Help Articles Archive - Page 6 of 6

Unlink and Relink a Payment

You can link a payment to specific charges when you post charges or post payments.

Later, you can also edit, unlink, and relink personal payments in the Payments tool in PCC EHR.

Recall Patients with the Partner Patient Recaller

The Patient Recaller (recaller) creates call lists, form letters, and mailing labels for your patients and families. You can create custom searches using different criteria combinations.

Use the Recaller to find the right patients and then print out physical reminders, flu shot announcements, or immunization recalls. You can also use the Recaller to do quick research and reporting on your patient populations.

Recall in Partner, or Recall in PCC EHR?

The fastest and easiest way to run a patient recall is found in PCC EHR’s Report Library. Read the Recall Overdue Patients for Well Visits article to learn how.

In addition to Well Child recall, your practice can create custom reports based on any criteria.

The article below covers the Partner Recaller (recaller), which provides unique output options (such as generating form letters for a batch of patients).

Partner Recaller Overview: Run the Recaller and Create a List of Patients Based on Criteria

You can use recaller to find and contact patients who need flu shots, patients due for physicals, or any other subset of your patient population. Running recaller works the same way regardless of your goal. Follow the procedure below.

Run the Recaller

Run recaller from the Practice Management windows.

Enter a Criteria to Build a List of Patients

Your patient database includes thousands of patients. Enter one or more criteria that will determine which patients to recall. For a list of possible criteria, enter an asterisk and press Enter.

For the example above, the user needs to see all patients who have visited the practice in the past three years, a common way of displaying all “active” patients. They will therefore limit by the patient visit date criteria.

All Patients?: If you want to work with all patients in your database for some reason, enter no criteria and press F2 – Output to continue to the output selection screen. You can skip down to Step 8, below.

Press [F1 – Next]

Press F1 to add the criteria to your report and proceed to select specific details.

Enter Criteria Details

For each criteria item you select, recaller will ask you for details. You will see one or more screens asking you to clarify the criteria.

In our example, the user wishes to review a list of active patients, so they will enter a range of the past three years. The user could also press F7 – Specific Dates to find patients who had visited for a specific date range.

After answering the criteria questions, press F1 – Next.

Review Patient Totals

After you have entered criteria details, Partner will return you to the first recaller screen. At the top, you can see the current account and patient totals, based on your criteria so far.

Optional: Add More Criteria

You can add multiple criteria for a more refined recall list. Add a criteria in the “and” fields by using the asterisk (*). Then press F1 – Next and answer questions to enter recall criteria details.

As you add additional criteria, the size of your recall list will shrink as the number of patients who meet all the criteria reduces. In the above example, the office now knows they have 425 patients who have had some kind of asthma diagnosis billed within the past three years.

Note: In the above example, the user wishes to limit the list of active patients to those who have had an asthma diagnosis of any kind. When entering diagnoses, they used the F6 – List By Pattern function. For more information on all recaller criteria and the tools for entering criteria details, read Recaller Criteria Reference at https://learn.pcc.com.

Optional: Review Criteria Details

At any time, press F5 – Report Details to review the details of your selected criteria.

Press F1, or F12 to return to the criteria list screen.

Press [F2 – Output] to Continue

Once you have finished selecting your criteria, press F2 to visit the Output screen.

Select Output

Use the first output selection question to choose what the Recaller should produce. The Recaller can create patient lists, form letters, labels, or a special age and sex subtotal report.

For the first three options, you can use an asterisk to select the specific style of patient list or form letter or label category. Some options, such as form letters or labels, will prompt you for details after you press F1 – Process.

For a guide to all available output formats, read the Recaller Output Reference.

Select Sorting Option

Select whether your lists, form letters, or other output should be sorted by Last Name, ZIP code, Birthday, or Birthdate.

Birthday or Birthdate?: If you are printing physical reminders or birthday cards, you may want to sort the patient list by their birthday, regardless of the year of their birth. If you are generating other materials, by age, you may wish to sort patients by actual birthdate, including the year.

Press F1 – Process to Continue

Choose Output Destination

On the Output Selection screen, choose whether to send your resulting output to the screen, printer, e-mail, or file. Then press F1 – Process to continue.

Review Results, Optionally Select New Output

The default output is a patient call-back list, with custodian information, on the screen:

Press F12 or F4 to select a different output. Press F12 twice to return to the Criteria screen and add or change recall criteria.

Partner Recaller Example: Recall Patients for Physicals

Reminding patients and families about their physicals is good for your patients and good for your practice. The Partner Patient Recaller can produce phone lists, form letters, and mailing labels for patients who are overdue for a physical or have a physical due date coming up soon.

Read the steps below to learn how an office could recall for physicals.

Add Physical Due Date Criteria

After running the Recaller, select the “Include by Date of Physical Due” for a physical criteria. You can search for it by entering “*due*”, as shown.

Enter a date range that will include patients who have recently missed their physical due date and/or those for whom the time for a physical is approaching.

Note: A patient’s next-due physical date is set, based on your office’s custom physical schedule, whenever they are billed for a Well Child procedure. You can also change a patient’s physical due date in the Patient Editor (notjane).

Add Last Visit Date Criteria to Find Active Patients

Use the Last Visit criteria to limit your recall to active patients, those who have visited your practice in the past three years or so.

Add Account and Patient Flag Criteria to Exclude Removed Patients

Use the two “Exclude by Flag” criteria to remove Inactive, Dismissed, Deceased, or other sets of patients or accounts that you do not want to include in your recall.

You can also use the Exclude by Flag criteria to remove patients and families who have asked not to be contacted. Read Exclude Patients From Recaller and Notify to learn more.

Add Exclude by Appointment Criteria to Avoid Patients with Upcoming Appointments

Since you don’t want your Recaller output to include patients who already scheduled an upcoming physical, select the “Exclude by Appointment” criteria. Then enter a date range and select all physical visits.

Optional: Add Additional Criteria

You may also choose to limit your well child recall to certain geographical locations (by zip code), primary care physician, or other criteria.

Optional: Review Criteria

At any time, press F5 – Report Info to review the specific details you have entered for each criteria in your recall.

Press F1 – Done to continue.

Optional: Save Your Physical Recall for Later Use

You can save and restore your criteria settings for a report so you will not have to rebuild them whenever you run a physical recall. Press F4 – Save Criteria from the criteria screen, enter a name, and press F1.

For a complete guide to re-using Recaller report sets, read Saving and Restoring Recaller Settings.

Select Output, Finish Recall

Press F2 – Output and select your output. You can produce custom form letters, mailing labels, or a simple contact list. For a complete guide to Recaller output, see the Recaller Output Reference below.

Save and Restore Partner Recaller Criteria Settings

You can save, and later restore, complex sets of report criteria for the Partner Recaller. The Partner Recaller has a wide range of criteria, with thousands of possible criteria combinations. After you set up a recall report, you may wish to save the criteria. When you return to the Partner Recaller later, you can restore your old criteria, make adjustments (such as a date range or type of patient to recall), and re-run the output.

Relative Dates: Many of the Partner Recaller’s date-specific criteria use relative dates. For example, if you use the “Last Visit Date” criteria, the report will calculate for the number of days from whatever date you run the report. Since relative dates will keep your reports current and accurate, many types of reports can be saved and restored.

Save a Recaller Report

After entering your report criteria, press F4 – Save Criteria and enter a name and description to save your report.

Press F1 – Save to save your report.

Restore a Recaller Report

Press [F3 – Restore Criteria] to restore a set of Recaller criteria.

Arrows for the two options, one is “Restore Recall Criteria, Jump to Output”, “Restore and Review/Alter Criteria”

Choose from your list of criteria and then press F1 – Jump to Output to proceed to the report’s output.

Which Report Did I Want, Again?: If you have trouble discerning the report you wish to restore, you can select one and press F4 – Description to review the description or F5 – Report Details to read the details of the criteria settings.

Walk-Through Instead: If you want to restore a report and then tweak it, making slight changes to the criteria used for the recall, press F2 – Walk Through instead of F1. You will see the list of the recall’s criteria. You can then use F1 – Next to walk through each criteria and adjust dates or selected items.

Delete Old Reports: Select any Recaller report on the Restore Criteria screen and press F8 – Delete to delete it.

Partner Recaller Criteria Reference

When you run the Partner Recaller, you begin by adding one or more criteria to limit the output. The criteria determine which patients will be part of your recall.

How do each of the Recaller criteria work? What would each one be useful for? The catalog of criteria options below explains the purpose and effect of each criteria, as well as how to fill them out.

Introduction: How Do I Find and Select Criteria for a Recall?

Selecting and Searching for Criteria: You can use an asterisk to see a list of all available criteria. Criteria are listed in alphabetical order, separated into “Include by” and “Exclude by” lists.

You can also search for a criteria by surrounding a search term with asterisks (i.e., enter “*due*” to search for criteria with the word “due” in the description).

You can add several different criteria, building a more and more refined list of patients for your recall. For examples of selecting and entering criteria, read the examples above.

Age

Select the age criteria in order to limit your recall according to patient’s age or date of birth.

When you select the age criteria, the Recaller will prompt you to enter an age range.

Optionally, you can press F7 – Specific Dates to enter a birth date range.

Uses: The age or birth date criteria can create a list of all patients of a certain age. You could use this criteria to recall certain patient age groups for flu shots or other services.

Appointments

Select an appointment criteria to include or exclude patients based on appointments in the Partner scheduler, either for any provider or a specific provider.

When you select an appointment criteria, the Recaller will prompt you for an appointment date range and a visit reason or reasons.

Use Select All: You may only care about a patient’s appointment date, regardless of the visit reason. Note that you can use the Select All function on the Visit Reason screen to remove that item from the Recaller’s filtering.

Uses: An appointment-based recall helps you exclude patients with scheduled appointments from physical reminders. You could also find all patients who are scheduled for a certain visit reason.

Appointments (or Procedures) By Provider

You may wish to see a list of all patients who have had certain procedures or appointments with a specific provider or providers. Use the “By Provider” criteria in the lists.

These criteria work like the procedures and appointments criteria, described in the sections above, except that the Recaller will also ask you to specify which providers should cause the patient to be included or excluded from the recall.

Uses: You can use these criteria to create a list of all the patients a certain provider performed a Well Child diagnoses for, or find out how many recheck visits are in the schedule for a certain nurse.

Birthday (next)

Use the upcoming birthday criteria to find patients with birthdays occurring within a specified future time frame.

When you select this criteria, the Recaller will ask you how far forward it should look when collecting birthdays.

Optionally, you can press F7 – Specific Dates to enter a birthday date range.

Uses: You could use this criteria to send birthday cards.

Date Added to Partner

Select the Partner date criteria to recall patients based on when they were added to the Partner system.

When you select this criteria, the Recaller will prompt you to enter a time frame.

Optionally, you can press F7 – Specific Dates to choose a precise date range.

