PCC’s built in Patient Notification Center interfaces with TeleVox (West) and manages automatic notifications.
However, you can also export a simple list of patients and their contact information for any of several different phone vendors. PhoneTree, TeleVox, and other vendors provide services to make automatic calls (or e-mails or text messages) to patients.
Read one of the examples below to learn how to find and export patient data for a phone vendor.
After a payor reviews your electronic claim, they will send your practice an explanation of what charges are paid, adjusted, or denied.
You can use PCC software to post payment and adjustment information from both ERAs and traditional EOBs.
Video: Watch Read ERA 835s from Payors and Autopost ERAs in PCC EHR to learn more.
Your PCC system can automatically receive ERAs from most payors and claim clearinghouses. Some insurance carriers require special registration steps to sign up to receive ERAs. Since an ERA interface is usually required to receive payments electronically and to use PCC’s autoposting features, you should sign up for ERA with as many of your major carriers as you can.
ERAs and Other Electronic Claim Communication is Part of Your PCC Comprehensive Care Plan: ERA connections, as with electronic claims and other forms of electronic data exchange, are services included with your Comprehensive Care Plan with PCC.
If you receive only a paper EOB, you can post the adjudication manually. If you receive an ERA, you can automatically post the adjudication against the charge records on your system.
While autoposting, PCC EHR checks for errors or problems that may require your intervention. You can review those issues and post payments and adjustments manually.
At any time, you can also print out any ERA from the Electronic Remittance Advice tool.
You can learn how to post ERAs and EOBs by reviewing the following:
You can learn more about how to read ERAs and research adjudication responses from payors here:
PCC Support can also train you and your practice billing staff on how to generate and send claims, post payments, and follow up on outstanding balances. Contact us at any time for help.
You can autopost almost all payments and adjustments from ERAs from participating carriers. PCC EHR automatically handles most situations, including changes in expected copay and reversals that appear on an ERA.
To learn how PCC EHR handles specific situations, and review a reference of what items on an ERA can not be posted automatically see:
When you review ERAs, you will see a full explanation of the payor’s response. ERAs include CARC and RARC codes, and PCC also identifies CORE Business Scenarios and displays information about them. These details can help you understand the payor’s adjudication. For more information, see Read 835s from Payors.
What is a Business Scenario?: Insurance payors add CARCs (Claim Adjustment Reason Codes) to your EOBs and ERAs to explain payments and adjustments. There are hundreds of CARCs. Affordable Care Act regulations group these codes into four “Business Scenarios” which use everyday language to clarify CARCs. When you view ERAs in PCC, you may see CARC codes and their associated CORE Business Scenarios.
With PCC, you can automatically post most insurance payments and adjustments sent to your practice as an ERA.
Next, if part of a payor’s response requires attention or you receive a paper EOB, you can manually post payments and adjustments.
Video: Watch Autopost ERAs and Manually Post Insurance Payments to learn more.
Most ERAs that arrive on your PCC system do not require direct manual attention. Follow the steps below to autopost your incoming insurance payments and adjustments that arrive on an electronic remittance advice (ERA).
Open the Electronic Remittance Advice Tool
Open the ERA tool from the Tools menu.
Select an ERA
Click on an any unprocessed ERA in the list. You can sort by a column, search, or use the Status filter at the bottom of the window to find unprocessed ERAs.
Click "Process"
Click "Process" to begin processing the ERA.
Optional: Enter a Transaction Date
When you autopost an ERA in PCC EHR, you can optionally override the payor’s remittance date and enter a different transaction date.
You can accept the default (the Remittance Date found on the ERA), select today's date, or enter a custom date.
Click "Next" to set the transaction date and continue. When PCC EHR enters the payments and adjustments from the ERA into your system, it will use the transaction date that you indicated.
Review Your Selections and Click "Process"
Double-check that you have selected the correct ERA and indicated the correct transaction date for payments and adjustments. Then click "Process".
Review Posting Results, Posting Exceptions, and Special Cases
After processing is complete, PCC EHR will open the ERA for you to review.
You can use the Autopost Processing Summary section to see totals, payor processing status, posting exceptions, and special cases. For most ERAs, there will be no (0) posting exceptions, as shown above. However, there may be items that PCC EHR could not post automatically.
Most posting exceptions require your review and attention. You may also need to address denials, unusual adjustments, and special cases. Review your processed ERA and identify any situation that may require manual posting, an appeal, or other action.
Optional: Filter the ERA to Specific Encounters
To work on exceptions or specific payor responses, you can use the filters at the bottom of the screen to change which encounters appear.
Use the Display filter to view encounters with a posting exception.
Use the Posting Exceptions filter to view encounter responses that have specific exceptions.
Use the Payor Processing Status filter to view encounters with specific statuses, such as Reversals or Denials.
Use the Special Cases filter to view encounters that have payor responses with certain conditions.
Post Additional Responses Manually and Edit Payments
As you review the details on an ERA, use the Insurance Payments tool to manually post and edit insurance payments.
For example, you may need to enter payments for which no encounter was found.
The Insurance Payments tool also includes one or more History tabs where you can review the complete history of payments for an account, edit payments and adjustments, reverse payments, and more.
Review Processed ERAs Later
You can return to the ERA tool at any time to review processed ERAs.
Use the Status filter to display processed ERAs.
Double-click on a processed ERA to review processing details. For more information, see Read ERA 835s from Payors.
PCC EHR can automatically post most payor responses found on an ERA. Read below to understand how PCC EHR handles adjustments, denials, and other less-common situations.
Adjustments: PCC EHR can automatically post all adjustment reasons. You can review specific CARC and RARC information on each ERA if you need more details about a payor’s adjudication.
Reversals (Takebacks): When you process an ERA that includes a reversal, PCC EHR applies an adjustment to the original payment and pends the charges back to the original policy. PCC EHR can only do this if it finds the original payment on the account. Your practice must also define a default reversal type in Practice Preferences.
Mismatched Copay Amounts and Medicaid: When you autopost a payor’s ERA, PCC EHR will update the expected copay on the visit charge to match the amount specified by the payor as it posts the adjudication. If the family already paid a copay, your PCC system will automatically unlink the payment and relink the appropriate copay amount to the charge, leaving any remaining payment amount as a credit on the account.
If a patient has a Medicaid plan active for the date of service, when you autopost the primary payor’s ERA your PCC system will set the expected copay to $0, as any personal balance due should be billed to Medicaid. Autoposting in PCC EHR will only set the copay to $0 when a patient has a policy configured as a Medicaid plan, with the Medicaid setting set to “Yes”. PCC also supports custom configuration for other types of plans, such as Medicaid HMOs. Contact PCC Support if you need help. You can edit payments, adjustments, and expected copays on the History tab of the Insurance Payments tool.
Negotiated Contract Rate (Allowable) Not Met: PCC supports the tracking of payor contract rates or “allowed” amounts, though many practices do not use this feature. When you autopost an ERA, PCC EHR posts all payments and adjustments regardless of the allowed amounts. It then indicates the number of charge responses that were greater or less than the allowed amount in the Special Cases section of the Autopost Processing Summary. You can review the encounters that underpaid the allowed amount (for example) by filtering the ERA. You can also use reporting to determine when payors are not paying your negotiated contract rate. See Configure Contract Fee Schedules to learn more.
Charge Not Pending Insurance: If an ERA includes payments for encounter charges that are not pending an insurance policy, your PCC system will look to see if the patient has a policy active for the encounter’s date of service. If it finds an appropriate active policy, it will post the payments and adjustments. If it is unable to locate an appropriate encounter, the number of unposted responses will be listed as a posting exceptions.
Claim ID Not Matching: If a payor’s claim ID does not match a Claim ID in your PCC system, PCC will attempt to match the claim to your records in other ways, such as matching the date of service and other encounter information. PCC will be unable to post payments and adjustments when encounter procedures do not match charges found on your system.
Secondary (or Tertiary, etc) Coverage: If a payor indicates that a claim was “Processed as Primary and Forwarded to Additional Payors” or similar, and/or the patient has additional coverage, PCC EHR automatically posts the payments and adjustments and then queues up a claim for the next active policy on the patient’s account.
Payor Changes to Billing Codes: When a payor changes a code modifier or removes a modifier, PCC EHR can still automatically post the payment and adjustment indicated on the ERA. If the payor’s base code does not match the code found on your system, however (for example, if they changed a 99214 to a 99213), the payor’s response will not post. You can review these and other payment exceptions on the ERA.
Payments For No Specific Charge (Interest, Incentive, and Other Communication): PCC will post payments and adjustments that match charges on your system. If a payor sends payment or adjustment information that is not attributed to a specific charge that your practice billed, PCC will ignore it. The most common example of this is an insurance interest payment. ERAs can also include discount and tax information. You can review these communications from the payor on the ERA and then record them if appropriate. See Post Capitation Checks, Incentive Payments, Interest Payments, Overpayments, and Withhold Payments for examples.
If PCC EHR cannot automatically post a payor’s response on an ERA, it is marked as a “Posting Exception”.
Read below to understand each possible posting exception. When you find a posting exception on an ERA, you can review the payor’s response and use the Insurance Payments tool to take appropriate action.
Claim Denials: PCC EHR will not automatically post claim denials. When an insurance payor sends a denial on an ERA, autoposting that ERA will mark the response as a Posting Exception for your review. PCC EHR will not autopost adjustments indicated in the payor’s denial as sometimes the claim must be resubmitted or else other action may be needed. You can review denials in the Electronic Remittance Advice tool.
Claim Status 'Not Our Claim' cannot be auto-posted: If your PCC system cannot match the encounter on an ERA to an encounter on your system, it will be unable to automatically post the ERA’s adjudication for the claim.
Claim Status 'Predetermination' cannot be auto-posted: If the payor’s response is a predetermination, which indicates an adjudication without any actual payment or adjustment, there is nothing for PCC EHR to automatically post.
Claim Status 'Reversal' cannot be auto-posted (if not configured): If your practice has not configured a reversal type for automatic posting in Practice Preferences, PCC EHR cannot post reversals.
Adjustment total is negative: If an ERA sends a negative adjustment total or negative payment for some reason, PCC EHR cannot automatically post the information.
Payment amount is negative: If an ERA sends a negative adjustment total or negative payment for some reason, PCC EHR cannot automatically post the information.
Procedure code not found in the charge history for this claim: If the base procedure code on the ERA is not found in your practice’s billing history for the claim, PCC EHR cannot post payments or adjustments. (PCC EHR can automatically post the payment if the payor only changed the modifier.)
Charge date listed did not match charge history: If the date of the charge on the ERA does not match the date of the encounter in your practice’s billing history, PCC EHR cannot post payments or adjustments.
Charge amount listed did not match charge history: If the charge amount on the payor’s ERA does not match how much was billed by your practice on the claim, PCC EHR will not automatically post the payments or adjustments for the charge.
Did not find a payment to reverse: If the ERA includes a reversal, but the payment is not present on the billing record, PCC cannot post the reversal.
Total of payments and adjustments was greater than the pending amount: If a payor’s response to a claim includes a greater amount than the pending amount, PCC EHR will not automatically post payments and adjustments for the encounter. As PCC EHR automatically posts adjustments and most reversals, problems with totals should be uncommon. This may occur in cases where the payor makes a mistake or when you have submitted charges using a different billing system.
If your practice used PCC’s previous autopost tool (autopip), you may see additional posting exception types when you review ERAs. The previous system was unable to post many more types of responses.
In addition to Posting Exceptions, which indicate a charge or issue that could not be posted automatically, you may wish to review other unusual circumstances on an ERA. For example, if a charge on a claim was 100% adjusted by the payor’s response, it may be normal or it may require an appeal. You can use the Special Cases summary and filter, as describe above, to review unusual situations on an ERA that may require additional action.
Read below to understand the special cases that PCC EHR will identify after you autopost. When needed, you can use the Insurance Payments tool to edit any payments or adjustments that were posted and take additional action.
Adjustment Reasons (CARC/RARC): Depending on challenges you are experiencing with a payor, one or more specific CARC or RARC codes on an ERA may require attention. You can use the Adjustment Reasons special case filter to review all encounters with specific CARC and RARCs. See the section below to learn more.
Charges 100% Adjusted: You may wish to review any charge on an encounter that the payor completely adjusted off. In some circumstances, this indicates a claim that was partially denied that you may need to review and resubmit.
Charges Made Fully Personal: You may wish to review any charge on an encounter that the payor paid $0.00 towards and did not adjust, making the charges become personally due to the patient. In some circumstances, this indicates a claim that was partially denied that you may need to review and resubmit.
Charges Queued to a Subsequent Insurance: When autoposting, PCC EHR automatically pends remaining balances to a patient’s secondary coverage. You may wish to review the primary payor’s response when this occurs.
Copay Amounts Changed: When autoposting, PCC EHR can automatically adjust the expected copay for the charge (see above). You may wish to review the payor’s response when this occurs.
General Adjustments: Insurance payors sometimes include payments and adjustments on ERAs that are not associated with specific claims. These might include overpayment recovery notices, which may be reflected elsewhere on the ERA. If an ERA contains one or more of these “General Adjustments”, which are also known as “Provider Level Adjustments”, you can identify it in the Autopost Processing Summary. The full details from the payor will be in a General Adjustments section at the bottom of the ERA. As general adjustments are not associated with an encounter, there is nothing for PCC to autopost. You may wish to review the information and use the Insurance Payments tool to post amounts indicated. You can use the Special Cases feature to quickly filter an ERA to only the General Adjustments section(s). To see examples, read Read ERA 835s from Payors.
Payments Less Than/More Than the Allowable: If your practice enters contract fee schedules into your PCC system, autoposting will automatically compare the payor’s response with the allowed amount. If they under pay or over pay on a charge, you can review the encounters as a special case.
Submitted If Different (CPT Code): If a payor changes a billing code’s modifier in their ERA, autoposting will still post the payor’s response. You may wish to review the encounter to understand why they changed the billed code and possibly appeal that decision.
Use the Adjustment Reasons special case to review all the responses on an ERA that included specific CARCs and RARCs.
First, click “Adjustment Reasons Selector” to select adjustment reasons.
Find and select the adjustment reasons you are looking for.
Click “Save”, then select the Adjustment Reasons special case.
The ERA will be filtered to display only encounters that include your selected adjustment reasons.
Use the Insurance Payments tool to manually post payments, adjustments, and CARC information. Many ERAs can be posted automatically, but when a payor sends a paper EOB or an ERA with an unusual response, you can enter details manually while also reviewing and updating patient information.
Video: Watch Manually Post Insurance Payments and Adjustments to learn more.
Open Insurance Payments
Open the Insurance Payments tool from the Tools menu.
Your practice can configure which users have access to this tool.
Enter the Claim ID
Enter a claim ID. When you press Enter or click “Find”, PCC EHR will find all charges from that claim that have a balance pending insurance.
Optional: Find a Patient and Select an Encounter
If you don’t have a claim ID, you can first find a patient and then select an encounter.
After you find a patient, PCC EHR will display all encounters with charges that have an amount due pending insurance. Double-click on an encounter to select it.
Optional: Review Payment Histories
As you work with a patient or an encounter in the Insurance Payments tool, you can click on an account history tab to review all past payments.
If a patient has had more than one billing account while at your practice, you may see more than one History tab.
Enter a Check Number, Review Other Details
Whenever you post payments, enter a check number.
You can also use the fields at the top of the screen to: review patient and account flags, adjust the transaction date, change the payment or adjustment types, double-check that the payment came from the current policy, and change the next responsible party for any remaining amount due.
PCC EHR will remember and automatically select your most recent transaction date, check number, and payment and adjustment types.
If you close and reopen the Insurance Payments tool, it will reset these values to their defaults. You can also select from your ten most recent check numbers.
By default, PCC EHR posts payments and adjustments as “Ins Pmt” or “Ins Adj”. You can optionally select from your practice’s custom payment and adjustment types.
Enter Payment and Adjustment Amounts
For each charge on the encounter, enter the payment or adjustment amount found on the payor’s response.
When you enter a payment amount and press Enter, PCC EHR automatically calculates the likely adjustment amount. If the payor’s communication indicates that the remaining balance is not adjusted off, you can make changes. You can also enter a remaining balance amount and PCC EHR will recalculate the amounts for each field.
View the Name of Procedures: Click on a procedure billing code to see your practice’s name for the code.
Optional: Change the Expected Copay Amount
Sometimes a claim is submitted with the wrong copay amount. The payor may respond with less or more than expected, and indicate the correct copay amount. You can change the expected copay for any charge as you enter payments and adjustments.
Automatic Calculation and Payment Relinking: When you change the expected copay, PCC EHR recalculates the adjustment amount on the screen for you. Also, if the family already paid the copay, then when you save and post, PCC EHR will automatically apply that payment correctly and (if appropriate) credit the account. For example, if a parent already paid $10 and now only $5 is expected, the remaining $5 will be a credit on their account.
Enter CARC Codes, Groups, and Amounts
As you enter payments and adjustments, you can also add Claim Adjustment Reason Code (CARC) information.
Payors use CARC codes, groups, and amounts to explain the adjudication of a claim. This information can be important for families as well as when you need to submit a secondary (or tertiary, etc.) claim.
When the next responsible policy is “Personal”, PCC EHR displays only the first CARC field by default, as shown above. If the patient has additional policies, however, then three Code, Group, and Amount columns will appear by default. You can click the CARC field label disclosure arrow to show or hide these extra CARC fields at any time.
Automatic Copay CARC: If a copay is expected for a charge, PCC EHR automatically adds the CARC code “3” for “Co-payment amount”, with a Group code of “PR” and the amount of the expected copay as the adjustment amount.
You can enter additional CARCs, and even search for a CARC adjustment using text from the adjustment reason, which typically appears in the payor’s response.
CARC Adjustments and Insurance Payments May Not Exceed the Charge Amount: CARCs explain adjustments. For that reason, the CARC amounts for a charge cannot exceed the original charge amount minus payments. PCC EHR will prevent you from entering more than the total possible amount, as that could result in a rejected claim from a secondary payor.
Optional: Review Covered Amount and Negotiated Rate
After you enter payments and adjustments, you can see the amount of the charge that the payor adjudicated as “covered” in the Covered Amount column. This displays the original charge amount minus adjustments.
If your practice tracks insurance contracts in PCC, and you’ve entered allowable amounts for these procedures for this insurance, then you will also see a “Negotiated Rate” column to the right.
You can quickly compare the Covered Amount with your practice’s Negotiated Rate.
Optional: Review and Update Policies, Account Demographics, and More
As you enter payments and adjustments, you can scroll down to review patient policies, patient and account demographics, account balances, and account notes.
Use these components to update the patient’s policies, contact the family, or add a note explaining issues with the encounter.
As you work, click “Save” to save patient and account demographics. Policy changes and Account Notes save automatically, but changes to other fields won’t be saved until you click “Save” or “Save + Post”.
Double-Check the Next Policy
Is there a remaining amount due on the charges for this encounter? Before you save and post payments and adjustments, PCC recommends you double-check the next policy, which indicates the next responsible party for these charges.
If the next policy is a payor, then PCC will automatically queue up a claim when you save and post your payments and adjustments. If it is “Personal”, then the remaining amount will become a personal balance.
You can change the next policy. For example, if you added a new patient policy to the Policies component, you can select that new policy. When you save and post, PCC EHR will queue up a claim for the remaining encounter balances.
Click “Save + Post”
When you click “Save + Post”, PCC enters the payments and adjustments into your system, saves any changes you made to demographics, updates balances, and queues up a claim for the next insurance if appropriate.
You will be returned to the first screen of the Insurance Payments tool so you can continue on to the next encounter.
After you post insurance payments and adjustments, where do they appear?
After posting all of the adjudications on an ERA, you can use the Payment Totals by Check Number and Payment Details by Check Number reports in the report library to ensure that posted amounts match the total check amounts and troubleshoot any discrepancies.
Read Review and Prove Out Insurance Payments by Check Number in the Report Library to learn more.
Click on the History tab in the Insurance Payments tool to review the complete payment history for the patient’s billing account.
If a patient has had more than one billing account, you may see more than one History tab.
You can review the entire payment history for any account that has had charges for this patient.
The History tab is also available in the Payments tool:
PCC EHR groups insurance payments and adjustments together, making it easier to review and work with payment history.
Note that if you unlink or delete parts of a payment or adjustment, the Payment History may display items on multiple lines.
You can review the history of all charges for an encounter in the Billing History section of a patient’s chart.
The encounter’s billing history includes more information about what diagnoses and procedures were posted and how claims were sent. For viewing and adjusting other claim history and claim information, use the Correct Mistakes (oops) program.
PCC includes reports for reviewing what your practice posted, examining insurance reimbursement trends, and more. Visit your Practice Vitals Dashboard to get started, and contact PCC Support for help with specific reporting needs.
When you need to edit an insurance payment or adjustment, select them in the Payment History and click “Edit”.
You can edit any aspect of the insurance payments and adjustments, including the transaction date and other payment information, amounts, and CARC information. You can also change the expected copay amount for a procedure. If you’ve learned the patient had another policy for the date of service, you can also update the Next Policy field to change the responsible party for the charges.
As you update payment amounts, PCC EHR will provide calculation support, filling out the adjustment and balance fields based on what you enter. You can edit and override those amounts.
You can click “Delete” to delete the entire payment and adjustment, removing them from the patient and account records.
When you have completed your edits, click “Save”. PCC will update the insurance payment and adjustment amounts, pend the charges to the next responsible party, queue up a claim if appropriate, and return you to the Payment History screen.
Back on the Payment History screen, you can review the changes you made and then use the buttons or the Posting tab to take additional action on the account.
When you automatically process ERAs in PCC EHR, what payment and adjustment types will PCC use?
You can review and update these types in Practice Preferences. By default, PCC will post payment types named “Ins Pmt” and “Ins Adj”. To post an insurance reversal, it will use an accounting procedure named “Insurance Takeback”.
If you need to edit or adjust your available payment and adjustment types, you can do so in the Payment Types and Procedures tables in the Table Editor. Contact PCC for assistance.
If you need to update the diagnosis, hospital, or other visit information for a visit, follow the procedure below. Remember that you will also need to rebatch (or reprint) the insurance claim when you are finished.
Run oops for the Account
Press
F5 – Visit Status
Select all Visit Charges
Enter the item numbers of those procedures that appeared on the rejected claim. You can also use the function keys on the screen to select charges by claim ID or by visit date.
Make Diagnoses Changes
On the Visit Status screen, change the diagnoses for the relevant procedures.
Press Page Down to View the Second Page of the Visit Status Screens
Enter Hospital or Other Claim Information
Add the admission and discharge dates in the hospital visit fields. If necessary, enter a resubmission authorization number as well.
Press F1 – Save Changes.
Rebatch or Print the Insurance Claim
Back on the main oops screen, press F2 – Generate Claim and select the charges that need to be resubmitted.
Before you can schedule a patient, you need to create the patient and their family accounts on your PCC system.
Read the steps below to learn how to add new patients and accounts. Whenever you add either, you begin by attempting to find the patient (or the account) and then creating the new account from the search results screen.
Read the procedure below to learn how to add new patients and families using the tools and screens in PCC EHR.
Attempt to Find the Patient
Before adding a new patient, you must first perform a search to make sure they do not already have a chart record.
Click the “Create Patient” Button
After you search for a patient, review the search results for a match. If the patient doesn’t have a record, click “Create Patient” at the bottom of the Patient Finder results window.
Add a Patient While Scheduling: If you are scheduling in the Appointment Book, you can also add a new patient while searching in the Schedule Appointment tab.
Got a Fax or Form for a New Patient?: Sometimes your practice receives documents before a patient’s first appointment. As you import documents, you can create a patient on the fly, once you search for their name in the Import Documents tool.
Fill Out Basic Patient Information
On the Create Patient screen, you can fill out patient information and add family accounts. PCC EHR will auto-fill the patient name fields with the search text, including first, middle, alias, and last names (in that order).
Follow Your Practice Standards: Some medical practices do not assign a primary care physician. Some practices have rules for how to record a patient’s full name. Others assign certain Patient Flags for new patients. You should follow the standards that your practice uses when entering data.
Customizable Fields: The four fields beneath the “PCP” field within the Patient Information section are customizable. Your office may use them for a special purpose.
Relation to Bill Payer: By default, PCC EHR will fill out the “Relation to Bill Payer” as “Child”. This prevents a common claim error later in billing. If the patient has their own Billing Account and their own insurance plan, or is covered by another individual, you should adjust this field. Note that Medicaid plans are configured to handle the claim appropriately (you do not need to change this field when a patient goes on Medicaid).
Click the “Assign Account” Button
You must add an account to the patient’s record when you create a new patient. You can add a single account as the patient’s Home and Billing Account, or add separate accounts.
Find or Create the Account
First, search for the account. If the account does not already exist, you can click “Create Account”.
Fill Out Account Information
If you are creating a new account, fill out the family name and basic information and click “Save”.
Your practice may have guidelines for what information you collect and what status flags you add when you create a new account.
For example, if your practice bills for home visits, remember to add the complete “Zip +4” Zip Code, as insurance carriers usually require all nine digits.
Verify and Optionally Add Another Account
After you select or create an account, you will be returned to the Create Patient screen. Verify that the selected account is correct.
The Account will be added as the Home and Billing Account (Custodian and Guarantor). If you need separate accounts, click “Reassign Account” to find or create another account. Read the procedure below for more details.
Add an Insurance Policy for the Patient
As you create a new patient’s record, you can optionally add their insurance policy immediately with the Policies component.
The Account will be added as the Home and Billing Account (Custodian and Guarantor). If you need separate accounts, click “Reassign Account” to find or create another account. Read the procedure below for more details.
Click “Save”
When you are finished entering information for the new patient, click “Save” to create and open the patient’s chart.
At any time, you can change the Home (Custodian) and Billing (Guarantor) account(s) for a patient. If a child is adopted by a new household, a family now has two households, or another account change is made, click “Reassign Accounts” to change the patient’s accounts.
Edit the Demographics Section of the Patient’s Chart
Click “Edit” at the bottom of the Patient Demographics component and then click the “Reassign Account” button next to the currently associated account.
Search for the New Account
Search for the account. If the account does not already exist, you can click “Create Account”.
Assign the Account
Select whether the account is the patient’s Home Account, Billing Account, or both.
Your PCC system keeps track of families and patients. Your practice’s database stores information about every patient, with a patient chart for each one. PCC also stores a database of accounts, or “families.” An account may be either a “Home” account for the patient or a “Billing” account. These are sometimes called the custodian and guarantor accounts.
Three siblings may all have one family account serving as both home and billing account. The whole family may be listed under a single parent’s name and address. Alternatively, a patient may have one family account assigned as the Home account and a different account assigned for Billing.
It may be helpful to think of your PCC system as holding two giant lists: a list of patients and a list of accounts. Patients are linked-up to one or more family accounts, and they can be moved around to different accounts when families change shape. You schedule an appointment for a patient, you chart a visit for a patient, but you mail a bill to the billing account for that patient, and you might send a Flu Clinic flyer to the Home account of that patient.
In the image below, a list of accounts is on the left-hand side, and a list of patients is on the right-hand side. You can see how PCC family accounts and patients can be linked together to handle different kinds of families.
As shown above, some patients live with one account but have their bills sent to another family. Tracy Jones lives with her mother Judy, but Jack Jones pays Tracy’s medical bills. Junior Jones also lives with Judy, but he is responsible for his own bills and is therefore his own Billing account. Your practice can handle all of these situations with ease using PCC.
Multiple Names in EHR Accounts: PCC recommends your practice avoid using two names in an account, such as “Jack & Jill Smith” and instead select a single person as a home and/or billing account. Additional parents or guardians, that are neither home nor billing account, should be added as Personal Contacts and given their own Patient Portal account linked to the patient.
Finding a patient or an account is the first step to many actions. Whenever you wish to post a payment, check an immunization record, or update demographic information, you must first find the relevant patient or account.
Practice Management’s “Find Routines” are the search screens you use when finding patients or accounts. Whenever you enter a patient’s first and last name, you are using the Find Routines. The Find Routines also help you find recently accessed patients and accounts, find family members, and find missing patients and accounts quickly by reviewing their demographic information or performing other searches.
Find Patients and Accounts in PCC EHR: This article refers to the find tools in PCC’s previous software suite, Partner, which is still used by some power-user tools in the Practice Management windows found in PCC EHR. For information on finding patients in PCC EHR, read Find Patients and Accounts.
Finding patients or accounts by name is easy. When you first run an account or patient based program, you will see a screen similar to this:
Type in part or all of the first and last name, pressing ENTER when finished with each. You can press either ENTER or F1 – Perform Search to continue to the list of results.
On the results screen, choose the number next to the patient or account you wish to view.
Press F1 – Check New List to find patients and accounts added to the system today. You can also press N to view the new list.
Once you have found and worked with a patient or account, you may wish to find them again without retyping their name. As shown below, the bottom part of the search screen will list the last patient or account you were viewing:
Press F2 – Use Last Patient to open the most recently viewed patient or account.
Do you ever need to schedule siblings from the same family, or update account demographic information after scheduling a patient?
When you search for a patient, you can review a list of patients who share a custodian or guarantor with the last patient record you opened. If you are searching for an account, you will see the related account of the last patient you viewed. These options make finding family members a quick and easy task.
As shown above, press F3 – Select Related and then choose one of the listed patients. When searching for an account, F3 will let you select from accounts related to the last patient viewed instead.
Press F8 – Repeat Search to return to the results page of a recent search. For example, if you choose the wrong family or patient from a results list, you can quit the program you have run and use the F8 – Repeat Search key to search for the same name you typed previously.
Enter a birth date in the First Name field of the find screen and press Enter twice or F1 – Perform Search to search by birth date.
The results of a search show you more information about the patients and accounts than just their names. For example, while viewing a patient, you may see both the date of birth and the last time the patient visited the office. This information makes it easier to choose the correct patient or account:
Press F5 – Prev View or F6 – Next View to cycle through even more information. The different results views can give you the hints you need to pick the right family or patient quickly. Press F7 – Select View to choose from a list of results views.
What if you know the patient’s phone number, but nothing else? What if you only know what street someone lives on, or their insurance ID? From the find routines, press F4 – Advanced Search to run the findem program, where you can search by a wide variety of criteria.
Tip: You can also press the A key from the search screen to run findem.
Choose Search Criteria
First, enter a criteria by which you wish to search, such as “Account Social Security #” or “Home Phone.” Enter an asterisk (*) to see a list of possible search criteria:
Press [F1 – Generate Report]
Enter the Text For Which You are Searching
Type the text or number for which you wish to search. Press F1 – Process to continue.
Select From Results
The findem program will give you a list of patients who matched the criteria you entered. Use the arrow keys to pick the desired family and press F1 – Select Patient/Account to continue.
The pediatric biller’s job would be easier if accounts all paid on time and insurance companies always reimbursed the correct amount. Unfortunately, accounts build up balances and credits and insurance companies overpay, underpay, and demand “takebacks”.
Read and watch from the list below to learn how to use PCC’s tools to handle common accounting challenges.
As always, contact PCC support at support@pcc.com or 802-846-8177 or 800-722-7708 for help. We can walk you through any of these procedures and help you make configuration changes to meet your practice’s needs.
The notes screens in the Family Editor (fame), the Patient Editor (notjane), and the visit notes feature in Correct Mistakes (oops) are useful places to store information about interactions with patients, families, and insurance companies. For example, if you have an unusual billing situation with a family, you might use a notes screen in fame or a visit note in oops to store details.
This document describes how notes are stored in fame, notjane and oops. Read below to learn how to add new notes, add follow-up notes, and search for and edit existing notes. Structured Notes screens also have a criteria feature, allowing you to change what kind of notes you will see on your screen.
In addition to the tools described below, your practice can review and update account notes in the Account Notes component in PCC EHR.
Read Enter and Review Account Notes to learn more, or watch the Enter and Review Account Notes video.
Structure Notes screens work the same way in the Patient and Family Editors (fame, notjane) as in Correct Mistakes (oops). However, you reach the notes in different ways.
To view notes in fame or notjane, run either program and press Page Down until you see the notes page.
The most recent note appears at the top of the screen. All notes are organized in reverse chronological order. Press F3 – Scroll Forward and F2 – Scroll Back to scroll through the entire notes history.
Every note has a header indicating the date and time that the note was posted and the username of the poster.
Follow-up notes appear indented, underneath the original note:
Copay and Billing Notes: The Family Editor (fame) also stores copay notes, which appear in checkout when a user checks out a patient, and billing notes, which appear on personal bills sent home to the family. Press Page Down from the Account Notes screen to view the two other notes screens.
In the Correct Mistakes (oops) program, the first line of the most recent note for a visit appears in the charge history.
A single note is associated with all charges for a particular visit date, for a particular patient. You can add additional notes about the visit and add followup notes and they will all be associated with all charges for that patient’s visit date.
You can make notes visible/invisible by pressing N – Toggle Notes. (You can also make billing history items visible/invisible by pressing E – Toggle Billing History.)
To visit the full note for the visit, press F4 – Insurance Status or F5 – Visit Status, enter item number(s), and then press F4 – Add/Edit Note to view the Visit Notes screen for a set of charges.
The oops screen only has room to display the top line of the note. You can use the Visit Notes screen to review the full text of the note or edit the note.
On an account, patient, or visit note screen, type any text into the “Search Pattern” field at the top of the screen and press Enter to search. The Structured Notes screen will highlight all of the matching results and automatically scroll to the first one.
Press F8 – Search For Next to scroll to the next result. You can press F8 repeatedly to scroll through all of the matches for your search word.
Search on whole words?: If you search for the word “sore,” the search engine will find any note containing “sore,” including soreness and bedsore. If you only wanted the result “sore” and not words that contain “sore,” you should change the “Search on whole words” setting to “Yes.”
On a notes screen in fame or notjane, press F4 – Post New Note to add a new note. You do not need to scroll to the top first. Structured notes will manage the order of your notes for you.
After pressing F4, you will see an empty text box. Type the text of your note and press F1 – Save & Quit. You can press F12 to cancel your new note and return to the notes screen. The note-editing screen has additional function keys for performing basic word-processing functions.
After you save your note, it will appear at the top of the screen, along with your username and the creation date and time.
Once a note is posted on a family or patient’s notes screen, it is a permanent part of the record for the account or patient. In some cases, however, you may need to modify or edit a mistake in a note. Select any note and press F6 – Modify Note to edit it.
You will see the same editing window for adding new notes. Make your changes and press F1 – Save Quit. Press F12 to cancel and return to the notes screen without changing the note.
Make additions or corrections to the note and press F1 – Save & Quit. Notes that have been edited indicate that they were modified:
Security Feature: Are you worried that users may erase or modify notes incorrectly? Partner now keeps a record of all changes and saves every version of each note. You can review old versions of the notes by modifying which notes are visible.
Select any note on a notes screen and press F5 – Post Followup to add a follow-up note.
A text box for the new note will appear:
Type the follow-up information and press F1 – Save & Quit to save your note.
Follow-up notes appear underneath their parent note:
Do you need to see only patient or account notes that a certain user posted, or limit the notes screen to show notes posted at a specific office location, or see notes from a certain date range? Do you want to review a record of every time any user modified a note? On either the patient or family notes screen, press F7 – Change Settings to add or modify criteria that control which notes appear.
There are two separate settings you can change from this screen.
You can set the “Show Note Modification Details” setting to “Yes” or “No.”
This setting determines whether the notes screen will show a record of every time any user edited a note. Activate this option if you need to know who edited a note and what changes they made. When set to Yes, a complete record of changes will appear under every modified note.
You can add, delete, or modify criteria that control which notes appear on the notes screen. For example, you could add criteria that limited the visible notes to only those written between two dates.
In most situations, you will want to view all notes. If you wish to restrict the notes, however, use the function keys as described below.
Function Keys
F1 – Show Notes
Press F1 to return to the notes screen, saving any criteria settings you have changed.
F6 – Add Criteria
Press F6 to add restriction criteria. There are three possible criteria to choose from: Location of Posting, Date of Posting, and User Who Posted.
Once you have chosen the criteria type from the list, you can enter details about how the criteria should be restricted. For example, the Date of Posting criteria screen looks like this:
Fill in the desired range and press F1 – Save Criteria.
Press F1 – Show Notes to return to the notes screen with your new criteria in effect.
F7 – Delete Criteria
Choose an existing restriction and press F7 to delete it. After you delete a restriction criteria and press F1 – Show Notes, you will see any notes that were previously hidden by the restriction.
F8 – Modify Criteria
Choose an existing restriction and press F8 to make changes and redefine the details for that restriction. For example, if you wanted the notes screen to show visits for a wider date range, you might select the Date of Posting restriction, press F8, and define a different date range.
If your office accidentally creates duplicate patients or duplicate family accounts on your PCC system, you may need to merge them. Some clean up may be required if there has been duplicate data entry.
Proceed With Caution: Merging two patients or accounts permanently combines all available data. After completion, it will appear that all charges, visits, and other activity occurred for a single patient. This cannot be reversed. Do not merge patients or accounts due to marriage or divorce. Instead, use the Demographics section of the patient’s chart to adjust billing and home accounts, and create new accounts if appropriate. Keep old accounts, as they include account and patient-related history.
Because combining patients or accounts is a permanent change that cannot be undone, consider being selective about who in your office has access to this tool. Permission to use to Combine Patients and Accounts is managed through PCC EHR’s User Administration tool. Select a role, and check “Combine Accounts and Patients.”
Users assigned to a role with “Combine Accounts and Patients” enabled will find“Combine Accounts” and “Combine Patients” in PCC EHR’s Tools menu.
Open Combine Patients
Open “Combine Patients” in the Tools menu.
Select Duplicate Patients
Before combining duplicate patients, each must be assigned to the same EHR home account. In the Combine Patient window, search for the home account to which each duplicate is assigned.
Select the account, then select the duplicate patients and click “Next Step”
Select Patient Demographics
Review each patient’s demographic information and select which should be kept.
If you need to change which demographics to keep and which to discard, click the double arrow button between each panel. Then click “Next Step”.
Review Combined Data
Review your choices.
The blue field shows a list of flags and a count of clinical data associated with the demographics you chose to keep. The yellow field shows flags and clinical data that will be appended to the patient demographics you kept. The combined count and flag list appears in green.
Click “Combine.”
Confirm Your Selection
The confirmation window is your last chance to cancel the merge without discarding, combining, or changing any patient information. Before clicking “combine” be certain that you’re combining the correct pair of duplicate patients, this action cannot be undone
Combining two accounts will irrevocably combine all billing history, balances and notes. If duplicate patients are assigned to duplicate accounts, combine the accounts first, then the patients. Combining accounts cannot be undone.
Open Combine Accounts
Open Combine Accounts from PCC EHR’s Tools menu.
Find Duplicate Accounts
Click one of the “Find Account” buttons to search for the first of the duplicated accounts. Select it, then click the other “Find Account” button to search for the matching duplicate account.
Review Account Demographics
Compare the two accounts to ensure they are duplicates. Each panel includes the date it was created and the last billed encounter. Scrolling in either panel will scroll both panels, so you can easily compare.
Click “Next Step”.
Choose Account Demographics
After reviewing the account details, select which account’s demographics information to keep, and which to discard. Click the double arrow button to make your choice.
Then click “Next Step”.
Select the Account to Keep
Finally, compare the billing history and notes.
Review the balances and number of account notes. Data and account information that will be kept appears in blue. The information in the yellow field will be appended to the account you selected in the previous step. If the combined data, shown in green, is as expected, click “Combine”.
Confirm Your Choice
The accounts you selected to keep and to discard appear in a final confirmation window.
