA number if performed at an in-house lab facility that is linked to an appointment location.
You can customize the report criteria, rearrange the columns, and schedule the report to run at regular intervals.
When you export the report results to CSV format, the elements of most names and addresses separate into discrete columns. This makes the export easier to work with in your favorite spreadsheet program.
Contact PCC Support if you need help customizing the Test Results report to meet specific reporting requirements for COVID or other test results.
Find Open Referrals (and Other Types of Orders) for Inactive, Transferred, and Dismissed Patients
In PCC 9.1, you can filter patient list and orders reports in the PCC EHR Report Library by patient flag and order status to find inactive, transferred, and dismissed patients who still have incomplete orders.
Edit the patient flag filter to include patients who are inactive, have transferred out, or were dismissed from your practice. Edit the orders filter to find orders with the status “Not Complete”. Generate the report.
You can use the resulting list to clear incomplete orders for inactive, transferred, and dismissed patients from your Visit Tasks queue.
Flexible Filters: There is more than one way to use the patient flag and order status filters on the patient list and order reports. Whenever you tackle a new reporting task, keep in mind that the patient flag and order status filters can be used in combination on a number reports.
See Patients’ Age at Last Visit on Reports
When you generate a Patient List in the Report Library in PCC EHR, you can optionally include a column that displays how old patients were at their last visit.
The Age at Last Visit column is also available on the Preventive Care Recall, Chronic Condition Recall, Patients Overdue for Weight Management, and Broadcast Messaging Patient List reports.
You can share this information with third party requesters or use it to perform practice-level analysis about how you deliver care to patients in different age groups.
Discrete Columns for Name and Address Elements When You Export Reports to CSV Format
Reports in the PCC EHR Report Library combine the elements of names and addresses into the same column.
In PCC 9.1, the elements of most names and addresses separate into discrete columns when you export report results to CSV format.
Discrete columns for name and address elements make it easier to work with report results in your favorite spreadsheet program.
Not All Names and Addresses Split Out: You might notice that the names and addresses in certain columns on certain Report Library reports do not split out when exported to CSV format. The splitting function will be extended to all name and address types in a future PCC release.
Sort Reports by Patient Age
In PCC 9.1, you can sort report results according to patient age in the PCC EHR Report Library.
The patient age column now sorts logically in ascending or descending age order, rather than sorting strictly numerically. For example, in ascending order, patients who are 11 months old will now come before patients who are 1 year old.
Find Emancipated Patients Whose Healthcare Information Remains Visible to Other Portal Users
You can use the Portal Users by Relationship report in PCC 9.1 to find patients who have reached the age of emancipation and who continue to share health information with portal user accounts other than their own.
Open the Portal Users by Relationship Report
In the Report Library in PCC EHR, open the Portal Users by Relationship report from the Appointment or Patient Portal category.
Edit the Patient Age Filter
In the report criteria, set the minimum age in the Patient Age filter to the age of emancipation in your locality.
The age of emancipation in your region should be the same age at which your practice enables age-based privacy for patients who choose to hide their healthcare information from portal user accounts other than their own.
Edit the Portal User Relationship Filter
In the report criteria, edit the Portal User Relationship to Patient filter and select all relationships except “Self”.
In order for this filter to work as intended, your practice must have relationships set up between portal users and the patients to whom they are connected.
Edit the Age-Based Privacy Filter
In the report criteria, change the Age-Based Privacy filter to “Disabled”.
This setting allows you to find patients whose healthcare information is visible to other portal users.
Generate the Report
Generate the report. The results contain the names of patients who have reached the age of emancipation and continue to share their health information with portal user accounts other than their own.
Verify Your Patients’ Privacy Preferences
Speak with the patients on your list and affirm that their intent is to continue sharing their healthcare information with other portal users.
Update Age-Based Privacy Settings Based on Patient Preferences
You can change the age-based privacy setting for patients who would like to hide their information from other portal users in Patient Portal Administration.
Patients who opt to continue sharing their information with portal accounts other than their own past the age of emancipation should sign a release form.
Easily Report on a 14-Day Date Range
All reports in PCC EHR now include a fourteen-day date range option.
You can use this option to generate reports about patients who have visits in the next two weeks, or to identify encounter charges from the last two weeks that have yet to be posted.
The fourteen day date filter is available on default reports, custom reports, and scheduled reports.
Improved PCC EHR Release Deployment
During the release of a new PCC EHR update, the update cannot be completed if a user is logged in to PCC EHR, or if a user logs in during the deployment process. To ensure that you get the newest versions of PCC EHR without delay or interruption, users are now prevented from using PCC EHR while an update is in progress.
The login screen will include a message that maintenance is in progress.
If a user is already logged in when an update begins, they will be automatically logged out and will prevented from logging in again until the update is complete. After the update, the window will refresh and the username and password fields will reappear.
A Better Way to Set Patients’ Immunization Registry Status
Practices who are required by their immunization registries to include a patient status with vaccine record submissions can now set a patient immunization registry status under Communication Preferences.
The patient immunization registry status field is only visible to practices who have it enabled in the Communication Preferences component.
You should only enable the patient immunization registry status field if your registry requires you to send a patient status with vaccine record submissions. Contact PCC Support if you receive such a request. A PCC immunization registry support specialist will work with you to enable the field and make sure that your practice is using it the way your registry requires.
Immunization Registry Status is Not Connected to Patient Flags: Patient immunization registry status is used solely for the purpose of communicating patient status to a registry and is not tied in any way to patient flags in Practice Management and PCC EHR.
New and Updated Interfaces Available in PCC 9.1
With each release, PCC expands and updates direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 9.1:
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New and Updated Clinical Interfaces: During the PCC 9.1 release cycle, PCC updated our immunization registry interfaces with Oregon (ALERTIIS), Florida (Florida SHOTS), and Louisiana (LINKS) to support state-specific requirements around COVID vaccine and VFC status reporting.
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New Insurance Eligibility and Financial Interfaces: During the PCC 9.1 release cycle, PCC enabled real time insurance eligibility-checking for LA Medicaid, VA Medicaid, Optima Health Plan, Neighborhood Health Plan Rhode Island, Triple S, LA Healthy Blue, and NC Healthy Blue. PCC also updated eligibility configuration for Meridian Health, Harvard Pilgrim, and Cigna. PCC 9.1 also introduced claim interface improvements for Advocate Lutheran, Community Health Choice, PA Medicare, Cook Children’s Health, Parkland, AmeriHealth Caritas North Carolina, Healthy Blue North Carolina, IL Aetna Better Health, and Aetna Better Health PA..
If your practice would like to take advantage of these connections, or you have other interface needs, contact PCC Support.
Background Improvements to PCC eRx
Ahead of the PCC 9.1 release, your practice received an important, non-disruptive background update to PCC eRx which:
- Fixes common prescription errors related to frequency, dose form, quantity, and missing instructions that prevent you from e-prescribing
- Fixes the “Add New Medication” button so that you can prescribe new medications immediately after renewing existing medication entries
- Gives you the ability to view or adjust Dispense as Written (DAW) information for pending prescriptions on the Rx Queue, and fixes an issue where the DAW checkbox was sometimes being selected without user input
- Reduces possible confusion at the pharmacy by removing the generic epinephrine option mapped to brand-name only manual injector pens (Symjepi)
- Resolves issues surrounding saved prescriptions and stop dates, ensuring the calculated date is always present and, if selected, the “Use Stop Date” box is honored when editing a 3 month supply
- Gives you the ability to revert a pending 3 month supply prescription to a single month, and ensures that the set of 3 prescriptions remains linked by preventing individual processing
- Resolves unintended duplication in the PCC EHR Prescriptions component that resulted from editing three month supply prescriptions
- Picks up patients’ preferred pharmacy when you renew medications
Contact PCC Support if you have any questions about the improvements included in this update.
Other Feature Improvements and Bug Fixes in PCC 9.1
In addition to the features described above, PCC 9.1 includes these smaller improvements and squashed bugs.
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Updated VIS, MVX, and CVX for the new VAXELIS Vaccine and More: PCC 9.1 includes updates to the list of supported immunization Vaccine Information Sheets, manufacturers, and product codes. Among other updates, PCC EHR now supports VAXELIS (CVX 146), a new vaccine that immunizes against diptheria, tetanus, pertussis, polio Hib (Haemophilus influenzae type b), and hepatitis B, developed in a partnership with Merck and Sanofi Pasteur (requiring a new manufacturer code, MSP). For help adding new immunizations to your PCC system, read Add, Update, and Configure Immunizations in PCC EHR and contact PCC Support.
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New Vaccine Product Codes (CVX) Pending Approval of Pfizer SARS-COV-2 Vaccine for 5 through 11 Years of Age: You can begin to configure your PCC system for administrations of Pfizer’s tris-sucrose SARS-COV-2 vaccine formulations for ages 5 through 11 (CVX 218) and ages 12 and older (CVX 217) in anticipation of FDA approval for emergency use. Instead of vaccine information sheets (VIS), these vaccines will have emergency use authorization (EUA) sheets that you can share with patients and their families. PCC is preparing to assist practices with the configuration needed to carry out a mass SARS-COV-2 vaccination campaign. Until further communication is released, you can contact PCC Support to notify PCC of your intent to administer the vaccine and of your potential need for configuration assistance. For more information about these vaccines and the associated CVX, NDC, and CPT codes, please refer to the CDC’s web resources concerning COVID-19 vaccines.
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CVX Code 207 for Moderna SARS-COV-2 Booster Dose: Per the CDC, the description of CVX code 207 has been updated pending FDA emergency use authorization to allow its use for a booster dose of the Moderna COVID-19 vaccine drawn from existing product vials.
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Call PCC Before You Start Billing for COVID-19 Boosters (Third Shot): With a little custom configuration, PCC supports the procedure codes for billing third-dose boosters of COVID-19 vaccines. Call PCC Support to request the custom configuration before you begin billing for COVID-19 booster shots.
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Use Apostrophes in Names on Claims: PCC’s claim processing now supports apostrophes in patient and account names. Names like D’Angelo and O’Hara will no longer cause claim errors.
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More Information Sent to CHADIS: Gestational Age is now sent to CHADIS, so that CHADIS can calculate an adjusted age and better match questionnaires to patients up to three months old. Multiple birth information is also included with patient information, though CHADIS does not yet make use if it.
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Reduce Claim Errors Related to Subscriber Relationship: Claims will use the relationship to subscriber entered for the patient’s specific policy first, and then use the relationship entered in the patient’s record if needed.
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Improved Messages Queue Speed: The Messages queue in PCC EHR now caches information, speeding up how the queue refreshes. At large practices, this will lead to noticeable improvement on the Messages queue, and may result in improved performance elsewhere in PCC EHR.
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Unable to Save Documents from Patient Education to the Chart: Under certain circumstances, sending patient education would create a blank document. PCC patched this problem to all clients mid-release.
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Appointment Note Crash: While reviewing Appointment Notes on the Schedule screen, an automatic refresh of the screen could cause PCC EHR to crash. PCC 9.1 fixes this issue.
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New Patient Sync Problems: When adding a new patient or modifying their date of birth, sometimes the records would not be adjusted in the Partner PM system right away. This update now happens more quickly.
Install a Fujitsu fi-7160 Scanner for PCC EHR
PCC recommends the Fujitsu fi-7160 scanner because of its reliability and performance. Older models of the fi series, like the 6110, are acceptable alternatives. All scan settings are controlled through the included PaperStream software.
Install a Fujitsu fi-7160 Scanner for PCC EHR on Windows
Follow the steps below to install and configure a Fujitsu fi-7160 on a Microsoft Windows PC for use with PCC EHR.
Download the Scanner Driver and Application
Unplug Your Scanner
Unplug your scanner from your workstation before software installation. Fujitsu fi-7160 scanners plug into workstations with a USB cable.
Visit Fujitsu’s Downloads Page
Open a web browser to Fujitsu’s fi Series downloads page (https://imagescanner.fujitsu.com/global/dl/).
Download the PaperStream IP Driver
Select your scanner’s series, scanner model, and your PC workstation’s operating system. Click “Display software list”.
Click “Download” next to PaperStream IP (TWAIN)
If the download does not begin automatically, click the “Download” link called PSIPTWAIN(version number).exe
If prompted to run or save, select “Save”.
Download the PaperStream Capture Application
Click the “Back” button on your browser to view the previous page. In the applications section, click “Download” next to PaperStream Capture.
Enter your scanner’s serial number.
If the download does not begin automatically, click the “Download” link containing PSC(version number).exe. If prompted to run or save, select “Save”.
Install the Scanner Driver and Application
Launch the PaperStream IP Driver
Open your Downloads folder and launch the driver installer, PSIPTWAIN(version number).exe. If prompted to allow changes to this computer, select “Yes”. The installer will run a script to install necessary files, and then open a PaperStream IP Driver Setup window. Click “Next” to continue.
Install the PaperStream IP Driver
On the following screen, confirm that PaperStream IP and Scanner Central Admin are both checked, then click “Next”.
Read the agreement, check the “I accept…” box and click “Install”.
Installation may take several minutes. When complete, all three boxes (PaperStream, Software Panel and Scanner Agent) will be checked, and the “Stop” button will change to “Close”. Click “Close” to complete the driver installation.
Install PaperStream Application
Return to your Downloads folder and open the PaperStream application installer. You may be prompted to choose your language, and a PaperStream setup window will open.
- Check “I accept the terms…”
- Select “Basic (use basic functions with no limitations)”.
- Uncheck “Display sample profiles”.
- Uncheck “Show Welcome on startup”.
Click “Install”. When the installation is completed, click “Finish”. Click “OK” when prompted.
Configure Scanner Buttons
Plug in Your Scanner
PCC recommends that you plug your scanner into a USB 3.0 port for optimal speed.
Open the Windows Printers & Scanners Settings Panel
Find and open the Printers & Scanners settings window from your Windows Start menu. The fi-7160 should appear on the list of added devices.
Select Scanner and Properties
Click the device once, then click the “Manage” button.
Next, click “Properties”.
Configure the Scan Button to Launch PaperStream Capture
Select the Events tab.
- Confirm that “Select an event:” is set to “Scan Button”.
- Select “Start this program:”
- Choose PaperStream Capture from the drop-down menu.
Now PaperStream Capture will run when the scan button is pressed on the physical scanner. Click “OK” to close this window.
Configure Scanner Profile and Destination
In this section you will configure the scanner’s settings and route the finished scans to PCC EHR.
Open the PaperStream Capture Application
Open the PaperStream Capture Application from the Start menu or desktop icon.
Create a Scanner Profile
Click the Lines menu next to the blue Scan button.
Select “Configure Profiles” from the drop-down options and click on the plus (+) button to add a scanner profile.
On the left menu select “1. Name” and add the Name “EHR”.
Confirm that PaperStream IP fi-7160 is in the Source Box
Select “2. Source” from the left menu. PaperStream IP fi-7160 should be visible in the “Source” box.
If the PaperStream IP fi-7160 is not in the “Source” box, there may be a problem with installation. Contact support at 1(800)722-7708 or support@pcc.com to troubleshoot the issue.
Configure Source Parameters
In the Source Parameters box, set the following:
- Color Mode: Auto Color
- Resolution: 200 dpi
- Leave the Paper Size, Sides, and Continuous Scan as defaults.
Configure Display Options
In Display Options, set the following:
- “Release After Scan”
- “Minimize App. During Scan”
- Do not select “Exit App After Scan”, as this can slow scanning time.
Leave Mark Options on the default settings.
Save and Name Your Profile
Click “Save As” under the Scanner Driver Profile drop-down. Name this driver profile “EHR” at the prompt.
Configure Your Scanner Profile Destination
Select “3. Destination” on the left menu. Change the default TIF to a PDF.
In the Folder field, type: \\acro\scanning\bucket###. Replace “acro” with your PCC practice acronym and “###” with your chosen bucket number (bucket001, for example). Use only lowercase for the acronym, and backslash “\” as opposed to “/” forward slash.
Which Bucket?: To pick a bucket number, log in to PCC EHR, select Documents from the Configuration menu, visit the Import Documents tab, and choose a bucket from the “File Source” column. For more information on buckets, visit Configure Document Categories, File Sources, and Default Behaviors.
Save You Scanner Configuration
Click “Save”. If a warning pops up, click “Yes” and “Close”.
Return to the Main Screen
Click the “Back” button to return to the main screen.
Map Your Scanner to the EHR Profile
Click the Lines menu and select the Administrator Tool. Select “Usability” from the left menu. Choose the “EHR” profile from the Scan drop-down.
Save Your Scanner Profile
Click “Save” and then “Close” to return to the main screen. Your EHR profile and rules are now set and you are ready to try a test scan.
Test Scanning a Document to PCC EHR
Follow the Fujitsu fi-7160 instructions to scan your first document. This first scan will be slow as the service is running for the first time.
When the scan completes, log into PCC EHR and navigate to Import Documents. The PaperStream application will flash orange on your toolbar as the scan is processed and the “Load New Files” button on the Import Documents screen will highlight yellow. Click the “Import Documents” button to load the scan into PCC EHR.
By default, you will see documents from all sources. You can change the File Source drop-down to select a specific bucket. Your scanner is now fully installed. For more information on importing documents, visit Import and Attach a Document to a Patient’s Chart.
PCC 9.1 Migration Considerations
The PCC 9.1 release includes new features that may need configuration and for which you may want to do extra planning or training. Read below to learn more, and share relevant details with your physicians and staff.
Read the PCC 9.1 Release article for complete details on these features.
Contact PCC Support for help implementing features in PCC 9.1.
Update Your Workstations, Expect Some Slowness On Day 1
After a PCC update, your practice will need to update workstations around your office. Users will see an update reminder on their login screen.
Update Slowness: After you install a PCC EHR update on a workstation, the software needs to cache the code it uses to display information. You will experience slowness until this finishes.
Add User Permissions for Post Payments in PCC EHR
Your practice can now post personal payments (and write off charges) inside PCC EHR. Your PCC 9.1 update will grant this permission to all users who have administrative privileges. After your PCC 9.1 update, use the User Administration tool to update your Roles to include the new tool.
Link vs Unlinked: When you post a personal payment in PCC EHR, the payment is by default linked to unpaid personal charges, starting with the oldest charges first. In PCC’s previous payment tool, the pam
program in Practice Management, the default was to leave payments unlinked (unless the user pressed a key to link them.)
Understand the Differences Between Account Notes in PCC EHR and Partner Practice Management Tools
Your practice can now edit Account Notes in both the Payments tool in PCC EHR and the previous, Practice Management system’s Family Editor tool (fame
). If your billers use this feature to track issues with an account, you may notice some differences.
- In the Family Editor, deleted notes were turned into a message indicating that a note was deleted. Those messages will still appear on old deleted notes in PCC EHR and Practice Management. When you delete an Account Note in PCC EHR, however, the note disappears and a record is kept in PCC EHR’s Audit Log indicating the note was deleted.
- In the Family Editor, notes could have descending hierarchy, with children of children notes. This made threaded notes more difficult to read and led to confusion when tracking issues. In PCC EHR, all child notes of an initial note are displayed at the same hierarchy, and are sorted chronologically.
Pilot Test the Forms Configuration Tool
In PCC 9.1 you can volunteer to pilot test a new tool in PCC EHR that you can use to create and edit your own patient form letters. You should consider becoming a pilot tester if you want to gain early access to making your own patient form letters in PCC EHR and to provide feedback that will inform the future development of the Forms Configuration tool.
Pilot testers will also get a head start migrating their existing patient form letters in the new tool.
Get Started with Forms Configuration
There are a few steps that you and your Client Advocate need to take in order for you to get started with the Forms Configuration tool.
Tell Your Client Advocate That You Want to Be a Pilot Tester
Talk to your PCC Client Advocate if you are interested in pilot testing the new Forms Configuration tool. Your Client Advocate will take several steps to launch the pilot test at your practice.
Your Client Advocate Schedules a Call to Review Pilot Test Information
Your Client Advocate schedules a call with you to share information about how the pilot test works and what you can expect to be able to do in the Forms Configuration tool in PCC 9.1.
Your Client Advocate Enables Forms Configuration
After the information session, your Client Advocate enables the Forms Configuration tool in PCC EHR and notifies you that the pilot test is live. Once the pilot test is live, a “Forms” option appears in the Configuration menu in PCC EHR.
Your Practice Configures User Permissions
Decide who should be allowed to access the Forms Configuration tool. Then, assign the correct permissions to those users.
In the User Administration tool in PCC EHR, click on the Roles tab and add the Forms permission to relevant user roles, or create a new role just for Forms Configuration access.
Permission to delete forms is controlled separately.
If you decide to create a new role, assign it to the relevant users.
User Administrators Have Forms Access by Default: Users at your practice who have access to User Administration in PCC EHR will automatically be given access to Forms Configuration when the tool is enabled. You can revoke this access in the User Administration tool.
Optionally, Your Client Advocate Migrates Existing Forms into Forms Configuration (Highly Recommended)
Once Forms Configuration is live, you have the option to migrate some or all of your existing forms from the PCC EHR Forms component into the new tool. Your Client Advocate must complete this step on your behalf.
You are not required to migrate existing forms in order to use the Forms Configuration tool. However, if you decide that you would like to move some or all of your existing forms into the new tool, it is highly recommended that your Client Advocate do so as soon as Forms Configuration is enabled.
Migrated forms remain linked to the chart note protocols where they are currently configured for one-click generation.
After Migration, Configure Your Forms: After your Client Advocate migrates your existing forms into the Forms Configuration tool, you must configure them for use. The steps you need to take depend on whether the migrated forms started out as text forms or PDF documents. Learn how to configure your migrated forms in Configure Migrated Forms.
What If I Decide to Migrate Later?: If you decide to migrate your existing forms later, be aware that it could overwrite new forms that were created in the Forms Configuration tool in the interim. This would occur in cases where your new forms share a background ID with the forms that you are migrating.
Your Practice Starts Making Patient Form Letters!
With the Forms Configuration tool enabled, your migration plan in place, and user permissions squared away, you can start making patient form letters!
First, try creating a test form from scratch. You can delete this form later if needed.
Once you get a feel for the tool, you can start creating realistic patient form letters.
Configure Migrated Forms Before Creating New Letters From Scratch: If your Client Advocate migrated your existing forms, you should configure those for use before making new letters from scratch. See Configure Migrated Forms to learn how.
Your Practice Provides Feedback About the Forms Configuration Tool
As you gain experience within Forms Configuration, let your Client Advocate know what you like, what seems confusing or broken, and what could make the tool more useful for your practice. Your feedback during the pilot test will steer the future development of the Forms Configuration tool.
You can see what features PCC already plans to add to the Forms Configuration tool in the PCC 9.1 Release article.
Configure Migrated Forms
If your Client Advocate migrated some or all of your existing forms into the Forms Configuration tool, you need to take some steps to configure them for use. The configuration steps depend on whether the migrated forms started out as text forms or PDF documents. In a future PCC release, you will be able to generate your migrated forms for patients.
Review Your Migrated Forms
Migrated forms appear in Forms Configuration with the same titles as you are used to seeing in the Forms component in PCC EHR and are indicated as having last been saved by the PCC user on your system. Those with a PDF icon are PDF documents. Those that do not have an icon are text forms.
Your next steps depend on whether the migrated forms are text forms or PDF documents.
Start Recreating the Contents of Migrated Text Forms
Text forms undergo a conversion when your Client Advocate migrates them into Forms Configuration. They retain their titles but not their contents. This is so that you can recreate them using the new text editor within the Forms Configuration tool.
Double-click on the title of a migrated text form to open it for editing.
Use the embedded text editor to recreate the form’s contents within the blank document template. If you have a version of the form saved on your computer or in the cloud, you can copy and paste that text into the Forms Configuration text editor.
The Forms Configuration tool is still under construction, so you might have to wait for a future PCC release before you can make your migrated text forms look and work just the way you want. You can see what has yet to be added to the Forms Configuration tool in the PCC 9.1 Release article. Tell your Client Advocate if you think you will need something that is not mentioned in the list.
Optionally Review and Edit the Titles of Migrated PDF Forms
PDF documents retain their titles and contents when your Client Advocate migrates them into Forms Configuration. You can edit their titles within the Forms Configuration tool, but you cannot view or edit their contents.
If you want to make changes to the contents of PDF forms in the Forms Configuration tool, you must contact PCC Support.
If Necessary, Re-Migrate Forms
Your Client Advocate can re-migrate forms into the Forms Configuration tool at any time. You might want to do this if you significantly updated a PDF form since first migrating your forms into the Forms Configuration tool.
When you re-migrate a form, the newly migrated version overwrites the existing entry in the Forms Configuration tool and any changes you might have made to it.
If you have questions about the Forms Configuration tool, the forms migration process, or the pilot test, contact your PCC Client Advocate.
Use the Test Results Report Instead of the Lab Test Report
The new Test Results report in the PCC EHR Report Library replaces the Lab Test report that lives under the Reports menu in PCC EHR.
Unlike the Lab Test report, you can customize the Test Results report to meet the specific reporting requirements of third party requesters. You can also schedule different versions of the Test Results report to run regularly.
Try using the Test Results report to report COVID test results to your local health department.
Adjust Staff Workflow for Indicating Patient Immunization Registry Status
Prior to PCC 9.1, practices whose immunization registries required them to report a patient immunization registry status set that status in the Patient Status field, which was positioned at the top of the Patient Demographics chart section.
This field was often misused because of its name and placement in the chart, so it was moved and renamed in PCC 9.1. In the new version, staff members can set patients’ immunization registry status under Communication Preferences.
The Patient Immunization Registry Status field is only visible at practices where it is enabled within the Communication Preferences component.
You should only enable this field if your immunization registry requests that you send a patient status with vaccine record submissions. Contact PCC Support if your registry makes such a request of your practice. An immunization registry support specialist will work with you to enable the field and make sure your practice is using it the way your registry requires.
Add VAXELIS Vaccine to Your System
If your practice plans to administer and bill for the new VAXELIS combination vaccine, contact PCC Support.
Prevent Claim Rejections for Third Dose of Pfizer-BioNTech COVID-19 Vaccine
If your practice administers the Pfizer-BioNTech COVID-19 vaccine, and you administer (or plan to administer) booster shots (a third dose), contact PCC Support for help adjusting your configuration. PCC has seen claim delays and rejections without proper configuration. (In an upcoming update, PCC may implement these configuration changes for all practices.)
Update Your MacOS 10.12 or 10.13 Workstations and Your Windows 7 PCs
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. If your practice is still using workstations that run Windows 7 or MacOS 10.12, that support has already ended and you should upgrade those machines.
Apple is expected to end support for 10.13 in 2021. PCC EHR includes a reminder to users when they log in on workstations running older operating systems. The reminder encourages them to review and update their operating system. Contact PCC Support for recommendations.
PCC EHR requires a workstation running on Windows 8 (or higher) or MacOS 10.14 (or higher). For more information, read Hardware Guide: Your Personal Computer and Equipment.
PCC 9.0 Release
In August of 2021, PCC will release version 9.0 of our electronic charting and practice management software to all PCC users.
PCC 9.0 is a release focused on eRx functionality.
Watch a Video: If you would like to watch a brief overview of the features in PCC 9.0, watch the 9.0 Release Video.
Implementation: PCC 9.0 includes features that require configuration and user-specific software training. Read about the features below and then review the 9.0 Migration Considerations article.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Access Prescription Favorites from a Drop-Down Menu
You can now access your favorites in a drop-down menu at the top of the Prescribe component. You can search directly in this drop-down for the favorite you want.
If you want to hide or show this drop-down, or the favorite tiles, you can independently activate or deactivate either feature in the My Settings section of PCC eRx.
Number of Favorites to Display: The “Number of Favorites to display in Prescribe section” setting in your PCC eRx settings only affects the number of favorite tiles. The drop-down will always contain all favorites.
Create Favorites While Prescribing
You can now create favorites on the fly, while you are prescribing. Click the “Add to Favorites” button at the bottom of the Add New Med section, or click the gray heart icon next to the drug name.
If you are prescribing something that is already a favorite, the heart will be colored blue. If you make changes to that favorite, the heart will turn gray, indicating that it is no longer a favorite. You can then save this new prescription as a new favorite.
What Fields are Saved as Part of a Favorite?: The following information is saved as part of a favorite: drug name, route, frequency, dosage form, dose, dose max, dose unit of measure, strength, strength max, strength unit of measure, dispense quantity, dispense unit of measure, and refills.
Can I Delete a Favorite?: You cannot remove a favorite while prescribing. To remove something from your favorites list or otherwise manage favorites, go to the My Settings tab in PCC eRx.
Create Three Month Supply of Schedule II Substances More Easily
In PCC 9.0, instead of having to create three separate prescriptions to create a three month supply of a Schedule II drug, you can now do so with one click.
Whenever you create a prescription for a Schedule II drug, PCC eRx will display a “Create 3 month supply” checkbox. When you check the box, dates will auto-populate the Date to Fill fields for 30 and 60 days out from today’s date.
In the Prescription History and Medication History components, this will appear as only one entry, simplifying and clarifying those items in the history.
Pre-date Prescriptions
If you want to allow patients to pick up prescriptions early, you can change the Date to Fill dates to allow for that.
You can set a default pre-date duration under My Settings, so that all prescriptions created using the “Create 3 month supply” checkbox will automatically set dates to fill 2 and 3 with a pre-dated value.
What does the Pharmacy Receive?: Even though PCC eRx displays the three month supply as one prescription, the pharmacy will receive three separate prescriptions, all identical except for the start date. You can see the serial numbers of these prescriptions in the Prescription History component.
Stop Dates: Stop dates are added automatically to the first two prescriptions in this series; they will drop off the “active” list in the Medication History component after 30 days. The final prescription, however, will have no stop date; it will persist in the Medication History component until you manually discontinue it.
No More Waiting for Prescriptions to Send
With PCC 9.0, you do not have to wait for prescriptions to send from the Review and Sign component before moving on to your next task. After you have finalized your prescriptions and clicked “Send Prescriptions”, the Prescription Review window will close immediately, and you can continue on with the visit.
What If There Are Errors?: If the prescription cannot make it to the pharmacy for any reason, an error will appear on the Rx Task Queue.
Renew Prescriptions More Easily From the Prescription and Medication Histories
You can now renew prescriptions with fewer clicks. Prior to PCC 9.0, clicking the Renew Prescription icon queued the prescription in the Review & Sign component. Now that icon opens the Renew Prescription window directly, where you can click the “Process Now” button to send the prescription immediately.
RapidRx Permissions: This feature is enabled by default for all users who have the eRx role of Provider or Mid-Level Provider. You can enable or disable this feature in the My Settings section of eRx.
Reassign Renewal Requests on the Queue to Another Prescriber
In PCC 9.0 you can assign renewal requests to other providers at your practice. Perhaps you were covering for a colleague when you made the initial prescription, but want the patient’s PCP to field the incoming request. Or, you’re managing the queue and the prescribing physician is on vacation so you need to redirect the request to a different physician. To reassign a renewal request, select the “Reassign” option and select the appropriate prescriber.
The queue will update within a minute, and the assigned prescriber will see the request on their queue.
Repeat Requests for Renewals from Pharmacies Only Appear Once on the Queue
When pharmacies send multiple renewal requests for the same prescription, these requests are now represented as one item in the queue, so you only have to reply once.
The queue will display the number of times the request has been submitted.
Make Adjustments to Renewal Requests from the Pharmacy
When you get a renewal request from the pharmacy, you can now make adjustments to the requested renewal, such as changing the dispense amount, and send that updated prescription to the pharmacy right from the Rx Task Queue.
Assign a Follow Up Provider When Creating a Prescription
If you are covering for another provider who is out of the office, or otherwise want to pass off any follow-up for a prescription (including phone calls and renewal requests) to another provider, simply select the provider from the Follow Up Provider drop-down.
The pharmacy will be notified that you want all follow-up communication for this prescription to go to that provider.
Disable Renewal Requests for Specific Prescriptions
If you want to indicate to a pharmacy that they should not send a renewal request for a particular prescription, click the Prevent Renewal Request checkbox when creating a prescription.
Updates to the Rx Task Queue
Edit and Delete Pending Prescriptions from the Rx Task Queue
PCC 9.0 adds a red edit pencil and a trash can icon to pending prescriptions in the Rx Task Queue. Use these to edit or delete prescriptions.
Note: As before, you can click on a patient’s name in the Rx Task Queue brings you directly to the eRx section of the chart for the encounter of the prescription.
Send Pending Prescriptions for All Patients with Fewer Clicks
You can now batch send all pending prescriptions from the Rx Task Queue. Click “Select All” and/or manually select the prescriptions you want to send, and then click “Process Unsigned Prescriptions”.
Prior to PCC 9.0, processing unsigned prescriptions opened a verification window. This extra step has been removed, so prescriptions will be sent when you click “Process Unsigned Prescriptions”.
New Error Section on the Rx Task Queue
Prescription transmission errors can occur when the pharmacy’s system is down, or when Surescripts, the entity that manages the communication between pharmacies and PCC EHR, is unable to process your prescriptions. These transmission issues can prevent prescriptions from reaching the pharmacy. When that happens, PCC eRx will display errors at the top of the Rx Task Queue.
After encountering an error, PCC will make multiple attempts to send a prescription. If you’d like PCC to stop trying to send the prescription so you can take action yourself, click “Stop Retrying” to end the process.
When a prescription fails to send (or when you tell PCC eRx to stop retrying), you can take one of three actions:
- Select “Keep” to indicate that you’ve called the pharmacy and resolved the issue.
- Select “Delete” to delete the prescription.
- Select “Print” to print the prescription to give to the patient or fax to the pharmacy.
Once you make a selection, click “Resolve” to remove the prescription from the queue.
Transmission errors will also appear in the Prescription History section of PCC eRx.
Receive Electronic Prescription Change Requests from the Pharmacy
You can now receive questions and communications from the pharmacy electronically. Maybe the pharmacy would like to substitute a generic for a name brand, or they want to dispense a therapeutically equivalent substitution due to insurance coverage. You can see and respond to these requests in the Rx Queue.
These requests from the pharmacy appear in the Rx Task Queue. You can approve, deny, or reassign a request to another provider.
Updates to the Medication History Component
Easily Discontinue Medications in the Medication History
You can now discontinue medications in the Medication History component by clicking on the new trash can icon.
Discontinue Date: When you click the trash can icon in the Medication History, the medication is discontinued as of today’s date. If you want to record something as being discontinued in the past, you must edit the medication and enter the stop date manually and then click “Save”. If you click “Discontinue” before clicking “Save”, the date you entered will be ignored.
Delete More Than One Entry From the Medication History at the Same Time
You can now discontinue multiple medications at once in the Medication History component. Click “Clean Up Med Hx”, select the medications you want to discontinue, and then click “Discontinue Medications”.
Communicate Canceled Prescriptions Electronically to the Pharmacy
When you delete a prescription from the Review and Sign component (or an active prescription from the Medication History), PCC eRx will automatically send an electronic cancelation to pharmacies that accept that type of electronic communication. A pop-up will indicate whether an electronic cancelation was sent, or if you need to call the pharmacy.
You can confirm the pharmacy received the cancellation by checking the Rx Queue History.
Changes to eRx Reporting
PCC 9.0 groups eRx reports together in one place, under the Rx Logs section of PCC eRx.
PCC 9.0 streamlines eRx reports, removing some fields and adding others to make the reports more focused and useful, and adds a Security Log.
Rx Audits
The following changes have been made to the Rx Audits log:
- Added: Search by Prescriber
- Added: Search by Patient
- Removed: Free text search field
- Removed: Event search field
Rx Queue History Updates
The following things have been changed in the Rx Queue History:
- Added: Drug schedule
- Removed: Search Type radio button
- Removed: Pharmacy search
- Removed: Location search
Security Logs
The new Security Logs section lets you monitor and audit suspicious activity regarding eRx and EPCS usage, such as multiple incorrect password attempts.
One feature of the Security Log is the ability to track prescribing activity based on a prescriber’s vacation hours and your practice’s office hours. A user with an administrator role can set your office’s hours in the Administration section of eRx.
All prescribers can set their vacation hours in My Settings in eRx.
If you want full data on all prescribing activity, use the Rx Audits log.
PCC eRx Logs Are Not Backwards-Compatible with Earlier Versions of PCC EHR: The Rx Queue History, Rx Audit, and Audit Log reports, along with many of the new features in PCC 9.0, use a more current standard for prescription information exchange. These reports cannot display information in the older format, and so will only give access to data as far back as the date you went live with PCC 9.0. If you need access to older data, contact PCC.
See If a Prescription Has Been Filled
Some pharmacies have the capability to send back information indicating that a prescription has been filled. When they do, the Prescription History component will display a pill bottle icon. You can click the icon for more history.
PCC 9.0 Migration Considerations
The PCC 9.0 release includes new features that might need configuration and for which you may want to do extra planning or training. Read below to learn more, and share relevant details with your physicians and staff.
Read the PCC 9.0 Release article for complete details on these features.
Contact PCC Support for information about these or any features in PCC 9.0.
Find Out Which Weekend You Are Updating to PCC 9.0
PCC 9.0 is rolling out to practices over the course of several weekends in August. Your office will be notified in advance of the date that you are scheduled to receive PCC 9.0.
If you need help remembering when your update will occur, or need special accommodations to receive the update at a time other than what was originally planned, please contact your PCC Client Advocate at your earliest convenience.
Approve or Deny Outstanding Renewal Requests Before Your Office Updates to PCC 9.0
A new standard data format for electronic prescriptions will be implemented when your office updates to PCC 9.0, and this will render outstanding renewal requests on your Rx Queue unusable. As part of the update, PCC will remove these defunct requests from view and you will no longer be able to see or respond to them.
In order to avoid confusion or delays in patient care, PCC recommends that you respond to all outstanding renewal requests on your Rx Queue before your office updates to PCC 9.0.
After the update to PCC 9.0, any new electronic renewal requests you receive will follow the new standard data format, and you will be able to respond to them from the Rx Queue.
Process Pending Prescriptions Before Your Office Updates to PCC 9.0
PCC 9.0 introduces new code that changes the way pending prescriptions display on the Rx Queue, causing those that were created before the update to display improperly in the new version. In order to prevent confusion that might result from this display issue, PCC will hide unprocessed pending prescriptions from the Rx Queue during the update to PCC 9.0.
In order to avoid confusion or delays in patient care, PCC recommends that you process all relevant pending prescriptions on your Rx Queue before your office updates to the new version. PCC will clean up any you leave behind during the update.
New prescriptions that pend to the Rx Queue after the update will display normally.