Uses: This criteria can help you find new patients or families, regardless of their visit history. You could create a list of all patients added to your Partner system in the past year. During a data conversion from another billing system, this recall criteria could list precisely those patients added to your system on a certain day.

Date of Last Physical

You can build a list of patients based on the date of their last physical.

After selecting this criteria, the Recaller will ask you to input a range of time within which the patient’s last physical must have occurred to be included in the recall.

Optionally, you can press F7 – Specific Dates to enter a specific date range instead of a time relative to today.

Date of Last Visit

Select the patient’s last visit date criteria in order to limit your recall to all patients who were seen within a specified time frame.

When you select this criteria, the Recaller will prompt you to enter a length of time to search for past patient appointments.

The Recaller will run a search relative to today (the time you run the report) and include patients with visits in that time period. Optionally, you can press F7 – Specific Dates and enter a precise date range.

Uses: The visit date criteria is often used to limit a recall to active patients, as determined by those who have visited your practice within the past three years. You could also use it to create a list of patients whose last visit was several years ago so that their charts may be archived.

Date of Physical Due

Select the physical due date criteria in order to limit your recall according to a patient’s physical schedule.

When you select the physical due date criteria, the Recaller will prompt you to enter a time frame for when the patient’s next physical is due. Keep in mind that this may include both patients who are overdue for a physical or will be due for one soon.

Note: Partner enters a “Due Date for Next Physical” into a patient’s record when their guarantor is billed a Well Child procedure during checkout. It uses a customizable physical schedule for your office, originally based on the AAP’s recommendations. Run the Patient Editor (notjane) to see any patient’s next physical due date.

Uses: The physical criteria can help you find all patients who are overdue for a physical or have a physical due during the coming months. You can use the Recaller to print mailing labels for reminder postcards.

Diagnoses

Select a diagnoses criteria to include or exclude patients who have received certain diagnoses.

When you select a Diagnoses criteria, the Recaller will prompt you to select a date range and then a diagnosis or diagnoses.

Uses: A diagnoses recall is ideal for finding all asthma patients, all ADD patients, or all patients suffering from any other diagnoses, in order to remind them of services or opportunities. You could also run a recall using a list of diagnoses to remind high-risk patients of a flu clinic.

Ethnicity, Race

Use the ethnicity and/or race criteria to limit your recall to specific ethnicity or race, based upon the U.S. Federal Government’s standard values.

The Recaller will ask you to select races/ethnicity to include or exclude.

Note: Race and ethnicity are stored in the Patient Editor (notjane) or in the Demographics section of the patient’s electronic chart. These criteria will only be useful if your practice collects this information.

Flags, Account or Patient

Select one of the four status flag criteria to filter Recaller results by patient or account status flags. You can include or exclude by patient or account flags.

When you select any of the status flag criteria, the Recaller will prompt you to select the flags.

Any, or All?: By default, when you are including patients by flag, any of the selected flags will cause them to be included in the recall. When you are excluding by flag, the Recaller will knock them out of the recall if they have any one of the selected flags. You can change these default behaviors by pressing F7 – Set to All/Any. For example, if you want to recall patients who are both Special Needs and Referred, you would select both flags and then press F7 to indicate that patients needed all flags to be included in the recall.

Auto-Selected: You may notice that certain status flags are already marked for exclusion by default. You can set the default behavior for excluding flags in the Table Editor (ted).

Uses: Status flags are used to categorize and mark accounts and patients for a wide variety of reasons, any of which may be a good reason to recall a patient or exclude them from a recall. If a patient record is flagged deceased, dismissed, or transferred, for example, you would want to exclude them from a physical reminder recall. You could also use the Recaller to send a form letter to all accounts flagged “Collection”, or to exclude all families that have asked not to receive recall messages.

Insurance Plan

Select an insurance plan criteria in order to limit your recall to all patients who have (or do not have) specific insurance plans.

When you select an insurance plan criteria, the Recaller will prompt you to select a plan or group of plans.

Use function keys at the bottom of the screen to select individual plans, all plans, deselect all plans, list and select plans by insurance group, or search for a plan.

Uses: You may need to contact all families under a certain insurance plan to inform them of a change in policy or that you are dropping the plan. You may wish to inform your patient population of a new service, but only inform patients with insurance policies that permit the service.

Procedures

Select a procedure criteria to find or exclude patients who received (were billed for) certain procedures.

When you select a procedures criteria, the Recaller will prompt you to select a date range and a procedure or procedures.

Uses: A procedure recall is ideal for performing an immunization recall when you discover a bad immunization lot. You could also combine the exclude procedure criteria with the “Patient’s Date of Birth” criteria to find all patients of a certain age who have not received a specific immunization or other recommended procedure.

Provider (Primary Care)

Select the primary care provider criteria to include only a specific provider’s (or providers’) patients in a recall.

When you select this criteria, the Recaller will prompt you to select providers or provider groups.

Note: Primary care provider information is stored in the Patient Editor (notjane). This criteria will only be useful if your practice assigns this information.

Uses: Add this criteria to limit your recall to a subset of your providers. You may need to inform all of a provider’s patients that a physician has new office hours or that he or she is retiring.

Sex

Select the sex criteria to find only male or female patients.

When you select the sex criteria, the Recaller will prompt you to select male or female patients.

Uses: You can limit any recall, for any reason, to one sex or the other. You could use the sex criteria to send Gardasil information, for example.

ZIP Code of Custodian

Select the ZIP code criteria to find patients living in a certain area.

When you select the ZIP code criteria, the Recaller will prompt you to enter a ZIP code or ZIP code range.

Uses: A ZIP code recall could help you notify families and patients of regional issues, such as a new office location or new city and state ordinances.

Partner Recaller Output Reference

After you select criteria or restore a saved Recaller report, use the Output screens to specify what you will generate with the Recaller results. You can create patient lists, form letters, mailing labels, or a subtotal report.

After you select an output type and a sorting method, press F1 – Process to proceed to additional output questions or the final output selection screen.

Read below to learn details on each section of the Output screen and options, along with information about the additional questions or screens for each output type.

Totals

The top section of the screen indicates report totals. Since the Recaller finds patients by both patient and family characteristics, it lists patient, guarantor, and custodian totals. These numbers will differ because some families have more than one patient meeting your recall criteria, and patients may have different custodians and guarantors.

Recaller Output Types

The first question on the Output screen asks what type of report output you wish to generate.

Patient Lists

A patient list includes basic information about each found patient. You might use a patient list to contact a list of patients by phone, or export the list to another program or an auto-calling system.

After checking off “Patient Lists”, use the asterisk (*) to select the specific patient list.

Customize Patient Lists: Patient lists work just like form letters, described below, except that they use only a line or two for each patient.. You can create a patient list using waffle, including any text and patient or account variables. PCC Support can move your custom lists from the form letter section to the list section.

Form Letters

You can output a form letter for each patient found in your Recaller results. Select the Form Letters option, and then choose which list of form letters to select from.

When you press F1 – Process, the Recaller will prompt you to choose a specific form letter and may ask you form-letter specific questions.

Custom Form Letters: You can create, edit, and share form letter templates using the waffle program.

Mailing Labels

You can create printable labels, formatted to standard Avery sizes or your own custom label. Select the Labels output, and then indicate whether you want one label for each patient, custodian, or guarantor.

When you press F1 – Process, the Recaller will prompt you to select or design your label.

Laser Labels: Select the Laser Labels option, select your Avery label, and put the labels in your printer’s drawer or manual feed. Note that your printer should be configured to 66 lines per-page. PCC Support configures all printers to 66 lines per-page during our installation visit to your office, but you may want to create a test recall with only a few patients before printing a large batch.

Pin-Feed or Custom Labels: Select the Pin-Feed Labels option, enter your label dimensions, and load the labels into your printer.

Multiple Sets: If you need two or more copies of each label, enter a number for the “How many sets of labels should be created?” question under the Laser Labels or Pin-Feed Labels sections.

Subtotal By Age and Sex Report

Sometimes, instead of contacting a list of patients, you may wish to view detailed totals of the patients found by your Recaller criteria. Select the Subtotal By Age and Sex Report and press F1 – Process.

Recaller Sorting Options

After selecting your output type, you can indicate a sorting method. You can sort the output, whether it is a list or a stack of form letters, by last name, zipcode, birthday or birth date.

Output Selection

After choosing an output, pressing F1 – Process, and answer any additional questions. The Recaller will display the standard Partner Output Selection screen.

You can view the results on the screen, send them to a specific printer or e-mail address, or save the results to a computer or the srsfiles program. You could also review items on the screen first, and then press F12 or F4 to return to these options and send the output to the printer.

For more information about the Partner default Output Selection screen, read Report Destination Selection.

ERAs and EOBs with PCC

August 3, 2015/in Get Started Post Insurance Payments Post Insurance Payments /by Douglas Beagley

After a payor reviews your electronic claim, they will send your practice an explanation of what charges are paid, adjusted, or denied.

On paper, this information arrives as an Explanation of Benefits (EOB) and a check.
The electronic version of an EOB is called an Electronic Remittance Advice, or ERA. An ERA usually arrives in coordination with a direct deposit to your practice’s bank account.

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.

How Do I Get Signed Up for ERAs with Carriers?

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.

Contact PCC Support for help determining your biggest payors and to find out how to sign up for ERA.
Or, contact PCC Support about a specific payor, and we will begin the setup process. It is helpful if you include your name, contact and practice information, and the insurance payor’s national identification number (the “payor ID”).

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.

When Will I Autopost ERAs, and When Will I Manually Post Payments and Adjustments?

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.

When My PCC System Receives ERAs and EOBs, How Do I Review and Post Them?

You can learn how to post ERAs and EOBs by reviewing the following:

Post Insurance Payments

You can learn more about how to read ERAs and research adjudication responses from payors here:

Read ERAs

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.

What Sort of Responses Can PCC Automatically Post from Incoming ERAs, and What Will Need My Direct Attention?

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:

View CARC, RARC and CORE Business Scenarios on ERAs

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.

Post Insurance Payments and Adjustments

August 3, 2015/in Get Started Post Insurance Payments Post Insurance Payments /by Douglas Beagley

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, Handle Claim Responses that Can’t Be Autoposted, and Manually Post Insurance Payments to learn more.

Post Payments and Adjustments

Automatically Post ERAs

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 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.

Use the Posting Exceptions worklist tab to address all payor response that could not be autoposted. You may also need to address denials, unusual adjustments, and other special cases. Review your processed ERA and identify any situation that may require manual posting, an appeal, or other action.

Handle Claim Responses That Can’t Be Autoposted

Sometimes your PCC system can't automatically post something found on an ERA. Maybe the family paid for an encounter already, the payor changed the procedures on the claim, or your practice made changes to the encounter after you sent the claim.

After you autopost ERAs, use the Posting Exceptions worklist in the ERA tool to address each claim response that could not be autoposted.

Process ERAs

Open the Electronic Remittance Advice tool and process ERAs.

Exceptions are added to the Posting Exceptions worklist whenever you process an ERA that contains something that could not be autoposted.