This is the last chance to cancel without making any changes to either account. Click “Combine” to permanently merge the two accounts. Combining accounts cannot be undone.
PCC’s previous product suite “Partner” was a collection of individual programs. The programs all had a single-word name for easy reference. Whereas in PCC EHR, you edit patient information in the Demographics section of a patient’s chart, in the Practice Management interface, you might use the “fame” program (the Family Editor) instead.
This document is a glossary of the old program names, with brief descriptions of their function.
Deprecated: In most cases, the programs or tools list below have been replaced by a modern solution in PCC EHR. Contact PCC Support for help finding the right tool for your office’s needs.
activityactivity) provides a quick review of all activity for each insurance group for any date range. Because activity displays the number of visits and charges, you can quickly see which companies make up the largest part of your business. Since payments per visit are also on the report, you can use activity to begin evaluating which companies are paying you well and which are paying you poorly.
addblockaddblock) program adds a single block to the Partner schedule for a given date, provider, block type, and time range. Use addblock to quickly block a specific time from a provider’s schedule. You can also review existing blocks, read block notes and remove blocks from within addblock.
aginginsaging) shows an aged summary of your practice’s outstanding charges broken down by insurance group. Use it to see which carriers owe you the most money and how old those balances are. insaging is also a quick way to see your total A/R, and it can help you determine which insurance carriers need special attention. The report lists the percentages of your A/R for which each insurance group is responsible.
autopipautopip) automatically processed and posted adjudication from ERAs sent to your practice. This functionality has been replaced by the Electronic Remittance Advice tool in PCC EHR. See Post Insurance Payments.
apptsappts) is a powerful scheduling analysis report. In appts, you can list appointments by a variety of criteria and subtotal by provider, visit reason, and other items.
ardaysardays) report ages your accounts receivable and shows the number of days of work outstanding in each aging category. ardays can tell you, for example, how many days of your accounts receivable are over 90 days old.
autoflagrecaller). You can work with your PCC account team to create up to six sets of unique criteria for assigning status flags. Later, you can use autoflaglog to see what flags were assigned to patients. Contact PCC Support for help configuring autoflag.
autoflaglogautoflag, you can review which patients were marked as Inactive with the autoflaglog program. After you run autoflaglog and enter a date range, you will see a list of all patients who received the Inactive flag.backupsbackups program makes backups of your PCC Server. Backups occur every night, automatically, either into a cloud backup service or onto a local backup tape. You can run backups manually if you need to create an additional backup or if the nightly backup failed.
billsbills program generates personal bills.
bumpbump program lists overlapping appointments for any given day.
byinsbyins report lists all insurance plans by their insurance group. Insurance groups are important because many financial reports use them. Use byins to review your insurance groups and find problems, then make changes to the groups in the Table Editor (ted).
byprocbyproc report lists all procedures by their procedure group. Procedure groups are used by various reports. Use byproc to review your procedure groups and find problems, then make changes to the groups in the Table Editor (ted).
byprovbyprov report lists all of your providers sorted by provider group. Provider groups are used by several programs and reports. Use byprov to review your provider groups and find problems, then make changes to the groups in the Table Editor (ted).
caprepcaprep) provides usage numbers which can help you evaluate the pros and cons of a capitated plan.
cedced) contains lists of questions that control the behavior of some PCC programs.
cfscfs) generates an interactive list of accounts. The available lists are based on your office’s status flags or one of several built in criteria, such as overdue accounts or accounts with credits.
chartchart) was written to help users pull charts. It displays a single provider’s appointments for a single day without showing spaces for available appointments. chart is usually shorter than the scan report, making it easier to read and print.
checkincheckin) program is a Practice Management program used to confirm or update a patient’s demographic, insurance, and balance information. It has been replaced by Patient Check-In in PCC EHR.
checkout (formerly chuck)checkout) is a Practice Management program used to posts procedures, diagnoses, payment, and accompanying claim information. It has been replaced by Post Charges in PCC EHR.
chuck -dchuck -d command runs a report that displays all of the charge-posting screen data and HCFA configuration data for your system. If there are any apparent errors, the word “ERROR” will appear in the report’s output. When you run chuck -d, you can use the pipe symbol to send the output to less. At a command prompt, type “chuck -d | less”. This will prevent the report’s text from scrolling off your screen.
collcoll) shows detailed information about outstanding charges for a single account. Basic demographic information and payments for any date range are also available in the report. coll can also display all payments from a family during a certain time period, such as a full tax year. The Collection Report has been replaced by the Encounters with Outstanding Personal Balances function available during Patient Check-In, in the Payments tool, and in other screens in PCC EHR.
cscbcscb) places multiple blocks in Partner’s schedule according to a specified date range and list of providers. cscb works from block template files that must be edited before running the program.
cseditcsedit) allows you to configure which diagnoses and procedures appear on the charge posting screen in checkout, the charge posting tool found in Practice Management. You can link custom lists of procedures and diagnoses to different locations, providers, and visit reasons.
curimmscurimms) report and the Epidemic Prevention (epidemic report both check for missing immunizations. The curimms report output can be added to any encounter form and will show you if your system does not have a record for a specific immunization for the patient. The epidemic program can be run on an entire age group and will list all patients who do not have immunization records that meet your system’s configurable immunization standards.
cvxreportcvxreport) program lists your practice’s immunizations and diseases, along with the CVX codes currently assigned in your Immunization and Disease table. When you have a CVX code assigned to an immunization, the report also displays that code’s official CDC name. Use this report to get a quick look at your configuration and spot any immunizations with missing or incorrect CVX codes.
dailycheckdailycheck) lists all visits posted on a single day and includes every diagnosis, procedure, amount charged and payment posted. Use dailycheck to review a day’s postings and compare them against the encounter forms. Many office managers run dailycheck every evening or early the following morning.
daysheetdaysheet report can help reveal why. Every entry includes the poster’s username. The report includes erased or “oops-ed” items, and there are many useful sorting and subtotal options.
depositdeposit report lists all cash, check, and charge payments posted on a single day or date range. Check deposit against your cash drawer at the end of the day or the end of a shift. Each item includes the username of the person who posted the payment. This report has many powerful sort and subtotal options.
dsscandsscan) lets you view all daysheet entries for one particular account. You can see every charge, payment, or adjustment that was posted or deleted on the account, along with the user who performed the action. dsscan is useful when a charge is posted by one user and deleted by another user, or when the account or deposit report is difficult to understand.
duplicatesduplicates) shows all accounts and patients that have a duplicate entry in Partner. If your office frequently adds a new account or patient when they should be editing an old one, duplicates can help you clean up the double entries.
ebsebs) program runs the bills program for electronic personal billing. ebs sends your personal bills to a company that prints and mails them for you. You must have a contract with the company before you can run this program.
ECSECS) program, along with the preptags program, were used to process and submit your insurance claims electronically. They have been replaced by Submit Claims in PCC EHR.
ecsreportsecsreports program displays electronic claim submission reports, ebills reports, and electronic remittance advice (ERAs). The program displays incoming reports by date and includes a category view and various search features for finding and working with old reports. Run ecsreports when you need to find out why a claim was rejected or need proof of timely filing. A full catalog and explanation of the reports inside ecsreports is available in the EDI Reports ([prog]ecsreports[/prog]) manual.
elig
epidemicepidemic) creates a list of children who are missing a specified immunization. The output is based on your immunization configuration and patient records, so a review of your configuration and patient records is essential before running the program. See also: currimms.
escbescb) places blocks in Partner’s schedule based on a selected date, time range, and provider. Use escb to add extra blocks, of any type or size, for a certain week.
famefame) manages account information. Run fame to update family demographics, add a new insurance policy to an existing account, or add a new account to Partner. From within fame, you can also review a billing summary, run a collection report, or review an account’s transaction history.
findemfindem) allow you to find and list patients by a wide range of criteria. For example, you can use findem to find patients by insurance certificate number, home address, or immunization lot number.
fullfull report displays an abbreviated daily schedule for several providers, side-by-side. Along with the time and provider, the report lists the length of each appointment, the patient’s first initial and last name, and the visit reason.
hcfahcfa) prints paper insurance claims.
hmohmo to find out how many patients under five years old have BCBS and Dr. Smith as their primary care physician. The same information is available in the recaller, but hmo lists all physicians for all age ranges in a single report, and includes subtotals.
immcheckimmcheck report will list all of the details surrounding immunization and physical configuration at your office. When you run immcheck, you should use the pipe symbol to send the output to less. At a command prompt, type “immcheck | less”. This will prevent the report’s text from scrolling off your screen.
immsimms) stores an immunization record for every patient. Run imms to review immunizations or print an immunization record.
immsregimmsreg) sends your patient immunization records to a state or commercial immunization registry.
inquireinquire program displays a list of any patient’s appointments. You can review a patient’s appointment history, see details about upcoming appointments, and cancel or reschedule any appointment.
insaginginsaging) shows an aged summary of your practice’s outstanding charges broken down by insurance group. Use it to see which carriers owe you the most money and how old those balances are. insaging is also a quick way to see your total A/R, and it can help you determine which insurance carriers need special attention. The report lists the percentages of your A/R for which each insurance group is responsible.
inscoarinscoar) report provides a detailed, charge-by-charge accounts receivable report for your insurance companies. Use inscoar to find unpaid insurance charges and to work on old, overdue charges. You can also run inscoar interactively, allowing you to jump into different programs and research or modify charge information while viewing the report.
inscowsinscows) program generated a worksheet for planning the behaviors of a new insurance plan. The worksheet helped a user visualize which procedures would require a copay, appear on a claim, be adjusted off at time of service, and so forth. As PCC Support now handles the creation of custom insurance configuration files (“Special Information Files”), they no longer use this worksheet with practices.
iraira) produces a number of different reports with a wide range of customizable options. You can use ira to show procedure and charge activity for an entire year, compare the work done by different providers, evaluate the reimbursement levels of different insurance companies, and track payment of individual charges. With powerful subtotal and criteria options, ira is a catch-all report that can answer many important questions when you are making financial decisions for your practice.
lablab) stores lab orders, prints lab order forms, and records lab results.
listinslistins) report produces lists based on insurance plan effective dates for any plan or group of plans. Use listins to find all patients who have a particular insurance plan during a specified date range.
maketagsmaketags) is an insurance billing program that finds and rebatches large groups of unpaid or paid claims. After running maketags, you can send the batched claims using ECS or hcfa.
ministatsministats report produces a break-down of your practice income for a given date range. How much money did you receive from credit card payments? How much did Aetna pay you last month? What was the total of all personal checks for 2005? ministats can answer those questions and more.
nimmsnimms) program adds immunizations to a patient’s record. The advantage of nimms over imms is that you can add multiple immunizations quickly while adding provider and immunization lot information.
notify
notify) is a configuration tool for creating one-time or recurring notifications for appointment reminders, patient recall, and other purposes. After creating a notification, Partner automatically contacts patients by phone, text, or email.
notjanenotjane) manages patient information. Run notjane to update patient information, view an immunization record, research visit history, or read about a patient’s major diagnoses and allergies.
oopsoops) can make changes to posted procedures, including the insurance status and many visit details that appear on a claim. Use oops to change a procedure’s diagnoses or add a resubmission number.
oopslogoopslog) can help you research daily activity in the oops program. If you are having trouble understanding what happened with various charges or payments, the oopslog can show you a complete record of all activity in the oops program for any day.
openpmtsopenpmts) report lists credits and payments that are not linked to a specific charge. Partner automatically applies unlinked payments towards each account’s balance, but payments are difficult to locate or understand if they are not linked. openpmts can be subtotaled in various ways to help you clean up accounts with unlinked payments.
pampam) program, posts personal payments or adjustments to an account. pam can quickly post a stack of checks or a single co-pay.
patinfopatinfo) are the Visit History report and the Diagnosis History report. The Visit History includes a section with major diagnoses and a section that lists each visit date along with the provider, diagnoses, and procedures for that date. The Diagnosis History shows each diagnosis that has been posted for the patient and lists each date that diagnosis was given.
penpen) records and reports on phone calls. Nurses can use pen to record details of a phone call and jump into scheduling or a patient’s record. Providers can later review and process flagged phone calls using pen‘s interactive reporting features.
persviewpersview) is an interactive report for managing accounts with outstanding personal balances. Use persview to manage personal billing. You can limit persview to show families that are extremely overdue or who owe more than a specific amount. From persview‘s output, you can mail bills or form letters for one or many accounts. You can also jump directly into other programs for more information about an account on the report.
pippip) was used to manually post insurance payments and adjustments. It has been replaced by Insurance Payments in PCC EHR.
pnpscanpnpscan) shows scheduled appointments for one or more providers and can be limited to a specific location.
policypolicy program was used to manage an account’s insurance information. It was available directly from the Practice Management interface as well as in checkin, fame, or checkout. It has been replaced by the policy component in PCC EHR.
policylogpolicylog program displays a log of all changes made to a patient’s insurance policy records. If an insurance policy was accidentally deleted or edited, you can use policylog to review what changes were made. You can run policylog from within the policy program or from a command prompt.
prencprenc program, also called the “Print Encounter Forms” program, was used in Partner to print encounter forms for the day. It has been replaced by the Print Visit Forms tools in PCC EHR.
prepareprepare program recompiles your schedule with new hours. Whenever you make changes to a provider’s hours in profile, you must run prepare for them to take effect.
preptagspreptags program prepares insurance claims that are waiting to be submitted and runs the ECS program.
printpatstats and specstatsprintpatstats) program generates a series of printed charts on demographic data such as sex and age distribution. While this information is available in other reports, some prefer the visual representation of printpatstats. Run specstats to use the recaller screens to limit the patients included in the report.
If you would like to see a comparison chart of patient age but want to exclude patients who have left your practice, run specstats and use the recaller screens to exclude various patients. After you are finished making criteria selections, printpatstats will run automatically.
profileprofile) sets the work hours for each provider. Run profile when you need to edit providers’ IN and OUT times. You can have more than one “profile” or set of work hours.
providsprovids) allows you to override providers’ standard ID numbers submitted with insurance claims.
prscprintprscprint report will show every provider’s in and out times for a given date or date range. When you are configuring multiple providers’ schedules and need a quick view of who is in and out of the office, prscprint is a quick and easy reference.
rara) is a collection of pick-lists for running different Partner Programs. New Partner users use the ra windows to find and run Partner Programs. Most Partner users see the ra program automatically when they log in. The alternative to using ra is to run programs from a command prompt.
recallerrecaller) builds patient or account lists based on a wide range of criteria. In addition to producing customizable lists, the recaller can generate form letters and address labels.
Use recaller to recall patients for physicals, find patients who received a certain procedure, list patients based on a status flag, generate appointment reminder postcards, review a list of patients with asthma diagnoses, or view patients who have a particular insurance plan. You can mix and match these and other options and modify the report output to include information about the patient or their account(s).
referralreferral) records referral information, tracks referrals for each patient, and generates referral forms and referral reports.
refundrefund) posts refunds, account adjustments, and penalty fees. Items posted in refund behave similarly to charges posted in checkout. For example, you can link a payment or a credit to a refund, and each refund type can be found in the procedure table in ted.
rmscbrmscb) program removes blocks of any type based on a date range and provider list. Run rmscb to remove lots of blocks from your schedule at once.
rolorolo) is a basic address list storage program. It can manage many different rolodex lists for different purposes and includes a basic search function.
samsam) schedules appointments for patients.
scanscan) displays the day’s schedule for one or more providers. In scan, you can flip through the days of your schedule using the right and left arrow keys.
PCC can customize the information shown in the scan report. Along with normal schedule information, it could show you who scheduled each appointment and the date the appointment was made.
scrodscrod) program tells Partner which days providers work and which days they are off. scrod is a calendar on which you configure a provider to work their regular hours, work a special profile, work other “strange” hours, or go on vacation.
spectstatsprintpatstats.
squishsquish report displays an abbreviated schedule for any provider for an entire week. The report lists each visit reason, the length of the appointment, and the patient’s name.
srssrs) is a report library in Partner. srs contains dozens of powerful, customizable reports, all run with a consistent interface.
tatertater) provides a complete history of all transactions on an account. tater reports on all charges, payments, refunds, and other transactions. Use tater to track a running balance or produce a detailed financial report on a family.
tedted) contains a list of lists used by Partner. Use ted to add insurance companies, providers, and other items to your Partner system.
tickletickle) is an automatic email reminder program. Use tickle to create reminders or messages about patients and accounts that will be delivered at a later date to a specified email account. Some offices use a list of tickle messages as a cancelation list for appointments.
twomonthstwomonths report sends a calendar-style schedule directly to your default Partner printer. You can run the twomonths report from a command prompt.
useradminuseradmin) program adds or locks-out Partner users, changes passwords, and modifies permission lists for some Partner functions.
utilizeutilize) report shows you all of the patients who visited during a given date range and had a certain insurance carrier as their primary payor. For example, utilize shows you who your Aetna patients were last year, how many times they visited, and how much was charged to them.
wafflewaffle, makes changes to Partner’s form letters. Use waffle to modify existing form letters or create new ones.
Your office may have a front-desk printer for receipts, a chart room printer for encounter forms, a back office printer for everything else, and printers that are only connected to certain workstations. When you log in, you may have printer needs that are particular for you, or particular for where you are working today.
This article describes all the different methods you can use to set your printer preferences in the Practice Management window.
While running programs in Practice Management, you can often specify a printer before you print.
To select a printer, place your cursor in the printer name field, then type an asterisk (*) to call up the list of printers configured for use with your PCC system.
If the printer you need is in the list, select it with your arrow keys and press Enter. Otherwise, select the “Local Print Dialog” option.
Once you have selected a printer, type F1 to finish sending the job.
When you print using the “Local Print Dialog” option, Practice Management calls up your local workstation’s list of connected printers, including both networked and USB-connected devices, and allows you to choose where you want to send the job.
Practice Management can automatically set your default printer based on your login username, assigning you the same printer every time you log in.
Contact PCC Support to configure this feature.
If PCC manages your office’s network, Practice Management can detect which computer you are sitting at when you sit down and log in. Practice Management can then set your default printer automatically by that location.
Contact PCC Support to configure this feature.
You can use the Pick-A-Printer program to set your default printer. PCC Support can configure Pick-A-Printer to run automatically at login for users. You can also run Pick-A-Printer manually at any time by selecting the “Pick a Default Printer” option in your Practice Management menus.
Select a printer and press F1 – Save to continue.
Choose Local Print Dialog for Flexible Print Options: When you set your default printer to the “Local Print Dialog” option, Practice Management will call up your local workstation’s print options every time you print, allowing you to choose the perfect destination for every job.
Add Pick-A-Printer to Your Menu: If you do not see the Pick-A-Printer option in your Practice Management menu, contact PCC Support to have it added.
Ask Again at Login?: You can set whether or not you wish to see the Pick-A-Printer screen at login. If you answer “No”, you can still run Pick-A-Printer manually. If your office decides that all users must set their printer at login (because PCC does not maintain your office network, for example), then this option may be hidden in order to prevent confusion.
Note: If your office uses your workstation location or username to set your printer, your Pick-A-Printer choice can only last until you log out. Your location or username settings will take preference the next time you log in. If you wish to turn off the automatic printer selection and only use Pick-a-Printer, contact PCC Support.
PCC Support configures a printing command for many features in Practice Management. Your HCFA forms probably always print to a particular drawer of a particular printer, for example and your bills may behave the same way. Those printer settings typically work the same for any user, anywhere in your office.
If you are familiar with Practice Management configuration, you may make some of these feature-specific printer changes yourself. If you print form letters to a specific printer, for example, you can configure that in the Form Letter Editor (waffle).
Other printer choices are set in the Configuration Editor (ced). Please contact PCC Support if you need help making program-specific printer changes.
This is an Archived Manual For Older Software: When you need to add users, change a password for an employee, disable a user, or set roles and permissions for PCC products and services, use the User Administration tool in PCC EHR. The Practice Management window contains an older, under-the-hood user administration tool. This article is the manual for that program.
As of PCC 8.15, the functions in this program are deprecated. You should only use this tool if you are troubleshooting a user account problem on your system, you need to adjust access to a non-PCC EHR database, or similar.
For more information, contact PCC Support.
To learn how to add a new user account to practice management and your practice’s PCC server, read Add a New PCC User Account.
Contact PCC support for additional assistance.
Run useradmin from either the System Administration window in your Practice Management windows or by typing useradmin at a command prompt.
Since useradmin performs sensitive administrative functions, only authorized personnel can run it, such as your office’s System Administrator or PCC’s Customer Care Team. useradmin keeps an internal list of authorized users; the System Administrator can change this list at any time.
The main useradmin screen looks like this:
Authorized users may press the appropriate function key to add or lock out a user, change a user’s password, or edit authorization lists.
Command Prompt Shortcuts: Authorized users can type the commands listed on the screen instead of running the useradmin program to select them. For example, a system administrator might type userpasswd at a command prompt to reset a user’s password.
If a user forgets their PM password, the System Administrator can reset it for them in useradmin. Press F4 – Change Password to begin.
You will be shown a list of users:
Select the user and press Enter to change their password. You will be shown a warning, and then asked to enter the new password four times:
Passwords must be at least 5 characters long.
Better Password Security: The user should log into Partner and change their password once you have reset it to something new. Encourage users to pick passwords that are difficult to guess or contain a mix of letters and numbers.
Your practice’s System Administrator should lock out any user who should no longer be using your Partner system. Your Partner server contains Private Health Information (PHI) as well as sensitive financial information about your practice. Whether an employee has left your practice or is being assigned to a new position away from the computer, they should be locked out of the Partner system as soon as their Partner related responsibilities are finished.
Run useradmin and press F3 – Lockout User to retire a user’s login name. You will be shown a list of users from which to choose:
Select the user whom you wish to lock out and press Enter.
Computer System Names: You may see some system login names that are part of how the operating system functions. Do not lock out those users.
CALL PCC: You may want to inform PCC when you remove a user from your system. If a former employee often spoke with PCC, you should tell our support team that the user should no longer be given access to your system. If the user had access to Partner from a home or remote office, it is especially important that you contact PCC and tell us to turn off that connection.
When your practice re-hires an employee or for some other reason restores access to the Practice Management system and your PCC server, you can unlock a formerly locked account.
Select Restore a Locked Out User to the System from the useradmin menu.
You can adjust most permissions and user authorizations in the User Administration tool in PCC EHR.
Your PCC server has additional authorization lists for under-the-hood billing and administrative tasks.
Open the Partner useradmin program and press F8 – Authztn List to edit authorization lists.
There are two system authorization lists that you can edit:
First, you can edit the list of users authorized to add new users to the system. This includes access to changing passwords, locking out users, and access to changing this same authorization list. Users on this list can run the useradmin program.
Second, you can edit which users are allowed to edit patient and account notes for the Structured Notes option in the Family Editor and Patient Editor.
When you edit an authorization list, you will see a simple text box with a list of usernames:
Make changes and press F1 – Save to confirm. Press F12 to quit without making changes.
PCC uses the WebEx service to connect you to online training courses and training sessions.
When you sign up for a web lab, PCC will send you a direct link to a class or one-on-one session when you sign up.
You can also view available meetings, register, and begin your webinar at one of these links:
Parents and patients can use PCC’s patient portal, My Kid’s Chart, to access their medical records. Your practice manages the login account, and grants secure access to each patient’s records. Read the sections below to learn how to create and configure patient portal accounts.
You can use the Patient Portal Users component in PCC EHR to quickly review portal information and see if mom, dad, or another guardian has access to the patient’s records through the patient portal (My Kid’s Chart).
The Patient Portal Users component is in the Patient Check-In ribbon by default, but your practice can add it to phone notes, visit protocols, or wherever it will be useful for your workflow.
In addition to reviewing and updating portal access, you can use the Patient Portal Users component to understand how the family is using the patient portal. You can see the time of last login and if there are unread messages from your practice or documents they have not reviewed yet. You can also see if a billing account for personal balances is assigned for the user.
If a patient has passed your practice’s emancipation age, you will see a message letting you know that the user does not actually have access to a patient’s records.
You can jump straight to the Patient Portal Administration tool from the Patient Portal Users component, if you need to add a new portal user, or manage an existing user’s portal account, just by clicking either the “Add Portal User” or the “Manage Portal User” button.
At the bottom of the Account Demographics click the “Add” button under Home and Billing Account’s Portal User. If you’ve added both a Home and Billing account, each will have their own, labeled “Home Account’s Portal User” or “Billing Account’s Portal User”. Click “Add” to create a portal user to link to the selected account.
The “Add” button creates a new patient portal user for the selected account. The portal user’s name is filled in automatically. Select a phone or email address to use as the Portal Sign-In. The phone or email you select here will be used to sign in to the patient portal.
Click “Continue” to create the portal user.
The portal account you selected appears in Account Portal User section. If needed, use the “Unlink” button to remove the portal user from this account.
In some cases siblings will share a Home or Billing Account, but not be connected to the same patient portal user.
The Account Portal User section will indicate this situation with the text “Patient… is not connected to this account’s portal user. Manage portal user to add this patient”.
Clicking “Manage” will open the Patient Portal Administration and automatically connect this patient to the portal user.
If needed, a Patient Portal account can be created for users other than the PCC EHR Home or Billing account, such as a second parent or other guardian. Unlinked Patient Portal accounts can be created through the Patient Portal Administration, found under PCC EHR’s Tools Menu.
To find a specific portal user, click on the “Manage Portal User” option and search by name, email address, or phone number.
Click on the “select” link to choose an account to work with.
Can't Find It?: If you are not able to open the Patient Portal Administration tool in your Tools menu, contact your office manager. They can use the User Administration tool in PCC EHR to grant you a role with patient portal administration privileges.
If a patient has no portal account users, or if you want to add another portal user for the same patient, you can click “Add Portal User” from the Patient Portal Users component to jump into the Patient Portal Administration tool.
Enter a first name, last name, and sign in, and click “Add User” to create the account and send the user an email or text with login information.
Optionally, if the user would like to use a different notification method than their sign in, click the “Use a different method” radio button, and fill out their notification preferences.
Once the account is created, the Manage Portal User screen will automatically display so you can associate a billing account for the portal user or make other changes. The patient whose chart you originated from will automatically be connected to the portal user’s account.
Alternate Method: If you prefer not to use the Patient Portal Users component, you can get to the same screen from the Tools menu, as described above. However, you will have to manually connect patients with the portal user’s account, as the automatic linking only happens through the Patient Portal Users component.
User verification helps to prevent email errors and preserves confidentiality.
Each newly enrolled portal user will need to verify the birthdate of the oldest (living) patient on their account before they can access the portal. They will only need to do this the first time they sign in, unless your practice resets their password.
The portal user will get three attempts to choose the correct birth date from their phone’s date selection tool. If they enter the wrong date three times, they will receive a message stating that the answer is incorrect (even if they have finally entered the right date), and they will be locked out of the account for 15 minutes.
The portal user can either wait the 15 minutes and try again, or they can call your office and ask to have their password reset so that they can try again immediately.
When you need to make changes for a patient portal user, the quickest way to access their account is by clicking “Manage Portal User” from the Patient Portal Users component.
You can check their verification status, reset their password, edit their contact information, delete their account, grant permission to view patient records, and manage or associate a billing account.
Alternate Method: If you are not in the Patient Portal Users component, you can get to the same screen from the Tools menu, as described above.
You can track the status of your portal users’ verification process in both the Portal Administration tool and the Patient Portal Users component, with the “Identity Verification” field.
There are five possible statuses that may appear within this field:
Never: displays when there have been no attempts to verify
Verified: displays when the portal user has successfully verified their account, and created a new password
Incomplete: displays when the verification process was successful, but the user did not continue on and create a new password
Failed: displays when the portal user’s most recent attempt to verify was unsuccessful
Never - requires connected patients: displays when there are no patients connected to the portal user (rare)
If a portal user forgets their password or gets locked out of their account, they can call your office to have their password reset.
You can reset a portal user’s password in the Patient Portal Administration tool.
If you reset the password, the portal user will need to go through the identity verification process again, which will require them to enter the birthdate for the oldest child on the account.
While managing a portal user, click “Add Patients” to grant the user access to a patient’s medical records. Then, search for the patient by name.
From the search results, click “add” to add permissions for one or more patients. Then click “Done”.
You can add additional patients, or click “Add Siblings” to add a sibling, which will provide a list of patients who share a home or billing account with currently connected patients.
The Manage Portal User screen will display a list of all patients that an account user may access.
Click “remove” to remove access to any patient.
Patients From Different Care Centers?: If your office is part of a large, multi-office practice that uses PCC’s Care Centers feature, you will see which care center a patient is assigned to when you search. Use that information to help you connect the correct patient record to the portal user account.
You can decide for each portal user whether it is appropriate to show the personal balance for the patient(s) they are connected to in the portal.
When you set up or edit a portal user’s account, you can select a billing account that is associated with the patient(s) who the portal user is connected to.
The selection defaults to “Do not display balance”. Users will only see the balance if the portal administrator decides to change the selection.
In the above example, the portal administrator decided not to have Wilma’s portal account include personal balance information, since the billing account was in Fred’s name. If the practice chose to show balance information, Wilma would only see the charges that were outstanding for Pebbles, since Dino’s name is in italics (indicating that his information will not be visible to Wilma).
NOTE: If you do not wish to display Personal Balance for any portal users, and you do not plan to accept payments through the portal, you can use the Configuration tab to turn off this feature for your practice.
Depending on your state or region’s regulations, emancipation age can vary. PCC can handle whatever age your patients’ medical records become their own. For more detailed information about patient privacy in the portal and elsewhere in PCC EHR, read the Patient Privacy Features Overview article.
When a patient reaches the age of emancipation set by your practice, their record will automatically become private. The “Privacy Enabled” message will appear beside their name.
Users will still be able to see the patient’s name, and send a message to the physician in relation to the patient, but they will have no access to medical information.
Here are some issues to keep in mind:
Messages Are Still Available: If your practice uses the Messages feature of My Kid’s Chart, parents will still be able to send your office messages and questions in relation to connected patients, even after they turn eighteen. Your staff should keep this in mind when responding to incoming questions on the Messaging queue in PCC EHR.
18, 16, or 21?: Age eighteen is the My Kid’s Chart default emancipation age, but your practice can set your emancipation age to whatever is applicable for you, based on your state or region’s regulations.
Your practice can use the Patient Portal Administration tool to grant individuals the right to access a patient’s information after they are over the emancipation age. Do this for the patient themselves if they use My Kid’s Chart, or when special circumstances apply for an adult patient with a guardian.
In the example above, the My Kid’s Chart user Wilma Flintstone has four patient records attached to her account. However, as shown by the “Hide at age 18” column, when three of these children reach eighteen, Wilma will no longer have access to their medical records (Thoracia has turned eighteen already). The exception is Bambam, an adult patient whose records will remain visible to Wilma.
The patient portal administrator can change the status for any of these patients by clicking in the “Hide at age 18” column.
When a patient who is over eighteen opens a new My Kid’s Chart account, your administrator should set this question to “No” for their account, so as not to hide their records from themselves.
Review Connected Patients: When working with a My Kid’s Chart user account, the Age column can help you know what to expect. If a user is over 18, the age will appear in bold red to indicate they are over your state’s emancipation age.
If you need to find out who has accessed a patient’s record in your patient portal, you can review the Patient Portal reports from the Report Library.
You can review all users who have accessed a specific patient’s chart or all patient charts that a specific user has accessed, as well as other information about patient portal activity. You can customize reports to work with your practice’s workflow.
For more information about running reports, read the PCC EHR Report Library article.
Keep in mind, if you believe a user has access to a patient record they should not, you can use the instructions in the sections above to add or revoke access to a patient’s record at any time.
If you need additional help with auditing access to patient records through your patient portal, contact PCC Support.
My Kid’s Chart is an online tool that patients and families can use to access medical records, review lab results, generate an immunization record, review their visit history (including growth charts), send a message to their pediatrician’s office, or pay their bill online.
My Kid’s Chart is designed especially for mobile phones and tablet devices, but families can also log in on any computer browser on any operating system.
The articles in this help section include a user’s guide, instructions for managing user accounts, and a guide to the secure messaging feature.
Contact PCC Support at 802-846-8177 or 800-722-7708 or support@pcc.com for further assistance.
PCC provides an informational handout for patients and families, registration forms, and custom flyers for your practice.
You can learn more, download the kit, and request a custom flyer on PCC’s Patient Portal Kit page.
You can download and print a manual for patients and families here: My Kid’s Chart User’s Guide.
When your patient families sign up to use PCC’s patient portal, My Kid’s Chart, you can meet two Meaningful Use requirements:
You can also meet these requirements using a combination of reports and other online services, but you can meet both of them more easily with PCC’s patient portal, MyKidsChart.com. Once you are live with MyKidsChart.com, PCC EHR’s Meaningful Use measure report calculates usage for you.
Patients and family members can use the patient portal (My Kid’s Chart) to send secure messages directly to your practice. Your practice can use PCC EHR to read and respond to messages, create and send new messages to portal users, and communicate with families and answer questions.
Read below to learn how to use PCC EHR to receive and send messages (and attachments) between your practice and users of My Kid’s Chart.
Working in pocketPCC?: You can also read and respond to portal messages in pocketPCC.
When a parent or other user sends a message to your practice, it will appear on the Messaging tab in PCC EHR.
Your practice can use the Messaging queue to review all incoming messages from My Kid’s Chart (along with phone notes, follow-up tasks, and other items). You can see a summary of the message, including the date, patient, subject, and whether or not there are any attachments. The “From” field lists which Patient Portal user sent the message, and their relationship to the patient, if one has been entered.
As with other queues in PCC EHR, you can use filters to display exactly the items that pertain to you. If it’s your job today to handle incoming portal messages, you can use the “Task” filter to select “Portal Message”.
Double-click on a portal message on the Messaging queue to open it.
Inside the portal message protocol, you can read the full text of the portal message, review any attachments, and type a response and send it to the family member. Your office can customize this protocol with additional components and other information.
As you type a reply, you can use chart navigation buttons to review the chart. You can even leave the chart, save a draft of your message, and return later to finish.
If you send a written reply, the My Kid’s Chart user (usually a parent) will get an e-mail telling them that a message awaits. They can log in to My Kid’s Chart to read your reply message.
Portal Message Templates: If a portal message was sent using a Portal Message Template, you may see fields with specific answers. Your practice can customize these templates to help parents enter the correct information when they request an appointment, a prescription refill, or other need. When you see a template, you might schedule an appointment or take other action, or you could create a new task for a different user.
Complete the Message: PCC EHR considers the message incomplete until you send a reply. It will continue to appear on the Messaging queue, will appear in the patient’s Outstanding Tasks component, and be highlighted as needing attention in the Visit History. If you have reviewed a message and it no longer needs a reply, you can click “No Reply”. For example, you may have reached the end of the conversation, or you may have called the sender on the phone or taken a different action.
Clarify vague message subjects or add details by adding a summary, which appears in place of the message’s subject line.
Initially, the message’s subject appears in the summary field. Click the text field and edit the summary line, then save your changes.
After saving your changes, the summary line will appear in place of the subject in the Messaging Queue and Patient History. The original subject still appears in the message itself, below the summary line.
Click “Add Portal Message” to create a new portal message. (You can also find this option in the Edit menu whenever a chart is open.)
If more than one portal user has access to the patient’s records, use the pull-down menu to select the recipient. For example, the message may be for a parent or intended for the teenage patient. The pull-down list will include all patient portal users who have access to the selected patient’s records.
Next, enter a subject and message and click Send. Optionally, you can add attachments or create a task for the Tasks queue based on this message.
Privacy: The message you send will not be sent by e-mail, nor will it be accessible by the patient or by any other parent or guardian, unless they elect to share their My Kid’s Chart login information. The user will receive an e-mail message telling them that a message is waiting for them in My Kid’s Chart. For more information about sending and receiving messages, read the My Kid’s Chart User’s Guide.
Patient Portal Messages vs. Direct Secure Messaging: The patient portal and PCC EHR support two different messaging technologies. Portal messages are a secure, optional messaging tool built into the patient portal. Patient portal users can exchange messages with their pediatric practice, and the practice can receive and send portal messages with PCC EHR or pocketPCC. Direct Secure Messaging, on the other hand, is a specialized message technology used to share and send medical information. It requires registration with a third-party service and it allows for secure transmission of C-CDA transition of care documents or visit summaries. For more information, refer to Receive and Respond to Portal Messages or Direct Secure Messaging.
You can send portal messages with attachments. For example, you could send a lab result or important handout in a portal message with an accompanying explanation, and your families will never lose their copy. Families will see your attachments within the portal message, which makes the document much easier to find.
When you are working on a portal message, click “Add Attachment” to add a document.
You can select from the Recent Documents section, or choose a document from another category. Click “Attach” to attach the document.
As you compose your portal message, you can see information about the attachment, and click “Send” to send the message and attachment together.
What will the family see in the patient portal? The attachment will appear in line with the discussion.
The family can click on the attachment to download and view the document.
Portal messages are always sent to one, specific portal user. When you attach a document to a message, it will be sent only to that portal user. However, your practice can also make documents visible to all portal users, as part of the patient portal record. What workflow should you follow to ensure that a document is only shared with one user?
For example, if you’re sending contraceptive information to a teenage patient, or a form intended only for a parent, you want to attach a document to a portal message but not have it appear elsewhere on the patient portal.
When you add a private handout or document to a patient’s chart in PCC EHR, make sure that the “Display in Portal Documents” checkbox is not checked.
Next, reply to or create a portal message and attach the document.
Since the attachment is not visible in portal documents, you can be sure that the document will only be seen by the specific portal message recipient. (If you’d like to make changes you can click “View Document” and then “Edit” to change whether or not it is available to all portal users.)
The document will only appear as a message attachment for the specific portal user.
Maximum Attachment Size: Each portal message is limited to a maximum of 30MB of attachments. Single attachments over 30MB, or multiple attachments totalling over 30MB, cannot be sent.
If the patient portal user attached a document to the message, you can review it as you read the message.
As you view an attachment, you can click “Edit” to change the document’s tags. You can give the file a new name, category, or re-attach it to a different visit or order. If you move the document to a different visit, it will no longer be attached to the portal message. You can also remove it from the patient’s chart and send it out to the Import Documents tool (for example, if it needs to be put into a different chart).
The 'Display in Portal Documents' Checkbox: When you edit any image or document in PCC EHR, you will notice a “Display in Portal Documents” checkbox. The checkbox is not checked by default, even for documents sent from the portal user. There may be more than one parent or other guardian who has patient portal access for a patient. If you select this box, all patient portal users for a patient will have access to the document.
The “status” line for each portal message indicates whether or not a message has been read. When a portal message is opened, the status updates from “Unread” to “Read” with a timestamp of exactly when the message was opened, and which user opened it.
Unread messages include the option to create a new task type: “Follow Up On Unread Message”. Assign that task to a user to have them contact the recipient to be sure that your message gets to them.
When a user at your practice begins writing a portal message and saves without sending it, the draft message is saved. Draft messages are available within the patient’s visit history, and are now also found on PCC EHR’s Messaging queue. Filter the messaging queue by the “Portal Message” task to find both draft and other portal messages, and filter by user to find drafts saved by any EHR user.
To remove a draft message, open the message from the Messaging queue and delete the content.
Double-click, or select the line in the Messaging queue and click “open” to open the message so you can complete and send it.
An EHR user who cannot be assigned tasks will now appear in the Messaging queue’s Assigned User list, so that they can filter to find their own drafts.
You can find draft messages in pocketPCC’s Messaging queue. Messages can be opened and edited there, just like in PCC EHR.
Draft messages do not have their own entry in the Messaging Queue’s task filter, but are included within the Portal Message filter.