Update Your Workstations, Expect Some Slowness On Day 1
After a PCC update, your practice will need to update workstations around your office. Users will see an update reminder on their login screen.
Update Slowness: After you install a PCC EHR update on a workstation, the software needs to cache the code it uses to display information. You will experience slowness until this finishes.
Enable Electronic Renewal Requests to Take Advantage of an Improved Workflow
You can take advantage of improvements to electronic renewal requests in PCC 9.0 as long as your PCC eRx account is enabled to receive them.
If your PCC eRx account has not already been set up to receive electronic renewal requests, your office administrator can enable the service for you in the User Administration tool in PCC EHR.
Edit the user whose settings you want to change, then click on the PCC eRx tab.
On the PCC eRx tab, check the box for “Electronic Renewal Request Service”. This allows the user to receive electronic renewal requests from pharmacies on the Rx Queue.
Click “Save” to register the new settings.
You can disable electronic renewal requests for a user by unchecking the box for “Electronic Renewal Request Service” within their PCC eRx account settings in the User Administration tool in PCC EHR.
For Providers Only: You can only enable the electronic renewal request service for users with the Mid-Level Provider or Provider role in PCC eRx.
Configure the Way Favorites Appear When You Prescribe
In PCC 9.0, there are two ways to select from your favorites list while prescribing a medication: a drop-down menu and thumbnail tiles.
If you find that you only use one of the two methods to access your prescription favorites, you can optionally hide the other and make more space on your prescribing screen.
In PCC eRx, click “My Settings”.
In the “Favorites” section of your settings page, uncheck the box beside whichever favorites display method you want to hide.
If you choose to display favorites as tiles, you can choose how many tiles to display.
If you would rather not see favorites at all when you prescribe, you can uncheck both display methods.
Favorites are optional and customizable. Learn more about how to set up and work with favorites in Customize Your PCC eRx Favorites.
Get Help Cleaning Up Your Favorites List
With the update to PCC 9.0, your prescription favorites will appear in an easy-to-reference drop-down menu on the Prescribe screen.
If you find that your list of prescription favorites is too long to be useful, PCC can help you clear the list, or at least prune it to a more manageable size.
Call PCC Support if you need help cleaning up your favorites list.
Grant Users Access to the Security Log and Other eRx Reports
Office administrators can give users permission to access reporting functions in PCC eRx.
Open User Administration from the Tools menu in PCC EHR.
Edit the user whose settings you want to change, then click on the “PCC eRx” tab.
On the PCC eRx tab, check the box for “Reports”. This allows the user to access reports in the Rx Logs and Audit Log tabs in PCC eRx.
Click “Save” to register the new settings. Users’ eRx permissions automatically update within a minute of saving. The users do not have to log out for their new account settings to take effect.
Enable Electronic Change Requests Per Provider
You can allow pharmacies to send you electronic requests to change a prescription to another brand, medication, or dose form. When enabled, electronic change requests appear on the Rx Queue in PCC EHR.
If there are prescribers at your practice who wish to incorporate electronic change requests into their workflow, your office administrator can enable the service for them in the User Administration tool in PCC EHR.
Edit the user whose settings you want to change, then click on the “PCC eRx” tab.
On the PCC eRx tab, check the box for “Electronic Change Request Service”. This allows the user to receive medication change requests from pharmacies on the Rx Queue.
Click “Save” to save the new settings.
If you wish to disable change requests for the user, open their PCC eRx settings in User Administration and uncheck the box for “Electronic Change Request Service”.
For Providers Only: You can only enable the electronic change request service for users with the Mid-Level Provider or Provider role in PCC eRx.
Plan Your Workflow Before Enabling Change Requests: Electronic change requests can be incorporated into your office workflow in several different ways. You can explore different workflow options with your PCC Client Advocate.
Review and Update the Roles of Users Who Will Be Expected to Respond to Electronic Change Requests on the Rx Queue
Users must have the Provider Agent, Mid-Level Provider, or Provider role in PCC eRx in order to be able to respond to electronic change requests from pharmacies on the Rx Queue.
You can review and update the PCC eRx role of users who will be expected to respond to electronic change requests in the User Administration tool in PCC EHR.
Update Your Filters on the Rx Queue to Show Change Requests and ePrescribing Errors
PCC 9.0 introduces two new types of tasks that display on the Rx Queue: change requests and prescription errors. Users should update their filters on the Rx Queue in order to display these new task types.
On the Rx Queue, open the Task filter and check the boxes next to “Prescription Errors” and “Change Requests”.
Click “Save My Defaults” to save these new settings as your default for the Rx Queue.
You can change your default settings on the Rx Queue any time; just update your filters and click “Save My Defaults”.
The 'All Types' Filter Automatically Displays Errors and Change Requests: If your default on the Rx Queue is to display “All Types” of tasks, you will automatically be able to see change requests and prescription errors after your office updates to PCC 9.0.
Set Vacation Hours and Office Hours in PCC eRx for Security and Reporting Purposes
In PCC 9.0, you can configure office hours and vacation hours in PCC eRx so that it’s easier to see in reports when prescribing occurs outside of expected times.
The office and vacation hours you set in PCC eRx do not affect provider hours templates and appointment scheduling in PCC EHR.
Configure Vacation Hours
If you are a prescriber, you can set vacation hours in PCC eRx as a security measure. Prescription activity that occurs through your account during your vacation hours will stand out on PCC eRx reports.
From the Rx Queue or the PCC eRx tab in a patient’s chart, click “My Settings”.
Under Vacation Hours, use the calendar icon to set a start date and time and an end date and time for your vacation. The time is expressed in 24-hour notation.
Click “Save”. The vacation hours will remain in your settings until you manually alter or clear them.
Configure Office Hours
Users who have Administrator permissions in PCC eRx can set up office hours in order to make it easier to report on prescription activity that occurs at unexpected times.
In PCC eRx, click on the “Administration” tab, then click “Application Administration”.
Within Application Administration, click “General Settings”.
Set an end time and start time for what you would consider to be your practice’s overall office hours. Then, click “Update Value” beside each field to save your changes.
Use 24-Hour Notation: Use 24-hour notation (also known as military time) to set up your office hours in PCC eRx. For example, if you generally close by 8 p.m., set your end time to “20:00”.
The office hours you set up in PCC eRx will apply to all of your practice locations for every day of the week and will only be used on PCC eRx reports to help you differentiate between prescription activity that occurs during those hours and that which occurs outside of them.
PCC eRx Office Hours Do Not Affect the Appointment Schedule in PCC EHR: Provider hours and the appointment schedule in PCC EHR are not affected by the office hours you configure in PCC eRx.
Not All Pharmacies Can Accept Prescriptions With More Than 140 Characters Before September 1, 2021
All vendors who participate with Surescripts are required to update to a new standard for data exchange by September 1, 2021. Surescripts is the entity that facilitates prescription information exchange between pharmacies and other vendors, including those like PCC which provide e-prescribing software.
Because not all vendors are implementing the new standard at exactly the same time leading up to the September 1, 2021 deadline, prescribers in PCC 9.0 might encounter an error during the month of August 2021 indicating that their intended destination pharmacy cannot yet receive a prescription as written.
This error almost always occurs because the prescription written in PCC 9.0 exceeds 140 characters, which is the maximum that pharmacies can accept if they have not yet updated their data exchange infrastructure to the new Surescripts standard.
The prescriber should edit the prescription to be 140 characters or less and try again to send it to the pharmacy.
If the error occurs again, get in touch with PCC Support for assistance.
After September 1, 2021, all pharmacies should be able to accept prescriptions containing up to 1000 characters.
The Rx Queue History, Rx Audit, and Audit Log Reports No Longer Show Data Prior to PCC 9.0
The Rx Queue History, Rx Audit, and Audit Log reports in PCC eRx, along with many of the new features in PCC 9.0, use a more current standard for prescription information exchange. As a result, these reports will only give access to data as far back as the date you went live with PCC 9.0.
If you need access to older data, you can find historic information in patients’ medication, retail, and prescription histories, or run reports in the PCC EHR Report Library. If you cannot find the historic information you seek in one of these other places, contact PCC Support.
Update Your MacOS 10.12 or 10.13 Workstations and Your Windows 7 PCs
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. If your practice is still using workstations that run Windows 7 or MacOS 10.12, that support has already ended and you should upgrade those machines.
Apple is expected to end support for 10.13 in 2021. PCC EHR includes a reminder to users when they log in on workstations running older operating systems. The reminder encourages them to review and update their operating system. Contact PCC Support for recommendations.
PCC EHR requires a workstation running on Windows 8 or higher, or MacOS 10.14 or higher. For more information, read Hardware Guide: Your Personal Computer and Equipment.
Configure Incoming CHADIS Questionnaire Results
When your patients, parents, and other users complete a CHADIS questionnaire, the results are automatically returned to PCC EHR, so you can review results quickly, without logging in to CHADIS at all.
To configure results, and ensure that incoming results are matched to the correct visit type, begin by linking questionnaires to orders through the Protocol tool in PCC EHR’s Configuration menu.
Open Protocol Configuration
In Protocol Configuration, select Component Builder, and open the Screening Orders component.
Any of these orders can be associated with a CHADIS questionnaire.
Open Questionnaires
Click “Add a Questionnaire” to open the full list of CHADIS questionnaires.
Select Questionnaire
Select one or more questionnaires to link it to the screening order selected above. You can use the search box in the upper right corner of the window to narrow the list of questionnaires and find exactly the questionnaire you need.
Each Questionnaire Can be Assigned Once: Each order can have multiple questionnaires assigned to it, but each questionnaire can only be associated with a single order. If a questionnaire is gray and cannot be selected, that questionnaire is already assigned to an order.
Some things to consider as you’re adding questionnaires to orders:
- The simplest configuration is to add one order per questionnaire. For example, if you use CHADIS questionnaire #947, ADHD Developmental Intake Form, then create an order called “ADHD Developmental Intake Questionnaire” and assign the questionnaire to it.
- For questionnaires that have different versions sorted by age, consider assigning all ages to a single order. Assigning all ages to one screening order, means you only need to configure billing for one order, rather than a separate order for each age.
- Some questionnaires have different versions based on the respondent. For example, the Pediatric Symptom Checklist questionnaires include versions for both the parent and patient. Assigning both to the same order will group the results together in the visit, making it easier to compare the two without and closing two separate orders.
- Consider the workflow for incoming results. If results require creating a task, such as manually updating medical history, assign those medical history questionnaires to a single order, and then assign one task from that order.
Decide If a Signature is Required
If a signature should be required on the results when they arrive, check the signature required box. Any questionnaire that requires a signature will appear on the signing queue when the result arrives.
Tasks are automatically assigned a due date the same day as the visit, so that tasks won’t appear on the task list before the patient arrives.
When a provider opens the visit, the results are available to review. New tasks can then be assigned and results entered.
Clicking “Details” opens the CHADIS results. If an order includes results from multiple respondents, each respondent’s results will have their own tab.
If a CHADIS result arrives that has not been assigned to a patient or portal user, results will appear unassigned in the messaging queue.
Unassigned results are similar to documents or lab results. Select them, search for the patient and assign them to a visit. Once results are assigned the patient and visit, they can be reviewed, signed and marked complete.
PCC 8.16 Release
In the second quarter of 2021, PCC will release version 8.16 of our electronic charting and practice management software to all PCC users.
PCC 8.16 completes the first set of CHADIS integration features in PCC EHR. If your practice uses CHADIS, you can now automatically send patients and families questionnaires through the patient portal and receive results right inside your orders on the chart note. Additionally, appointment notes are now available on the PCC EHR schedule screen, and PCC 8.16 includes many other features and improvements.
Watch a CHADIS Video: Want to learn about PCC’s CHADIS integration updates in PCC 8.16? Watch the Configure CHADIS in PCC EHR.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Review CHADIS Questionnaire Results in the Patient’s Chart
Results for CHADIS screenings can now appear automatically in a visit’s chart note.
When your patients, families, and other users complete CHADIS questionnaires, those results are sent to PCC EHR. You can review CHADIS results directly on the chart note without logging in to CHADIS.
First, your practice adds CHADIS questionnaires to screening orders in the PCC EHR Protocol Configuration tool.
When new results arrive, they’ll be matched to the screening order in the patient’s visit.
Your practice can use tasks and task tracking, like the orange ball on the Schedule screen, to make sure every result is reviewed. A task will be automatically scheduled for the visit date. You can review results and enter notes even before the patient has arrived.
Read the Full Article: For an in-depth walk-through of setting up and managing CHADIS results, review the Configure CHADIS Results article.
View Appointment Notes on Your PCC EHR Schedule
As you review today’s schedule, you can quickly review appointment notes for each encounter.
If an appointment has an appointment note, you will see a triangle in the Visit Reason column.
Click anywhere on the visit reason to show the note.
Visit Type Color Code: If your practice defines visit types by color, then the appointment note triangle will also display the color of the visit type. That means anyone at your practice can quickly see which appointments are sick, well, or consults, for example. You can configure Visit Types in the Visit Reasons Editor.
Add a Custom Summary to Direct Secure Messages
In PCC 8.16, you can add your own summary to a Direct Secure Message and reference it later from the patient’s Visit History.
Start by linking a Direct Secure Message to a patient. You can learn how to do that in the article Receive a Direct Secure Message and Add It to a Patient’s Chart.
Once the message has been linked to a patient, write a brief description of its contents in the “Summary” field at the top of the window.
After you save and exit, the message appears in the patient’s Visit History with your custom summary.
If you choose not to write a summary, the message’s original subject will appear in the patient’s Visit History. You can revise a custom summary at any time by editing the Direct Secure Message.
Request Attachments in Portal Message Templates
Receive multiple documents directly from your patients and families through your Patient Portal Message system.
When you create a new Secure Messaging Template through PCC EHR’s Patient Portal Configuration window, you have the option to add a new component that includes an “Attach a Photo or PDF” button, so that you can make a specific request and the recipient can include the attachment in line with the message.
Open Patient Portal Configuration from PCC EHR’s Configuration menu and click the Message Templates tab. When editing or adding a new message, you’ll find a new “Attachment” component in the Build Template menu.
Add as many Attachment components as you’d like, alongside any other components.
For each attachment component, you can select a document category for the requested document.
When your patient or family sends a message to you, they’ll have the opportunity to attach their PDF or photos in line with their message.
You’ll find those attachments in PCC EHR’s Messaging queue, as usual. The list of files will appear below the message text, in the same order as the components were uploaded.
Look Up and Import Immunization Records from Your State’s Registry
Practices in California, Wyoming, Indiana, and Florida are now eligible to sign up for bidirectional connections with their state immunization registries.
With a bidirectional connection, you can look up and import vaccine records from your local immunization registry within your patient’s chart in PCC EHR.
To read about how it works, check out Look Up and Import Patient Immunization Records from Your Local Registry.
Contact PCC Support to get started, or to let us know that you’re interested in establishing a bidirectional connection with your registry once it’s available in your region.
Securely Retrieve Patient Information from Hospitals and Other Practices
Pilot testers can request and securely retrieve their patients’ records from other healthcare organizations on demand within PCC EHR. This is the latest addition to PCC’s Clinical Document Exchange functionality.
Read all about how to retrieve clinical documents on demand from other healthcare providers in the article Securely Retrieve Patient Information from Hospitals and Other Practices.
Use the Latest SNOMED-CT Descriptions
During the PCC 8.16 release cycle, PCC updated your practice’s system with the latest SNOMED-CT code set. You can read about the changes in PCC’s April 2021 SNOMED-CT Update article.
Continue to View Productivity Data in Your Practice Vitals Dashboard
PCC 8.16 removes the red COVID-19 banner from the front page of the Practice Vitals Dashboard. You can continue to view your practice’s daily productivity data and trends on the Dashboard’s COVID-19 page.
New and Updated Reports in PCC 8.16
With each release, PCC improves upon the reports you can generate in PCC EHR. Here are the reporting updates for PCC 8.16:
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Better Time Format When You Export Appointment Reports to CSV: When you export an appointment report to comma-separated value format (CSV), the appointment time column is now formatted for easy import into your favorite spreadsheet program.
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Optionally Add Appointment IDs to Your Appointment Reports: Sometimes you need to include an appointment’s unique ID number on a report, especially when sending appointment lists to a third-party appointment notification vendor. In PCC 8.16, you can add a column for unique appointment ID to your appointment reports.
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Find Documents that Need to be Signed: Run the Document Modification report to find documents that have been (or need to be) signed. Use the “Signature Requested” field to find documents where no signature was requested, or where a signature was requested from a particular provider. And use the new “Signed By” field to see who signed a particular document.
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See When Patients Were Added to PCC EHR: In PCC 8.16, the Patient List, Broadcast Messaging Patient List, Preventive Care Recall, Patients Overdue for Weight Management, and Chronic Condition Recall stock reports in the PCC EHR Report Library allow you to see when patients were added to PCC EHR. You can filter these reports and their custom versions by the date that patients were added to PCC EHR, or simply add a column to the output that shows you when patients on the list were added to your system.
New and Updated Interfaces Available in PCC 8.16
With each release, PCC expands and updates direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 8.16:
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New and Updated Immunization Interfaces: During the PCC 8.16 release cycle, PCC updated our immunization registry submission interface with ShowMeVax (Missouri), and added the ability to request patient immunization records from WyIR (Wyoming), CHIRP (Indiana), and Florida SHOTS state immunization registries.
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New Insurance Eligibility and Financial Interfaces: During the PCC 8.16 release cycle, PCC enabled real time insurance eligibility-checking for Maryland Physicians Care (payer ID 76498).
If your practice would like to take advantage of these connections, or you have another interface need, contact PCC Support.
Updates to Immunization Forecasting
Shortly after your office updates to PCC 8.16, you will receive a behind-the-scenes update to the immunization forecaster. These are the immunization forecasting updates for PCC 8.16:
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No Waiting Period After COVID-19 Vaccine: The immunization forecaster will now allow for co-administration of other vaccines with the COVID-19 vaccine without a 14-day waiting period.
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Forecasting Added for COVID-19 Vaccine: Administrations of the Johnson & Johnson (CVX 212), AstraZeneca (CVX 210), or Novavax (CVX 211) COVID-19 vaccine will now be reported in the immunization forecaster. Additionally, a COVID vaccine will now be recommended for patients 12 years and older.
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Forecasting Added for Ebola Vaccine: Patients who receive a vaccine in the ebola family, including the Ebola Zaire vaccine (CVX 204) or an unspecified ebola vaccine (CVX 214), will present as up-to-date for ebola vaccination in the immunization forecaster.
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Forecasting Added for MenQuadfi: Administrations of the MenQuadfi meningococcal polysaccharide (groups A, C, Y, W-135) TT conjugate vaccine (CVX 203) will now be reported in the immunization forecaster, and will trigger a forecast for the next dose based on the patient’s age and place in the series.
PCC updates the immunization forecaster throughout the release cycle. If you have questions or encounter issues with your immunization forecasting, contact PCC Support.
Other Feature Improvements and Bug Fixes in PCC 8.16
In addition to the features described above, PCC 8.16 includes these smaller improvements and squashed bugs.
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COVID-19 Vaccine VIS Entry Updates: During the PCC 8.16 release cycle, multiple updates occurred for the VIS listings for COVID-19 vaccines. These updates did not always follow the normal standards, and in fact re-used identification numbers. These issues were corrected by the CDC in May, so PCC patched all client systems with the May VIS update for COVID-19 vaccines.
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Puerto Rico: You can now select Puerto Rico, with the abbreviation PR, as a state in demographics in PCC EHR.
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Handling of Relinked $0 Payments: In rare cases, when a payment was posted during check-in and then relinked to multiple charges in the Correct Mistakes (
oops
) program with part of the payment being $0, payments could fail to apply properly. This will no longer occur. -
Care Center Assignment Improvements: Under certain circumstances, removing a patient’s care center assignment while also adjusting other status flags could result in the patient remaining in the care center. Additionally, new patients assigned care centers sometimes did not receive the corresponding status flag. PCC fixed these issues in PCC 8.16.
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Phone Notes on Messaging Queue: For practices who use care centers, sometimes a phone note for a patient with no care center assigned would not appear properly on the Messaging queue. PCC patched this on all practice systems that use care centers in May of 2021.
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TOS Adjustments with Copays: When a user posted a charge that would be written off by a capitation adjustment that also had a copay, an overpayment could sometimes result, which could then be recorded as a negative payment. PCC corrected this in PCC 8.16.
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Insurance Address Issues: Under rare circumstances, when editing the address for an insurance plan, the table interface could freeze. PCC 8.16 corrects this issue.
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Dashboard Corrections: During the PCC 8.16 release cycle, PCC corrected a calculation for patients who are overdue for a well visit, as well as an issue which could result in a 0% score for seasonal flu vaccine rates.
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Patient Portal Messages in pocketPCC: Patient Portal messages in pocketPCC are now clearer and easier to read.
Mark an Appointment As Missed or Canceled
When a patient doesn’t show up for a visit or your practice needs to cancel an appointment, you can change the appointment’s status in PCC EHR and report on it later.
These Instructions Are for Practices Using the Appointment Book: If your practice does not use the Appointment Book, you can mark appointments as missed or canceled in Practice Management instead.
Mark an Appointment as Missed or Canceled in the Patient’s Chart
You can mark an appointment as missed or canceled in the Appointment History component within a patient’s chart.
Open the Patient’s Chart
Use the search box in the top left corner of the PCC EHR window to search for the patient whose appointment you need to mark as missed or canceled.
Select the patient from the search results to open their chart.
Find the Appointment History Component
Find the Appointment History component within the patient’s chart. Usually it appears in the patient’s Medical Summary.
Where is the Appointment History Component?: The Appointment History component can be configured to appear in patient charts and other places in PCC EHR. If you can’t find the Appointment History component, speak to an administrator at your practice and ask to have it added, or contact PCC Support for help.
Find the Appointment and Mark It Missed or Canceled
Within the Appointment History component, find and select the appointment you want to mark as missed or canceled.
Click the “Remove” button, then choose a reason for removing the appointment.
Optionally leave a note, then click the “Remove” button to finish marking the appointment as missed or canceled.
Missed and canceled appointments do not appear on the schedule screen in PCC EHR, and also get removed from the Appointment Book.
You can report on missed and canceled appointments in the PCC EHR Report Library.
Mark an Appointment as Missed or Canceled in the Appointment Book
It’s easy to mark appointments as missed or canceled when working in the Appointment Book.
Open the Appointment Book
Find the calendar icon in the bottom left corner of your PCC EHR window and click it to open the Appointment Book.
You can also open an Appointment Book window from the File menu in PCC EHR.
Go to the Day of the Appointment
Once in the Appointment Book, go to the day of the appointment that was missed or needs to be canceled.
You can advance the calendar view one week or day at a time by using the arrows at the top of the Appointment Book window.
You can also click on the calendar icon at the top of the Appointment Book and use it to select the day you want to view.
Find the Appointment in the Schedule
Once on the right day in the Appointment Book, locate the appointment you need to mark as missed or canceled.
Depending on how you are viewing the schedule, you might need to scroll up and down or from side to side in order to find the appointment.
Select the Appointment and Mark it Missed or Canceled
Click on the appointment with your mouse.
Once selected, details about the appointment appear on the left edge of the Appointment Book window, along with buttons which allow you to take actions.
Click the “Remove” button, then choose a reason for removing the appointment and optionally leave a note.
Click the “Remove” button to finish marking the appointment as missed or canceled.
Missed and canceled appointments do not appear on the schedule screen in PCC EHR, and also get removed from the Appointment Book.
You can report on missed and canceled appointments in the PCC EHR Report Library, or look up any patient’s missed and canceled appointments in the Appointment History component in their chart.
Report on Missed and Canceled Appointments
You can generate lists of missed and canceled appointments in the PCC EHR Report Library, then use them to post missed appointment fees or to identify patterns of cancellation at your practice.
Build a Custom Report for Missed and Canceled Appointments
There is no default report in the PCC EHR Report Library to help you find missed and canceled appointments, but you can create one of your own.
Open the Report Library
Open the Report Library from the Reports menu in PCC EHR.
Open the Appointments Report
Once in the Report Library, select the “Appointment” category, then open the “Appointments” report.
Customize the Appointments Report
In the Appointments report, click the “Customize” button at the bottom right of the window to begin setting up a custom report for missed and canceled appointments.
Set Up the Report to Find All Missed and/or Canceled Appointments
Set up a basic report that will allow you to find all missed and canceled appointments.
First, the report a unique title, description, and category so that you can find it again later.
Click the “Edit” button in the “Select Columns to Include” section, then select the columns you want to see on the final report. At a minimum, you should make sure to include the “Last Scheduling Action” column.
Once you have picked and saved the columns for your report, click the “Select Criteria” button and choose the report criteria. At a minimum, your report should include the “Appointment Date” and “Last Scheduling Action” criteria.
Once you select the criteria, set up their default values. These settings will be used as a default whenever you generate this report.
These criteria will allow you to find all missed and/or canceled appointments within a selected date range.
Add More Criteria for More Granular Reporting: You can include additional criteria in your report if you want to be able to filter the results in a more granular fashion. For example, if you want to be able to generate a list of all missed or canceled appointments for a particular provider, visit reason, or location, select those criteria from the list now to add them to your report settings.
Preview Your Custom Report and Adjust the Output
After setting up criteria for your custom report, click the “Preview” button to see how the report will look once generated.
In the preview screen, open the “Columns” drop-down list and select whichever columns you want to display on your report by default. Be sure to include the column called “Last Scheduling Action”.
If you want to make other changes to the way your report looks when you generate it, do that now. You can click, drag, and drop columns to rearrange them, group your results, or re-sort the list by clicking on column headers.
The display settings you choose now will be the default for this report.
Save Your Custom Report
Click “Save As” to save your custom report.
Generate Your Custom Missed and Canceled Appointment Report
Once you create a custom report for missed and canceled appointments, you can generate it at any time in the Report Library in PCC EHR.
Find Your Custom Missed and Canceled Appointments Report in the Report Library
In the Report Library in PCC EHR, find your custom report for missed and canceled appointments.
If you don’t know which specific category the report is in, you can find it under “All Reports”.
Generate the Report and Review the Results
In the report criteria screen, pick a date range of appointments to report on, then click the “Generate” button.
There might be a pause while the results generate. Once the results appear on the screen, check that the list contains the information you need.
You can sort on a certain column, reorder the columns, or group the results to suit your purpose.
If you need to change the report settings, click the “Back” button, make adjustments to the criteria, then re-generate the report.
Optionally Export the Results and Save Them to Your Workstation
Once you are happy with the way your report results are organized on the screen, you can export the list from PCC EHR and save it on your local workstation.
Click the “Export” button, then choose an output format.
Click the “Save” button, then choose where to save the report file on your local workstation.
Optionally Print the Results
If you need to be able to scribble on the report and make notes in pencil or pen, you can print the list out of PCC EHR.
Click the “Print” button, then choose a printer.
Click the “Print” button to finish sending the report to your printer.
Optionally Schedule the Report to Run Again at a Later Date
If you like your report and plan to use it routinely, you can schedule it to run automatically at set intervals.
Click the “Schedule” button at the bottom of the report results window, then choose a name, the frequency with which you want to run the report, and the time of day at which you want it to generate.
Click “Schedule” to finish scheduling the report to run at regular intervals. You can find the results of scheduled reports in the “Saved Results” tab of the Report Library.
April 2021 SNOMED-CT Update
On April 11, 2021, PCC updated the SNOMED-CT diagnostic terms on your practice’s PCC system to the latest code set.
PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure codes.)
Read below to learn about changes to preferred terms that may affect searching, new allergies, common diagnosis descriptions that were removed from SNOMED-CT, and new additions to your practice’s quick search Favorites.
Changes to the Preferred Term for Common Descriptions
The April 2021 SNOMED-CT update changes some terms that are used at pediatric practices. Clinicians may need to type a different search word to find these descriptions than what they used before. For example, the spelling of “weal” has been changed to “wheal”, and “Adverse reaction to vaccine product” is now “Vaccine adverse reaction”.
Here is a table of common SNOMED-CT diagnosis descriptions that have new preferred terms. PCC identifies these as possibly requiring a different search term, or just being useful to know for awareness.
New Preferred Term | Old Preferred Term |
Bilateral infantile esotropia of eyes | Bilateral congenital esotropia of eyes |
Bullous wheal | Bullous weal |
Childhood granulomatous periorificial dermatitis | Facial Afro-Caribbean childhood eruption |
Chronic irritant contact dermatitis of hands | Cumulative irritant contact dermatitis of hands |
Contact dermatitis caused by chlorinated hydrocarbon | Contact dermatitis due to chlorocompound |
Contact dermatitis caused by feces | Feces-induced contact dermatitis |
Contact dermatitis caused by fiberglass | Fiberglass dermatitis |
Contact dermatitis caused by poison primrose | Contact dermatitis due to primrose |
Contact dermatitis caused by ragweed | Contact dermatitis due to ragweed |
Contact dermatitis caused by saliva | Saliva-induced contact dermatitis |
Contact dermatitis caused by urine | Urine induced contact dermatitis |
Contact dermatitis of hand | Contact hand eczema |
Decreased body mass index | Body mass index below normal parameters |
Dermatosis in childhood | Dermatosis in a child |
Erythema multiforme due to viral disease | Erythema multiforme caused by virus |
Exanthem due to varicella | Exanthem due to chicken pox |
Fetal disorder due to disease in mother | Fetal damage from disease in the mother |
Increased body mass index | Body mass index above normal parameters |
Infantile esotropia | Congenital esotropia |
Infantile esotropia of left eye | Congenital esotropia of left eye |
Infantile esotropia of right eye | Congenital esotropia of right eye |
Infection caused by Paragonimus westermani | Infection by Paragonimus westermanii |
Irritant contact dermatitis caused by ring | Ring dermatitis |
Irritant contact dermatitis due to lip-licking | Lip-licking eczema |
Irritant contact dermatitis of hand | Irritant contact hand eczema |
Mass of head and/or neck | Mass in head or neck |
Normal body mass index | Body mass index within normal parameters |
Pervasive developmental disorder with disorder of intellectual development and absence of functional language with loss of previously acquired skills | Pervasive developmental disorder with disorder of intellectual development and abscence of functional language with loss of previously acquired skills |
Psoriasis of scalp | Scalp psoriasis |
Psoriasis with eczema | Psoriasis-eczema overlap condition |
Swelling of ear | Swelling of ear structure |
Vaccine adverse reaction | Adverse reaction to vaccine product |
Wheal | Weal |
New Allergies of Interest to Pediatrics
The April 2021 SNOMED-CT update adds 14 allergies which may be of interest to pediatric clinicians.
Acute allergic otitis media of left middle ear |
Acute allergic otitis media of right middle ear |
Allergic contact dermatitis caused by grease |
Allergic contact dermatitis caused by oil |
Allergic contact dermatitis caused by poison primrose |
Allergic contact dermatitis caused by ragweed |
Allergic contact dermatitis caused by soap |
Allergic contact dermatitis caused by urushiol from Eastern poison ivy |
Allergic contact dermatitis caused by urushiol from poison sumac |
Allergic contact dermatitis due to jewelry |
Allergic reaction caused by Hevea brasiliensis latex protein |
Allergy to hair dye |
Bilateral acute allergic otitis media of middle ears |
Bilateral chronic allergic otitis media of middle ears |
Deprecated SNOMED Diagnosis Descriptions
The April 2021 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.
Here are the top codes used by PCC’s pediatric practices that were removed from the international SNOMED-CT diagnosis library in 2021. When practices had these codes available for one-click selection on a chart note protocol, PCC added a replacement. For other diagnoses, your providers can find related descriptions with a search, but you may want to plan ahead.
Allergy to dairy food | 425525006 |
Allergy to latex | 300916003 |
Blood in feces symptom | 249624003 |
C/O – cough | 272039006 |
C/O – low back pain | 161894002 |
C/O – postnasal drip | 162382001 |
C/O nasal congestion | 272034001 |
C/O: a rash | 162415008 |
Fetal or neonatal effect of maternal problem unrelated to pregnancy | 206001006 |
Knee pain | 30989003 |
O/E – erythematous rash | 135888007 |
O/E – expiratory wheeze | 162894004 |
O/E – general eye examination | 162806009 |
O/E – intoeing | 275864001 |
O/E – itchy rash | 304386008 |
O/E – pyrexia of unknown origin | 164288004 |
O/E – rash present | 268911002 |
O/E – rhinorrhea | 164184005 |
O/E – speech delay | 391099000 |
O/E-herpes labialis-cold sore | 163139004 |
Tick bite without infection | 443930005 |
Unilateral earache | 162358006 |
Unilateral undescended testis | 268227001 |
New Favorites Available in Diagnosis Quick Search
The SNOMED-CT update adds 1710 diagnosis descriptions to your system.
In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 314 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses, which include the COVID-19 diagnosis, to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.
What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.