Review Unposted ERA Responses

Click on the "Posting Exceptions" tab to review claim responses that could not be autoposted.

For each encounter, you can see the status, the date the ERA was processed, the check number, the remittance date from the ERA, the payor, the patient, the date of service, the exception reason, and the user who processed the ERA.

You can click column headers to sort the list, search, or use filters at the bottom to find specific encounters you wish to work on.

Posting Exception Status: By default, each ERA response that cannot be autoposted is assigned a posting exception status of "Needs Attention". By filtering by this status, you can isolate the encounter responses that still need to be addressed.

Work On a Posting Exception

Double-click on a posting exception to review more details and address it.

The Posting Exceptions - View Details screen includes the full ERA section that couldn't be autoposted, encounter details, and billing tools.

Understand Why Payments Cannot Be Autoposted

To understand the full story of what's happened with an encounter and why the ERA couldn't be autoposted, you can review the section of the ERA that pertains to the encounter.

Scroll down to review the Encounter Billing Notes, Account History, and Claim History sections to review what's happened with the encounter so far.

If PCC EHR Can't Find the Encounter: If a payor sent you an ERA response that doesn't match an encounter that your practice billed, some of these billing-related components will not appear.

Edit Charges and Other Encounter Details

You may need to edit something about the encounter in order to post the payor's response. Click "Edit Charges".

On the Edit Charges screen, you can edit diagnosis and charge information, change the responsible party for charges, and more.

For more information about using Edit Charges, read Edit Encounter Charges and Other Claim Information and Resubmit a Claim.

Manually Post the ERA or Edit Insurance Payments

When you are ready to post the ERA manually click "Insurance Payments".

If the encounter can be identified, the Insurance Payments tool will open to the payment screen and you can manually post details from the ERA.

You can also use the Insurance Payments tool to edit previously posted payments, perform takebacks, and more.

Add a Note About the Exception's Resolution

After you've taken action to address a posting exception, you can optionally add a new encounter billing note.

By adding a note, you'll have a record of what happened if there are more issues with the encounter later.

Update the Exception's Status

After you address an exception (or discover it is invalid and safe to ignore), update the exception's status.

When you update the status, you mark the posting exception to indicate it cannot be posted, is a duplicate, is invalid, or has now been addressed manually. This will remove it from the default Posting Exceptions worklist. Later, you can revisit resolved exceptions using the Posting Exceptions Status filter on the worklist.

Manually Post Insurance Payments and Adjustments

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.

You might also reach the Insurance Payments tool from another workflow, such as the Posting Exceptions worklist or while performing a reversal from the Payments tool.

Optional: Enter a Claim ID

Enter a claim ID for which you wish to post payments. 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 a payment 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, Payor Claim Control Number, And Other Details

Whenever you post payments, enter a check number and (if available) the payor claim control number. If your PCC system already knows these values, the fields may be filled out for you.

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 (if you select a custom type) 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 Tab or 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.

Review Posted Insurance Payments and Adjustments

After you process incoming ERAs and post insurance payments and adjustments, how can you review totals and take a closer look? Where do the payments show up in records?

Review Special Cases on Posted ERAs

After autoposting your ERAs, and addressing posting exceptions on the Posting Exceptions worklist, your practice may still have specific issues you wish to review on an ERA. For example, you may wish to review situations where the payor adjusted off the entire charge, or other special cases.

Open a Posted ERA

An ERA opens immediately after autoposting. You can also return to the Electronic Remittance Advice tool and open any ERA at any time.

To find posted ERAs, use the status filter.

Double-click on a processed ERA to review processing details. For more information, see Read ERA 835s from Payors.

Filter the ERA to Specific Encounters

To work on 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.

Edit Payments and Adjustments and Post Responses Manually

As you review the details on an ERA, use the Insurance Payments tool to edit posted insurance payments and post payments and adjustments manually.

The Insurance Payments tool 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 an Autoposted ERA For Specific Adjustment Reasons

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.

Prove Out and Audit Insurance Payments By Check

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.

Review an Account’s Payment History

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.

Review an Encounter’s Payment History

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.

Review a Complete Account History for a Family

Use the Account History in a patient’s chart to review a family’s complete account record, including all payments and adjustments for all encounters.

Review Insurance Payment Totals and Other Trends

PCC includes reports for reviewing what your practice posted, examining insurance reimbursement trends, and more. Visit your Practice Vitals Dashboard to get started. To learn more about reporting on adjustment trends, read Report on Adjustment Trends in PCC EHR. You can always contact PCC Support for help with specific reporting needs.

Edit Posted Insurance Payments and Adjustments

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.

'Pending Insurance' Column When Editing a Payment: When you post an insurance payment, the Pending Insurance column displays the expected sum of the payment and adjustment, as the charges are still pending insurance. When you edit an insurance payment, however, the Pending Insurance column displays the amount due on the charge (which may be affected by other payments on the account), minus any unpaid copay amount, plus the amount of the edited payment as originally entered. Personal payments on the account can interfere with your ability to increase the payment amount if (for example) it was entered incorrectly.

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 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.

Need to Queue Up a New Claim?: After you edit an insurance payment, you can use the Edit Charges feature in the patient’s Billing History to revise the current responsible party and queue up a new claim or file a corrected claim. See Edit Encounter Charges and Other Claim Information and Resubmit a Claim.

Insurance Posting Reference

Read the sections below to understand more about how PCC automatically posts insurance payments and adjustments, and how you can use the Electronic Remittance Advice tool to find and deal with unusual situations on ERAs.

Record the Payor Claim Control Number for Claim Responses from Payers

Whether autoposting an ERA or posting an EOB manually, PCC EHR can store the Payor Claim Control Number for easy access when you need to resubmit claims or communicate with the payer.

Record the PCN Automatically: When you process an ERA in the Electronic Remittance Advice tool, PCC EHR will automatically record the Payor Claim Control number for each response to each encounter.
Enter a PCN Manually: When you manually post the payer’s response in the Insurance Payments tool, you can enter the Payor Claim Control number along with the check number.

Recording the Payor Claim Control Number for every claim response makes it available when you need to contact the payer to discuss an issue or resubmit a claim, void a claim, or file a corrected claim.

For example, when you use Edit Charges to resubmit a claim, you can quickly pick from a list of claim control numbers recorded for the encounter.

What's a Payor Claim Control Number?: A Payor Claim Control Number (PCN) is a unique identifier assigned by payers to a given claim for a given encounter. Your practice uses the PCN when communicating with the payer about the claim. Insurance payers issue a PCN when they adjudicate a claim and send you an ERA or EOB. The number is also known as the Claim Control Number (CCN) and is called the Original Reference Number (ORN) on a paper claim. Medicare claims refer instead to an Internal Control Number (ICN) or Document Control Number (DCN).

Understand How PCC EHR Automatically Processes ERAs

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.

Understand Posting Exceptions

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.

Understand Special Cases

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.

Configure Your Autopost Payment and Adjustment Types

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 Tables tool. Contact PCC for assistance.

Patient and Family Accounts in PCC Explained

August 3, 2015/in Get Started Edit Patient and Family Information Edit Patient and Family Information /by Douglas Beagley

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.

Add New Patients and Accounts

August 3, 2015/in Get Started Edit Patient and Family Information Edit Patient and Family Information /by Douglas Beagley

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.

Add New Patients and Family Accounts in PCC EHR

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.

Click “Save”

When you are finished entering information for the new patient, click “Save” to create and open the patient’s chart.

Reassign or Add Another Account

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.

Blended Families and the Siblings Component

The Siblings Component shows other patients associated with the same home or billing account allows quick access to siblings and other patients who share a home or billing account. Care should be taken when assigning Billing and Home accounts.

In the case of blended families, patients who share a billing Billing or Home account appear in the Siblings Component. So if a parent appears as the billing account for their biological children and a step-child and the home account of just the step-child, both the step-child and biological children will be linked to each other in the siblings component.

Accounting Challenges

August 3, 2015/in Other Tools and Resources for Your Practice /by Douglas Beagley

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.

Refund Personal Credits (2.5 min • 2022-11)
Post a Returned Check or Other Personal Payment Reversal (4 minutes • 2022-11)
Reverse an Insurance Payment (Post a Takeback) (5 min • 2025-09)
Requeue Large Numbers of Claims and Resubmit (8.5 min • 2024-03)
Refund or Write-Off Account Credits
Post a Returned Check or Other Personal Payment Reversal
Reverse an Insurance Payment (Post a Takeback)
Requeue Large Numbers of Claims and Resubmit
Write Off Charges and Bad Debt
Turn an Account Over to Collections

Merge Duplicate Patients and Accounts

August 3, 2015/in Edit Patient and Family Information Edit Patient and Family Information /by Douglas Beagley

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.

Set Permissions for Combining Accounts and Patients

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.

Combine Patients

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

Combine Accounts

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.

Practice Management Program Name Index

August 3, 2015/in /by Douglas Beagley

PCC’s previous product software suite, Partner, was a collection of individual programs. The programs all had a single-word name for easy reference.

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.