Portal Messaging includes the option to prevent replies to a message thread after a selected number of days. 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.
The length of time before a conversation becomes inactive is set in Patient Portal Configuration.
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.
Use the Personal Money Tracking Assistant, or persview program, to manage your practice’s “personal” accounts receivable. It creates an interactive list of accounts with personal balances. The list can contain all outstanding accounts or just a portion, depending on your custom criteria.
Billers can use persview to work down unpaid balances. By specifying different criteria, a user can focus on a certain portion of your practice’s personal A/R. For example, some offices split up overdue accounts by last name, while others work on the accounts based on the age or amount of the balance. Regardless of how your office works, persview can help you hone in on the accounts you need to contact.
The report’s results can be printed or saved in your e-mail box, but the real power of persview comes from working with the list on your screen. By pressing different function keys, you can send out form letters, review account histories, generate bills, enter notes, post payments, post late fees, and even write off bad debt… all from the same interface.
You can find persview in your Practice Management windows.
When you first run persview, you are presented with a criteria screen:
Press F1 – Generate Report to view a list of all accounts with personal balances.
Before you press F1, you can use the criteria options on the screen to limit which accounts will appear.
Criteria Options in persview
Aged How
You can choose how outstanding charges should be aged. Account totals appear in aging categories on the report, and they can be aged by transaction date (when the service occurred), by posting date (when the service was entered onto the system), or by payor date (the date the balance became the account’s responsibility).
Aged as of…
Select a date to base the report on. Use the last “Nightly File” for a quick report, as the aging data is automatically prepared the previous night. Use the Existing File to quickly review the last report you manually aged. Or, ask persview to manually regenerate to a particular date. In most situations, you should stick with the Nightly File. If you have just finished entering dozens of payments, you may want to “Regenerate” the aging information for today.
Personal Balance Range
You may not want to work with an account unless they owe over ten dollars. If you only want to list accounts that have a certain balance, enter a dollar amount range in the fields provided.
Name Range
The Name Range question allows you to select a specific range of the alphabet. Enter the starting and ending letters of your alphabet range in place of the A and Z. Use this option if your office’s billers divide their responsibilities by account last names.
Which Accounts to Include
By default, all of the categories shown are selected. If you wish to limit the accounts based on how long they have owed you money, you can remove or add X’s in front of each category. The “Exclude by Account Flag” option can be useful if you don’t wish to view certain account types.
How to Sort the List
You can sort the printed report or persview’s interactive on-screen report in alphabetical order or by the total balance owed by the account. To indicate your selection, place an X in front of one of the two choices. You may find it useful to sort accounts by who owes you the most.
Destination
Finally, you must decide where to send the report output. To indicate your selection, just place an X in front of your choice.
If you specify the “Screen” as your destination, the results will appear on your computer screen in an interactive report. You will be able to scroll through the list and easily access information about the various accounts that are listed. It is also easy to generate a form letter or bill for some or all of the accounts. See below for more information.
If you send the output to your “Mailbox”, you will receive an e-mail that you can review at a later time. You can also save the e-mail in a folder for archival purposes.
If you opt to print the report, it will be printed on your default Partner printer unless you enter the name of a different printer. Enter an asterisk (*) to view and select from a list of available printers.
While printing or sending the list as an e-mail may be useful, you will find the interactive list (Screen) the most powerful choice. The remaining sections in this chapter explain how to take full advantage of the “Screen” option.
After making your criteria selections, press F1 – Generate Report to run the report. persview may take a few minutes to gather the information about accounts with personal balances.
After you select criteria and press F1, persview will show you a list of accounts with aged balances and a balance total.
The accounts are grouped in sets of three, making the list easier to read. Press Page Down and Page Up to scroll through the list and view all accounts.
In the example shown, the user set the criteria option to sort the list by “Total Personal Amount” owed. As shown in the “Total” column, the accounts with the largest outstanding balances appear first.
The “Work With Individual Accounts” screen allows you to work with a specific account. Select an account by placing an X in the box in front of the account name. Once you have selected an account, you can do a variety of different operations by pressing different function keys. For example, press F2 – Edit Account to run the Family Editor (fame) for the selected account. From fame you can check the account’s insurance companies and run the coll report to review the reasons for the balance.
Actions From the Individual Account Screen
F1 – Main Menu
Press F1 to return to the Main Menu, where you can enter a different set of criteria.
F2 – Edit Account
Press F2 to access fame for the selected account. In fame you can review demographic information, run the collection report, view a complete account history, review insurance information, enter account notes, and more.
F3 – Refund
Press F3 to run refund for the selected account. In refund you can quickly refund a credit, print a bill, and post late charges and other fees.
F4 – Pam
Press F4 to post payments or adjustments in pam. This is useful when the selected account agrees to pay with a credit card over the phone. You can also write off debt by using an appropriate payment type.
F5 – Daysheet History
Press F5 to scan through the daysheets and view all transactions related to the selected account. If you suspect a payment or charge has been deleted, the daysheet history can show you the amount and which user deleted it.
F6 – Form Letters
Press F6 to print one or more form letters for the selected account.
F7 – Print One Bill
Press F7 to print a bill for the selected account. When you press this function key, you will be asked to enter a date range for the bill.
F8 – Work With All
Press F8 to switch to working with all accounts listed. See the section below for more information.
When you press F8 – Work With All, persview shows you new function keys for performing batch functions on all listed accounts:
The new function keys will perform actions upon all the accounts in the list.
Actions for All Accounts
F1 – Main Menu
Press F1 to return to the Main Menu, where you can enter a different set of criteria to change the list of accounts.
F6 – Form Letters
Press F6 to select one or more form letters and print them for every account in the list. By using persview‘s criteria options and this function, you could generate a form letter for all accounts with specific overdue balances amounts or a specific account flag.
F7 – Print Bills
Press F7 to print bills for all accounts on the list. You will be prompted for a date range.
F8 – See Totals
Press F8 to view the Personal Totals screen, described below.
Press F8 – See Totals from the “Working With All” screen in persview to view a summary for the accounts.
When you press F8, persview tallies up the personal money owed to your practice by everyone on the list. It then presents the totals to you, broken down by the age of the balance.
As long as you run the reports with similar criteria (same alphabet range, same aging categories, same aging types, etc) the totals on this persview screen should match those from the aging and insaging reports.
Press F8 – Work With One to cycle back to the other persview screens.
My Kid’s Chart is the patient portal for your pediatrician’s office. You can use My Kid’s Chart to access medical records, communicate with your pediatrician, pay our bill, and more.
Use this guide to learn how to log in to My Kid’s Chart, review your child’s records, and send messages to your pediatrician. You’ll also find instructions for reviewing your outstanding balance and reviewing a log of activity on your account. For more information, contact your pediatrician’s office.
In order to access your child’s information through the portal, you need to get a portal account.
Call your pediatrician’s office; they will ask for your email address or phone number to use as a sign in and will verify which patient records you are authorized to access. Then they will create an account for you.
Next, you will receive an email or text with your temporary login information.
After you receive your new account information, you can click on the “sign in” link in or type the URL into a Web browser. You can use My Kid’s Chart on a personal computer or on your smart phone.
You may want to bookmark or save this link for later, or add it as an icon to your smart phone’s home screen.
Next, enter your email address or phone number and temporary password to log in.
If your portal account has just been created, you’ll need to verify the birthdate of the oldest (living) patient on your account. You’ll only need to do this the first time you sign in, or if you ask your pediatrician’s office to reset your password for you.
First Time Login: If this is your first time logging in, My Kid’s Chart will ask you to enter a new password when you log in.
Enable Cookies: My Kid’s Chart uses cookies to keep you logged in. If you have trouble logging in, or find yourself being logged out frequently, ensure that your browser accepts cookies.
Once you log in, you will see your child/children listed, along with any upcoming appointments they may have. You may also see a Messages section for sending messages to the office, if your pediatrician’s office has activated that feature.
Do You See the Patients You Expect?: If you are a parent or guardian of several children, your pediatrician’s office can add each child to your user account. Patients can also appear on more than one login, so more than one parent or guardian, and the patient themselves, may be granted an account with access to the same patient’s medical records. Contact your pediatrician’s office if you are not seeing the patients you expect to see.
Automatic Log Out: After 5 minutes of inactivity, MyKidsChart will log you out.
Does Your Name Appear Correctly?: You can click the “Settings” button to change how your name appears on the screen.
Click on your child’s name to open their medical records.
You will see your child’s name and birth date, along with their last physical date. If they have any upcoming appointments, you will see them listed as well.
Scroll down to review your child’s past visits, lab results, medications, and other information.
How tall was your child at their last physical? What was your pediatrician’s diagnosis when your child had a cough last month? For a complete visit summary, select the visit you want from the list.
For each visit, you can see information that was collected and any labs or diagnostic notes from that visit. You can review the vision or hearing screenings and any other items noted in the chart on that day.
Vitals Percentiles Based on Patient Data: You will notice a percentile value listed with your child’s weight, height, and BMI. These values show how your child’s information compares to that of other children of the same age and sex. If your child has a Down syndrome diagnosis, you will see “AAP-DS”, which indicates that the percentile is based on Down syndrome patients of the same age and sex.
If your practice uses a third-party telemedicine vendor, they’ll include a link to begin the telemedicine visit in the appointment information. Click the link at the appointment time to begin.
When you want to review the results of a lab test, vision test, or any other medical procedure or order, just scroll down to the relevant section. Alternatively, you can click on the visit at which the test was given and review results in the visit summary.
The information in My Kid’s Chart is updated automatically from the patient’s medical chart at the office, so you can be sure that the latest information is always available. Contact your pediatrician if you have any questions.
Do you need a copy of your child’s immunizations record? In the Immunizations section, you can select the PDF button to download a copy.
Your pediatric practice can share educational handouts, plan notes, or other documents with My Kid’s Chart. You will see these shared items in a Documents section on your child’s record.
The five most recent items appear by default, and you can click “More” to see the full list. Documents appear in reverse chronological order, and if a document doesn’t have a title the word “Document” will appear instead. Click on a document to download and view it.
Do you want to see how your child’s weight and height have progressed over the past several years, and how they compare to other kids their age? You can see graphs of your child’s growth over time in the Growth Charts section of your child’s record.
Your child’s height and weight are displayed as points on each chart, with gray lines indicating percentile averages. Percentile ranges are specific to a patient’s age and sex, and come from the World Health Organization (WHO) and the Centers for Disease Control (CDC).
You can tap through all available charts for your child, using the arrows shown just above the chart.
For a larger view, turn your mobile device sideways.
You can view the specifics of each entry (including percentiles) by clicking on the “Measurements” button beneath the chart.
If one of your children is over your state’s emancipation age, then their records will automatically become private, and your pediatrician’s office will have to grant special permission for you to view their records. Your pediatrician has a policy on whether or not to give parents access to records for children of different age groups, which must follow state and federal guidelines.
Your pediatrics office can also create a Patient Portal user account for the patient, and provide the patient with access to their own records.
As you review patient records in My Kid’s Chart, you can exchange private messages with your pediatrician’s office. You can also attach images or other documents.
After you log in to My Kid’s Chart, you can see a Messages section underneath your child’s name.
Messaging Features May Not Be Implemented: If your pediatric practice would rather communicate via phone or email, they may not use the Messages features described in this section. Contact your pediatric practice to learn the best way to keep in touch.
Click “Create Message” to create a new message.
Enter a subject for your message, and the text of your question. If you want to attach images or other documents from your device, you can click to do so. Then click Send.
My Kid’s Chart will deliver the message (and any attachments) directly to your pediatrician’s office, where clinical staff can review it and answer your question.
Maximum Attachment Size: Each portal message is limited to a maximum of 30MB of attachments. Single attachments over 30MB, or multiple attachments totalling over 30MB, cannot be sent.
Add to a Message: After you send your message, you can add more information to it. Just open the message, add additional text, and click Send again.
If a physician or other staff member sends you a message, or replies to your message, My Kid’s Chart will send you an email telling you that a message is waiting.
Log in to your account to view your messages.
The most recent messages appear on the portal home page. For portal accounts with more than one patient, each message will include the patient’s name. A green dot indicates that a message is unread.
Select a message to read it, or click “All Messages” to see the full message history.
The All Messages view includes a search field. To find a specific message, enter your search term, made up of only letters or numbers, and click or tap the magnifying glass icon.
The list of matching messages will appear, with a count of how many messages match your criteria. To reset search and review the full list again, click the back button.
The list of matching messages will appear, with a count of how many messages match your criteria. To reset search and review the full list again, click the back button.
To reply, select a message from the portal home page or the All Messages list. If the message is a reply to a previous message, or part of an ongoing thread, previous messages in the thread appear below the message reply field, so they can be easily referred to without leaving the draft message.
When your message is ready, click the “Send” button to send the message to your practice.
Messages are Private: Your conversation is not stored in any email account. Your messages can not be read by any other My Kid’s Chart user, even those who have access to the same patient’s records.
You can see if you have any outstanding charges at your pediatric practice, and can even make a payment through the portal, in the Personal Balance section.
These Features May Not Be Turned On: You may not see a Personal Balance section, and/or be able to pay your bill online, if your pediatric practice chooses not to use either of these features. Contact your pediatric practice if you have questions about this feature.
You will see charges for all patients associated with your portal account, whether the patient is privacy-enabled or not. However, for privacy-enabled patients you will only see the date and charge – not the provider, location, or procedure name.
What charges will show up?: Charges will only be included if there is an unpaid balance on the visit. Pending insurance will be displayed if there is also a personal amount due. Credit balances will not be displayed. You will only see data for patients who are connected to your portal account.
If your pediatric practice is using this feature, and if a billing account is linked to your portal account, you will see a “Make a Payment” button beneath your personal balance information.
If you have used the mobile payment option previously, you will also see a “Last Payment” listed above the button. Only the most recent portal payment will be shown.
If you have not previously saved credit card information, then when you press the “Make a Payment” button, the portal will prompt you to enter your basic credit card information, billing address, and email address.
If you choose to save the new credit card, it will default to your “preferred” card for future use.
Alternatively, if you have previously made a mobile payment and opted to save your credit card, the credit card information will pre-populate.
If you have multiple credit cards stored, your preferred card will be selected by default. You can select a different card by clicking the drop-down and choosing another stored card.
After the payment is made, you will immediately see the result of the transaction. The date and time of payment will appear, and whether the payment was successful or not.
The balance in the patient portal will not be adjusted until the practice posts the payment to their billing system.
The BluePay service will send receipts to the email address that you entered on the payment screen.
The patient portal includes a “Payment Methods” setting, where you can add a new card or edit stored cards.
Select a card to make edits.
You can update the expiration date or change your preferred card. If you no longer want a card to be stored, you can remove it.
Expired cards will appear in red.
You can use My Kid’s Chart to download a visit summary for any encounter.
First, select the visit.
At the bottom of the visit, you have options for exporting the information.
Download PDF: You can download a visit summary as a PDF.
Download C-CDA: C-CDA is a data format that allows for easy and accurate sharing of medical data between electronic systems. If you need to share your child’s visit summary with a specialist, for example, you may be able to use this option to transfer information with them electronically.
Send Direct Secure Email: If your pediatrician’s office has activated this feature, you can use Direct Secure Messaging (DSM) to send a visit history directly to other physicians and medical professionals with a DSM address. You can only use the Direct Secure Message option if both your pediatrician and your desired recipient have activated Direct Secure Messaging. The recipient must supply you with their Direct Secure Messaging address. A normal email address will not work!
Use the Patient Portal Settings to make changes to your basic demographic information, reset your password, or view a history of portal activity related to your account or the patients you are connected to.
Click on the “Settings” button to access your account settings.
Click “Edit Account” to make changes to your name, sign in, and portal notification options.
Click “Save” to confirm your changes.
Click “New Password” to change your password.
Click “Save” to set the new password.
If you have opted the mobile phone number you use for portal notifications out of text messages from your pediatrician’s office, a warning message appears at the top of the Edit Account page and the portal notification phone number appears highlighted in red.
If you want to continue using the phone number for portal notifications, you must opt back in to text messages from the practice. The steps to opt in are presented in the warning message on the Edit Account page.
If you are accessing the portal on the phone that is connected to the opted-out number, you can tap the “Opt in” button on the Edit Account page.
The “Opt in” button automatically composes an opt-in message to the practice. As soon as you send the message, you receive confirmation that you can once again receive texts from your pediatrician’s office, including portal notifications.
If you want to see a history of patient portal activity related to any patients you are connected to in the portal, click “Activity Log”.
The Activity Log shows all activity for your own login, as well as for any other portal user who has accessed one of the patient records that you are connected to. For example, if two parents both have portal accounts related to their child, and one parent downloads a visit summary, makes a payment, or uploads an image, the other parent will be able to see the date and time they did so.
The activity date range defaults to the most recent month, but you can review any date range you wish, by clicking in the date field and using the calendar function to select a new date, and then clicking “Apply”.
The activity shown in the log is only for actions made in the portal.
ICD-10-CM is the official diagnostic code language for U.S. medical insurance billing, as defined by CMS and NCHS. It is a national variant of the international ICD-10 language, and it was officially adopted on October 1, 2015.
This article includes training opportunities, useful links, and other resources to help practices with ICD-10.
Many of the materials below were prepared around the time of the ICD-10 transition. They may still be useful to your practice. In 2015 and 2016, PCC provided free consultation, classes, and system configuration for the ICD-10 transition. Now that ICD-10 is in use by every medical practice, we are happy to help clients as they encounter new coding challenges. Call or e-mail PCC to learn more about our training opportunities, software configuration tools, and other ways we can help you get ready for October.
During the ICD-10 transition, PCC offered a monthly web lab on coding and related topics. We continue to offer periodic web labs as well as “billing drop-in” events. PCC’s certified coder, Jan Blanchard, provides insight on code set conventions, how to document different kinds of visits, and answer your questions about ICD-10 implementation.
Register for a Web Lab: To sign up for a PCC web-lab, visit http://www.pcc.com/weblabs/ to pick a date and sign up.
Watch a Recorded Web Lab: You can review past web labs to get caught up and see more examples of ICD-10 in action. Watch Archived Coding Web Labs
The first episode of PCC’s “Confessions of a Pediatric Practice Management Consultant” podcast is all about ICD-10.
Chip Hart explores the impact of ICD-10 on pediatrics with PCC’s Jan Blanchard, CPC, CPEDC. They discuss the importance of documentation, the state of readiness of pediatric practices, EHR vendors and carriers, the role of episodes of care in coding, resources available to pediatricians, and more.
Click here to visit the podcast page
In 2015, PCC offered twelve all-day ICD-10 seminars in cities around the country. Students learned about pediatric coding for ICD-10, both from the clinician and biller point of view.
This video is a 4-hour cutting of our session in Texas. Contact support@pcc.com to learn more.
Watch a 4-Hour Session Video: Click to Watch “2015 PCC ICD-10 Training Seminar“.
You can also download:
PCC prepared the following guides in the lead up to the ICD-10 transition.
If you are filling out a form or need the ICD-10 code for a patient’s diagnosis, 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.
Here are some other useful links to ICD-10 materials. This list was collected from various seminars and training that PCC either attended or led.
Call or e-mail PCC Support at any time to talk about ICD-10 and the specific needs of your practice.
We can work with your office to create custom solutions, provide additional training, and work with you to get your practice ready for the changes.
PCC’s software and services include support for several diagnostic taxonomies.
How does PCC software support SNOMED-CT, ICD-10, and ICD-9?
SNOMED-CT: In the patient’s chart, clinicians record all diagnoses with SNOMED-CT. They select SNOMED terms during assessment or when updating a patient’s Problem List, for example. SNOMED is a detailed vocabulary that is ideal for charting and is required by industry standards. Programs such as PCMH and ARRA’s “Meaningful Use” prefer SNOMED-CT for the identification of patient diagnoses.
ICD-10: When billing for a visit, a practice must use ICD-10. Physicians select SNOMED-CT diagnoses in the chart, and PCC EHR can automatically select or suggest the appropriate ICD-10 codes for billing. Physicians can make additional coding choices (such as laterality) in the chart, and a practice’s biller or a billing service can also make adjustments when they review charges for the claim. Each practice can directly adjust the automatic mapping between SNOMED-CT and ICD-10 in order to meet their billing needs.
ICD-9: While ICD-9 is no longer an active or maintained code set, patient medical records may still contain ICD-9 descriptions and codes. ICD-9 may appear on old chart notes in PCC EHR, in billing records, and even on a patient’s Problem List. As you work with a patient’s chart, PCC recommends that you replace the ICD-9 Problem List entries with appropriate SNOMED descriptions.
Reporting: PCC’s reporting tools, including the customizable Report Library in PCC EHR, the Smart Report Suite, and your Practice Vitals Dashboard, all understand and report on both SNOMED and ICD-10 diagnoses. Some reports also support ICD-9 filtering. Consistent implementation of a coding taxonomy leads to excellent reporting. In addition to meeting requirements for insurance carriers, mandates, or incentive programs, consistent diagnosis language leads to improved patient recall and powerful tools for evaluating your practice’s clinical and financial health.
If you are filling out a form or need the ICD-10 code for a patient’s diagnosis, 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.
As your office works with SNOMED-CT and ICD-10, here are some configuration topics you should consider. Feel free to contact PCC Support to discuss any of these issues.
Billing Configuration for PCC EHR: PCC EHR includes a diagnosis billing code mapping for common pediatric codes, but your practice can configure which SNOMED diagnosis descriptions map to which ICD-10 billing codes with the Billing Configuration tool. If you wish to review and update all of your common code mappings, you may find the Partner snomedmap report useful.
Charge Screens and Posting Charges: Your practice can customize PCC’s software and services to meet their workflow. For example, your practice may adjust both the electronic encounter form that appears in PCC EHR and the charge posting screens to make selection of appropriate codes faster and easier.
Custom Diagnoses Descriptions: The ICD-10 and SNOMED-CT lists on your PCC systems are a national standard (based on a broader, international standard) and can not be edited. However, your practice can select which alternative or preferred SNOMED description appears in your charts in the Diagnosis Configuration Tool.
Favorites: When you start to type a diagnosis in PCC EHR, it automatically searches for matching diagnoses to help you. First, it looks from a subset of the complete list, your practice’s diagnosis “Favorites” list. You can customize which diagnoses appear in this smaller Favorites list. Next, you can also right-click in a diagnosis field to search the entire SNOMED-CT list.
As the medical industry moved away from ICD-9 and towards ICD-10 and SNOMED, PCC offered educational opportunities and created special tools to help practice’s handle the interaction between the different taxonomies. We now continue to offer web labs, videos, and coding classes to help your practice with your ongoing coding challenges.
Read the ICD-10 Resources article to learn more.
Call or e-mail PCC Support at any time to talk about SNOMED, ICD-10, and the specific needs of your practice.
We can work with your office to create custom solutions, provide additional training, and work with you to meet your coding needs.
You can use PCC EHR to collect data for the Clinical Quality Measures (CQMs) required by PCMH, the Medicaid EHR Incentive Program (“Meaningful Use”), and other mandate and pay-for-performance programs.
Read the article below to learn how to chart and configure your system in order to record medical information for each of 9 pediatric Clinical Quality Measures. By following these recommendations, and training your practice on charting workflow for CQMs, you can make sure that PCC EHR records the correct data to calculate your CQM performance.
The issues below affect every Clinical Quality Measure that PCC EHR measures, along with other reporting in PCC EHR.
Clinical Quality Measures are calculated based on patient visits with specific eligible professionals, where the professional is the provider of encounter (PoE).
The PoE for a visit is listed at the top of every chart note. By default, it is defined when the visit is scheduled or when the chart note is created (for a walk-in visit). However, your practice can change the PoE when a different clinician sees the patient.
Check Your Practice Workflow: You should review your practice’s workflow to make sure that the provider at the top of the chart note is not changed for billing or patient management reasons. You should only change the provider of the encounter if a different clinician actually sees the patient.
Check Your Scheduling Providers: You should review your practice’s provider configuration to make sure the correct provider appears at the top of each chart note. For example, if you do not have a clinician listed correctly, or your practice schedules for a placeholder physician, you may want to review your configuration with PCC Support or review the steps in Add and Configure a Clinician.
Individual Clinicians vs. Practice Wide Reporting: As you review your list of providers, keep in mind that the EHR Medicaid Incentive Program (“Meaningful Use”) required CQM reporting individually, for each eligible professional. PCMH programs require CQM reporting in aggregate for your entire practice.
The NIH maintains a repository of codes used for public reporting purposes in its Value Set Authority Center (VSAC). The CMS eCQM Value Sets specify the various codes required for each Clinical Quality Measure.
For a few of the CQMs, PCC recommends using specific codes, such as when creating screening orders for depression. If this is the case, the recommended codes will be provided. Otherwise, links will be provided to the appropriate eCQM Value Set, on the VSAC website, and you can choose from the list of acceptable code(s) published for that data element.
Following is an example of a note from the ADHD Follow-up Care CQM section of this article:
You will need to have a username and password to access the eCQM Value Sets. It is a simple process to get access to the site; you will be directed to the application page from the login screen if you do not already have an account, or you can click here to request one.
It only takes a couple of minutes to fill out the request, and it generally takes only a day or two to receive your password.
What If I Don't Have Time/Don't Want a VSAC Account?: If you prefer not to setup and account on the VSAC website, or want access to the list of codes while you wait for your account to be approved, you can download the eCQM Value Sets spreadsheet and manually search for the list of codes you need. Each CQM has its own tab, and you can filter or sort by the “Value Set Name” column. The “Code” column displays the codes used within the measure.
To correctly populate Clinical Quality Measures, your office should always use the “Bill” button, review the diagnoses and procedures for each visit, and select an appropriate visit code.
If your office does not use the electronic encounter form, contact PCC Support for help getting started.
What Visit Codes Should My Practice Use?: Valid encounter codes may vary from CQM to CQM, but generally include standard sick and well visits.
For example, the Childhood Immunization Status CQM calculation is based on patients who have an encounter code in one of the following Value Sets: “Office Visit”, “Face-to-Face Interaction”, “Home Healthcare Services”, “Preventative Care- Established Office Visit, 0 to 17”, and “Preventive Care- Initial Office Visit, 0 to 17”.
If you have questions about whether a specific SNOMED-CT, CPT, ICD-10, or other code meets the requirements for any CQM, you can reference the VSAC website. Alternatively, you can open the downloaded eCQM Value Sets spreadsheet, click on the tab for the appropriate CQM, and search/filter by the QDM Category “Encounter”.
You can check your practice’s numbers for each CQM at any time.
The Clinical Quality Measures Report is available in the Reports menu in PCC EHR. Read the Run the Clinical Quality Measures Report article to learn how to run the report and e-mail the results.
Clinical Quality Measures are designed to evaluate certain patient populations and compare chart activity to coding. You do not need to have a “high score” in order to qualify for the EHR Medicaid Incentive Program or to achieve PCMH recognition. The overall goal of CQM is to show improvement over time, and you can not show improvement for patient populations you do not serve.
It is important that you chart in such a way that the CQM tool can evaluate your score, but it is often not as important that you have a non-zero score. In fact, the new Dental Decay measure works in reverse, where decreasing your percentage over time is the goal. This is in contrast to the Meaningful Use Measures, for which your practice must meet certain threshold percentages in order to qualify for the ARRA incentive.
For a quick understanding of each measure, use the table below. You can click the “More Details” or “Show Me How” links to jump directly to a longer description, accompanied by screenshots and examples.
| CMS | NQF | Measure Name | Calculation Description | Configuration in PCC | Clinician Workflow |
|---|---|---|---|---|---|
| 2 | 0418 | Preventative Care and Screening: Screening for Clinical Depression and Follow-Up Plan | For all patients seen by the eligible professional during the reporting period, who were 12 years old or older before the beginning of the reporting period, who did not have a depression diagnosis or contraindication, who did not refuse the service, what percentage received a depression screening, and, if the result was positive, received additional followup care, such as a suicide risk assessment? (More Details) |
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| 75 | N/A | Children Who Have Dental Decay or Cavities | For all patients seen by the eligible professional during the reporting period, who were between 0 and 20 years old, what percentage had tooth decay or cavities? (More Details) |
PCC EHR’s standard installation includes all of the configuration required in order to chart for this measure. Optionally, your practice can edit your chart note protocols to make it easier to record dental health and/or order followup dental care. |
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| 117 | 0038 | Childhood Immunization Status | For all patients seen by the eligible professional during the reporting period and turning 2 years old during the reporting period, what percentage had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday, or had a documented history of the illness, seropositive result for the antigen, or a contraindication for a specific immunization? (More Details) |
PCC EHR’s standard installation includes most of the configuration required in order to chart for this measure.
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| 126 | 0036 | Use of Appropriate Medications for Asthma | For all patients seen by the eligible professional during the reporting period, who were between 5 and 64 years old, and have an active, persistent asthma diagnosis during the reporting period, what percentage were prescribed or had an active prescription for an appropriate medication? (More Details) |
PCC EHR’s standard installation includes all of the configuration required in order to chart for this measure. |
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| 136 | 0108 | ADHD: Follow-up Care for Children Prescribed Attention Deficit/Hyperactivity Disorder (ADHD) Medication | For all patients who were newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) during the reporting period, who were between 6 and 12 years old, what percentage had appropriate followup care, including a follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase, and, if remaining on the medication for at least 210 days, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended? (More Details) |
PCC EHR’s standard installation includes all of the configuration required in order to chart for this measure. Optionally, your practice can maintain an ADHD-specific chart note protocol, and include follow-up visit orders within that protocol. (Show Me How) |
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| 146 | 0002 | Appropriate Testing for Children with Pharyngitis | For all patients seen by the eligible professional during the reporting period, who were between 2 and 18 years old, who were diagnosed with pharyngitis during the reporting period, who were prescribed an antibiotic within three days of an encounter, for what percentage of those encounters did patients receive a group A streptococcus (strep) test? (More Details) |
PCC EHR’s standard installation includes all of the configuration required in order to chart for this measure. You may want to review your order configuration for group A streptococcus (Rapid Strep) orders, and/or edit your chart note protocols to make it easier to diagnose pharyngitis and create orders. (Show Me How) |
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| 153 | 0033 | Chlamydia Screening for Women (Summary) | For all female patients seen by the eligible professional during the reporting period, who were between 16 and 24 years old, who were sexually active, what percentage had at least one chlamydia test during the reporting period? (More Details) |
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| 154 | 0069 | Appropriate Treatment for Children with Upper Respiratory Infection (URI) | For all patients seen by the eligible professional during the reporting period, who were between 3 months and 18 years of age, who were diagnosed with an upper respiratory infection, what percentage were not dispensed an antibiotic prescription on or three days after the episode? (More Details) |
PCC EHR’s standard installation includes all of the configuration required in order to chart for this measure. You may want to edit your chart note protocols to make it easier to diagnose URI. (Show Me How) |
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| 155 | 0024 | Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents | For all patients seen by the eligible professional during the reporting period, who were between 3 and 17 years of age, what percentage had their height, weight, and BMI recorded, and what percentage received counseling for nutrition and/or physical activity? (More Details) |
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This measure calculates the percentage of patients aged 12 years and older who are screened for clinical depression on the date of their encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all patients who had an eligible encounter code billed in the electronic encounter form during the reporting period and who were 12 or older before the reporting period.
Numerator: PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who had a LOINC test for depression screening, generally inside a Depression Screening order, with a positive or negative result, on the encounter date. If the result was positive, the patient must have additional care in the form of a completed LOINC test for suicide risk assessment, follow-up or additional evaluation for depression, and/or a referral for depression, and/or a prescription for a depression medication, on the same date as the depression screening, in order to be included in the numerator.
Exclusions: If a patient had an active diagnosis for Depression or Bipolar Disorder on their Problem List or in the Diagnoses component for the visit, they will be counted in the Exclusions for the measure.
Exceptions: If a patient refused the screening, or had a medical contraindication for it being performed, such as an urgent medical situation or a lack of functional capacity to complete the screening, they are excepted from the denominator (and the numerator) for the calculation and will be counted in the Exceptions for the measure.
In order to chart depression screenings, followup, and suicide risk assessment, your practice can create screening orders and add the specified LOINC tests or SNOMED-CT descriptions to those orders. You can also configure referral orders so that they are recorded with an appropriate SNOMED-CT. Finally, you can add the orders to chart notes so they are easy to select at every visit.
For a step-by-step procedure on how to add codes to orders and add specific orders to chart notes, read Use Orders to Track Measures for Mandates.
Add SNOMED-CT and LOINC codes to your adolescent depression screening orders in PCC EHR.
For the initial depression screening, you should add SNOMED-CT procedure code 171207006, and LOINC test code 73831-0, “Adolescent depression screening assessment”. (You could also add LOINC 73832-8, “Adult depression screening assessment” for an order for patients 18 years or older.) The test should have a Negative/Positive result.
What About Other Depression Screening Tests?: Your practice might perform other depression screenings and use other LOINC tests to record discrete results. You can add more than one test to a single order. For example, if you perform a PHQ-9 at each visit, you might first add the “Adolescent depression screening assessment” test, which is used by the clinical quality measure, and then also add the “Patient Health Questionnaire 9 item (PHQ-9) total score” test in order to record the patient’s numerical result.
When a patient has a positive result on a depression screening, your practice might perform one or more additional evaluations, followup orders, or a suicide risk assessment screening order. Click “Add” to create a new screening order, or double-click on an existing order to make changes. Repeat the steps above to configure the order, and add any appropriate tests.
In order to affect the clinical quality measure for this additional evaluation, followup, or suicide risk assessment, your practice must also add SNOMED-CT procedures to the screening order. For each order, click “Add a Procedure” and search for the appropriate SNOMED-CT description.
Examples:
Suicide Risk Assessment: For a suicide risk assessment screening order, you should add SNOMED-CT code 225337009, “Suicide risk assessment (procedure)” to the order.
Followup For Depression: You could also create and add SNOMED-CT descriptions (and LOINC tests, if appropriate) for any number of depression followup orders, such as Completion of a Mental Health Crisis Plan, or Coping Support Management. Other options are included in the NIH’s Follow-up for depression – adolescent value set, found on the VSAC website. You can also find the “Follow-up for depression – adolescent” value set within the CMS2v4 tab of the downloaded eCQM Value Sets spreadsheet.
Additional Evaluation: For an additional evaluation for depression order, you could add one of the SNOMED-CT descriptions for psychiatric evaluation listed by NIH for Additional evaluation for depression – adolescent. The “Additional evaluation for depression – adolescent” value set can also be found within the CMS2v4 tab of the downloaded eCQM Value Sets spreadsheet.
Add SNOMED-CT procedures to your Referral orders for Depression.
Your practice may have one or more referrals related to depression. For example, you may have referrals for an initial psychiatric evaluation or a specific depression referral. Click “Add” to create a new order, or double-click on an existing order to make changes.
In order for the referral to be tracked as part of a clinical quality measure, you must add a SNOMED-CT description from the NIH’s list for “Referral for Depression Adolescent”.
Which Procedure Codes Can I Use for Referral Orders?: Your SNOMED-CT descriptions for depression-related referrals must be taken from the NIH’s Referral for Depression Adolescent value set, found on the VSAC website. Common selections include “Referral to psychiatry service” and “Referral for mental health counseling”. You can also find the “Referral for Depression Adolescent” value set within the CMS2v4 tab of the downloaded eCQM Value Sets spreadsheet.
Your practice may have other referrals that may follow a positive depression screening. Add new orders, or double-click on an existing order to make changes.
After you make changes to the various orders your practice uses, you can add them to chart note protocols to make them easier to order. Your clinicians will then see the “Depression Screening” order, for example, on every chart note.
For information on how to add specific orders to a chart note protocol, read Use Orders to Track Measures for Mandates.
When a patient twelve or older visits your practice, click “Order” to order a Depression Screening.
Optionally, you can assign the screening to another clinician, or complete the screening immediately. If the screening is refused, select “Refused”. If the screening is contraindicated, select “Contraindicated” and enter an appropriate contraindicated diagnosis in the Diagnoses component on the chart note.
When the screening is complete, enter a result.
Unless refused or contraindicated, a positive or negative result is required. Result interpretation, in the Interpretation field, is not required for the clinical quality measure, though your practice may have configured it to be required for completion of the order.
If the result is positive, record whatever additional care follows.
For example, you may prescribe appropriate medication, order a Suicide Risk Assessment or order a referral.
Enter results and take any other appropriate followup steps.
When you are finished charting, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients aged 0-20 who have a visit during the reporting period and have an active diagnosis of tooth decay or cavities during the measurement period. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all patients who had an eligible encounter code billed on the electronic encounter form during the reporting period and who were between 0 and 20 years old.
Numerator: PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who had a dental decay or cavity diagnosis in the Diagnoses component for a visit during the reporting period or an active dental decay or cavity diagnosis listed in their Problem List.
Exclusions: There are no exclusions for this measure. All patients can qualify for the numerator.
Exceptions: There are no exceptions for this measure. All patients can qualify for the denominator.
There are no recommended PCC EHR configuration changes for recording data that will affect the dental decay clinical quality measure.
Your practice may want to review your chart note protocols and make adjustments for recording dental health. For example, your physical exam component may benefit from a “Teeth (caries, white spots, staining)” or “Dental Health” item. Your practice may want to add other items to chart note protocols, such as a “Child has a dental home” option in the History component, which is a recommendation in the AAP’s Bright Futures materials. However, those changes will not affect this clinical quality measure.
If your practice administers fluoride varnish or does dental evaluations, you may want to review your chart note protocols and create and add appropriate orders to your chart notes. However, those changes will not affect this clinical quality measure.
When a patient visits your practice, evaluate and chart their dental health.
Optionally, you might record details in one or more components on the chart note.
If the patient has tooth decay or cavities, enter an appropriate diagnosis code in the Diagnoses component.
Which Diagnoses Should I Use for Dental Decay?: The NIH lists several acceptable SNOMED-CT diagnosis descriptions in the “Dental Caries Grouping Value Set” (2.16.840.1.113883.3.464.1003.125.12.1004). Diagnoses range from “Dental caries” to “Secondary dental caries associated with failed or defective dental restoration”.
Optionally, you might order and perform additional evaluations or treatment, or provide educational materials. Those actions do not affect this clinical quality measure.
When you are finished charting, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients turning 2 years old during the reporting period who have a visit during the reporting period and have four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three H influenza type B (HiB); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines with evidence of administration prior or on their second birthday. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all patients who turned 2 years old during the reporting period, who had an eligible encounter code entered on the electronic encounter form during the reporting period.
Numerator: PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who have evidence of meeting all the immunization requirements, either ordered, added manually to the patient record, or billed. In order to allow for “grace periods”, the timing requirements for each immunization (three shots, four shots, etc.) require a minimum of only a single day between each shot, and allow that the shots may occur at any time between birth and age 2 after each shot’s minimum age. For example, a patient’s first DTaP must be administered when the patient is at least 42 days old, but otherwise the four shots may occur at any time before or on the patient’s 2nd birthday, as long as they are at least a day apart.
Exclusions and Exceptions: There are no across-the-board exclusions or exceptions for this measure. However, there are numerous reasons that a patient may be included in the numerator even if they did not have a particular shot.