Acquired cryptorchidism | Acquired cryptorchidism of left testis | Acquired cryptorchidism of right testis | Acquired structural abnormality of pharyngotympanic tube following procedure |
Acute allergic otitis media of left middle ear | Acute allergic otitis media of right middle ear | Acute COVID-19 | Acute mucoid otitis media of left middle ear |
Adverse reaction to amoxicillin and/or clavulanic acid | Adverse reaction to ampicillin and/or floxacillin | Adverse reaction to COVID-19 antigen vaccine | Adverse reaction to COVID-19 mRNA vaccine |
Adverse reaction to COVID-19 vaccine | Adverse reaction to sulfamethoxazole and/or trimethoprim | Allergic contact dermatitis caused by grease | Allergic contact dermatitis caused by oil |
Allergic contact dermatitis caused by poison primrose | Allergic contact dermatitis caused by ragweed | Allergic contact dermatitis caused by soap | Allergic contact dermatitis caused by urushiol from Eastern poison ivy |
Allergic contact dermatitis caused by urushiol from poison sumac | Allergic contact dermatitis due to jewelry | Allergy to hair dye | At increased risk of forced marriage |
At increased risk of human trafficking | At increased risk of institutional abuse | At risk for medication error | Bilateral acute allergic otitis media of middle ears |
Bilateral adhesive otitis media of middle ears | Bilateral cracked nipples | Bilateral distortion of visual image of eyes | Bilateral mucoid otitis media of middle ears |
Bilateral swelling of ears | Bilateral swelling of wrist joints | Bilateral synovitis of joint of knees | Bilateral talipes calcaneovarus |
Bilateral talipes equinovarus | Bilateral testicular agenesis | Blount disease | Body piercing |
Breakthrough pain | Bronchial irritation | Bulimia nervosa in full remission | Bulimia nervosa in partial remission |
Bursitis of left wrist | Bursitis of right wrist | Carbuncle of left axilla | Carbuncle of left lower limb |
Carbuncle of left thigh | Carbuncle of right axilla | Carbuncle of right lower limb | Carbuncle of right thigh |
Carrier of Staphylococcus epidermidis | Chronic papillomatous dermatitis due to contact with urine and/or feces | Chronic perichondritis of left external ear | Chronic perichondritis of right external ear |
Chronic post-COVID-19 syndrome | Chronic rhinosinusitis | Chronic tubotympanic suppurative otitis media of left middle ear | Chronic tubotympanic suppurative otitis media of right middle ear |
Cleft of left hard palate | Cleft of right hard palate | Complete cleft of left hard and soft palate | Complete cleft of right hard and soft palate |
Conductive hearing loss of left ear | Conductive hearing loss of left ear with normal hearing on right side | Conductive hearing loss of right ear | Conductive hearing loss of right ear with normal hearing on left side |
Congenital clinodactyly of finger | Congenital clinodactyly of little finger | Congenital dislocation of bilateral elbows | Congenital dislocation of joint |
Congenital short ear | Congenital stenosis of male external urethral orifice | Congenital subluxation of left hip joint | Congenital subluxation of right hip joint |
Congenital torsion of left ovary | Congenital torsion of right ovary | Contusion of head and/or neck | Dermatitis due to cat mite infestation |
Dermatitis due to chicken mite infestation | Dermatitis due to dog mite infestation | Dermatitis due to exposure to man-made ultraviolet light | Dermatitis due to mouse mite infestation |
Dermatitis due to northern fowl mite infestation | Dermatitis due to rabbit mite infestation | Dermatitis due to rat mite infestation | Developmental dysplasia of left hip |
Developmental dysplasia of right hip | Distortion of visual image of left eye | Distortion of visual image of right eye | Does participate in outdoor sporting activities |
Domestic abuse victim in household | Enlargement of left tonsil | Enlargement of right tonsil | Epidermal burn of left upper arm |
Epidermal burn of right upper arm | Epidermal nevus of left lower eyelid | Epidermal nevus of left upper eyelid | Epidermal nevus of right lower eyelid |
Epidermal nevus of right upper eyelid | Excessive intake of ascorbic acid | Excessive intake of calcium | Excessive intake of energy |
Excessive intake of iron | Excessive intake of niacin | Excessive intake of phosphorus | Excessive intake of plant fiber |
Excessive intake of potassium | Excessive intake of protein and protein derivative | Excessive intake of riboflavin | Excessive intake of thiamine |
Excessive intake of zinc | Female genital Trichomonas vaginalis infection | Fissure of left nipple during lactation | Fissure of right nipple during lactation |
Food security | Fracture of knee | Frequent attender of emergency room | Furuncle of left ankle |
Furuncle of left forearm | Furuncle of left hand | Furuncle of left hip | Furuncle of right ankle |
Furuncle of right forearm | Furuncle of right hand | Furuncle of right hip | Headache after cough |
Hemiparesis of left side of face | Hemiparesis of right side of face | Hyperactive labyrinthine dysfunction of left inner ear | Hyperactive labyrinthine dysfunction of right inner ear |
Hypersensitivity to SARS-CoV-2 mRNA vaccine | Immunization series incomplete | Inadequate intake of ascorbic acid | Inadequate intake of calcium |
Inadequate intake of energy | Inadequate intake of fat and oil | Inadequate intake of iron | Inadequate intake of niacin |
Inadequate intake of plant fiber | Inadequate intake of potassium | Inadequate intake of protein and protein derivative | Inadequate intake of riboflavin |
Inadequate intake of thiamine | Inadequate intake of zinc | Indirect left inguinal hernia | Indirect right inguinal hernia |
Infection of left nipple during lactation | Infection of right nipple during lactation | Injury of head and/or neck | Injury of muscle and tendon of lower leg |
Injury of muscle of lower leg | Injury of shoulder and/or upper arm | Injury of tendon of lower leg | Injury of wrist and/or hand |
Irritant contact dermatitis caused by chlorine in swimming pool | Irritant contact dermatitis caused by feces | Irritant contact dermatitis caused by grease | Irritant contact dermatitis caused by oil |
Irritant contact dermatitis caused by saliva | Irritant contact dermatitis caused by urine | Irritant contact dermatitis due to concrete | Irritant contact dermatitis due to jewelry |
Irritant contact dermatitis due to stoma | Irritant contact dermatitis of hand caused by grease | Irritant contact dermatitis of hand caused by oil | Irritant contact dermatitis of hand due to concrete |
Itching of both hands | Lack of support for smoking cessation | Lesion of nasal cavity | Localized swelling of toe of left foot |
Localized swelling of toe of right foot | Marfan syndrome type 1 | Mass of left axillary region | Mass of right axillary region |
Middle ear effusion | Multisystem inflammatory syndrome in children | Neonatal conjunctivitis of left eye | Neonatal conjunctivitis of right eye |
Neonatal disorder due to abnormal maternal blood chemistry | Neonatal disorder due to and following amniocentesis | Neonatal disorder due to and following fetal blood sampling | Neonatal disorder due to and following operative procedure on fetus |
Neonatal disorder due to and following operative procedure on mother | Neonatal disorder due to and following sampling of chorionic villus | Neonatal disorder due to chronic maternal cardiovascular disease | Neonatal disorder due to chronic maternal respiratory disease |
Neonatal disorder due to disease in mother | Neonatal disorder due to maternal disorder of urinary tract | Neonatal disorder due to maternal gestational edema and proteinuria without hypertension | Neonatal disorder due to maternal hypertension |
Neonatal disorder due to maternal nutritional disorder | Neonatal disorder due to maternal obesity | Neonatal disorder due to maternal obesity with adult body mass index 30 or greater but less than 40 | Neonatal disorder due to maternal obesity with adult body mass index equal to or greater than 40 |
Neonatal disorder due to maternal overweight | Neonatal disorder due to maternal periodontal disease | Neonatal disorder due to maternal renal disease | Neonatal disorder due to maternal respiratory disease |
Neonatal disorder due to maternal traumatic injury | Neonatal spontaneous cerebellar hemorrhage | Neonatal vitamin B12 deficiency due to maternal vitamin B12 deficiency | Neural hearing loss of left ear |
Neural hearing loss of right ear | No cells seen in urine via microscopy | Nondependent abuse of tobacco | Nonvenomous insect bite of gum |
Nonvenomous insect bite of nose | Nonvenomous insect bite of scrotum | Not entitled to social services assistance due to income above limit | Onychia of finger of left hand |
Onychia of finger of right hand | Onychia of left thumb | Onychia of right thumb | Otalgia of left ear |
Otalgia of right ear | Pain in left abdominal lumbar region | Pain in left lumbar region of back | Pain in right abdominal lumbar region |
Pain in right lumbar region of back | Pain of joint of knee | Pain of knee region | Pain of left breast |
Pain of right breast | Performs social distancing | Premature baby less than 26 weeks | Rhinoconjunctivitis |
Steroid-modified tinea infection of foot | Steroid-modified tinea infection of lower limb | Strain of muscle and tendon of lower leg | Strain of muscle of lower leg |
Strain of tendon of lower leg | Superficial contusion of skin of thigh | Superficial foreign body in abdominal wall | Superficial foreign body in anus |
Superficial foreign body in axilla | Superficial foreign body in back | Superficial foreign body in breast | Superficial foreign body in buttock |
Superficial foreign body in cheek | Superficial foreign body in chest wall | Superficial foreign body in ear | Superficial foreign body in face |
Superficial foreign body in flank | Superficial foreign body in groin | Superficial foreign body in gum | Superficial foreign body in hand |
Superficial foreign body in interscapular region | Superficial foreign body in lip | Superficial foreign body in neck | Superficial foreign body in nose |
Superficial foreign body in penis | Superficial foreign body in perineum | Superficial foreign body in scapular region | Superficial foreign body in scrotum |
Superficial foreign body in trunk | Superficial foreign body in vagina | Superficial foreign body in vulva | Superficial foreign body of abdominal wall with infection |
Superficial foreign body of ankle with infection | Superficial foreign body of anus with infection | Superficial foreign body of axilla with infection | Superficial foreign body of back with infection |
Superficial foreign body of breast with infection | Superficial foreign body of buttock with infection | Superficial foreign body of cheek with infection | Superficial foreign body of chest wall with infection |
Superficial foreign body of ear with infection | Superficial foreign body of elbow with infection | Superficial foreign body of face with infection | Superficial foreign body of finger with infection |
Superficial foreign body of flank with infection | Superficial foreign body of foot with infection | Superficial foreign body of forearm with infection | Superficial foreign body of groin with infection |
Superficial foreign body of gum with infection | Superficial foreign body of hand with infection | Superficial foreign body of hip with infection | Superficial foreign body of interscapular region with infection |
Superficial foreign body of lip with infection | Superficial foreign body of lower limb with infection | Superficial foreign body of neck with infection | Superficial foreign body of nose with infection |
Superficial foreign body of penis with infection | Superficial foreign body of perineum with infection | Superficial foreign body of scalp with infection | Superficial foreign body of scapular region with infection |
Superficial foreign body of scrotum with infection | Superficial foreign body of shoulder with infection | Superficial foreign body of testis with infection | Superficial foreign body of thigh with infection |
Superficial foreign body of toe with infection | Superficial foreign body of trunk with infection | Superficial foreign body of upper arm with infection | Superficial foreign body of vagina with infection |
Superficial foreign body of vulva with infection | Superficial foreign body of wrist with infection | Superficial foreign body with infection | Superficial injury of gum |
Superficial injury of scapular region | Superficial injury of scrotum | Superficial injury of skin of eyelid | Sustained viral response |
Tenderness of left abdominal lumbar region | Tenderness of left lumbar region of back | Tenderness of right abdominal lumbar region | Tenderness of right lumbar region of back |
Undescended left testicle | Undescended right testicle | Victim of forced sexual activity | Viral load increased |
SNOMED Codes Mapped to ICD-10 for Billing
The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.
You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap
report to examine your practice’s diagnoses that may need updating.
Information Blocking in the 21st Century Cures Act FAQ
PCC created this FAQ to help pediatric practices learn about Information Blocking in the 21st Century Cures Act.
Watch PCC's Presentations on Information Blocking: To learn more, you can watch PCC’s Information Blocking presentation, or the April 2021 live Information Blocking Q&A session.
Consult Your Practice's Legal Counsel: PCC shares what we learn about pediatric industry issues and best practices, but we do not provide legal advice. For questions, consult your practice's legal counsel.
Contact PCC if you have questions about implementing solutions at your practice.
General Questions
What is Information Blocking?
Information blocking is defined in the 21st Century Cures Act. In summary, information blocking is “a practice that…is likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information,” unless such practice is required by law (e.g., HIPAA), or it meets an exception established through federal rulemaking (42 U.S.C. § 300jj-52(a)(1)).
Does information blocking apply to me?
Yes, information blocking applies to physicians and practitioners. Information blocking applies to three types of “actors”: Certified health IT vendors, HIN/HIEs and health care providers, regardless of whether or not they use a certified product or participate in federal or state quality incentive programs.
ONC uses the Public Health Service Act definition of a health care provider to further define what which health care providers information blocking applies to. The Public Health Service Act health care provider definition includes licensed physicians and practitioners (physician assistant, nurse practitioner, and clinical nurse specialist). For more information, please see this Fact Sheet published by the ONC: Cures Act Final Rule: 2015 Edition Cures Update Overview (healthit.gov)
When do the Information Blocking guidelines go into effect?
Information blocking guidelines go into effect on April 5, 2021. There are also several milestone due dates for the various “actors”; they are outlined here: New Applicability Dates included in ONC Interim Final Rule (healthit.gov)
Do I need to be using a Certified EHR?
No. The information blocking regulations do not require actors to have or use health IT certified under the ONC Health IT Certification Program.
How does the Cures Act handle paper charts?
While the intent of the Cures Act is to increase the electronic exchange of health data through various means of interoperability, paper charts are okay to use. At the same time, using paper charts does not exempt one from complying with the Cures Act. When patient health data is requested, it needs to be fulfilled in an alternate manner, likely via paper copy or fax. It is recommended to review the Infeasibility and Content and Manner exceptions to ensure compliance.
What is the United States Core Data for Interoperability?
USCDI stands for the United States Core Data for Interoperability. The USCDI replaces the Common Clinical Data Set (CCDS).
USCDI Definitions:
- USCDI: a standardized set of health data classes and data elements for nationwide, interoperable health information exchange
- USCDI Data Class: an aggregation of various data elements by a common theme or use case
- USCDI Data Element: the most granular level at which a piece of data is represented in the USCDI for exchange
The USCDI will be updated through a transparent, collaborative process of public commenting and input on an annual basis.
What is Electronic Health Information (EHI) and am I required to provide to patients upon request?
Please see the ONC fact sheet that explains what Electronic Health Information (EHI) is, and the intent of its use: Understanding_EHI.pdf (healthit.gov). The Information Blocking regulation requires a response to fulfill requests, and EHI is the most common way to fulfill said requests. If you are unable to fulfill a request, please review the Information Blocking Exceptions.
When is Information Blocking allowed?
There are circumstances when information blocking is allowed. The ONC defined eight exceptions for information blocking. There are five exceptions for not fulfilling information and three exceptions that apply to information being fulfilled, but in a different, or certain way. Please see the Information Blocking Exceptions section for more information.
Exceptions for not fulfilling information:
- Preventing Harm
- Privacy
- Security
- Health IT Performance
- Infeasibility
Exceptions applying to information fulfilled in a different (or certain) but still acceptable way:
- Content and Manner
- Fees
- Licensing
Should I be updating my practice’s policies and procedures to address Information Blocking?
Yes. Three of the Information Blocking exceptions (preventing harm, privacy, and security) require a written policy. In addition to the required policies it is recommended to write and maintain an Information Blocking policy that includes protocols for sharing electronic and non-electronic health data.
PCC created a sample Electronic Health Information Access Policy. PCC does not provide legal advice. This policy is an example of what you may want to consider including in your own policy. Before you finalize a policy such as this, we recommend you consult your own legal counsel.
Should my practice have a written “data sharing” policy? What should it include?
Written policies are encouraged by the ONC, however a written policy is not automatically a safe harbor to prevent allegations of Information Blocking.
Information Blocking is a practice that is likely to “interfere with, prevent, or materially discourage access, exchange, or use of electronic health information.” Your practice’s policies should be written with this statement in mind.
For example, setting a standard 10 business day turnaround time to respond to requests for information (especially those that can be fulfilled electronically much faster) will likely constitute Information Blocking. Requests for patient data should be completed in an appropriate amount of time given the capabilities of the practice and the needs of the patient.
PCC created a sample Electronic Health Information Access Policy. PCC does not provide legal advice. This policy is an example of what you may want to consider including in your own policy. Before you finalize a policy such as this, we recommend you consult your own legal counsel.
What are examples of Information Blocking?
- Provider has capability to provide same-day access to EHI but takes several days to respond
- Provider organization charges a patient for their electronic data
- Requiring patient consent to exchange electronic health information for treatment where it is not required by law
- Certified health IT developer refuses to share technical information needed to export data
- Health information network/health information exchange charges additional fees to exchange data or refuses to exchange data with non-members
Portal Access
Do we need to enable portal access to our patients if they request access?
Yes, if a patient requests portal access, it must be granted if you have the portal enabled. Additionally, if your practice does not have the portal enabled it is strongly recommended that you do so. If you do not have it enabled, you may choose to use the infeasibility exception, however it is not wise to use this exception for an extended period of time if you do have the ability to enable it and have chosen not to.
Can we charge patients for portal access?
No, charging patients to electronically access their electronic medication information is prohibited.
What exactly is being shared on the portal?
PCC practices have the ability to configure what they share in the patient portal, including the following information: allergies, care plans, clinical instructions, diagnoses, documents, future appointments and date of last physical, growth charts, immunizations, labs, medications, orders, race, ethnicity, preferred language, patient sex, problems, smoking status, vitals, and personal balances.
Practices may continue to share what they normally do. There are no specific requirements to share more or less information in this rule. If a patient requests additional PHI via the portal or otherwise, practices need to be prepared to respond to requests. The request for additional PHI should be provided electronically when that is feasible, otherwise it should be fulfilled in an alternative format (e.g. paper).
Interoperability
Does my practice have to connect to a HIE/HIN?
The Information Blocking rule does not require practices to connect to a HIE/HIN, however other incentive programs or payers may require it. HIE/HINs are actors subject to the requirements of the rule themselves.
Does my practice have to submit data to registries?
The Information Blocking rule does not require practices to connect data registries, however other incentive programs, local or state laws, or payers may require it.
Patient Confidentiality
Do we have to make all of our lab results accessible to patients in the portal?
It is not a requirement of the rule to make all lab results accessible to patients in the portal, it is your choice to do so or not. If a patient requests their lab results via the portal and you do not provide them, this is information blocking. You must acknowledge and respond to all requests for electronic health information. If you are unable to fulfill them in the manner they are requested, or have an additional reason for not fulfilling the request, please refer to the information blocking exceptions for additional guidance within the ONC Information Blocking exceptions Fact Sheet.
Our clinicians store confidential information in various places in PCC EHR. Do we need to make all of those notes available to patients?
The information blocking rule does not supersede the HIPAA privacy and security rules. It is not a requirement of the rule to release all confidential information available to patients (or their guardians). Please refer to the ONC information blocking exceptions to understand more about the circumstances to withhold information.
The ONC FAQ includes a question and answer regarding patient confidentiality when the patient is a minor: Information Blocking FAQs (healthit.gov)
For more information about patient privacy and making certain items confidential, read the Patient Privacy Features article.
If a parent requests their child’s entire health record to be shared (electronically or via paper), am I required to share clinical notes from specialists or hospitals that were included in the patient’s chart?
Providers and practices should share patient data that is clinically relevant and has been requested (e.g. HIPAA minimum necessary rule). If this includes data from other practitioners, then it should be shared. Conversely, if the provider believes there is a risk of harm or security when sharing the patient’s data, they should review and apply the appropriate Information Blocking exception given the specific circumstances.
Information Blocking Exceptions
What are the Information Blocking exception requirements? Read below to learn more.
Disclaimer: For the full regulatory language, please refer to §171.200 – .205 and §171.300 – 303 included in the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Certification Program final rule located on the Federal Register here.
Preventing Harm
Objective: Blocking information is justified when it is in the public interest to protect a patient and other persons against unreasonable risks of harm.
Conditions:
- The actor must hold a reasonable belief that withholding information will substantially reduce the risk of harm
- The actor’s practice must be no broader than necessary
- The actor’s practice must satisfy at least one condition from each of the following categories: type of risk, type of harm and implementation basis
- The practice must satisfy the condition concerning a patient right to request review of an individualized determination of risk of harm
Examples:
- Risk of corrupt or inaccurate data being recorded or incorporated in a patient’s electronic health record
- Risk of misidentifying a patient or patient’s electronic health record
- Determination by a licensed health care professional that the disclosure of EHI is reasonably likely to endanger life or physical safety
- Reasonable belief that practice is necessary to directly and substantially reduce likelihood of harm
Privacy
Objective: This exception recognizes that if an actor is permitted to provide access, exchange or use of EHI under a privacy law, then the actor should provide that access, exchange or use. However, an actor should not be required to use or disclose EHI in a way that is prohibited under state or federal privacy laws.
Conditions: The actor must meet at least one of the following four sub-exceptions:
- If patient consent or authorization is not in place, the rule refers to this as a pre-condition
- If the health IT developer is not covered by HIPAA
- If the data being requested is addressed by the HIPAA privacy exception; examples include psychotherapy notes and information for a court proceeding
- If the patient requests to keep his or her information private
Examples:
- Patient has not agreed to share her information with a certain other provider or has not yet signed a HIPAA consent form.
Security
Objective: This exception is intended to cover all legitimate security practices by actors but does not prescribe a maximum level of security or dictate a one-size-fits-all approach.
Conditions:
- The practice must be directly related to safeguarding the confidentiality, integrity and availability of the EHI. It must be tailored to specific security risks, and it must be implemented in a consistent and non-discriminatory manner.
- The healthcare provider/organization must document its security policy
Examples:
- There is an active or known virus or ransomware attack
- An individual has been unable to prove their identity
- Request for EHI from a patient-facing application or website causes actor’s system to raise a malicious software detection alert
Infeasibility
Objective: This exception recognizes practical challenges to comply with a request for EHI.
Conditions: The actor must meet one of the following
Conditions:
- There is an event beyond the actor’s control, such as a natural or human-made disaster (public health emergency, public safety incident, war, terrorist attack, civil unrest such as a labor strike, telecommunication or internet service being unavailable, or act of military or government authority)
- A request cannot be technically met as requested (via a certain format)
- The actor is not able to understand the request because of patients’ requests to keep it private or to keep them safe
- The current circumstance makes fulfilling the request not possible
- The actor must provide a written response to the requestor within 10 business days of receipt of the request with the reason(s) why the request is infeasible
Examples:
- A natural disaster occurs such as a hurricane, earthquake, or tornado affects electricity and internet availability in an area for a week.
- A small physician practice with limited financial and technical resources may find it burdensome to accommodate requests from other providers to establish and maintain outbound interfaces from the practice’s EHR system that it neither needs for its own health care activities nor to comply with any regulatory requirements
Health IT Performance
Objective: This exception recognizes the need for health IT to be taken offline for system maintenance and improvements.
Conditions:
- Unavailability of health IT must be for no longer than necessary to achieve the maintenance or improvements (e.g. upgrade)
- Unavailability of health IT for maintenance or improvements must be implemented in a consistent and non-discriminatory manner
- Unavailability of health IT for maintenance or improvements must be agreed (e.g., advanced notice of system downtime for maintenance)
- An actor may take action against a third-party app that is negatively affecting the health IT’s performance
- For a period of time that is no longer than necessary
- Implemented in a non-discriminatory manner
- Consistent with existing service-level agreements, where applicable
Examples:
- Planned maintenance or improvements such as routine repairs, updates, or new releases
- Unplanned maintenance or improvements to respond to urgent or time-sensitive issues, which cannot wait for the occurrence of a pre-planned time period to implement the required maintenance or improvements
Content and Manner
Objective: This exception provides clarity and flexibility to actors concerning the required content (scope of EHI) of an actor’s response to a request to access, exchange or use EHI and the manner in which the actor may fulfill the request. Content is the what. Manner is the how.
Conditions:
- Content: Establishes the content an actor must provide in response to a request to access, exchange or use EHI in order to satisfy the exception.
- Until October 6, 2022, the EHI data must be provided (at minimum) represented in the United States Core Data for Interoperability (USCDI) standard
- On and after October 6, 2022 , the EHI definition is no longer limited to the EHI identified by the data elements represented in the USCDI
- Manner: Establishes the manner in which an actor must fulfill a request to access, exchange or use EHI in order to satisfy this exception. An actor may need to fulfill a request in an alternative manner when the actor is either:
- Technically unable to fulfill the request in any manner requested
- Cannot reach agreeable terms with the requestor to fulfill the request
- If an actor fulfills a request in an alternative manner, such fulfillment must satisfy the Fees Exception and Licensing Exception, as applicable.
Examples:
- Client requests connection to Commonwell; vendor is not connected to Commonwell, but can offer connection to CareQuality
- Request for EHI that is not able to be fulfilled electronically, therefore it is send using a PDF (or other) format
Fees
Objective: This exception allows actors to charge fees related to the development of technologies and services that enhance interoperability.
Conditions:
- Fees charged must:
- Be consistent
- Be reasonable related to the cost to us to provide access, enable exchange or use EHI
- Be nondiscriminatory
- This exception does not allow:
- A fee based on the electronic access by an individual patient, his or her personal representative, or another person or entity designated by that individual to access the individual’s EHI
- A fee to perform an electronic health information export for a patient or a client looking to change to a different EHR unless a fee has been already agreed upon
Examples:
- Provider or practice charging a fee for patient access to their health information electronically (is prohibited)
- Health care provider or practice imposing fees to exchange data with a hospital system they are not affiliated with, but does not charge fees for affiliated facilities (and vice versa)
Licensing
Objective: This exception allows actors to protect the value of their innovations and charge reasonable royalties
Conditions:
- Scope of Rights: The license must provide all rights to enable the access, exchange, or use of EHI and achieve the intended access, exchange or use of EHI via the interoperability elements
- Reasonable royalties are permissible
- Non-discriminatory terms: The terms and conditions must be based on objectively verifiable and uniformly applied criteria
- Non-disclosure agreement safeguards
Send CHADIS Questionnaires Directly Through the Patient Portal
When you schedule an appointment in PCC, your practice can automatically send patients and families CHADIS questionnaires through the patient portal. Results will show up right in the encounter’s chart note, like any order. You can use CHADIS questionnaires to gather important diagnostic, screening, and other valuable information in advance of an encounter.
CHADIS Required: CHADIS integration into PCC EHR requires that your practice has a CHADIS subscription. New or current CHADIS subscribers should reach out to CHADIS and PCC Support to begin using CHADIS with PCC EHR.
Watch Videos: You can watch a Preview CHADIS Integration video, as well as a live Spring 2021 PCC CHADIS Integration Q&A.
Configure CHADIS in PCC EHR
Before you can send CHADIS questionnaires to patients when you schedule, you need to connect your practice’s visit reasons to CHADIS visit types. Then your patients will receive the appropriate CHADIS questionnaires for their visit. Open the Visit Reason Editor and click on the CHADIS tab.
The CHADIS Visit Type Mapping includes a list of each CHADIS visit type and lists the PCC EHR visit reasons associated with each. Click the Edit button.
In the Edit Mapping window, select which of your Visit Reasons should be assigned to the selected CHADIS Visit Type. Multiple PCC Visit Reasons can be mapped to a single CHADIS Visit Type, but each PCC Visit Reason can only be mapped to one CHADIS Visit Type. PCC Visit Reasons that have already been mapped to a CHADIS Visit Type will be gray and cannot be selected in the Edit Mapping window if it is already mapped to a CHADIS Visit Type.
Schedule Visits to Send CHADIS Questionnaires
Once your visit reasons are linked to Visit Types, simply begin scheduling visits. PCC automatically registers your patients with CHADIS and the matching CHADIS questionnaires for the scheduled visit type will be generated by CHADIS 7 days prior to the visit. If the visit is scheduled for less than 7 days in the future, the questionnaires will be made available the day of scheduling.
When a new questionnaire is ready, the patient’s portal user will receive a Patient Portal notification that a questionnaire is waiting for them. When they log into the Patient Portal, they’ll find an orange button inviting them to start their questionnaires. Clicking the orange button opens the questionnaire on CHADIS’s website in a new browser window. If no visit is scheduled or no CHADIS questionnaires are pending, users can access CHADIS from the Patient Portal by clicking the CHADIS Home button.
Upcoming PCC updates include importing CHADIS results directly into PCC EHR, where they can be linked directly to a patient and visit.
Add My Kid’s Chart to Your Home Screen
Follow the instructions in this article to add a My Kid’s Chart icon to your smart phone’s home screen.
My Kid’s Chart is the patient portal for your pediatrician’s office. You can access My Kid’s Chart from any web browser, and use it to access medical records, communicate with your pediatrician, pay your bill, and more. By saving a link to My Kid’s Chart on your smart phone’s home screen, your pediatrician will always be just one touch away. For details on how to use My Kid’s Chart, visit the My Kid’s Chart User Guide.
Add My Kid’s Chart to Your Apple iOS Home Screen
Open Your Web Browser
First, open your browser. My Kid’s Chart works in any browser; for this example, we’ll use Safari, the default browser for the iPhone.
Enter the URL for My Kid’s Chart
Enter the web address of your pediatrician’s patient portal, then go to the website. Contact your pediatrician’s office if you do not know the address.
Add the Link to My Kid’s Chart to Your Home Screen
Tap the Action icon at the bottom of your screen (you may have to scroll down to make the Safari system icons appear), and then select “Add to Home Screen.”
Name the icon anything you want (it will default to “Portal”) and tap “Add”.
Add My Kid’s Chart to Your Android Home Screen
Open Your Web Browser
First, open your browser. My Kid’s Chart works in any browser; for this example, we’ll use Chrome, the default browser for Android devices.
Enter the URL for My Kid’s Chart
Enter the web address of your pediatrician’s patient portal, then go to the website. Contact your pediatrician’s office if you do not know the address.
Add the Link to My Kid’s Chart to Your Home Screen
Tap the action overflow icon in the top corner of your screen, and then select “Add to Home Screen.”
Name the link anything you want (it will default to “Portal”) and tap “Add”.
Look Up and Import Patient Immunization Records from Your Local Registry
If your practice is located in a state or municipality that has a bidirectional immunization registry interface with PCC, you can look up and import patient vaccine histories from your registry without ever leaving PCC EHR.
Watch the Video: Watch this video to learn how to check the registry for updates to your patient’s immunization record and import them into PCC EHR.
Get Started with Bidirectional Immunizations
A bidirectional immunization registry interface lets you see and import your patient’s immunization registry records without ever leaving PCC EHR.
Because each immunization registry has unique specifications and not all registries offer bidirectional functionality, bidirectional interfaces are only available with certain registries.
Contact PCC Support to learn if your office is eligible to establish bidirectional exchange with your local immunization registry.
If a connection is available right away, you will work with an implementation specialist to get the interface up and running. If a connection cannot be established right away, PCC will take note of your interest and let you know whether we expect to establish an interface with your registry in the future.
Retrieve and Import Patient Immunizations from the Registry
Once your practice has been configured for bidirectional exchange with your local immunization registry, you can begin using the Retrieve Immunizations feature to look up patients’ vaccine histories in the registry and import them into PCC EHR.
Open Your Patient’s Immunization History
Open the patient’s Immunization History in PCC EHR.
You can get to the Immunization History from the History section of the patient’s chart or within the Immunizations component if you’re in a visit protocol.
Click the “Retrieve Imms” Button
Click the “Retrieve Imms” button to request the patient’s immunization history from your state registry.
When you click “Retrieve Imms”, you may see an error. To learn more about the error types and resolutions, see Troubleshoot Retrieve Imms Errors.
Confirm the Patient Match
Use the demographic comparison in the “Retrieve Immunizations” window to confirm that the registry found the right patient.
Click “Next” to view the patient’s vaccine history.
You Can Only Proceed with a Unique Patient Match: If the registry finds several possible matches for your patient or finds no exact matches you will not be able to retrieve the patient’s vaccine history from the registry within PCC EHR. Close the Retrieve Immunizations window and try looking up the patient’s vaccine history directly on the registry website. To learn more about the different kinds of error messages and their causes, read Troubleshoot Retrieve Imms Errors below.
Review the Information Sent by the Registry
Review the vaccine history from the registry. Dates that are already in the patient’s chart appear in a black font, while new dates appear in an orange font. You can decide what to do with the new dates on the next screen.
Click “Next” to begin importing new information from the registry into PCC EHR.
Immunization Registry Forecasting and Disease Data: Some registries send vaccine forecasting and/or vaccine-preventable disease data in addition to the patient’s vaccine history. You can view this information if the registry sends it, but you cannot import it into PCC EHR.
How Does PCC EHR Determine if a Vaccine is Already in the Patient's History?: For each immunization reported by the registry, PCC EHR checks to see if the associated CVX code and date already exist in the patient’s chart. If a registry immunization is reported with an NDC or CPT code instead of a CVX, PCC EHR attempts to convert it to CVX according to CDC guidelines before checking for an equivalent immunization in PCC EHR. If PCC EHR cannot convert a registry immunization to CVX, the immunization cannot be imported.
Select Vaccine Dates from the Registry to Import
Check the box beside the immunizations and dates you wish to import into the patient’s PCC EHR record. You can only import new entries from the registry; entries that already exist in the EHR are excluded from the import window, even if they have a different status in the registry than what is recorded in PCC EHR.
Once selected, immunizations from the registry are automatically mapped by CVX code to their equivalents in the EHR.
If a registry immunization has several equivalents in the EHR, all of the options are presented in a drop-down field in the import window. Review the options and manually select one to use for the import.
Sometimes new entries from the registry use CVX codes that are not configured in your PCC system. You must add the missing CVX codes to your immunization configuration in order to import these entries.
Contact PCC Support if you need help adding CVX codes to your immunization configuration.
Click “Import”
Once you have selected and mapped the immunizations you plan to import from the registry, click the “Import” button.
The information imports into PCC EHR and the Retrieve Immunization window closes on its own.
Review and Edit Imported Entries in the Patient’s Immunization History
Information imported from the registry appears immediately in the patient’s Immunization History in PCC EHR.
You can view details about the immunizations imported from the registry by editing the patient’s Immunization History.
Historic immunizations imported from the registry are recorded in the patient’s chart with the source “Historical Record from Other Registry”. Imported entries display as Refused or Contraindicated when relevant, and can also include information about the vaccine dose, lot number, site, route, and funding source.
Troubleshoot Retrieve Imms Errors
When you click “Retrieve Imms” for a patient, you may see one of two errors:
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No unique patient matches at (Your Registry): This error indicates that the immunization registry could not find a specific match for your patient, or that the registry has multiple possible records that might match your query and can not report a single, high-confidence match. Review the patient record and double-check common identifiers, like name and birthdate. If you cannot resolve the error, sign in to your registry’s online portal and look up the patient’s records there.
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Immunizations Could Not Be Retrieved From (Your Registry): This indicates that the registry is down, there is a connection problem between your system and the immunization registry, or that something is wrong with your configuration. Temporary connection interruptions and outages are normal, as with any web service, and some immunization registries are more prone to service outages than others. The connection also relies on your practice’s network connection, so this error may appear because of a momentary problem within your practice’s network. Try again in a few minutes, and if the problem persists, check with your immunization registry to see if they are experiencing an outage. If you are experiencing an ongoing outage or connection problem, PCC can troubleshoot and confirm if the registry is down.
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Immunizations Could Not Be Retrieved From (Your Registry) (Too many matches found): This indicates that the registry was unable to find a single patient who matched the criteria you sent, and therefore opted to send no records at all. You can try checking the patient’s demographics to make sure all of the fields are filled out, including Mother’s Maiden Name and the Multiple Birth Indicator if those fields are visible. If that does not resolve the issue, sign into the registry’s portal and use the information there to manually update the patient’s historic immunizations in PCC EHR.
When to Contact PCC Support: While PCC can’t solve connectivity problems, PCC can help you troubleshoot ongoing challenges with your immunization registry. Before you call, 1) identify the particular error message you are seeing, 2) find out if the error is for all patients or just one, 3) collect specific patient examples.
Current Connections
Bidirectional immunization registry connections are being rolled out one registry at a time and are currently available to practices in Alabama, Alaska, Arksansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Missouri, Mississippi, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York City, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Philadelphia, South Carolina, Tennessee, U.S. Virgin Islands, Vermont, Virginia, Washington, and Wyoming.
Point-in-Time Snapshot: The above map represents the status of PCC’s available immunization registry connections as of December 10, 2024 and does not guarantee completion of in-progress connections. For the most up-to-date information about the status of a particular immunization registry connection, contact PCC Support.
Contact PCC Support if you are interested in using this functionality once it becomes available in your area.
Configure Which PCC EHR Queues Appear for Each User
Your practice can define which PCC EHR queues will appear when a user logs in. For example, a staff member at the front desk may not need to see prescription renewals or signing. Their PCC EHR screen could look like this:
And a biller may only need to review today’s schedule and messages in order to post charges:
By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.
Configure User Roles to Display PCC EHR Queues
To adjust which queues are visible for each user at your practice, first open the User Administration tool and edit a user role.
Use one of your existing roles or create a new one. Double-click on the role to adjust permission settings.
First, select “Queues” to make queues visible to the user role. Then select each queue that users with this role should have access to. Repeat this process for each role at your practice. If a user role should only have limited access, you can deselect all queues. Then the user will see a blank PCC EHR window.
As you design roles, remember that users can be assigned more than one. Each user will see all the queues available for any of their assigned roles. Also, note that the eRx Tasks queue only appears for users who have both a role with the queue permission and an enabled PCC eRx account.
Next, edit each user’s account and adjust their assigned roles.
By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.
For a complete guide to defining and assigning Roles in the User Administration tool, read the main Set User Roles for Permissions and Security article.
COVID-19 Vaccines: Plan, Configure, Order, Administer, and Bill
You can use PCC EHR to order, administer, and track COVID-19 vaccines, either for pediatric patients or as part of a COVID-19 vaccine clinic for older patients. Read below to learn how to sign your practice up, plan for a vaccine clinic, configure your PCC system, and how to order, administer, and track COVID-19 vaccination.
Procedure Code Guidance: The procedure codes discussed in this article are intended only as examples. You should consult the AMA’s current CPT Coding Guide and work with your insurance payers to verify what codes you should report. Your practice updates and maintains your procedure list, codes, and prices in the Procedures table in the Table Editor on your PCC system.
Get Signed Up and Plan for COVID-19 Vaccinations
As of June 2022, pediatric practices are administering COVID-19 vaccines to adults, patients age 12 and up, patients age 5-11, as well as younger children. The Federal Government and President Biden have repeatedly announced that pediatric practices shall play a key role in the vaccination of young patients.
In 2021, PCC prepared this list of links for help “getting started”. While the situation has changed many time since, these resources may still be helpful!
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Register to Administer COVID-19 Vaccines: If you haven’t already registered to administer the COVID-19 vaccine, you can find your state specific registration details at the AAP’s State COVID-19 Vaccine Provider Registration Resources page.
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Evaluate Your Active Patient Population for Target Age Groups: Use PCC’s Report Library to estimate patient populations. For example, how many 5-11 year olds have visited your practice in the past three years? When planning a shot clinic, for example, don’t forget to consider children with birthdays in the upcoming months. Consider also contacting older patients who visit your practice: while families may receive vaccination elsewhere, your practice can help fill in the gaps.
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Plan Your Practice's Vaccine Clinic: Develop a plan to administer the vaccine with your practice. Consider holding a vaccine clinic and also offering COVID-19 vaccination during regularly scheduled visits. PCC has documentation and a blog article about running mass vaccine clinics.
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Communicate With Families: Use Broadcast Messaging to communicate your plan early to your patient families. This will help reduce phone calls to your office and encourage families to plan how and when they will get their children vaccinated.
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Add Immunization Billing Codes and Orders to Your PCC System: Use the links and the procedures below to add billing procedures to your system and set up orders and chart note protocols for quick and easy administration. Once you have added your procedures with prices and names and adjusted your orders in PCC EHR, you can immediately begin ordering, administering, and billing for the vaccines. PCC Support can help you with every step of the process.
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Contact PCC to Update Vaccine Tracking: Whenever you add a new immunization, contact PCC Support to configure new immunizations so they will track on a patient’s immunization record.
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Create or Obtain a Consent Form: Your practice can create your own consent form, or there may be a standard one available from your state. PCC has heard from pediatricians who use the new Massachusetts COVID-19 Vaccine for 5-17 Years form and Oregon’s Pfizer Minor Consent Form.
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Obtain VIS Forms (EUA Fact Sheets) at CDC.gov or through FDA: For COVID-19 vaccines in 2020-2023, there is no formal VIS form. Instead, manufacturers work with the CDC to provide Emergency Use Authorization Fact Sheets, or EUA. For example, in November of 2021, the FDA released Pfizer 12+ Fact Sheets and Pfizer 5-11 Fact Sheets. With each new vaccine approved for emergency use, there is an adjustment to the available EUA fact sheets.
Understand the Details and Codes for Each Vaccine
Before you set up any new vaccine in PCC’s system, you should review the details of the immunization. For example, you will need to know the manufacturer and their MVX code (such as PFR, for Pfizer), the dose amount, the CVX Code for the vaccine, the National Drug Code (NDC) for the vial, along with the CPT codes your practice will use for billing both the immunization and the administration. Your clinical staff will also want to review diluent information for administration and obtain VIS forms or “EUA” forms.
PCC's COVID-19 Vaccine Table: When the first COVID-19 vaccines rolled out, PCC created a table of available vaccines for each age group which included the information a pediatric practice needed to get started. From 2021 to April of 2023, we kept this table up-to-date when new vaccines were approved. We published this table on a short-term basis due to the importance of the issue and the rapid changes occurring. We’ve now removed it, and instead we recommend practices check codes, dosing amounts, NDC, and other details with official sources.
You can obtain more information from these resources:
- COVID-19 Vaccine Administration: Getting Paid: The AAP’s guide to COVID-19 vaccines as well as both product and administration billing codes.
- AAP’s COVID-19 Vaccine Chart:In 2022, the AAP began publishing their own COVID-19 Vaccine Coding Chart, and they continue to update it.
- COVID-19 Vaccine Related Codes at CDC.gov: The CDC’s table of COVID-19 vaccine information.
- Vaccine CPT and NDC Codes at AMA-assn.org: The AMA’s quick reference table.
- The AMA’s “Appendix Q”, which provides details on each vaccine.
Configure PCC EHR for COVID-19 Vaccines
Read below to learn how to add a COVID-19 vaccine to your PCC system. Contact PCC Support for assistance with any of these steps.
In addition to adding a vaccine that you will administer, you can use the steps below to add vaccines that your practice will track but will never administer.
See More About Adding an Immunization: For more screenshots and help with these configuration tools, see the main Add and Configure Immunizations in PCC reference article.
Create Immunization Entries in Your Practice’s Procedures Table
First, create procedure entries for the vaccine in the Procedures table in your practice’s Table Editor (ted
). If you’ve never done this before, contact PCC Support and we will walk you through the process. (You can see more screenshots on the main Add Immunizations article.)
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Procedure Name: You can name procedures anything that will be useful for your practice. As there will be several different COVID-19 vaccines coming into use in 2021, PCC recommends a naming convention that identifies the manufacturer of the vaccine. If you will be administering two different dosages of the Pfizer vaccine (for example, 0.3ml for older patients), you may want to incorporate the dosage or age range into the title of the procedure.
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Accounting Type: Billable procedures you perform in your practice should have an accounting type of “Revenue”.
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Procedure Group: The Procedure Group field is a customizable value used for reporting purposes; it does not affect billing or how a procedure is ordered or completed. Select an appropriate Procedure Group, such as “Immunizations”.
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TOS: The Type of Service should read “Medical Care” for all immunizations or medications you administer.
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Units: Enter one (1) unit. The Procedures table lists the smallest, standard administered value for the vaccine.