activity: The Insurance Activity Summary (activity) provides a quick review of activity for each insurance group for a given date range. Because activity displays the number of visits and charges, you can 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.
addblock: The Add Blocks (addblock) program added a single block to the schedule for a given date, provider, block type, and time range. You could also review existing blocks, read block notes and remove blocks from within addblock. This functionality has been replaced by Appointment Book functionality.
autopip: Autopost Insurance Payments (autopip) 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.
AniTa: AniTa was a Windows program that some clients used to connect directly to PCC practice management tools before PCC EHR. TeraTerm was an older program used for the same purpose. PCC did not write AniTa or TeraTerm. These tools have been replaced by Practice Management in PCC EHR.
appts: The Appointment Summarizer (appts) was a scheduling analysis report. It listed appointments by a variety of criteria and subtotaled by provider and visit reason.
ardays: The A/R Days (ardays) 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.
arra: The ARRA report reports on the Medicaid status of visits by patients within a given time frame. It is designed to help your office determine if you may qualify for the ARRA incentive program. For more information, read the ARRA Report help article.
autoflag: Your PCC system can automatically mark patients who haven’t visited recently as “Inactive”, or automatically add any other status flag based on a range of criteria. 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.
autoflaglog: When your practice uses autoflag, 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.
backups: The backups 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.
bills: The bills program generates personal bills.
bump: The bump program lists overlapping appointments for any given day.
byins: The byins report lists all insurance plans by their insurance group. Insurance groups are important because many financial reports use them. The Tables tool in PCC EHR allows users to review the insurance table by group, making byins obsolete.
byproc: The byproc report lists all procedures by their procedure group. Procedure groups are used by various reports. The Tables tool in PCC EHR allows users to review the procedure table by group, making byproc obsolete.
byprov: The byprov report lists all of your providers sorted by provider group. Provider groups are used by several programs and reports.
caprep: The Capitated Plan Member Report (caprep) provides usage numbers which can help you evaluate the pros and cons of a capitated plan.
ced: The Configuration Editor (ced) contains lists of questions that control the behavior of some PCC programs.
cfs: The Special Accounts Editor (cfs) 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.
chart: The Appointment Book Displayer (chart) 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.
checkin: The Patient Checkin (checkin) 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): The Checkout program (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 -d: The chuck -d command is a troubleshooting command for reviewing configuration settings in the charge posting infrastructure on your PCC system. It displays charge-posting and HCFA configuration settings 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.
coll: The Collection Report (coll) 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.
cscb: The Consistent Sick Call Blocker (cscb) 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.
csedit: The Charge Screen Editor (csedit) 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.
curimms: The Current Immunization (curimms) report and the Epidemic Prevention (epidemic report both check for missing immunizations based on billed data. The curimms report output can be added to a paper forms and will show you if your system does not have a billing 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. For a more powerful tool with better output, see the Overdue Vaccine Recall report.
cvxreport: The Immunization CVX Configuration Reports (cvxreport) 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.
dailycheck: The Daily Check program (dailycheck) lists all visits posted on a single day or range of days. The report includes every diagnosis, procedure, amount charged, and payment posted. Use dailycheck to review a day’s postings and compare them against paper encounter forms. Some office managers run dailycheck each day to review the billing for encounters before claims are submitted. For more information, read the Daily Check help article.
daysheet: The Daysheet report shows all charges, payments, and adjustments for any date range or a single day. If problems arise while balancing out at the end of a day, the daysheet report can help reveal why. Every entry includes the poster’s username. The report includes removed or changed items.
deposit: The deposit report lists all cash, check, and charge payments posted on a single day or date range. A practice can reconcile deposit against their cash drawer at the end of the day or the end of a shift. Each payment includes the username of the person who posted it.
dsscan: The Daysheet Scan (dsscan) displays daysheet entries for one particular account. You can see every charge, payment, or adjustment posted or deleted on an account, along with the user who performed the action. dsscan is useful when you need to audit account activity, as it can make it easy to see (for example) when a charge is posted by one user and deleted by another user.
duplicates: The Duplicate Account/Patient Report (duplicates) shows all accounts and patients that have a duplicate entry.
ebs: The Submit Electronic Bills (ebs) 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.
ECS: The ECS Submission (ECS) 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.
ecsreports: The ECS Reports (ecsreports) program is an archive of electronic communication to your system, including electronic claim submission reports, ebills reports, and electronic remittance advice (ERAs). The program organizes these communications by date and includes a category view and various search features for finding and working with old reports. The ECS Reports program is replaced by the Electronic Remittance Advice tool, the log found in the Bills tool, and the Billing History in the patient’s chart. See also Review Archived Claim and EDI Reports.

elig

The Eligibility (elig) program displays patient insurance eligibility. Use the program to view a list of appointments and their accompanying eligibility information, request an eligibility update, or make notes or set a status about eligibility. While using the program, you can also contact the patient’s family and update insurance information.
epidemic: The Epidemic Prevention program (epidemic) 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.
escb: The Extended Sick Call Blocker (escb) 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.
fame: The Family Editor (fame) 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.
findem: The Advanced Find Routines (findem) allow you to find and list patients by a range of criteria. For example, you can use findem to find patients by insurance certificate number, home address, and more.
full: The full 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.
hcfa: The HCFA Form Generation program (hcfa) prints paper insurance claims.
hmo: The HMO report generates an age distribution for each primary-care physician for any of your practice’s insurance groups. Run hmo to find out how many patients under five years old have BCBS and Dr. Smith as their primary care physician. hmo lists all physicians for all age ranges in a single report and includes subtotals.
immcheck: The immcheck report lists all of the details surrounding immunization and physical configuration at your office, based on billing procedures. 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.
imms: The Immunization Record (imms) stores an immunization record for every patient. Run imms to review immunizations or print an immunization record.
immsreg: The Immunization Registration (immsreg) sends your patient immunization records to a state or commercial immunization registry.
inquire: The Scheduler’s inquire 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.
insaging: The Insurance Accounts Receivable Summary (insaging) 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 practice’s 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. This report has been replaced by the Unpaid Encounters tab in the Insurance Balances tool.
inscoar: The Insurance Accounts Receivable Detail (inscoar) 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. This report has been replaced by the Unpaid Encounters tab in the Insurance Balances tool.
inscows: The Insurance Company Work Sheet (inscows) 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.
ira: The Insurance Company Reimbursement Analysis (ira) program 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. ira is a catch-all report that can answer questions when you are making financial decisions for your practice.
lab: The Lab Work Database (lab) stored lab orders, printed lab order forms, and recorded lab results.
listins: The List Account/Patients By Insurance (listins) 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.
maketags: Resubmit HCFA Forms (maketags) 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.
ministats: The ministats report produces a break-down of your practice income for a given date range by payment type, payer, and year.
nimms: The Nurses Immunization (nimms) 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

The Patient Notification Center(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.

notjane

The Patient Editor (notjane) 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.

oops

The Correct Mistakes program (oops) 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 payor claim control number. The Correct Mistakes program was replaced by Edit Charges functionality found in the Billing History in the patient’s chart.

oopslog

The Daily Corrections Log (oopslog) displays daily activity in the oops program.

openpmts

The Open/Unlinked Payments (openpmts) report lists credits and payments that are not linked to a specific charge. Your PCC system 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.

pam

The Post Regular Payments (pam) program, posts personal payments or adjustments to an account. pam can quickly post a stack of checks or a single co-pay.

patinfo

The Patient History report (patinfo) includes both a Visit History report and a Diagnosis History report. The information is based on billing data and not clinical information from the chart. The Visit History includes a section with billed 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.

pen

Phone Encounter Notes (pen) 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.

persview

The Personal Money Tracking Assistant (persview) is an interactive report for managing accounts with outstanding personal balances. 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 generate bills or form letters for one or many accounts. You can also jump directly into other programs for more information about an account.

pip

The previous Post Insurance Payments program (pip) was used to manually post insurance payments and adjustments. It has been replaced by Insurance Payments in PCC EHR.

pnpscan

The Appointment Book Displayer by Location (pnpscan) shows scheduled appointments for one or more providers and can be limited to a specific location.

policy

The policy 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.

policylog

The policylog 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.

prenc

The prenc 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.

prepare

The prepare 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.

preptags

The preptags program prepares insurance claims that are waiting to be submitted and runs the ECS program.

printpatstats and specstats

The Print Patient Statistics (printpatstats) program generates a series of text based charts on demographic data such as patient sex and age distribution. The specstats script allows users to filter the printpatstats data using recaller‘s criteria interface.

profile

The Provider Profile Machine (profile) 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.

provids

The Provider ID Editor (provids) allows you to override providers’ standard ID numbers submitted with insurance claims.

prscprint

The prscprint 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.

ra

The Partner Windows (ra) 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.

recaller

The Patient Recaller (recaller) 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.

Before PCC EHR replacements were introduced, clients used 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.

referral

Referral (referral) recorded basic referral information, tracked referrals for each patient, and generated referral forms and referral reports. The Referral Statistics Report (refreport) sorted and displayed patient referrals. These features have been replaced by orders in PCC EHR.

refund

Post Refunds (refund) 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.

rmscb

The Remove Sick Call Blocks (rmscb) 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.

rolo

The Rolodex (rolo) is a basic address list storage program. It can manage many different rolodex lists for different purposes and includes a basic search function.

sam

The Scheduling Appointment Minder (sam) schedules appointments for patients.

scan

The Appointment Book Displayer (scan) 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.

scrod

The Provider Schedule (scrod) 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.

snomedmap

The snomedmap program is a collection of custom reports that you can use to understand the relationship between the clinical SNOMED-CT and billing ICD-10 diagnosis codes you use on your PCC system.

spectstats

See printpatstats.

squish

The squish 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.

srs

The Smart Report Suite (srs) is a report library in Partner. srs contains dozens of powerful, customizable reports, all run with a consistent interface.

tater

The Account History Report (tater) provides a history of transactions on an account. tater reports on charges, payments, refunds, and other transactions. This report was replaced be the Account History in the patient’s chart.

TeraTerm

TeraTerm is a Windows program that connects a PC computer to Partner. You run all Partner programs by first running TeraTerm and logging into Partner. AniTa is a newer program used for the same purpose. PCC did not write AniTa or TeraTerm.

ted

The Table Editor (ted) contains a list of lists used by your PCC system. This configuration tool was replaced by the Tables tool in PCC EHR.

tickle

The Tickler Module (tickle) 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.

twomonths

The twomonths report sends a calendar-style schedule directly to your default Partner printer. You can run the twomonths report from a command prompt.

useradmin

The User Administration (useradmin) program adds or locks-out Partner users, changes passwords, and modifies permission lists for some Partner functions.

utilize

The Insurance Utilization (utilize) report shows you all of the patients who visited during a given date range and had a certain insurance carrier as their primary payor.

waffle

The Friendly Form Letter Editor, waffle, makes changes to Partner’s form letters. Use waffle to modify existing form letters or create new ones.

Choose Your Practice Management Printer

August 3, 2015/in Configure Billing Functions Previous System Tools /by Douglas Beagley

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.

Choose a Printer When You Print

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.

Set Your Default Printer Automatically, By Username

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.

Set Your Default Printer Automatically, By Workstation Location

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.

Set Your Default Printer Using “Pick-A-Printer”

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.

Set a Program or Specific Feature’s Printer

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.

Edit Encounter Charges and Resubmit Claims

July 23, 2015/in Video Edit Charges and Encounter Claim Information Post Charges and Queue Up a Claim, Edit Charges and Encounter Claim Information /by Douglas Beagley

Configure PCC EHR Protocols (Detailed w/ Examples)

July 23, 2015/in Video Configure Chart Notes and PCC EHR Components Configure Chart Notes and Components /by Douglas Beagley

Work With Phone Notes and Tasks

July 23, 2015/in Video Triage a Phone Call Triage a Phone Call /by Douglas Beagley

Create and Complete Orders in PCC EHR

July 23, 2015/in Video Create and Complete Procedures, Referrals, Labs, and Other Orders Create and Complete Orders /by Douglas Beagley

Import and Work With Documents

July 23, 2015/in Video Import and Work With Documents in a Chart Import Documents to a Chart /by Douglas Beagley

Clinical Alerts in PCC EHR

July 23, 2015/in Video Review a Patient's Chart Review a Patient's Chart /by Douglas Beagley

Chart with Multiple Protocols

July 23, 2015/in Video Chart a Visit Chart a Visit /by Douglas Beagley

Prepare an Encounter for Billing

July 23, 2015/in Video Select Codes and Make an Encounter Ready For Billing, Select Codes and Make an Encounter Ready for Billing Select Codes and Make an Encounter Ready For Billing /by Douglas Beagley

Chart with Answer Memory, Last Answer, and Your Custom Auto-Notes

July 22, 2015/in Video Chart a Visit Chart a Visit /by Douglas Beagley

Chart a Visit in PCC EHR

July 2, 2015/in Video Get Started in PCC EHR, Chart a Visit Get Started in PCC EHR, Chart a Visit /by Douglas Beagley

Storm and Emergency Preparation

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

When bad weather or other emergencies approach, your practice’s medical and financial 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.