For the MMR, hepatitis B, VZV and hepatitis A vaccines, numerator inclusion criteria include: evidence of receipt of the recommended vaccine; documented history of the illness; or, a seropositive test result for the antigen. For the DTaP, IPV, HiB, pneumococcal conjugate, rotavirus, and influenza vaccines, numerator inclusion criteria include only evidence of receipt of the recommended vaccine. Patients may be included in the numerator for a particular antigen if they had an anaphylactic reaction to the vaccine. Patients may be included in the numerator for the DTaP vaccine if they have encephalopathy. Patients may be included in the numerator for the IPV vaccine if they have had an anaphylactic reaction to streptomycin, polymyxin B, or neomycin. Patients may be included in the numerator for the influenza, MMR, or VZV vaccines if they have cancer of lymphoreticular or histiocytic tissue, multiple myeloma, leukemia, have had an anaphylactic reaction to neomycin, have Immunodefiency, or have HIV. Patients may be included in the numerator for the hepatitis B vaccine if they have had an anaphylactic reaction to common baker’s yeast.
The measure allows a grace period by measuring compliance with these recommendations between birth and age two. (From the “Guidance” section of CMS’s definition of the CQM.)
For the above exclusions, PCC checks the patient’s diagnosis history, Problem List, and Allergies List.
When your practice implemented PCC software and services, the initial setup and configuration was sufficient to allow clinicians to chart in order to meet this CQM.
However, if your practice implemented PCC software before the introduction of CVX codes, which are used to uniquely identify immunizations, you need to add them to your Immunization and Disease table in the Table Editor (ted).
You may also want to review your chart note protocols so that every clinician can quickly and easily order age-appropriate immunizations for each patient.
CVX codes are the industry-standard unique identifier for each vaccine or combination vaccine. Follow the procedure below to update your immunizations with CVX codes.
Open the Table Editor (ted)
Open the Immunization and Disease Table
Open the First Immunization You Record, Administer, or Bill
Update It With the Correct CVX Code
Enter the CVX code in the “CVX Code” field.
What CVX Code Should I Use?: Different combination vaccines and different formulations have different CVX codes. The only way to be certain you are selecting the correct code is to visit your immunization refrigerator, and optionally use PCC’s cvxreport to compare your practice’s configuration with the CDC’s library of CVX codes. However, the some common CVX codes for each immunization are as follows: DTaP 20, IPV 10, MMR 03, HIB 49, Hepatitis B 08, Varicella (chicken pox) 21, Prevnar 13 (pneumococcal conjugate PCV) 133, Hepatitis A 83, Rotavirus 116, Influenza (Flu) Preservative Free 140.
Repeat the Above Steps for Each Immunization You Administer or Record in a Patient’s Chart
Whether you order and administer an immunization or combination vaccine, or only need to be able to record it in a patient’s history, enter the appropriate CVX code for each entry.
If an immunization is missing, review the steps in the Add and Configure an Immunization in PCC EHR and Partner help article.
Review Your Entire CVX Code Configuration and Compare it With All CDC Codes
Optionally, your practice can run PCC’s cvxreport program to review all your CVX codes and compare them with the national code list.
Do all of your custom chart notes have age-appropriate immunization orders ready, easy for your clinicians to click?
If not, follow the procedure below to update your chart note protocols.
Add Age-Appropriate Immunizations to Your Custom Chart Notes
When a patient visits your practice, review their immunization history in the chart note or in the Immunization History section of the chart.
Optionally, you can review Forecasting Results and Forecasting Warnings to see what immunizations a patient may be missing.
If you need to update a patient’s past immunization history, visit the Immunization History section of the chart, click “Add Imms” and add any immunizations they received that are not in the chart record.
Use the Immunizations component on the chart note to order any age-appropriate immunizations.
Use the same component (or “Edit Orders” orange indicator tool on Schedule screen) to record that the immunization is administered, refused, contraindicated, or canceled.
When Should Each Shot Be Given?: PCC EHR can display Immunization Forecasting, with results and forecasting calculated by STC’s implementation of the ACIP immunization schedule guidelines from the CDC. Your practice may have their own set of standards for how these guidelines are implemented, and CMS has their own published clinical recommendation based on ACIP’s guidelines. The rules for reporting for the Childhood Immunization Status CQM, however, are much simpler, only requiring the correct number of shots, given more than a day apart.
If you make a decision not to give an immunization, chart the reason in the following manner:
Contraindications: If a patient has a contraindication for an immunization, click “Contraindicated” in the order, and add the appropriate diagnosis description to the Diagnoses component in the chart note and/or to the patient’s Problem List or Allergies list. For example, if a patient has acute HIV infection, or an allergy to an immunization component, you should record that information in the Problem List and the Allergies List respectively.
History of an Illness: If a patient has a history of an illness for which an immunization would otherwise be administered, add that illness to the patient’s Problem List or chart it in the Diagnoses component.
Evidence of Immunity: If your practice performs titers, or receives a test result showing that the patient is seropositive for an antigen, record that result as a diagnosis or on the Problem List.
When you are finished charting, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients 5-64 years of age who were identified as having persistent asthma and were appropriately prescribed medication during the measurement period. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all patients who had an eligible encounter code billed on the electronic encounter form during the reporting period, who were between 5 and 64 years old, who had a diagnosis of persistent asthma.
Numerator: PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who were dispensed at least one prescription for a preferred therapy during the measurement period or had an active medication listed during the measurement period.
Exclusions and Exceptions: Patients will be excluded from the denominator if they have a diagnosis of emphysema, COPD, cystic fibrosis or acute respiratory failure during or prior to the measurement period.
There are no required PCC EHR configuration changes for recording data that will affect the Appropriate Medications for Asthma CQM.
Your practice may want to review your chart note protocols and make adjustments for reviewing medication history for a patient. For example, you could add the Medication History component to chart notes, or add a “Reviewed Medications” checkbox.
Your practice or clinicians may want to review your prescription Favorites lists, found in PCC eRx, the prescription module in PCC EHR. For example, you could add common asthma medications to the list.
When a patient visits your practice, chart any appropriate asthma diagnoses in the Diagnoses component and/or the patient’s Problem List.
When a patient has a diagnosis of persistent asthma, use the Prescriptions section of the chart to prescribe appropriate medications.
What Specific Diagnoses Count as Persistent Asthma for this CQM?: The four SNOMED-CT descriptions that are considered persistent asthma by CMS are Persistent asthma, Mild persistent asthma, Moderate persistent asthma, and Severe persistent asthma. There are additional ICD-10 billing codes, which are included in the NIH’s Persistent Asthma value set, found on the Value Set Authority Center website. You can also find the “Persistent Asthma” value set within the CMS126v3 tab of the downloaded eCQM Value Sets spreadsheet.
What Are Appropriate Medications for Persistent Asthma for This CQM?: The NIH includes a number of medications in its Preferred Asthma Therapy value set, including common medications such as fluticasone, cromolyn, salmeterol and fluticasone combinations, theophylline, etc. You can also find the “Preferred Asthma Therapy” value set within the CMS126v3 tab of the downloaded eCQM Value Sets spreadsheet.
Review medications with all patients at every visit.
If a patient is prescribed asthma-related medications by a specialist or other clinician outside of your practice, update their medication history with that information.
When you are finished charting each visit, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported:
Measure 1 (Initiation Phase): Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
Measure 2 (Continuation Phase): Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended. (CMS at eCQI)
Denominator 1 (Initiation Phase): PCC EHR calculates the denominator of this measure by counting all patients who had an eligible encounter code billed on the electronic encounter form during the reporting period, who were between 6 and 12 years old, who were dispensed an ADHD medication 90 days before the start of the reporting period through 60 days after the start of the reporting period.
Denominator 2 (Continuation Phase): PCC EHR calculates the denominator of this measure by counting those patients from the Measure 1 denominator who remained on the ADHD medication for at least 210 days of the 300 days following the medication date.
Numerator 1 (Initiation Phase): PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who had at least one face-to-face visit with any EP within 30 days after the ADHD medication date.
Numerator 2 (Continuation Phase): PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who, in addition to the first visit during the Initiation Phase, had at least two additional follow-up visits with a clinician within 270 days (9 months).
Exclusions and Exceptions: Patients will be excluded from the denominator if they were actively on on an ADHD medication within the 120 days prior to the newly dispensed ADHD prescription; if they have a diagnosis of narcolepsy during or prior to the measurement period; and/or if they had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the ADHD medication date (for the Initiation Phase) or 300 days after the ADHD medication date (for the Continuation Phase).
There are no required PCC EHR configuration changes for recording data that will affect the ADHD Follow-up Care CQM.
Optionally, your practice may want to use a chart note protocol specifically for patients on ADHD medication that includes follow-up orders as a reminder to schedule visits into the future, depending on how long the patient is expected to be on the medication.
These options might help you to keep track of the patients that need follow-up visit, but will not affect this clinical quality measure.
When appropriate, use the PCC eRx section of the chart to prescribe ADHD-related medications.
Which ADHD Medications Count for This CQM?: A number of medications count toward this measure, including dexmethylphenidate hydrochloride, methylphenidate, clonidine, and guanfacine. The NIH includes the full list of medications in its ADHD Medications value set, located on the VSAC website. You can also find the “ADHD Medications” value set within the CMS136v4 tab of the downloaded eCQM Value Sets spreadsheet.
Review medications with ADHD patients at every visit. If a patient is prescribed ADHD-related medications by a specialist or other clinician outside of your practice, update their medication history with that information.
For patients on a newly prescribed ADHD medication, schedule at least one follow-up visit with a prescribing clinician during the 30-day Initiation Phase, dated from when the ADHD medication is dispensed.
You can use the Followup orders component to create a task for your nurse or scheduler to schedule another visit within 30 days.
If the patient is remaining on ADHD medication for a longer period, schedule periodic follow-up visits with a prescribing clinician. Specifically, after the 30-day Initiation Phase, make certain the patient is seen for a follow-up at least twice within the following 9 months.
Follow-up visits during the Continuation Phase do not need to be with the same provider.
You can also use the Measure 1 (Initiation Phase) Details report as a recall tool to identify kids with newly prescribed ADHD meds during the reporting period, who will need follow-up visits scheduled.
When you are finished charting each visit, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients 2-18 years of age who were diagnosed with pharyngitis during the reporting period, were prescribed an antibiotic within 3 days, and received a group A streptococcus (strep) test. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting the number of visits for patients who had an eligible encounter code billed on the electronic encounter form OR an emergency department (ED) visit during the reporting period, who were between 2 and 18 years old, had a diagnosis of pharyngitis AND an antibiotic ordered on or three days after the visit.
Numerator: PCC EHR calculates the numerator of this measure by counting the number of visits for patients in the denominator who received a group A streptococcus (strep) test in the 7-day period of 3 days prior through 3 days after the diagnosis of pharyngitis.
Exclusions and Exceptions: Patients will be excluded from the denominator if they were taking antibiotics in the 30 days prior to the diagnosis of pharyngitis. Patients who were in hospice care during the measurement year are also excluded.
There are no required PCC EHR configuration changes for recording data that will affect the Appropriate Testing for Children with Pharyngitis CQM.
You may want to review your order configuration for group A streptococcus (Rapid Strep) orders, and/or edit your chart note protocols to make it easier to diagnose pharyngitis and create orders.
Which Codes Can I Use for Strep Test Orders?: Your LOINC lab test result codes must be taken from the Group A Streptococcus Test value set, from the NIH’s Value Set Authority Center. PCC recommends using “Streptococcus pyogenes Ag [Presence] in Unspecified specimen by Immunofluorescence”. You can also find the “Group A Streptococcus Test” value set within the CMS146v3 tab of the downloaded eCQM Value Sets spreadsheet.
When a patient visits your practice, chart any appropriate pharyngitis diagnoses in the Diagnoses component and/or the patient’s Problem List.
What Specific Diagnoses Count as Pharyngitis for this CQM?: You can select diagnoses from either the Acute Pharyngitis or the Acute Tonsillitis value sets, from the NIH’s Value Set Authority Center. Examples include: Acute pharyngitis, Acute tonsillitis, Streptococcal sore throat, and Viral pharyngitis. You can also find both the “Acute Pharyngitis” and the “Acute Tonsillitis” value sets within the CMS146v3 tab of the downloaded eCQM Value Sets spreadsheet.
When appropriate, create and complete lab orders to test for group A streptococcus and enter results in the lab order.
When appropriate, prescribe antibiotics. (To be included in the measure, antibiotic needs to be ordered on or within three days of the visit.)
Which Antibiotics Count for This CQM?: A number of medications count toward this measure, including common antibiotics such as minocycline, azithromycin, doxycycline, and amoxicillin. The NIH includes the full list of antibiotics in its Antibiotic Medications for Pharyngitis value set, found on the VSAC website. You can also find the “Antibiotic Medications for Pharyngitis” value set within the CMS146v3 tab of the downloaded eCQM Value Sets spreadsheet.
Review medications at every visit. If a patient is prescribed antibiotics by a specialist or other clinician outside of your practice, update their medication history with that information.
When you are finished charting each visit, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of women 16-24 years of age who were identified as sexually active and who had at least one visit with the clinician and at least one test for chlamydia during the measurement period. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all female patients who had an eligible encounter code billed in the electronic encounter form during the reporting period, who were between 16 and 24 years old, and who were considered sexually active by evidence of a charted diagnosis, problem on the Problem List, billed diagnosis, lab test, order, or prescribed medication.
Numerator: PCC EHR calculates the numerator of this measure by counting all of the patients in the denominator who had a LOINC test for Chlamydia, generally inside a Chlamydia test lab order, with a positive or negative result, on an encounter date within the reporting period.
Exclusions: If a patient would be considered sexually active because of a pregnancy test, but they had a radiology LOINC test afterwards or were prescribed certain qualifying medications, they will be excluded from the denominator as the pregnancy test could have been done solely as a precautionary measure.
Exceptions: None.
In order to properly record Chlamydia tests, your practice should review your lab order configuration and add appropriate LOINC tests to your order or orders.
Additionally, you might want to review the following optional steps:
Open the Lab Configuration Tool
Click on the Tools menu and select Lab Configuration.
Edit or Add Chlamydia Test Lab Order
Double-click on your Chlamydia test order, or click “Add” to create one.
Configure Basic Order Details for Your Chlamydia Test Order
Review the order name and set any other configurable options. For example, you may want an order to be private by default, in which case you would deselect the “Include on Patient Reports” option.
Review and/or Add Tests
Review tests for the order. To add a test, use the drop-down menu for each e-lab vendor or the manual result entry section.
Which Codes Can I Use for Chlamydia Tests?: Your LOINC lab test result codes must be taken from the Chlamydia Screening value set, from the NIH’s Value Set Authority Center. One example is “Chlamydia trachomatis Ag Presence in Vaginal fluid”. You can also find the “Chlamydia Screening” value set within the CMS153v3 tab of the downloaded eCQM Value Sets spreadsheet.
Repeat for Other Lab Orders
If you have other chlamydia screening orders, such as an entry for e-labs and one for manually entered lab results, review each one and check that appropriate LOINC tests are tracked for each.
When you see patients, chart any appropriate diagnoses that may indicate sexual activity, such as pregnancy, genital herpes, etc., in the Diagnoses component and/or the patient’s Problem List.
What Specific Diagnoses Indicate Sexual Activity for this CQM?: The Chlamydia value set includes a number of diagnoses that count for this measure. Diagnoses are also taken from the Complications of Pregnancy, Childbirth and the Puerperium, Genital Herpes, Gonococcal Infections and Venereal Diseases, HIV, Inflammatory Diseases of Female Reproductive Organs, Other Female Reproductive Conditions, and Syphilis value sets, all found on the VSAC website. All of these value sets are available within the CMS153v3 tab of the downloaded eCQM Value Sets spreadsheet.
You might also complete lab tests that indicate sexual activity, such as pregnancy tests.
Which Lab Tests Might Indicate Sexual Activity for this CQM?: The Pregnancy Test value set includes lab tests that count for this measure. Lab tests are also taken from the Lab Tests During Pregnancy, Lab Tests for Sexually Transmitted Infections, and Pap Test value sets, all found on the VSAC website. All of these value sets are available within the CMS153v3 tab of the downloaded eCQM Value Sets spreadsheet.
In addition, some prescriptions that you order might indicate sexual activity, such as birth control pills.
Which Medications Might Indicate Sexual Activity for this CQM?: The Contraceptive Medications value set includes medications that count for this measure. The Isotretinoin value set also includes prescriptions that count. Both of these value sets are found on the VSAC website. The “Contraceptive Medications” and “Isotretinoin” value sets are also available within the CMS153v3 tab of the downloaded eCQM Value Sets spreadsheet.
When appropriate, order a Chlamydia screening test in the Lab Orders component on the chart note. Later, enter results.
For each visit, make sure the correct Provider of Encounter clinician is indicated on the chart note.
When you are finished charting each visit, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients 3 months-18 years of age who were diagnosed with upper respiratory infection (URI) during the reporting period, and were not dispensed an antibiotic prescription within 3 days of the visit. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting the number of visits for patients who had an eligible encounter code billed on the electronic encounter form during the reporting period, who were between 3 months and 18 years old, and had a diagnosis of upper respiratory infection (URI).
Numerator: PCC EHR calculates the numerator of this measure by counting the number of visits for patients in the denominator who did not receive a prescription for antibiotic medication on or 3 days after the visit.
Exclusions and Exceptions: Patients will be excluded from the denominator if they were taking antibiotics in the 30 days prior to the diagnosis of URI.
There are no required PCC EHR configuration changes for recording data that will affect the Appropriate Testing for Children with Pharyngitis CQM.
You may want to edit your chart note protocols to make it easier to diagnose URI.
When you see patients, chart any appropriate URI diagnoses in the Diagnoses component and/or the patient’s Problem List.
What Specific Diagnoses Count as URI for this CQM?: You can select diagnoses from the Upper Respiratory Infection value set, from the NIH’s Value Set Authority Center. Examples include: Acute upper respiratory infection and and Acute laryngopharyngitis. You can also find both the “Upper Respiratory Infection” value set within the CMS154v3 tab of the downloaded eCQM Value Sets spreadsheet.
When appropriate, prescribe antibiotics. (To be included in the measure, antibiotic needs to be ordered on or within three days of the visit.)
Which Antibiotics Count for This CQM?: A number of medications count toward this measure, including common antibiotics such as minocycline, azithromycin, doxycycline, and amoxicillin. The NIH includes the full list of antibiotics in its Antibiotic Medications for Pharyngitis value set, found on the VSAC website. You can also find the “Antibiotic Medications for Pharyngitis” value set within the CMS154v3 tab of the downloaded eCQM Value Sets spreadsheet.
Review medications at every visit. If a patient is prescribed antibiotics by a specialist or other clinician outside of your practice, update their medication history with that information.
When you are finished charting each visit, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
This measure calculates the percentage of patients 3-17 years of age who had had a visit during the reporting period, and had their height, weight, and body mass index (BMI) documented, and/or received counseling for nutrition, and/or received counseling for physical activity. (CMS at eCQI)
Denominator: PCC EHR calculates the denominator of this measure by counting all patients who had an eligible encounter code billed on the electronic encounter form during the reporting period and who were between 3 and 17 years old.
Numerator 1: PCC EHR calculates the first numerator of this measure by counting all of the patients in the denominator who had a height, weight, and BMI percentile recorded during the measurement period.
Numerator 2: PCC EHR calculates the second numerator of this measure by counting all of the patients in the denominator who received counseling for nutrition during a visit that occurred within the measurement period.
Numerator 3: PCC EHR calculates the third numerator of this measure by counting all of the patients in the denominator who received counseling for physical activity during a visit that occurred within the measurement period.
Exclusions and Exceptions: Patients will be excluded from the denominator if they have an active diagnosis of pregnancy during the measurement period.
In order to chart counseling for nutrition or physical exercise, your practice can create medical procedure orders and add the specified SNOMED-CT procedures to those orders. Then you can add the orders to chart notes so they are easy to select at every visit.
For a step-by-step procedure on how to add codes to orders and add specific orders to chart notes, read Use Orders to Track Measures for Mandates.
Create or edit a medical procedure order for nutrition counseling.
For the nutrition counseling order, you should select SNOMED-CT code 61310001, “Nutrition education”.
Create or edit a medical procedure order for physical activity counseling.
For the physical activity counseling order, you should select SNOMED-CT code 281090004, “Recommendation to exercise”.
Use the Specified SNOMED Codes: Please note that the 2018 ICD-10 code Z71.82, “Exercise counseling” will not work with PCC EHR reporting.
After you create the new medical procedure orders, you can add them to chart note protocols to make them easier to order. Your clinicians will then see the “Nutrition Counseling” order, for example, on every chart note.
For detailed instructions on how to add orders to a chart note protocol, read Use Orders to Track Measures for Mandates.
For each protocol, find or add the Medical Procedures Orders component, and then add the nutrition and physical exercise orders.
Collect height and weight during normal office visits, well exams and other appropriate visit types.
When appropriate, order your practice’s nutrition and/or physical activity counseling medical procedure.
When you are finished charting, remember to click “Bill” and select an appropriate visit encounter code. In addition to billing, the visit encounter code is used to calculate the CQM.
PCC EHR is Prevalidated for PCMH: By using PCC EHR, your practice is pre-validated for automatic credits towards PCMH recognition. Many pediatric practices have used PCC to achieve PCMH recognition.
Please contact PCC for help understanding and applying for PCMH programs in your state. PCC Support and our Pediatric Solutions team can show you what you need to apply and help you evaluate your options.
You have several options for reporting on Clinical Quality Measures at your practice, depending on whether you applied for the EHR Medicaid Incentive Program or are applying for PCMH recognition.
Learn About PCMH Programs: Just getting started? Read Become a Patient Centered Medical Home (PCMH).
When you completed your Meaningful Use attestation each year, you calculated and submitted each clinician’s numbers for 9 Clinical Quality Measures, from a total of 64. Those nine measures needed to be drawn from at least three of six domains (Patient and Family Engagement, Population/Public Health, Patient Safety, Care Coordination, Efficient Use of Healthcare Resources, Clinical Process/Effectiveness).
In order to simplify the selection of measures, CMS identified a set of 9 CQMs for pediatric populations that meet all the requirements of the program. These recommended measures “focus on conditions that contribute to the morbidity and mortality of most Medicaid beneficiaries. They also focus on areas that represent national public health priorities or disproportionately drive health care costs.” (CMS.gov)
PCC built charting and workflow technologies, and our CQM report, around these 9 recommended pediatric CQMs.
Below are the 9 measures for which PCC EHR tracks and provides calculations under the EHR Medicaid Incentive Program 2014-edition CQM rules:
CMS2: Preventative Care and Screening: Screening for Clinical Depression and Follow-Up Plan
CMS75: Children Who Have Dental Decay or Cavities
CMS117: Childhood Immunization Status
CMS126: Use of Appropriate Medications for Asthma
CMS136: ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication
CMS146: Appropriate Testing for Children with Pharyngitis
CMS153: Chlamydia Screening for Women
CMS155: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
CMS154: Appropriate Treatment for Children with Upper Respiratory Infection (URI)
While you consider workflow and configuration adjustments, remember that there is no threshold for these measures; the program required that clinicians simply submit data as it pertains to each CQM.
There are many different ways a pediatric practice can achieve PCMH recognition. Reporting on CQM measures is not required. That being said, reporting on Clinical Quality Measures can help you complete element 6a of your PCMH application. It would be very difficult to proceed beyond PCMH recognition level 1 or level 2 without CQM reporting.
Element 6a requires that a practice measures and receives data on at least two immunization measures, at least two other preventive care measures, and at least three chronic or acute care clinical measures. Additionally, the performance data must be stratified for vulnerable populations.
The nine Pediatric CQMs described in the “CQMs For Meaningful Use” section above, and available in PCC EHR’s Clinical Quality Measures report, meet or exceed these requirements. However, your practice could choose other measures.
For example, you could use PCC’s Practice Vitals Dashboard to report on:
For your PCMH application, your practice could use the 9 CMS recommended CQMs that are described in this document, or use data from Practice Vitals Dashboard to report on other CQMs, or use an entirely different set of CQMs, or forego CQM reporting altogether and aim for a lower level of PCMH recognition.
How can you use PCC EHR to meet the Meaningful Use measures required for your EHR incentive attestation? How should you chart and configure your system, in order to record medical information so that your numbers are accurate?
PCC EHR includes a Meaningful Use Measures report that calculates how well your eligible professionals meet each statistical Meaningful Use measure. You can adjust your office’s workflow and use PCC EHR differently in order to satisfy the requirements for your clinicians. Read below for configuration and usage tips.
PCC EHR is 2015E Cures Update-certified and is listed on the Certified Health Product List (CHPL) maintained by the Office of the National Coordinator for Health Information Technology (ONC). Please contact PCC Support if you’d like an update or for help understanding and attesting for the EHR Medicaid Incentive program or PCMH programs in your state. A member of our team can show you what you need to apply and help you evaluate your options.
Here are some other topics to consider as you use PCC EHR to chart for and measure Meaningful Use.
The Meaningful Use Measures report, available in the Reports menu, calculates your eligible professionals’ compliance with the Meaningful Use measures.
Before you run the report, make sure that you exclude visit reasons that aren’t actually physician visits (such as vaccine-only visits, nurse-only visits, lab-only visits, etc.).
It’s a good idea to familiarize yourself with these reports, and to check them periodically, to make sure you are seeing the results you expect.
Read the Meaningful Use Measures report help article to learn how to run the report.
You may evaluate some of your Meaningful Use measures using other methods, such as your office’s record-keeping or policies outside of PCC EHR. For example, some of the measures are not statistical and merely require attestation, and some require evaluation based on all patients, whether they are in PCC EHR or not.
Your whole office can make workflow and policy changes to help meet Meaningful Use and CQM, but the reporting and evaluation is always done based on eligible professionals who see a certain percentage of Medicaid patients.
Eligible professionals under the Medicaid EHR Incentive Program include:
To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:
Children’s Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.
The MU and CQM reports evaluate a specific provider’s visits from a certain time period. Your whole office may institute a policy of providing patient handouts, recording vitals and charting in a certain way. The reports, however, will reflect how well the eligible professional meets those standards for the patients.
You should always have an eligible professional sign their visits, and your office should use the “Bill” button and review the diagnoses and procedures for each visit.
If your office does not use the electronic encounter form, contact PCC Support for help getting started.
There is more information about Meaningful Use at pcc.com. Visit cms.gov to learn more about Meaningful Use. You can read more about the modified stage 2 program requirements for 2017 on the CMS website.
Beginning in 2015 and extending through the end of 2018, eligible professionals (EPs) can meet Meaningful Use requirements by following the Modified Stage 2 Objectives and Measures.
In addition, eligible providers must report on nine Clinical Quality Measures, although there are no required thresholds for these measures. Read How to Chart for Each Clinical Quality Measure in PCC EHR for more information.
For a quick understanding of each objective, use the table below. You can click the “More Details” links to jump directly to a longer description, accompanied by screenshots.
| MU Objective | Objective Description | Attestation Requirements | Configuration in PCC | Clinician Workflow |
|---|---|---|---|---|
| Objective 1: Protect Patient Health Information |
Protect electronic health information created or maintained by the certified EHR through the implementation of appropriate technical capabilities | Y/N (must answer “Yes”) |
N/A | Conduct or review a security risk analysis of certified EHR technology, and implement updates as necessary |
| Objective 2: Clinical Decision Support |
Measure 1: Implement 5 clinical decision support interventions related to related to 4 or more clinical quality measures (CQMs)Measure 2: Enable drug-drug and drug-allergy interaction checks | Y/N (must answer “Yes” to both measures) |
Measure 1: Create clinical alerts related to four or more CQMsMeasure 2: Set up PCC eRx user access for each EP | Measure 1: Acknowledge clinical alerts as they appear while charting for affected patientsMeasure 2: PCC eRx automatically checks all medication orders for drug or allergy interactions |
| Objective 3: Computerized Provider Order Entry (CPOE) |
Use computerized provider order entry (CPOE) for medication, laboratory, and radiology orders directly entered by eligible providers | Measure 1: >60% of medication ordersMeasure 2: >30% of laboratory orders
Measure 3: >30% of radiology orders |
Measure 1: Set up PCC eRx user access for each EP; use the Table Editor in Partner to link each provider to their PCC EHR user IDMeasure 2: Set up lab orders in PCC EHR, and add them to chart note protocols
Measure 3: Set up radiology orders in PCC EHR, and add them to chart note protocols |
Measure 1: Use PCC eRx to generate and send prescriptions electronicallyMeasure 2: Use the Lab component to order labs when charting in PCC EHR
Measure 3: Use the Radiology component to order radiology tests when charting in PCC EHR |
| Objective 4: Electronic Prescribing |
Generate, query for a drug formulary, and transmit permissible prescriptions electronically | >50% of prescriptions written |
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| Objective 5: Health Information Exchange |
Generate a summary of care record through the EHR and electronically submit to the receiving provider for patients who are referred or transferred to another setting of care | >10% of referral orders and transitions of care |
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| Objective 6: Patient Specific Education |
Use certified EHR technology to identify clinically relevant patient-specific education resources and provide them to patients | >10% of patients seen during the reporting period | N/A |
|
| Objective 7: Medication Reconciliation |
Perform a medication reconciliation whenever a patient is transitioned into the eligible provider’s care from another setting of care | >50% of incoming transitions of care |
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During visits:
When receiving incoming DSM:
|
| Objective 8: Patient Electronic Access |
Measure 1: Provide patients (or authorized representatives) the ability to view online, download, and transmit their health information within 4 business days
Measure 2: Patients or their authorized representative view, download, or transmit to a 3rd party their health information |
Measure 1: >50% of patients seen during the reporting period
Measure 2: >5% of patients seen during the reporting period |
Measure 1: Contact PCC support to enable the patient portal, My Kid’s Chart, for your practiceMeasure 2: Use the Patient Portal Manager tool to customize what data your practice will share with patients | Measure 1: Use the Patient Portal Manager tool to create portal accounts for patients or their authorized representative within 4 business days of the visitMeasure 2: Encourage patients and their families to use My Kid’s Chart |
| Objective 9: Secure Electronic Messaging |
Use secure electronic messaging to communicate with patients about relevant health information | >5% of patients seen during the reporting period |
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| Objective 10: Public Health Reporting | Actively engage with a public health agency to submit electronic public health data from a certified EHR except where prohibited and in accordance with applicable law and practice | Y/N (must answer “Yes” to 2 of 3) Measure 1: Immunization RegistryMeasure 2: Syndromic SurveillanceMeasure 3: Specialized Registry |
Contact PCC support to discuss any needed configuration changes | Measure 1: Contact PCC support to determine if you are submitting to your state or if a connection can be establishedMeasure 2: Check with your state/AAP to see if your jurisdiction has a public health agency that is capable of receiving electronic syndromic surveillance data
Measure 3: Check with your state/AAP to determine if a specialized registry exists. Document your efforts |
You can download specification sheets for each measure from the EHR Incentive Program Modified Stage 2 Objectives and Measures chart, provided by CMS.
What actions do you need to take to meet each of the Meaningful Use measures, and which measures require tracking statistical data through PCC EHR?
This objective requires the protection of electronic health information created or maintained by the certified EHR through the implementation of appropriate technical capabilities.
This is a Yes/No objective.
You must be able to answer “Yes” in order to meet this objective.
Your practice needs to conduct or review a security risk analysis of certified EHR technology, and implement updates as necessary. The risk analysis or review needs to be completed prior to the end of the reporting period. If you are reviewing an existing risk analysis, be sure to document and date that review. States can (and will) audit your analysis and/or review.
Security Risk Analysis online resources:
This objective requires the use of clinical decision support to improve performance on high-priority health conditions.
This is a Yes/No objective, with two separate measures.
You must be able to answer “Yes” to each of the measures in order to meet this objective.
Measure 1: Implement Clinical Decisions
You need to attest that you have implemented five (5) clinical decision support interventions, related to four or more clinical quality measures at a relevant point in patient care for the entire reporting period.
PCC recommends using PCC EHR clinical alerts to meet this measure.
If your practice prefers not to use clinical alerts, CMS has identified the following alternative examples of “clinical decision support”:
Measure 2: Enable Drug-Drug and Drug Allergy Interaction Checks
This is a built-in default feature of PCC EHR, so you can attest “Yes”.
This objective requires the use of computerized provider order entry (CPOE) for medication, laboratory, and radiology orders directly entered by eligible providers.
This objective has three separate measures.
You must meet the required threshold for each of the measures in order to meet this objective.
Measure 1: Use CPOE for >60% of Medication Orders
In order to meet this measure, you must use CPOE to create more than 60% of prescriptions for patients who visit your practice.
Each eligible provider (EP) needs to have PCC eRx enabled on their user account in PCC EHR. In addition, each EP needs to be mapped to themselves as EHR users in the provider table in Partner’s Table Editor (ted). If this isn’t done, all measures for this objectives will show 0%.
Using PCC EHR’s electronic prescriptions screen (PCC eRx) to create new prescriptions will meet this measure.
For help prescribing with PCC eRx, read the Prescribe Medications article on learn.pcc.com.
Measure 2: Use CPOE for >30% of Lab Orders
In order to meet this measure, you must use CPOE to order more than 30% of your lab orders.
If you use PCC EHR to create lab orders, then you are doing what is needed to meet this measure.
For help setting up lab orders in PCC EHR, read the Lab Configuration article on learn.pcc.com.
For help ordering labs in PCC EHR, read the Order a Lab, Procedure, Supply, or Other Order article on learn.pcc.com.
Measure 3: Use CPOE for >30% of Radiology Orders
In order to meet this measure, you must use CPOE to order more than 30% of your radiology orders.
If you use PCC EHR to create radiology orders, then you are doing what is needed to meet this measure.
For help setting up radiology orders in PCC EHR, read the “Configure Radiology Orders with Discrete Results” section of the Order Configuration Examples article on learn.pcc.com.
For help with radiology orders in PCC EHR, read the Order a Lab, Procedure, Supply, or Other Order article on learn.pcc.com.
This objective requires permissible prescriptions to be generated, queried for a drug formulary, and transmitted electronically, using a certified EHR.
In order to meet this measure, more than 50% of prescriptions that you write need to be queried for a drug formulary and transmitted electronically. You may choose to include or not include controlled substances.
Your practice must be using PCC eRx in order to generate and transmit prescriptions electronically.
Each eligible provider (EP) needs to have PCC eRx enabled on their user account in PCC EHR. In addition, each EP needs to be mapped to themselves as EHR users in the provider table in Partner’s Table Editor (ted). If this isn’t done, this measure will show 0%.
PCC EHR’s electronic prescribing system (eRx) automatically queries all prescriptions for a drug formulary.
If you use PCC eRx to record and transmit most of your prescriptions to pharmacies, then you are doing what is needed to meet this measure.
You may choose whether to include controlled substances in your totals, if your state allows it. PCC’s MU report can include or exclude controlled substances.
Prescriptions that are generated through the eRx, but are then printed instead of being sent electronically, will not count toward meeting this measure. They will however be counted toward your total prescriptions for the reporting period.
This objective requires summary of care records to be sent electronically for patients who are referred or transitioned to another setting of care.
In order to meet this measure, you must generate a summary of care record through the EHR, and electronically submit it to a receiving provider for more than 10% of referral orders and transitions of care.
When you refer a patient to a provider outside of your practice, use PCC EHR’s Referral component to create a referral order.
After you have documented the referral – or for patients who you did not refer, but are transferring to an external provider – you will generate a Summary of Care Record report and select either the relevant referral, or “Related to an outbound transition of care” from the drop-down list.
Finally, you need to send the Summary of Care Record to the receiving clinician or practice as a C-CDA file, via Direct Secure Messaging (DSM).
For step-by-step directions on how to generate the report, indicate the referral, and send the file via DSM, read the Summary of Care Record Report article on learn.pcc.com.
If your practice is not currently using DSM, read the Direct Secure Messaging article on learn.pcc.com, and contact PCC Support to get set up.
This objective requires the use of a certified EHR to identify clinically relevant patient-specific education resources, and to provide those resources to patients.
In order to meet this measure, you must use EHR technology to identify and provide an appropriate patient handout or other resource to more than 10% of the patients who visit your office during the reporting period.
While the measure applies to patients with office visits during the reporting period, the education material only needs to have been given during the same calendar year.
To meet this measure, you must access the education source through the Patient Education report, and you need to select one of the patient’s problems, medications, or lab tests from the drop-down field before you select a handout.
Once you select a handout, you can either print it or save it to the patient portal. Either option will satisfy this objective.
PCC EHR has a built-in library of resource materials for patients. Read Patient Education and Handouts for more information.
This objective requires a medication reconciliation to be performed whenever a patient is received from another setting of care.
In order to meet this measure, you must perform a medication reconciliation for more than 50% of patients who are transitioned into your care, or for whom you receive an incoming Direct Secure Message with a C-CDA.
If you are meeting with a new patent, or if your established patient was seen elsewhere since their last visit with you, review their medications using the Medication History component in PCC eRx. You can add and remove medications to their chart as appropriate.
For help with conducting a review of a patient’s medications, read the Review and Update Medication History article on learn.pcc.com.
In order to track this measure during a visit, make sure that you are using the Transition of Care (ARRA) component within all of your visit protocols, and check the boxes to indicate that a patient has transitioned into your care, and that you performed a medication reconciliation.
Direct Secure Messages that you receive on the Messaging queue are also considered incoming transitions of care.
When you see an incoming C-CDA in a Direct Secure Message, you can click “Reconcile” to review and import medication data (along with problems and allergies).
For help with receiving incoming messages, read the “Receive Direct Secure Messages, Including Inbound C-CDA For Transition of Care” section of the Direct Secure Messaging article on learn.pcc.com.
This objective requires the practice to provide patients the ability to view online, download, and transmit their health information.
This objective has two separate measures.
You must meet the required threshold for each of the measures in order to meet this objective.
Measure 1: Timely Online Access
In order to meet this measure, more than 50% of patients seen during the reporting period need to have a My Kid’s Chart user with access to their records.
PCC EHR includes an optional patient portal, My Kid’s Chart (mykidschart.com).
My Kid’s Chart gives patients and families 24-hour access to their medical history, visit summaries, and other helpful information.
Contact PCC to set up My Kid’s Chart. Once the portal has been enabled for your office, you can sign up patients or their authorized representatives using the Patient Portal Manager tool through PCC EHR.
For help creating portal accounts, read the My Kid’s Chart User Account Administration article on learn.pcc.com.
A portal account needs to be created within 4 days of the patient’s visit in order to be counted toward the measure.
If age-based privacy is enabled, patients who meet the emancipation age will still be included in the denominator but will not count in the numerator unless portal access is individually enabled.
To get started with using My Kid’s Chart, read What is My Kid’s Chart, PCC’s Patient Portal.
Measure 2: View, Download, or Transmit Health Information
In order to meet this measure, at least 5% of patients seen in the reporting period need to view, download, or transmit their health information.
When your patients or their authorized representatives log in to My Kid’s Chart, PCC will record their actions. Simply viewing their account will count toward this measure.
To help your patients and families with using My Kid’s Chart, you can print out and share the My Kid’s Chart User’s Guide, found on learn.pcc.com.
This objective requires the use of secure electronic messaging to communicate with patients about relevant health information.
For more than 5% of patients seen by the EP during the EHR reporting period, a secure electronic message must be sent using the patient portal to the patient (or their representative), during the reporting period. The message may be a reply to an incoming message.
Patients or their representatives must use PCC’s patient portal, My Kid’s Chart, to send secure messages to their provider. The provider can respond through PCC EHR’s Messaging queue.
Contact PCC to set up My Kid’s Chart. Once the portal has been enabled for your office, you can turn on the Messaging feature using the Patient Portal Manager tool through PCC EHR. For help with portal configuration, read the Patient Portal Practice Settings and Configuration article on learn.pcc.com.
The EP may also send messages through PCC EHR that will show up on the patient portal. These messages will also count toward the measure, for patients who had an office visit during the EHR reporting period.