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NDC: Enter the National Drug Code for the COVID-19 vaccine. You can use the CDC’s informational table, but you should check the labeling on the vaccine vial itself when it arrives at your practice. You can also cross-reference the National Drug Code Library.
11 Digits From the Vial, Not the Box: You should enter the NDC code printed on the smallest administered dose, such as the specific tube, vial, or pouch that contains the vaccine or medication. This is sometimes referred to as the “Use” NDC. Do not use the NDC code printed on a box or carton that contains more than one dose, often referred to as the “Sale” NDC. The NDC code standard supports both 10 and 11 digit NDCs, and PCC recommends you use the 11 digit version.
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Dose Amount and Dose Units: Enter the dose amount and dose units found on the vial, pouch, or tube that you administer. For example, the Pfizer COVID-19 vaccine is administered as 0.3 mL for older patients, so you would enter “0.3” and “mL”. The 5-11 vaccine is a 0.2mL dose. If you are administering different doses, you should set up different entries in your Procedures table.
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Procedure Code or CPT: Use the CDC or AMA links to locate the billing procedure code and enter it in all schedules. PCC does not provide or distribute CPT codes, and can not add this information to your system. Enter the same code for all schedules. PCC includes optional schedules in order to support “local codes”, which are no longer part of the claim standard. However, if your practice has a schedule specifically configured for Medicaid billing, and your state Medicaid program requires a modifier, you can enter the full code + modifier in the “CPT” field for that schedule.
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Price: Enter a price for the procedure in the fields for each schedule. In 2021, PCC expected most practices should enter a $0.00 price for COVID-19 vaccines, though your situation may vary. For example, CMS publishes a $0.01 price, and some payers may not be able to process $0.00 charges on claims. In general, procedure prices should be identical in all fields, though a practice can use different fee schedules for TOS payment or Medicaid vaccines (VFC). The examples in the image above are for illustration only and are not fee suggestions.
Add the New Immunization Administration Procedures to Your Procedures Table
Next, clone an existing Immunization Administration procedure and adjust the description and code for administration of the COVID-19 vaccine. Each administration for some vaccines have a unique code! Refer to the CDC or AMA resources to know the correct codes to add.
PCC expects most pediatric practices will be tracking five or six different administration billing codes, including the first and second dose of the expected Pfizer 5-11 vaccine and administration and followup shots for the 12+ vaccine.
What should I charge for COVID-19 immunization administration?: We recommend you check with your payers to determine expected payment for COVID-19 vaccine administration codes. Note that Medicare presently pays $40 for each administration and some private payers or individual states may be paying more. The pediatric benchmark for procedure pricing in the U.S. is to charge above 180% of Medicare reimbursement amounts, which are publicly available per-relative value unit for each region.
Create or Adjust Entries in Your Immunization Manufacturers Table
Next, review and update your practice’s Immunization Manufacturers table in the Table Editor (ted
).
Your table may already include Moderna, for example, but you may need to add Pfizer.
Create Entries in the Immunization and Disease Table
PCC Support will complete this step for you. Contact them at support@pcc.com or 1-800-722-1082.
The Immunization and Disease table handles how specific immunization procedures in your Procedures table align with vaccination and/or diseases. Contact PCC Support for assistance.
Configure Your System to Display the Vaccine and to Print It on Immunization School Forms
PCC Support will complete this step for you. Contact them at support@pcc.com or 1-800-722-1082.
Your Client Advocate or other PCC support team member will add the new vaccine to four “under-the-hood” configuration tables, work with you to make adjustments to your printable immunization school form(s), and work with you to test the configuration and make sure that the new vaccine appears correctly in PCC EHR.
Add a COVID-19 Immunization Order to Specific Chart Note Protocols
Use the Protocol Configuration tool to add the COVID-19 vaccine to the Immunizations component for specific chart note protocols.
A clinician can always search and find any immunization order. You can save clinicians’ time by putting specific immunizations right on your practice’s chart notes, so they will be available with a single click.
Add Catch-Up Imms, Flu Shots, and More: The AAP recommends practices take advantage of every encounter to get patients caught up on immunizations and offer flu shots. As you adjust your protocols for a COVID-19 vaccine clinic, consider other components and immunizations you can add to help your clinicians during the visit.
Map Z23 and Billing Procedures to the COVID-19 Immunization Order
When a clinician clicks “Order” next to a COVID-19 vaccine, PCC EHR can automatically place diagnosis and procedure billing codes onto the encounter for billing. Whenever you add a new vaccine, use the Billing Configuration tool to map precisely which codes should be triggered by that order.
In the example above, the practice has mapped the COVID-19 (Pfizer, 5-11) immunization order to a Z23 diagnosis, a billing CPT code, and two specific immunization administration codes.
Customize How the Immunization Appears in the Patient’s Chart
Use the Immunization Configuration tool in PCC EHR to configure the order that immunizations appear in a patient’s Immunization History. Use the same tool to set whether or not the immunization will always appear in a patient’s chart or will only appear if they have had a dose.
Click and drag to rearrange how immunizations appear in a patient’s chart. Click the “Display” checkbox next to all immunizations you would like to appear in a patient’s Immunization History, even if they have never received a dose.
Always Display: In a patient’s chart, the Immunization History will display all immunizations that a patient has received. You can also configure an immunization to appear on every patient’s record, even if they have never received a dose. For example, since all patients should receive an IPV, most practices select “Display” next to “IPV” in the Immunization Configuration tool. In contrast, a practice might sometimes administer a cholera vaccine, but would only need it to appear in the patient’s record if a patient received it. They therefore would not check “Display” next to Cholera.
Create a COVID-19 Vaccination Pre-Registration Form in the Patient Portal
Your practice can create a pre-registration template in the patient portal, so parents can answer COVID-19 vaccine registration questions quickly and easily on their smart phone. You can use these forms to gather information ahead of a vaccine clinic, or send the form to families after they’ve schedule their appointment.
To learn about patient portal templates, read Configure Your Patient Portal Message Templates.
To see what other practices have done, download Portal Message Template – 5-11yr COVID Shot Pre-registration.
Add Incoming COVID-19 Vaccine Lots in the Lot Manager
When a vaccine arrives at your practice, add it to the Lot Manager in PCC EHR.
You can use a barcode scanner to enter information, or enter it manually. Use the documentation that accompanies the vaccine and/or the CDC links at the top of this article to learn more about dosage, diluent, and NDC code information for each vaccine. Note that cartons and vials have different NDC codes.
Order and Administer a COVID-19 Vaccine
Prior or during an encounter, use the Immunizations component on the chart note to order a vaccine.
You can complete the order on the chart note, from the patient’s Outstanding Tasks component, or from the convenient orange orders indicator found on PCC EHR’s main schedule screen.
When you chart the administration of any immunization, you can select a lot, select which VIS/EUA Fact Sheet you provided, and then indicate that you administered the shot or that it was canceled or refused. PCC EHR will enter your practice’s default or most recent shot information for some fields.
Provide an EAU Fact Sheet Instead of a Vaccine Information Sheet (VIS)
In PCC EHR, you can indicate which VIS you provided to a patient. There are currently no VISs for COVID-19 vaccines. Instead, the CDC and FDA are working with vaccine manufacturers to prepare and share Emergency Use Authorization Fact Sheets to recipients. In PCC EHR, the EUAs will appear in the drop-down menu instead of the VIS.
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CDC EUA Fact Sheets: Your practice can download the EUA Fact Sheets for all COVID-19 Vaccines on the CDC’s web site.
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FDA's New 12+ and 5-11 Fact Sheets: In November of 2021, the FDA released Pfizer 12+ Fact Sheets and Pfizer 5-11 Fact Sheets.
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Distribute EUA Fact Sheets as QR Codes: In addition to handing parents a printed copy of the EUA Fact Sheet, your practice can print and display QR codes. Parents can then use their smartphone camera to jump directly to the web site.
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The CDC's COVID-19 Vaccine Handout: In addition to the EUA Fact Sheet, your practice may choose to distribute your own materials or the CDC’s What to Expect after Getting a COVID-19 Vaccine document. You can find this document on the CDC’s information pages for COVID-19 vaccines approved in the United States.
Bill for COVID-19 Vaccines
When your practice clicks “Order” next to a COVID-19 vaccine, your practice’s configured billing diagnoses and procedure codes will appear on the Bill screen automatically.
A clinician will see the codes when they prepare the encounter for billing.
You can make any adjustments needed. (Note that the above example does not include a visit code or other billing codes that might be part of a typical encounter.)
After the clinician has made the encounter ready for billing, the biller can post the charges from the Schedule screen in PCC EHR.
As they post charges, the biller can review and adjust patient information, along with the diagnosis and procedure codes.
What Billing Diagnoses and Procedures Do I Use for a COVID-19 Related Encounter?: While circumstances will vary, PCC has an overview of Coding and Billing for a COVID-19 Related Encounter.
Review and Understand COVID-19 Immunization Forecasting Details
As of 2022, PCC has observed that automated immunization forecasting for COVID-19 is inconsistent. There are numerous vaccines in play, each with different dosage rules. Federal and State governments may decide to advise clinicians to ignore some periodicity requirements, and those requirements are changing rapidly.
PCC is working with our immunization forecasting vendor to deliver updated forecasting as the schedules change. In the meantime, you may only see a COVID-19 line in the Immunization Forecasting component if a patient has (for example) received a first dose of a multi-dose vaccine. Long term, our immunization forecasting vendor plans to support all dose schedules for each approved vaccine.
Immunization Forecasting in PCC EHR
Can My Pediatric Practice Become a COVID-19 Vaccine Site for Adult Patients?
Many pediatric practices are working with their local health department in order to administer COVID-19 vaccines to both children and adults.
PCC has worked with practices to help them get set up, and you can read more at COVID-19 Vaccine: What Pediatricians Need to Know.
Become a Medicare Provider
If you plan to administer the COVID-19 vaccine to Medicare patients, or see Medicare patients for other reasons, you may decide to register as a Medicare provider.
The Federal Government is working to expedite the Medicare enrollment process in order to make sure more clinicians are able to see Medicare patients for COVID-19 related needs and/or to administer the COVID-19 vaccine. Clinicians need to enroll in Medicare in order to bill for encounters with Medicare patients.
You can learn about the expedited enrollment process here: CMS (https://www.cms.gov/files/document/provider-enrollment-relief-faqs-covid-19.pdf). Once a clinician is enrolled, they can see Medicare patients and administer the COVID-19 vaccine. After the pandemic, a clinician would have to complete the full enrollment process.
Medicare does not accept paper claims, and signing up for electronic claim submission with Medicare is a separate process. PCC’s EDI experts can assist you with setting up claim submission. This process has not been expedited in the same way as enrollment, and PCC anticipates initial claim submission could take up to a month.
Report on COVID-19 Vaccination at Your Practice
As of PCC EHR 9.4, coming to all practices in the third quarter of 2022, you can review your COVID-19 vaccination rates in the Practice Vitals Dashboard.
You can also use PCC EHR’s Report Library to create custom immunization and charge-based reports, and perform recalls to patients.
Submit COVID-19 Vaccines to Your State’s Immunization Registries
In all states and regions where PCC offers immunization registry connections, COVID-19 immunization data is included in your practice’s immunization registry submissions.
If you have a bidirectional connection with your immunization registry, COVID-19 vaccine information is included when you look up and import patients’ state immunization records.
If you are experiencing problems with your state registry and COVID-19 vaccine lookups, contact your state’s immunization registry vendor.
Submit Immunization Records to Registries
Look Up and Import Patient Records from Your Local Immunization Registry
Help Families Resubscribe to Broadcast Emails and Opt In to Text Messages From Your Practice
When a patient or their caregiver indicates that they did not receive your latest text (SMS) message or broadcast email, you can easily determine if it is because they have opted out of communication from your practice.
Look up the person’s phone number or email address in PCC EHR and see if an icon appears beside it.
If you see an icon, it indicates that the contact method will not receive an email or SMS message from PCC EHR.
PCC EHR Does Not Contact Unsubscribed Emails and Opted-Out Phone Numbers: PCC EHR does not send broadcast messages to unsubscribed email addresses, nor does it send any kind of text message to opted-out mobile phone numbers, including broadcast messages, single text messages, and patient portal notifications.
Clicking that icon opens a window explaining the issue with that contact method and how to resolve it.
Unsubscribed Email Addresses
If a user has unsubscribed from receiving emails, they’ll receive no messages from PCC. Clicking the icon pops up a window with the option to send an invite email. Clicking the link in that email will resubscribe the email address to your emails.
Spam and Invalid Email Address
If the email address is not unsubscribed but still not receiving emails, then either the email address itself is incorrect, or the recipient has marked messages from Patient Portal or Broadcast Messaging as spam or junk. Broadcast Messaging and Patient Portal messages will not be sent to any addresses that have marked a previous messages as spam. The recipient must resolve the invalid spam complaint then use the resubscribe link from a previous PCC email.
If the email address is not unsubscribed but still not receiving emails, you’ll find the option to correct any typo in the email address, or mark the email address as correct. Marking the address as correct does not guarantee the next message will send, but it clears the error and attempts to send future messages.
Invalid Phone Numbers
If the phone number is incorrect or formatted incorrectly, such as a missing area code, or it’s a landline and cannot receive SMS messages, you’ll have the opportunity to fix the number. Like the email above, marking the number as correct doesn’t guarantee the next message will go through.
Phone Number is Unsubscribed
If the phone number has opted out of receiving text messages, the only resolution is for that user to text UNSTOP to the number displayed in the window.
PCC 8.15 Release
In the first quarter of 2021, PCC will release version 8.15 of our electronic charting and practice management software to all PCC users.
PCC 8.15 includes group chat, improved user management, COVID-19 vaccine support, improvements to preparing an encounter for billing, and much more!
Watch a Video Series: Want to see videos about the updates in this release? Watch the PCC 8.15 Release Video Series.
Implementation: PCC 8.15 includes features that require configuration and user-specific software training. Read about the features below and then review the PCC 8.15 Migration Considerations article.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Chat With Groups in Your Office
When you want to chat with a group of PCC EHR users at your practice, select a chat group and enter your message.
The message appears to the whole group, and any replies will be marked with the replying user’s name.
Set Up Your Practice's Chat Groups: You can create and edit chat groups through the User Administration tool. See PCC 8.15 Migration Considerations to learn how.
Configure Which PCC EHR Queues Appear for Each User
Your practice can define which PCC EHR queues will appear when a user logs in. For example, a staff member at the front desk may not need to see prescription renewals or signing. Their PCC EHR screen could look like this:
And a biller may only need to review today’s schedule and messages in order to post charges:
Use the User Administration tool to define which roles will see each PCC EHR queue.
Read the PCC 8.15 Migration and Implementation guide to learn more.
By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.
All Users Will Still Have Access After the PCC 8.15 Update: Configurable queues are brand new! The PCC 8.15 update won’t hide any queues. When users log in after the update, they will see the same queues they have always seen. After the update, your practice’s office manager or system administrator can configure roles for your users, and also set expectations about the change. If you need help, contact PCC Support.
Manage All Usernames and Passwords in PCC EHR
PCC 8.15 automatically syncs authentication between PCC EHR and the Practice Management window. Your practice can use PCC EHR’s User Administration tool to manage user accounts for all PCC products.
When you enable or disable an account, adjust a Full Name, or change a password, the changes will affect all of PCC’s products for the user, including both Secure Connect access, PCC email accounts, and the Practice Management window.
When you create a new user account, PCC EHR will automatically create accounts and sync the authentications that each user needs.
If a user updates their own password in PCC EHR, that will automatically update their password for all PCC products.
The new “one stop shopping” for user account administration in PCC 8.15 will save time and reduce username and password problems, especially for your staff who access both PCC EHR and the advanced billing tools found in the Practice Management window.
Prepare for Password and Username Updates: While the password and username transition will be seamless for most users at your practice, there are special circumstances which may lead to confusion after the PCC 8.15 update. Please have your practice’s system administrator take a look at the Prepare for Username and Password Updates Across PCC Products and Services section of the PCC 8.15 migration article.
Configure, Order, Administer, and Track COVID-19 Vaccines in PCC EHR
In December and January, PCC applied several updates to your system to support COVID-19 vaccines. The PCC 8.15 software update includes further adjustments to improve COVID-19 vaccine support. Your practice can configure, order, administer, and track all available COVID-19 vaccines in PCC EHR.
For a complete guide, read COVID-19 Vaccines in PCC EHR: Configure, Order, Administer, and Track.
Here’s a list of the related updates that arrived during the PCC 8.15 release cycle:
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CVX and MVX for Pfizer, Moderna, Janssen and AstraZeneca Vaccines: Mid-release updates to your system added CVX codes 208 and 207 for Pfizer-BioNTech and Moderna COVID-19 vaccines. PCC 8.15 adds CVX 212 and 210, for Janssen (J&J) and AstraZeneca. The MVX table is also updated to support new codes for Pfizer-BioNTech, Janssen, and AstraZeneca (PFR, JSN, and ASZ).
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VIS Entries for Pfizer, Moderna, Janssen and AstraZeneca: There are no VIS forms for the COVID-19 vaccines. In their place, the CDC has worked with manufacturers to provide EUA Fact Sheets. PCC added VIS table entries for the EUA Fact Sheets for both the Pfizer-BioNTech and Moderna COVID-19 vaccines to all practice systems in a mid-release patch. PCC 8.15 adds entries for Janssen (J&J) and AstraZeneca EUA Fact Sheets for their COVID-19 vaccines.
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0.3mL Dosage Support for Pfizer COVID-19 Vaccine: PCC 8.15 adds support for a 0.3mL dose in vaccine record keeping, which is the dosage used for the Pfizer-BioNTech COVID-19 vaccine. Prior to this update, the vaccine could be recorded with an “unspecified” dose. After the update, your practice may want to adjust your configuration and update those records if you administered any Pfizer-BioNTech COVID-19 vaccines.
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Immunization Forecasting for Pfizer and Moderna COVID-19 Vaccines: PCC’s Immunization Forecasting partner, STC, updated the underlying schedule logic to support both the new Pfizer-BioNTech and Moderna mRNA vaccines, when identified by the 208 and 207 CVX codes.
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Immunization Forecasting with an Unspecified COVID-19 Vaccine: Your practice can optionally add a “COVID-19 (Unspecified)” vaccine to your system, using CVX 213, in order to record a shot on a patient’s record when you do not know the specific vaccine. A recent STC update to Immunization Forecasting logic allows for that vaccine to be valid. For example, an unspecified COVID-19 vaccine can report as valid for Dose 2 of a vaccine schedule that began with a Pfizer-BioNTech or Moderna vaccine. (Note that an unspecified vaccine entry should not used to record immunization administration.)
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Vaccine Family 33 for Immunization Forecasting: PCC 8.15 adds the vaccine code family of 33, for COVID-19, to the underlying data structure for immunization forecasting. This allows Immunization Forecasting to display a line and label for COVID-19 forecasting.
Details on Forecasting for COVID-19: PCC 8.15 will not forecast an expected or missing immunization for COVID-19 until a patient has received a first dose in a two-dose series. Additionally, we expect Immunization Forecasting for COVID-19 vaccination to change in the coming year. Recent updates to your system lay the groundwork for forecasting, but COVID-19 forecasting results at this time may not produce the expected result.
Prepare an Encounter for Billing More Easily
PCC 8.15 includes two improvements to how your clinicians prepare encounters for billing in PCC EHR. Linked codes from orders and the consolidation of duplicate diagnoses will save time and reduce errors.
Automatically Link Diagnoses and Procedures From Orders
When you create an order for a patient, the correct diagnoses and procedures can now appear linked when you prepare the encounter for billing.
When a user creates an order in PCC EHR, it can automatically add diagnoses and procedures to the Bill window (also called the electronic encounter form). For example, you might configure a Wart Removal order to add both a plantar wart diagnosis and a cryosurgery procedure code for billing. In PCC 8.15, these codes will automatically be linked and ready for charge posting.
Billing codes for diagnoses and procedures are based on your practice configuration. Once you’ve set up your orders, both your clinician and biller will save time, as they will not need to manually indicate which diagnoses correspond to the billing procedures for the order.
Configure Your Orders: Your practice can configure exactly which diagnoses and procedures are triggered for each order. Use the Billing Configuration tool to add diagnoses and procedures to orders. Use the Protocol Configuration tool to specify which orders appear on each chart note.
No More Duplicate Diagnoses on the Bill Screen
When you prepare an encounter for billing, you will no longer see duplicate diagnoses from orders. For example, when your practice orders multiple immunizations, PCC EHR will consolidate the Z23 diagnosis into a single entry.
In the Bill window, all orders that have the same configured diagnosis will appear on a single line. Based on your practice’s configuration, the diagnosis will also be automatically linked to the procedure codes you use to bill each order.
If the clinician needs to link an additional procedure or make other changes, they can spot the diagnosis more quickly and link it without the confusion of seeing duplicate entries.
After the clinician clicks “Make Ready for Billing”, Post Charges in PCC EHR will also deduplicate and only display the diagnosis once, making it easier for the biller to review details and post charges.
Deduplication is Only in PCC EHR: If your practice still uses the post charges tool in the Partner Practice Management system, sometimes called chuck
or checkout
, billers may still see a diagnosis multiple times. The older charge posting program does not deduplicate diagnoses.
Update an Encounter’s Billing Provider Separately from the Scheduled Appointment Provider
In PCC 8.15, you can schedule an appointment for one provider and then easily select a different provider for billing. Your practice could potentially use different clinicians when you schedule, see the patient, and bill for an encounter.
When you need to change the scheduled appointment provider for an encounter, you can adjust it in the Appointment Book, or right at the top of the chart note:
When you need to select a different billing provider, you can make that change at the top of the Bill window (the electronic encounter form) when you prepare the encounter for billing.
Alternatively, the biller can make that adjustment later, when they post charges.
You can change the billing provider without changing the scheduled appointment provider. PCC EHR’s records will display both the Appointment Provider and the Provider of Service in the patient’s Billing History.
When Would I Need to Change the Provider for an Encounter?: Your practice might schedule a stand-in “Flu” provider in the Appointment Book. Then on the day of the encounter, you might change the scheduled clinician for the appointment to Nurse John, who gives the patient the flu shot. Afterwards, when you prepare the encounter for billing, you might define the supervising Provider of Service as the credentialed M.D., Dr. Williams. PCC supports these and other workflows, and in PCC 8.15 you can more easily adjust the provider of service while not altering the appointment provider.
Apply Past Credits When You Post Charges in PCC EHR
When you post charges, PCC EHR will display any credits on the patient’s Billing Account in the Payments component.
By default, the full credit will be applied towards any personal (non-insurance) charges for today. Optionally, you can adjust the amount you wish to link to today’s charges.
You might do this in order to apply only the amount of a copay, for example, or if only part of the credit should be applied.
When you are finished reviewing charges and payments, click Save and Post. PCC EHR will link the payment from the past directly to the charges that have a personal amount due.
Review and Fix Invalid ICD-10 Codes When You Post Charges
When you post charges, and an ICD-10 code is expired (or not yet in effect), PCC EHR will warn you and prevent posting. The diagnosis will appear in red text and include an explanation in parentheses. For example, this screenshot was taken in December of 2020:
PCC EHR will not allow you to post charges with diagnoses that are invalid for the date of service. You can immediately add the correct code into the Diagnoses component, link and post the charges, and queue up a claim.
Fix Your Diagnosis Configuration: If an invalid ICD-10 appears on the Post Charges screen, you can fix the problem so it doesn’t appear again. For example, you might have an order that is configured to trigger the old diagnosis, or an expired ICD-10 might be manually mapped to a SNOMED description. You can fix these issues in the Billing Configuration tool. In Billing Configuration, you can only map ICD-10 diagnoses that are valid or will be valid in the future; expired ICD-10s are not available for mapping.
Help Families Resubscribe to Broadcast Emails and Opt In to Your Practice’s Text Messages
When a patient or their caregiver indicates that they did not receive your latest text (SMS) message or broadcast email, you can easily determine if it is because they have opted out of communication from your practice.
Look up the person’s phone number or email address in PCC EHR and see if an icon appears beside it.
If you see an icon, it indicates that the contact method has been opted out of communication from your practice.
Unsubscribed Email Addresses Still Receive Portal Notifications: Patients and families who unsubscribe from your practice’s broadcast emails are still able to receive email portal notifications.
Opted-Out Phone Numbers Cannot Receive Any Text Messages from Your PCC System: Patients and families who opt their phone numbers out of text messages from your practice cannot receive any kind of text message sent from your PCC system, including broadcast messages, single text messages, and patient portal notifications.
Click the icon to learn how you can help the person opt back in to communication from your practice.
If the contact method is an email address, you can send a resubscribe email.
The recipient must open the email and click the “Opt-In” button in order to complete the process.
If the contact method is a mobile phone number, the person whose number it is must text “UNSTOP” to your practice’s texting number. You can find your practice’s texting number in the instructions that pop up when you click the icon beside the opted-out number.
As soon as the person texts the word “UNSTOP” to your practice’s texting number, they receive confirmation that they have opted back in.
The icon in PCC EHR disappears once a contact method can receive messages again.
Where Does My Practice’s Texting Number Come From?: A text messaging number is automatically assigned to your practice by the telecommunications vendor PCC works with to provide broadcast messaging services. It is not possible to alter or customize this number.
Portal Users Can Opt In Mobile Phone Numbers from the Patient Portal
Portal users see a message in the patient portal if their phone number cannot receive portal notifications. They can click “Edit Notification Settings” to correct the issue.
The button brings the user to the Edit Account page.
A message at the top of the page explains why the opted-out phone number cannot receive notifications and how to fix it. The opted-out phone number is highlighted in red at the bottom of the page.
If the user is signed into the portal on their phone, an “Opt in” button appears beside the opted-out number. When tapped, the “Opt in” button automatically composes a text message to your practice with the word “UNSTOP” in the body.
Once the person opts the phone number in, they can once again receive text messages from your practice, including portal notifications.
Portal users can find opt-in instructions in the My Kid’s Chart User’s Guide.
Opt In the Right Device: Users should only resubscribe via the “Opt in” button if they are signed in to the portal on the mobile device associated with the unsubscribed phone number.
Some Contacts Intentionally Opt Out of Text Messages: Contacts who intentionally opt out of text message communication from your practice should remove opted-out numbers from their portal notification settings.
See if a Patient or Family Member Read Your Patient Portal Message
Learn exactly when your patients and families read your portal messages, so you can be sure you’re reaching them.
When you review a patient’s Portal Messages in PCC EHR, check the “status” line for each portal message. When the recipient opens a Patient Portal message, the status updates from “Unread” to “Read” with a timestamp of exactly when the message was opened, and which user opened it.
Make sure your message is received by assigning a follow-up task. Unread messages include the option to create a new “Follow Up On Unread Message” task. This new task type can be assigned to a user, but will also automatically be marked as completed if the message recipient reads the message before the assigned user marks it as completed.
More Easily View Portal Message Attachments in pocketPCC
Use pocketPCC to review attachments sent to your office via the Patient Portal to stay in complete contact with your patients from anywhere.
When you view a portal message in pocketPCC, any attachments appear below the message text. Click the arrow to the right of the file name to hide or show the attachment.
Click the arrow again to hide the image.
Click “Add Task” to create a new task associated with this document.
Quickly Find Recently Added Documents in pocketPCC
PCC 8.15 changes how documents are sorted and managed within pocketPCC, bringing it in line with PCC EHR, so you can quickly find a patient’s most recent documents.
The Recent Documents category appears at the top of each patient’s Documents and includes the five documents most recently added for the selected patient. Each document can also be found under its own category.
Likewise, within each document category, documents are sorted by date, with the most recent documents at the top of the list, so you can find the documents you’re looking for quickly.
Pick From Your Last 10 Patients When You Import Documents
When you need to import documents to a recent patient’s chart, you can now select from the last 10 patients in the Import Documents window.
In addition to the quick “Last Patient” button, you can now easily pick from any patient you worked with recently.
The last 10 patients menu now appears wherever you search for patients—in Import Documents, but also in the PCC EHR Audit Log, the Delete Charted Visit window, the Immunization Registry Message Viewer, and more.
See Clinical Measures for Each of Your Office Locations in the Dashboard
The Practice Vitals Dashboard helps you monitor the health of your entire pediatric practice at a glance.
In PCC 8.15, multi-location practices can drill down even further to measure how well each specific location delivers patient care.
Launch the Practice Vitals Dashboard from the Reports menu in PCC EHR.
A new label in the top-right corner of each page tells you which location the data on the page is for.
On pages that have location-specific data, the location label turns into a drop-down list and you can select the location you want to view.
When you change the location filter, the page automatically refreshes and updates the measures and benchmark calculations with data specific to your selection.
Location-specific calculations are based on the patients who are assigned to the location that is selected. At most, each patient at your practice is represented only once in location-specific data sets for each measure.
How Are Patients Assigned to Office Locations for Dashboard Measure Calculations?: Patients who have had a well visit are assigned to the location of their last well visit. Patients who have never had a well visit are assigned to the location of their most recent office visit. Patients who have had neither a well visit nor an office visit are excluded from location-specific data sets.
You can filter all Clinical Pulse and PCMH measures by location, except for weight assessment and counseling measures and the measures for influenza immunization rates.
When navigating between pages that have location-specific datasets, the Dashboard remembers the last location you selected.
Location-specific Dashboard measures can help you understand if a location needs extra help in the clinic or is providing particularly good care to patients.
Practices working toward Patient-Centered Medical Home (PCMH) recognition can also use location-specific datasets in the Dashboard to attest to the fact that they are meeting program benchmarks.
Contact your PCC Client Advocate for help interpreting information in the Practice Vitals Dashboard, including data about specific practice locations.
Delete Scheduled Reports
Clean up your list of scheduled reports in PCC EHR by deleting those you no longer need.
Open the Report Library from the Reports menu, then click the Scheduled Reports tab.
Select a schedule you never plan to use again, then click the Delete button.
Deleted scheduled reports are permanently removed from the Report Library and cannot be re-enabled. If you want to temporarily disable a scheduled report, try stopping it instead.
You can continue to view past saved results of deleted scheduled reports in the Report Library in the Saved Results tab.
Only Users With Permission Can Delete: The ability to delete scheduled reports is restricted to users who have permission to do so. You can set this permission in User Administration.
Report More Easily on Hospital and Billing-Only Encounters
Improvements in the PCC EHR Report Library make it easier to report on hospital and billing encounters.
Find Hospital Visits and Billing-Only Encounters by Billing Status
The Encounters by Billing Status report can now include hospital and billing encounters.
When building your report, you can use the Encounter Type filter to include or exclude hospital and billing encounters from the results.
You can also use the Location filter to include or exclude encounters that occurred at hospital locations.
Report on Diagnoses Billed for Hospital Visits
The Billed Diagnoses by Date report can now include hospital encounters.
You can include or exclude hospital encounters from the report using the Location filter on the report criteria screen.
When you run the report for all locations, the results include hospital encounters.
Other Report Library Improvements
PCC 8.15 tweaks and tunes the Report Library to make it an even more powerful tool for your practice.
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See When You Last Reviewed Care Plans: The date of last review for care plans has been added to the Care Plans by Date report. This change helps all practices track the progress of care plans more closely, and especially helps offices working toward PCMH recognition.
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Filter and Sort Care Plan Reports by Patient Flag: You can now filter and sort by patient flag in the Care Plans by Date report. This change is most useful if you want to exclude inactive patients from the report so that you can focus on active patients with care plans.
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When You Delete a Custom Report, See If It Is Scheduled: When you delete a custom report that was used as the basis for scheduled reports, the Report Library notifies you of the schedules before deleting the report. You can use this information to decide if you want to keep the report in place or delete it anyway. If you choose to delete it, the associated schedules will also be deleted.
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No More Canceled and Missed Appointments When Reporting by Billing Status: The Encounters by Billing Status report now excludes canceled and missed appointments, allowing you to focus on the visits which did occur and might need some biller or clinician follow-up.
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More Locations When Reporting By Billing Status: As of PCC 8.15, the Location filter for the Encounters by Billing Status Report allows you to select both scheduling and non-scheduling locations.
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Navigate the Report Library More Quickly: Performance improvements introduced in this release result in a Report Library that loads screens faster and smoother than before.
Coming Soon: Look Up and Import Immunization Records from Your State’s Registry
When a new patient joins your practice or an established patient comes in after a hiatus, you want to be sure you have the most complete and up-to-date version of their immunization history.
PCC 8.15 gives pilot practices the ability to look up and import vaccine records from their local immunization registry without ever leaving PCC EHR.
If you are interested in using this feature once a connection has been established with your registry, speak with PCC Support.
Open the Patient’s Immunization History in PCC EHR
Open a patient’s chart in PCC EHR and navigate to the Immunization History.
You can get to the Immunization History from the History section of the chart or within the Immunizations component if you’re in a visit protocol.
Click the “Retrieve Imms” Button
Click the “Retrieve Imms” button to request the patient’s immunization history from your state registry.
Confirm the Patient Match
The registry searches its records for your patient and PCC EHR asks you to confirm that it found the right person.
Once you confirm that the registry found the right patient, click “Next” to view the patient’s vaccine history.
You Can Only Proceed with a Unique Patient Match: If the registry finds several possible matches for your patient or finds no exact matches you will not be able to retrieve the patient’s vaccine history from the registry within PCC EHR. Close the Retrieve Immunizations window and try looking up the patient’s vaccine history directly on the registry website.
Review the Information Sent by the Registry
Review the vaccine history from the registry. Information that is already in the patient’s chart appears in a black font, while new information from the registry appears in an orange font. You can decide what to do with the new information on the next screen.
Click “Next” to begin importing new information from the registry into PCC EHR.
Immunization Registry Forecasting and Disease Data: Some registries send vaccine forecasting and/or vaccine-preventable disease data in addition to the patient’s vaccine history. You can view this information if the registry sends it, but you cannot import it into PCC EHR.
How Does PCC EHR Determine if a Vaccine is Already in the Patient's History?: For each immunization reported by the registry, PCC EHR checks to see if the associated CVX code and date already exist in the patient’s chart.
Import New Vaccine History Information from the Registry into PCC EHR
Select the immunizations and dates you wish to import from the registry into the patient’s PCC EHR record. You can only import new entries from the registry; entries that already exist in the EHR are excluded from the import window.
Once selected, immunizations from the registry are automatically mapped by CVX code to their equivalents in the EHR.
If a registry immunization has several equivalents in the EHR, all of the options are presented in a drop-down field in the import window. Review the options and manually select one to use for the import.
Sometimes new entries from the registry use CVX codes that are not configured in your PCC system. You must add the missing CVX codes to your immunization configuration in order to import these entries. Contact PCC Support if you need help adding CVX codes to your immunization configuration.
Once you have selected and mapped the immunizations you plan to import from the registry, click the “Import” button.
The information imports into PCC EHR and the Retrieve Immunization window closes on its own.
View and Edit Imported Entries in the Patient’s Immunization History
Information imported from the registry appears immediately in the patient’s Immunization History in PCC EHR.
You can view details about the immunizations imported from the registry by editing the patient’s Immunization History.
Historic immunizations imported from the registry are recorded in the patient’s chart with the source “Historical Record from Other Registry”. The imported entries can also include information about the vaccine dose, lot number, site, route, and funding source.
You can edit or delete an imported immunization just like any other item in the patient’s Immunization History.
Continued Pilot Test: Send CHADIS Questionnaires to Families in the Patient Portal
PCC continues piloting the integration of CHADIS questionnaires into PCC EHR and PCC’s Patient Portal. If your practice is part of our pilot testing, your Patient Portal now links directly to CHADIS, so your portal users can get started on their patient’s CHADIS questionnaires as soon as their appointment is booked.
Coming Soon: CHADIS integration into PCC is currently in pilot testing and not yet available to all PCC clients. Stay tuned for additional functionality and the wide release. CHADIS integration into PCC EHR requires that your practice has a CHADIS subscription.
Continued Pilot Test: Securely Retrieve Patient Information from Hospitals and Other Practices
Do your patients see other doctors? Do you wish you could retrieve records from those providers on demand?
Pilot testers can request and securely retrieve their patients’ records from other healthcare organizations right within PCC EHR. This is the latest addition to PCC’s Clinical Document Exchange functionality.
To retrieve a document, click “Find Clinical Documents” within the History section of the patient’s chart.
Select one or several healthcare organizations to query, then search for your patient within their records. If you find matches for your patient, you can then see if the organizations have clinical documents to share, and retrieve any you wish to view and save to PCC EHR.
You can set up default healthcare organizations to query for each of your patients, and also decide if certain organizations (such as local hospitals or urgent care clinics) should be queried for all patients.
Users need special permissions in PCC EHR in order to request patient records from other organizations. All PCC EHR users can view retrieved documents after they have been saved in patients’ charts.
How do I Participate?
Although it is not yet possible to sign up to securely retrieve your patients’ records from other healthcare providers, you can prepare for the feature by becoming a Clinical Document Exchange Responder.
Clinical Document Exchange Responders allow other healthcare organizations who participate in the Carequality interoperability framework to retrieve their patients’ records for treatment purposes. In order to eventually be able to initiate records requests, you must first enroll to respond to requests from others.
To become a Clinical Document Exchange Responder, contact PCC Support.
Learn About Clinical Document Exchange
Is Clinical Document Exchange secure? How does it work? Which organizations can I query for my patients’ records? Find answers to all of these questions and more in the PCC Learn article about Clinical Document Exchange.
Other Feature Improvements and Bug Fixes in PCC 8.15
In addition to the features described above, PCC 8.15 includes these smaller improvements and squashed bugs.
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Delete Hospital and Administrative Fee Billing Encounters: When you use Correct Mistakes (
oops
) to delete all diagnoses, procedures, payments and adjustments for a hospital encounter or other charge that does not have an appointment, PCC EHR will automatically remove that encounter from the Billing History and the Visit History sections of the patient’s chart. -
Diagnoses and Procedures Remain Available in Post Charges: When you need to delete and repost charges, or return and finish posting additional items for an encounter, the Post Charges workflow will continue to display all of the diagnoses and procedures originally added to the encounter.
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2021 RVU Values for Reporting: During the PCC 8.15 release cycle, PCC updated all practices with RVU values for 2021. This updates many reports, such as the RVU-Per-Visit measure in the Practice Vitals Dashboard.
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0.3ml Dose Amounts: PCC EHR now supports the recording and tracking of immunizations that require a 0.3ml dose.