Print Out a Week’s Schedule

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.

Protect the On-Premises Physical PCC Server at Your Practice

If you have a physical PCC server located at your practice, perform the following steps.

Perform a Backup

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 Down the Server

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.

Turn Off and Unplug the APC UPS

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 and Unplug Other Equipment

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.

Unplug Internet, FAX, and Other Communication Devices

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.

Consider Covering or Moving the Server and Other 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.

Move to a Safe Location

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.

Stay In Touch

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.

Installation Specifications for PCC Systems

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

Introduction

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.

The PCC Server

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.

PCC recommends that you place the PCC Server away from the front-desk area to limit its exposure to physical activity.
The PCC Server consists of the computer itself, a monitor, and keyboard. The monitor and keyboard are often called “the console.” The console must be within two feet of the Server.
A typical layout places the PCC Server on a firm, level desk or held vertically in a computer stand. The PCC Server may have a number of peripheral devices attached directly to it (an uninterruptible power supply, a modem, a backup drive, network switches, etc.), so make sure you have ample space for the PCC Server.
Do not use the PCC Server console as a workstation. It is for system operations, backups, error messages, or emergency access to your system.
The PCC Server and attached equipment should be positioned so that your practice’s System Administrator has easy access to them for daily backup maintenance and troubleshooting. Ideally, a phone should be nearby for support assistance.
Dust is a computer’s worst enemy. Please make sure that the new home for your PCC system is thoroughly cleaned before the computer is installed. Also, please make arrangements for the area around the computer to be cleaned on a weekly basis. Cleaning should be done by someone familiar with the computer system so that if cables or adapters are accidentally knocked loose they can be properly reconnected.
Ventilation is also very important for your computer. It is preferable to set up the system on a shelf where it is free from other objects and can ventilate properly. If you plan on putting the computer in a closet, make sure the closet is properly ventilated and that the server has ample space around it.
During a typical install visit, PCC installs your server and connected equipment. However, PCC cannot cut holes in your walls, ceilings, or furniture for cabling. You are responsible for arranging such work to be completed before the PCC Server is installed.
If you need to reinstall or move your practice’s PCC Server (such as in the event of an office move), PCC can provide free telephone assistance, given 2 weeks notice. PCC can also visit your office and reinstall the hardware for a standard per-day on-site charge.

Other Approved Hardware

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.

Internet Requirements

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.

Electrical Requirements

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.).

Cable Requirements and Specifications

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.

General Cabling Guidelines and Recommendations

All cabling for devices (printers, PC workstations) must run to one central location in the office where PCC will install a network switch and the PCC Server. The design should look a lot like an octopus, with many arms returning to a central location. Do not run a ringed network, resembling a big circle, around the office.
If you cannot run all cables to the same central location where the PCC server will reside, you can run them to a central location where the switch and hub will be located. You may then need two or more cables running to the PCC Server location from the switch. Contact PCC for help designing your wiring plan.
Cables must be labeled at both ends for PCC to identify the cables correctly. Installation delays and additional charges can result if cables are not properly labeled.
For peripherals located more than a few feet from the PCC Server, cables are typically run through the walls, ceilings, and floors of your office. This not only has aesthetic advantages, but it eliminates exposure of your cables to tugging, tearing, and disconnecting. Plan a path for running each cable. Avoid running cables outside of the walls. Where unavoidable, use wiring guides to cover cables that cross between walls. Ideally, there will be a “home run” through which all cables will travel to a patch bay.
Finally, PCC suggests that you consider running additional cabling to locations that could house workstations or printers in the future. This will save the expense of rehiring an electrician when you expand your office.

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.

Technical Details about Your Network

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.

IP Address Assignment

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.

Email

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.

Remote Offices

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.

PCC Downloads

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

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.

PCC Downloads Page

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

PCC EHR

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.

Tools for Connecting From Home

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.

ScreenConnect and ConnectWise View

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.

Adding and Managing Patient Portal User Accounts

March 8, 2015/in PCC's Patient Portal PCC's Patient Portal /by Douglas Beagley

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.

Review and Update Portal Users in a Patient’s Chart

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.

Add Portal User

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.

Open Patient Portal Administration from the Tools Menu

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.

Portal User: Identity Verification

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.

Manage a Portal User’s Account

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.

Track Your Portal Users’ Identity Verification Status in PCC EHR

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)

Reset a Portal User’s Password / Help a Locked Out Portal User

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.

Add/Remove Permission to View a Patient’s Records

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.

Display Personal Balance and Associate Billing 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.

Privacy and the Patient Portal

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.

Automatic Privacy When the Patient Reaches Emancipation Age

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.

Grant Access to Adult Patient Records

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.

Audit a Patient’s My Kid’s Chart Record Access

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.

What is My Kid’s Chart, PCC’s Patient Portal?

March 8, 2015/in Get Started PCC's Patient Portal PCC's Patient Portal /by Douglas Beagley

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.

Get a Patient Portal Starter Kit For Your Practice

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.

My Kids Chart Helps Your Office Meet Meaningful Use Standards

When your patient families sign up to use PCC’s patient portal, My Kid’s Chart, you can meet two Meaningful Use requirements:

Provide Patients with Timely Online Access to Their Health Information: If 10% or more of your visiting patients have a My Kid’s Chart user with access to their records during the reporting period, you will meet this requirement.
Provide Clinical Summaries to Patients for Each Visit: If 50% or more of your visiting patients have a My Kid’s Chart user with access to their records during the reporting period, you will meet this requirement.

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.

Receive and Respond to Patient Portal Messages from My Kid’s Chart

March 8, 2015/in PCC's Patient Portal PCC's Patient Portal /by Douglas Beagley

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.

Review Incoming Patient Portal Messages

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”.

Read and Reply to a Patient 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.

Add a Summary to Patient Portal Messages

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.

Send a New Portal Message to a Portal User

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.

Send Attachments in a Patient Portal Message

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.

Send a Private Document Directly to One Portal User

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.

Receive and Review Attachments from Parents and Patients

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.

Check if Your Message Has Been Read

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.

Review Draft Portal Messages

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.

Inactive Conversations

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.

Delete Portal Messages

Patient portal message can be deleted if needed. Deleting a patient portal message is permanent and cannot be undone. Therefore, Patient Portal Message Deletion is a separate permission within PCC EHR’s User Administration Role permissions. PCC recommends carefully considering which role you assign this permission to, to ensure that patient portal messages are only deleted when absolutely necessary.

When viewing a portal message, users with the Patient Portal Message Deletion permission will find “Delete Portal Message” in PCC EHR’s Edit menu.

Selecting “Delete Portal Message” will open a confirmation window. Clicking “Delete Encounter” will irrevocably remove the message from both PCC EHR and the patient
portal.

My Kid’s Chart User’s Guide

March 8, 2015/in Get Started PCC's Patient Portal PCC's Patient Portal /by Douglas Beagley

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.

Get an Account

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.

Log In to My Kid’s Chart

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.

Review Your Child’s Records

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.

Review Visit Summaries

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.

Telemedicine Visits

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.

Check Test Results

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.

Download an Immunization Record

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.

Review Documents Shared By Your Pediatrician

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.

View Growth Charts

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.

Teenagers and Patients Who Are Over 18

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.

Send Messages, Images, or Documents to Your Pediatrician

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.

Send a Message and Attach a Document

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.

Read and Respond to Messages

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.

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.

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.

Personal Balance & Online Bill Pay

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.

Review Your Personal Balance

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.

Make a Payment Through the Portal

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.

Manage Your Stored Cards

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.

Download Visit Summaries

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!

Account Settings and Activity Log

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.

Edit Account

Click “Edit Account” to make changes to your name, sign in, and portal notification options.

Click “Save” to confirm your changes.

New Password

Click “New Password” to change your password.

Click “Save” to set the new password.

Opt In a Portal Notification Phone Number

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.

Activity Log

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 Training Resources

March 8, 2015/in Coding and Documentation /by Douglas Beagley

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.

Attend or Watch PCC Pediatric Coding and ICD-10 Web Lab Training

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.

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

Listen to an ICD-10 Podcast Presentation (2015)

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

Watch an All-Day ICD-10 Training Course (2015)

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’s ICD-10 Don’t Panic Guide (2015)

PCC prepared the following guides in the lead up to the ICD-10 transition.

PCC Software ICD-10 To-Do List: This at-a-glance checklist shows you all the various configuration tools and issues in PCC Software that you may want to consider in preparation for ICD-10. Use this as a last-minute review to be sure your PCC configuration will be ready for October 1st. If any of the issues on this list surprise you, contact PCC Support for help.
ICD-10 Notes for Notes: How can you make it easier to select the best ICD-10 codes for each patient issue? PCC’s Jan Blanchard has created a quick reference on pediatric-specific topics, from ADHD and asthma to UTIs and Well Care visits. For each problem, this document provides keywords for quickly looking up the best diagnosis descriptions on the chart note. ICD-10 Notes for Notes is a guide to the details clinicians should be sure they include in encounter notes in order to support choosing the most specific possible ICD-10 codes available. PCC’s ICD-10 training workshops taught attendees how to make their own reference sheet, but in the absence of your own, you can use this one to get started.
CMS’s ICD-10-CM Tabular Lists and Indexes of Diseases and Injuries: CMS.gov’s page with index and tabular lists of ICD-10 tables.
Common Pediatric Unspecified Codes: This is a list of common pediatric codes for which the “Unspecified” version may be appropriate and defensible. When you have more detail, you should always document and code for it. This list, however, shows common circumstances where the additional detail may not be available.
Sample Superbill from AAP

Look Up ICD-10 Codes for Patient Diagnoses

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.

Call Us

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.

Diagnostic Code Sets (SNOMED-CT, ICD-10, ICD-9) in PCC’s Software and Services

March 8, 2015/in Coding and Documentation /by Douglas Beagley

PCC’s software and services include support for several diagnostic taxonomies.

How does PCC software support SNOMED-CT, ICD-10, and ICD-9?

Overview

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.

Look Up ICD-10 Codes for Patient Diagnoses

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.

Software and Configuration Considerations

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 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.

2015 Transition to ICD-10

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 Us

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.

How to Chart for Clinical Quality Measures in PCC EHR

March 8, 2015/in PCMH, CQMs, Measures, and Incentive Programs /by Douglas Beagley

You can use PCC EHR to collect data for standardized measure reporting required by NCQA’s Patient Centered Medical Home (PCMH) Program or other external entities requiring clinical measure reporting from your practice. To learn more about NCQA’s standardized measure reporting, visit PCMH Standardized Measurement.

Read the article below to learn how to chart and configure your system in order to record medical information for each clinical quality measure. 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.