For help with portal messages, read Receive and Respond to Portal Messages from My Kid’s Chart.
This objective requires the EP to be in active engagement with a public health agency to submit electronic public health data from a certified EHR except where prohibited and in accordance with applicable law and practice.
This is a Yes/No objective, with three separate measures.
You must be able to answer “Yes” to two out of three of the measures in order to meet this objective.
An EP must be in active engagement with a public health agency to be able to answer “Yes”.
Active engagement may include any of the following options.
Measure 1: Immunization Registry Reporting
In order to meet this measure, the EP must be in active engagement with a public health agency to submit immunization data.
PCC EHR currently submits immunization data to many state registries.
Contact PCC support to determine if you are submitting to your state or if a connection can be established.
Measure 2: Syndromic Surveillance Reporting
In order to meet this measure, the EP must be in active engagement with a public health agency to submit syndromic surveillance data.
Measure 3: Specialized Registry Reporting
In order to meet this measure, the EP must be in active engagement to submit data to a specialized registry.
Check with your state and specialty society (the AAP) to determine if a specialized registry exists that will accept pediatric-specific data. This action should be documented.
PCC uses both billing and charting data to calculate Meaningful Use Measure percentages. Use the Table Editor (ted) to link your Partner Practice Management system providers, used for billing and scheduling, to a PCC EHR user ID.
First, open the Table Editor (ted), select the Providers table, and choose from the list of providers.
For each provider, enter their PCC EHR username into the EHR User field.
Depending on the state you live in, pediatric practices using PCC software can receive payment incentives from payers by becoming a Patient Centered Medical Home.
By adopting the functions of PCMH, you help your patients and families gain access to care and you gain additional benefits for your practice.
PCMH encompasses a philosophy of patient care as well as a set of standards. It is an approach to care where “practices seek to improve the quality, effectiveness, and efficiency of the care they deliver while responding to each patient’s unique needs and preferences.” (AAFP.org) The core principles of a medical home are defined in the Joint Principles of the Patient-Centered Medical Home document, and endorsed by the AAP, AAFP, ACP, and AOA.
Summarized, the principles are:
Physician-led practice: Patients have access to a personal physician who leads the care team within a medical practice.
Whole-person orientation: The care team provides comprehensive care, including acute care, chronic care, preventive services, and end-of-life care, at all stages of life.
Integrated and coordinated care: Practices take steps to ensure that patients receive the care and services they need from the medical neighborhood, in a culturally and linguistically appropriate manner.
Focus on quality and safety: Practices use the quality improvement process and evidence-based medicine to continually improve patient outcomes.
Access: Practices commit to enhancing patients’ access to care. (AAFP.org)
Various state and local organizations, insurance carriers, and other governing bodies have adopted the PCMH standard and created paid incentive programs for practices that implement these principles.
As of 2017, NCQA’s PCMH Recognition program includes six concepts that align with the principles of primary care. Within each concept are competencies which are meant to organize the criteria within each concept area. Criteria are the individual structures, functions and activities that indicate a practice is operating as a medical home.
The program includes ongoing, sustained recognition status with annual reporting.
To achieve PCMH recognition, practices must:
This ensures a minimum set of capabilities and gives practices the flexibility to focus on activities that not only mean the most to their patient population, but are feasible to accomplish with their resources and the resources of their community.
PCC’s tools and services can help you meet the goals and requirements for PCMH recognition.
PCC has organized the 2017 PCMH Standards on our public wiki website, to provide quick reference to the 2017 standards themselves and, where applicable, documentation showing how PCC functionality applies to individual PCMH factors.
The PCMH standards and guidelines ask practices to show that they meet PCMH principles through using a certified EHR, attestation, and providing report details on meeting Meaningful Use Measures, Clinical Quality Measures, and other standards. Many program requirements are similar to those defined by CMS in the Medicaid EHR Incentive Program (renamed Promoting Interoperability in 2018).
To learn more, read:
You can also get data for your PCMH application with PCC’s reports. For more information, read:
PCC Prevalidation: As of March 2018, practices utilizing PCC can benefit from reduced documentation for criteria designated as “partially met criteria” and have criteria designated as “fully met criteria” marked as “met” in full. If you are interested in learning more about using PCC EHR to achieve PCMH recognition, please contact your Client Advocate.
Once a practice has gone through PCMH for the first time, they are required to meet some annual reporting requirements. These requirements are comprised of a small subset of the 2017 PCMH requirements. Contact PCC support for assistance.
PCC sponsors and maintains a public wiki where we share information gathered from PCC clients who have successfully achieved PCMH recognition.
The website includes screenshots and descriptions of how to use PCC’s software to complete your PCMH process. We welcome your input!
PCMH programs vary from region to region. You can find out what’s available in your region at the Patient-Centered Primary Care Collaborative map.
PCC has partnered with the Verden Group to offer discounted consultation services to PCC clients looking to achieve PCMH recognition.
Get in touch with pedsol@pcc.com to learn more.
Your PCC system supports the American Medical Association’s CPT II code specification, a subset of the standard CPT codes used for procedures.
CPT II codes, commonly used for Medicare billing, report performance measures and can show how well offices are meeting quality measures (PQRI – Physician Quality Reporting Initiative). They are not like regular procedure codes, and they have no associated price. They identify a condition and the clinical component for assessment of that condition.
Should You Participate?: Some insurance carriers may offer pay-for-performance bonuses to practices that use CPT II codes. You can enroll in these programs with your insurance carriers, use the codes during checkout and billing, and payors will then evaluate whether clinical improvement was achieved and send you an incentive bonus.
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.
Providers use ICD-9/ICD-10 diagnosis codes to indicate patient conditions. They use CPT codes to record the office visit and clinical procedures. The provider may use CPT II in addition to CPT codes in order to indicate how diagnoses and treatment relate. Some CPT II codes are redundant with ICD-9 codes.
There may be extenuating circumstances for why particular care is not performed. If you report those circumstances using CPT II codes with special modifiers (1P, 2P, etc.) you can remain in compliance with a carrier’s Pay for Performance goals. This may happen when a family refuses care, for example.
Only a small subset of the total CPT II codes are of interest to pediatricians. The most common relate to Asthma and Pharyngitis. The table below lists common pediatric CPT II codes. Note that new PQRI measurs and CPT II codes are added regularly.
| Code | Description |
|---|---|
| 4015F | Use this code for patients diagnosed with asthma to indicate whether or not they were prescribed long-term medication or acceptable alternative treatment. |
| 1005F | Use this code for patients diagnosed with asthma to indicate whether the patient was evaluated for frequency (numeric) of daytime and nocturnal asthma symptoms. |
| 4120F | Use this code for patients diagnosed with URI (Upper Respiratory Infection) or Pharyngitis who were prescribed antibiotics on or within 3 days of visit. |
| 4124F | Use this code for patients diagnosed with URI (Upper Respiratory Infection) or Pharyngitis who were *NOT *prescribed antibiotics on or within 3 days of visit. |
| 3210F | Use this code for patients diagnosed with pharyngitis who received a group A strep test. |
| 4130F | Use this code for patients diagnosed with Acute Otitis Externa who were prescribed topical preparations |
| 1116F | Use this code for patients diagnosed with Acute Otitis Externa who were assessed for Auricular or periauricular pain. |
| 4132F | Use this code for patients diagnosed with Acute Otitis Externa who were *not* prescribed Systemic antimicrobial therapy. |
| 4131F | Use this code for patients diagnosed with Acute Otitis Externa who were prescribed Systemic antimicrobial therapy. |
| 2035F | Use this code for patients diagnosed with OME (Otitis Media with Effusion) who had assessment of tympanic membrane mobility with pneumatic otoscopy or tympanometry. |
| 3230F | Use this code for patients diagnosed with OME (Otitis Media with Effusion) to indicate documentation of hearing test performed within 6 months prior to tympanostomy tube insertion. |
You can learn more about CPT II by visiting the American Medical Association’s web site about CPT II. Visit http://www.ama-assn.org/ and search for CPT II.
Read the procedure below to learn more about CPT II and the steps for PCC system implementation.
Research and Evaluate Your Options
Work with your carriers to understand the guidelines of their CPT II, PQRI and pay-for-performance agreements. Evaluate the additional work your providers, front desk, and billing staff will need to perform to implement CPT II on your encounter forms, charge screens, and during the checkout and billing process.
Sign Up or Enroll
In some cases, you may need to adjust your contract or “opt in” to a carrier’s pay-for-performance program before beginning.
Decide What CPT II Codes to Implement
Study the CPT II codes your carriers accept and develop a plan for the codes your office will use. PCC’s coding expert can answer basic questions, and you can learn more about CPT II from the AMA.
Add CPT II Codes to Your PCC System
Run the Table Editor (ted) and create the CPT II code entries in the Procedures table.
Adjust Your Office Workflow and Configuration
Work with your providers and your billers. Teach them how to select the correct CPT II codes along with tradition diagnosis and procedure codes. You may need to adjust your encounter forms and charge screens. Contact PCC Software Support at 800-722-1082 for help.
Post Charges and Use CPT II
Once you begin using CPT II, you will be able to run procedure-based reports and track your posting compliance. You can also check your office’s posting work using the dailycheck program.
Post Pay-for-Performance Bonuses
If your pay-for-performance work results in an incentive payment from an insurance carrier, post that money into a holding account. You may create a holding account and patient named for the insurance company.
For your accounts to balance, PCC recommends you post an adjustment in the Refund program. That adjustment, created in the Procedures table, should also have an accounting type of “Revenue – Non-Service.” Next, post the payment in the Post Payments and Adjustments program (pam). You may wish to create new incentive payment types in the Payments table with the name of the insurance carrier.
Reporting: As CPT II procedures have no revenue, they should not adversely effect your reporting. You can run procedure-based reports to watch CPT II coding trends as with any other code. Posting CPT II codes (which should all have a $0.00 amount) will not affect per-visit reimbursement analysis.
This page contains software downloads that help you connect to PCC’s software or that facilitate PCC services. Some of these items were created by a third-party. If you are uncertain what download you need, please contact PCC Support at 802-846-8177 or 800-722-7708.
Each client has their own download page that can be accessed with a web browser and gives you direct access to important PCC downloads, as well as links to PCC support and our online documentation at learn.pcc.com.
The url is simply your PCC acronym followed by pcc.com/downloads. So, if your acronym was ABCD, your downloads page would be at https://ABCD.pcc.com/downloads
If you need to download or update PCC EHR software for your individual PC or Macintosh computers, follow these instructions:
Macs running the Sequoia operating system may require additional steps when installing PCC EHR for the first time. Please reach out to PCC Support for assistance.
PCC SecureConnect is a secure way to log into your full PCC system from a supported web browser on any laptop or computer that is connected to the internet. Every practice has a PCC SecureConnect login page from day one.
To learn more about how to log in via SecureConnect, read Connect to Your PCC System from Home
You can find information about how to authorize your staff to use SecureConnect in Authorize Users for PCC SecureConnect.
Your practice can use ScreenConnect and ConnectWise View tools to grant PCC live access to your workstation for faster support, troubleshooting, and training.
To learn more about how to share your screen with PCC during triage calls, read Share your Screen with PCC.
Welcome to PCC. The instructions below contain a detailed explanation of the hardware installation requirements for PCC systems. These specifications define what is included in your PCC Customer Care Plan and provide information to help you avoid problems during the design and installation of your office network.
Please read these instructions carefully, whether you are a new PCC client, opening a new office, or upgrading your existing PCC hardware. Offices that do not adhere to these guidelines violate the terms of their subscription agreements with PCC and may also experience system problems and service delays.
If you have any questions, please do not hesitate to call PCC Support at 802-846-8177 or 800-722-7708, or send your question to support@pcc.com. We are always glad to help!
Read a Summary of Network and Equipment Services: PCC's Technical Solutions Team provides a Network and Equipment Services guide which includes answers to common questions around what PCC installs, how equipment is maintained, how backups are performed, and more.
Unless otherwise specified, your PCC system will be a LINUX-based server network. This section includes important guidelines for the placement and maintenance of your server.
The purchase and installation cost of your PCC Server and some associated equipment is included in your subscription plan. The purchase and installation cost of your individual PCs, printers, or other workstations is not. For complete details regarding approved hardware, read the PCC Supported Hardware Guide at learn.pcc.com.
Placement: Place workstations, terminals, printers, and personal computers where they will be most useful to you. Carefully consider how the hardware will be used. For example, each workstation should have enough room in front of it for a keyboard and should be located near a network outlet and power supply. Laser printers need space to open their paper feed drawers.
Security Updates and Virus Protection: It is important to perform security updates and maintain virus protection on your personal computers. You should have someone in your office learn how to perform these updates or contract with a local vendor for this service.
Printers: PCC recommends you purchase network capable, PCL or postscript printers that can meet the demands of a busy office. A typical office might choose to purchase a front-desk printer, a lab area printer, a billing printer, and a centralized copier/printer/scanner. Contact PCC Support at (800)722-1082 or support@pcc.com to discuss your printer options or to check on the compatibility of a specific printer model.
Setup and Installation Help: PCC can help you install recommended hardware. Hardware purchased after your initial installation will be installed by your System Administrator using phone assistance from PCC.
Other Included Hardware: A standard PCC installation includes one or more network switches, an Uninterruptible Power Supply (UPS), and an external modem. You may wish to purchase other equipment, such as additional surge protectors for your individual PCs, but you do not need to supply one for your PCC Server.
Operation of your PCC products requires a reliable internet connection of sufficient bandwidth and speed. Business-class internet service over fiber or cable is strongly recommended. PCC will verify that the service you currently have is adequate. If you are ordering new service or upgrading existing service, PCC can help you with your internet service order. PCC requires that your internet service be operational before we install your server and network equipment.
PCC will work closely with you to help you chose the right service. PCC’s minimum requirements are an internet connection with a download speed of 10 Mbps and an upload speed of 3 Mbps. Internet service with download speed of 25 Mbps or better and an upload speed of 5 Mbps or better will give your office superior performance. These requirements may change over time. If you have remote offices that will be connecting to your main office over the internet, there may be additional requirements. PCC requires that your internet service be provisioned with a static IP address. If fiber or cable is unavailable at your office location(s), or you cannot otherwise purchase service that meets our requirements, PCC will work with you to see what other options are available.
Your internet service provider’s (ISP) equipment should be terminated near your PCC router, typically at the PCC server location. Your ISP may require the purchase of a cable modem or similar device, but you do not need to purchase a router or firewall (PCC will provide one). PCC will manage routing of the internet connection and sharing it with the computers in your office.
PCC recommends that you install a dedicated, 3 prong, 110 volt, negative-grounded outlet for the PCC Server’s power supply. PCC will supply a power backup unit, also know as an uninterruptible power supply, to protect the PCC Server from power fluctuations and outages. Please make any necessary arrangements with your electrician to ensure that you have a dedicated electrical outlet.
If a dedicated outlet is not installed, you may use a regular wall outlet, provided that it is properly grounded and that there is no electronic equipment on the same circuit with a heavy electrical draw. Equipment that causes problems often includes (but is not limited to) photo copiers, microwave ovens, refrigerators, coffee makers, air conditioners, and most medical equipment. Hardware on a non-dedicated electrical circuit is more likely to experience difficulties due to power draws and surges.
PCC also recommends the use of surge protectors for each of your peripheral devices (PC workstations, printers, modems, etc.).
PCC requires that your office has a gigabit Ethernet network using Category 5e cabling (or better). PCC will install and maintain network equipment to support a TCP/IP network in your office, including a firewall(s), Ethernet switch(es), and wireless access points as required. PCC will not install the premise cabling upon which the network operates.
You must contract with a local vendor to install or make changes to your office’s network cabling.
Important: Once you have decided where the servers, workstations, and printers will be located in your practice, you need to arrange to have your office cabled properly by an electrician. PCC cannot install cable in the walls, ceilings, or floors of your office.
The details below are for network support personnel or your practice’s System Administrator. In the event that you need assistance from a local network support group or if you are really interested in the technical underpinnings of your network configuration, this is where to look first.
Please Note: The information below describes our desired configuration. Your office may use a different network configuration, especially if you had an existing network before your PCC installation.
Your network will be configured using a DHCP server provided by your PCC Server. This means that whenever you turn on a machine that is connected to the network, it will query the DHCP server on the PCC Server for its IP configuration. This allows PCC to keep the entire configuration of your network in one place and makes it easy to expand, enhance, and adjust your network configuration.
Your network will not use static IP addresses entered into each machine. While this is a very easy way to set up a network initially, it is very inflexible and time-consuming to maintain.
Your DHCP server will assign a specific IP address to each network device, based on that device’s unique MAC address. This will allow PCC software to route printing tasks to the appropriate printer.
Please note: If there is an existing network with a DHCP server, the old DHCP server must be disabled so that the PCC Server can provide DHCP services. A network can only have one DHCP server.
Your PCC Server includes an email server and an available e-mail account for each user at your practice. Users can access their email from any browser using the Roundcube mail software. PCC provides training and support for Roundcube.
PCC will only assist you with configuration, support, and troubleshooting of your PCC email account.
There are many different ways to connect to your PCC Server from a remote location. PCC will help you design and select solutions to meet the needs of your practice.
Remote connections usually require high-speed internet access in both locations and may also involve additional connections, routers, or other equipment.
The wiring in your remote location needs to accommodate the type of remote office connection used. The termination of the internet connection in your remote location must be in an area near the PCs or routers they serve. As with your main office, the wiring design should look like an octopus, with many arms returning to a central location.
You may have a choice of remote office connection solutions with varying prices and features.
DSL or Cable Internet Connections
Cable and DSL internet connections are the two most commonly available high-speed internet solutions. They are usually sold by your local cable television or telephone service provider. In most situations, routers and additional equipment are not necessary.
When each location has a high-speed internet connection using DSL or Cable service, PCC connects the two locations with single or multiple virtual private network connections, as previously described.
When bad weather or other emergencies approach, your Partner practice and PCC EHR data may be the last thing on your mind. By taking a few simple precautions, you can protect your equipment as well as your patient database and accounts receivable records.
PCC’s Support Team recommends the following emergency preparation measures. If you have any questions or concerns, call us at 802-846-8177 or 800-722-7708. Follow these steps whenever there is a risk of power failure, electrical storm, or flooding in your region.
What if I'm in a hurry? And what does my PCC equipment look like?: If you need to shut down your server immediately, follow the instructions on the Shut Down Your Server article. You can see photos of the PCC equipment in your office on the PCC Hardware Overview article.
If there’s a risk you may be without Internet or a working computer system, PCC recommends you open the Report Library in PCC EHR and generate a report for upcoming appointments. You can customize your report to include patient contact information or any additional information you may need.
If you have a physical PCC server located at your practice, perform the following steps.
Run a System Image Backup of your server. Although a backup is run automatically every night, you can perform one manually at any time.
First, ask all users to log off the system. Next, type backups at a command prompt or choose “Backup the System” from the System Administrator window. From the list of options in the backups program, choose “System Image Backup.”
Contact PCC Support for a Remote Backup: Please contact PCC support as soon as you know you want to shutdown your PCC equipment, and at least four hours before you plan to shut your system down, so that we can initiate a remote backup. A remote backup may take several hours to complete and the system should only be used for lookup purposes during that time. Any changes you make once the remote backup is started could be lost if we need to restore your system. Once the remote backup is complete, you may shutdown your system.
Shut your server(s) down and turn off the power. Follow the instructions on the Shut Down Your Server help article.
For most systems, simply run the Shutdown program in the System Administrator window, or log in as the root user and type shutdown -h now at a command prompt. Once you see the “Power Down” message on the console screen, your system may power down automatically. If not, press and hold the power button on the front of the server until the machine turns off.
Nightly Backups Will Not Occur While Server is Off: If your server is shut down overnight, normal nightly cleanup programs will not run. They will run the first night after the server is turned back on. Some complex financial aging reports, for example, may not be up-to-date after a night with no power.
Your server and other PCC hardware are plugged into an APC UPS battery backup device in your office or server location. The device provides some protection against unexpected surges and brown-outs.
If you know ahead of time that your power may fail or office may flood, you should turn off the APC and unplug it from the wall for added protection.
Use Caution When Working with Your UPS: Your APC UPS device is a large battery. Even when it is unplugged, it has enough current to cause harm or death. Treat it as you would any live electrical outlet.
Turn off your printers, PCs, and all other electrical equipment. Even if you use surge protectors around your office, unplugging your PCs and printers will better prevent electrical damage.
If possible, disconnect your ISP modem (cable, DSL, etc.) and FAX machine phone lines. A power surge on a phone or coaxial cable internet line can also damage your equipment. Contact your phone system provider for information about protecting that equipment.
If there is a possibility of flooding, you should raise the server and other equipment off of the floor and use plastic tarps to prevent water damage. Do not wrap your server in a plastic tarp while it is still running.
As always, remember that your safety and the safety of your patients is far more important than your equipment. Do not return to your office to perform the above steps unless it is safe to do so.
Please call PCC Support (802-846-8177 or 800-722-7708) if you need assistance performing the above steps or if you have any questions. Remember that we are available 24 hours a day and seven days a week for emergency calls.
Every quarter, PCC performs a network vulnerability scan on your PCC server and network infrastructure. This service is included in your PCC support contract.
PCC uses vulnerability scanning software to review connections to your server or router and firewall. We check known vulnerabilities on commonly used system ports available from the internet. For example, we scan the services on your server that run your e-mail, manage remote connections and remote offices, and your built-in web server.
We automatically send your office’s system administrator an e-mail letting you know the results of the scan.
If a high-risk vulnerability is found, an email is automatically sent to support@pcc.com.
We treat that security vulnerability as a top priority. Our Technical Solutions team resolves the issue, and then notifies your office.
Sometimes even high-risk vulnerabilities cannot be remediated without negatively affecting your system, due to an unusual configuration or because your firewall or network is managed by a third-party. When that happens, PCC can help you communicate problems to whomever manages your firewall.
If PCC manages your office’s router, we can apply any required updates or patches. If you use a local or in-house IT technician to manage your network, they must handle the update and upkeep of your router.
In addition to high-risk vulnerabilities, your network vulnerability scan will find many other medium or low-risk vulnerabilities. Some normal aspects of your network configuration may be labeled as low or medium-risk vulnerabilities, such as when a port is opened to allow communication between remote offices.
Your system administrator can review the e-mailed report and take appropriate action. Contact PCC Support for any questions about the results of the scan.
If you need to move equipment or are preparing your office for a bad storm, you may want to shut down your PCC server. This might also be needed if a technician is visiting your office.
Follow this procedure:
Tell Your Staff to Log Off
Ask your staff to log out of PCC EHR and Partner/Practice Management. You should make sure they are finished with their tasks and have logged off before proceeding.
Turn Off Your PCC Server
There are three different ways you could shut down your PCC server. First, you can just press the power button, located in the top-left of the front panel of your server (or under the grille, for some models). Press it once to begin the shutdown procedure.
If you can’t find the button, you could also log into your Partner windows and select System Administration, and then “Shut down the System”.
Alternatively, you can always ask your PCC CA or PCC technician. They can turn your server off remotely.
Watch Your Server’s Console
Watch the monitor attached to your server as the system shuts down or reboots. If you are rebooting, you can tell your staff that they can log back in once you see the log in prompt. If you are shutting down, your server will turn off on its own.
Do I Have to Perform the Shut Down at the Main Console?: You can perform a shut down or reboot from any PC or terminal in your office. Using the main console is recommended only because it will show you the full range of messages as the system shuts down and it will be easier to observe when the system comes back up after a reboot.
Password Required on Start Up: When you push the power button to turn your PCC server back on, you will need your practice’s decryption passphrase. PCC shares this passphrase only with your practice’s office manager or PCC system administrator.
Here is a typical hardware and network layout for a PCC office. Your practice may have different equipment or a different configuration, but the image below identifies how a PCC Support technician works with your local IT vendor to arrange the PCC Server, network, and firewall equipment in a pediatric practice.
Your practice may have one or more remote office locations. PCC can design a custom network configuration for your remote connection needs. This image depicts a typical remote office hardware map.
PCC installs a Fortinet Fortigate in each practice as part of your PCC subscription. This router/firewall device connects your office to the internet and secures your network from unauthorized access.
My Practice Already Has One: In some cases, you may already have a suitable router/firewall provided by another IT consultant. In that case, PCC will work with you to ensure the existing device is adequate and configured correctly for use by your PCC equipment and applications. PCC prefers to provide and administer your router/firewall. It is a critical component of your network infrastructure and is the gateway through which PCC updates and administers your PCC server and other network devices.
The router/firewall performs the following functions in your office:
Router: Your router/firewall device routes traffic between network segments.
Firewall: Your router/firewall device helps prevent unauthorized access to your network and can help block incoming network attacks.
Internet Sharing: Your router/firewall device provides a gateway to the internet for all of the devices on your network.
Remote Connection: Your router/firewall device establishes secure Virtual Private Networks (VPN) between locations, such as your main and remote office or your office and a remote billing service. Your router/firewall devices are the endpoint for the connection at each location. PCC strongly recommends that clients with multiple offices install dedicated point-to-point connections between offices (typically fiber). In select cases, or when those services are not available, PCC may set up a persistent VPN connection between your offices.
DHCP and DNS Services: Your router/firewall device may also provide DNS and DHCP service to your network devices. (DHCP provides IP addresses to your network devices. DNS resolves domain names to IP addresses so traffic can be properly routed.) Generally DNS and DHCP services run on your PCC server, but in some cases your router/firewall may perform these functions.
Your office’s PCC-installed router/firewall is a configurable unit, allowing PCC’s Technical Solutions Team to add features and change the configuration as your office’s needs change.
The Fortinet Fortigate is a high-performance, commercial firewall with optional Universal Threat Management (UTM) features. Fortinet is a major provider of network security appliances and solutions.
More Questions?: If you or your network consultant needs more information about the router/firewall devices provided by PCC, contact PCC’s Technical Solution Team at (800)-722-1082.
PCC may install a server, peripherals, and other hardware in your office. This article is a quick reference to that equipment. You can use the sections below as a photo guide to your PCC hardware.
Contact PCC Support with any questions about your practice hardware.
Read a Summary of Network and Equipment Services: PCC's Technical Solutions Team provides a Network and Equipment Services guide which includes answers to common questions around what PCC installs, how equipment is maintained, how backups are performed, and more.
What About Equipment that Your Practice Purchases?: Read the Personal Computer and Equipment guide to learn about PCs, printers, and other equipment that your practice purchases and maintains.
PCC typically installs the following equipment:
Unless your practice will host your PCC server in the cloud, PCC installs one or more servers in your practice. The PCC server runs PCC EHR, the Patient Portal, and other PCC software and services. Your personal computers connect to the PCC server using a network connection.
PCC servers use the CentOS Linux operating system and require internet connectivity.
A PCC server includes provisions for failure and redundancy. PCC provides a guaranteed 4-hour response for onsite service. We typically include a monitor, keyboard and mouse for the server, but the server can not be used as a user workstation.
When PCC installs a physical server, we currently use a Dell PowerEdge server.
Height: 430.3mm (16.94 in)
Width: 218mm (8.58 in)
Depth: 603 mm (23.7 in)
Weight: 26 kg (55.67 lb.)
How to Turn Off Your PCC Server: Whenever possible, your PCC server should be rebooted or shutdown from the System Administration menu in the Practice Management window. Should that not be possible, you can use the illuminated green power switch on the front of the server. Push and release the button. When pushed and immediately released, the server should go through a proper shutdown procedure before powering down. In exceptional circumstances, you can also press the power button and hold it for several seconds to immediately power down the server. If you have any doubt about when or how to reboot or power down your server, please contact PCC support.
For a typical pediatric practice, PCC installs and maintains one or more network switches.
Switches are the center of your PCC network. All network devices, including PCs and the Partner Server, plug into a port on the switch, through cabling in your wall. If you have a wireless access point, it also plugs into the switch directly or through a cable in the wall.
You can plug devices into any port on a switch, the ports do not need to be individually configured.
To reset a switch or router, unplug the power cable from the back of a unit, wait fifteen seconds, and plug it back in.
If your practice has an in-office PCC server, then PCC installs a UPS battery device that supplies power. It protects anything that is plugged into it from power surges, brown-outs, and black outs.
A UPS works silently until a power problem occurs. Then the UPS will begin to beep loudly and supply filtered power to devices plugged into it. The UPS will supply five minutes to an hour of power to your PCC server when the power fails completely.
When your power fails, shut down your server as soon as possible. When five minutes of battery remain, the UPS will attempt to safely shut down the PCC server for you automatically.
A typical PCC-installed CyberPower UPS:
You can read technical specifications for this UPS at cyberpowersystems.com.
A typical PCC-installed APC UPS:
You can read technical specifications for this UPS at apc.com.
Replace the Battery in an APC UPS: You can watch a tutorial video to learn how to replace an APC UPS battery.
PCC installs and maintains a firewall for each of your offices. This device connects your office to the internet, connects remote offices, and provides connections to approved third-parties, such as a remote billing office. The firewall provides security features that help protect your network. At this time, PCC provides Fortinet firewalls.
Height: 38mm (1.5 in)
Width: 216mm (8.5 in)
Depth: 160mm (6.3 in)
Weight: 0.9 kg (1.9 lb)
Depending on your practice’s configuration, PCC may install an NAS device. PCC’s NAS device is a RAID array of hard drives connected to your network that is used to store backups. PCC currently installs two different brands of NAS device:
How to Turn Off Your Synology NAS: The power switch for the NAS is on the front, illuminated in blue, in the lower righthand corner.
How to Turn Off Your FreeNAS: The power switch for the NAS is on the front, in the upper lefthand corner.
Depending on your practice’s configuration, PCC may install one or more wireless access points. A WAP is a radio transceiver that allows your wireless devices to transmit and receive data without a wired ethernet connection.
Height: 48.1 mm (1.89 in)
Width: 220 mm (8.66 in)
Depth: 220 mm (8.66 in)
Weight: 830 g (1.83 lb)
In most cases, a WAP is mounted on the ceiling and connected via a cable to your wiring closet. WAPs can be distributed throughout your office to achieve better WiFi coverage.
Most installations use a power injector which plugs into the wall; one cable goes to the wiring closet and one cable to the WAP. In some cases we may use a power-over-ethernet switch for this purpose.
Note: For new installations, your PCC TST technician will advise you on the WAP location(s) for your contractor to install appropriate cabling prior to PCC’s arrival.
Before purchasing new or replacing any equipment or services that PCC typically provides at no cost to you as part of your contract, please contact PCC Support for guidance.
PCC manages all or most of the network for the majority of our clients. In most cases it is more effective, and less expensive, to let PCC provide network equipment and install and support your backbone network (firewall, UPS, switches, wireless, server and backup). Local IT is great for administering your Windows network, workstations and printers.
Details about equipment and services that PCC provides can be reviewed in the fine print accompanying your PCC contract.
If your practice has multiple locations that operate independently, you can turn on the Care Center features in PCC software. Once the feature is turned on, you can assign patients to a specific care center.
When you assign a patient to a care center, a special location flag is added to the patient’s record and many new features and abilities are available in PCC EHR and the patient portal.
The Care Center features will help large practices or multiple-practice partnerships where different office locations operate independently. Read below to learn more.
When you search for a patient chart, you can see the patient’s care center in the search results.
Any office location can open any patient’s chart. When you search for a chart, you can use the Care Center column to know if you have found the correct patient.
When your practice uses the Care Center features, the Messaging queue includes a Location filter.
Use the filter to see messages that relate only to the care center location where you work.
By default, all incoming, new messages or tasks on the Messaging queue will have the patient’s care center set as the item’s care center.
If a nurse creates a phone message task, as shown above, or a physician creates a new order follow-up task, the message will be assigned to the patient’s care center location.
However, any user can open the message task and change its care center location to redirect the message to a different care center.
Messages for Patients With No Care Center: If a patient does not have a care center assigned, messages about that patient will be visible to all locations on the Messaging queue.
You can open any message (created after your PCC 6.27 update) and assign it to a care center to make sure the correct office handles the issue.
When a patient has a care center, the care center information can appear during patient checkin, during scheduling, and elsewhere in PCC EHR.
If you assign patients to specific care centers, you can use new care center variables to produce form letters that contain the care center location. You can also configure the care center address to appear on the Health Information Summary report and in MyKidsChart.
Read the PCC 6.27 Migration Considerations document to learn more.
When a patient has a care center, that care center appears as a patient flag. You can filter by the care center flag when you run the Recaller, SRS, or other reports.
Use the care center flag, along with other report options, to report on or contact a precise patient population.
When your practice adds patients to a MyKidsChart user account, you will see the care center information for each search.
Use the Care Center column to correctly identify the patients you should add for a patient portal user.
If your practice has multiple locations that operate independently, you may want to turn on the patient Care Center feature. Contact PCC Support to discuss the feature and decide if it is right for you.
Read the sections below to learn how to configure care centers for your practice locations.
After PCC Support turns on the Care Center feature at your practice, you should double-check your location configuration. PCC can intelligently assign care centers based on the flags you are already using, or you can create new flags and locations and assign them to users.
First, each care center should have a location flag in the Patient Flags table in the Table Editor (ted). You may already have this configured at your practice. If not, clone or create new flags.
Next, each care center should have a scheduling location in the Places of Service table in the Table Editor (ted). You may already have this configured at your practice. If not, create new locations.
Make sure that each of your scheduling locations is also designated as a login location.
To activate a care center, enter the matching patient flag in the Care Center Patient Flag field, as shown above. All patients with the flag will be automatically assigned to the care center.
As you adjust address and other information for each Place of Service in each Care Center, consider how encounters will be billed. If a location is a subpart of another location for billing purposes, you can indicate that at the bottom of the screen.
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.
When you schedule appointments using care centers, PCC scheduling tools need to know which locations belong to each care center.
This is done by a PCC Administrator, using login locations.
Talk to PCC Support about mapping your login locations to the correct care center.
An office manager or other administrative user at each care center location should review and set the care center for each PCC EHR user.
Many features in PCC EHR, including order assignment, provider lists, the Appointment Book and MyKidsChart administration will refer to a user’s care center.
Use the User Administration tool to edit a user’s care center.
The Care Center field controls who each PCC EHR user will see in various pull-down menus, and controls which MyKidsChart location they will access when using the Administration tab of the Patient Portal Management tool.
If your practice uses the Appointment Book in PCC EHR, your scheduling staff will only be able schedule for the locations that are mapped to the care center location(s) that they are assigned to. Similarly, when setting up providers’ default hours, only those locations that are mapped to the care center(s) which the provider is assigned to will be available for selection.
If a user floats between multiple locations, you can leave their care center blank. A user with no care center assigned will see, and be visible to, all other users, regardless of care center.
Have You Linked Clinicians to Billing Providers?: Some PCC features, including Care Center features, rely on having PCC EHR users linked to the providers in the under-the-hood configuration settings found in the Practice Management interface. You can see whether or not your clinicians are linked up in the Provider column in the User Administration tool.
If you believe a provider is not correctly assigned, open the Providers table your Practice Management window and enter the appropriate PCC EHR user.
After PCC Support turns on the Care Center features at your practice, all message protocols, such as your phone notes, will include the Care Center component at the top.
New messages automatically receive the care center of the patient, but users can change that care center to redirect a message to a different location.
You can use the Protocol Configuration Tool to move the component anywhere in the ribbon.
After turning on the Care Center features at your practice, you may need to spend some time answering and completing old message tasks that do not have an assigned care center. All new messages can have a care center, but your practice may have a backlog of message tasks.
Any message without an assigned care center will appear for every location, regardless of the user’s location filter setting.
During patient checkin, or whenever you create a new patient record, your practice should assign a care center.
Your staff can select a care center on the Demographics section of PCC EHR, anywhere the Demographics component is added (on a chart note, for example), as well as in checkin, checkout, and the Patient Editor (notjane).
One Care Center Only: Note that if you add a new care center to a patient, PCC will automatically remove the old care center (and flag) for them.
In the User Administration tool, you can customize your drop-down user lists for your care center. You can sort users in three ways: by first name, by last name, or in a manually arranged order.
On the Messaging queue, your staff can set their location. If they are responsible for handling tasks for patients from several care center locations, they can select more than one.
After setting their location, your staff can click “Save My Defaults” and PCC EHR will remember their preferences the next time they log in.
Any Messaging queue items that do not have an assigned care center will appear for all users, regardless of their Location filter.
When you generate a school excuse letter or other form letter, should it display your practice’s default address, or the patient’s care center address?
Review your practice’s common form letters and work with PCC Support to change your form letter variables to display the preferred address.
Use the Practice Preferences tool to set which location address appears on the Health Information Summary report and in the patient portal, MyKidsChart.
After setting this option, the Health Information Summary report and the patient portal will automatically display either your practice’s default address or the patient’s care center address. If the patient has no care center assigned, they will see the practice’s default address instead.
If a parent has several patients who visit physicians at different care centers, both addresses will appear for them when they log in to MyKidsChart.
PCC continues to add and update PCC EHR features to support the needs of offices that use the Care Centers feature. Some of the recent additions include:
You can use PCC SecureConnect to remotely access all of PCC EHR and your Practice Management system.
Video: Watch how to remotely connect to your PCC system using PCC SecureConnect.
PCC SecureConnect is a secure way to log into your full PCC system from a supported web browser on any laptop or computer that is connected to the internet. Every practice has a PCC SecureConnect login page from day one.
PCC SecureConnect uses two-factor authentication to keep your data safe. Two-factor authentication is a system that requires you to enter a security code at login in addition to your username and password. The security code is generated on your smartphone, which only you should have access to.
Once you log into PCC SecureConnect, you can access all of PCC EHR and your Practice Management system.
Supported Web Browsers: SecureConnect requires Google Chrome or Mozilla Firefox. While SecureConnect may work on Safari, Microsoft Edge, or other browsers, PCC only tests and explicitly supports PCC SecureConnect on Google Chrome and Mozilla Firefox web browsers.
Is PCC SecureConnect Different from pocketPCC?: pocketPCC is a curated version of your PCC system that you can access from any internet-connected device, including a smartphone or tablet. It does not require two-factor authentication and your practice can set users up without calling PCC Support. SecureConnect grants access to your entire PCC system but requires two-factor authentication and works best on a laptop or computer. Additionally, you must call PCC Support to authorize users. If you are only looking for access to your schedule, certain parts of patient charts, phone notes, and portal messages, get started with pocketPCC. If you need remote access to your full PCC system, read on.
Every practice has a PCC SecureConnect login page from day one, but not all users are authorized to connect.
PCC keeps your system locked down so that only approved users can connect with SecureConnect. Your practice’s system administrator decides which users should be allowed to connect from home, a remote office, or while traveling.
Manage User Access Yourself: User administrators can add or remove users from the authorized SecureConnect list. Learn how.
After your practice’s system administrator has added you to the list of authorized PCC SecureConnect users, you can set up two-factor authentication for your account.
Sync Your Phone and Computer Time Settings: Two-factor authentication is time-based and will not work if the time settings on your phone and computer are wrong or do not match. Be sure that the date and time settings on your phone and computer are correct before you begin this process.
On Your Phone, Install and Set Up the Authy App
Each time you log into PCC SecureConnect, you will need to enter a security code in addition to your username and password. Security codes for PCC SecureConnect are generated in a smartphone app called Authy.
If you don’t already have the Authy app on your smartphone, follow these instructions to download it, create an account, and register your device before moving on to the next step.
On Your Computer, Log Into PCC SecureConnect
Set aside your phone, but keep it awake and ready.
Use a supported web browser on your laptop or computer to navigate to your practice’s PCC SecureConnect login page, then enter your PCC username and password.