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Additional COVID-19 Terms Available as Diagnoses: Among other updates in support of charting COVID-19 related encounters, the PCC 8.15 update adds three SNOMED situations to the standard Diagnosis favorites list so they can be used as diagnoses: Suspected disease caused by severe acute respiratory coronavirus (mapped to B97.21), History of disease caused by Severe acute respiratory syndrome coronavirus (mapped to Z86.19), and Disease caused by Severe acute respiratory syndrome coronavirus 2 absent (mapped to Z03.89).
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See If PocketPCC or the Patient Portal is Being Updated When You Sign In:
Users who try to sign in to PocketPCC or the patient portal while PCC is updating your software to a new release will be notified that an update is in progress and that they should try again later.
Users who are signed in to PocketPCC or the patient portal when an update begins will be logged out the next time they take an action. They will be redirected to a page explaining that an update is underway. Any unsaved work will be lost.
PCC 8.15 Migration Considerations
The PCC 8.15 release includes new features that may need configuration and for which you may want to do extra planning or training. Read below to learn more, and share relevant details with your physicians and staff.
Read the PCC 8.15 Release article for complete details on these features.
Contact PCC Support for information about these or any features in PCC 8.15.
Update Your Workstations, Expect Some Slowness On Day 1
After a PCC update, your practice will need to update workstations around your office. Users will see an update reminder on their login screen.
Update Slowness: After you install a PCC EHR update on a workstation, the software needs to cache the code it uses to display information. You will experience slowness until this finishes.
Add COVID-19 Vaccines to Your PCC System
For a complete guide to adding COVID-19 vaccines to your PCC system, read Configure, Track, and Administer COVID-19 Vaccines in PCC EHR (COMING SOON).
In addition to other COVD-19 vaccine updates, PCC 8.15 adds the 0.3ml as an option for dosage. If your practice added the Pfizer COVID-19 vaccine to your system prior to PCC 8.15, you should update the dosage from “Unspecified” to “0.3ml”.
Configure Which PCC EHR Queues Appear for Each User
To adjust which queues are visible for each user at your practice, first open the User Administration tool and edit a user role.
Use one of your existing roles or create a new one. Double-click on the role to adjust permission settings.
Select each queue that users with this role should have access to. Repeat this process for each role at your practice.
As you design roles, remember that users can be assigned more than one. Each user will see all the queues available for any of their assigned roles. Also, note that the eRx Tasks queue only appears for users who have both a role with the queue permission and an enabled PCC eRx account.
Next, edit each user’s account and adjust their assigned roles.
By fine-tuning which queues appear for each user role in your practice, you can make PCC EHR easier to use and you can control who has access to different functions in PCC EHR.
All Users Will Still Have Access After the PCC 8.15 Update: Configurable queues are brand new! The PCC 8.15 update won’t hide any queues. When users log in after the update, they will see the same queues they have always seen. After the update, your practice’s office manager or system administrator can configure roles for your users, and also set expectations about the change. If you need help, contact PCC Support.
Adjust Order Configuration to Make Billing Easier
PCC 8.15 improves how orders (including labs, immunizations, and others) show up when the clinician prepares the encounter for billing. Orders can now automatically add linked diagnoses and procedures to the Bill window, and duplicate diagnoses (such as for immunizations) will now consolidate into a single entry.
After your PCC 8.15 update, your practice may wish to adjust what codes are triggered by common orders at your practice.
If your practice uses PCC EHR to post charges, for example, you can add the Z23 diagnosis to every immunization order without worrying about a long list of Z23s for busy well visits. Use the Billing Configuration tool to adjust the diagnoses and procedure codes for each order at your practice. Use the Protocol Configuration tool to adjust which orders appear for each visit reason.
If your practice still uses the Practice Management tools (chuck
, checkout
) to post charges, you may decide not to do this, as the previous system does not deduplicate diagnoses.
Prepare for Username and Password Updates Across PCC Products and Services
PCC 8.15 automatically syncs authentication between PCC EHR, the Practice Management window, and other PCC products and services. Your practice can use PCC EHR’s User Administration tool to manage user accounts for all PCC products. This includes password, username, and each user’s “Full Name” which appears in various programs. This syncing will occur the first time a user logs into PCC EHR.
After the update, your practice should be on the lookout for the following:
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What If My Passwords Were Different Before PCC 8.15?: If you previously used synced accounts on PCC EHR and Practice Management, but those accounts had different passwords, PCC 8.15 will update your Practice Management password to match your PCC EHR password when you next log in to PCC EHR. Your practice should share this information with some users, particularly if they access the Practice Management tools directly using terminal emulation software, such as AniTa.
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Use Your PCC EHR Password for All Logins: If a user connects to your PCC server using a Secure Connect connection or other remote connection technology, they will now use their PCC EHR password.
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Web-Based Email Login: If your practice uses a web-based email program to access an email account run on your PCC server, such as Roundcube, that password will also be synced to the user’s PCC EHR password.
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What If I Used Different PCC EHR and Practice Management User Account Names Before PCC 8.15?: If you had two different login usernames on your PCC system, one for PCC EHR and one for the Practice Management window, PCC 8.15 will not touch your accounts and you can continue to use them without interruption.
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What If My Practice Shares User Accounts Among Multiple People?: If your practice shares either PCC EHR or Practice Management account logins among multiple employees, PCC strongly suggests you work with PCC Support to end this practice, as it represents a security risk and makes it impossible to audit account access. After your PCC 8.15 update, only one PCC EHR account can be linked to a Practice Management username and password. Prior to the PCC 8.15 update, PCC will proactively contact your practice if you have multiple PCC EHR users connected to a single Practice Management account.
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Attribution in Some Programs May Look Different: If a user had a different Full Name in their PCC EHR account than they used in their Practice Management account, they may notice differences in how their name appears in some programs after the PCC 8.15 update. For example, if your practice uses initials to indicate who performed various advanced billing functions (like correcting and rebatching a claim), those initials will now match the full name from their PCC EHR account. Contact PCC Support for assistance.
Allow Users to Delete Scheduled Reports
A new permission in User Administration grants users the ability to delete scheduled reports in the Report Library.
You can add the permission to any role which requires it.
With the update to PCC 8.15, the permission will be granted by default to all users who already have both Report Library *and* User Administration access. If you need step-by-step instructions about how to assign permissions to users in PCC EHR, read Set User Roles for Permissions and Security.
Get Started with Bidirectional Immunization Functions in PCC EHR
The ability to look up and retrieve immunizations from your local registry within PCC EHR is currently in pilot testing with California Immunization Registry (CAIR).
If you are interested in using this feature once a connection has been established with your registry, contact PCC Support.
Continued Pilot Test: Securely Retrieve Patient Information from Hospitals and Other Practices
PCC continues to roll out the ability to securely retrieve patient documents from other healthcare providers in PCC EHR to practices who are already Clinical Document Exchange responders.
Clinical Document Exchange responders allow other providers to securely retrieve patient documents from their PCC system. You must become a responder before you can enable the ability to retrieve patient documents from other healthcare organizations.
Contact your PCC Client Advocate if you wish to become a Clinical Document Exchange responder in preparation for the ability to retrieve patient documents from other providers.
Or, learn more about Clinical Document Exchange.
Create Chat Groups For Your Practice
Expand your communication reach using PCC EHR’s chat feature by creating groups of users. With a chat group, you can send a message to a list of users all at once.
Create, manage and edit groups through the User Administration tool’s Chat Groups tab. Click “Add Group” to create a new group of users.
Check the box alongside each user’s name to add that user to the new group. Name the group at the top of the window and click save. Each group name can only be used once, so you won’t be able to duplicate group names, but to avoid confusion, be sure that your group names don’t match existing users. For example, if you have a user called “Nurse” make sure to name your group of nurses something like “Nurse Group” to differentiate the group from the individual.
When you’ve created one or more groups, they’re available in the chat window’s “To” menu.
You can edit or delete groups at any time in the User Administration tool. To add or remove users, or rename a group, select the group in the Chat Groups tab and click Edit.
Check or uncheck the box to add or remove a user, then click Save.
When a user is removed from the group, they’ll still be able to see the message history, but will no longer see any new messages or have the option to send messages to the group.
If your practice deletes a group, the same is true. Each user will be able to see the history of the conversation, but the option to send a message will be removed, and replaced with “This conversation is closed.”
Review Custom Report Settings
PCC 8.15 introduces many Report Library improvements. Although none of the improvements changed your custom report settings, the settings you already had in place might now work a little differently.
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Encounters by Billing Status Report: Check the settings of your custom Encounters by Billing Status reports. If they are set up to report on all locations and/or all encounter types, hospital and billing-only encounters will be included in the report results.
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Billed Diagnoses by Date Report: Check the settings of your custom Billed Diagnoses by Date reports. If they are set up to report on all locations, hospital encounters will be included in the report results.
Update Your MacOS 10.12 or 10.13 Workstations and Your Windows 7 PCs
When a manufacturer stops providing security updates for an operating system, PCC ends support as well. If your practice is still using workstations that run Windows 7 or MacOS 10.12, that support has already ended and you should upgrade those machines.
Apple is expected to end support for 10.13 in 2021. PCC 8.15 includes a reminder at login to review and update your workstation’s operating system. Contact PCC Support for recommendations.
PCC EHR requires a workstation running on Windows 8 or higher, or MacOS 10.14 or higher. For more information, read Hardware Guide: Your Personal Computer and Equipment.
Record Sexual Orientation and Gender Identity in a Patient’s Chart
Use PCC’s Sexual Orientation and Gender Identity components to securely record information in a patient’s chart. When a patient decides their gender identity is public, your practice can optionally display a patient’s pronoun and preferred name in the Appointment Book and elsewhere in PCC EHR.
Watch a Video: You can watch a video guide to these features: Record Sexual Orientation and Gender Identity.
Record Sexual Orientation in a Patient’s Chart
When your practice charts a patient’s sexual orientation, you can record the patient’s information in the Sexual Orientation component.
Your practice can add this chart-wide component to chart note protocols or anywhere you need it for your workflow.
Sexual Orientation is a Confidential Component: When you open a chart, the contents of this component are hidden. A clinician or other PCC EHR user must click the disclosure arrow to display the contents of the Sexual Orientation component. PCC EHR records that this information was accessed, and your practice can review who accessed the information in the PCC EHR Audit Log.
Record Gender Identity, Preferred Name, and Pronoun in a Patient’s Chart
Use the Gender Identity component to record a patient’s gender identity, preferred name, pronoun, and notes.
The component appears on the Medical Summary by default. Your practice can move it, remove it, and add this chart-wide component to chart note protocols or anywhere you need it for your workflow.
Patient information in this component is marked private by default. When private, the fields in the component are not visible anywhere in PCC EHR except in the Gender Identity component.
Gender Identity is a Confidential Component: When you open a chart, the contents of this component are hidden. A clinician or other PCC EHR user must click the disclosure arrow to display the contents of the Gender Identity component. PCC EHR records whenever this information was accessed, and your practice can review who accessed the information in the PCC EHR Audit Log.
Make a Patient’s Preferred Name and Pronoun Visible On Various Screens in PCC EHR
When a patient’s gender identity information is no longer private, select Public in the “Privacy Status” drop-down menu.
When Public is selected, PCC EHR and pocketPCC can display the patient’s preferred name and pronoun in the Patient Banner as well as in other places in PCC EHR.
On the Appointment Book, for example, your staff will be able to see the patient’s preferred name and pronoun as they make an appointment. The preferred name can also appear on the Schedule screen and PCC EHR queues, except for the Rx Queue (which uses the patient’s legal name) and the E-lab Results queue (where a patient’s name is provided by a lab vendor). Your practice can find the patient by searching for either the preferred or legal name.
The patient’s preferred name can also appear at the top of forms and patient and family-facing reports that include the green name header. This includes the Patient Visit Summary:
Note that the patient’s legal name and sex appear elsewhere on the form. Documents that can include the preferred name in the green header include: Care Plans, PDF versions of Continuity of Care Documents, Growth Charts, the Health Information Summary, Lab Order Details, the Patient Visit Summary, Summary of Care Record, and Visit and Billing History printouts.
Configure How Your Practice Displays Preferred Name and Pronoun
A patient’s preferred name and pronoun do not appear at all if their Gender Identity component is set to Private. Your practice can configure whether PCC EHR displays only a patient’s legal name, only the preferred name, or both the legal and preferred names when they are set to Public in a patient’s chart. You can also optionally turn off the preferred pronoun display.
Open Practice Preferences to review your options.
In addition to adjusting your practice’s display preferences, your practice may wish to change the location of the component. You can also adjust your practice’s existing workflows for patients. For example, if a patient’s preferred name was kept in the Nickname field in Demographics, you can use the Gender Identity component instead.
Other PCC EHR Tools to Support Patients: Some practices use a patient status flag, an entry in the Reminders component, or a Clinical Alert to inform clinical staff when a patient has gender identity information they should be aware of. For example, if a patient shares private information about their gender identity with a clinician, the practice may record that information in the confidential Gender Identity component. A flag and a corresponding Clinical Alert could inform clinical staff that they should review that component prior to the appointment.
Fall 2020 SNOMED-CT and ICD-10 Updates Add COVID-19-Related Issues and Other Diagnoses
On September 20th of 2020, PCC updated the SNOMED-CT diagnostic terms and the ICD-10 diagnosis billing codes on your practice’s system.
PCC regularly updates your system’s ICD-10, LOINC, SNOMED-CT, NDC, RVU, VIS, and other standardized lists so you won’t encounter challenges when you chart, order a lab, interface with a care provider, or bill for a visit. (Your practice’s local system automatically updates your practice’s procedure code validation, as well.)
In PCC EHR, clinicians enter diagnoses using SNOMED, which maps to ICD-10 billing codes for claims. We updated both of these codesets in order to provide you with the most up-to-date diagnostic language in the chart, and to support the 2021 edition of ICD-10, which takes effect for dates of service after 2020-10-01.
Read the sections below to learn about the updates, educational opportunities, and diagnosis codes and descriptions of particular interest to pediatricians.
Use 2021 ICD-10 Diagnosis Billing Codes, Including New COVID-Related Codes
The 2021 ICD-10 update includes new sections for COVID-19-related infections and vaping-related disorders. You can review the complete, updated guidelines in the CDC’s ICD-10-CM Official Guidelines for Coding and Reporting.
The new codes and guidelines take effect for dates of service starting on 10/1/2020. You can learn about the updates that are of most interest to pediatric practices by attending PCC Web labs held by Jan Blanchard (CPC, CPEDC). Missed a web lab? You can watch a recorded session as well.
In addition to COVID-19 and vaping-related guidelines and codes, Jan notes that the 2021 ICD-10 update includes more specificity for substance abuse codes, several adjustments to influenza coding, and new codes for reflux, headaches/face pain, and more. In the “curiosities” bucket, the update includes “Pedestrian on electric scooter and standing micro-mobility pedestrian conveyance (hoverboard, segway)” added to V00-V06.
Chart Diagnoses Mapped to Deprecated ICD-10 Billing Codes: Were there any 2021 code changes for items that your practice frequently bills? You can review your system configuration using the snomedmap report tool in Partner. While there were no major disruptions in the 2021 ICD-10 update, it’s always worth taking a look at your code mapping reports to head off any billing challenges.
Use the Latest SNOMED Diagnoses, Including New COVID-Related Descriptions
The SNOMED-CT update includes thousands of new descriptions for diagnoses, allergies, therapies, and procedures. It also updates thousands of text descriptions for diagnoses and their mapped ICD-10 billing codes. You can review information about the update on the National Library of Medicine website.
Review Your COVID-19 SNOMED to ICD-10 Mapping: As codesets continue to change in response to COVID-19, PCC recommends you review the diagnoses you use to chart and bill for COVID-19 issues. For example, this update includes a new recommended mapping of the Exposure to SARS-CoV-2 SNOMED description to the Z20.828 ICD-10 code. This mapping was not included by default in the previous SNOMED standard. You can double-check your practice’s diagnosis billing configuration in the Billing Configuration tool.
New COVID-19-Related Diagnosis Descriptions
The update includes 22 new diagnoses for the use of identifying when an issue is related to COVID-19. For example, there are new descriptions for otitis media and several new descriptions for respiratory distress and infections, pneumonia, bronchitis, and similar. For a complete guide to COVID-19-related descriptions, you can read the COVID-19 section of the SNOMED-CT International Release Notes.
Acute bronchitis caused by SARS-CoV-2 |
Asymptomatic SARS-CoV-2 |
Acute hypoxemic respiratory failure due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Acute kidney injury due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
At increased risk of exposure to Severe acute respiratory syndrome coronavirus 2 |
Cardiomyopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Conjunctivitis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Dyspnea caused by Severe acute respiratory syndrome coronavirus 2 |
Encephalopathy due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Fever caused by Severe acute respiratory syndrome coronavirus 2 |
Infection of upper respiratory tract caused by Severe acute respiratory syndrome coronavirus 2 |
Lower respiratory infection caused by SARS-CoV-2 |
Lymphocytopenia due to Severe acute respiratory syndrome coronavirus 2 |
Myocarditis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Pneumonia caused by SARS-CoV-2 |
Otitis media due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Rhabdomyolysis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Sepsis due to disease caused by Severe acute respiratory syndrome coronavirus 2 |
Severe acute respiratory syndrome coronavirus 2 detected |
Severe acute respiratory syndrome coronavirus 2 not detected |
Thrombocytopenia due to Severe acute respiratory syndrome coronavirus 2 |
New Favorites Available in Diagnosis Quick Search
The update adds 2043 diagnosis descriptions to your system. PCC added 245 of them to the “Favorites” quick search feature of all diagnosis fields in PCC EHR.
In preparation for the update, PCC’s certified coder, Jan Blanchard, assembled a list of 245 new SNOMED-CT descriptions of interest to pediatricians. The update added these diagnoses to your practice’s default Favorites list for quick searching, unless your practice has specifically requested otherwise.
What is a diagnosis 'Favorites' list?: As you type or search in any diagnosis field, PCC EHR automatically searches a customizable list of Favorites. Use the Diagnosis Configuration tool to adjust your practice’s list of Favorites. You can also right-click on any diagnosis field in PCC EHR to search your system’s full SNOMED-CT diagnosis library.
You can review the list of 245 new Favorite descriptions. Attend PCC’s monthly coding weblabs to learn more about the new descriptions and other coding topics.
Deprecated SNOMED Diagnosis Descriptions
The Fall 2020 SNOMED-CT update removes or replaces many codes common to pediatric practices. Your practice may want to take special note of them.
Here are the top 25 codes from PCC’s pediatric practices that have been removed from the SNOMED-CT diagnosis library in 2020. When these codes appeared for selection on a chart note protocol, PCC added a replacement if available. For other diagnoses, your providers can usually find new appropriate descriptions with a search, but you may want to plan ahead.
Allergy to edible egg | 91930004 |
Seborrhea | 86708008 |
Sprain, ankle joint, lateral | 209532000 |
Allergic reaction to insect bite | 213024000 |
Dermoid cyst of skin | 276729007 |
Hearing loss in right ear | 1091501000119106 |
Pilonidal cyst with abscess | 85224001 |
Allergic reaction, due to correct medicinal substance properly administered | 57302007 |
Toxic erythema | 58767000 |
Infective hepatitis immunization | 275849001 |
Sprained finger/thumb | 287097007 |
Adverse effect, due to correct medicinal substance properly administered | 45376003 |
Pilonidal cyst without abscess | 76545008 |
Adverse reaction to vaccine properly administered | 699017007 |
Allergic reaction to bite and/or sting | 418484009 |
Gastrointestinal allergy to food | 414314005 |
Photosensitization due to sun | 258155009 |
Sprain of toe joint | 262998001 |
Angioedema of eyelids | 402405007 |
Angioedema of lips | 402406008 |
Adverse drug reaction resulting from treatment of disorder | 708809007 |
Discharge of eye | 18628002 |
Allergic reaction to systemically administered drug affecting oral mucosa | 702559001 |
Facial seborrheic dermatitis | 402210009 |
SNOMED Codes Mapped to ICD-10 for Billing
The SNOMED-CT update includes new mappings to ICD-10 billing codes. Many previous mappings have been updated.
You may wish to review billing configuration for your diagnoses. You can open the Billing Configuration tool to configure which ICD-10 diagnoses are mapped to each SNOMED-CT description in PCC EHR. You can also use the snomedmap
report tool to examine your practice’s diagnoses that may need updating.
Schedule Reports in PCC EHR
You can schedule reports to run in the future in PCC EHR.
Schedule a Report to Run Automatically
Use scheduled reports to automate recall lists, billing oversight reporting, and other workflows.
Select a Report
Open the Report Library and select the report you would like to schedule.
Set Report Filters and Click “Schedule”
Set the filters for the report, then click “Schedule”.
Set up the Report Schedule
Choose a name for this scheduled report and the frequency at which you want it to run. You may want to schedule multiple instances of the same report with different filter settings, or to run on different schedules. Choose a name that will help identify which instance of a report this is.
Finish Scheduling the Report
Click “Schedule” to finish scheduling the report.
Your report is scheduled. If you’d like, you can click “Generate” to generate the report immediately or move on to other tasks.
Preview Results and Save Output Settings
What if you want to check the output of the report before you schedule it, or you want to save column and group by (subtotaling) settings with your output? You can schedule from the results page of a report, which will retain any column and group settings you configure.
Reports scheduled in this manner will retain any column and group settings you configure here.
View Scheduled Report Results
You can view scheduled report results in the Saved Results tab.
Here you can see the results for all scheduled reports.
You can see the date the report was run, the name of the schedule, the name of the source report the scheduled report was based on, and the number of results in the report.
To see reports that last ran more than 30 days ago, change the “Result Date” filter setting.
By default, you will see all report results in this view. To see only the most recent results for each scheduled report, change the “View” filter setting.
Click on the report you want to view to open the results.
From here, you can export or print the results.
If a report has been run more than once, you can use the drop-down at the top of the report results to switch between results without going back to the Results tab.
Edit Scheduled Reports
To edit a report, click the Scheduled Reports tab. Here you can see all scheduled reports.
Click a report to edit it.
At the top of the report, you can change the schedule name, and the frequency and time the report will run. Below that, you can adjust the filter settings for all future runs of this report.
Click “Save” to save your edits. Or, if you’d like to make edits to the output formatting or to preview your report, click “Preview” to view report results.
Previewing Reports Takes Time: Previewing a report will run an instance of the report. If it’s a report that takes a long time to generate, this will take a while.
Stop and Start Reports
To stop a scheduled report from running, open it from the Scheduled Reports tab.
Click “Stop Schedule” to stop running the report.
Click “Save” to commit the change.
To start a previously stopped report, open it from the Scheduled Reports tab.
Click “Start Schedule” to activate the report.
Make any adjustments you want to the name, frequency, and filters, and then save (or preview and save) the report.
Delete Scheduled Reports
To delete a scheduled report from the Report Library, open it from the Scheduled Reports tab.
Click the “Delete” button, then confirm that you truly want to delete the schedule.
Deleted schedules are permanently removed from the Report Library and cannot be re-enabled. You can continue to view past saved results of deleted scheduled reports in the Saved Results tab of the Report Library.
Run a Pediatric Drive-Up Flu or COVID-19 Shot Clinic
Your practice can use PCC EHR to perform a shot clinic while also meeting COVID-19 safety protocols.
PCC has worked with several practices who are running “drive through” or “curb side” flu clinics. In addition to providing your families and communities with a vital service, by running a drive through flu shot clinic, you can prepare your practice for for participation in other vaccine clinics, such as expected upcoming vaccinations for COVID-19.
Learn More From the Experts: PCC spoke with several practices to draw together the ideas and tips below. We especially learned a lot from Dr. Jeanne Marconi, who delivered a seminar sharing her experience and expertise in running this kind of flu clinic. You can watch a recording of her seminar.
Check Out PCC's Blog Post: PCC posted a great guide to How to Open a Drive Thru Flu Clinic at a Pediatric Practice! It includes our notes below and so much more. Take a look!
Watch PCC Pediatric Flu Clinic Roundtable: In September of 2020, PCC hosted a Flu Clinic roundtable, talking about drive-thru strategies and more!
Pick a Location
If you’re reading this article, then your practice wants to run a vaccine clinic, but (especially during COVID-19), you do not want to do so in your physical office space. Where can you hold an outdoor, drive-thru flu shot clinic?
You may have a parking lot or other large enough area near your practice to support a drive-through clinic, or you may not. A local business might. Consider reaching out to banks, stores, and/or your local municipality to find a location.
If your practice does not own your parking lot, you may wish to take additional precautions or seek permission.
You may want to double-check your location’s general liability policy. It usually covers things that happen in your parking lot, even if you rent or lease your property. You may want to share your policy with your landlord, or connect with your insurance company to discuss the issue.
Prepare Things You Will Need
How will you maintain the cold-chain for your vaccines? Do you need traffic cones? What additional PPE will you need? And can you buy a tent from Walmart?
Some practices erect pop-up tents for checkin and administration stations. You’ll need to plan time for erecting and disassembling your tents. If there’s no rain, you might decide to skip the tent that day.
The CDC website hosts an excellent preparation checklist that covers the more serious issues, like vaccine storage, supplies, and rules around administration.
Plan for Safety
Your practice should plan the drive-up visit workflow to ensure safety. Ask yourself how you will “shepherd” cars, and where do they will wait when they pull in. Your location may have specific safety needs, and you will need to plan for traffic flow.
You should also make safety parameters clear to your families and all attendees. For example, instructing families that they should always stay in their car, and instruct staff to not approach a car until it has been placed in park.
You may need additional staff to help monitor and direct traffic so you are not blocking a major roadway.
Set Expectations and Get Your Staff On Board
You can hold a full, all-hands meeting: our practice is going to do a drive-thru flu clinic! Explain how this will help your families and your community. Every staff member plays a part, even if its just promoting the clinic at each contact point.
Dr. Marconi recommends having a “champion” on staff to be the point person, to help clarify and handle questions that come up. Offer food and other encouragement to your staff!
Pick a Date(s)
When will you host your drive-through flu shot clinic? You’ll need a date with adequate staff, and you’ll need to calculate how many patients or families you are likely going to be able to see.
Since you are looking for low traffic and wide open parking lots, a weekend date may work best.
Promote Your Drive-Thru Flu Shot Clinic
How will you get the word out?
Talk to families, use PCC’s Broadcast Messaging, and provide verbal reminders at every point of contact. Dig into social media, update your practice’s home page, Facebook, your phone hold announcement, and consider sending a press release to publications in your community.
Are you the first one in your community to offer this valuable service? Local media might help you promote the flu clinic, and/or report on it, which helps build your practice which in turn means you are better able to support your community.
Schedule Patients
How will you communicate your flu clinic “slot” availability to all patients and families? And how will they Schedule?
High volume visits mean that scheduling has to be easy. You can have families use of PCC’s portal message scheduling template so that families can pick a time or slot. You could also use a service like FullSlate, Calendly, or Acuity. These services create an online website for you so parents can easily sign up for an open slot.
Perform Pre-Visit Patient and Family Preparation
Your flu clinic will run best if you’ve worked with every family before the actual clinic. Send them the VIS beforehand, do pre-visit COVID-19 questions. When you speak with a family, always take the opportunity to do wellness questions, update information about patient chronic problem and care plan maintenance, and review their medications.
You can send the Influenza Vaccine VIS through PCC’s patient portal. You can also laminate a copy and hand it into the car at the time of service.
You can ask COVID-19 screenings ahead of time, or tell the family to expect them at the clinic. Remember to screen all occupants of the car at the time of service. Practices have developed alternative ways of asking kids COVID-19 screening tests, such as asking what they ate for breakfast and what it tasted like.
Use the Opportunity: You’ve got the family or patient on the phone? Use that opportunity to check in on all recall topics. Chronic disease management, updated immunizations, and more. You can schedule Telehealth and Well visits based on what you learn. You should also review and update demographics, verify insurance, and plan how they will pay! (Get credit card on file, for example.)
Plan For Payment
Many practices simply ask for “cash” payment for flu shots: for a non-office visit, occurring as fast as possible, billing insurance may not make sense for you.
Either way, your practice should work to make payment as touch-less and efficient as possible.
You can work with your financial services vendor to set up secure credit card on file, for example.
Set Up Your Intake Station and Your Shot Administration Station
To see patients quickly, you can have each car stop at two stations. First, an intake station for COVID-19 screening and prep, to help the family get ready (loosen clothes, set expectations), and to collect any forms. Next, the shot station, where the clinician should double-check the child’s age and consent, confirm the vaccine they believe they are receiving, administer the vaccine, confirm the patient appears well, and document that the vaccine was administered.
At each station, you’ll want signs (or hand-held posters) with “Stop Here” and “Put your Car in “P”ark!”. Someone should individually verify that a car is in park as they approach.
Have an Emergency Plan
Your practice already knows your emergency procedures when seeing patients at your practice. Take some time to review and update that plan for your drive-thru flu clinic.
If something goes wrong, or the patient has an emergency, everyone should know the plan. Who will call 911?
How Did It Go?
As with all new initiatives, things will go wrong. You’ll learn how to improve, what to do differently next time.
Send a survey to some patients or check in with families. Did it work? And ask your staff: They helped a huge number of patients in a short period of time! Congratulate and reward them for doing this.
Other Things We’ve Heard
Dr. Marconi shared that with practice and experience her staff can now manage to see 10 cars an hour. She uses a pre-check station, with 1 MA, followed by a shot station, with 1 staff. You can create multiple lanes as well.
We also learned from many PCC practices that a drive-thru clinic has a surprising bonus: kids are in their car seats, in familiar surroundings, and ready for what’s coming. Some administrations are harder in a car, but some are actually easier!
Your practice may also want to have a plan for “guest” flu shot customers. If someone is not a patient at your practice, how will you handle them? Schedule them for a new patient visit?
There are a number of great online resources for flu clinics and drive-thru flu clinics! Check out Sanofi’s resources, or the CPP Buying Group’s resources.
Code and Bill for E&M Office Visits
Upon completion of a sick visit encounter, a clinician selects an “Evaluation and Management” or E&M code. This is sometimes called the “office visit” level. E&M level selection is based on the clinician’s medical decision making or the amount of time spent on care for that patient on the calendar date of the encounter.
Procedure Code Guidance: The procedure codes discussed in this article are intended only as examples. You should consult the AMA’s current CPT Coding Guide and work with your insurance payers to verify what codes you should report. Your practice updates and maintains your procedure list, codes, and prices in the Procedures table in the Table Editor on your PCC system.
Why is E&M Code Selection Important to a Pediatric Practice?
E&M services make up a large percentage of the work you do as a pediatrician. They represent the cognitive work, information gathering, and decision making that goes into patient care. Because so much of the work you do falls under the umbrella of E&M, it’s vital that you code those services correctly. Many pediatricians under-code their encounters, resulting in significant lost revenue for their practice.
Documenting your encounters is not only important for continuity of care. It also supports collecting and retaining the revenue those services generate.
PCC’s E&M Coding Tool
PCC’s Jan Blanchard (CPC, CPEDC) developed a printable guide for E&M Coding.
2021 Transition Resources Archive
On January 1st, 2021, the guidelines for coding and billing an office visit changed significantly. PCC collected resources, created tutorials, and managed an FAQ at that time.
2021 Resource Guide: Some of the details below have changed since 2021. You should consult the current AMA CPT Coding Guide for the most up to date requirements and guidance. Reach out to PCC Support or attend a live PCC Billing Drop-In session to learn more.
How Do I Select an E&M Code for 2021 and Beyond?
For encounters that occur after December 31st, 2020, a clinician no longer uses history or physical exam performed during the encounter as criteria for code selection. Instead, they select a code based on either medical decision making or time spent practicing care for the patient on the day of the visit.
Here’s a brief explanation of how you select a billing code level for an “evaluation and management” or “Office Visit” after January 1st, 2021. These guidelines apply to common visit billing codes, such as 99212, 99213, 99214, or 99215, as well as to the selection of codes 99202 through 99205.
Select a Code Based on Medical Decision Making
You can base your visit level code on medical decision making, which is comprised of three elements:
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Problems Addressed: The number of problems you addressed for the patient during the day of the encounter.
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Items Reviewed: The tests, chart information, and other data you reviewed in relation to the problems addressed today.
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Risk: The level of risk presented to the patient.
- 2021 Evaluation and Management Updates: What changed? This 15 minute video explains the new way of selecting E&M codes in context with how you coded sick office visits before.
- PCC’s 2021 E&M FAQ&A: Frequently asked questions, and a live Q&A about 2021 E&M leveling.
- 2021 E&M Workshop: A live workshop led by PCC, this session includes an overview of the changes and examples of real-world level selection.
- The Impact of 2021 E&M Coding Changes on Pediatrics: Learn about the E&M coding changes in context, and then hear PCC’s ideas about how these changes will affect the business of pediatrics.
- Pediatric Management Institute’s September COVID-19 Webinar: During the September 2020 session of the PMI’s ongoing webinar series, The Business Impact Of COVID19 On Pediatric Practices, this topic is covered along with other current topics. This recorded live webinar includes some additional Q&A.
- PCC Resources
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Evaluate Your Practice's E&M Habits and Patterns: Your Practice Vitals Dashboard, available from within PCC EHR, provides a number of metrics, tools and recommendations related to E&M coding included on the “E&M Coding Distribution” measure.
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Confessions of a Pediatric Practice Management Consultant: PCC’s Chip Hart runs a blog and podcast, covering many topics related to practice management, including E&M coding. You can find it here.
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- Other Resources
- AAP FAQ: E&M 2021 coding questions and answers by the American Academy of Pediatrics.
- AAP MDM Grid: A direct link to the AAP’s chart which illustrates levels of medical decision making. It includes several useful examples. (AAP hosts this file here.)
- MDM Tracker: An online tool for selecting visit level based on medical decision making in 2021.
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Where can I find PCC’s 2021 MDM Tool?Here it is: PCC’s 2021 E&M Coding Tool.
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Where can I find the online MDM calculator Chip Hart shared?You can find it on the Confessions of a Pediatric Practice Management Consultant blog post entitled “Free E&M Medical Decision Making Calculator”.
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Is fever a systemic symptom which can elevate a visit’s level?Sometimes. It depends on the patient’s presentation, and only when paired with an acute illness.
CPT defines systemic symptoms this way:
“Acute illness with systemic symptoms: An illness that causes systemic symptoms and has a high risk of morbidity without treatment. For systemic general symptoms, such as fever, body aches, or fatigue in a minor illness that may be treated to alleviate symptoms, shorten the course of illness, or to prevent complications, see the definitions for self-limited or minor problem or acute, uncomplicated illness or injury. Systemic symptoms may not be general but may be single system. Examples may include pyelonephritis, pneumonitis, or colitis.” (p12-14 2021 CPT Manual)Fever had become a mainstay of complexity expression in E&M documentation. In 2021, not all fevers meet the definition of a systemic symptom. AMA says that in cases where the fever is a “general symptom in a minor illness”, it is *not* systemic. So using it to express visit complexity becomes a case-by-case determination for 2021. Things like age and other risks will be determining factors that clinicians will have to consider when they decide this point.
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Can we get points for both ordering and reviewing tests and labs in our MDM leveling?No. For any one test or lab, you may include *either* the ordering or reviewing done on the service date. To include both points would be “double dipping”.
Furthermore, the AAP has interpreted the AMA’s position to be that you may not consider tests performed in your office in your MDM level determination. This interpretation is under review.
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Will documenting multiple diagnoses lead to a higher level of MDM?
Maybe. “Problems” are the units of determination for MDM. So, if you treat three problems in a visit, but there are five ICDs listed, the ICDs do not inherently support higher complexity leveling. Some ICDs are reported because they represent circumstances and/or problems which complicate care but which are not specifically addressed at that visit. Documenting the role that those existing problems play in your thinking could support assigning higher Problem values to what *is* addressed.
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Can I really get credit every time a parent or guardian contributes history to a visit?Maybe. If you feel confident that the contribution they made is required for appropriate care to be rendered, yes. Document the reason for their perspective being necessary if it is not obvious. For example, little ones who can’t speak for themselves obviously require someone to give their history. But for teens, the necessity of another perspective in, say, behavioral or social concerns where objective input is valuable, document a statement to that effect and take the independent historian point(s).
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If I spend time reviewing records from a different practice, even if they’re from a practice where I formerly practiced medicine, can I count that time toward my day’s total?Technically, I would say yes. If the patient is familiar to you, the review would likely not take very long, necessarily.
Follow Up Question: What if I am reviewing records at my practice that are “old”, say, greater than 3 yrs?
Answer: No, not the way requirements are currently written: “Review of prior external note(s) from each unique source.” Only records from sources outside your own organization can be considered external and valid for those points. -
How do Social Determinants of Health (SDoH) count toward MDM?Per CPT 2021, SDoHs are “Economic and social conditions that influence the health of people and communities. Examples may include food or housing insecurity.”
Per the Elements of Medical Decision Making grid published by AMA in CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes, an example of Moderate risk of morbidity from additional diagnostic testing or treatment is “Diagnosis or treatment significantly limited by social determinants of health”. I interpret these references to suggest that any SDoH which significantly limits the patient’s ability to carry out the clinician’s plan meets the Level 4 risk requirement.
According to the U.S. Department of Health, Social Determinants of Health are economic and social conditions that influence the health of people and communities. Their examples include:
- Safe housing, transportation, and neighborhoods
- Racism, discrimination, and violence
- Education, job opportunities, and income
- Access to nutritious foods and physical activity opportunities
- Polluted air and water
- Language and literacy skills
Some of these may be reported using ICD codes found in “Persons with potential health hazards related to socioeconomic and psychosocial circumstances Z55-Z65”
- Z55 Problems related to education and literacy
- Z56 Problems related to employment and unemployment
- Z57 Occupational exposure to risk factors
- Z59 Problems related to housing and economic circumstances
- Z60 Problems related to social environment
- Z62 Problems related to upbringing
- Z63 Other problems related to primary support group, including family circumstances
- Z64 Problems related to certain psychosocial circumstances
- Z65 Problems related to other psychosocial circumstances
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How will billing sick care that was rendered during a well visit be affected by the 2021 E&M changes?As a physical exam is not a consideration in leveling 2021 E&M visits, clinicians can now capture sick care for New Patient well visits, and can more easily level any visit that includes both sick and well care.
The new MDM focus on visit leveling represents less subjectivity in discerning which parts of a service were part of the well care and which were part of the sick care.
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Do I need to document in the note the exact amount of time spent on each activity, or is it ok to just document total time?Full day totals are permissible, but I would feel better seeing at least time segments. Rough estimates for segments would do, but to expect that human brains can recreate a day’s worth of timed detail accurately for work that gets interrupted and broken up and then wrapped up after everyone else has gone home is a stretch which can be avoided.