Run the Clinical Quality Measures Report and See Your Practice’s Current Results

You can report on your practice’s numbers for in your Practice Vitals Dashboard.

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.

Pediatric CQMs Overview Chart: Adjust Your Practice’s Configuration and Visit Workflow

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)	Add appropriate SNOMED-CT procedures and/or LOINC tests to screening orders, such as adolescent depression screening and suicide risk assessment orders. Add SNOMED-CT procedures to psychiatric or other depression-related referral orders. Add depression screening orders to your chart note protocols for any visit that could be charted for a patient who is 12 years or older. (Show Me How)	When you see a patient who is twelve or older, order and perform an age-appropriate depression screening. Enter a result to indicate the order is complete. If the result is positive, order and perform an additional depression evaluation, followup, or suicide risk assessment, or refer the patient for additional help or prescribe an appropriate medication. Alternatively, enter a depression diagnosis or a contraindication diagnosis in the Diagnoses component or in the patient’s Problem List, and/or click “Refused” for either order. Make sure the correct clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code. (Show Me How)
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. Depending on the specific brand of immunization your practice uses, and when your practice came online with PCC, your practice may need to review and update your immunization CVX codes. Optionally, your practice may want to review and update your chart note protocols to ensure they display the Immunizations component and display each age-appropropriate immunization order on every chart note. (Show Me How)	When you see a patient, review their immunization history and update their immunization record. Order and administer age-appropriate immunizations. Enter any relevant contraindications, allergic reactions, or evidence of immunity on the patient’s Problem List or in the Diagnoses component on the chart note. Make sure the correct clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code. (Show Me How)
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)	Add two medical procedure orders in PCC EHR, for nutrition and physical activity counseling. Add the specified SNOMED procedure codes to those orders. Add nutrition and physical activity counseling orders to your chart note protocols for any visit that could be charted for a patient who is over 3 years old. (Show Me How)	Collect height and weight during normal office visits, well exams and other appropriate visit types. On the chart note, order your practice’s nutrition and physical activity counseling medical procedures when appropriate. For each visit, make sure the correct Provider of Encounter clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code. (Show Me How)

CMS

NQF

Measure Name

Calculation Description

Configuration in PCC

Clinician Workflow

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)

Add appropriate SNOMED-CT procedures and/or LOINC tests to screening orders, such as adolescent depression screening and suicide risk assessment orders.
Add SNOMED-CT procedures to psychiatric or other depression-related referral orders.
Add depression screening orders to your chart note protocols for any visit that could be charted for a patient who is 12 years or older.

(Show Me How)

When you see a patient who is twelve or older, order and perform an age-appropriate depression screening.
Enter a result to indicate the order is complete.
If the result is positive, order and perform an additional depression evaluation, followup, or suicide risk assessment, or refer the patient for additional help or prescribe an appropriate medication.
Alternatively, enter a depression diagnosis or a contraindication diagnosis in the Diagnoses component or in the patient’s Problem List, and/or click “Refused” for either order.
Make sure the correct clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code.

(Show Me How)

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.

Depending on the specific brand of immunization your practice uses, and when your practice came online with PCC, your practice may need to review and update your immunization CVX codes.
Optionally, your practice may want to review and update your chart note protocols to ensure they display the Immunizations component and display each age-appropropriate immunization order on every chart note.

(Show Me How)

When you see a patient, review their immunization history and update their immunization record.
Order and administer age-appropriate immunizations.
Enter any relevant contraindications, allergic reactions, or evidence of immunity on the patient’s Problem List or in the Diagnoses component on the chart note.
Make sure the correct clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code.

(Show Me How)

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)

Add two medical procedure orders in PCC EHR, for nutrition and physical activity counseling.
Add the specified SNOMED procedure codes to those orders.
Add nutrition and physical activity counseling orders to your chart note protocols for any visit that could be charted for a patient who is over 3 years old.

(Show Me How)

Collect height and weight during normal office visits, well exams and other appropriate visit types.
On the chart note, order your practice’s nutrition and physical activity counseling medical procedures when appropriate.
For each visit, make sure the correct Provider of Encounter clinician is indicated on the chart note, click “Bill”, and select an appropriate visit code.

(Show Me How)

CMS2: Preventative Care and Screening: Screening for Clinical Depression and Follow-Up Plan

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 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.

Recommended PCC EHR Configuration for CMS2 Depression Screening

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.

Configure Your Depression Screenings

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.

Configure Followup Depression Care

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.

Configure Depression Referral Orders

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.

Add Depression Screening, Suicide Risk Assessment, and Referral Orders to Your Chart Note Protocols

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.

Recommended Charting and Workflow for CMS2 Depression Screening

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.

CMS117: Childhood Immunization Status

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 Immunodeficiency, 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.

Recommended PCC EHR Configuration for CMS117 Childhood Immunization Status

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 may need to add them to the Immunization and Disease configuration in your PCC system. CVX codes are the industry-standard unique identifier for each vaccine or combination vaccine. Contact PCC if for help.

For more information on CVX and MVX codes in your PCC system, read CVX, MVX, VIS and NDC Codes in PCC.

What CVX Codes Are In Use?: Different combination vaccines and different formulations have different CVX codes. To review what CVX codes you administer, visit your immunization refrigerator. PCC Support can also help you compare the CVX codes in your PCC system with the CDC’s library of CVX codes. Common CVX codes for each immunization as of 2019 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.

Add Age-Appropriate Immunizations to Your Custom Chart Notes

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

Recommended Charting and Workflow for CMS117 Childhood Immunization Status

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.

CMS155: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

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.

Recommended PCC EHR Configuration for CMS 155 Weight Assessment and Counseling

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.

Configure Your Nutrition Counseling Order

Create or edit a medical procedure order for nutrition counseling.

For the nutrition counseling order, you should select SNOMED-CT code 61310001, “Nutrition education”.

Configure Your Physical Activity Counseling Order

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.

Add Nutrition and Physical Activity Counseling Orders to Your Chart Note Protocols

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.

Recommended Charting and Workflow for CMS 155 Weight Assessment and Counseling

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’s Current Certification Status and Required CQMs for PCMH

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.

What CQMs Are You Required to Report On

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).

CQMs that Were Required for the EHR Medicaid Incentive Program

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.

CQMs for PCMH

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:

Seasonal flu vaccine rates (vaccine measure)
Asthma patients up-to-date on flu vaccine (vaccine measure)
ADHD Followup Rate (chronic/acute measure)
Well Visit Rates (preventive measure)
Developmental screening rates (preventive measure)

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.

Meet Meaningful Use Measures with PCC

March 8, 2015/in PCMH, CQMs, Measures, and Incentive Programs /by Douglas Beagley

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’s Current Certification Statuses for MU and PCMH

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.

Things to Consider Before You Begin

Here are some other topics to consider as you use PCC EHR to chart for and measure Meaningful Use.

Run the Report, Review Your Meaningful Use Scores

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.

Meaningful Use Measures Outside of PCC EHR

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.

Eligible Professionals

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:

Physicians (primarily doctors of medicine and doctors of osteopathy)
Nurse practitioner
Certified nurse-midwife
Dentist
Physician assistant furnishing services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.

To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:

Have a minimum 30% Medicaid patient volume
Have a minimum 20% Medicaid patient volume, and is a pediatrician
Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals

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.

End of Visit: Sign Visits and Use the Electronic Encounter Form

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.

Learn More About Meaningful Use

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.

What Measures Am I Required to Meet and Report On?

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.

Overview of Modified Stage 2 Objectives and Measures

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 (More Details)
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 (More Details)
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; work with PCC Support to ensure that each provider is correctly linked to a PCC EHR user. Measure 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 (More Details)
Objective 4: Electronic Prescribing	Generate, query for a drug formulary, and transmit permissible prescriptions electronically	>50% of prescriptions written	Set up PCC eRx user access for each EP Work with PCC Support to ensure that each provider is correctly linked to a PCC EHR user.	Use PCC eRx to generate and send prescriptions electronically PCC eRx automatically queries all prescriptions for a drug formulary (More Details)
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	Set up referral orders in PCC EHR, and add them to chart note protocols Contact PCC support to set up Direct Secure Messaging for your practice	For patients who you are referring to an external provider, use PCC EHR to create a referral order Generate a Summary of Care Record report and select either the relevant referral order, or select “Related to an outbound transition of care” Use Direct Secure Messaging to send the Summary of Care Record electronically, as a C-CDA file (More Details)
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	Open the Patient Education report Select a problem, diagnosis, medication or lab test for the patient Select a handout Either print the handout for the patient, or upload it to their patient portal (More Details)
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	Set up PCC eRx user access for each EP Add the Transition of Care (ARRA) component to all of your chart note protocols Contact PCC support to set up Direct Secure Messaging for your practice	During visits: Determine if the patient is transitioning to your care from another setting (hospital or other practice) Review the patient’s medication history in PCC eRx Document the med rec using the Transition of Care (ARRA) component within the visit protocol When receiving incoming DSM: Receive an incoming C-CDA on your Messaging queue Document the med rec by clicking the “Reconcile” button (More Details)
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 (More Details)
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	Contact PCC support to enable the patient portal, My Kid’s Chart, for your practice Use the Patient Portal Manager tool to turn on the Messaging feature	Respond to portal messages through the Messaging queue in PCC EHR Send new messages to patients/their families through the portal, from PCC EHR (More Details)
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 (More Details)

You can download specification sheets for each measure from the EHR Incentive Program Modified Stage 2 Objectives and Measures chart, provided by CMS.

Adjust Your Workflow to Meet MU Objectives

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?

Objective 1: (Y/N) Protect Patient Health Information

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:

HIPAA and Security Risk Assessments for the Pediatric Practice on learn.pcc.com.
Security Risk Analysis Tip Sheet from cms.gov.
Security Risk Assessment Tool from HealthIT.gov.

Objective 2: (Y/N) Clinical Decision Support

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”:

Clinical guidelines (consider developmental or depression screening templates built into PCC EHR)
Condition-specific order sets
Documentation templates
Diagnostic support
Contextually relevant reference information

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”.

Objective 3: Computerized Provider Order Entry (CPOE)

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.

Denominator: Number of medication orders created by the EP during the EHR reporting period
Numerator: Number of medication orders in the denominator recorded using CPOE
Exclusion: If you wrote fewer than 100 prescriptions during the reporting period, you can take an exclusion for this measure

Each eligible provider (EP) needs to have PCC eRx enabled on their user account in PCC EHR. In addition, each EP needs to be correctly linked to a PCC EHR user and an underlying system provider. Contact PCC Support for assistance. 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.

Denominator: Number of lab orders created by the EP during the EHR reporting period
Numerator: Number of lab orders in the denominator recorded using CPOE
Exclusion: If you wrote fewer than 100 lab orders during the reporting period, you can take an exclusion for this measure

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.