Upon logging in, the website displays a QR code.
Keep this page open while you turn back to your phone.
What’s My PCC SecureConnect Login Page?: You can reach your PCC SecureConnect login page by typing https://your-practice-acronym.pcc.com/secureconnect/ into your web browser and replacing “your-practice-acryonym” with your practice’s PCC acronym (e.g., https://abc.pcc.com/secureconnect/). Note that the prefix is https, not http.
On Your Phone, Open the Authy App and Tap “Add Account”
Open the Authy app on your phone and tap the “Add Account” button.
Use Your Phone to Scan the QR Code on Your Computer Screen
Tap the “Scan QR Code” button in the Authy app on your phone.
Allow the Authy app to access your camera, then point your camera at the QR code on your computer screen.
Authy automatically scans the QR code and links to your PCC SecureConnect account.
On Your Phone, Customize How PCC SecureConnect Displays in Authy
As soon as Authy links to your PCC SecureConnect account, you can save the connection. Before you save, you have the option to customize how it displays in Authy.
Your PCC SecureConnect account will appear in the Authy app with whichever name and image you choose.
On Your Phone, Save Your Work
Tap “Save” to finish linking your PCC SecureConnect account to the Authy app.
Once saved, you can use the security codes generated in your Authy app to log into PCC SecureConnect.
Optionally, Test It Out
After linking your PCC SecureConnect to the Authy app, your phone will display a six-digit security code on a 30-second timer. To test that your two-factor authentication is properly configured, you can enter this code into the PCC SecureConnect login page on your computer.
The security code should allow you to log into PCC SecureConnect and access your PCC system. Once logged in, click the “Start” button to open PCC EHR.
Security Codes Regenerate Every 30 Seconds: Authy security codes are only valid for 30 seconds. When the time runs out, a new one generates automatically. If you don’t enter the first code before it times out, don’t worry. Just use the next code that appears on your smartphone.
Multiple Authy Accounts?: If you prescribe controlled substances in PCC eRx or have used Authy for two-factor authentication before, you will see multiple accounts in your Authy app. Each account generates a unique code for a specific service. Make sure you have your PCC SecureConnect account selected in Authy when you are finding your security code to log in.
After you set up two-factor authentication, it’s easy to log into your PCC system from anywhere.
Go to Your PCC SecureConnect Login Page
Open a supported web browser on your laptop or computer, then type in the URL for your practice’s SecureConnect login page. You can reach your PCC SecureConne
ct login page by typing https://your-practice-acronym.pcc.com/secureconnect/ into your web browser and replacing “your-practice-acryonym” with your practice’s PCC acronym (e.g., https://abc.pcc.com/secureconnect/). Note that the prefix is https, not http.
Then, enter your PCC username and password.
Enter Your Code from the Authy App
Open the Authy app on your smartphone and tap on the PCC SecureConnect account. Use the six-digit security code on your Authy screen to finish logging into PCC SecureConnect on your computer.
Security Codes Regenerate Every 30 Seconds: Authy security codes are only valid for 30 seconds. When the time runs out, a new one generates automatically. If you don’t enter the first security code before it times out, don’t worry. Just use the next code that appears on your smartphone.
Multiple Authy Accounts?: If you prescribe controlled substances in PCC eRx or have used Authy for two-factor authentication before, you will see multiple accounts in your Authy app. Each account generates a unique code for a specific service. Make sure you have your PCC SecureConnect account selected in Authy when you are finding your security code to log in.
Log Into PCC EHR
Once you are connected to your PCC system, click the “Start” button to open PCC EHR.
From here, you can access all software functions of PCC EHR and your Practice Management system.
Sign Out Before Closing Secure Connect: Please make sure to sign out of PCC EHR before closing your Secure Connect tab or window to avoid multiple login instances.
If you need additional access to remote resources such as printers when working from home, contact PCC Support. PCC can help set up alternate remote connection methods on a case by case basis.
Sometimes there are hiccups and you need to reset your two-factor authentication account in the Authy app. PCC has found the following links useful for resolving issues in the Authy app.
Restore Authy Access on a New, Lost, or Inaccessible Phone: Did you lose your phone or upgrade to a new one? Learn how to restore Authy access or recover your account.
Delete, Hide, or Decrypt Two-Factor Authentication Accounts in the Authy App: Do you need to delete a connection in the Authy app? Learn how.
Reconfigure Authy After Losing or Forgetting Your Backup Password: Did you forget the backup password for your Authy account? Learn how to reconfigure Authy.
All PCC clients have a guaranteed support plan. You should always feel free to contact PCC for help with our software, hardware, or services. Talk to PCC when you are considering new hardware or software, making major configuration changes, or moving your office. Let us know so we can help!
PCC sets up regular Client Advocate calls with every pediatric practice. You can also email, call, or fax PCC Support at any time.
PCC Calls You: Your practice’s Client Advocate will reach out and chat with someone at your office at a time that works best for you. These regularly scheduled optional calls are the perfect time to ask for configuration changes, learn how to implement new features and tools at your practice, or get additional training.
Email PCC: Send all PCC emails to support@pcc.com. We will route your email to PCC Support, your practice’s Client Advocate, or the appropriate specialist.
Call PCC: PCC’s support phone is 802-846-8177 or 800-722-7708. Live support techs are available between 8:30am and 8pm ET (5:30am to 5pm PT), except for a few days during the year. Emergency help is available 24/7, 365 days a year.
Fax PCC: You can also fax PCC a problem at 1-802-846-2197. This works particularly well for work on form letters, reports, or other visual problems. Be sure and identify your office and yourself on the fax and include a number where you can be reached.
PCC Support solves many problems immediately, during your first call or in response to your first email.
If we can’t talk right away, we’ll call or email you back. Either way, we’ll open a support ticket for you. You’ll get an automated email describing your support ticket.
You can visit https://support.pcc.com to review all of your support tickets. PCC Support can help you set up an account.
You can decide which users at your practice should have access to this tool, and whether they should be able to see all support tickets practice-wide, or just the tickets they open.
PCC Support tracks every ticket until it is completed to your satisfaction. If you need something we can’t help you with, we’ll open a development enhancement request or help you find a different tool or workflow.
When you start using PCC at your practice, will your patient and account records already appear in PCC, or will you be entering everything from scratch?
For most practices, PCC performs a data conversion from your previous vendor. You will need to request an export from your previous vendor that we will import into PCC.
Many different factors determine what data can and can’t be converted. The success of the data conversion relies on PCC’s efforts, your communication with your previous vendor or practice, and the cooperation of that vendor. When we work together to convert your previous data, your first few months with PCC will be much easier for you, your patients, and your staff.
This document will explain the data conversion process and help set expectations. By reading it, you will learn:
As always, please feel free to call or email us to discuss any of the details in this document.
Even before you sign a contract with PCC, your practice will need to communicate with your previous vendor about a data export. This process can take time so you want to start the discussion and request the export as soon as possible.
Two Types of Data Conversion: A data conversion involves two types of data: practice management data and clinical data. Practice management data includes your patient and account demographic, appointment, and charge data. Clinical data includes labs, visit history, visit notes, and similar data. While PCC can retrieve practice management data from your system, clinical data requires an export from your previous vendor.
Practice Export: If your patients’ data is housed on a software system belonging to another practice, we require an export for clinical data. Your practice is responsible for communicating with the other practice to obtain the data export.
Below is a timeline of a successful data conversion. For each step, you can see what happens, what PCC does, and what your practice needs to do.
PCC can usually retrieve practice management data, such as patient demographics, policies, billing history, and appointments, from your current system once you grant access.
Before you sign with PCC, or any other vendor, we recommend that you understand the location and service contracts related to your existing data. We cannot guarantee the success of any data conversion, as there are many unforeseen technical obstacles and sometimes difficulties getting cooperation from other vendors. Even the data exported from distinct practices using the same system can differ in subtle or significant ways. However, PCC has experience converting data from dozens of systems of various complexity, from homegrown systems to advanced EHRs.
What Your Practice Does: First, we recommend that you make a list of all the data you have in different software systems and review their related contracts. Do you have an existing EHR, a billing system, a contacts database? Where is your data? Next, ask your previous vendor what type of export is available.
What PCC Does: PCC will provide you with information on how your data can be converted.
As soon as you sign with PCC, we begin asking questions and researching the reports we can generate for your practice management data. If we have worked with your vendor in the past, we may have an existing conversion process that we can start adapting for your system. For example, we may already be aware of the reports available for your practice management data. The scope of the practice management conversion will depend on the availability and format of available reports.
What Your Practice Does: First, you will provide PCC with a description of where your patient and account records are currently stored. Second, you will provide PCC with remote access to your existing computer system with login credentials.
What PCC Does: PCC will maintain your patients’ privacy in accordance with HIPAA regulations. Our data conversion specialists log into your existing system and evaluate the reports available to convert practice management data, which is your patient and account demographic, appointment, and charge data.
As we do this research, we will send your practice questions and sample data to review.
For most practices, PCC can retrieve your practice management data. You must request a separate clinical data export from your previous software vendor.
What Your Practice Does: Your practice will communicate with your previous vendor for help exporting the clinical data. Your practice will assist with data mapping as needed.
What PCC Does: PCC will inform you of the reports available on your system for the practice management data conversion. PCC will ask for assistance mapping data as needed.
PCC can provide a written description of the data we typically convert to help you facilitate communication with your previous vendor about the data export.
Other Important Notes
Prepare for Unexpected Costs: Your support agreement with your previous vendor may specify a cost for helping you access and export your patient data. Depending on the size of your practice, this may be a significant fee. PCC’s approach to the practice management conversion helps you avoid extra costs when possible.
Your Practice Is in Charge of Communication About Your Data Export: It is important to remember that your practice must be the manager of communication with your previous vendor. All communication occurs in the context of your practice’s existing support contract with your previous vendor, as you are their paying customer. PCC does not have the authority to deal directly with your previous vendor.
For most practices, PCC performs an initial conversion of the practice management data for review. Your practice must log in to PCC, look closely at the data and report any problems.
What Your Practice Does: Your practice will log in to PCC, review the data conversion, and report any problems. Did the practice management data come over correctly? Are patient insurance policies appearing? Do you also want to retain additional data, like the previous system’s account numbers?
What PCC Does: PCC will run an initial data conversion of the practice management data. PCC will help you log in and review your converted data.
PCC will work with you to correct issues that you found during your review. Timely and thorough examination, as well as frequent communication during this stage are vital to a high-quality data conversion.
A day or two before your go live day, PCC runs the final practice management data conversion from your previous system to PCC.
What Your Practice Does: Your practice will review the data conversion one last time. Is the practice management data ready for your go live?
What PCC Does: PCC will complete a final conversion for the practice management data. We will use the data conversion process we developed in the previous steps to import your practice’s patient and family data into your PCC system.
Authorize That Data Conversion Was Complete: For some practices when there needs to be communication between many different physicians or different office locations, PCC may ask a physician or office manager to sign a statement that the data was reviewed, and the conversion was acceptable. We do this so that all parties involved understand that the conversion was completed and reviewed, and so everyone knows that the data expected in PCC is present.
PCC trainers are available to you, usually on site at your office, for the first two days of charting in PCC EHR. This short period is your PCC “Go Live”. Once you start charting in PCC EHR, the practice management conversion is complete.
Your practice enters the clinical conversion queue once PCC receives a complete clinical export from your previous vendor. The duration of this period varies based on several factors, including how quickly vendors send the complete export.
Your previous vendor should pull the clinical data export once you have seen your last patient in your previous system. Therefore, the clinical data conversion occurs after you go live with PCC.
Until PCC has converted the clinical data, you will need to access your previous system for clinical information.
The clinical data conversion involves mapping and importing the exported data from your previous vendor. Clinical data may include labs, visit history, visit notes, and similar patient and medical data. Clinical data conversions repeat the same conversion stages as described above: evaluation, research, sample review, correction, and verification. As with the practice management conversion, PCC needs your input to ensure the clinical data is converted correctly.
Until PCC has converted the clinical data, you will need to access your previous system for clinical information. This process may take a few weeks from when your previous vendor provides the export.
What Your Practice Does: Your practice will follow the same stages as described above to complete the clinical data conversion. That is, your practice will assist with mapping, review sample data, provide corrections, verify the conversion, and communicate in a timely way.
What PCC Does: PCC will research, map, and import your practice’s clinical data into PCC. Once the data is reviewed, PCC will make corrections and complete a final import of your clinical data.
Each conversion, even coming from the same vendor, is slightly different. PCC works hard to make sure that your converted data lands in the correct location. We will communicate with you at every step along the way. As a PCC client PCC Support is available to you at any time. Please don’t hesitate to reach out.
Authorize That Data Conversion Was Complete: For some practices when there needs to be communication between many different physicians or different office locations, PCC may ask a physician or office manager to sign a statement that the data was reviewed, and the conversion was acceptable. We do this so that all parties involved understand that the conversion was completed and reviewed, and so everyone knows that the data expected in PCC is present.
Once you sign off on your clinical conversion, the entire conversion process is complete. Happy charting!
The procedure above walks through each step of the data conversion process. But what are the most important points you need to know? What are the issues that practices sometimes overlook or underestimate about saying goodbye to your previous system?
Keep Your Previous System Up and Running: You will need your existing software system for verification of data conversions, for understanding any discrepancies, and for working down your practice’s existing accounts receivable. We recommend that every practice keep their previous system tools available until several months after your final clinical conversion.
Who Knows the Previous System Best?: Who at your practice will be the go-to for information about your previous system? As PCC designs your data conversion, we will contact your practice to ask questions about logging in and other details about your previous system.
Prepare For Data Verification: Your practice will need to schedule time for verifying data conversions. We may do a series of data conversions and verifications, and your practice plays a crucial role in making sure all data is brought over correctly. We can’t do it without you!
You Are the Communication Hub with Your Previous Vendor: All responsibilities for communicating with your previous vendor rests with you.
Inform Your Previous Vendor of Your Departure: As long as your practice has a paid contract with your previous vendor, they are obligated to provide you with service. For this reason, we always recommend being up-front and direct with your previous vendor.
Data Export From Your Previous Vendor: Your clinical data conversion, and in some cases your entire data conversion, will require an export from your previous vendor. PCC can provide a list of the data we typically convert to help facilitate your communication with your previous vendor. Do not specify “all data” as vendors may skip important details, creating delays.
PCC knows that your practice’s transition will be much smoother if your new PCC system has as much useful data from your previous system as possible. Here’s a list of what we can usually convert, and what we don’t. The data in your practice’s conversion will be dependent on the reports available for the practice management data and the export received from your previous vendor.
Your PCC data conversion will potentially include the following:
Your PCC data conversion will probably also include the following, though the level of detail varies depending on the export received from your previous vendor.
PCC does not convert the following information.
Account Balances: Outstanding balances are stored in a way that is too specific to your previous software vendor. We cannot convert your accounts receivable, as the payment and adjustment history between the two systems would not match up. Keep your previous system operational until you have finished outstanding claims and personal balances.
Open Tasks: Typically we can convert order history, but only as text for reference. Open tasks will not appear in PCC. We recommend generating a report from your previous system to keep track of those tasks and when they are completed.
Audit Logs: Your previous system may track an audit log of which users viewed and edited data. User accounts cannot be brought over from your previous system, so the audit log cannot be converted. If your practice wishes to preserve your audit logs, your may wish keep a backup of your previous system or maintain a relationship with your previous vendor.
Once PCC completes your practice’s data conversion, you must review the new information to ensure that the conversion was successful. Were all patients and accounts transferred to the PCC system? Are patient demographics identical between your old system and PCC? Are some appointments missing or do any duplicates appear? Are vitals correct? Do all chart notes appear?
The sections below describe PCC’s recommended process for reviewing your data conversion. Use this article when PCC asks you to review your data conversion.
If you find discrepancies, contact PCC. If you are working in a New Client Basecamp project, please do not post Private Health Information (PHI) to that project. Instead, please refer to the patient’s PCC number and not their name. Let us know what you see in PCC EHR and what you were expecting to see. The more details you provide, the easier it will be for us to research and resolve the issue. If you find the same issue with all patients, provide a few examples (using PCC numbers).
PCC recommends that you review a random selection of patients, and that you include some patients with complex names and detailed histories.
Results May Vary: PCC designs a unique data conversion for every customer. We may not have been able to convert every item listed below, and we may have converted extra information specifically for your practice. While following the guide below, keep these potential discrepancies in mind. For more information, read Your PCC Data Conversion.
For this review, log in to the live database in PCC EHR and select fifteen patients. Open their charts, and visit the Demographics section using the anchor button on the left-hand side of the screen. Verify that the information in PCC EHR matches the information in your old system. Report any discrepancies to your PCC contact or your on-site support technician.
Information to review includes:
Billing history can be found under the History anchor on the left side of a patient’s history. Pick several patients and review:
Next, review appointments in the same live database. Pick two dates on which you have several scheduled appointments.. Do not pick a date after the appointment data was gathered from your old system, as it may be missing appointments. In PCC EHR, click on the Appointment Book icon and click on each appointment to review the full details.:
If you find information that does not match between the Appointment Book and your previous system, please track details in a separate document with the associated patient PCC number. Describe what you see in PCC and how it differs from the appointment record in your previous system.
For clinical data, please make sure you log in to the Sample database, not the live database. At the EHR login screen, click on your practice name, which should appear as a blue link. The login window will display three databases. Pick the one which starts with “Sample”. Use the same login and password for this database.
As with the patient demographics review, you should review 15 patients to review clinical data.
Open the patient’s chart and verify the following details in the chart section indicated:
When a software update for PCC is ready for your office, what should you do to prepare?
PCC EHR updates require the workstation’s administration password. Inform your in-house system administrator or office manager that each workstation will need their attention, and the administration password, on the morning of the update.
Does your practice have a local system administrator or a contract with a local IT professional who updates and services your computers? Do you implement an office-wide network, not monitored and updated by PCC, that requires administrative permissions to make changes? Contact appropriate entities so that they know a PCC update is coming.
With every software release, PCC answers client requests and implements new features and tools that can improve your office workflow and save you time. You should review the new software feature list and arrange for your staff to attend a training web lab, when needed.
Some new tools or features in PCC EHR require configuration, or may make your office’s workflow faster and easier. When there are significant configuration or software usage changes, PCC publishes a Migration Considerations document.
Once PCC schedules your update, inform all of your PCC EHR users. The PCC EHR login screen helps you out the week before the update by notifying all users that an update is coming.
Remind users to log out on the date of the update and encourage them to review the “Details” link on the login screen, which points to the PCC Release article.
The evening before your PCC EHR update, be sure and visit all the computers that use PCC EHR and log out. Completely close the login window on each workstation.
PCC recommends that all users log out of PCC EHR and close the login window whenever they are not working. PCC cannot update your software if you are not logged out. The PCC EHR application must be closed.
Once your update is complete, you may wish to return to the PCC Release and Migration Considerations documents and implement the recommended configuration changes.
Remember that PCC Support (support@pcc.com, 802-846-8177 or 800-722-7708) can help you review your setup and work with you to optimize your PCC EHR work environment.
Your practice’s PCC Server, either located in a secure cloud or in a physical server at your practice, contains the record of your A/R as well as important patient medical information. A backup protects that data from fire, natural disasters, or a server crash.
Because backups are so important, your PCC Server is configured to perform an overnight backup every night. Your server is backed up to both a secure remote location as well as a local network drive. You can also perform a backup manually at any time.
The sections below describe PCC’s different backup solutions, how to run a manual backup.
Every office is different, and PCC works to find the best backup solution depending on your location, office configuration, and other factors.
Here is a summary of PCC’s different backup solutions:
Network Accessible Storage: PCC typically installs a networked hard drive in each practice’s office that automatically backs up all data. The NAS drive is a fast, local backup that makes data recovery easy.
Remote Backup: PCC uses a secure, encrypted internet connection to backup your data on a remote server. This solution requires very little maintenance and ensures that data is encrypted and safely stored offsite.
RAID Array: If your practice has a physical server in your office, that server includes a RAID array, one or more extra hard drives that automatically duplicate all information on the server. RAID is not a backup solution and can not be used to recover deleted files. Instead, your RAID array prevents data loss in the event of a hard drive failure. One faulty drive can be swapped out for a working drive without any interruption of service.
Contact PCC Support at 802-846-8177 or 800-722-7708 or support@pcc.com to discuss backup solutions for your practice. We periodically review the technical needs of your practice to ensure your data is safe and secure from theft, natural disaster, and hardware failure.
PCC Does Not Keep a Copy or Store Your Data: PCC does not maintain a copy of your data at our central office. Your data is kept on a server and on an encrypted local storage device, both of which remain under your office’s oversight at all times. An encrypted copy is also stored at secure remote “cloud” location.
backups)When a nightly backup fails, or when you need to move a physical PCC server or shut it down for an extended period, or a major storm is due in your area, you may wish to do a manual backup of your data.
Ask PCC: You can call PCC support at any time and ask them to begin an immediate back up of your data. Please allow several hours for the backup to complete. If you anticipate needing to restore from that backup, you should stop working on your system after that backup has begun as new changes will be lost.
You can also begin a backup yourself, without contacting PCC Support. Follow this procedure:
Warn Your Staff and All Users
Tell your office staff to log off the system. Make sure everyone has finished their current task and logged off.
Open a Practice Management Window
Run the Backups Program
Run the “Backup the System” option from the System Administration menu in th Practice Management window.
You can also run backups from a UNIX prompt.
Select a Local-Only or Remote Cloud Backup
Select “S) System Image Backup” to backup your PCC server to your NAS device, which is located in your office.
Select “T) System Image Backup (also to cloud)” to backup your PCC server to both your local NAS device as well as to a remote, cloud backup service.
Wait for Backup to Finish
Depending on the option you select and the size of your practice, your backup will take from one to three hours.
Check that the Backup Was Successful
You will see a message telling you whether or not the backup was successful.
The PCC Users’ Conferences offers three to five days of pediatric practice management-focused learning opportunities, along with advanced PCC EHR and Practice Management training, financial analysis help, pediatric coding lectures, and more!
In 2023, PCC’s Annual Users’ Conference celebrated PCC’s 40th birthday in Burlington, VT. In 2024, the Users’ Conference was in Denver, Colorado. See UC 2023 and UC 2024 to watch session videos and download materials.
PCC's Coast-to-Coast UC History: The 2009 PCC Users’ Conference was held at Walt Disney World® Resort, Florida. The 2010 and 2011 conferences were in Burlington, Vermont. The 2012 PCC Users’ Conference was back at Disney. In 2013 and 2014, we returned to Vermont. In 2015, the conference was in San Francisco, California. In 2016 and 2017, PCC returned to Burlington, Vermont. In 2018, we were in Denver, Colorado. In 2019 we returned to Burlington, VT. UC Courses during 2020 and 2021 were held online using new remote conference tools. In 2022 and 2023 the conference returned to Burlington, VT, and in 2024 we returned to Denver, Colorado!
Stay tuned to pcc.com to see the schedule and get registered for next year!
In addition to PCC’s annual conference, we sponsor and take part in numerous conferences and events around the country. Come see us at your local event! Get in touch to learn more, and check out the event sections on PCC.com.
You can access some of the handouts from past Users’ Conferences here:
PCC-ers Living it Up w/ Donald and Goofy at UC 2012!
Every insurance claim in your PCC system has a unique identification number. The number appears in various reports and programs, and you can use it to improve claim tracking and payment posting.
As soon as a claim is submitted, your PCC system creates a unique claim ID. The number is submitted on the claim, along with the patient’s account number. It should appear on all resulting claim communication, though some insurance carriers have trouble distinguishing the numbers.
When you work to track down a problematic claim, you can see the claim ID number in the Claims tool, when you read ERAs as well as on many other screens.
While your PCC system can identify the Claim ID quickly and easily, different reports and EOBs may display the claim ID in different ways. Below are some examples.
For most claims, your PCC system automatically identifies the claim ID and can post incoming payments and adjustments automatically. When you need to post a payment or adjustment manually, you can use the claim ID to select it quickly.
If you can not find a claim ID for some reason, you can also search by patient name, birthdate, phone number, or other information. See Post Insurance Payments to learn more.
Use the Claims tool to prepare and submit claims to insurance companies and other payers, work on claims that could not be submitted, and review a log of submissions.
Video: Watch Submit Claims to learn more.
When you are ready to prepare and submit claims to payers, use the Claims tool in PCC EHR.
Open Claims
Open the Claims tool from the Tools menu in PCC EHR.
Click “Prepare Claims”
Click “Prepare Claims” to begin preparing your claims.
Your PCC system will review all charges that are ready to be turned into a claim.
What Makes a Charge Ready to Be Turned Into a Claim?: Encounter charges are ready to be turned into a claim as soon as you post them into PCC’s system. You also make charges ready when you select “Generate a Claim” from the Correct Mistakes (oops) screen, which you would do (for example) after you change the responsible party for charges.
Claim Scrubbing and Preparation: As your PCC system reviews charges and prepares outgoing claims, it removes duplicates; verifies patient, charge, and payer information; and checks over other details, such as whether CPT codes are valid for a given date of service. Next, it determines which payer or clearinghouse-specific configuration will be used to format the claim.
Review Claim Processing Results
When it finishes preparing, the Claims tool displays how many claims will be submitted and routed to paper. It also lists how many claims will be held, delayed, or need corrections.
Use the reference below to learn more about each of the sections and totals.
Selected Batches:
Prepared Claims:
Claims prepared to submit: Prepared claims that will be sent electronically when you click “Submit Claims”.
Claims prepared to route to paper: Prepared claims that will be moved over to a paper holding batch when you click “Submit Claims”. You can print these claims later with the hcfa program.
Claims That Will Not Be Submitted:
Claims held: Claims held due to a Claim Hold.
Claims delayed: Claims delayed due to your practice’s claim delay, usually a few days.
Claims need corrections: Claims that contain one or more problems that prevent the claim from being submitted. These claims will not leave your system until you correct the problems.
Optional: Select Specific “Batches” to Submit
If your practice divides up billing responsibility by payer, or you have another less common workflow need, you might wish to submit only a portion of the prepared claims.
Click Edit, and then select which batches you wish to submit.
What is a Batch?: A batch represents an under-the-hood custom claim configuration on your PCC system. All the claims in a batch use the same claim configuration, so a batch might be named for a large group of payers. If your practice has an unusual claim configuration need, PCC’s EDI configuration specialists sometimes create a custom batch. Your list of batches may also reflect claim clearinghouses or other entities.
Click “Submit Claims” and Confirm
When you are ready to send the prepared claims, click “Submit Claims”. Then click “Submit Claims” again to verify and proceed.
Submitting claims can take several minutes, especially when you have a large number of claims, as PCC re-verifies claim information.
Review Results
When claim submission is finished, you can review how many claims were submitted and routed to paper.
Click “Close” to close the window.
Additional Prepared Claims: If you prepared claims and then only selected and submitted certain claim batches, you can now select additional batches and submit them.
Print Paper Claims
If some claims can not be sent electronically and need to be printed, they will be “routed to paper”.
Use the hcfa program in your Practice Management windows to print paper claims.
Follow Up on Claims that Need Corrections
If a claim can not be submitted, you can find an explanation of the problem on the Needs Correction tab. See the sections below to learn more.
These claim errors must be resolved before the claim can go out.
Optional: Review Log
When you are finished submitting claims, you can use the Log tab to review the record of what occurred during claim processing.
When you prepare and submit claims, your PCC system checks for claim errors. If a claim is missing an insurance ID number or the policy isn’t active for the date of service, for example, PCC will hold back the claim.
Review claims with these issues on the “Needs Correction” tab in the Claims tool.
For each claim, you can review the patient, the date of service, the insurance plan, and the reason the claim could not be submitted. You can use the Search Filter to find specific claims or issues affecting multiple claims.
These claim errors must be resolved before the claim can go out. For example, you may need to update patient, account, or charge information. As these claims have yet been submitted, you do not need to file a “corrected claim” or include a payor claim control number. You can fix the problems and then return to the Submission tab to prepare and submit claims again.
Double-click on a claim to work on it.
You can see encounter details and the reason the claim cannot be submitted. The window also displays suggested instructions for correcting the issue.
To get a better understanding of the problem, you can click a disclosure arrow to review patient, account, and policy information.
Use the buttons at the bottom of the screen to open different tools and resolve the issue. You can jump to the patient’s demographics, for example, if you need to edit certificate numbers or start and end dates for the policy assigned to the claim.
If you need to change the responsible party and generate a new claim, you can use the Correct Mistakes tool.
When you are finished making corrections, you can click “Close” or “Next” to continue on to the next stuck claim on your system. PCC EHR will revalidate the claim and check if you have resolved the issue. If there is something else wrong with the claim, PCC EHR will let you know.
If in the process of fixing the problem you generate a new claim, you can delete the old one that is waiting on the Needs Correction tab.
Read Claim Error Reference to learn about each possible claim processing error and how to fix it.
Use Other Reports: You can also find stuck claims in the “Bad Claim Report” in the EDI Reports (ecsreports) tool. Or, you can use the SRS “Claim Error Report” to track down both claims that could not be submitted and claim rejections. Read Work On Claim Errors and Rejections to learn more.
After you update the patient and/or charge record, click “Validate” to recheck all claim information.
If there are additional problems with a claim, you will see the newly discovered issue in the “Reason” column. If a claim is now ready to submit, the Status will change to “Validated”.
You can filter the list of claims on the Needs Correction tab to see claims that need corrections or are validated.
After you fix the problems with claims on the Needs Correction tab, you can prepare and submit claims on the Submission tab. Clean claims will then be processed and sent, and the Needs Correction tab will refresh with any new issues that need your attention.
If you fix an issue and need to generate a new claim for an encounter, you may need to delete the old claim. For example, after you generate a claim for a different insurance policy, you can select the old claim on the Needs Correction tab and click “Delete Claim”.
Deleting a claim on the Needs Correction tab will only remove the claim. The charges will remain on the account.
Where Do I Change the Responsible Party for Charges and Generate a New Claim?: If a claim is pending the wrong insurance policy, you can use the Correct Mistakes (oops) tool to change the responsible party for the charges and then queue up a new claim. See Change the Responsible Party and Copay for Charges.
When you use PCC EHR to submit claims, you can use the “Log” tab in the Claims tool to review the details of a claim submission. You can also review which claims were held, delayed, needed corrections, or were routed to paper.
The Log tab displays a record of all claim submissions run from PCC EHR, filtered by year. In addition to date and time, you can see which user at your practice submitted the claims and how many claims were held, delayed, needed corrections, were routed to paper, and were submitted. If only some batches were submitted, you can see how many under the Batches column.
Where's My Log?: The Log tab displays claim submission sessions submitted from PCC EHR. If you prepare claims but do not submit, the Claims tool will not add a record to the Log tab. Also, if your practice sometimes uses the previous Practice Management tool to process and submit claims, those submissions will not appear in the logs.
Double-click on a session log to see more information.
On the “Claims – Submission Session Log – View” screen, you can review details about each claim that was processed during the claim submission. If the user prepared and submitted multiple batches during the same session, they can use the drop-down menu in the upper-left to select and review each submission.
Use the Search Filter to find claims by name, date of service, insurance plan, batch, or claim ID.
To see details about all claims held due to a claim hold, select “Held” in the session drop-down menu.
Your practice can configure custom claim holds based on dates of service, billing providers, and insurance plans.
If your practice uses a customizable claim delay, select “Delayed” from the session drop-down menu to see claims that were delayed.
You can review the details of claims that didn’t go out because the claim delay period had not yet passed. The claim delay period is displayed in the upper-right corner. Typically, practices ask PCC Support to configure a claim delay period of a few days, in order to ensure enough time has passed for charges to be reviewed before claim submission.
If PCC’s claim processing found problems with claims that prevented them from being submitted, you can review these issues by selecting the Needed Corrections option.
You can see all claims that could not be submitted at the time of the submission. You can use the Needs Correction tab to work on these claims, but this log lets you review what the system found at that time. See Work on Claim Errors and Rejections and Claim Error Reference to learn more.
These issues must be resolved before the claims can go out. For most problems with an outgoing claim, a biller updates patient, account, or charge information. If this alters the responsible party for the encounter, they may need to edit the insurance information for the charges, generate a new claim, and delete the old claim. See the sections above to learn more.
If some claims needed to be routed to a paper batch for printing, you can select “Routed to Paper” to review details.
To generate and print paper claims, use the HCFA Form Generation program in your Practice Management windows.
When you receive an insurance payment reversal or “takeback” on an ERA or EOB, use the Insurance Payments tool to quickly reverse the payment so you can then post the corrected payment and adjustment amounts.
Video: Watch Reverse an Insurance Payment (Post a Takeback) to learn more.
Open the Insurance Payments Tool and Find the Patient
Open the Insurance Payments tool and find the patient for the takeback.
Select the Payment the Payer is Reversing
On the History tab, find and select the payment that must be reversed.
You can use the Search Filter and the disclosure triangles to ensure you have identified the payment and adjustment indicated by the payor.
Click “Reverse Payment”
After you’ve selected the correct payment and adjustment, click “Reverse Payment”.
Update the Transaction Date and Select a Transaction Type
On the Reverse Payment screen, optionally update the transaction date for the reversal. Then select an appropriate Transaction Type, such as a “Takeback” adjustment.
As you finalize your selection, you can use the original payment details on the screen to double-check that you are working with the correct encounter.
Click “Save” and Review
Click “Save” and review the outcome of the reversal.
The payment will be reversed and any adjustment(s) will be deleted. The encounter charges will pend the original payor.
Back on the History tab, you can review that the original payment has been struck through, with the date and reversal transaction listed in the Refunds/Reversals column.
Post Updated Payments and Adjustments, or the Denial, and Add an Account Note
Now that you have reversed the original payment and deleted any associated adjustments, you can return to the Posting tab and post updated payment and adjustment information provided by the payor.
Typically, an ERA or EOB that indicates a reversal also includes updated adjudication information for the encounter. For example, if the patient was not enrolled, you can post the rejection or denial.
As you post the updated payor response, you can use the components on the screen to update policy information, contact the family, and record additional details about the reversal in Account Notes.
Reapply the Money “Taken Back” or Send a Check
After you post a takeback, you can continue posting any remaining payments for other encounters that appear on the same ERA. Often, the takeback amount was accounted for in the check’s total. When you run reports to review posting, you will see the takeback among the other payments. Finally, in some cases you may be required to mail a check to the insurance company.
If you post a takeback incorrectly, you can use the Correct Mistake (oops) program to unlink the original payment from the Insurance Takeback, delete the Insurance Takeback, and then link the payment back to encounter charges.
When you post an insurance payment reversal or “takeback”, you select a Transaction Type to record the event.
Your PCC system should already have an “Insurance Takeback” or “Insurance Reversal” transaction type, which you can pick from the drop-down menu.
If you need to edit or update the available transaction types, use the Procedures table in the Table Editor (ted). All procedures with an accounting type of “Receipt – Refund” will be available in the Transaction Type drop-down menu when you post an insurance reversal. For help making changes, contact PCC Support at 802-846-8177 or 800-722-7708 or support@pcc.com.
You may receive an insurance reversal for a payment you posted to an overpayment holding account. If so, you can post a refund to that account and link the payment to that refund, releasing the amount to either be sent back to the insurance company or applied to charges on the new ERA.
Read how to Post and Refund Insurance Overpayments.
You can review insurance reversals, along with all payments and adjustments, on the daysheet report. Run daysheet, choose the “wide” report, and review the payment column.
Insurance reversals do not show up on the deposit report. Posting the reversal along with other payments on an ERA will increase the day’s deposit total, but deposit does not display “negative” payments. When you perform an insurance takeback, you should note this variance and share your actions with the other billers in your office. You can use the daysheet report to ensure your end-of-day numbers match expectations.
PCC’s insurance billing tools help you process and prepare claims, send them electronically or print them, review rejections and denials, fix problems and resubmit, and work down your insurance accounts receivable. You can maximize the use of your time as you pursue proper payment.
Learn All Steps for the Biller Role: For a complete guide for billers, see New User Training for Billers. You can use that outline to learn how to complete all billing tasks in PCC EHR.
Here’s an overview of the insurance billing process with PCC:
Ensure All Charges Are Posted
Before you bill insurance, your practice can use PCC’s tools to post charges and then review that all charges were posted.
Generate and Submit Claims
Next, your practice submits claims electronically. In unusual circumstances, you may need to print some claims.
Work on Claims that Can’t Be Sent or Were Rejected
As you process your claims, your PCC system checks for errors that prevent claims from being sent. You can work on those claims inside the Claims tool. Later, you can use other PCC tools to correct rejected claims.
Post Insurance Payments and Adjustment (and Submit Remaining Charges to the Next Responsible Party)
When your practice receives ERAs and EOBs from payors, you can automatically post most payments and adjustments and then manually post any that need your attention. When payments and adjustments do not cover the full amount of a charge, or the payer sends an unusual adjustment or denial, you can fix account problems and resubmit the charges, send them to a secondary policy, or bill the family.
Work on Outstanding Claims
While the above steps should ensure that every claim is accounted for, you can use PCC’s reporting features to track your accounts receivable and follow-up on old unpaid claims and ongoing problems with payors.
PCC includes hundreds of customizable reports. For working on old insurance A/R, PCC recommends you use the Insurance Accounts Receivable Summary (insaging) report for an overview, and then use the Insurance Accounts Receivable Detail (inscoar) report to analyze specific claims based on insurance company, provider, or other criteria.
Correct Mistakes and Recreate Claims
During any of the above steps, or even before you first submit a claim, you may need to fix a problem with a charge and recreate the claim. For example, if you find the account has a new insurance plan or was responsible for a larger copay, you can use the Correct Mistakes (oops) program to change the details of the charge and then re-batch the claim to the new payer. In rare cases, you might use the maketags program to re-prepare a large batch of claims based on a date range, a provider, or other criteria.
PCC automatically checks insurance eligibility for all upcoming appointments. You can also review a patient’s eligibility as you schedule, during Patient Check-In, or at any time.
Do You Trust Automated Electronic Eligibility in PCC EHR, or Do You Have to Visit a Payer's Web Site?: PCC wants automated eligibility to be 100% reliable, the perfect tool to give 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 notify PCC Support at 802-846-8177 or 800-722-7708 or support@pcc.com. Let us know so we can track down and correct the issue.
Here are some important notes about verifying eligibility in PCC:
Not All Carriers: Not all insurance carriers support electronic eligibility, and different payers support it to varying degrees. PCC keeps track of your carriers and will configure your practice for all that are available. To request help setting up an EDI connection with a payor, contact PCC Support.
Automatic Real-Time and Nightly Eligibility Reports: PCC checks eligibility as soon as a patient is scheduled or whenever you change demographic information or update an active insurance policy for a patient with an appointment. If you schedule a sick visit today or change appointment information, PCC will immediately check eligibility.
Check Manually at Any Time: You can also request an instant eligibility update at any time. If you haven’t scheduled an appointment, PCC will request eligibility for today’s date. If you’re working in the context of an appointment, you can recheck eligibility during Patient Check-In or in the Insurance Eligibility tool. (Note that if an insurance company does not support instant eligibility requests, PCC displays a batch request result, usually answered from the previous evening.)
Who Will Check Eligibility?: Your practice can confirm eligibility a day or two early, and/or your front-desk staff can recheck eligibility at checkin. You can work with your New Client Implementation specialist or PCC Support to figure out the best eligibility workflow for your practice.
Use the Insurance Eligibility tool to review and confirm eligibility for upcoming patient encounters. You can find it in the Tools menu.
The Insurance Eligibility appointment list shows all scheduled appointments for the next day, but you can select any date.