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Is there still a Level 1 visit for nurse-only visits?Yes, for established patients only, a Level 1 nurse visit can be reported using 99211. New patient level 1 code 99201 expires on 12/31/20 and is not reportable thereafter. This is due to the identical MDM requirements for both 99201 and 99202. By 2021 standards, 99201 becomes redundant to 99202.
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If I continue to chart after hours, can I add that time for the purposes of leveling the visit?Yes. Caveat: The only after hours charting time (or any other clinical activity time) you may include in your billed time is the time spent *on the date of service*. If you chart any part of yesterday’s visit today, you may bill by time but you cannot include the time you spent today in the total you use for choosing your level. For example, if on Monday you see an established patient and spend 5 minutes reviewing records, 10 minutes in a visit, 5 minutes on a results call Monday night and 10 minutes charting on Tuesday morning, you may only bill a level 3 visit using Monday time: 5+10+5=20 minutes; Tuesday’s 10 minutes cannot count toward the leveling.
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Will I get MDM data points for tests like rapid flu or rapid strep for which I also charge?Currently, no. The current interpretation of the relationship between awarding data points for tests and labs and paying for tests and labs is that they are mutually exclusive.
Discussions around this continue, but currently you should not expect to level using data points for test and labs you bill.
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Are a CBC and differential counted as more than 1 lab? Or for example COVID-19/Flu/RSV combo - is that 1 test or 4 tests?It depends on the number of CPTs. If CBC and differential are one CPT, it is one data point for either ordering or reviewing. If the COVID-19/Flu/RSV combo is one CPT, one point is its data value.
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Could I count one of several screenings towards data reviewed and bill for the other and not be double-dipping?This is not in the spirit of the requirement, but is still under discussion. Billing effects are impossible to explore here. The sheer variety of payers and policies means the outcome can not be predicted. Furthermore, carrier behavior makes predictions of future claim determinations little more than a guessing game.
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Do I get credit if some historians are in office and others participate over facetime, phone, etc., for the same visit?Yes. There is no cumulative credit for historians, but if someone other than the patient is required to participate that requirement is met.
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If you use a formal screen for SDoH that is scored and payable, then you can’t count that screening towards MDM, correct?Currently, that is correct.
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Does pulse oximetry give a data point?I don’t know, and this question is more complex than it looks. The debate between clinicians about whether pulse ox is a vital sign is a factor. If you consider it a vital, it is not a test, and counting it as a data point is questionable. However, pulse ox has a billable CPT, so some may consider it a test.
Also, the question of whether in-house tests and labs may be used for data credit remains unanswered. I am undecided on this as yet and will count on the clinicians with whom I review encounters to help me arrive at a position on this point in future.
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We do our huddle and "run the schedule" (i.e. review referrals, lab results, vaccines, and consult notes) the day *before*, not the day of! Can we count that time when leveling each of those encounters?No. Currently, the only “billable” time is that spent by the clinician for that patient on the service date.
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Does 'undiagnosed new problem with uncertain prognosis' relate to when we don’t yet have a diagnosis, or does it mean a new previously undiagnosed problem that you identified at the visit?This phrase comes from a MDM requirement. Our interpretation is that it means a new problem for the patient that you have never seen before, and for which you are uncertain of the outcome.
CPT 2021 is light on guidance on this point. “Undiagnosed new problem with uncertain prognosis: A problem in the differential diagnosis that represents a condition likely to result in a high risk of morbidity without treatment. An example may be a lump in the breast…” The AAP offered an additional example of a potentially malignant lesion in the Feb 2020 issue of the Coding Newsletter.
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If we bill for one Vanderbilt, could we then claim MDM credit for the ones from other sources?My sense of this is that doing so is *not* in the spirit of the guideline. Additionally, performing a service and not billing for it will run afoul of many insurance contracts. Also, please see above for information about Data credit for in-house labs and tests.
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What about the hand-on-the-doorknob minor things that parents like to bring up? If there are enough of these, or significant ones, can I document them in a manner that might bump MDM up a level?
Example: Rash (insect bite) + been a little constipated (give some prune juice), been having stomach aches (few questions to make sure it’s nothing worrisome, asked to schedule another visit to evaluate further)…
Yes, but MDM is based on significance, not the number of problems. The total number of problems does not necessarily increase the credit you can claim for complexity in the Number and Complexity of Problems Addressed element. Rather, the most complex problem addressed (Minimal, Low, Moderate, High) in a given encounter typically represents the level of “problems addressed” which should be used for leveling. Exceptions include self-limited, minor problems (1 = Minimal while 2 = Low) and stable chronic illnesses (1 = Low, 2 = Moderate).
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Can concussion be considered an acute complicated injury - a head injury that gave other systemic symptoms?Described that way, absolutely. Be sure to familiarize yourself with the AMA’s definition of Systemic Symptoms.
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What is meant by 'risk'? The guideline only lists examples. Is there a way to determine risk on MDM without these examples? Is that purely a judgment call?Yes, this is a clinical judgment.
From the AMA: “Trained clinicians apply common language usage meanings to terms such as high, medium, low, or minimal risk and do not require quantification for these definitions (though quantification may be provided when evidence-based medicine has established probabilities). For the purposes of MDM, level of risk is based upon consequences of the problem(s) addressed at the encounter when appropriately treated. Risk also includes MDM related to the need to initiate or forego further testing, treatment, and/or hospitalization.”
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If you send a kid to the Emergency Department, or for testing due to concern for appendectomy, does that discussion get you to a higher level of risk? Does discussion of a possible ER visit count?Not usually. If the decision is purely for testing consideration, meaning the tests could be done in another care setting without ready access to acute or surgical or inpatient care, I would *not* say that meets the spirit of the requirement.
From the AMA: “… decision about hospitalization includes consideration of alternative levels of care…Examples may include a psychiatric patient with a sufficient degree of support in the outpatient setting or the decision to not hospitalize a patient with advanced dementia with an acute condition that would generally warrant inpatient care, but for whom the goal is palliative treatment.”
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Will PCC develop a software timer to capture clinician charting time?PCC is not currently developing a timer in PCC EHR. Our research mid-2020 about this feature found that users did not see enough value in having to activate a timer whenever they turned their attention to a particular chart.
For example, if PCC EHR automatically records your time with a chart open, you would be required to close and reopen every chart every time you were interrupted while charting in order for it to be accurate. If you had to actively click a button to stop and start a timer, it would be an ever-present timer that required their attention. Users shared this would be distracting at best and annoying at worst. Most users were happier to state their own estimates of how much time was spent, either in total or in segments to be used for totaling when they were sure services were complete for the whole day.
Select a Code Based on Time
You can base your visit level code selection on the total time that the rendering clinician spent on the patient that day. That can include the time the pediatrician spent before, during, and after the actual encounter.
Watch PCC 2021 E&M Coding Videos
These 2021 videos provide examples of how to level your E&M visits:
Configure PCC EHR to Support Your Clinicians and Billers for E&M Level Selection in 2021
Your practice can add fields to your chart note protocols in order to track time spent before, during, and after the encounter by the clinician. You can also track the number of problems addressed, items reviewed for the problems, and the level of risk present.
As an example, this sample chart note protocol includes components designed to quickly note problems, time and risk.
For help customizing your protocols, check out Configure Chart Note Protocols, and get in touch with PCC Support for assistance.
2021 Additional Resources and Guides
In the lead up to the 2021 transition, PCC published blog posts and other organizations published guides and online tools.
2021 Questions and Answers on Interpreting E&M Guidelines
PCC’s Jan Blanchard works with pediatric practices to help them interpret coding guidelines. Read below to see a selection of the 2021 E&M questions received at the time of the transition. These Q&As were last updated on 2021-01-08, so you should consult your AMA CPT Guide for more recent details.
Questions and Answers
PCC 8.14 Release
In the fourth quarter of 2020, PCC will release version 8.14 of our electronic charting and practice management software to all PCC users.
PCC 8.14 focuses on quickly delivering improvements clients asked for and may need immediately. PCC updated SNOMED-CT, ICD-10, and LOINC code sets to the most recently published standard, which includes COVID-19 terms and codes for billing. PCC 8.14 also introduces new chart features for sexual orientation and gender identity and the next phase of our CHADIS integration, allowing families to open questionnaires from inside the patient portal.
Watch a Video Series: Want to see videos about the updates in this release? Watch the PCC 8.14 Release Video Series.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Send Broadcast Messages for Overdue Immunizations and Much, Much More
You can now send broadcast messages from the PCC EHR Report Library to recall patients who are behind on their vaccines.
Open the Report Library and generate the Overdue Vaccine Recall report.
Once the report has generated, click “Export”.
Select the “Send Message to Patients” option to start a broadcast message.
Decide whether to contact patients by text, email, or both. Then, compose your message and hit “Send”.
You can also use Broadcast Messaging with most other reports in the PCC EHR Report Library, including Appointment reports, Prescription reports, and Visit reports.
Now you can leverage reports to get in touch with patients in powerful and creative ways:
- Remind families without portal accounts to sign up at their next visit
- Send a message to all patients affected by a medication recall
- Offer tailored guidance to at-risk patients during a public health emergency
Contact PCC Support to explore how Broadcast Messaging can help you stay connected to your patients.
To learn more about how to create, send, and track broadcast messages, read Send Batch Messages to Patients and Families.
Record Sexual Orientation in a Patient’s Chart
When your practice charts a patient’s sexual orientation, you can record the patient’s information in the Sexual Orientation component.
Your practice can add this chart-wide component to chart note protocols or anywhere you need it for your workflow.
Sexual Orientation is a Confidential Component: When you open a chart, the contents of this component are hidden. A clinician or other PCC EHR user must click the disclosure arrow to display the contents of the Sexual Orientation component. PCC EHR records that this information was accessed, and your practice can review who accessed the information in the PCC EHR Audit Log.
Record Gender Identity, Preferred Name, and Pronoun in the Patient’s Chart
Use the Gender Identity component to record a patient’s gender identity, preferred name, pronoun, and notes.
The component appears on the Medical Summary by default. Your practice can move it, remove it, and add this chart-wide component to chart note protocols or anywhere you need it for your workflow.
Patient information in this component is marked private by default. When private, the fields in the component are not visible anywhere in PCC EHR except in the Gender Identity component.
When the information is no longer private, select Public in the “Privacy Status” drop-down menu.
When Public is selected, PCC EHR and pocketPCC can display the patient’s preferred name and pronoun in the Patient Banner as well as in other places in PCC EHR.
On the Appointment Book, for example, your staff will be able to see the patient’s preferred name and pronoun as they make an appointment. The preferred name can also appear on the Schedule screen and PCC EHR queues, except for the Rx Queue (which uses the patient’s legal name) and the E-lab Results queue (where a patient’s name is provided by a lab vendor). Your practice can find the patient by searching for either the preferred or legal name.
The patient’s preferred name can also appear at the top of forms and patient and family-facing reports that include the green name header. This includes the Patient Visit Summary:
Note that the patient’s legal name and sex appear elsewhere on the form. Documents that can include the preferred name in the green header include: Care Plans, PDF versions of Continuity of Care Documents, Growth Charts, the Health Information Summary, Lab Order Details, the Patient Visit Summary, Summary of Care Record, and Visit and Billing History printouts.
Configure How Your Practice Displays Preferred Name and Pronoun: A patient’s preferred name and pronoun do not appear at all if their Gender Identity component is set to Private. Your practice can configure whether PCC EHR displays only a patient’s legal name, only the preferred name, or both the legal and preferred names when they are set to Public in a patient’s chart. You can also optionally turn off the preferred pronoun display. Open Practice Preferences to review your options.
In addition to adjusting your practice’s display preferences, after your PCC 8.14 update your practice may wish to change the location of the component. You can also adjust your practice’s existing workflows for patients. For example, if you formerly used the Nickname field, a patient flag, or a Reminders note to indicate a preferred name or gender identity, you can decide how that usage will change.
Gender Identity is a Confidential Component: When you open a chart, the contents of this component are hidden. A clinician or other PCC EHR user must click the disclosure arrow to display the contents of the Gender Identity component. PCC EHR records whenever this information was accessed, and your practice can review who accessed the information in the PCC EHR Audit Log.
Track Relationship to Patient in Patient Portal
Track the relationship between your Patient Portal users and their patients, and avoid errors by knowing exactly who you’re communicating with.
PCC 8.14 adds a new column to the Patient Portal Administration’s Manage Portal User called “Portal User’s Relationship to Patient”. Each patient has a drop-down menu listing all relationship types – the same list that appears under Personal Contacts in PCC EHR. If the Patient Portal user also appears under the patient’s Personal Contacts in PCC EHR, setting the relationship in Patient Portal Administration will also update the relationship in Personal Contacts.
The top of the list shows the ten most frequently used relationships, so that you can quickly select common relationships.
Selecting the “Self” relationship automatically changes the Hide at age of emancipation setting to “no” to avoid locking a user out of their own data.
Once you’ve selected your relationship, it will appear in PCC EHR and pocketPCC under the Patient Portal Users component.
Track Vaccine NDC Codes Alongside Other Vaccine Lot Details
PCC EHR’s Vaccine Lot Manager now tracks NDC codes, alongside manufacturer, expiration date, lot number and other details.
Lot Manager Only: NDC codes in the Vaccine Lot Manager are not used for billing. NDC codes needed for billing should still be managed through the Procedures Table.
When scanning a new vaccine into the Vaccine Lot Manager, the NDC code will be added with the rest of the vaccine’s information.
When entering vaccines manually through the Add Lot window, NDC codes can be entered several ways. When adding a new lot, click the NDC drop-down menu to review a list of all active NDC codes. You can skim through the numerical list until you find the code you’re looking for, or begin typing the code to narrow the list to matching results. Selecting an NDC code will automatically enter the immunization name and the manufacturer.
Alternately, by entering an immunization name first, the NDC menu will automatically filter to NDC codes that match your selected immunization. Entering a manufacturer will filter further, to NDC codes that match your immunization and manufacturer.
Access CHADIS Questionnaires Directly through the Patient Portal
PCC continues piloting the integration of CHADIS questionnaires into PCC EHR and PCC’s Patient Portal. If your practice is part of our pilot testing, your Patient Portal now links directly to CHADIS, so your portal users can get started on their patient’s CHADIS questionnaires when their appointment is booked.
Coming Soon: CHADIS integration into PCC is currently in pilot testing and not yet available to all PCC Clients. Stay tuned for additional functionality and the wide release.
CHADIS Required: CHADIS integration into PCC EHR requires that your practice has a CHADIS subscription.
Configure CHADIS in PCC EHR
You first need to connect your practice’s visit reasons to CHADIS visit types, so that your patients will receive the appropriate CHADIS questionnaires for their visit. Open the Visit Reason Editor and click on the CHADIS tab.
The CHADIS Visit Type Mapping includes a list of each CHADIS visit type and lists the PCC EHR visit reasons associated with each. Click the Edit button.
In the Edit Mapping window select which of your Visit Reasons should be assigned to the selected CHADIS Visit Type. Each visit reason can be assigned to multiple CHADIS types, and each CHADIS type can be assigned to any number of visit reasons.
Schedule Visits to Send CHADIS Questionnaires
Once your visit reasons are linked to Visit Types, simply begin scheduling visits. PCC automatically registers your patients with CHADIS and the matching CHADIS questionnaires for the scheduled visit type will be generated by CHADIS 7 days prior to the visit. If the visit is scheduled for less than 7 days in the future, the questinnaires will be made available the day of scheduling.
When a new questionnaire is ready, the patient’s portal user will receive a Patient Portal notification that a questionnaire is waiting for them. When they log into the Patient Portal, they’ll find an orange button inviting them to start their questionnaires. Clicking the orange button opens the questionnaire on CHADIS’s website in a new browser window. If no visit is scheduled or no CHADIS questionnaires are pending, users can access CHADIS from the Patient Portal by clicking the CHADIS Home button.
Upcoming PCC updates include importing CHADIS results directly into PCC EHR, where they can be linked directly to a patient and visit.
Improvements to the Practice Vitals Dashboard
PCC 8.14 improves your Practice Vitals Dashboard, making it a more valuable tool for insight to your practice’s clinical and financial trends.
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The COVID-19 Dashboard Page Now Loads Faster: Under-the-hood improvements to your COVID-19 Dashboard page now allow you to load the same great data in less time. The COVID-19 Dashboard page is designed to help you measure and respond to the impact of COVID-19 on your business. To learn more about this tool, read Analyze and Respond to COVID-19’s Impact in Your Dashboard.
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Corrections to Adolescent Immunization Rate Benchmarks: More accurate PCC Average and Top 10% benchmark calculations reveal how your adolescent immunization rates for HPV, Meningococcal, and TdaP compare to other PCC clients and top performers.
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Corrections to Reporting of Sick Visit Modality: The COVID-19 Dashboard page allows you to view trends in how you deliver sick care to patients. Sick visits conducted over the phone or through the patient portal were being reported incorrectly prior to 8.14, and have now been corrected to give you a more accurate view of how patients are receiving sick care at your practice.
Use 2021 ICD-10 Diagnosis Billing Codes, Including New COVID-Related Codes
On September 20th of 2020, PCC updated your practice with 2021 ICD-10 diagnosis billing codes.
The 2021 ICD-10 update includes new sections for COVID-19-related infections and vaping-related disorders. You can review the complete, updated guidelines in the CDC’s ICD-10-CM Official Guidelines for Coding and Reporting.
The new codes and guidelines take effect for dates of service starting on 10/1/2020. You can learn about the updates that are of most interest to pediatric practices by attending PCC Web labs held by Jan Blanchard (CPC, CPEDC). Missed a web lab? You can watch a recorded session as well.
In addition to COVID-19 and vaping-related guidelines and codes, Jan notes that the 2021 ICD-10 update includes more specificity for substance abuse codes, several adjustments to influenza coding, and new codes for reflux, headaches/face pain, and more. In the “curiosities” bucket, the update includes “Pedestrian on electric scooter and standing micro-mobility pedestrian conveyance (hoverboard, segway)” added to V00-V06.
Chart Diagnoses Mapped to Deprecated ICD-10 Billing Codes: Were there any 2021 code changes for items that your practice frequently bills? You can review your system configuration using the snomedmap report tool in Partner. While there were no major disruptions in the 2021 ICD-10 update, it’s always worth taking a look at your code mapping reports to head off any billing challenges.
For more details, read Fall 2020 SNOMED-CT and ICD-10 Updates Add COVID-19-Related Issues and Other Diagnoses.
Use the Latest SNOMED Diagnoses, Including New COVID-Related Descriptions
On September 20th of 2020, PCC updated the SNOMED-CT diagnostic terms on your practice’s system.
The SNOMED-CT update includes thousands of new descriptions for diagnoses, allergies, therapies, and procedures. It also updates thousands of text descriptions for diagnoses and their mapped ICD-10 billing codes. You can review information about the update on the National Library of Medicine web site.
Review Your COVID-19 SNOMED to ICD-10 Mapping: As codesets continue to change in response to COVID-19, PCC recommends you review the diagnoses you use to chart and bill for COVID-19 issues. For example, this update includes a new recommended mapping of the Exposure to SARS-CoV-2 SNOMED description to the Z20.828 ICD-10 code. This mapping was not included by default in the previous SNOMED standard. You can double-check your practice’s diagnosis billing configuration in the Billing Configuration tool.
For more details, read Fall 2020 SNOMED-CT and ICD-10 Updates Add COVID-19-Related Issues and Other Diagnoses.
Use New COVID-19 Test Descriptions With the LOINC 2.68 Update
On August 31st of 2020, PCC patched all practice systems with LOINC 2.68, an update to the standard list of labs used to make tests interoperable between different systems.
PCC reviewed the updates to LOINC before the update: there will not be any disruption to labs your practice currently orders, and you shouldn’t need to take any action to see the effects of the patch.
The update includes over a thousand new terms and updates, including specific LOINC descriptions for SARS-CoV-2 laboratory tests. The update also adds terms for COVID-19 case reporting and related issues.
If your pediatric practice is performing COVID-19 tests, you’ll be able to configure your labs for appropriate tests in the Lab Configuration tool. This includes the new 95209-3 SARS-CoV+SARS-CoV-2 Ag code, among others.
For details on how to add a COVID-19 test or other lab order to your system, you can read Create a COVID-19 Test Lab Order and Lab Configuration.
Continued Pilot Test: Securely Retrieve Patient Information from Hospitals and Other Practices
Do your patients see other doctors? Do you wish you could retrieve records from those providers on demand?
Pilot testers can request and securely retrieve their patients’ records from other healthcare organizations right within PCC EHR. This is the latest addition to PCC’s Clinical Document Exchange functionality.
To retrieve a document, click “Find Clinical Documents” within the History section of the patient’s chart.
Select one or several healthcare organizations to query, then search for your patient within their records. If you find matches for your patient, you can then see if the organizations have clinical documents to share, and retrieve any you wish to view and save to PCC EHR.
You can set up default healthcare organizations to query for each of your patients, and also decide if certain organizations (such as local hospitals or urgent care clinics) should be queried for all patients.
Users need special permissions in PCC EHR in order to request patient records from other organizations. All PCC EHR users can view retrieved documents after they have been saved in patients’ charts.
How do I Participate?
Although it is not yet possible to sign up to securely retrieve your patients’ records from other healthcare providers, you can prepare for the feature by becoming a Clinical Document Exchange Responder.
Clinical Document Exchange Responders allow other healthcare organizations who participate in the Carequality interoperability framework to retrieve their patients’ records for treatment purposes. In order to eventually be able to initiate records requests, you must first enroll to respond to requests from others.
To become a Clinical Document Exchange Responder, contact PCC Support.
Learn About Clinical Document Exchange
Is Clinical Document Exchange secure? How does it work? Which organizations can I query for my patients’ records? Find answers to all of these questions and more in the PCC Learn article about Clinical Document Exchange.
New and Updated Interfaces Available in PCC 8.14
With each release, PCC’s Interoperability team expands and updates PCC’s direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 8.14:
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New and Updated Immunization Interfaces: During the PCC 8.14 release cycle, PCC updated our immunization registry interfaces with SCIR (South Carolina), TennIIS (Tennessee), and ORALERT (Oregon).
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Updated Clinical Interfaces in PCC EHR: PCC added or updated clinical interfaces with Huntsville Hospital, WellCentive, Epic, Wyoming Department of Health, and Affinia.
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New Insurance Eligibility and Financial Interfaces: PCC also added or improved interfaces with Wyoming BCBS and Boston Medical Center Healthnet.
If your practice would like to take advantage of these connections, or you have another interface need, contact PCC Support.
Immunization Forecasting is Up to Date
During the PCC 8.14 release cycle, PCC updated your immunization forecasting schedules to meet the latest CDC ACIP schedules and to correct unusual schedule scenarios or errors in forecasting.
PCC EHR automatically reviews each patient’s immunization record and provides a table showing any immunizations that were missed, are recommended soon, or that occurred outside of the CDC’s ACIP schedule.
PCC uses immunization logic and calculation services provided by Immucast by STC. During the PCC 8.14 release cycle, STC applied their latest patch (5.24.0), updating and correcting immunization schedules and bringing your system’s Immunization Forecasting in line with the latest ACIP recommendations.
Here’s a summary of the most notable improvements:
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Influenza: This update adds new influenza CVX codes to the forecaster. Also, under certain circumstances, when a child turned 9 during a flu season, the second dose of an influenza vaccine was marked invalid. This no longer occurs. Finally, when a patient received one dose, and then received a two dose series the following season, the second dose can now be marked as valid.
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Meningococcal: This update adds new meningococcal CVX codes to the forecaster.
PCC tests all adjustments to the immunization schedules. Please get in touch if you’d like to learn more about the updates, or if you observe a forecasting result or warning that doesn’t match your expectation. You can review the full list of updates by reading the STC ImmuCast 5.24.0 release notes.
To learn more, read the guide to PCC’s Immunization Forecasting features.
Other Feature Improvements and Bug Fixes in PCC 8.14
In addition to the features described above, PCC 8.14 includes these smaller improvements and squashed bugs.
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Scheduled Reports Update in September: Due to last minute challenges found in beta, PCC delayed the release of the new Schedule Reports feature in PCC 8.13. We updated all systems with this new functionality on 9/2/2020. You can learn more about it by reading the documentation or watching a quick tutorial video.
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Find Next Available Appointments More Quickly: During the PCC 8.14 release cycle, PCC corrected a problem that caused the Availability Finder in the Appointment Book to take twice as long as it should. This fix was distributed on 9/2/2020.
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Better Reporting of Immunizations Not Administered on Summary of Care Documents (C-CDAs): In Release 8.14, PCC EHR more accurately reports immunizations which were ordered but not administered on Summary of Care documents (C-CDAs). Practices in Washington State will notice immediate improvement in the way these immunizations are reported to Wellcentive. To learn more about how Summary of Care records can help you exchange patient information with other healthcare providers, read about how to Send and Receive Direct Secure Messages.
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See Account Number in Open Payments Report: When you track down unlinked payments on accounts with Practice Management’s
openpmts
report, you can now see the billing family’s PCC#, which makes it easier to identify the account. -
Retire Old Immunizations On Your PCC System: When you need to remove an immunization from available options in PCC, you can now adjust an “Orderable in PCC EHR?” option in the Practice Management’s immunization and disease configuration table. PCC Support makes this adjustment for most clients. This option will not disrupt charted orders or patient records, and it will prevent your practice from selecting the retired immunization in the future. Your practice should no longer use the tilda (~) to retire immunizations.
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Re-Enable Locked Out Practice Management Users: When your practice re-hires an employee or for some other reason restores access to the Practice Management system, they can now unlock a formerly locked account. For more information, read Partner User Administration.
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Editing Notes on an Appointment Reset Form Printing: Under certain circumstances, editing the note on an appointment could cause the encounter to switch back to “not printed”, which could result in needless reprinting of visit forms. This no longer occurs.
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New Flu Shot CVX Code: PCC updated the CVX codes on your system, including the new code 205: Influenza vaccine, quadrivalent, adjuvanted.
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Improved Patient Search in pocketPCC: PCC 8.14 updates patient searching in pocketPCC. You can now look up patients using the PCC account number. Also, the search algorithm now matches the results in PCC EHR, which includes better guessing on search text that doesn’t quite match the patient’s name.
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See Who Scheduled an Appointment in Reports: Appointment reports in the Report Library now correctly display the user who created the appointment.
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Add Complete Lists of Allergies or Problems to a Form: PCC 8.14 includes three new form letter variables (
probs
,allers
, anderxallers
) which you can use to display all of a patient’s Problem List items, PCC EHR allergies, or eRx allergies on a form letter. PCC Support can help you customize your forms to take advantage of these new variables.
Review an Encounter’s Billing History
Use the Billing History in a patient’s chart to see full details of what was billed for an encounter, what payments were collected, when claims were sent, acknowledged, and received, and more.
Video: Watch Work With a Patient’s Billing History to learn more.
Visit the Billing History
Click the “Billing History” button inside the History section of a patient’s chart to review the billing history for any encounter.
Office visits, telemedicine encounters, phone notes, portal messages, hospital charges, and administrative encounters that have been billed or may be billable appear in the index at the bottom.
When Do Encounters Appear in the History?: An appointment has a billing history entry as soon as an encounter’s status is set to “Arrived” or the patient is checked in. Phone notes and portal messages only have a billing history if the clinician clicked “Bill” and selected “Ready for Billing”. Hospital and administrative encounters appear after a user creates the encounter and posts the charges.
Review the Billing History for a Specific Encounter
Click on an encounter in the index to see details in the window above.
You can review encounter billing details, such as what diagnoses and procedures were posted, a payment history for the encounter, and a claim history for the encounter.
If an encounter still has the “Ready to Post” status, or has new items added to post, you can work with those encounters on this screen. Select the encounter and click “Post Charges” (or double-click on the encounter) to open up Post Charges.
Review Attached Documents: You can review any documents attached to an encounter in the Billing History section of the chart. For example, if a user attached a scanned insurance card, a hospital note, or other document to an encounter, you can double-click to open it.
Review Charge and Payment History for an Encounter
In the Procedures section of an encounter’s billing history, you can review charges for the encounter and a history of all payments.
For each charge, you can see personal payments, insurance payments, and adjustments.
If any unapplied (or “unlinked”) payments on an account are paying off charges, you will see the “Payment (Unapplied)” amount indicated for each charge and in the totals section.
In the Payments section, you can review all payments posted on the same date as the encounter. To configure which payment types appear in this section, contact PCC Support.
For each payment, you can review what charges the payment applies towards.
For more details about reviewing payment history, see Review Payment History and Edit Payments.
Other Ways to Review What Was Billed for an Encounter
In addition to the Billing History, there are two other ways to revisit the diagnoses and procedures for an encounter.
Open the Post Charges Workflow
You can reopen the Post Charges workflow after charges are posted. From there you can see what was posted and optionally add additional items to the claim. Reopen the Post Charges workflow from the patient’s Billing History as shown above or from the Schedule screen.
Click “Posted” or “New Items” on the Schedule screen to return to the Post Charges screen for an encounter your practice has already posted.
For information about the Post Charges window, read Post Charges and Check Out Patients in PCC EHR.
Review Diagnoses and Procedures on a Chart Note’s Electronic Encounter Form
You can also open a chart note’s “Bill” window and review the Electronic Encounter Form, which shows the selections originally made by the clinician.
Open the Patient Chart
Use the Find tool or double-click on an appointment to open a patient’s chart.
Click “Visit History”
Go to the Visit History section of the chart.
Find the Visit Date You Wish to Review
Use the list at the bottom to locate and select the visit you wish to review.
Double-Click or Click “Edit”
Click Edit to open the chart note. It will appear along with chart navigation buttons.
Click “Billed”
Click the “Billed” button at the bottom of the chart note to open the visit’s saved encounter form.
What Was Selected, Not What Was Billed: The Billed window retains a record of the procedures and diagnoses on the electronic encounter form, how they were linked, and how many units were indicated. After that information is made ready for billing, however, the biller can adjust that information when they post the charges and file the claim. The Billed window is a static record of what was made ready for billing by the clinician and does not reflect later changes.
Added After Posting: If a clinician added diagnoses or orders to the chart note after the visit was posted, those items will appear in a special section on the encounter form.
Look Up ICD-10 Codes for a Patient’s Diagnoses During an Encounter
If you are filling out a form or need the ICD-10 code billed for a patient’s diagnosis during an encounter, you can use the Diagnosis Flowsheet in a patient’s chart to quickly get the codes you need.
For more information, read the Look Up ICD-10 Codes for Referrals, DME, Requisitions, and Pre-Authorizations article.
Review Claim History for an Encounter
When you want to know the status of a claim and when it was accepted and paid, review the Claim History component in the encounter’s Billing History.
Use the Claim History component to review the lifecycle of all claims for the encounter, from submission to resolution. You can see when a claim was queued, held, delayed, processed, received by PCC’s clearinghouse, acknowledged by the payor, and more.
For each event, you can see the date, the event, and the insurance plan. When available in your system’s records, the component displays additional details, the claim ID, and the user who performed the action.
If an encounter was submitted multiple times, the claim history will show you each submission along with claim acknowledgements and other events.
Read Claim Files, Acknowledgements, and Other Responses for an Encounter
When you need to dig deeper into a problem claim, you may want to review the claim submission log, acknowledgement, or other electronic response from a payor. When an electronic record is available for a claim event, you can click on a link to open it.
You can review the outgoing electronic claim file, claim acknowledgements, rejections, and most other responses for claims. (To review the ERA, use the Electronic Remittance Advice tool.)
Print an Encounter’s Complete Billing History
Select any encounter and click “Print” to print the billing history. It will include all charge, payment, and adjustment information along with details about the claim.
Create a New Encounter
Billers typically post charges for appointments on the Schedule screen, or post charges for phone notes or portal messages from the Messaging queue. You can also create a new encounter in the Billing History section of a patient’s chart.
Click “Create Encounter” to post charges of any kind, without a scheduled appointment. For example, you may want to post a hospital encounter or administrative fees.
Post Hospital Charges
If your practice bills for hospital visits, you can post the charges in PCC EHR and queue up a claim. Read the procedure below to learn how.
Watch a Video: For a video introduction, see Post Hospital Charges in PCC EHR.
Open the Patient’s Chart and Navigate to Their Billing History
When you are ready to post hospital charges for a patient, open their billing history and create a new encounter.
Select the Provider, Location, and Service Dates
PCC EHR will create a blank Post Charges encounter for billing. In the Encounter Details section, select a provider, a hospital location, and enter dates of service.
If you select an inpatient hospital location, PCC EHR will display Admit and Discharge fields for the encounter instead of a Service Date field. If the hospital visit was only a single day, you can leave the discharge field blank or enter the same date in both fields.
What If I Don't See the Location I Need, or I Don't See the Admit and Discharge Date Fields?: Your practice can customize your location list and specify which locations are for inpatient visits. Contact PCC Support for help customizing your billing locations.
Select Hospital Diagnoses and Procedures
Use the Diagnoses and Procedures components to search for and select charge information for the hospital encounter.
You can optionally enter from and to dates for procedures, or simply use a single date in the From field. You can set units, select insurance or self pay, adjust the personal due amount, and optionally add a discount. If a procedure has no defined price at your practice, you can edit the price field.
Remember to link the appropriate diagnoses with each procedure using the tools in either the Diagnoses or Procedures component.
Optional: Adjust Claim Information, Work w/ Personal Balances and Payments
You can use the Claim Information component to adjust the billing provider or other claim details. While you probably don’t have a personal payment on hand for a hospital visit, you can use the Payments component to review personal balances and enter discounts as well, if needed.
Click “Save + Post” and Review the Encounter
When you are finished entering hospital encounter and charge information, click “Save + Post” to save your work and queue up a claim.
You can review hospital charges in the Billing History. They also appear in the patient’s Visit History.
You can use the Search Filter field and the Display Filter drop-down menu in either History chart section to quickly find and review details about hospital encounters.
Optional: Import and Attach Documents
After you post a hospital encounter, you can attach a hospital note or other document to the encounter. Just select the hospital encounter when you import or edit a document.
Optional: Delete a Hospital Encounter Posted in Error
As of PCC 8.15, use the Correct Mistakes (oops
) tool to delete all diagnoses, procedures, payments and adjustments for a hospital encounter (or other billing encounter without an appointment). Once you have deleted all items for an encounter, PCC EHR will automatically remove the encounter from the Billing History and Visit History sections of the patient’s chart in PCC EHR.
Generate Patient Forms with Information from a Specific Encounter in PCC EHR
PCC Support can add forms to your PCC system that auto-insert patient vitals, provider signatures, and other information based on where you generate them in PCC EHR. These auto-insert fields are called variables.
If you need forms that auto-fill with information from a particular visit, phone note, or portal message, ask PCC Support to add encounter variables to your forms. Forms that include encounter variables pay attention to where you are generating them in PCC EHR, and insert information accordingly. If you generate a form with encounter variables from a visit note, the encounter variables populate with information from that visit. If you generate the same form from a generic place in PCC EHR, like a patient’s Medical Summary or the check-in ribbon, the encounter variables populate with information from the patient’s most recent visit.
There are encounter variables for patient vitals, provider of service, place of service, and provider signatures.
Contact PCC Support to get help creating and using form templates that include encounter variables.
Generate a Form with Details from a Specific Visit
Open the Visit in PCC EHR
Open the visit that contains the details you want to print on a form. It can be a visit that is currently in progress or a past visit.
You can open visits from the Schedule screen in PCC EHR, or from the patient’s Visit History.
Generate a Form
Navigate to the Forms component within the visit.
Select the form template that includes encounter variables and generate it.
A preview of the form opens in a Document Viewer window.
The encounter variables on the form populate with information from the visit where the form was generated.
No Forms Component? Add It to the Visit Protocol: You can only include visit-specific information on a form if you generate the form from that visit’s note, but not visit protocols contain a Forms component. You can add a Forms component to your visit protocols in the Protocol Configuration tool.
Save the Form
Review your form to make sure the auto-inserted details are correct. Then, save, print, or share it to the patient portal. You can also create tasks from it, or send it to a provider for signing.
Generate a Form with Details from a Phone Note or Portal Message Encounter
Open the Patient’s Chart
Search for your patient in PCC EHR or open their chart from the schedule screen.
Create a New Phone Note or Portal Message
Create a new phone note or portal message from the Edit menu.
You can also create a new phone note or portal message using the buttons displayed at the bottom of the Medical Summary, Demographics, and History sections of the patient’s chart.
Fill Out the Encounter Details
Choose a provider and location for the encounter, and fill out the encounter details.
Save the Encounter Details
Click “Save” to save the contents of the phone note or portal message. You must save the encounter details before they can appear on a form with encounter variables.
Do Not Exit the Encounter: Do not click “Save + Exit” at this stage. If you exit the phone note or portal message, you will not be able to generate a patient form within the encounter.
Generate a Form
Navigate to the Forms component within the phone note or portal message. Select the form template that includes encounter variables and generate it.
A preview of the form opens in a Document Viewer window.
The encounter variables on the form reflect information from the phone note or portal message where it was generated.
Save the Form
Review your form to make sure the auto-inserted details are correct. Then, save, print, or share it to the patient portal. You can also create tasks from it, or send it to a provider for signing.
Generate a Form With Details From a Patient’s Last Visit
When you generate a form template that includes encounter variables from a generic place in PCC EHR such as a patient’s Medical Summary or during check-in, the encounter variables populate with details from the patient’s last visit.
Learn More About Encounter Variables: For a list of encounter variables and to learn how to incorporate them onto your patient forms, contact PCC Support.
Post Administrative Fees Without an Appointment
When you post charges for an appointment, you can also add fees and payments. You can also collect copays right in the Patient Check-In tool in PCC EHR.
But what if there is no appointment?
You may need to collect a fee or post other charges (and payments) that do not have an encounter.
Create a Billing Encounter to Bill a Fee
To bill for a fee of any kind, visit the Billing History in the patient’s chart and click Create Encounter to record an administrative encounter.
Follow the procedure below to learn how.
Open a Patient’s Billing History
Open the patient’s chart, click on the History navigation button, and select “Billing History”.
Click “Create Encounter”
After optionally reviewing the patient’s current billing history, click “Create Encounter” to create a new administrative encounter.
Select a Provider
Select a provider for billing. Charges require a provider.
Optionally Adjust the Place of Service or Date
You can optionally change the Place of Service and Service Date for the administrative encounter.
Select the Fee’s Billable Procedure and Adjust the Procedure Details
Find and select a billable procedure in the Procedures component. Your practice keeps a customizable list of administrative fees in your system’s Procedures table.