Denominator: Number of radiology orders created by the EP during the EHR reporting period
Numerator: Number of radiology orders in the denominator recorded using CPOE
Exclusion: If you wrote fewer than 100 radiology orders during the reporting period, you can take an exclusion for this measure

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.

Objective 4: Electronic Prescribing

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.

Denominator: Number of prescriptions written for drugs requiring a prescription in order to be dispensed (including or not including controlled substances) during the EHR reporting period
Numerator: Number of prescriptions in the denominator generated, queried for a drug formulary and transmitted electronically using a certified EHR
Exclusion: If you wrote fewer than 100 prescriptions during the reporting period, you can take an exclusion for this measure

Your practice must be using PCC eRx in order to generate and transmit prescriptions electronically.

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.

Objective 5: Health Information Exchange

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.

Denominator: Number of referral orders during the reporting period where the EP was the provider for the visit, combined with the number of Summary of Care Records generated where “Related to an outbound transition of care” was selected
Numerator: Number of referrals and outbound transitions from the denominator where a Summary of Care Record was sent electronically to another clinician or practice via Direct Secure Messaging
Exclusion: If you initiated less than 100 transfers or referrals (to another setting of care) during the reporting period, you can take an exclusion for this measure

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.

Objective 6: Patient Specific Education

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.

Denominator: Number of unique patients with at least one office visit, seen by the EP during the EHR reporting period
Numerator: Number of patients in the denominator who were provided patient-specific education resources identified by the certified EHR

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.

Objective 7: Medication Reconciliation

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.

Denominator includes:
- Any visit for the EP where the “Patient transitioned to my care” checkbox is checked in the Transition of Care (ARRA) component
- Direct secure messages received by the EP that include a C-CDA
Numerator includes:
- Visits from the denominator where the “Medication Reconciliation performed” checkbox is checked in the Transition of Care (ARRA) component
- Direct secure messages from the denominator where the “Reconcile” button has been clicked

Medication Reconciliations During Visits

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.

Medication Reconciliations With Incoming Direct Secure Messages

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.

Objective 8: Patient Electronic Access

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.

Denominator: Number of unique patients seen by the EP during the EHR reporting period
Numerator: Number of unique patients (or their authorized representatives) in the denominator who have had a patient portal account created within 4 days of their visit
Exclusion: If you are located in a county where >50% of patients do not have 3Mbps broadband availability, you can take an exclusion for this measure

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.

Denominator: Number of unique patients seen by the EP during the EHR reporting period
Numerator: Number of unique patients (or their authorized representatives) in the denominator who have viewed online, downloaded, or transmitted to a third party the patient’s health information
Exclusion: If you are located in a county where >50% of patients do not have 3Mbps broadband availability, you can take an exclusion for this measure

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.

Objective 9: Secure Electronic Messaging

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.

Denominator: Number of unique patients seen by the EP during the EHR reporting period
Numerator: Number of patients in the denominator for whom a secure electronic message is sent, or in response to a secure message sent by the patient (or authorized representative)
Exclusion: If you are located in a county where >50% of patients do not have 3Mbps broadband availability, you can take an exclusion for this measure

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.

Objective 10: (Y/N) Public Health Reporting

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.

Option 1: Completed Registration [with Public Health Agency or Clinical Data Registry] to Submit Data
Option 2: Testing and Validation: The EPis in the process of testing and validation of the electronic submission of data
Option 3: Production: The EP has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR

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.

Exclusion: Any EP that meets one or more of the following criteria may be excluded from this measure:
- Does not administer any of the immunizations to any of the populations for which data is collected by their jurisdiction’s immunization registry or immunization information system during the EHR reporting period
- Operates in a jurisdiction for which no immunization registry or immunization information system is capable of accepting the specific standards required for CEHRT at the start of their EHR reporting period
- Operates in a jurisdiction where no immunization registry or immunization information system has declared readiness to receive immunization data from the EP at the start of the EHR reporting period

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.

Exclusion: Any EP that meets one or more of the following criteria may be excluded from this measure:
- Is not in a category of providers from which ambulatory syndromic surveillance data is collected by their jurisdiction’s syndromic surveillance system
- Operates in a jurisdiction for which no public health agency is capable of receiving electronic syndromic surveillance data from EPs in the specific standards required to meet the CEHRT definition at the start of the EHR reporting period
- Operates in a jurisdiction where no public health agency has declared readiness to receive syndromic surveillance data from EPs at the start of the EHR reporting period

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.

Exclusion: Any EP that meets one or more of the following criteria may be excluded from this measure:
- Does not diagnose or treat any disease or condition associated with, or collect relevant data that is collected by, a specialized registry in their jurisdiction during the EHR reporting period
- Operates in a jurisdiction for which no specialized registry is capable of accepting electronic registry transactions in the specific standards required to meet the CEHRT definition at the start of the EHR reporting period
- Operates in a jurisdiction where no specialized registry for which the EP is eligible has declared readiness to receive electronic registry transactions at the beginning of the EHR reporting period

Provider Configuration for Meaningful Use Calculations

PCC uses both billing and charting data to calculate Meaningful Use Measure percentages. Each EP needs to be correctly linked to a PCC EHR user and an underlying system provider. PCC completes this step upon your initial installation. Contact PCC Support for assistance.

Prepare for a PCC Software Update

March 8, 2015/in Get Started Manage and Administer Your PCC Tools /by Douglas Beagley

When a software update for PCC is ready for your office, what should you do to prepare?

Notify Your In-House System Administrator and/or Third-Party IT Consultant

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.

Learn About the New Features Ahead of Time

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.

PCC New Feature Release Notes
The Pulse: PCC’s Newsfeed announces updates, documentation, web labs and other training opportunities.

Review Important Update Configuration or Workflow Considerations

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 makes note of them in the PCC Release Manual.

Tell Your Doctors and Other Staff

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.

Encourage them to review the “Details” link on the login screen, which points to the PCC Release Overview, Manual, and Video Series.

After the Update: Review New Options, Work with PCC Support

Once your update is complete, you may wish to return to the PCC Release Manual 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.

Review Your PCC Data Conversion

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

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.

Review Patient Demographics

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:

Patient Demographics
- Name
- Date of birth
- PCP (if you track this currently)
- Sex
Siblings
Billing and Home Account
- Name
- Address
- Phone Numbers
Insurance Policies
- Insurance plan name
- Copay amount
- Subscriber ID (which appears as “Certificate”)
- Group number
- Subscriber name

Review Billing History

Billing history can be found under the History anchor on the left side of a patient’s history. Pick several patients and review:

Dates for each visit
ICD-10 codes
CPT codes
Provider
Location

Review Appointments

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.:

Patient
Date and time
Visit Reason
Provider
Location (if you have more than one)
Length of visit

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.

Review Clinical Data

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:

Medical Summary
- Allergies
- Problem List
- Medical / Family / Social History
History
- Visit History
  - Previous visits (note that visits may be labeled as “Historical EHR Visit”)
    - Visit dates (do all visits appear?)
    - Notes, orders, results, and diagnoses for each visit
  - Phone notes (note that phone notes may be labeled “Historical EHR Phone Note” and should include a subject line if available)
    - Phone note dates
    - Text, contact information, or other data from your previous system
- Immunizations History
  - Dates for each immunization
- Flowsheet
  - Diagnoses
  - Vitals data
- Documents
  - Documents are under the correct Category, linked to the correct visit date (if applicable), and that multi-page documents have all pages

Review a Log of Generated Account Bills

March 8, 2015/in Bill the Family Bill the Family /by Douglas Beagley

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.

Archived Electronic Communications from Your Ebills Vendor

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.

Backing Up Your Practice Data

March 8, 2015/in Get Started Manage Your Office's Hardware /by Douglas Beagley

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.

Your Office’s Custom Backup Solution

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.

Perform a Manual Backup (`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.

Network Vulnerability Scan

March 8, 2015/in Manage Your Office's Hardware /by Douglas Beagley

Every quarter, PCC performs a network vulnerability scan on your PCC server and network infrastructure. This service is included in your PCC support contract.

What Do We Check?

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.

What Happens When a Problem Is Found?

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.

Medium or Low-Risk Vulnerabilities

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.

Shut Down Your PCC Server

March 8, 2015/in Get Started Manage Your Office's Hardware /by Douglas Beagley

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 your PCC system. 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 a Practice Management window 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.

A Pediatric Practice Hardware Map

March 8, 2015/in Manage Your Office's Hardware /by Douglas Beagley

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.

A Remote Office Hardware Map

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 Router and Firewall

March 8, 2015/in Manage Your Office's Hardware /by Douglas Beagley

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.

Device Specifics

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.

Hardware Guide: Your PCC System Hardware

March 8, 2015/in Get Started Manage Your Office's Hardware /by Douglas Beagley

PCC may install a server, peripherals, and other hardware in your office. This article is a quick reference for 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.

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.

Introduction: What Does PCC Install at Your Practice?

PCC typically installs the following equipment:

a PCC server (typically a Dell PowerEdge server) If your practice is hosted in a cloud service, PCC will not install a server
one or more network switches
a UPS battery backup unit
a router/firewall (Fortigate)
a network-attached storage device (NAS)
one or more wireless access points

The PCC Server

Unless your practice will host your PCC server in the cloud, PCC installs one or more servers at 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 Rocky 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 include a monitor, keyboard and mouse specifically for the PCC server.

Current Server Installations

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.

Network Switch

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 your PCC 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. Some models have ports with a lightning bolt to signify it can supply power to a phone or credit card machine. Please make us aware if these ports are needed for your practice.

UniFi 24-port Gigabit Network Switch(You may have a similar-looking 48-port model)

Dell 24-port Gigabit Network Switch(You may have a similar-looking 48-port model)

UPS Power Backup System

PCC installs a UPS battery device to protect your new equipment from power surges, brown-outs, and black outs.

A UPS works silently until an electrical problem occurs. When a problem occurs for more than five minutes the UPS will send a signal to shut down the server. It is not meant to power machines for extended periods.

CyberPower Models

PCC-installed CyberPower UPS for an On-Site Server:

Cloud Server Model:

You can read technical specifications for this type of UPS at cyberpowersystems.com.

Router or Firewall Device

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 offices. 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)

Network Attached Storage Device (NAS)

Depending on your practice’s configuration, PCC may install a 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 TrueNAS devices:

TrueNAS-Mini (network-attached storage backup)

How to Turn Off Your TrueNAS: The power switch for the NAS is on the front, in the upper righthand corner, behind the door that closes over the disks.

Wireless Access Points

Depending on your practice’s configuration, PCC may install one or more Wireless Access Point (WAP). 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. These need to be properly mounted in the correct orientation to function correctly. They don’t work well if covered with papers or under a desk.

Note: For new installations, your PCC technician will advise you on the WAP location(s) for your contractor to install appropriate cabling prior to PCC’s arrival.

Replacing Hardware

PCC manages the network equipment that we supply. 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. If you choose to have your local IT manage your network they must supply the equipment.