You can see if a patient is active or inactive in the Coverage Status column. You will see an “n/a” if eligibility is not available electronically for an insurance carrier or if the patient is not insured (self-pay). “Unknown” means that an error occurred when eligibility was last checked, or the payer returned an uncertain reply. If the field is blank, eligibility has not yet been checked.
Click “Request Eligibility” to request an eligibility update for all visits that either have not yet had eligibility checked, or that received an error when the request was previously made.
After responses arrive, you can work with individual records. Double-click on an encounter to open the Review and Verify window.
On the Review and Verify window, you can review information sent back from the insurance payor along with general information about the patient’s policy and demographics.
Select a “Status” to mark the encounter’s eligibility status as reviewed. Enter a note if needed. Then click the “Save + Next” button to move to the next patient.
Read the Understand Eligibility Responses, Errors, and Reports section below to learn how to read the payer’s response and any eligibility errors you may encounter.
Configure Your Custom Review and Verify Ribbon: The Insurance Eligibility – Review and Verify window includes the Insurance Eligibility component, Policies, and other useful components. You can add other components to this ribbon in the Insurance Eligibility Builder within the Protocol Configuration tool.
In addition to using the Insurance Eligibility tool (which shows each day’s encounters) your front desk staff, clinicians, and billers can review patient insurance eligibility at other times.
You can check a patient’s insurance eligibility before you schedule using the Insurance Eligibility component. When you are scheduling an appointment, for example, you can use the component in the Patient Details ribbon.
When you click “Request Eligibility”, PCC will contact the payor and retrieve any available eligibility responses using today’s date as the date for the encounter. If the payor responds, PCC EHR will display the “Active” or “Inactive” result.
If you wish to review the complete eligibility report from the payor, click “Edit”.
Eligibility For Future Appointments: When you request eligibility without a scheduled appointment, the payor returns eligibility information for today’s date. The patient may not be eligible for future appointments.
Your front desk staff can verify eligibility when a patient checks in. By default, an Insurance Eligibility component appears on the Patient Check-In ribbon.
When you first open Patient Check-In, PCC EHR will automatically check eligibility. If your front desk adds a new policy to a patient, PCC EHR will check eligibility automatically. You can also click “Request Eligibility” to manually refresh eligibility (for example, if you changed the Date of Birth or other information about the policy or patient).
Read the Understand Eligibility Responses, Errors, and Reports section below to learn how to read the payer’s response and any eligibility errors you may encounter.
Your practice can add the Insurance Eligibility component to chart note protocols. Then a clinician can review eligibility during the context of working with the patient during an encounter.
When the chart note is opened, Insurance Eligibility is displayed in view mode. You can make changes by clicking the “Edit” button.
Read the Understand Eligibility Responses, Errors, and Reports section below to learn how to read the payer’s response and any eligibility errors you may encounter.
When the biller posts charges for an encounter, they can review and update a patient’s insurance eligibility on the Patient Details section of Post Charges in PCC EHR.
Billers can check insurance eligibility for scheduled appointments, as well as billed phone note and portal message encounters.
Post Charges is the only place where it is possible to verify insurance eligibility information for billed phone note and portal message encounters. It is not possible to record eligibility notes or verification statuses for phone note and portal message encounters.
Read the Understand Eligibility Responses, Errors, and Reports section below to learn how to read the payer’s response and any eligibility errors you may encounter.
Whenever you review the eligibility information for a patient’s encounter, you can optionally select a Status and enter a date.
This “Verification Status” is a useful note to your practice that you’ve reviewed eligibility for the encounter. It will appear wherever your practice sees eligibility information for the encounter. It also appears in the “Verification Status” column in the main Insurance Configuration tool in PCC EHR.
If you update a patient’s insurance information or other demographic information, click “Request Eligibility” to submit a new request to the insurance carrier. The request will run in the background, so you can continue to work on the screen while the eligibility request is processing.
You can use the information and tools inside the Insurance Eligibility component to review the response from the insurance payer and then mark the encounter’s eligibility with a status.
Whether you are looking at the Insurance Eligibility component inside the Review and Verify window, during Patient Check-In, during Post Charges, or on a patient’s chart note, the tools are the same.
When a patient has multiple insurance plans, each plan will be displayed within a separate bubble. Each eligibility request is performed independently.
The Eligibility Response field will display “Active” in green, to indicate that the patient is covered, “Inactive” in red, meaning that the patient is not currently covered, or “Eligibility Undetermined” if the payer’s response is not sufficient to make a determination.
In some cases, such as when the eligibility request could not be submitted, you might also see a response of, “The eligibility request cannot be submitted.”
Whatever the Eligibility Response, you can read Alerts, Explanations, and Actions to know what to do next, and click to review the payers Summary Report and Full Report, when available.
When an error has occured, PCC EHR explains the error 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 click “Request Eligibility” to 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 also summarizes more complex responses from the payer, and then provides the full payer report, when available.
If the payer has responded to the eligibility request, you can usually read a Summary and/or Full Report.
Click the disclosure triangles to see full details from the payer.
When a clearinghouse fails to process and acknowledge your claims, or claims for a specific payor or date range fail, you may need to create and submit new claims for a large number of encounters. You can use PCC’s under-the-hood Resubmit Claims (maketags) program to queue up new claims for encounters.
Maketags is a Power Tool: Only use maketags in those rare cases when you need to resubmit a large number of claims based on a date of service or other criteria. You can create a new claim for any single encounter from the Correct Mistakes (oops) program (see Resubmit a Claim).
Video: Watch Create New Claims and Resubmit to learn more.
maketagsWhy would you need to find and resubmit a large batch of claims?
ted), you need to find every claim that had this procedure code and resubmit.
Use the Correct Mistakes (oops) program to resubmit single claims. Use maketags to queue up claims for a large number of encounters.
Follow the procedure below to create new claims for encounters.
Have You Fixed the Problem?: The maketags program is powerful, but it does not address outstanding billing problems and will not increase revenue. Before you run maketags to create new claims, you should understand why claims were rejected (or need correction) and adjust your configuration or use other PCC tools to work on unpaid claims. Contact PCC for help.
Run Resubmit Claims (maketags)
Run the maketags program from your Practice Management windows.
Select Criteria
Use the criteria options to tell maketags which charges you need to resubmit.
Include Entire Visits?: When the Resubmit Claims tool finds encounters matching your criteria, do you wish to resubmit only the unpaid charges or all charges for each encounter? If the “Include Entire Visits” question is set to No, then only procedures that meet your chosen criteria will appear on the new claims. If the question is set to “Yes”, then all charges for the matching encounters will appear on the resulting claims.
Press F1 – Find Claims
If a criteria option requires more information, you will be asked to make additional selections.
Review Total and Optionally Review List of Encounters
You will see the total number of encounters that match your criteria.
Press F8 – Show List to review or print the list of encounters that maketags found.
Press F1 – Create Tags to Create New Claims
After the claims are batched, you can prepare and submit your practice’s claims.
Do you need to resubmit all claims with a certain billing status, procedure, place of service, or for accounts with a specific status flag? Use the “Restrict with SRS” function to create more detailed custom restrictions.
Override Criteria: When you use the “Restrict with SRS” function, all of the criteria you specify on the first screen will be overridden by the advanced restriction options you select using the SRS screens as described below.
Follow the procedure below to create new claims for encounters based on SRS criteria options.
Run Resubmit Claims (maketags)
Run the maketags program from your Practice Management windows.
Indicate Whether or Not to Include the Entire Visit
When the Resubmit Claims tool finds encounters matching your criteria, do you wish to resubmit only the unpaid charges or all charges for each encounter? If the “Include Entire Visits” question is set to No, then only procedures that meet your chosen criteria will appear on the new claims. If the question is set to “Yes”, then all charges for the matching encounters will appear on the resulting claims.
Press F5
Press F5 – Restrict with SRS.
Indicate Whether to Include Charges Regardless of Balance
Indicate whether to include only charges with a balance due or all charges regardless of the balance.
Enter a Date Range
Enter a date range within which PCC will search for encounter charges to resubmit. Indicate whether to use the date of service (“Transaction Date”), or the posting date. Press F1 – Generate Report to continue.
Select Insurance Plans
Next, specify the insurance plans for which you need to create new claims.
Press F2 – Select to select individual plans, press F5 – List By Group to quickly select a group of plans, or select by the pattern of your choice using F6 – List By Pattern. Press F3 – Select All to include all insurances and all personal charges.
After you finish selecting plans, press F1 – Process to continue.
Create Claims for Charges Pending Personal?: Do not select “Personal” unless you want to create new claims for encounter charges that are currently pending the patient or family.
Review Criteria
Review your chosen search criteria.
Optional: Select Additional Criteria
If you wish to restrict by billing status, provider, place of service, or another criteria, press F8 – Add/Edit Criteria. Then add as many criteria as you need.
You can use the asterisk (*) symbol to view a list of available criteria.
Press F1 – Accept Criteria to continue.
Optional: Enter Restriction Details for Additional Criteria
For every criteria, PCC will ask you for specific details. Select your desired criteria from each screen and press F1 – Accept Criteria to continue.
In the example above, the user added the “Current Billing Status” criteria to the report, and selects the status of “Claim Generated”. By using this criteria, you can find all encounter charges for which a claim was submitted but never acknowledged.
Review and Accept Criteria
Once you have added all of your restrictions, press F1 – Accept Criteria to accept your criteria. Your PCC system will gather encounter charges based on the criteria you specified.
Review Results and Queue Up New Claims
Once you have added all of your restrictions, press F1 – Accept Criteria to accept your criteria. Your PCC system will gather encounter charges based on the criteria you specified.
Review Total and Optionally Review List of Encounters
You will see the total number of encounters that match your criteria.
Press F8 – Show List to review or print the list of encounters that maketags found.
Press F1 – Create Tags to Create New Claims
After the claims are batched, you can prepare and submit your practice’s claims.
Save Frequently Used Criteria: As with other srs-based reports, maketags criteria can be saved and reused. If you commonly rebatch claims for one particular insurance or procedure, for example, you may want to save the detailed report criteria you entered and restore it the next time you need to resubmit claims. After entering your criteria the first time, press F5 – Save Rpt Criteria on the summary screen. When you next need that same criteria, press F8 – Restore Criteria from the first srs criteria screen.
Read below to learn more details about the criteria options shown on the first screen in the Resubmit Claims (maketags) tool.
SRS Reporting Ignores These Criteria: If you use F5 – Restrict with SRS, the criteria options in this reference will be ignored.
Under most circumstances, you only want to recreate claims if they are unpaid and still pending an insurance company. You may occasionally need to create batches for an entire insurance company, regardless of whether or not there is an outstanding balance. Use these settings to select which charges, based on pending and paid statuses, maketags will batch:
If you select “Just One Plan,” you can choose the insurance plan of the claims you wish to resubmit on the first screen:
If you leave the default of “Many Plans” selected, however, maketags will ask you to select the insurance plan or plans when you press
F1 – Generate Report
.
Press Page Down, Page Up, or the up and down arrow keys to select the desired plan and press F2 – Select to mark it. If you want to submit claims from all insurance plans, press F3 – Select All.
Press F1 – Process after you have selected all the needed plans.
Use Groups: Select the “Group” heading at the top of a list of plans to select the entire group. You can also press F5 – List By Group to view all of your insurance groups. By selecting groups instead of individual plans, you can very quickly pick out the different insurance companies whose claims you need to resubmit.
List By Pattern: Press F6 – List By Pattern to search for a word or number, such as “Aetna” or a PO Box number. You can then select plans from the list of results.
You can sort and resubmit charges for all providers or for specific providers. This comes in handy if you use the wrong provider ID# for a period of time and you need to resubmit all the claims from that time.
Change the “All Providers” field to “No” and press F1 – Generate Report to select a specific provider.
On the provider selection screen, use the arrow keys and press F2 – Select to pick providers or provider groups. Then press F1 – Process to continue.
After you submit claims, your practice will receive clearinghouse and payor acknowledgements as well as ERAs and other electronic notifications from PCC, claim clearinghouses, and payors.
You can use tools in PCC EHR to review these responses. When you need to do deeper research, you can use the EDI Reports (ecsreports) program, which holds a library of all “Electronic Data Interchange” reports sent to your practice.
Learn All Steps for the Biller Role: This article is part of the New User Training for Billers. You can use that outline to learn how to complete all billing tasks in PCC EHR.
To view an encounter’s claim history, including the log of submission, acknowledgements, and all responses, visit the Billing History of the patient’s chart.
When an electronic record is available for a claim event, you can click on a link to open it.
Read Review an Encounter’s Billing History or Work on Claim Errors and Rejections to learn more.
To review the complete details of a claim response from a payor, open the Electronic Remittance Advice Tool in PCC EHR.
ERAs provide the details about the payor’s adjudication, including payments, adjustments, denials, and unusual circumstances. Read the Read ERA 835s from Payors article to learn more.
In addition to the communication you can review in context in PCC EHR, the EDI Reports (ecsreports) tool logs communication from clearinghouses, payors, and your third-party bill printing service.
Open the ecsreports program in your Practice Management windows.
Reports are grouped together by the date they were received, with the most recent delivery date appearing at the top. Press F8 – List By Type to review reports by type instead. For each report, you can see the title or type, the general category, the time it was received, and how many times it has been printed.
Your office can use this screen to review the history of EDI-related communication sent to your PCC system. If your practice prints ERAs, Bad Claim reports, or other claim responses you can use the “Times Printed” column to facilitate that workflow.
Reports Recycle: Because your practice receives thousands of reports every year, ecsreports does not keep all old reports on your system. Instead, reports will remain on the system for one to two years. If you would like to change the length of time that EDI reports remain on your system, contact PCC Support.
Select any report and press F1 – View Selected to read it.
While viewing a report press Page Up or Page Down to scroll.
You can select more than one report in order to view them all at once in the same window:
Select any report and press F2 – Print Selected to print it.
Press F8 – List By Type to see reports grouped by type. Reading and searching through a specific report type may be more convenient than viewing all the reports from a specific date.
The “By Report Type” screen displays all report types stored on your system. To view all available reports of a certain type, select the type and press F1 – Select Type. Press F12 to return to the listing by date.
While viewing a report or multiple reports, press F8 – Search Pattern and enter text to perform a search:
After typing your search value, press Enter to scroll to the first matching value.
Matching items will be highlighted on the screen, and you can press F7 – Search For Next to scroll through all matching results.
You may need to search through multiple reports for a name, certificate number, or other identifier. You might know in which report the information is located, or on what date you received the information.
Select Reports to Search
Select all the reports you would like to search:
Press F6 – Search Selected
Press F6 to begin your search.
Enter Search Text
On the File Search screen, enter the text for which you wish to search and press F1 – Process.
Whole Words?: If you wish to find your text pattern only as a whole word and avoid results that contain your text pattern as part of another word, change the “Search on whole words?” question to “Yes.”
Select Specific File From Results
The ecsreports tool will list all the files from your selection that contain the text for which you searched.
Select an individual report to review or press F3 – Select All to select all reports that contain your search pattern. Then press F1 – View Selected.
Review Result, Jump to Next
The ecsreports tool will display the first matching result. The search text will be highlighted:
Press F7 – Search For Next to scroll through each matching result.
Optionally, Change Search Pattern
Press F8 – Search Pattern to change the search pattern. You will continue to search the same files you selected in step four above.
Here are some reports you may find in the ecsreports program, along with sample text.
preptags/tagsplit Bad Claim ReportBad Claim Report Generated On: March 11, 2005
Date: 03/10/05 PCC #: 243 Patient: Pebbles Flinstone
Guar PCC#: 751 Cus PCC#: 751
Claim is for an insurance company no longer on the account
Charge filed with: Cigna $0
In the example above, a claim was rejected because the insurance company (Cigna $0) was no longer listed on the account. The insurance information was probably updated by another user, and the claim probably needs to be pended and re-batched in oops. It may already have been re-batched, but you should review the account to be certain.
Run date: 20050310 Batch: PCC – Aetna Claims 03/08/05 * $ 111.00 – Flinstone, Pebbles 03/08/05 * $ 165.00 – Doe, Johnny 03/07/05 * $ 111.00 – Crusher, Wesley 03/08/05 * $ 81.00 – Duck, Louie Total claims processed: 4 Total claim charges: $468.00
The report excerpt above shows four claims that were sent out in the Aetna insurance batch on 3/10/05.
ecsreports. Your system receives the log within 48 hours of submitting claims. The report indicates that your connection to PCC was active and provides a “paper trail” proving that each claim passed through PCC’s central claim system. Your PCC system automatically parses this report and adds a note to each account history to indicate the claim was received by PCC, so under normal circumstances there is no need to review this report directly.
PCC CLEARINGHOUSE
DAILY SUBMISSION SUMMARY
FILE PROCESSING DATE: 03/11/2005
*******************************************************************************
030501021 BEDROCK PEDIATRIC PRACTICE CLAIM BILLING DATE: 03/10/2005
*******************************************************************************
PATIENT / CLAIM PATIENT NAME CLAIM
ID NUMBER LAST FIRST MI FROM DATE CHARGES
***************** ****************** ********** * ********** ********
AETNA HMO 15 PAYOR ID: 60054
243 10077 FLINTSTONE PEBBLES 03/08/2005 111.00
AETNA EPO 10 PAYOR ID: 60054
394 10078 DOE JOHNNY 03/08/2005 165.00
AETNA PPO 8 PAYOR ID: 60054
848 10079 CRUSHER WESLEY 03/07/2005 111.00
AETNA POS 20 PAYOR ID: 60054
1068 10080 DUCK LOUIE 03/08/2005 81.00
030501021 TOTAL CLAIMS: 4 CHARGES: 468.00
The above section shows that PCC received and processed four Aetna claims On March 10, 2005.
ecsreports.
ecsreports tool. The provider of these services was originally known as RelayHealth, but has since been named and renamed Diamond and OSG. The reports your practice may receive from OSG include:
File Receipt Report: OSG’s acknowledgement of receiving an ebills submission file from your practice’s system.
Remote Statement Processing File Summary: OSG’s report of the total number of accounts, pages, and returns generated for a given ebills submission.
Suggested Address Correction Report: An error report sent by OSG when an address needs to be changed. In some cases, OSG will correct the address automatically, or it may indicate that a bill was “marked by USPS as unsuitable for delivery of mail.”
Hopefully your practice can submit almost all of your claims electronically. Some claims must still be printed on paper, however.
Read the Submit Claims article to review the basic steps of submitting both electronic and paper claims.
This reference article will help you better understand your paper claims, and provides details and options available in the under-the-hood hcfa program, found in Practice Management.
Why would you need to print a paper claim?
Secondary Claims That Require EOB: In some cases, a secondary claim requires a copy of the EOB from the primary payer, and therefore can not be submitted electronically. You will need to print out the claim and staple a copy of the EOB to it.
Unusual Rendering Provider Situations: When a charge is posted to a non-provider, such as the “Office” provider or a nurse, you may encounter a situation where a claim can not be submitted electronically. You should speak with PCC Support for help configuring which providers are valid for electronic submission. Whenever you add a new provider, inform PCC Support so they can properly configure your provider for electronic claim submission.
There are three ways to generate a paper claim form in PCC’s software:
Use the HCFA Form Generation Program: Use the hcfa program, described below, to print batches of claims that need to be printed on paper.
Generate a Single Claim: Press F2 – Generate Claim in the Correct Mistakes (oops program and then select charges to appear on the claim. You can print single paper claims from many Practice Management screens, including checkout, pip, or oops. You would use this same key to generate or regenerate either a paper or electronic claim.
For more information, read Correct a Claim: How to Fix and Resubmit…
Force Print Claims Based on Criteria: Contact PCC for help using maketags to find and force claims to print, based on criteria, and override your payor-specific configuration settings. This is not a common need. For more information, read Resubmit Batches of Claims.
Run the hcfa program when you need to print an entire batch of paper claims. As hcfa runs, you will see a number of messages on the screen. Review the steps below to learn more about each step.
Open the HCFA Program
Select the Print Paper Claims (hcfa) program in the Insurance Billing & Collections section of your Practice Management window.
Review and Select Claim Batches
When you run hcfa, you are first presented with a list of batches.
On this screen, you can review the number of waiting claims, the date the batch was last printed, and the name of each batch. Select any batch and press Enter to begin printing.
Is that the Number of Claims that Will Print?: The number of claims in this list does not represent the exact number of claims that will print. When you select a batch and press Enter, PCC processes the claims and may discover that some of the claims no longer exist, were printed and submitted earlier, reference charges that have been deleted, or reference charges that have been corrected and regenerated (creating an unneeded duplicate tag).
What are the ECS Batch Lines For?: The hcfa program can generate paper claims for any set of claims waiting to be submitted. You can even print out claims that are supposed to be submitted electronically by selecting one of the “Z_ECS” lines listed in hcfa. This is not recommended and should only be done in an emergency (i.e., your internet connection is down and a timely filing limit is approaching). Even then, it is probably preferable to run oops and print the claims you need one at a time.
Review Claims as They Are Prepared
The hcfa program processes all of the tags waiting in the batch you chose. You will see a message listing the claims:
I am getting ready to process the claims.
I am now processing the claims.
Flinstone, Pebbles 07/01/04 $ 50.00 B MEDICAID
Flinstone, Bam Bam 04/02/04 $ 50.00 C MEDICAID
Canning, John 03/03/04 $ 26.00 C MEDICAID
I am done processing the claims, and am ready to print them.
Optionally Print a Test HCFA 1500
Next, hcfa gives you the option to print a sample form to make sure your paper is properly aligned. This is especially important if you print HCFA 1500 forms on a pin-fed printer.
I can print a test form for you, so that you
can check the alignment of the paper.
Do you want a test MEDICAID form printed (yes or no)? Yes
Do you want another test MEDICAID printed (yes or no):
You can print as many test forms as you need.
Confirm You Are Ready to Print
The hcfa program double-checks that you are ready to print your claims. You can type “No” and then follow the prompts to quit, or type “Yes” to print out your claims.
I am all ready to print these MEDICAID forms. Are you?
If you say yes, I will print them, otherwise I won’t:
Confirm Printing Was Successful
In case there was an error while printing, hcfa asks if the claims printed successfully. You should wait until the claims finish printing and review them before answering “Yes” to this question.
Here Goes… I am printing the forms.
Are you satisfied with the MEDICAID forms printed? If you are,
I shall clear out the queue for this type of form. If you are
not, I will give you another chance to print them.
Are you satisfied with the MEDICAID forms?
Print a Log of Which HCFA Forms You Printed: A log of all the HCFAs generated will automatically print out when you quit the HCFA program.
Your PCC system stores a record of the last printing of each HCFA Batch so you can easily reprint it. At the bottom of the list of batches, you will find options to reprint the last run of each batch:
If you need just a log of the last batch printed, but do not need to print the batch itself, simply select the “Reprint…” option for the needed log, and then answer “No” to the subsequent questions (do not print any claims). Upon quitting the hcfa program, the log will reprint.
How is a claim created, and what happens in the background to make sure your practice is paid? Read below to learn some of the “under the hood” workings of claims with PCC.
First, a clinician sees a patient. They create orders and enter diagnoses on the chart note, and they also add billing details and select visit codes on the Bill screen in PCC EHR. (learn more)
Next, either the front desk or a biller reviews those diagnoses and procedures and posts them as charges. PCC queues up those charges and creates a claim tag, an under-the-hood entry which contains a collection of charges that are ready to be turned into a claim. (learn more)
Your practice creates claim tags in other ways, too. When you fix a problem with a charge, such as changing the responsible party, you also generate a new claim, which creates a new claim tag. As another example, a new claim tag is created automatically when you post payments and adjustments and the remaining balance pends the next responsible party.
Next, your practice uses the Claims tool in PCC EHR to transform claim tags into outgoing claims. (learn more)
Your PCC system sorts the tags, checks for errors, filters out claims that should be delayed or held, routes certain claims to be printed on paper (when needed, learn more), and then sends electronic claims to PCC for routing.
Claims travel through additional verification on PCC’s servers. Then we route them either directly to the payer or to a claim processing clearinghouse, which then directs the claim to the payer.
Next, the payer adjudicates the claim. They send payment and adjustment details back through PCC and into your system as an ERA (electronic remittance advice). You can post most ERAs automatically and enter any denials or unusual responses manually. (learn more).
During the above steps, your PCC system logs errors, acknowledgements, rejections, and other reports sent by claim clearinghouses and payors. Your practice’s billers review those logs and other “EDI responses” (learn more). They use PCC tools to fix claims that need corrections and respond to rejected claims (learn more). Other PCC reports help your practice track down any unpaid insurance A/R (learn more).
For more information, or for help understanding how claims are created or why a claim can be rejected, contact PCC Support at 802-846-8177 or 800-722-7708. PCC also hosts free interactive web labs where you can ask billing, coding, and practice management questions.
PCC's Pre-Submission Claim Error Scrubbing: When you process claims, PCC “scrubs” them, checking for common errors that would prevent the claim from being accepted and paid. Your system stops those claims and lets you correct the problems before they are sent. Check out the Claim Error Reference to learn what claim details are verified on claims during processing.
Under-the-Hood Vocabulary: When you speak with PCC’s EDI teams, you may hear references to tags (which are queued up claims on your PCC system), and the underlying tools that manage tags, interface with your practice’s custom needs, and turn tags into claims (preptags, tagsplit, splitconfig, and consorttags). If you want to know the true nerdy side of what these words mean: when you process claims, PCC’s preptags program calls the tagsplit program according to your practice’s settings. The tagsplit program processes queued-up claims (“tags”) and sorts them by insurance batch while doing a number of other validation checks, all of which refers back to your practice’s custom splitconfig configuration. The preptags program automatically runs the ECS program, which is the underlying software which sends your claims out the door through a secure internet connection to PCC.
You can use PCC’s tools to work on claims with errors, rejections, and denials.
But what if a problem is fixed, but the claim wasn’t resubmitted? Or what if an insurance payor simply never responds? Are some insurance payers regularly failing to pay you in a timely fashion?
You may need specialized tools to find claims that slipped through the cracks and work down your practice’s insurance A/R.
Run the Insurance Company Aging Report (insaging) to review an aged summary of your practice’s outstanding charges broken down by insurance group.
You can find out which carriers owe you the most money and how old those balances are. The insaging report is also a quick way to see your total A/R, and it will help you determine which insurance carriers need follow-up attention. For example, if you know that an insurance company comprises a large portion of your outstanding receivables, yet only represents a small fraction of your patient population, you may use that information the next time you review the payor’s contract.
insaging ReportYou can find the insaging report in your Practice Management windows.
From the opening configuration screen, press F1 – Generate Report to view the report. (For report configuration options, see below.)
Here is a sample insaging output:
Insurance Company Aging Report Generated on 06/01/00
By Transaction date, As of 05/31/00
All Providers
Current 30 – 59 60 – 89 90 – 119 120+ Total Perc
————————————————————
Personal 3,515 9,410 12,994 9,408 24,342 59,671 32%
Other 7,357 777 399 0 0 8,534 4%
Anthem 361 230 0 0 0 591 0%
Aetna 3,392 2,011 0 0 0 5,403 2%
Aetna/HMO 2,542 171 105 0 0 2,818 1%
Affordable 1,185 497 171 0 0 1,853 1%
BCBS 4,652 1,024 385 0 0 6,062 3%
CIGNA 9,016 1,228 466 1,736 1,846 14,294 7%
HARRIS 1,544 1,015 215 24 0 2,798 1%
HUMANA 5,056 855 89 2,973 1,363 10,336 5%
Medicaid 829 41 0 0 0 870 0%
ONE Health 1,089 782 51 0 0 1,922 1%
PHCS 8,089 2,716 336 0 0 11,142 6%
. . . . . . . .
. . . . . . . .
. . . . . . . .
UNITED 5,897 793 331 3,370 1,685 12,076 6%
————————————————————
Total 69,922 26,034 18,421 20,323 47,055 181,757
Percentage 38% 14% 10% 11% 25%
Total Aging 181,757
Personal Credits across entire practice 57,127
Medicaid Credits across entire practice 0
———-
Total A/R 124,629
Your practice’s total outstanding balances are shown with one row for each insurance group. The columns split each insurance group’s total into aging categories. The report includes a “Personal” insurance group for outstanding personal charges.
For group, insaging lists the outstanding A/R that is “Current” or less than 30 days old, 30-59, 60-89, 90-119, and over 120 days old. The total outstanding balance and the percentage of your practice’s total A/R are also listed. At the bottom of the report, you can see the “Total Aging” A/R, along with the total outstanding personal and Medicaid credits (if any).
You can use the insaging report to:
Evaluate Insurance Companies: If you compare the “Percent” of total A/R column with the percentage figures in the activity report, you will see when an insurance group’s percentage of your total outstanding receivables does not line up with its percentage of your office’s workload. Comparing how hard you have to work to get paid against how many patients you actually see can help you identify “good” and “bad” payors.
Target a Group that Requires Further Attention: After identifying a payor with a large or particularly old A/R, you can run the Insurance Company Accounts Receivable (inscoar) report to review all the outstanding claims for that insurance group.
You can change how the insaging report ages receivables, recalculate aging to a different date, limit the report to a specific provider, and make many other changes.
Here is the options screen you will see when first running insaging:
Aged How?: By default, insaging calculates the age of your A/R by the “Transaction Date.” You can set insaging to age by “Posting Date”, which is when each charge was entered into your system. This will change the amounts in the report’s aging categories if your office often posts visits long after they occur. Finally, you can choose to age by “Payor Date,” which ages by the date each balance became the current carrier’s responsibility. For example, charges that have recently been forwarded to a secondary insurance will appear as “Current” even though the visit occurred months ago.
Aged as of what date?: Since aging calculations involve every charge on your system, they are performed each night and stored in a “Nightly File”. insaging uses the previous evening’s Nightly File by default. You can tell insaging to regenerate a file representing unpaid charges aged to any date you prefer. Once you have regenerated an aged nightly file, you can select that report again by choosing the “Use Existing File…” option.
Destination: Choose whether you want to view the report on your screen, mail it to your e-mail inbox, or print it on a specified printer.
When To Run: Run the report “Right Now” and have your terminal wait for the job to finish, run it “In The Background” so you can go on and do other things at the same time, or schedule the job to run “Later At” a specified time. This option was useful on older computer systems (pre-2003) and should no longer be needed.
Generate...: You can include charges for all providers, or select individual providers or a provider group. PCC can help you set up any provider group you would find useful for A/R Analysis. All credits are assigned (by default) to the Office provider. If this provider is not included when the report is run, then no credits will be reported.
The insaging report tallies charges by the plan they are pending. Charges that do not pend an insurance company are totaled in the Personal line of the report.
If you see a blank line in the middle of the insaging report, there is an active insurance group in the Table Editor (ted) with no plans assigned to it.
Use the byins program to review how your insurances are grouped. Edit your Insurance Companies and Insurance Groups tables in ted to re-group plans if necessary. For example, you may want to consolidate two insurance groups with very few plans and little activity, or you may choose to break up an insurance group if it represents a large portion of your business and you want to track it more closely. For more help creating and organizing insurance groups for reporting purposes, contact PCC Support.
While you can use workflow tools to address claims with errors, rejected claims, and denied claims, you may want to work with a list of all unpaid claims, regardless of billing status. To work claim-by-claim on your practice’s unpaid, pending charges, use the Insurance Company Accounts Receivable (inscoar) report.
The inscoar report also includes an interactive mode, which allows you to research billing history, make changes, and then resubmit claims all from the same screen.
inscoar ReportYou can find the inscoar report in your Practice Management window.
From the configuration screen, press F1 – Generate Report.
Every account with unpaid insurance charges appears on the report. The accounts are sorted by the insurance company to which their charges are pending. inscoar shows you the insurance company’s name and phone number. With each account name, you can see the family’s insurance ID number and group number. The patient name, procedure dates, names, codes, and primary diagnoses codes are all shown, along with the outstanding balance information.
Visit Notes and Billing History: If there are any Visit Notes, they will appear under the first charge for that visit. If there is any billing history, it will appear under each charge. If a claim was generated, you will see a billing message with batch information and the total original amount of the claim.
Contact Insurance Companies about Unpaid Claims: Because the inscoar report shows insurance ID information, full procedure information, and the insurance company’s phone number, along with the original amount of the claim, inscoar is a great report for working down old, unpaid claims.
Jump to Other PCC Tools for More Information or to Resubmit: With the interactive inscoar report option, you can jump straight from this report into more information and different Practice Management tools, making inscoar an even more powerful insurance billing tool. See Below.
inscoarYou can choose the age of receivables you wish to review, limit the report by insurance company, provider, or place of service, and make many other configuration choices that change the output of inscoar. Here is the options screen you will see when first running inscoar:
inscoar You can view the inscoar report on the computer screen, print it out, or have it sent to your e-mail inbox. You can also view the report as an “Interactive Screen,” which allows you to work on the charges as you review them.
inscoar You can limit the inscoar report to only those charges that are over a certain age, those that within a certain age range, or those that occurred during a specific date range. Using these options, you could, for example, choose to view only insurance charges that are nearing the end of a particular carrier’s timely filing limit.
If you enter “No,” you will be prompted to select insurance plans or groups that you wish to view. Otherwise, you will see all insurance plans that have outstanding charges. This option is useful if you are dealing with a particularly poor payor.
If you enter “No,” you will be prompted to select providers or provider groups for which you wish to view charges. The default of “Yes” will run the report for all providers that have any outstanding charges.
If you enter “No,” you will be prompted to select the place of service for which you wish to view charges. The default of “Yes” will run the report for all places of service for which there are outstanding charges.
Change this item to “Yes” if you wish to view all charges, regardless of whether they pend an insurance carrier or are the guarantor’s responsibility. In this way, you could analyze personal charges at the same time as insurance charges.
inscoar Change this item to “No” if you do not wish to view Visit Notes. A visit note is added to charts in the Correct Mistakes (oops) program.
Change this item to “Yes” if you want the date the charges were batched or submitted, along with other billing messages, to show in the report. This may be useful when dealing with old charges that have been resubmitted several times.
inscoar can create a list at the bottom of the report of insurance plans that meet your criteria but do not currently have any outstanding charges pended to them. Keep this option as “No” to suppress the list.
Change this field to “Yes” if you wish to print the report in one long section. By default, inscoar prints different insurance plans to different pages for your convenience.
Use these settings to show the information from the four boxes in the Patient Editor (notjane) on the report. For example, if your office stores insurance ID# information in one of those boxes, it may be useful to have that information on your inscoar report.
Use the Interactive Screen in inscoar to work on claims. While reviewing unpaid claims, you can research account history, correct and resubmit problem claims, and add notes to the patient or account.
To access the interactive features of inscoar, check off the “Interactive Screen” option on the configuration screen:
As with other output settings, you can modify the other options on the screen, such as the “All Insurances?” option, to limit what portion of your A/R you will view interactively.
When you run the report, you will notice new fields and functions:
Every item on the report, whether an insurance company, an account, a patient, or a charge, has a selection box at the left hand side of the screen. Function keys at the bottom of the screen let you show or hide additional information, work with an item, or move around the report by searching.
When you select an item and press F1 – Show MoreInfo, the report expands to include additional information about that item. For example, if you select an account and press F1, you will see all of the account’s contact information.
When you select a procedure and press F1 – Show MoreInfo, you will see information about the charge.
If you then select “View Charge History” and press F1, you will see billing history messages about the charge:
Press F2 – Hide MoreInfo whenever you wish to collapse or hide the extra details.
What if you call the insurance company about a claim listed on the report, and they want to know more details about the patient? What if they explain the problem, and you then need to correct a diagnoses code and resubmit the claim? You can do all of this from within interactive inscoar by using the “Work With Entry” function. You can also use this tool to access information about any patient or account listed on the report.
To start, select any item on the screen that you wish to work with. Then press F4 – Work With Entry.
What can you do when you select an item and press “Work With Entry?”
Insurance Plans: Select an insurance plan and press F4 to view the plan’s entry in the insurance table in ted, the Table Editor. From there you can review plan information, claim batch, plan notes, and other data.
Account Name: Select an account name and press F4 to run the Family Editor (fame). From there you can view collection and account history reports, add notes about your interaction with the insurance company, review insurance information, and perform many other functions.
Patient Name: Select a patient name and press F4 to view an interactive “Patient Information” screen.
From this screen, you can do the following:
notjane.
sam, from which you can schedule a new appointment or review past and upcoming appointments in inquire.
Procedures: Select a charge or procedure and press F4 to view an interactive “Visit Information” screen.
refund. You can use refund to post refunds or any accounting adjustment that takes money away from an account or increases its balance.
pam, the Payment Posting program. Use pam to post personal payments or any accounting adjustment that reduces its balance.
oops, the Correct Mistakes program. Use oops to modify charge information, such as diagnoses and claim information, as well as for printing or batching a new claim.
checkout, the Charge Posting program. Use checkout to post additional charges or repost a charge that you deleted in oops.
fame, the Family Editor. Use fame to review account history, insurance policies, or other account information.
Go Back: When you are finished working with an entry, press F12 to go back one screen. You can repeatedly press F12 and move back through each screen, all the way to the original inscoar configuration screen.
Depending on the criteria you used, your Interactive inscoar report may be very long. Use the four search function keys (F5 through F8) to navigate the report and jump directly to the account or insurance with which you wish to work.
Press
F5 – New Pattern
When you are ready to begin a search, press F5.
Enter a Search Pattern
Type in the desired account, insurance name, or other criteria. Press F1 – Process to continue.
Work With Results
There may be a brief pause as inscoar finds the information you entered. You will then see the first matching name or item matching your search criteria:
You may use all of the Interactive inscoar tools to work with this account, patient, or charge.
Optional: Press
F6 – Next Match
If there are several matching entries, you can use F6 and F7 – Previous Match to rotate through all instances of your search.
Optional: Press
F8 – Bop to Top
If you get to the end of the report and wish to jump to the top and repeat the search, press F8.
When a patient is checked in, PCC records the time of check in, the user who checked them in, and the office location. You can view that information later to discover who checked a patient in.
You can see who checked a patient in PCC EHR in the Appointment Details component.
You can find that component at the top of a chart note or in Patient Check-In. So, for example, if you wanted to know who checked a patient in, you could highlight the appointment on the Schedule screen and click “Patient Check-In’. Or, you could open the visit’s chart note and look at the top of the protocol.
When insurance carriers send payment and adjustment information, either on an EOB or an ERA, they often include a code with a small message. These codes are known as CARC values, or Claim Adjustment Reason Codes, and they are an industry-wide standard. CARC values can include a code, an amount, and an additional group code.
Remittance Advice Remark Codes (RARCs) provide additional explanation for an adjustment already described by a Claim Adjustment Reason Code (CARC). A RARC can be supplemental or informational.
PCC stores and displays CARC information to help you understand charge history, communicate adjustment information on patient bills, and submit secondary claims.
You may see a 45 on your EOB or ERA, with a note indicating that 45 means, “Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.” Number 45 is the most common CARC value, and it indicates that the payer has adjusted your charge to their pay schedule.
If PCC received the remittance electronically, it will record “45” when it automatically posts the payment and adjustment.
If you are posting a payment by hand, you can enter 45 when you Post Insurance Payments manually, along with a CARC amount and group, if provided.
You can review the CARC information in most places where payment history appears, such as the Billing History, various Account History tools, and personal statements.