Many practices leave the default price of administrative procedures blank. You can then enter the price as you post the charge. You can also adjust units, the responsible party for the charge (the patient’s insurance policy or “Self Pay”) and enter a time-of-service discount.
What About Diagnoses? Will a Fee Require One?: Normally, a procedure requires a diagnosis. However, you can post an administrative fee without a linked diagnosis. In your practice’s procedures table, you can define all of your various fees and optionally set their default amounts. Any procedure that has a billing code with fewer than five characters will not require a diagnosis when you post charges. For more information, read Edit Your Practice’s Prices and Billing Procedure Codes.
Optionally Enter a Payment
Optionally select a Payment Type and enter a payment. You can adjust the payment to apply toward’s the fee you are entering or past due balances.
You can optionally click “Add Payment” to add more payments.
Optionally Generate a Receipt
Click the “Generate a Receipt” checkbox to ask PCC EHR to print a receipt as soon as you save the charges.
You can also return to Post Charges for this encounter later and generate a receipt.
Click “Save + Post” and Review the Charges
Click “Save + Post” to save the charges. The new administrative encounter will appear in the Billing History.
On the Billing History, you can see full details of the encounter, including which user at your practice posted the charge, the fees that were posted, and any payments.
Will Administrative Fees Appear on the Chart's Visit History?: Hospital charges, telemedicine visits, and other clinical encounters appear on the patient’s Visit History. Administrative encounters, such as a forms fee, do not appear on the Visit History and only appear on the Billing History.
Optional: Delete Items Posted in Error
As of PCC 8.15, use the Correct Mistakes (oops
) tool to delete all diagnoses, procedures, payments and adjustments for a billing encounter without an appointment. Once you have deleted all items for an encounter, PCC EHR will automatically remove the encounter from the Billing History of the patient’s chart in PCC EHR.
Post a Payment Without Creating an Encounter
The procedure above shows how to create a billing encounter, and optionally post a payment.
What if you wish to post a payment without an encounter?
Read Post Personal Payments and Write Off Charges or watch a tutorial video to learn how to post payments.
Review, Order, and Administer Immunizations
Use PCC EHR to track, review, order, and administer immunizations in PCC EHR. The procedure below will ensure smooth administration of immunizations for you, your staff, and your patients.
Review Patient’s Immunizations
A patient’s immunization history appears two places: on most chart notes and in the Visit History section of the patient’s chart.
Immunization History includes a date for each administered immunization listed in chronological order. When an immunization is administered, the date will appear automatically.
Vaccines are color coded – black text indicates a normal application, red indicates that it was not given. Vaccines not given include a reason: refused, or “CI” for contraindicated. Vaccines that are ordered but not yet administered are listed in the Ordered line. Vaccine preventable diseases are listed with the diagnosis date in the Diseases section.
Review Forecasting and Immunization Recommendations
Next, review the Vaccine Forecasting below. The Forecasting Results compares each patient’s immunization history to the IMMUCAST immunization schedule, and shows a range of dates for each, depending on the patient’s details.
For each vaccine family, from left to right, you can see:
- the next expected dose in the series (1st dose, 2nd, 3rd, etc),
- the recommended date (when it is ideal to receive this immunization) along with the patient’s age on that date,
- the minimum date the immunization could be given early,
- a past due date,
- and a maximum date after which the shot or series would be invalid. (Rotavirus is the only common immunization with a normal Maximum Date.)
This information is intended as a guideline or reference, the ultimate decision on when a vaccine should be given is up to you and your patients, but you may find it helpful when making that decision. To learn more, read Immunization Forecasting.
Check VFC Status
Before you create immunization orders for today’s visit, review the patient’s insurance policy and optionally update their VFC status.
If it’s not already entered from a previous visit, you can select the patient’s VFC status right in the Immunizations component on the chart note.
You can also select VFC status in each individual immunization order, but selecting it here will apply the same choice automatically to all future immunizations for this patient.
Order Immunizations and Optionally Assign Tasks
If the visit’s chart note protocol includes pre-selected immunizations appropriate for this visit type, it can be ordered with a single click of the edit button.
If today’s immunization isn’t available in the protocol, start typing the immunization’s name in the text field, or select any immunization from the drop-down menu below and then click order.
If you aren’t administering the immunization yourself, click edit and assign the task to someone else with the “To” menu.
Answer Memory: The next time you click order, PCC EHR will remember your selection and automatically assign this task to that person. To select someone else, click edit and select again.
If you’re assigning the task to someone else, you’re done. Click save changes and move on with the visit. The immunization task will appear as an orange order indicator on the Schedule in PCC EHR and on the selected user’s Visit Tasks queue.
To complete the order, click the orange ball indicator on the schedule or double-click from the Visit Tasks queue.
The order details screen includes everything you need to record to complete the immunization. If you selected the VFC status above, it will be copied here already. You can manually select an appropriate immunization lot from inventory. If you have a barcode scanner, click the scan button to open the scanning window, where you can scan the vial and automatically enter the lot number and dose.
If you don’t use a barcode scanner, you’ll need to select the lot number and dose manually from the drop-down menu, or if needed, launch the Lot Manager to add a new lot.
Enter any notes, and click the result of the order; administered, refused, contraindicated or cancelled.
Any selection or note entered in an immunization order can be changed later, even after saving.
Answer Memory: As with the order assignment above, PCC EHR will remember your previous answers and will suggest the same VIS, dose and other details the next time you order this Immunization
With the order details entered, and the vaccine is administered, save your changes and move on to the rest of your visit.
Add Historical Immunizations
In addition to administering current immunizations, you may find it necessary to record historical immunizations, or immunizations administered elsewhere – like a flu shot – without completing the order process.
You can edit and update each immunization’s VFC information, dose, lot number, manufacturer, VIS information, note, as well as whether the immunization was administered, refused, contraindicated, or canceled. When selecting certain options, such as Contraindicated, you can add additional details, such as a contraindication reason. All completed immunization orders can also include who completed the order and a date and time.
Historical immunizations or those given elsewhere – a flu shot given outside of your office, for example – can be added manually by clicking Add Imms.
Select an immunization from the drop-down menu, or begin typing to search, and then enter the date or dates of immunization. Clicking save will add the date to the appropriate spot in the patient’s history.
Generate Outbound Lab and Radiology Requisitions
After ordering labs or x-rays during a visit, you can easily generate requisitions with the patient demographic, insurance, diagnostic, and testing information that the lab or radiologist needs.
Generate a Requisition
Requisitions are generated within the chart note and populated with diagnoses, orders, and other information from the encounter. If the patient needs tests from multiple labs, you can generate multiple requisitions within the visit and include only the specific information each facility needs.
Open the Chart Note
In PCC EHR, open the visit, phone note, or portal message of a patient who needs a lab or radiology requisition.
Document Diagnoses
In the chart note, document the patient’s diagnoses, including those you will need to report on the lab or radiology requisition.
Order Labs and/or X-Rays
Order labs and/or x-rays for the patient.
Generate a Requisition
Depending upon which kind of requisition you want to generate, click the “Generate Requisition” button within the lab or radiology orders component.
Select a Requisition Form
In the Generate Requisition pop-up window, select a template from the Requisition Form drop-down list.
If you do not see a Requisition Form drop-down, it means your practice only has one requisition template configured for use.
Select a Facility
In the Generate Requisition pop-up window, select which facility the requisition is for. If all of your orders list the same facility, that facility will be pre-selected in the Facility drop-down. In-office laboratories are excluded from the list of facilities.
If you do not see a Facility drop-down, or the Facility drop-down field is left blank, the requisition will generate without a facility address or phone number.
No Facility Drop-Down for Radiology Requisitions: Because there is no place to record radiology facility information in PCC EHR, the Facility drop-down is never available for radiology requisitions.
Select Requisition Orders and Diagnoses
In the Generate Requisition pop-up window, select the orders and diagnoses you want to include on the requisition.
The orders and diagnoses presented in the Generate Requisition window come from the chart note and exclude in-office tests.
Fill Out Instructions
Use check boxes to indicate if the requisition is for STAT or fasting orders.
For STAT orders, indicate if you would like a call with results and which phone number to use. Manually type a number or pick one from the drop-down list. The drop-down list comes pre-populated with phone numbers for each of your office locations, and also remembers the numbers used most recently by the user generating the requisition.
Write additional details or instructions in the Additional Instructions field.
Finish Generating the Requisition
Click the “Generate” button to finish generating the requisition.
A preview of the requisition opens in a Document Viewer window.
If you need to make changes before saving, printing, or sharing the requisition, click the “Back” button.
Save, Print, and Share Requisitions
Once you generate a requisition, you can edit and manage it like any other document in PCC EHR.
Review and Edit the Document Details
After you generate a requisition, it opens in a Document Viewer window, where you can review and optionally edit its attributes.
Depending upon the type of requisition, the document title defaults to either “Lab Requisition” or “Radiology Requisition”, and the document category defaults to either “Lab” or “Radiology”.
Requisitions get linked by default to the visits from which they originate. They are further linked to whichever orders are on the form.
Create Tasks
Optionally select a task and assign it to a user. You can also include a note and a due date.
You can use document tasks to inform users at your practice that there are steps to take with the requisition. When the task is done, the assigned user can mark the task complete and create subsequent tasks if needed.
Call PCC Support to Add More Task Options: You might find that you need to add more options to the list of document tasks in PCC EHR. Contact PCC Support for help adding new task types.
Print and Share the Requisition
There are multiple ways to share requisitions with patients and the lab.
You can print out a physical copy and hand it to the patient or fax it to the lab. You can also share a digital copy of the requisition with the patient.
Click “Print” to generate a hard copy of the requisition or check “Display in Portal Documents” to add a digital copy to the patient’s portal documents.
Optionally click “Add to Portal Message” to send the requisition as a portal message attachment.
Save the Requisition
Click the “Save” button to save your settings, close the window, and file the requisition in the Documents section of the patient’s chart.
If you don’t want to save the document, you can click the “Discard” button instead.
Configure In-Office Lab Orders and Facilities
In-office lab facilities and orders are automatically excluded from outbound lab requisitions in PCC EHR. You can configure in-office lab facilities and orders in the Lab Configuration tool in PCC EHR.
Configure In-Office Lab Facilities
Open Lab Configuration from the Configuration menu in PCC EHR. Click the Lab Facilities tab.
A green check appears in the In-Office column beside lab facilities which are considered to be internal to your practice.
You can edit a facility by double-clicking it, or selecting it and clicking the “Edit” button. Check or uncheck the “In-Office” box within the lab facility settings, then click “Save”.
Once you have configured all of your in-office facilities, map them to your appointment locations.
Map In-Office Lab Facilities to Appointment Locations
Within the Lab Facilities tab, click the “Location Mapping” button. Map each of your appointment locations to an in-office lab facility.
Once all appointment locations are mapped to a lab facility, click “Save”.
Next, check that the lab tests you conduct internally default to using whichever lab facility is linked to the location of the appointment.
Configure a Default Facility for In-Office Lab Tests
Click the Lab Orders tab. If all of your in-office lab orders follow a similar naming convention, use the search box to narrow down the list.
Check that “Use Appointment Location” appears in the Default Lab Facility column beside each in-office lab order.
If you need to edit an order’s default lab facility, double-click it, or select it and click the “Edit” button.
Set the Default Lab Facility field to “Use Appointment Location”, then click “Save”.
Lab orders which use the appointment location as their default lab facility are prevented from appearing on outbound lab requisitions, provided the appointment location is mapped to an in-office lab facility.
To learn more about how to set up lab orders and facilities, read all about Lab Configuration.
Lab Configuration Changes Take Effect the Next Time Users Log In to PCC EHR: The changes you make to in-office lab facilities and orders will not take effect for users until the next time they log in to PCC EHR.
Set Up Default Document Categories for Lab and Radiology Requisitions
By default, PCC EHR saves lab requisitions in the “Lab” document category, and radiology requisitions in the “Radiology” document category. You can change these defaults in the Document Configuration tool.
Open Document Configuration tool from the Configuration menu in PCC EHR. Click the “Assigned Categories” tab.
Use the drop-down lists under the Lab Requisition and Radiology Requisition headers to select the document categories where lab and radiology requisitions should be saved by default.
Click “Save” to save your changes.
Configure Provider Signatures to Automatically Appear on Lab and Radiology Requisitions
You can configure lab and radiology requisitions to generate with the signature of the ordering provider. Contact PCC Support for help adding signatures to lab and radiology requisitions.
Configure Custom Requisition Forms
PCC provides a stock lab and radiology requisition template to all practices, but offers the option to upload custom requisition form templates by special request. Please note that PCC cannot configure custom lab and radiology requisition forms containing checkboxes at this time.
Contact PCC Support to learn more about custom requisition form requirements, and to get help adding custom requisitions to your system.
Learn More
To learn more about how to use orders within the patient chart, read Order a Lab, Procedure, Supply, or Other Order. Practice administrators can also learn more about Lab Configuration in PCC EHR.
Securely Retrieve Clinical Documents from Hospitals and Other Providers
Watch a Video: Watch Clinical Document Exchange: The Initiator Role to learn how to configure your PCC system to submit requests and retrieve clinical documents.
Initiate a Query for Patient Records
If a new patient transfers to your practice, or if you know that an existing patient has received care at another healthcare facility, you can request and retrieve their records on demand within PCC EHR.
Open the patient’s chart and navigate to the History component. Click on “Find Clinical Documents”.
If the patient has default organizations configured, PCC EHR immediately begins querying them for records.
If the patient does not have default organizations configured, or you want to query organizations which are not part of the patient’s defaults, click the triangle beside the Healthcare Organizations to Query header.
The triangle reveals a list of healthcare organizations that your office has historically queried for the patient. Check marks appear beside the patient’s default organizations.
To query an organization that is on the patient’s list but is not a default, check the box beside it and click the “Find Patient” button.
If you want to query an organization that is not on the patient’s list, search for it by name or address and add it to the patient’s list.
Search Results Only Show Organizations You Can Query: Search results include healthcare organizations that both match your search terms and have adopted the Carequality interoperability framework.
After you add the new organization to the patient’s list, click the “Find Patient” button.
The “Find Patient” button initiates a query to all of the selected organizations for patients whose name, date of birth, and sex match yours. Each organization returns patient match results in its own table.
Patient Not Found: If an organization does not have any records that match your patient’s demographic criteria, the query will return a message that says “Patient Not Found”. If the request times out, you will receive a message that says “No response, please try again later.”
Select your patient from the query results, then click “Find Documents”.
Found documents display in a table beneath the organization and patient they are associated with.
You can filter the list of found documents by date. You can also expand the results to include previously retrieved documents, deprecated documents, and documents are of an unsupported file type.
Deprecated Documents and Unsupported File Types: Deprecated documents are flagged by the source organization for being out of date. Unsupported file types are documents that cannot be retrieved and imported into PCC EHR due to their file format.
If you want to run the query again, click the “Refresh” button in the top-right corner of the results table. The time stamp in the top-right corner of each table shows the last time a query was performed.
Query Results Remain Visible All Day: Clinical document queries persist on the Find Clinical Documents screen until 11:59 p.m. and can be seen and refreshed by all users who have query permissions. After midnight, the Find Clinical Documents screen clears its queries, leaving a blank slate for users who access it the next day.
View and Manage Retrieved Documents
Once you have determined that there is a document for your patient at a queried healthcare organization, you will need to import it in order to view its contents and save it to PCC EHR.
Click the “Retrieve” button beside the document you wish to import. If there are multiple documents and you want to import all of them, you can click the “Retrieve All” button beneath the table.
Wrong Patient? Try Again: If you realize at this point that you have requested documents for the wrong patient, you can cancel your search by clicking the “Back to Patient Match” button beneath the table.
Once you retrieve documents, the “Retrieve” button is replaced by “View” and “Reconcile” buttons. The “View” button appears for all document types. The “Reconcile” button only appears for CCDA documents.
You can open a retrieved document by clicking the “View” button.
Once open in a Document Viewer window, you can see the document’s contents and other information about it, such as its title and source, the date it was last modified, and the name of the document category under which it is saved in the patient’s chart in PCC EHR. Retrieved documents are always saved into the Retrieved Documents category when you first import them.
Click the “Edit” button to modify the document’s title, re-assign it to a different category, attach it to a visit, send it to a provider for signing, share it to the patient portal, attach it to a portal message, annotate it, or create messaging tasks from it.
You can remove the document from the patient’s chart by clicking the “Remove Document” button.
Removed Documents Get Deleted Altogether from PCC EHR: Unlike other kinds of documents in PCC EHR which return to the Import Documents screen when you remove them from the patient’s chart, clinical documents retrieved from other healthcare organizations are deleted from your PCC system altogether when you click the “Remove Document” button. Documents deleted in error can usually be retrieved anew from the source organization, as long as the source organization has not deleted them.
You can find and edit retrieved documents anytime in the Documents section of the patient’s chart.
Reconcile Retrieved Documents
You can import Problems, Medication Allergies, and Medications from retrieved documents into your patient’s chart in PCC EHR.
If you already have a retrieved document open in a Document Viewer window, click the “Reconcile” button to review and import its data.
You can also begin reconciling a document from the Find Clinical Documents screen within the History section of the patient’s chart, provided the document was retrieved the same day you are reconciling its contents.
The reconciliation window compares the Problems, Medication Allergies, and Medications in the retrieved document to those already in your patient’s chart. You can select which items, if any, you wish to import from the retrieved document.
Once you have selected all of the items you wish to import, click the “Next” button.
Review your changes. If you notice duplicate or outdated information in the preview, click “Edit” to make corrections.
The corrections you make in this window will be reflected in the patient’s chart once you complete the reconciliation.
When you have finished making corrections, click “Done” to exit the editor. Then, click “Save” to finish reconciling the retrieved document.
The patient’s Problem List, PCC eRx Allergies, and Medication History in PCC EHR will reflect the choices you made while reconciling the retrieved document.
Reconciled documents include a “Last Reconciled” date and user stamp.
You can reconcile documents as many times as you need. The “Last Reconciled” date and user stamp updates each time a document is reconciled.
Manage Default Healthcare Organizations
You can set up default healthcare organizations for just one patient and for all patients at your practice.
Set Up Default Organizations for One Patient
You can manage a patient’s default healthcare organizations within the Find Clinical Documents section of their chart in PCC EHR.
On the Find Clinical Documents screen, click the triangle beside the Healthcare Organizations to Query header.
The triangle reveals organizations which have historically been queried for this patient.
Place a check mark beside organizations that should be queried by default for the patient, and uncheck those that should not.
You can add more organizations to the list using the “add another healthcare organization” search field.
As soon as you place a check mark beside an organization, it is considered a default for this patient. Default organizations are automatically queried when users open the Find Clinical Documents section of the patient’s chart.
Set Up Default Organizations for All Patients
If your practice frequently request records from a local hospital or urgent care clinic, and that organization has adopted the Carequality interoperability framework, you can set it up as a default healthcare organization to query for all of your patients.
Click on the PCC EHR Configuration menu and select “Clinical Document Exchange”.
Use the search field to find a healthcare organization that you regularly request patient records from.
The search results include healthcare organizations that both match your search terms and have adopted the Carequality interoperability framework. Select an organization from the search results to add it to the list of healthcare organizations that should be queried by default for all patients.
Repeat this process for as many organizations as you want to query by default for all patients. Click “Save” to save the configuration and close the window.
If an organization is no longer active with the Carequality network, an Inactive icon (red triangle with exclamation point) appears beside it in the Clinical Document Exchange configuration window.
Inactive organizations are automatically hidden from patient charts, but they remain in the Clinical Document Exchange configuration list until you manually remove them by clicking the “x”.
Note: Sometimes organizations are marked inactive in the Carequality directory as the result of a name change or a change in ownership. Search for the new name of the organization to re-add it to your list of default organizations to query.
User Permissions
Allow Users to Retrieve Clinical Documents
Users require special permissions in order to query other healthcare organizations for patients’ clinical documents. Permissions are assigned on a per-user basis in PCC EHR.
Open User Administration from the Tools menu in PCC EHR.
Select a user from the list and click the “Edit” button.
Under the “Clinical Document Exchange” header, check the box labeled “This user is allowed to query for clinical documents.”
Select a role for the user. The list of roles is defined by the Carequality interoperability framework and cannot be modified. Each user at your practice may only be assigned one role. Role assignment is required.
Once you have assigned permissions and a role to the user, click the “Save” button.
Repeat this process for all users at your practice who need to be able to query other healthcare organizations for patients’ clinical documents.
Users with Clinical Document Exchange permissions are able to see the “Find Clinical Documents” button within the History section of patient charts. The “Find Clinical Documents” button is hidden from users who do not have Clinical Document Exchange permissions.
Allow Users to Manage Practice-Wide Clinical Document Exchange Settings
Some users at your practice will require special permissions in order to manage your practice’s default healthcare organizations to query. These permissions are assigned on a per-role basis in PCC EHR.
Open User Administration from the Tools menu in PCC EHR.
Click the “Roles” tab at the top of the window.
Select an existing role and click the “Edit Role” button.
Check the box for “Clinical Document Exchange Configuration”, then click “Save”.
If you would rather create a new role to manage Clinical Document Exchange Configuration permissions, click “Add Role” instead of editing an existing one.
Name the role, check “Clinical Document Exchange Configuration”, then click the “Save” button.
Assign the new role to relevant users in PCC EHR.
Users with Clinical Document Exchange Configuration permissions are able to manage your practice’s default healthcare organizations to query.
Close User Administration when you have finished assigning permissions. The new permissions will take effect the next time users log in to PCC EHR.
PCC 8.13 Release
In the third quarter of 2020, PCC will release version 8.13 of our electronic charting and practice management software to all PCC users.
PCC 8.13 includes new and improved lab and radiology requisition forms, sibling scheduling, additions to the new charge-posting tool in PCC EHR, signing in pocketPCC, and more. We are also pilot testing the initiator or “query” side of Clinical Document Exchange, which means your practice will soon be able to retrieve your patients’ records from other healthcare providers on demand within PCC EHR.
Watch a Video Series: Want to see videos about the updates in this release? Watch the Release Video Playlist.
Implementation: PCC 8.13 includes features that require configuration and user-specific software training. Read about the features below and then review the PCC 8.13 Migration Considerations article.
Read below to learn more, and contact PCC Support for information about these new features or about any PCC product or service.
Generate Outbound Lab and Radiology Requisitions in PCC EHR
You’ve ordered your patient to get labs or x-rays, and it’s time to generate a requisition that they can take to the facility. Beginning with Release 8.13, you can generate that requisition right from the patient’s chart note in PCC EHR!
First, make sure the chart note contains whichever orders and diagnoses you want to be able to include on the requisition.
Next, click the “Generate Requisition” button within the lab or radiology orders component. This opens the Generate Requisition window.
Check off the orders and diagnoses you want to include on the requisition. The orders and diagnoses presented in this window come from the chart note.
You can also optionally indicate whether the orders are STAT or fasting, specify a phone number for STAT results, and write out any special instructions you have for the lab or radiologist.
If this is a lab requisition, you can optionally pick which facility the requisition is for. If you pick a facility, its name, address, and contact information print on the requisition. You can also leave the Facility field blank. You cannot pick a facility for radiology requisitions.
After filling out the options in the Generate Requisition window, click “Generate” to preview the requisition.
The requisition opens in a Document Viewer window. From here you can to print the requisition, attach it to a portal message, or share it to the patient’s portal documents.
Click the “Back” button if you need to modify the requisition before printing or sharing it.
When you are done, click “Save” to save the requisition and return to the patient’s chart note.
You can create multiple requisitions from the same chart note, each with its own unique options. For a more in-depth look at lab and radiology requisitions in PCC EHR, read Generate Lab and Radiology Requisitions within PCC EHR
In-Office Labs Don’t Appear on Requisitions: Lab orders which list an in-office facility are prevented from appearing on requisitions. If you need help configuring in-office lab facilities and orders, contact PCC Support.
Configure Custom Requisition Forms: PCC provides a stock lab and radiology requisition template to all practices, but offers the option to upload custom templates by special request. Contact PCC Support to learn more about custom requisition forms.
Schedule Siblings in the Appointment Book
PCC EHR’s Appointment Book now includes the option to select multiple patients and schedule for all of them at the same time, making scheduling siblings quicker and easier.
When searching for a patient, click the plus button to the right of the search box to open the Schedule Multiple Appointments window.
The Schedule Multiple Appointments window works like the Schedule Appointment, except you’ll have the option to add additional patients: find your first patient, select your visit reason, and enter any appointment notes. As soon as you select your first patient, another patient name search box will appear below, and you can then search for another patient—either a sibling of the first patient, or any other patient.
Every time you add a patient, a new patient name search box will appear below for the next patient. Enter as many patients as you need, then click “Continue”.
The patient details appear in the schedule appointment panel, and you can review the calendar and select an available time slot exactly as you would with a single patient. If there’s not enough space available for all appointments, the block of appointments appear with a red border, indicating the overlap with existing appointments.
If your user account has permission to force in appointments, you can click Force to save all appointments despite the overlap.
Select a different time slot, where all the appointments fit, and you’ll be able to save without forcing in the appointments.
After scheduling multiple appointments, each can be edited, rescheduled, or canceled individually, just like any other appointment.
Schedule Reports to Automatically Run in the Future
Coming Soon: Originally scheduled for August’s PCC 8.13 update, we held back this feature due to some outstanding issues. The feature is now available and will be updated in a patch scheduled for Wednesday evening, September 2nd.
Do you have reports you want to schedule to run at a specific date? Maybe end of month reporting for billing purposes?
You can now schedule reports to run in the future in PCC EHR.
To schedule a report, open the report library and select a report you’d like to run.
Set the filters for the report as you’d like them, and then click “Schedule”
Next, choose a name for this scheduled report, and the frequency at which you want it to run. You may want to schedule multiple instances of the same report with different filter settings, or to run on different schedules. Choose a name that will help identify which instance of a report this is.
When you’re done, click “Schedule”.
Your report is scheduled. If you’d like, you can generate the report immediately by clicking “Generate”, or move on to other tasks.
Preview Results and Save Output Settings
What if you want to check the output of the report before you schedule it, or you want to save column and group by (subtotaling) settings with your output? You can schedule from the results page of a report, which will retain any column and group settings you configure.
Reports scheduled in this manner will retain any column and group settings you configure here.
View Report Results
You can view report results in the Saved Results tab.
Here you can see the results for all scheduled reports.
You can see the date the report was run, the name of the schedule, the name of the source report the scheduled report was based on, and the number of results in the report.
To see reports that last ran more than 30 days ago, change the “Result Date” filter setting.
By default, you will see all report results in this view. To see only the most recent results for each scheduled report, change the “View” filter setting.
Click on the report you want to view to open the results.
From here, you can export or print the results.
If a report has been run more than once, you can use the drop-down at the top of the report results to switch between results without going back to the Results tab.
Edit Scheduled Reports
To edit a report, click the Scheduled Reports tab. Here you can see all scheduled reports.
Click a report to edit it.
At the top of the report, you can change the schedule name, and the frequency and time the report will run. Below that, you can adjust the filter settings for all future runs of this report.
Click “Save” to save your edits. Or, if you’d like to make edits to the output formatting or to preview your report, click “Preview” to view report results.
Previewing Reports Takes Time: Previewing a report will run an instance of the report. If it’s a report that takes a long time to generate, this will take a while.
Stop and Start Reports
To stop a scheduled report from running, open it from the Scheduled Reports tab.
Click “Stop Schedule” to stop running the report.
Click “Save” to commit the change.
To start a previously stopped report, open it from the Scheduled Reports tab.
Click “Start Schedule” to activate the report.
Make any adjustments you want to the name, frequency, and filters, and then save (or preview and save) the report.
Review Medications and Allergies While Charting in PCC EHR
In PCC 8.13, you can mark a patient’s Medication History and eRx Allergies as reviewed right on the chart note in PCC EHR, avoiding the need to open PCC eRx just for this purpose.
Once a component has been reviewed, the date and attribution for the most recent review will appear below the component.
The last reviewed date on the Medication History and eRx Allergies components in the patient’s chart note only updates when the patient’s medication history or eRx allergies are reviewed from within the chart note. Reviewing them from within PCC eRx will not change the reviewed date in the chart note.
If changes are made to the patient’s medications or allergies after you review them, PCC EHR will indicate that there have been changes, prompting a new review.
The final visit note and the visit history will show eRx Allergies and Medication History items that were reviewed in the context of the chart note. Allergies and medications that have not been marked as reviewed from within the chart note will not appear in the visit history.
You can see all historical medications and eRx allergies, regardless of their associated visit, in the Medical Summary. The last reviewed date in the Medical Summary reflects the latest review, whether it occurred in PCC eRx or in the patient’s chart note.
Sign Visit Chart Notes, Phone Notes, and Documents in pocketPCC
PocketPCC includes the option to sign visits, phone notes, and documents, so you can complete your signing tasks conveniently, from anywhere.
Sign in to pocketPCC from your phone or other mobile device. If your PCC EHR user account has permission to sign, even with a co-signer, you’ll have the option to sign under pocketPCC’s menu.
The signing window lists all items in the signing queue. Green checks indicate the item has been signed, and the orange icon indicates that a co-signer is needed.
Click the gear icon in the upper right to open the filter options. You can limit by the type of item, the current signed status, or by provider. Select filters and click “Done” to refresh the list to match your selection.
Select a signable item to open the visit, note, or document for you to review. At the bottom of the window, after you’ve reviewed the item, you can sign or co-sign with a single click.
While reviewing a visit, document, or phone note, you can click any of the edit buttons and make additional notes, assign tasks, or any other edit to the item. Then, you’ll have the option to simply save your changes, or both save and sign the item in one click by selecting “Save & Sign”.
When you’ve saved, or saved and signed, you’ll be returned to the signing queue, where you can select another item to sign.
View and Work With a Patient’s Billing History in the Chart
In PCC 8.13, you can review all of a patient’s billable encounters in the Billing History section of the chart.
Office visits, telemedicine encounters, phone notes, portal messages, hospital charges, and administrative encounters that have been billed or may be billable appear in the index at the bottom. Appointments appear when the chart note is “arrived” or the patient is checked in, phone notes and portal messages appear if a clinician marks them as “Ready for Billing”. Hospital and administrative encounters appear after a user creates an encounter and posts the charges.
Click on an encounter in the index to see details in the window above.
You can review encounter and charge details, such as the date the charges were posted and how a claim was batched.
If there is an encounter that has the Ready to Post status, or an encounter with new items to post, you can work with those encounters on this screen. Select an encounter and click “Post Charges” (or double-click on an encounter) to open up Post Charges.
You can also click “Create Encounter” to post charges of any kind.
Post Any Type of Charge: You can post charges for appointments directly from the Schedule screen and post charges for phone notes and portal messages from the Messaging queue. You can also post those charges from the Billing History in the patient’s chart, and you can create encounters to post other types of charges, such as hospital visits or administrative charges.
Attached Documents: You can review any documents attached to an encounter on the Billing History section of the chart. For example, if a user attached a scanned insurance card, a hospital note, or other document to an encounter, you can double-click to open it.
Post Hospital Charges in PCC EHR
If your practice bills for hospital visits, you can now post the charges in PCC EHR and queue up a claim.
Open the Patient’s Chart and Navigate to Their Billing History
When you are ready to post hospital charges for a patient, open their billing history and create a new encounter.
Select the Provider, Location, and Service Dates
PCC EHR will create a blank Post Charges encounter for billing. In the Encounter Details section, select a provider, a hospital location, and enter dates of service.
If you select an inpatient hospital location, PCC EHR will display Admit and Discharge fields for the encounter instead of a Service Date field. If the hospital visit was only a single day, you can leave the discharge field blank or enter the same date in both fields.
What If I Don't See the Location I Need, or I Don't See the Admit and Discharge Date Fields?: Your practice can customize your location list and specify which locations are for inpatient visits. Contact PCC Support for help customizing your billing locations.
Select Hospital Diagnoses and Procedures
Use the Diagnoses and Procedures components to search for and select charge information for the hospital encounter.
You can optionally enter from and to dates for procedures, or simply use a single date in the From field. You can set units, select insurance or self pay, adjust the personal due amount, and optionally add a discount. If a procedure has no defined price at your practice, you can edit the price field.
Remember to link the appropriate diagnoses with each procedure using the tools in either the Diagnoses or Procedures component.
Optional: Adjust Claim Information, Work w/ Personal Balances and Payments
You can use the Claim Information component to adjust the billing provider or other claim details. While you probably don’t have a personal payment on hand for a hospital visit, you can use the Payments component to review personal balances and enter discounts as well, if needed.
Click “Save + Post” and Review the Encounter
When you are finished entering hospital encounter and charge information, click “Save + Post” to save your work and queue up a claim.
You can review hospital charges in the Billing History. They also appear in the patient’s Visit History.
You can use the Search Filter field and the Display Filter drop-down menu in either History chart section to quickly find and review details about hospital encounters.
Optional: Import and Attach Documents
After you post a hospital encounter, you can attach a hospital note or other document to the encounter. Just select the hospital encounter when you import or edit a document.
Post an Administrative Fee Without an Appointment in PCC EHR
When you post charges for an appointment, you can also add fees. But what if there is no appointment? You may need to collect a fee or post other charges that do not have an encounter.
To bill for a fee of any kind, visit the Billing History in the patient’s chart and click Create Encounter.
Select a provider and optionally adjust location and service date. Then add the fee in the Procedures component of Post Charges.
You can optionally enter payments and review the account’s new balance.
Click “Save + Post” to save the fees and payments.
You will see administrative fees without appointments as their own line in the Billing History index. As they are not encounters and have no clinical element, they do not appear in the patient’s Visit History.
Enter Time-of-Service Discounts As You Post Charges in PCC EHR
When you post charges in PCC EHR, you can now enter a discount amount or discount percentage. To enter a discount for a charge, use the Discount column in the Procedures component.
If you type a percentage, PCC EHR will automatically calculate the discount amount.
The Payments component below will automatically fill out the details of the discount for you.
Alternatively, if you want to apply a discount towards all charges in the encounter, you can skip the Procedures component. In the Payments component, select a discount as the “Payment Type” and enter a percent or an amount.
The Discounts column in the Procedures component will automatically update with the discounted amounts. If you enter an exact discount amount instead of a percentage, PCC EHR will apply the discount to the procedures in order, starting from the top.
You can adjust discount amounts in either component, make other changes to the charges, or add additional payments for the remaining balance. Click “Save + Post” to finish posting the charges, payments, and discounts.
The Billing History section of the patient’s chart will display the discount along with other time-of-service payments or adjustments.
How Much Can I Adjust Off With a Time-Of-Service Discount?: Time-of-service discounts are for the amount due to the personal billing account of the patient, not for charges pending an insurance payer. You can only discount up to the total amount due personal on a charge.
Receipts Display Only Services and Payments: Discounts occur for a variety of reasons, some of which involve PHI or administrative decisions. Therefore Time-of-service discounts do not appear on the printed receipt. The Post Charges receipt only displays the billed services and any payments. To create a complete account history (including discounts), use the Account History (tater
) report in Practice Management.
Search Your Task Queues (Visit Tasks, E-lab Results, Messaging, and Signing)
Search PCC EHR’s Visit Tasks, E-Lab Results, Messaging, and Signing queues to quickly find the task you’re looking for, no matter how many items are on your queues.
Click the magnifying glass icon above each queue to reveal the search box. PCC EHR will automatically search when you finish typing, and the queue will refresh and show only items that include your search term.
Search looks through the details of each task in the queue, more than just the column headings. You can search for specific names, orders, subject lines, e-lab result, or phone note to find exactly what you’re looking for.
Don't Forget the Queue Filters: Search only includes items in your current view. If the queue filters at the bottom of the PCC EHR window are set to limit your view to a certain task type, provider, or other option, the search will only include items from the filtered list. To search all items on a queue, reset your filters to “all”.
To return to the full list, just delete your searched text and the queue will reset to the complete list of items.
Include Information from a Specific Encounter on Patient Forms in PCC EHR
Need to pull details from a specific visit onto a patient form? Now, you can!
As of Release 8.13, PCC Support can help you create forms with smart fields that populate based on the encounter where they are generated.
Say your patient needs a sports form with details from last month’s physical. You can open that physical from the patient’s visit history and generate the sports form inside the visit protocol. The smart form fields will populate with details from that specific encounter.
There are smart form fields for patient vitals, the provider of the encounter, and the location of the encounter.
If you generate smart form fields outside a specific encounter, they populate with information from the patient’s most recent visit.
Read more about how to Generate Patient Forms with Encounter-Specific Information in PCC EHR.
Convert Your Existing Forms Into Smart Forms: If you want to put smart fields onto an existing form in PCC EHR, contact PCC Support.
Include Multiple Vitals Measurements Per-Visit on Patient Forms
You can now include multiple vitals measurements per-visit on patient forms in PCC EHR. For example, if you take multiple blood pressures during a visit, you can include some or all of those measurements on a form.
If you would like to create form templates which allow you to include multiple vitals measurements per-visit, contact PCC Support.
You can print multiple measurements of any vital:
- length
- height
- weight
- body mass index
- blood pressure
- head circumference
- oxygen saturation
- pulse
- respiration
- temperature
To print the vitals from a particular visit on a patient form, generate the form within the visit protocol. If you generate the form outside a visit protocol, it will populate with information from the patient’s most recent visit.
Automatically Add Provider Signatures to Forms and Requisitions
You can now automatically add provider signatures to forms in PCC EHR. Automatic signatures can either be based on the provider who sees a patient, or a patient’s primary care provider.
Automated signatures can be configured to work with any form you generate within PCC EHR, including lab and radiology requisitions.
Contact PCC Support for help configuring forms and requisitions which automatically generate with a provider signature.
Review Flu Shot Rates by Provider
You can now review seasonal influenza vaccine rates per provider in your Practice Vitals Dashboard.
Open the Dashboard from the Reports menu in PCC EHR, then click the Clinical Pulse tab to view your practice’s clinical measures. Scroll to the Immunization Rates section of the page and click on the “Immunization Rates – Influenza” hyperlink.
The Immunization Rates – Influenza page offers a snapshot of your whole practice’s flu shot rates. Click “View Detailed Breakdown” in the How You Compare section to see how each primary care provider at your practice performs.
The detailed breakdown shows the number of active patients assigned to each provider, how many are overdue for a flu shot, and how many are up-to-date. You can compare providers to one another, as well as other PCC and industry benchmarks, and use this information to tailor your patient recall efforts to the providers and populations who need them most.
Review Provider Flu Shot Rates by Care Center: If your office belongs to a Care Center, the detailed breakdown of influenza immunization rates only includes providers assigned to the Care Center whose Dashboard you are viewing.
Configure CVX Codes For All Influenza Immunizations: CVX codes are codes published and maintained by the Centers for Disease Control which indicate the product used in a vaccination. The immunization rate measures in your Practice Vitals Dashboard expect a CVX code to be configured for each vaccine your practice administers. Vaccine administrations which are not linked to a CVX code are excluded from the Dashboard measure immunization rates. If you need help evaluating or updating your immunization configuration, contact PCC Support.
See How Well Your Payors are Paying for Telemedicine Sick Visits
Do your payers pay you for telemedicine sick visits, and do they do so on par with payment for in-person sick visits? Use the new Telemedicine Payment Parity section of your Practice Vitals Dashboard to find out. This section was added to all practice dashboards during the 8.13 release cycle in June of 2020.
The overall practice percentage summarizes how well you are being paid for telemedicine sick visits versus in-person visits, and compares your payment parity rate to other PCC practices.
The Dashboard also displays a breakdown of your top five payors: You can see what their percentage is of your total visit volume, and then see how well they are paying for telemedicine sick visits versus in-person sick visits.
Is a specific payor paying you on par for 99214s, but paying you less for 99213s? The CPT Breakdown section shows which visit codes are being paid on par and which are falling short. You can choose to look at all insurances or just one specific payor.
PCC updates the Telemedicine Payment Parity numbers, along with the rest of the data on the COVID-19 dashboard, every day. For questions or help interpreting your numbers, contact PCC.
100% Parity or Greater Doesn't Always Mean Telemedicine Pays Better: You might notice that your overall score, or that of a certain payor, exceeds 100%. This usually does not indicate that telemedicine sick visits pay better than those conducted in-person. It is more commonly a reflection of how many telemedicine visits you are billing to each payor, and what proportion of your overall visit volume they represent. If you have questions about your payment parity score, please contact PCC.
Pilot Test: Securely Retrieve Patient Information from Hospitals and Other Practices
Do your patients see other doctors? Do you wish you could retrieve records from those providers on demand?
As of Release 8.13, pilot testers will be able to request and securely retrieve their patients’ records from other healthcare organizations right within PCC EHR. This is the latest addition to PCC’s Clinical Document Exchange functionality.
To retrieve a document, click “Find Clinical Documents” within the History section of the patient’s chart.
Select one or several healthcare organizations to query, then search for your patient within their records. If you find matches for your patient, you can then see if the organizations have clinical documents to share, and retrieve any you wish to view and save to PCC EHR.
You can set up default healthcare organizations to query for each of your patients, and also decide if certain organizations (such as local hospitals or urgent care clinics) should be queried for all patients.
Users need special permissions in PCC EHR in order to request patient records from other organizations. All PCC EHR users can view retrieved documents after they have been saved in patients’ charts.
How do I Participate?
Although it is not yet possible to sign up to securely retrieve your patients’ records from other healthcare providers, you can prepare for the feature by becoming a Clinical Document Exchange Responder.
Clinical Document Exchange Responders allow other healthcare organizations who participate in the Carequality interoperability framework to retrieve their patients’ records for treatment purposes. In order to eventually be able to initiate records requests, you must first enroll to respond to requests from others.
To become a Clinical Document Exchange Responder, contact PCC Support.
Learn About Clinical Document Exchange
Is Clinical Document Exchange secure? How does it work? Which organizations can I query for my patients’ records? Find answers to all of these questions and more in the PCC Learn article about Clinical Document Exchange.
New and Updated Interfaces Available in PCC 8.13
With each release, PCC’s Interoperability team expands and updates PCC’s direct connections, partnerships, and integrations with insurance payers, immunization registries, and more. Here are the clinical and financial interoperability updates for PCC 8.13:
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New and Updated Immunization Interfaces: During the PCC 8.13 release cycle, PCC updated our immunization registry interfaces with WAIIS (Washington State), DOCIIS (Washington DC), TennIIS (Tennessee) and ImmTrac VXU (Texas).
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Updated Clinical Interfaces in PCC EHR: PCC added or updated clinical interfaces with Delaware Health Information Network (DHIN), Affinia Health Network, Multicare Labs Northwest, Kent General Hospital, Christiana Care, Bayhealth, Nemours, and American Esoteric Laboratories.
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New Insurance Eligibility and Financial Interfaces: PCC also added or improved interfaces with Nemours Healthy Planet, Illinois Medicaid, Alabama Medicaid, CHAMPVA, Bright, Highmark Health, Vivida Health, and BCBS Louisiana.
If your practice would like to take advantage of these connections, or you have another interface need, contact PCC Support.
Immunization Forecasting is Up to Date
During the PCC 8.13 release cycle, PCC updated your immunization forecasting schedules to meet the latest CDC ACIP schedules and to correct unusual schedule scenarios or errors in forecasting.
PCC EHR automatically reviews each patient’s immunization record and provides a table showing any immunizations that were missed, are recommended soon, or that occurred outside of the CDC’s ACIP schedule.
PCC uses immunization logic and calculation services provided by Immucast by STC. During the PCC 8.13 release cycle, STC applied their latest patch (5.22.3), updating and correcting immunization schedules and bringing your system’s Immunization Forecasting in line with the latest ACIP recommendations.
Here’s a summary of the most notable improvements:
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Polio: Prior to the 5.22.3 update, a 4th dose of polio vaccine, with an immunization date where the patient was <= 48 months – 4 days old, that was administered prior to 08/07/2009 (when ACIP changed their Polio guideline), would be incorrectly marked as Invalid. This no longer occurs.
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Hepatitis B: When the 3rd dose of Hepatitis B vaccine is administered too early to satisfy the guidelines for the last dose in a Hepatitis B series, immunization forecasting will now calculate the next recommended dose based on a Hepatitis B 4-dose schedule.
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DTaP: Under certain circumstances, a compromised DTaP vaccination at >= 4 years was counting as valid when evaluating for Pertussis and forecasting the Tdap adolescent dose. This will no longer occur.
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DTaP: When a patient received the 4th dose of DTaP when they were >= 4 years old and just prior to 7 years, they have not completed the primary series. A Td vaccine given at age 7 will now be considered valid to complete the primary series. (An additional Tdap following that Td will continue to be correctly marked as Inadvertent.)
PCC tests all adjustments to the immunization schedules. Please get in touch if you’d like to learn more about the updates, or if you observe a forecasting result or warning that doesn’t match your expectation. You can review the full list of updates by reading the STC ImmuCast 5.22.3 release notes.
To learn more, read the guide to PCC’s Immunization Forecasting features.
Other Feature Improvements and Bug Fixes in PCC 8.13
In addition to the features described above, PCC 8.13 includes these smaller improvements and squashed bugs.
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Better Posting of Payments for Sibling Visits: When you post time-of-service payments for multiple patients who share a billing account (such as siblings) who are visiting on the same day, the Post Charges screen will leave the remaining payment amount unapplied until you post the final sibling’s charges.
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Automatically Remove Flags: PCC Support can configure your system to automatically remove flags from patients or accounts based on your practice’s custom criteria.
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For In-Home Encounters, Claim Processing Will Now Check For a 9-Digit Zip Code: If you see a patient in their home, and your practice creates a claim with the patient’s home as the place of service, PCC’s claim processor will now pause and prompt the biller if the home address lacks the required “Zip+4” zip code. This will prevent possible claim rejections, as payers generally require the full 9-digit zip code for places of service.
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Four Digit Years on Immunization Forms: PCC Support can now customize PCC’s immunization form generator to produce four digit years for immunization administration dates.
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Claim Processing Will Check the NPI of a Claim's Place of Service: PCC’s claim scrubber will now validate the NPI of each claim’s place of service instead of the place of service’s insurance code.
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'Generating...' Message When You Export from the Report Library: When you generate a report in the PCC EHR Report Library, a new ‘Generating…’ pop-up window will decrease confusion when you are working with a large, complex report.
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Changing the Provider on a Phone Note: If a user created a phone note, and then later changed the “Provider of Encounter”, depending on filters the phone note could appear on both the original provider and new provider’s signing queues. This issue has been resolved.
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View Who Posted Each Charge in PCC EHR: During the development of PCC 8.12 and the two COVID-19 releases in the spring of 2020, the ability to review who posted encounter charges was removed from PCC EHR. In PCC 8.13, you can now again review who posted any billed encounter in the new Billing History chart section, as described above.
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Posting TOS Payments on Back-Posted Visits: When you post charges that occurred on a previous date, and you post time-of-service payments (or discounts) at the same time, the payment or discount will now be linked to that past date. Receipts and the Billing History will display the amounts.
Sign Notes, Visits, and Documents in pocketPCC
PocketPCC includes the option to sign visits, phone notes, and documents, so you can complete your signing tasks conveniently, from anywhere.
Sign in to PocketPCC from your phone or other mobile device. If your PCC EHR user account has permission to sign, even with a co-signer, you’ll have the option to sign under pocketPCC’s menu.
The signing window lists all items in the signing queue. Green checks indicate the item has been signed, and the orange icon indicates that a co-signer is needed.
Click the gear icon in the upper right to open the filter options. You can limit by the type of item, the current signed status, or by provider. Select filters and click “Done” to refresh the list to match your selection.
Select a signable item to open the visit, note, or document for you to review. At the bottom of the window, after you’ve reviewed the item, you can sign or co-sign with a single click.
While reviewing a visit, document, or phone note, you can click any of the edit buttons and make additional notes, assign tasks, or any other edit to the item. Then, you’ll have the option to simply save your changes, or both save and sign the item in one click by selecting “Save & Sign”.
When you’ve saved, or saved and signed, you’ll be returned to the signing queue, where you can select another item to sign.
PCC 8.13 Migration Considerations
The PCC 8.13 release includes new features that may need configuration and for which you may want to do extra planning or training. Read below to learn more, and share relevant details with your physicians and staff.
Read the PCC 8.13 Release article for complete details on these features.
Contact PCC Support for information about these or any features in PCC 8.13.
Configure Options for PCC 8.13’s New Lab and Radiology Requisition Forms
As your practice implements the new lab and radiology requisition forms, you should review and update your configuration for in-house labs, document categories, and custom form needs.
Exclude In-Office Lab Orders from Outbound Requisition Forms
When you use the new Lab Requisition forms in PCC 8.13, you can easily and automatically prevent in-office lab orders from appearing on outbound lab requisitions. Certain kinds of lab tests are done at your practice and should not appear on outbound lab requisitions.
Review and Update Your In-Office Lab Facilities
Open Lab Configuration from the Configuration menu in PCC EHR. Click the Lab Facilities tab.
A green check appears in the In-Office column beside lab facilities which are considered to be internal to your practice.
You can edit a facility by double-clicking it, or selecting it and clicking the “Edit” button. Check or uncheck the “In-Office” box within the lab facility settings, then click “Save”.
Once you have configured all of your in-office facilities, map them to your appointment locations.
PCC Will Configure As Many In-Office Facilities As It Can: When Release 8.13 is deployed to your practice, PCC will look for lab facilities which are mapped to an appointment location and automatically designate those in-office facilities.
Multi-Location Practices: Map In-Office Lab Facilities to Appointment Locations
Within the Lab Facilities tab, click the “Location Mapping” button. Map each of your appointment locations to an in-office lab facility.
Once all appointment locations are mapped to a lab facility, click “Save”.
Next, check that your in-office lab tests are configured to use an internal lab facility by default.
Configure a Default Facility for In-Office Lab Tests
Click the Lab Orders tab. If all of your in-office lab orders follow a similar naming convention, use the search box to narrow down the list.
If you are a multi-location practice, check that “Use Appointment Location” appears in the Default Lab Facility column beside each in-office lab order. Single location practices should see the name of their in-office lab facility.
If you need to edit an order’s default lab facility, double-click it, or select it and click the “Edit” button.
Set the Default Lab Facility field to your in-office facility (single location practice) or “Use Appointment Location” (multi-location practice), then click “Save”.
Lab orders which use an in-office lab facility or the appointment location as their default lab facility are prevented from appearing on outbound lab requisitions.
To learn more about how to set up lab orders and facilities, read all about Lab Configuration.
Lab Configuration Changes Take Effect the Next Time Users Log In to PCC EHR: The changes you make to in-office lab facilities and orders will not take effect for users until the next time they log in to PCC EHR.
Configure Default Document Categories for Lab and Radiology Requisitions
PCC 8.13 introduces the ability to create outbound lab and radiology requisitions, but where do requisitions get saved once you have created them?
Two new document categories have been added to PCC EHR: Lab and Radiology. By default, lab requisitions save into the Lab category and radiology requisitions save into the Radiology category.
You can change these defaults in the Document Administration tool.
Open the Configuration menu in PCC EHR and click “Documents”.
Open the Assigned Categories tab.
Under Lab Requisitions and Radiology Requisitions, select where you would like each type of document to save by default.
When you are done, click “Save”.
PCC Doesn't Create New Lab and Radiology Document Categories If You Already Have Them: If you already have document categories named Lab and Radiology, PCC will automatically use those existing categories as the default place to save lab and radiology requisitions.
Configure Custom Lab and Radiology Requisitions
PCC provides a stock lab and radiology requisition template to all practices, but offers the option to upload custom templates by special request. Contact PCC Support to learn more about custom requisition form requirements, and to get help adding custom requisitions to your system.
Please note that PCC cannot configure custom lab and radiology requisition forms containing checkboxes at this time.
Check Your Flu Shot Configuration for Optimal Reporting
PCC 8.13 includes new flu shot reports in your Practice Vitals Dashboard. For these and other immunization reporting features to work well, PCC recommends your practice track immunizations by CVX, and not only by procedure code.
Experienced administrators can check this configuration in Practice Management in the Table Editor program (ted)
. However, it is recommended that most users call PCC Support for help evaluating and updating their immunization configuration.
What Are CVX Codes and Why Are They Important?: CVX codes are codes published and maintained by the Centers for Disease Control which indicate the product used in a vaccination. Immunization measures in your Practice Vitals Dashboard expect a CVX code to be configured for each vaccine your practice administers. Vaccine administrations which are not linked to a CVX code are excluded from Dashboard measures for immunization rates. If you need help evaluating or updating your immunization configuration, contact PCC Support.
Prepare to Securely Retrieve Patient Records from Other Healthcare Providers
PCC 8.13 includes pilot functionality for requesting and retrieving patient records from other healthcare providers.
Although the new functionality is not yet widely available, you can prepare for it by becoming a Clinical Document Exchange Responder straight away.
Clinical Document Exchange Responders allow other healthcare organizations who participate in the Carequality interoperability framework to retrieve their patients’ records for treatment purposes. If you eventually want to be able to initiate records requests, you must first enroll to respond to requests from others.
To become a Clinical Document Exchange Responder, contact PCC Support.
Review and Update Your Practice’s Default TOS Discount Type
When you enter a discount in the Procedures column while posting charges, PCC EHR automatically creates the Discount line in the Payments component for you.
If your practice has many different types of discounts or adjustments that you apply at the time of service, you can change the discount to a different type with the pull-down menu in the Payments component.
Use the Practice Preferences configuration tool to adjust your practice’s default TOS Discount. During your PCC 8.13 update, PCC copied your practice’s default TOS discount from the charge posting configuration in Practice Management. You can review and update this default in PCC EHR, and pick from any payment type in your PCC system that is marked as an “Adjustment” and is configured for charge posting.
Configure Form Letters for Encounter-Specific Needs
After your 8.13 update, your practice can create forms which populate vitals, provider, and location fields with information from the encounter in PCC EHR where they are generated.
Contact PCC Support for help configuring forms that pull in data from the encounter where they are generated.
Once encounter-specific forms have been added to your system, learn how to use them! Read Generate Patient Forms with Encounter-Specific Information in PCC EHR.
Create a Form that Includes Multiple Vitals Measurements
You can now include multiple vitals measurements per-visit on patient forms in PCC EHR. For example, if you take multiple blood pressures during a visit, you can include some or all of those measurements on a form.
If you would like to create form templates which allow you to include multiple vitals measurements per-visit, contact PCC Support.
Configure Forms to Automatically Include a Provider Signature
You can now create form templates in PCC EHR which automatically generate with a provider signature. Lab and radiology requisitions can also be configured to include an automated provider signature.
Automatic signatures can either be based on the provider who sees a patient, or a patient’s primary care provider.
Contact PCC Support for help configuring forms and requisitions which automatically generate with a provider signature.
Transition to Post Charges in PCC EHR
PCC introduced Post Charges in PCC EHR in 2020 with PCC 8.12. PCC 8.13 expands that functionality by adding TOS discounts, hospital charges, administrative fees, a new Billing History chart section, and other improvements.
Your practice may decide that now is the time to expand the use of Post Charges, so that your front desk, billers, and other staff can more quickly enter encounter and administrative charges and queue up a claim, all inside PCC EHR.
Turn on Post Charges for Appropriate Users
Before your staff can can post charges in PCC EHR, you must grant permissions to a user role. Administrative users at your practice automatically have access to Post Charges. You should review your user roles and decide which other users can post charges and queue up an insurance claim.
Open the User Administration tool and visit the Roles tab.
You can create a new “Biller” role, or use an existing role.
When you edit the role, add the new “Post Charges” permission.
Next, review each user at your practice who will post charges and add the role.
For a more detailed guide to setting up roles and configuring user permissions, read Set User Roles for Permissions and Security.
Configure Your Practice’s Patient Details Protocol for Post Charges
As you post charges in PCC EHR, you can review a customizable Patient Details ribbon.
You can customize the Patient Details protocol to include any components your practice will need when they post charges.
Select “Protocols” from the Configuration menu to open the Protocols Configuration window.
Click “Post Charges – Patient Details” to customize the protocol.
To learn more about how to add and customize components on a protocol, visit the Configure Chart Notes and PCC EHR Components section of learn.pcc.com.
Adjust Your Practice’s Workflow and Train Staff
When your practice decides to use PCC EHR to post charges, you will have many questions: When will you generate a TOS receipt? What admin fees does your practice add during billing? Who is watching the Schedule screen in PCC EHR, and do you watch for a signature before you post charges? How are you tracking “add ons” by the provider after charges are posted? You can work with your practice to develop a Post Charges workflow in PCC EHR. Your PCC Client Advocate can help by answering questions, customizing your electronic encounter form, and more. Get in touch!
Complex Billing Configuration Available: As you work in Post Charges, you may see due amounts change based on your selection and your practice’s configuration. PCC supports configurations for price schedules, copay rules, capitated plans that adjust off charges immediately, and Medicaid plans (where nothing reverts to personal due). Your practice can customize the billing behavior of any procedure for any insurance policy. The correct amounts and adjustments will appear in the Procedures component automatically.
Update Your Windows 7 PCs
Microsoft has ended all support for Windows 7, along with Windows Server 2008 (R2). Mainstream support for Windows 7 ended in 2015, and extended support ended on January 14th, 2020.
PCC EHR requires a workstation running on Windows 8 or higher (or MacOS 10.14 or higher). For more information, read Hardware Guide: Your Personal Computer and Equipment.
Best Practices for Pediatrics in the COVID-19 Era
Pediatric practices around the country can continue to see patients, provide great care, and thrive as businesses during and following the COVID-19 pandemic.
PCC worked with practice managers and managing providers to develop this library of recommendations.
Recall Patients
PCC recommends that all practices launch a patient recall initiative. During the initial months of the COVID-19 pandemic, many practices experienced lower visit volume. Children’s developmental needs and other health concerns (diabetes, asthma, depression, and more) did not slow down, and this created an unmet need.
Consider contacting all families who have visited your practice in the past three years and schedule them for telemedicine or in-person appointments. Get your patients caught up on well visits, screenings, shots, and chronic problem and care plan management. As you provide much needed care, you will also be maintaining your practice’s relationships and your ability to help your community.
Read Why and How Pediatric Practices Should Launch a Recall Initiative Today to learn more.
Adjust How You Schedule Patients
When PCC spoke with pediatric practices, they shared changes they’ve made to patient scheduling during the COVID-19 era.
Implement the PCC EHR Appointment Book
The Appointment Book has built in Telemedicine features and can be configured with visit templates to help your schedulers. The close integration between the Appointment Book and the patient’s chart record make everything easier, from connecting to patients, to charting, to billing.
If your practice is not using the PCC EHR Appointment Book, PCC Support can help you get started.
Maximize Portal Communication
Contact your families and make sure they all have patient portal access. This will allow their initial contact with your practice to be asynchronous, which means your staff and clinicians can followup on questions and concerns whenever they are available.
By improving this initial point of contact, you can more efficiently triage issues and schedule appointments as needed.
Implement Appointment Requests in the Patient Portal
Your practice can create a patient portal template for appointment requests. Then, when the family wants an appointment, they can pick “Appointment Request” when they create a portal message.
With an Appointment Request template, you can encourage families to provide the information you need to schedule them.
Read Configure Your Patient Portal Message Templates to learn more.
Update How You Handle Scheduling Phone Calls
When your practice schedules an appointment, what do you review and communicate to the family?
Develop a quick script that informs the family what to expect when they visit your practice, and confirm demographic, insurance, and other information when you schedule. For example, if your practice requires masks, no longer uses your waiting room, or performs a phone-based checkin prior to the appointment, set that expectation when you schedule.
If your practice is implementing practice-wide credit card on file for all families, you can collect that information when you schedule. See below for more tips on CCOF implementation.
Adjust When You Schedule, Your Scheduling Blocks, and More
Review when your practice schedules different visit types, and make adjustments that balance what your families need with your practice’s enhanced safety protocols and other changes.
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Well Visits in the Morning: Some pediatric practices have implemented a “Well Visits in the Morning” schedule. That means all well visits are seen in exam rooms, normal cleaning takes place in between visits, sick visits happen in the afternoon, and the once-a-day more comprehensive cleaning happens after the office has closed.
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Sick vs. Well Locations: Another pediatric practice has two locations, and they have changed one to a “sick only” location and one to a “well visit only” location.
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Change Blocks, Stop Using Blocks: Some practices report that in 2020 they “threw out the visit template”, reworked their blocks based on daily trends, or no longer use visit blocks at all.
The above ideas may or may not suit your practice’s goals, but you might make other changes to how you schedule. In the COVID-19 era, pediatric practices need to stay agile as they tweak and adjust schedule blocks, hours, open time slots, and family expectations. As your community and culture rapidly changes in response to COVID-19, patient appointment needs will change too.
Proactively Schedule Followups and Recurring Appointments
When a followup appointment is appropriate, consider scheduling it at the same time as you schedule the initial visit, or during the initial visit. Rather than waiting the weeks or months before you contact a family to schedule, make the appointments when you have the family’s attention.
If your practice normally only schedules out six months, consider expanding that to 13 months so you can schedule annual well visits at the preceding visit.
Ask: “Could This Be a Telemedicine Encounter?”
Many practices schedule telemedicine encounters for sick visits and followup visits. Some are trying out partial well visits over telemedicine as well.
See the Telemedicine section below for ideas on expanding your practice’s telemedicine services.
Improve Your Practice’s Pre-Visit Steps
What does your practice do in advance of each appointment? During the COVID-19 era, you can examine your process and make changes that will make the visit itself easier and more efficient.
Your process might include:
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Expand When and How You Check Eligibility: Especially if you are increasing telemedicine visits or offering new services, you should review eligibility for all encounters in advance. You can do that with PCC’s built in eligibility tools. Practices report that payers do not respond to eligibility requests until 5 days previous, and anecdotally some Medicaid payers only provide day-of or day-before eligibility information. Regardless, it’s important to check eligibility as employment status, insurance payer rules, and state rules about visit types are rapidly changing.
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Implement Pre-Visit Questionnaires in the Patient Portal and/or With CHADIS: Since clinician in-person time now has additional constraints and challenges, you may want to implement or expand your pre-visit screenings or questionnaires. You can design your own questionnaires in the patient portal’s templates tool, or you could sign up for CHADIS or a similar service. PCC is working to enhance CHADIS functionality, and a partial CHADIS integration is in pilot test now. As you expand your pre-visit questionnaire use, keep in mind that you will need to adjust your workflow so the front desk or a nurse can send the families these materials or links.
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Collect Copays in Advance: In order to make in-person and telemedicine encounters as smooth and “touchless” as possible, your practice can implement a policy of collecting copays in advance of an appointment. Since account balances and payments can be done through the patient portal, families will have transparency and can see their credit if the visit ends up not requiring a copay, for example.
Change How You Checkin and See Patients
When it’s time for the encounter, what changes will your practice make to accommodate the additional challenges of COVID-19? This section includes recommendations we heard from pediatric practices across the country.
Eliminate or Reduce Use of Your Waiting Room
Some practices have closed their waiting rooms or greatly reduced any time spent in them. They tell families:
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Wait In Your Car: Your practice can instruct families to wait in their car until the time of their appointment.
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Call When You Arrive: When a family pulls in, they can call your front desk to checkin. You can verify insurance, demographics, and collect the copay over the phone.
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We Will Text You When Your Exam Room is Ready: PCC’s built-in text feature means your staff can quickly select an appointment and text the family when their room is ready.
As they make these transitions in their offices, some practices are changing their long term plans for their layout. For example, could you transition your waiting room into multiple exam rooms or office space?
Virtualize Your Checkin and Precheckin Processes
By using the patient portal, texting, and the phone, some practices have eliminated all parts of the in-person patient checkin.
To facilitate encounter management, some practices create a new Visit Status in PCC EHR, such as “Precheck”, so that everyone can understand when a family has completed their demographic updates, paid their copay, and are ready for the doctor.
At The Door: Take Temperature, Provide PPE
When a family enters the building, a practice can greet them at or near the entrance. They can use this opportunity to take temperatures and to review PPE guidelines for the practice.
If a patient or family member is not wearing a mask, a practice can optionally provide masks for them to wear.
Consider Car Visits and Shot Tents
PCC heard from practices that now see their patients right in their cars.
Instead of an exam room, the clinician visits the patient in the parking lot of the pediatric practice.
When an immunization or other medical procedure is needed, they can use a “shot tent” or station set up for that purpose.
Plan for Flu and Immunization Clinics
If your practice performs annual flu clinics, where you bring in patients en masse for their flu immunization, you can make adjustments to your usual procedures and do the same in 2020 and beyond.
Similarly, if you implement Telemedicine well visits (some practices are trying), you may have a backlog of kids who need to come in for immunizations. When COVID-19 vaccines are developed, pediatric practices may be an important part of distribution and administration.
Practices can work now to improve their “immunization-only” visit workflow and how they might run clinics while maintaining enhanced safety protocols.
Read More Here: Run a Pediatric Drive-Up Flu Shot Clinic
Implement and Expand Your Telemedicine Services
Telemedicine encounters can provide effective care without physical contact. During the COVID-19 era, practices across the country have expanded their use of phone, portal messages, and video telemedicine encounters. When a practice schedules a sick visit or a followup visit, they can stop to ask the both the family and themselves, “Could we do this as a telemedicine encounter?” The answer is often “Yes!”
You can learn how to use PCC EHR’s tools for these encounters here:
- Schedule, Chart, and Bill for a Telemedicine Encounter (Video, Article)
- Bill For Phone Calls and Portal Message Encounters (Video, Article)
Read below for an overview of tips and recommendations we heard from pediatric practices.
Schedule for Telemedicine Appointments
When you schedule a telemedicine encounter:
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Actually Schedule Telemedicine Encounters: A telemedicine encounter is not just a phone call that you decide to bill for later. Schedule your Telemedicine encounters. Adjust your schedule’s visit reasons, blocks, and more to make telemedicine a real part of your practice’s offerings that you will bill insurance for.
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Use the PCC EHR Appointment Book: When you schedule a telemedicine encounter in the Appointment Book, a telemedicine icon appears with the encounter for all users, additional fields are available for telemedicine connection information, and PCC EHR can optionally designate a telemedicine billing place of service based on your configuration.
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Perform Precheckin When You Schedule: As with any encounter in the COVID-19 era, it is important to review and update information as soon as you can, to make the actual encounter run smoothly. Update patient information, verify insurance, and collect credit card information for the copay when you schedule.
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Set Expectations: When you schedule a telemedicine encounter for a family, tell them exactly what to expect. For example, when will the practice call them for pre-visit questions? How will they receive telemedicine connection information? Let them know during scheduling.
Perform “Precheckin” Calls Before a Telemedicine Encounter
On the day of a telemedicine encounter, or the day before, your practice can call the family. At some practices, this call is made by the MA or nurse. During that call, they:
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Update Patient and Family Information: Verify demographics, insurance, and other details.
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Collect Money: Collect copays and payments for any outstanding balances. Since billing and collection for telemedicine visits are rapidly changing, some practices have made it their policy to always collect the copay ahead of time and issue a refund later once the EOB arrives.
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Tell Them How to Connect: Provide technical instructions on how to connect to the encounter. The caller can provide the telemedicine link verbally, and also send a portal message or followup text message with the URL, using PCC’s direct text message feature.
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Update Visit Status: When the precheck phone call is complete, the practice updates the Visit Status for the appointment so the practice can see it has been completed and the patient is ready for the telemedicine encounter.
Adjust Encounter Workflow, Charting, and Billing for Telemedicine
You can make changes to your workflow and PCC EHR configuration to help telemedicine encounters be successful.
For example, create additional Visit Reasons, Visit Statuses, and custom chart note protocols that include tools for recording information during a telemedicine encounter.
If some parts of a visit must be done separately, you must decide how you will chart and bill for the two different parts.
To help chart a telemedicine protocol, create one or more telemedicine protocols for your clinicians.
Get Paid and Maintain Practice Revenue
This section collects recommendations and tips for pediatric billing and collections during the COVID-19 era.
Here are some general recommendations:
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Consider Billing For Other Encounter Types: Prior to 2020, you may not have billed for phone consultations or portal messages. Many practices now do, and PCC has a guide which can help.
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Adjust Your Electronic Encounter Form: After a clinician is finished with an encounter, they click “Bill” to review diagnoses and procedures and select a visit code. You can customize your practice’s electronic encounter form to include phone consultations and telemedicine-related procedures to make it easier to bill for services.
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Update Your Chart Note Protocols and Orders: When you click on a procedure or other order on a chart note, PCC EHR can automatically add the appropriate CPTs to your encounter form. Review your lab, radiology, referral, and other orders so that they appear by default on appropriate chart notes and will automatically queue up the correct codes for billing.
Streamline Personal Payment Collection
Across the country, pediatric practices are finding ways to make personal payment of copays and outstanding balances as quick and “touchless” as possible.
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Implement Portal Payments: Families can pay their copay and outstanding balances in the patient portal. Read Get Started with Portal Payments to learn more. Once you’re set up, work with your schedulers and staff so that they can prompt families to use this service.
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Implement Credit Card on File (CCOF) for All Families: Your practice can use a third-party service to securely store credit card information, and incorporate CCOF into your practice’s billing policies. When you use portal payments, credit card information is similarly stored by a third party, but by expanding CCOF to all families for other billing needs, you can streamline payment and avoid problems at the time of service. Ask your bank and your merchant services for information about CCOF service. If you are doing portal payments with PCC, you have an existing contract with BluePay, a company which also offers CCOF for other billing needs. You can use a CCOF account flag and clinical alerts in PCC EHR to both drive adoption (by checking if a family has CCOF yet) and inform staff. You can then also create a custom report for the current week’s appointments showing who has CCOF and who still needs it set up.
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Collect Copays In Advance: As mentioned above, many practices have begun collecting copays during a pre-visit checkin call. For some encounter types, it may not be clear if a copay is needed. A practice can collect the copay for every visit and issue a refund later when the EOB arrives.
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Set Default Telemedicine Places of Service: Your practice can set default telemedicine billing places of service per scheduling location.
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Select Billing Place of Service When You Post: Your billers can select or change an encounter’s billing place of service when they post charges.
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Change Billing Place of Service for Previously Posted Charges: If needed, your biller can even update the billing place of service for charges after they have been posted.
Get Paid By Your Insurance and Medicaid Payers
Are your insurance and medicaid payers paying you for Telemedicine visits in parity with your in-person sick visits? According to regulations in some areas, they should be. You can research this and other topics at the COVID-19 section of your Practice Vitals Dashboard.
For common coding topics during the COVID-19 era, read Code and Bill for a COVID-19 Related Encounter, or take a look at PCC’s quick COVID-19 Coding Guide.
As insurance companies learn to respond properly to changing circumstances, your practice may need to be extra vigilant as you review claim rejections and underpayments and resubmit.
Is Billing Place of Service Still an Issue for Telemedicine?
Early on in the COVID-19 era, some practices encountered challenges with the billing place of service used on claims.
Insurance payers have mostly improved how they handle this. PCC has seen good response in many states to telemedicine billing and other encounter changes that practices have needed to make.
However, just in case, your practice should know about the capabilities in PCC EHR:
Apply for a CARES Grant and Other Available Support
Pediatric practice across the country have participated in the federal government’s CARES program, which includes grants and money for small business loans. As the COVID-19 pandemic continues, every practice should stay abreast of these opportunities, and PCC will help keep you informed.
Find Encounter Charges That Need to Be Posted
Use the Schedule and Messaging queues in PCC EHR, along with the Encounters by Billing Status Report, to ensure that your practice has posted charges for every encounter.
For every patient encounter, a provider needs to indicate billing codes and a biller needs to review and post the charges to queue up a claim. It is easy for a disconnect to occur between these two critical points; your practice renders so many services in a day that some charges, or whole encounters, could be missed. When a provider falls behind in their charting, or a practice loses track of which visits still need to be billed, charges can be missed and revenue lost.
Read on to learn the different tools in PCC EHR that can help you ensure everything is posted in a timely manner.
New Biller Training: This article is part of PCC Learn’s New User Training for Billers guide.
Review the Schedule Screen and Messaging Queue for Billing Status Updates
The billing status buttons on the Schedule screen and Messaging queue in PCC EHR indicate when a visit, phone note, or portal message is ready to be billed.
Watch for “Ready To Post” Encounters
Once a visit, phone note, or portal message has been made ready for billing by the clinician, an orange “Ready To Post” button appears in the Billing Status column beside it.
Visits can be billed right from the Schedule screen in PCC EHR. Phone notes and portal messages can be billed from the Messaging queue.
Click the “Ready To Post” button to open the Post Charges screen and bill the encounter.
Watch for “New Items” Encounters
Procedures and diagnoses are sometimes added to visits, phone notes, or portal messages after you post charges for them.
A “New Items” button appears in the Billing Status column beside such encounters, indicating that they require further attention from a biller.
New encounter charges can be billed from the Schedule screen. New phone note and portal message items can be billed from the Messaging queue.
Click “New Items” to open the Post Charges screen and bill the new items that were added to an encounter. You will not be able to edit procedures or diagnoses that were previously posted for the encounter.
Set Your Default Billing Status Filters
You can filter the Schedule screen and Messaging queue by billing status to find visits, phone notes, and portal messages that require a biller’s attention. Furthermore, billing status filter settings can be saved as part of your default view on the Schedule screen and Messaging queue.
In the Schedule screen or Messaging queue, open the “Billing Status” drop-down and select the items you wish to view.
If you decide to save these settings as your default view, click the “Save My Defaults” button.
The next time you log in, your window will already be filtered by the billing statuses you set as a default.
Save Separate Defaults for Each Screen or Queue: Each screen or queue in PCC EHR has its own settings and defaults. In order to update your default billing status filters on both the Schedule screen and the Messaging queue, you must set those parameters individually in each screen or queue.
Check Previous Days
As clinicians sometimes finish charting and signing charts later in the day, you may want to build into your workflow a habit of flipping back to the previous day’s schedule and looking for “Ready to Post” or “New Items” that need your attention.
Run the Encounters by Billing Status Report
Use the Encounters by Billing Status report to identify encounters that were not posted and other billing issues so that you can address them. The report can be filtered by provider, billing status, posting status, and location (for multi-location practices). The report can list visits, portal messages, and phone notes that require a biller’s attention. When generated routinely, the Encounters by Billing Status report helps you find and bill outstanding encounters well in advance of insurance carriers’ timely filing deadlines.
Open the Report Library
To generate the Encounters by Billing Status report, open the Report Library from the Reports menu in PCC EHR.
Open Encounters by Billing Status from the Billing Report Category
The Encounters by Billing Status report appears by default under the Billing category in the Report Library. Click on the category title, then click on the report title to open it.
Set a Date Range for the Report, and Optionally Filter by Provider and Location
Set criteria for the report. Choose a date range in the past, and optionally set filters by provider and location.
Choose the Billing Statuses for the Report
Which encounters do you want to see? Use the Billing Status filter to indicate the encounter statuses you are searching for.
For example, to generate a list of all encounters that are ready to post or have new, unposted items, select “New Items” and “Ready to Post”.
Or, to find old encounters that the clinician hasn’t yet made ready for billing, select “Not Ready”.
Remind Clinicians to Finish Charting: When you generate a list of encounters that have yet to be made ready for billing, you will likely need to remind the clinicians to wrap up their charting before you are able to post charges.
Generate the Report and Print or Export the Results
Once you have set report criteria, generate the report. Print the resulting list, or export it to your workstation.
Find and Bill Outstanding Encounter Charges
Use the results of your Encounters by Billing Status report to find and bill all outstanding encounters in PCC EHR.
Outstanding visits can be billed from the Schedule screen by navigating to the date of the encounter. Portal messages and phone notes can be billed from the Messaging queue.
You can also post charges from the Billing History section of the patient chart. Open the chart of a patient who appears on the Encounters by Billing Status report. Navigate to the History section of their chart, then click the “Billing History” anchor. An orange billing status displays beside encounters which have new items or are ready to post. Highlight the encounter you want to post, then click the “Post Charges” button in the bottom right corner of the window.
Encounters by Billing Status Report vs Visits by Billing Status Report: The Visits by Billing Status report only allows you to report on visit encounters. Portal message and phone note encounters are not included in its results. For the most complete information about encounters that need to be billed, use the Encounters by Billing Status Report.
Establish a Billing Routine
The most significant step you can take to ensure that your practice charges for all eligible encounters is to create practice-wide routines around chart note completion and charge posting. As a practice, decide how soon chart notes need to be completed after a visit, and how soon charges need to be posted after that.
By holding clinicians and billers accountable to a common standard, your practice reduces the chance that encounters will be made ready for billing when they shouldn’t, or that charges will be posted before chart notes are truly complete.
If you would like to explore how to improve your practice’s particular workflows, contact PCC Support. To learn more about posting charges in PCC EHR, visit Post Charges.