While there are hundreds of CARC values, the common ones comprise most of the codes you will receive. Here are the top nine:
|
CARC Value (in order of popularity) |
Message Text |
|---|---|
| 45 | Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement. |
| 42 | Charges exceed our fee schedule or maximum allowable amount. |
| 97 | Payment adjusted because the benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated. |
| 22 | Payment adjusted because this care may be covered by another payer per coordination of benefits. |
| 96 | Non-covered charge(s). |
| 104 | Managed care withholding. |
| 18 | Duplicate claim/service. |
| 24 | Payment for charges adjusted. Charges are covered under a capitation agreement/managed care plan. |
| 144 | Incentive adjustment, e.g. preferred product/service. |
CARC values enter your PCC system through autoposting or when you post an insurance response manually.
When you autopost an ERA, CARC and RARC values are recorded with payments and adjustments to which they pertain, along with amount and group codes required for secondary submission.
You will see CARC values on your EOBs and ERAs from most carriers. You can enter CARC values when you manually post or edit payments and adjustments.
For each charge, you can enter a CARC amount, code, and group code.
Do Not Post Other Carrier Codes in CARC Fields: If your insurance carrier uses a non-CARC system of coded messages, do not post them in the CARC column. CARC values are a national standard and do not match up with Georgia Medicaid message codes or other carrier codes. Instead, some PCC users use payment and adjustment types to indicate messages from carriers.
Once CARC values are entered with payments, where can you find them and how can they benefit your day-to-day work? Is there a way to review RARCs that came in electronically?
While you can automatically post most payments and adjustments, you can also read any ERA 835 files sent to your system from payors. Your PCC system keeps the ERA on file so you can review complete details later in the Electronic Remittance Advice tool.
In the Correct Mistakes (oops) tool, CARC codes appear in line with insurance payment information.
Press F7 – View Adj Reasons and enter an item number to read CARC, RARC, and descriptions.
CARC values entered automatically or manually also appear in the Account History Report (tater).
PCC’s personal bills, whether printed in your office or through a remote ebills service, include CARC values and an explanation of what they mean.
You can review the text of any personal bill and see the adjustment reasons in the Correct Mistakes (oops) program.
PCC can create reports based on CARCs and amounts. You can create custom CARC reports or use two predefined SRS reports: The “CARC Insurance Detail Report” and the “CARC Summary Report”.
To view a CARC-based report, run srs and visit the Billing and Collection Reports section.
When you run a report you will be prompted for a date range, and you can add additional criteria to customize the report. The results will display CARC information and help you understand trends in payer responses to your practice.
If you would like help creating a custom SRS report that includes CARC information, or other PCC billing data, contact PCC Support.
If a family paid you for a copay that they did not owe, or if they pay you twice for the same visit, you may need to issue them a refund. In some cases, you can leave the amount as a credit on the account and later link it to future charges for the family. When you return the credit to the family, follow the procedure below.
Watch a Video: Watch a video to learn how to refund personal credits in PCC EHR.
When you need to refund a credit on a family’s billing account, use the Payments tool in PCC EHR.
Open the History Tab of the Payments Tool
In PCC EHR, open the Payments tool, find or select an account or patient, and then click on the History tab.
Review the Account’s Credit
Before you refund a credit on an account, you may wish to review the account’s balances and the Payment History to understand why they have a credit.
For example, you might find a payment that is greater than the amount due on a charge. You can click the disclosure arrow next to a payment to review how a payment applies towards charges.
Click “Refund Credits”
Click “Refund Credits” to create a refund for the account.
Enter the Transaction Date and Refund Type
Optionally adjust the transaction date (which defaults to today), and select your practice’s personal credit refund type.
Your practice can customize what refund types are available on your system.
Enter the Refund Amount
Enter an amount to be refunded, up to the total credit balance on the account.
After you enter the refund amount and press Tab or Enter, the Balance will update to indicate the result of the refund.
Click Save
Click “Save” to save the refund.
You’ve now recorded that you refunded the money to the account. Next, you might pay the family from the front desk or issue a check.
Review Results in the Payment History
After you refund a personal credit, you can see the change in the Account Balances. You can also review your payments in the Payment History index to see the linked refund.
Optionally Enter an Account Note Explaining the Refund
After you refund a personal credit, you may decide to visit the Posting tab and enter an account note explaining the refund.
Correct Mistakes: If you refund a credit incorrectly, and need to delete the refund, use the Correct Mistakes (oops) program in PCC’s under-the-hood Practice Management tools.
When you post a refund, it appears as an adjustment that offsets a payment or credit on an account. By default, this is done with a “Personal Refund” or “Refund – Personal” procedure.
Your practice can post other types of adjustments as well. You can edit or add new refund or offset adjustments in the Procedures table in the Table Editor (ted). Any adjustment procedure with an accounting type of “Receipt – Refund” will appear in PCC’s tools for posting refunds or payment offset adjustments.
To learn how to edit procedures on your system, read Edit Your Practice’s Procedures, Codes, Adjustments, and Prices.
Sometimes a credit should be written off and counted as income to your practice. For example, if an account credit or insurance overpayment remains on your books for several years, your practice may decide to write it off and treat it as revenue.
To write off credits, post an adjustment in refund and then link the credit to that adjustment. Follow the procedure below.
Follow these step to write off a credit.
Run refund For the Account With a Credit
Run refund from the Practice Management window. Find the account with the credit. If you are writing off a credit from an insurance overpayment, it may be on the Insurance Overpayment account.
Post the Credit Write-Off Procedure
Using the Credit Write-Off procedure (with the accounting type of “Revenue Credit W/O”), post the full amount of the credit that you wish to turn into income.
Run oops
Run Correct Mistakes (oops) from the Practice Management window or just press the F6 – Correct Mistakes key while in refund.
Locate the Credit
Use Page Down and Page Up to locate the credit you are writing off. Note the item number next to it.
You may notice that part of the payment is linked to a charge on the account. The payment listing will use line numbers to indicate where portions of it are applied. In the example above, a $10 check pays off a $5 copay, leaving a $5 credit open and unlinked.
Press F7 – Relink Pmt and Choose the Credit
Press F7 and enter the number that appears next to the credit in the history:
Select the Credit Write-Off Procedure
From the list of outstanding charges, find the Credit Write-Off procedure you posted in refund. Type the corresponding number and press Enter. If the payment pays off other charges, and you are only writing off part of it, link the payment to both the Credit Write-Off procedure and the charges it is paying off, as shown in the example below:
Confirm the Credit Links to the Write-Off
On the next screen, confirm that the payment you are writing off links to both the Credit Write-Off procedure and any charges to which it is also applied. In other words, the payment should be fully accounted for, with no unlinked amount remaining. The Balance fields should be $0.00.
Record Your Actions in fame
Run the Family Editor (fame) for any affected accounts. Record your actions on the Notes page.
When you post a credit write-off, it appears as an adjustment that offsets a payment or credit on an account. By default, this is done with a “Credit Write-Off” adjustment procedure.
Your practice can post other types of adjustments as well. You can edit or add new credit write-off adjustment types in the Procedures table in the Table Editor (ted). For accounting purposes, you may wish to record different types of adjustments such as “Credit Write-Off (Personal)” or “Insurance Overpayment Write-Off”. All adjustment procedures for writing off a credit should have the accounting type of “Revenue – Non-Service.”
To learn how to edit procedures on your system, read Edit Your Practice’s Procedures, Codes, Adjustments, and Prices.
With a solid practice financial policy, and good use of PCC’s personal billing tools, you should have very few accounts that require a collection agency. When you need to use one, however, you can update the account record to indicate it is in collection and adjust charges so they will be handled correctly.
PCC has two recommended procedures for turning an account over to a collection agency in Partner. Your office can consider these options and create your own collection policy.
What Charges Should be Turned Over to Collection?: You can review accounts with high personal balances using persview, and srs can produce a list of accounts with charges that have been billed over and over again. Contact PCC support for help learning these reports.
When you turn charges over to a collection agency, you can post an adjustment against those charges. The charges will no longer generate a personal bill when you process bills, and the amount due will be removed from your accounts receivable.
The steps below require a bad debt adjustment in the Payment Types table in the Table Editor (ted). You could name the payment type “Bad Debt Adjustment (Collections)” or “Sent to Collection”.
Follow these steps to turn an account over to collection and adjust off the charges:
Print Charge Information for the Collection Agency
Use the Collection Report (coll) or the Account History (tater) to produce a summary of outstanding charges for the collection agency.
Run pam for the Overdue Account
Open the Payments tool for the account you are turning over to collection.
Post the Bad Debt Adjustment and Link it to the Overdue Charges
Enter the bad debt adjustment information, including the date you are turning the account over to collection, the bad debt adjustment name, and the total amount of the charges you are sending to collection:
Press F4 – Special Payments and link the bad debt adjustment to the procedures listed that you wish to turn over to collection. To learn more about pam and the Special Payments key, read Post Personal Payments and Adjustments.
Record Your Actions in Account Notes
Run fame for the account and add details to the Notes page. Record which charges were sent to collection. You should also add a “Sent to Collection” status flag to the account.
When you receive a payment from the collection agency, you can post it in one of two ways:
Delete the adjustment you posted above and post the payment using a payment type that indicates the payment was from a collection agency.
Post a “Collection Income” adjustment in the refund program and then post a Collection Payment against that adjustment using pam.
Whichever method you use, be sure and carefully note your actions on the notes page of the Family Editor.
You can pend charges to a collection agency just as you would pend them to an insurance company. The family will no longer receive personal bills from your practice, and the collection agency will bill the account directly. The charges you turn over to the collection agency will remain as balances on the patient’s account, and they will remain part of your practice’s total accounts receivable.
For this procedure to work, you will need two items in your Partner tables:
An insurance group named “Collections”
An insurance company called “1. Collections.” While you can name the insurance company anything, giving it a number at the beginning of its name will make it easier to find and apply charges towards.
Follow these steps when an account is turned over to collection:
Print Charge Information for the Collection Agency
Use the Collection (coll) report or the Account History (tater) to produce a summary of outstanding charges for the collection agency.
Run oops
Run Correct Mistakes (oops) from your Practice Management window.
Locate the Procedures to Turn Over to Collections
Use Page Up and Page Down to browse the account history and find the procedures that should be passed to collection.
Press F4 – Insurance Status and Enter the Procedure Numbers
Enter the number adjacent to each procedure you are sending to collections.
Press
F5 – Make All Insurance
On the Changing Insurance Information screen, press F5 and choose “Some Other Insurance.”
Choose “1. Collections”
The collections insurance will appear at the top of the list. Press Enter to select it.
Press
F1 – Save Changes
After saving your changes, press F12 to quit oops.
Record Your Actions in fame
Add a note to the Notes screen of the Family Editor (fame), add a “Collection” status flag to the account, and send the account a collections notification form letter.
Run insaging Periodically: Run Insurance Accounts Receivable Summary (insaging) to review the outstanding balances in collections. The amounts should appear in the Collections insurance group.
Run inscoar Periodically: Run Insurance Accounts Receivable Detail (inscoar) for the Collections insurance group to review each individual account’s collection amounts.
When you receive a payment from the collection agency, you can post it in the pip program, selecting an appropriate payment type. You should also update your note on the notes page of fame.
Read this article to learn about how to post personal payments in PCC. When a family pays their bill, you can use the Payments tool to enter their payment, link it to charges, and optionally enter account notes. You can also write off bad debt and post other adjustment types.
Watch a Video: For an overview, watch the Post Personal Payments video.
How do personal payments enter your PCC system?
Post Payments and Write-Offs in the Payments Tool in PCC EHR: Use the Payments tool in PCC EHR to review account information and enter any payment at any time. See the sections below to learn more.
Post Payments at Patient Checkin: You can post a copay, or any payment amount, at the time of service during patient checkin.
Post Payments When You Post Charges: Later, when you checkout the patient and post charges, you can link the payment collected at checkin and enter any other personal payments.
Post Payments When You Create a Billing Encounter or Hospital Visit: You can open any patient’s chart and create a billing encounter in the Billing History section of the chart. You can post administrative fees or use the same interface to post a hospital encounter and enter personal payments at the same time.
Families Can Pay Their Own Bill in the Patient Portal: If your practice uses the service, your families can review their balance and pay their bill in the patient portal.
Post Payments and Adjustments in Previous Tools: As of PCC 9.8, you can still use the Personal Payments program (pam) in your Practice Management window to enter personal payments and adjustment.
The Payments tool in PCC EHR makes it fast and easy to post personal checks, money orders, credit card payments, and cash and link the money to outstanding personal balances. In addition to posting payments, you can use the Payments tool to write off bad debt, reverse payments, and post other adjustments. Payments from insurance companies are posted using the Insurance Payments tool.
In addition to the personal payment components found during patient check-in, when you posting charges, and in the patient portal, your practice can use the Payments tool to post any payment for any account at any time.
Open Payments
Open the Payments tool from the Tools menu in PCC EHR.
Find an Account or Patient
Find the billing account for the payment.
You can search by account name or patient name.
You can also use other search parameters, such as a phone number. When you search by account, 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.
Optionally Specify How to Apply Payment
By default, a payment is applied towards the oldest charges on an account that have a personal amount due.
You can specify how much of a payment should be applied.
The Unapplied amount will become a floating personal credit on the account.
You can also click “Distribution” and specify how much of a payment should be applied to each charge on an account with a personal due amount.
Read the section below for more information.
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.
If the payment was greater than the personal balance, PCC EHR will apply payments and leave the remainder as a credit on the account.
After you enter a payment, 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.
When you want to write off a charge that is unrecoverable (“bad debt”), or post other account adjustments that reduce the amount due for a charge and decreases an account’s outstanding personal balance, use the Payments tool.
See Write Off Charges and Bad Debt.
By default, a payment or adjustment will automatically link to an account’s oldest charges with a personal balance.
As you enter payment or adjustment information, you can specify how the payment should be applied to charges.
Payments are usually linked to charges. You can optionally specify that only a portion (or none) of a payment or adjustment shall be applied to charges.
The full amount will still be reflected in the account’s balance, but under-the-hood the payment will remain unapplied or “unlinked” from any specific charge.
When you indicate that a portion (or all) of a payment shall be unapplied, you can optionally select a provider for accounting purposes.
Payments are normally linked to charges, which already have an associated provider. If a payment is not applied to charges, you can optionally indicate an appropriate provider manually.
Reporting Unlinked Payments By Provider: If your practice posts an unapplied payment and assigns a provider manually for accounting purposes, PCC reports will reflect your manual selection. As long as some portion of the payment remains unlinked, that amount will appear on reports as being linked to the manually assigned provider. However, once your practice has linked the entire payment to charges, the provider of those charges overwrites the manually assigned provider for the payment. If you need to change the provider for a payment, you can relink it to charges for the correct provider. Or, if you need to unlink a payment and assign it to a provider without specifying linked charges, you can delete the original payment and repost it.
Click “Distribution” to review and update how a payment or adjustment will be applied when you click “Save Payment”.
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.
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.
As you post payments and account adjustments, you may want to enter notes. Read Enter and Review Account Notes to learn more.
After you post a personal payment, how can you review what you did? How do you review an encounter’s complete payment history, an account’s complete payment history, and edit personal payments that you posted incorrectly?
To learn more, visit:
At the end of the day, your practice may wish to balance out a cash drawer or check that credit card receipts match what was posted. Use the Payment Reconciliation report to see totals for each payment type.
When you post a payment or adjustment anywhere in PCC, you first select a “Payment Type”.
Your practice can configure your payment types in order to improve your reports, determine which payment types are available in different PCC tools, and make other configuration changes in support of your billing workflow.
In PCC’s under-the-hood Payment Type configuration, found in the Table Editor (ted), each Payment Type has some basic settings.
Your practice can create and edit payment types. For each type, you can indicate a name, a “base” type (cash, charge, etc.), and answer configuration questions that determine how and where a payment type appears.
For example: if your practice wanted to report a personal check posted during checkin or checkout separately from a personal check posted at other times, you could have two different payment types, such as a “TOS Personal Check” and a “Personal Check”. Both payment types would have the base type of “check”. You would use the configuration questions to make one payment type available to post in “chuck” and the other in “pam”, which affects all checkin/checkout functions and all stand-alone personal payment functions respectively (in both PCC EHR and Practice Management).
The table below shows how to adjust your configuration to make payment types available in different PCC tools.
| Action | Where | Description |
|---|---|---|
| Post a Payment During Check In or Check Out | PCC EHR Check-In, Post Charges, and checkout |
All payments with a base type of check, cash, or charge, that also have the “chuck” question set to “Yes”, are available in during patient check-in, when posting charges, or when posting personal payments in either PCC EHR or the previous Practice Management tools. |
| Post Other Personal Payments | PCC EHR Payments, pam |
All payments with a base type of check, cash, charge, or adjustment, that also have the “pam” question set to “Yes”, are available when posting other personal payments in the Payments tool in PCC EHR or the pam tool in Practice Management. |
| Review and Edit Payment History | PCC EHR Payments and Insurance Payments tools (History tabs) | All payments of any kind appear in the payment histories found in the Payments and Insurance Payments tools. |
| Review Payments Applied to Charges | PCC EHR Billing History, oops, tater |
All payments of any type that are applied to charges will appear in the Procedures section of an encounter’s Billing History in the chart. The history tabs in PCC EHR also displays all payments and displays the charges to which they apply. All payment types will also appear in under-the-hood account and charge history tools in Practice Management, like oops and tater. |
| Review Payments Made During a Particular Encounter | PCC EHR Billing History’s “Payments for ##/##/####” section | All payments made on the date of an encounter, that have a base type of check, cash, or charge, and that have the “chuck” question set to yes, appear in the Payments section of an encounter’s billing history, found in the patient’s chart. |
Use the Bills tool in PCC EHR to generate personal bills for families.
Video: Watch Generate Personal Account Bills to learn more.
Follow the procedure below to generate personal statements for families.
Open the Bills Tool
When you are ready to send out personal bills, open the Bills tool in PCC EHR.
Select Electronic Bills or Paper Bills
If your practice sends some or all bills out electronically to a printing service, select whether you are sending e-bills or printing paper bills.
Electronic Bills are Printed By a Third Party: An electronic bill refers to when your practice electronically sends bill files to a third party, OSG (formerly “Diamond Health”), for printing and mailing to families.
Paper Bills Require a Bills Printer: If your practice generates paper bills, you must have a printer available to print the bills. You may need to contact PCC Support to select which printer your practice will use to print bills or else set your individual user printer settings in the Practice Management window before you open the Bills tool. Contact PCC Support for more information.
Select Age of Bills to Send
Optionally adjust which bills you wish to generate, based on age of the oldest balance on the bill. Or click “Select All”.
For example, your office may wish to send current bills to your electronic printing service but print 90+ or 120+ bills manually.
Click Prepare E-bills
Click “Prepare E-bills” (or “Prepare Bills”) to process account balances and prepare bills. They will not be sent yet.
Review Totals and Optionally Work With Accounts
Review the total number of prepared bills. Optionally, click “Work With Accounts” to see all families for whom a bill was prepared.
Click “Submit E-bills” To Send Bills
When you are ready to send bills to your third-party printing service, click “Submit E-bills”. If you are printing bills at your practice, click “Submit Bills”.
When bills are sent, the account’s individual bill cycle and “Last Bill Sent” date will be updated, indicating that they have received a bill this month.
Automatic Billing Cycle: Your PCC system tracks when you last sent each account a bill. Your practice can configure a billing cycle so a family won’t receive more than one bill per billing period. With cycle billing, you can run bills every day and your system will only generate bills for accounts that either had their last bill sent more than 28 days ago (for example) or have new personal charges due on their account. To learn about your practice’s cycle billing settings, contact PCC Support.
You can review a log of all bill submissions. Read Review the Bill Log to learn more.
Your practice can customize the messages that appear on your bills. Read Customize the Messages on Personal Bills to learn how.
In addition to processing and batching a large set of bills, you can also generate a single bill for any billing account.
Run the Under-the-Hood Bills Program
Run the bills or ebs program from your Practice Management window.
Press F5 – Print One Bill.
Find the Account that Needs a Bill
Enter a Date Range for the Bill
Print the Bill
Press F1 – Print Bills to Print the Bill
PCC has a wide range of tools that help you keep your personal A/R under control. From collecting copays and generating bills, to bill follow-up and sending accounts to collections, PCC tools can make you more productive.
Collecting personal balances can be broken down into these steps:
Collect the Payment and Information at the Time of Service
There is no better time to collect a personal balance than while the patient is still in your office. Use PCC’s Patient Check-In tool to review and update demographic information and policies, review insurance eligibility, review old balances with the family, and post copays and other payments. Everything you collect while the patient is still in the building saves you time and money.
Tip: Have your families review and sign a financial policy that is annually reviewed by your billers, managers, and the owners of your practice. A good financial policy encourages families to remember that they are ultimately responsible for all of their charges.
Generate Bills
Use the Bills tool to generate personal bills. Whether you print and mail your paper bills in the office or send them electronically to a remote printing service, PCC includes numerous features to make your collection process more efficient. You can create custom messages that appear on bills of different aged receivables. You can also review and work on a list of people who need bills before generating them.
Follow Up on Outstanding Bills
At every encounter, your practice can review balances with the family during patient checkin, and go into more detail using the Payments tool. You can also use reporting tools, like The Personal Money Tracking Assistant (persview), to work down old, outstanding personal bills.
Post Payments
Patients and families can pay their bill directly in the patient portal. When you receive a check or a payment through some other method, you can post personal payments and link them to specific charges in the Payments tool in PCC EHR.
Send Accounts to Collections
Turn delinquent accounts over to collections. There are different methods for doing this in PCC, depending on whether you want to leave the outstanding balance on the patient’s account or not. You can adjust off collection charges, or you can pend the balance to the collection agency. Don’t forget to make notes in an account’s history and add appropriate status flag for reporting and tracking.
Unfortunately, not every family pays their bills on time. An address may be incorrect, a family may have questions about their balance, or they may be unable to pay. Following up on outstanding bills is a vital part of the billing process.
persview program will help you track and work down outstanding personal balances. cfs) helps track and manage accounts that are overdue, on budget plans, or have special statuses.Use the Special Accounts Editor (cfs) to work with all accounts with certain status flags or other specific characteristics.
For example, you may want to list all accounts that your office put on a budget plan, or all accounts that were flagged as “Cash Only” for writing a bad check. You can view and work with all of these types of accounts by using the cfs report.
cfs and Select CriteriaYou can run cfs from the Practice Management window.
There are two types of lists found in cfs:
Standard lists that appear on all systems. These include accounts that are Overdue, on a Budget Plan, who have Credits or have Bills Held by a flag.
Customized lists based on your office’s Account Flags. These include all of the Account Status Flags in the Table Editor (ted). If you add a new account flag and assign it to specific accounts, you will be able to work with those accounts using a report option in cfs.
Note: The lists stored in cfs are created overnight. Transactions posted through the day will not affect whether an account appears on a list or not. No matter what changes you make to an account, they will remain on a list until the lists are recreated in the evening.
Enter the letter or number next to a list and press Enter to view it. All accounts on the selected list, along with their balance information and phone number, will appear:
The example above shows all of the Collection accounts. Collection accounts are accounts that have been assigned the “Collection” flag on the status line in the Family Editor (fame).
As you view the list and work with each of the families, you can perform the following functions:
Actions in cfs
F1 – Start of List
Press F1 to jump to the top of the list.
F2 – Jump to Letter
Press F2 and input a letter to jump to a spot somewhere in the alphabetical list of accounts.
F3 – End of List
Press F3 to jump to the bottom of the list.
F4 – Remove Flag
Press F4 to remove the status flag (such as the “Collections” flag) that causes the account to appear on this list. Remember that the account will remain on the list until cfs rebuilds its lists overnight.
F6 – Form Letters
Press F6 to select and print a form letter for any account on the list.
F7 – Oops Account
Press F7 to run the Correct Mistakes (oops) program for any account on the list. In oops, you can view billing history, change insurance pending status, and rebatch or print outstanding claims.
F8 – View Account
Press F8 to run the Family Editor (fame) program for any account on the list. In fame, you can view a detailed family history, run the Collection report (coll) to review outstanding charges, add notes to the account, review insurance information, and more.
Use the Account Balances component to review account balance totals and the details of all charges with a personal amount due.
Unpaid balances are broken down into Personal, Insurance, and Medicaid charges. They are aged across aging categories (0-29 days, 30-59 days, etc.), with the total personal balance due displayed in red.
Click the disclosure triangle to view a summary of the charges that have an outstanding personal (non-insurance) balance.
To print a copy for the patient or family, click Print.
In addition to balance details, the printout includes your practice’s information as well as the date it was generated.
Where Can I Find the Account Balances Component?: The Account Balances component appears in Patient Details (while scheduling), Patient Check-In, the Payments tool, Post Charges, and the Demographics section of the chart. Your practice can add the component to any protocol or ribbon in PCC EHR where it would be useful for your practice.
PCC’s previous software suite includes the Collection Report (coll), which explains an account’s current balance and recent payment history. You can run coll for a particular account by pressing F3 – Collection Report while in the Family Editor (fame).
On the criteria screen, you can select report output destination, choose to include only certain sections of the report, and enter a date range of payments to display. Press F1 – Process Report to create the report.
The report includes the following sections:
Account Info: The first section of the report contains simple demographic information, including the account name, address and phone numbers, as well as some key dates (date of last visit, last bill sent, last personal payment made, and last insurance payment made.) If you use the “Hold Bill Till” and “Budget Amount” functions of the Family Editor (fame), you will see information about those settings in this section of the report.
Aging Summaries: The coll report shows you different ways of aging an account’s outstanding personal charges. Balances are first aged by Payor Responsibility Date, and then by Transaction Date.
Payor Responsibility is different in that it will age items based on when the amount became personal, instead of aging strictly from the date of service. Within each category, amounts are shown for balances that are overdue 30, 60, 90, and 120 days.
Outstanding Charges: The report contains a list of currently unpaid, personal charges. This section makes it especially easy to explain an account’s balance to someone over the phone.
Each unpaid charge includes the patient’s name, the diagnoses and procedures of the visit, and three columns to indicate how much was originally charged, how much is due to the personal account, and how much is still pending an insurance company.
Totals, Recent Payments, and Summary: At the bottom of the coll report, you can see the total of unpaid charges along with a summary of recent payments.
Accounts that are working to pay off an old balance should show regular payments.
Every time your practice generates a batch of bills, PCC keeps a log of the bill run. Use the Log tab of the Bills tool to review each bill run, including full details of who ran bills, when they were run, and a list of every account for whom a bill was generated or excluded. You can also review a copy of any bill.
Click on the Log tab in the Bills tool to review when and how your practice generated bills.
Double-click on an entry to see details of the bill run.
The log of the bill run displays each account that received a bill, their account number, and the amount billed. You can search for a specific name, amount, or account number. You can click “Accounts Not Billed” to see a list of all accounts that did not receive a bill during that bill run.
Double-click on a family to see the text that appeared on the bill.
A Log of Bills Generated, Not Sent: The Log tab displays a record of every time your practice generated bills. If your practice printed bills without mailing them, or your practice encountered a problem with your third-party bill printing service (OSG, formerly “Diamond Health”), then the bills may have been generated but not sent.
In addition to reviewing the Log tab in the Bills tool, your PCC system also stores e-bills reports when they are sent by your third-party bill printing vendor. You can access these files with the EDI Reports (ecsreports) program. See Review Archived EDI Reports for more details.
Personal bills include a text area that displays a custom billing message from your practice. You can adjust the billing message that appears for both electronic bills and bills you print at your office. Additionally, PCC support can add a custom “Pay Your Bill” website address.
In the Bills tool in PCC EHR, click on either the E-billing Messages or Paper Billing Messages tab to review your current billing messages.
You can enter a default bill message for all bills and optionally enter bill messages for each bill age category (bills containing balances that are 30, 60, 90, or 120 days past due). As you type, the fields automatically constrain your message to the printing limit for bills printed by the electronic billing service or at your practice.
Click Save to save any changes to your billing messages.
Here are a few examples of messages that pediatric practice’s use:
New Provider: “We would like to welcome Dr. Smith to our practice!”
Open House: “Come see our new facilities at 10 Main St. from 9am-4pm.”
Credit Card Payments: “We now accept VISA card payments.”
In addition to these general messages, you can also include messages specific to each billing category. For example:
Current: “Thank you for your patronage.”
Overdue 30: “Payment is now past due. Please send payment promptly.”
Overdue 60: “Failure to pay balance due in full may result in termination.”
Overdue 90: “Your account may be sent to collection. Please contact the office.”
Overdue 120: “Your account will be sent to a collection agency in 30 days.”
When you print or send your bills electronically, the appropriate bill message will print automatically. If a category doesn’t have a specific message, then a default message will be used instead (if it exists).
Your practice can include a custom website address on personal bills which indicates where the family can pay their bill online.
To customize the website address for online bill pay, contact PCC.
Your practice can use automatic cycle billing to spread your bills out throughout a month or other period of time. With cycle billing, your revenue and billing workload will stretch throughout the month, and no family will accidentally receive more than one bill per cycle.
Some offices print current (or “normal”) bills on the first of the month and then print overdue bills on the fifteenth. Some offices break this up weekly. Other offices generate account bills every week (or every day!) and have their PCC system automatically exclude accounts if their last bill was generated within 28 days. These are all different types of cycle billing. You can control your billing cycle manually or automatically.
Manual Cycle Billing: Your practice can manually control your billing cycle by generating bills on a set date cycle, such as every 28 days, or by altering which aged bills you generate on different weeks.
Automatic Cycle Billing: Your practice can set a cycle billing period, such as 28 days, to indicate how often an account should receive a bill. When you generate bills, your PCC system will then exclude accounts if their last bill was generated within that bill cycle duration.
When you use automatic cycle billing, you may experience faster collections. You can generate bills every day or every week and accounts with new personal balances will receive their statement sooner. Another advantage of cycle billing is that it spreads the billing workload and income over an entire month (for example), instead of having a busy period of printing and mailing followed by a busy period of handling incoming responses and phone calls.
Contact PCC Support for help configuring your practice’s billing cycle.
When a check bounces, or a credit card payment is stopped, you can quickly reverse the payment in the Payments tool in PCC EHR. You can optionally post a fee, in accordance with your office’s financial policy. Follow the steps below to learn how to manage personal payment reversals in PCC.
Watch a Video: Watch a video to learn how to reverse a payment in PCC EHR.
When a check bounces, or a credit card payment is reversed, you can quickly mark the payment as returned and optionally post a fee.
Open the History Tab of the Payments Tool
In PCC EHR, open the Payments tool, find or select an account, and click on the History tab.
Select the Payment in the Payment History
Locate and select the payment that needs to be reversed.
You can optionally use the Search filter to quickly locate a payment by check number, date, or other criteria. You can only reverse checks or credit card payments.
Optionally Review Payment and Account Information
Before you reverse the payment, you can click on the disclosure arrow to review how the payment is currently applied.
You can also visit the Payments tab to read the Account Notes and/or contact the family to see if there is any information about the account or payment that may inform your decision.
Click “Reverse Payment”
When you are ready to proceed, click “Reverse Payment”.
Enter the Transaction Date and Select the Reversal Type
Optionally change the date of the reversal (the default is today), and then select your practice’s reversal type.
PCC includes the “Returned Check” type on practice systems by default, but your practice can create other custom reversal types.
Select a Fee Type and Adjust the Fee
If you also need to charge the account a fee, select a fee type and enter a fee amount.
Your practice can customize your fee types and amounts. If your practice configures a default fee amount, it will appear automatically when you select the fee type. If you select a fee by mistake and you don’t wish to post a fee, simply change the amount to $0.00.
Click “Save”
Click save to reverse the payment and post a fee (if entered).
Review the Result in the Payment History
In the Payment History, you can see the original payment is now crossed off. You can also see that it is now linked to a returned check refund procedure and the fee that you charged.
You may also notice that the account’s personal balance has increased by the amount of the returned payment and the fee, which may result in a personal bill when your practice next generates bills.
Enter an Account Note, Contact the Family, or Take Other Actions
Use the Account Notes component on the Payments tab to record any additional details. You might also wish to contact the family, generate and send a personal bill immediately, or send the account a portal message.
If you reverse a payment by mistake, or the payment actually clears and you received the message in error, you can delete the reversal and the fee.
Select the payment in the Payment History and double-click (or click “Reverse Payment”).
Then click “Delete” next to the reversal and/or the fee to remove them from the account.
PCC software includes a Returned Check adjustment and Returned Check Fee procedure by default. Your practice can customize the adjustment and the charge in the Procedures table in the Table Editor (ted).
You can also create distinct adjustments to handle stopped credit cards or other reversed payments, and custom fees.
For more information about creating or updating adjustments in your Procedures table, read Edit Your Practice’s Procedures, Codes, Adjustments, and Prices.
The default procedures are:
A “Returned Check” procedure with the accounting type of “Receipt – NSF.” This adjustment procedure is used to offset the reversed payment.
A “Returned Check Fee” procedure with the accounting type of “Revenue – Non Service.” This procedure is used as a penalty or processing fee for the returned check. You can set a default price for this procedure, or leave it at $0.00 and adjust it at the time of posting.
After you submit claims, your office receives many different electronic responses. Your PCC system logs submission activity, PCC’s central server sends your system a daily summary, claim clearinghouses and other vendors send back acknowledgment reports, and payers send back rejections and ERAs.
Read the sections below to learn what kinds of responses are sent to your practice, which you should review, and where you can go to research responses when you run into a billing problem.
What is "EDI"?: EDI stands for “Electronic Data Interchange.” When you submit electronic claims or receive any kind of electronic reports, you are using EDI. PCC has several different dedicated teams working on EDI, and you can contact PCC Support with any questions.
Learn All Steps for the Biller Role: This article is part of the New User Training for Billers. You can use that outline to learn how to complete all billing tasks in PCC EHR.
PCC, claim clearinghouses, ebill vendors, and payors all send your practice various electronic communication.
Electronic personal bills are fairly straightforward: Your PCC system logs what went out on the bills, and the ebill vendor sends back an acknowledgement that bills were received.
Claims, however, result in a series of logged information, responses, and reports:
For most of these responses, your PCC system automatically receives the report, parses it, and adds appropriate items to each family’s account history. You don’t need to review the full report file, because the information is recorded for each encounter and (in some cases) for each charge. However, the full report file is archived on your system, should you need it.
Which electronic responses are important to review, and which are just for reference? There are three claim responses in the chart above that your practice will always respond to:
Need Corrections: When you process claims, your PCC system spots claim problems that need to be addressed before the claim can go out the door. You can review the “Need Corrections” claims in the PCC EHR Claims tool. Claims that are stuck also appear on the SRS Billing Error Report. Read Work on Claim Errors and Rejections to learn more.
Claim Acknowledgements that Include Rejections: Claim clearinghouses and payors will sometimes send your practice rejections, which indicate that the payor will not adjudicate the claim. You can find rejected claims in the SRS Billing Error Report or review them in the encounter’s Claim History in the Billing History in the chart. Read Work on Claim Errors and Rejections to learn more.
835s (ERAs): After a claim is adjudicated, payers typically send an 835 ERA file, which explains payments, adjustments, and denials. These ERAs replace a traditional paper EOB. Your practice can automatically post most of these payments, and then manually post any that did not match expectations. Read Post Insurance Payments to learn how to post your ERAs. Later, you can review archived responses in the Electronic Remittance Advice tool.
As described above, PCC included many powerful tools and reports for addressing claim and billing problems.
The Report Library in PCC EHR is a suite of reports designed to give you access to information about your practice.
Open Report Library
Open the Report Library from the Reports menu in PCC EHR.
Open a Report
Click on a row to open a report.
Set Report Criteria
Pick your desired date range and set other criteria.
Generate the Report
Click “Generate” to run the report.
Review and Adjust Output
As you review report results, you can choose which columns to display. You can also sort and arrange results.
For more information on working with your report output, read Adjust Report Output.
Export or Print
Export or print your report results.
The Report Library organizes reports into categories that are accessible to users with specific roles.
Categories are nested lists of reports organized by their use. Reports can appear in more than one category. Select a category and click the disclosure triangle to browse.
A colorful icon marks PCC’s built-in reports.
Use the Search field in any category to find a specific report by name or description.
You can control which users have access to specific report categories by adjusting roles in the User Administration tool and by managing categories in the Report Library. To learn more, visit Restrict Access to Reports in the PCC EHR Report Library.
The All Reports category contains a list of all the reports in PCC EHR’s Report Library.
The Data Source category includes a number of built-in reports. These reports contain all the criteria available for a given set of data. For example, the Patient List report is equipped with all the account, demographic, scheduling, clinical, and billing criteria you might need to generate a specific list of patients. Data Source reports are often used as a starting point for custom reports or for isolating a very specific data set.
Report criteria, such as Provider and Location, define which information appears on a report. Selected report criteria will be included in the report output. Once generated, you can select which included criteria to display on the report. See the Adjust Report Output section of this article for more information on working with the report output.
You can select a period of time from the Last Modified Date drop-down, enter dates manually in any free-text date field, or use the calendar icon when displayed.
Some financial reports run by transaction date or posting date.
Report criteria limit the data displayed in the report output.
You may wish to include by specific criteria when reporting on a narrow data set. When you select criteria such as Provider, Clinical Diagnosis, Location, or Include by Procedure, only the data that matches your selections will appear on the report output.
For example, if only one appointment reason is selected for inclusion, then the report will only display results for that one appointment reason.
Each criteria selection for inclusion builds on the previous selections. For example, if you include patient flags in addition to including account flags, the resulting output will display only results that contain any of the selected patient flags and also any of the selected account flags.
You can exclude criteria to remove related results from your report. This is most useful when you are reporting on a wide data set but need to remove certain criteria, such as specific flags or procedures.
For example, if three patient flags are set to be excluded, patients with the selected flags will not display in your report output.
Each criteria selection for exclusion builds on the previous selections. For example, if you exclude patient flags in addition to excluding account flags, the resulting output will display only the results that contain none of the selected patient flags and also none of the selected account flags.
To build a report of patients with specific diagnoses, use the Clinical Diagnosis field and include your chosen diagnoses.
Your output will be a list of only the patients with these diagnoses.
To report on a subset of patients with the above diagnoses who also take a certain prescription, keep the diagnoses selected and then select a drug name from the Include by Prescriptions drop-down.
Your output will show only the patient population with the selected diagnoses who also take the selected prescription. Patients with the same diagnoses who take a different prescription will not display on the report.
After you generate a report, the results appear on the screen. Your report criteria appear above the report output, in the report criteria summary.
You can scroll through report data with your mouse or with the scroll bars on the far right of the screen.
The navigation buttons below the report allow you to navigate within, and close, the Report Library window.
You can use the Search Filter in the report to find specific information within the data.
The results will display in the body of the report as you enter characters in the Search Filter.
You can organize your report output to display the information most relevant to your needs.
The criteria that you selected while creating your report will be included in the report output, but may not display automatically. Use the Columns drop-down in the report output to select which columns to display.
To move a column, click and hold the column header to select it, then move it to the desired location and release.
Select “Group By” to sort your output into subgroups.
Some financial reports use aggregate data. You can organize this data for your practice by including columns during report customization and then grouping the report output.
In this example, the user customized their financial report to display the Location column, then grouped the report output by location.
Numerical columns, when present, subtotal within a grouped section.
You can sort your report further by clicking on a column header. To sub-sort with other columns, hold the “Shift” key and click the column headers for your secondary sort, tertiary sort, and so on.
In the Report Library, you can export to PDF, CSV, or send batch messages to patients via email or text message.
Custom reports allow your practice to select additional criteria and set which elements will display on a given report. Read Create a Custom Report for more information.
You can schedule reports, such as daily huddle sheets and monthly recall lists, to run automatically. To find out more about scheduling a report read Schedule Reports to Run Automatically.