Details about equipment and services that PCC provides can be reviewed in the fine print accompanying your PCC contract.

Patient Care Centers in PCC Software

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

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.

Use Care Center When Searching for Patients

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.

Filter the Messaging Queue By Care Center

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.

Review Patient’s Care Center While You Work

When a patient has a care center, the care center information can appear during patient checkin, during scheduling, and elsewhere in PCC EHR.

Display the Care Center’s Address on Form Letters, Reports, and in MyKidsChart

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.

Use Care Center Flag for Recaller and Other Reports

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.

Review Care Center Information When You Add Patients in MyKidsChart

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.

Turn On and Configure Patient Care Centers

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.

Configure Your Location Flags and 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. Contact PCC Support for help updating your places of service. They can add your location flag to the correct place of service, ensure that your scheduling locations are available as login locations, and configure whether or not the location should be a subpart of a main office for claims. After these changes, all patients with the flag will be automatically assigned to the care center.

Assign Login Locations to Care Centers

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.

Assign Users to Care Centers

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 drop-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.

Move the Care Center Component in Messaging Protocols

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.

Clean Up Unassigned Messages

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.

Train Your Staff to Assign Care Centers for Every Patient

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.

Configure User Selection Lists

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.

Set Location Filters and Save Your Defaults

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.

Change Your Form Letters to Display the Care Center Address

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.

Configure the Address for the Health Information Summary and MyKidsChart

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.

Other Care Center Features

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:

If you assign your PCC EHR users to a care center (see above), the various lists of users found in PCC EHR and pocketPCC will show only those users who share your care center or who have no assigned care center.
If you assign your PCC EHR users to a care center (see above), when you use the My Kid’s Chart administration tool your settings will refer to your assigned care center so families will see the correct care center-specific practice names and addresses.
If you assign your PCC EHR users to a care center (see above), and your practice uses the Appointment Book, your scheduling staff will only be able to schedule within their assigned care centers, and your providers will only be able to be scheduled for appointments within their assigned care centers.

Connect to Your PCC System from Home

March 8, 2015/in Get Started Manage and Administer Your PCC Tools, Access Charts Remotely /by Douglas Beagley

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.

About PCC SecureConnect

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.

Authorize Users for PCC SecureConnect

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.

Set Up Two-Factor Authentication

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.

Log Into PCC SecureConnect

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.

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.

Helpful Authy Links

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.

Contact Physician’s Computer Company Support

March 8, 2015/in Get Started Manage and Administer Your PCC Tools /by Douglas Beagley

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!

How to Contact Support

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.

What Happens After I Call?

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.

Can I Follow-Up On Unresolved Support Tickets?

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.

Your PCC Data Conversion

March 8, 2015/in Manage and Administer Your PCC Tools /by Douglas Beagley

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:

The step-by-step data conversion timeline
What data we can usually convert, and what data we cannot convert
What PCC does and what your practice needs to do to ensure a successful data conversion

As always, please feel free to call or email us to discuss any of the details in this document.

The Data Conversion Process: Who Does What, and When?

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.

Practice Management Conversion

PCC can usually retrieve practice management data, such as patient demographics, policies, billing history, and appointments, from your current system once you grant access.

Conversion Stage 1: Take Stock of Your Existing System

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.

Conversion Stage 2: Research Data Availability

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.

Conversion Stage 3: Map Available Data

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.

Conversion Stage 4: Review, Correct, and Verify Initial Conversion

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.

Conversion Stage 5: Review, Correct, and Verify the Final 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.

Go Live with PCC

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.

Clinical Queue Waiting Period

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.

Clinical Data Conversion from Vendor Export

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.

Conversion Complete

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.

Once you sign off on your clinical conversion, the entire conversion process is complete. Happy charting!

What Does My Practice Need to Do to Ensure a Good Data Conversion?

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.

Data Conversion Results: What Data Will We Get?

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.

Data We Almost Always Convert

Your PCC data conversion will potentially include the following:

Demographics: patients, families, family relationships, addresses, and other demographic data
Insurance policies and your insurance plan list
Charge History, including diagnoses, CPTs, and procedure pricing
Appointments, including past and future scheduled appointments

Data We Are Usually Able to Convert

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.

Patient and Family Notes, Flags, Etc.
Patient Problem Lists, Allergies, Family History, Medical, and Social History
Immunization Records
Visit Chart Notes
Vitals and Diagnoses from Each Visit
Phone Notes
Scanned Documents
Lab/Order History (as text)
Medication History (as text)

Data We Do Not Convert

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.

Become a Patient Centered Medical Home (PCMH)

March 8, 2015/in Get Started PCMH, CQMs, Measures, and Incentive Programs /by Douglas Beagley

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.

What is a Patient Centered Medical Home?

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.

What is the Process of Achieving PCMH Recognition?

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:

Meet all core criteria
Earn 25 credits in elective criteria across 5 of 6 concepts.

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.

How Can My Practice Use PCC to Achieve PCMH Recognition?

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:

Meaningful Use Measures Report: The Meaningful Use Measures report in PCC EHR calculates your office’s performance on the Meaningful Use standards indicated in ARRA’s EHR Medicaid Incentive program and referenced in PCMH requirements.
Clinical Quality Measures Report: The Clinical Quality Measures report in PCC EHR calculates your clinicians’ performance on CQMs (Clinical Quality Measures).
PCC EHR Report Library: The PCC EHR Report Library contains several reports specifically designed to help you calculate numbers needed for your PCMH application, including “Care Plans By Date”.
Practice Vitals Dashboard: Your Practice Vitals Dashboard contains numerous measures that you can use for your PCMH application.

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.

After Recognition, Are There Annual Requirements?

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.

What Are Other PCC Practices Doing to Achieve PCMH Recognition?

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!

http://pcmh.pcc.com

What PCMH Programs Are There in My Area?

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.

PCMH Consultation with the Verden Group

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.

CPT II in PCC

March 8, 2015/in Coding and Documentation /by Douglas Beagley

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 on claims. Your practice updates and maintains your billable procedure list, codes, and prices in the Procedures table in the Tables configuration tool on your PCC system.

Coding with CPT II, an Overview

How do CPT II codes relate to ICD-9/ICD-10 and regular CPT codes?

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.

What are CPT II modifiers?

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.

What CPT II codes and measures are common for pediatrics?

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.

Get Started with CPT II in PCC

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.

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

Use the Tables tool to create the CPT II code entries in the Procedures table.

Assign a $0 price for these new procedure codes. Your carriers may have special guidelines or require a $.01 charge for all procedures, so double-check their coding requirements.
Assign the accounting type of “Revenue – CPT II”. This will ensure that the codes are cataloged properly during reporting.

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. Contact PCC Support for help finding specific reports.

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 when you post the payment. To learn more about posting pay-for-performance bonuses or other unusual income, read Post Capitation Checks, Incentive Payments, Interest Payments, Overpayments, and Withhold Payments. 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.

Connect to PCC’s Web Conferences and Web Labs

March 8, 2015/in Other Tools and Resources for Your Practice /by Douglas Beagley

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:

PCC’s Web Lab Schedule and Signup Page
PCC’s WebEx Event Center For Classes and Other Events
PCC’s WebEx Meetings Center (for sessions by invite)
PCC’s Pediatric Coding Web Labs

What is a Claim ID Number?

March 8, 2015/in Post Insurance Payments Post Insurance Payments /by Douglas Beagley

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.

Claim ID Creation and Tracking

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.

Find the Claim ID on Reports and EOBs

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.

Use the Claim ID to Post Payments and Adjustment

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.

Submit Claims

March 8, 2015/in Get Started Bill Insurance Bill Insurance /by Douglas Beagley

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.

Prepare and Submit Claims

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 can also queue up a claim later, when you use the Edit Charges feature in the Billing History in the patient’s chart.

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 billing 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:
- Claims are grouped into batches. By default “All batches” will be selected. (See the next step for more information.)
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.

Work on Claims that Cannot Be Submitted

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.

Review Details and Resolve Claim Problems

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 edit any aspect of the encounter, change the responsible party, or generate a new claim, click “Edit Charges”.

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.

Validate a Claim Needing Corrections

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.

Re-prepare and Submit

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.

Delete a Claim

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 open the encounter in the Billing History in the patient’s chart and use Edit Charges to update the responsible party for each charge. See Change the Responsible Party and Copay for Charges.

Review Claim Submission Session Logs

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.

Review Held Claims

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.

Review Delayed Claims

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.

Review Claims that Need Corrections and Can Not Be Submitted

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.

Review Claims Routed to Paper

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.

Reverse an Insurance Payment (Post a Takeback)

March 8, 2015/in Post Insurance Payments Post Insurance Payments /by Douglas Beagley

When you receive an insurance payment reversal or “takeback” from a payor, you can post it automatically or manually.

Video: Watch Reverse an Insurance Payment (Post a Takeback) to learn more.

Automatically Post Reversals

When you autopost an ERA that contains a payment reversal, PCC EHR can usually post both the reversal and the updated adjudication from the payor. When this occurs, a reversal adjustment is linked to the original payment and associated with the provider of the originally linked charges.

However, your PCC system cannot automatically post a reversal if any charge, payment, or claim detail does not match what is found in your PCC system. For example, if the amount reversed does not match your records, or the payor fails to provide identification information, the takeback will not autopost and you will see it when you review the ERA after autoposting and on the Posting Exceptions worklist.

Read Post Insurance Payments to learn how to autopost an ERA and then review responses that could not be posted.

If a reversal cannot be automatically posted, or you received a paper notification of the reversal, you can post it manually in the Insurance Payments tool using the procedure below.

Manually Reverse an Insurance Payment

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 Payor 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”

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 Choose Whether to Repost

Click “Save” and then decide whether to repost the payment while making changes to the adjudication, or just reverse the payment.

After you make a selection, the payment will be reversed and any adjustment(s) deleted. The encounter charges will pend the original payor.

Post Updated Adjudication, or the Denial, and Add an Account Note

On the posting screen, you can review how to original payment was applied and make the changes found on the new ERA.

Typically, an ERA or EOB that indicates a reversal also includes updated adjudication information for the encounter.

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.

Review the Results

Back on the History tab, you can review that the original payment is struck through, with the date and reversal transaction listed in the Refunds/Reversals column.

Reversing a Payment Posts an Adjustment: When you reverse a payment, you create an adjustment that links to the original payment. The adjustment behaves like any charge or procedure on your PCC system, and it is associated with the provider of the original charge (or charges) paid off by the payment.

Reversals That Appear With Other Encounters vs Sending a Check: After you post a takeback, you might continue posting other responses on the same ERA. The check’s total is often lowered by the reversed amount, and when you run reports to review posting, you will see the takeback among the other payments. In some cases, however, you may be required to mail a check to the insurance company.

Undo an Insurance Payment Reversal

If you post a takeback incorrectly, you can contact PCC Support or use the under-the-hood Correct Mistake (oops) program to unlink the original payment from the Insurance Takeback, delete the Insurance Takeback adjustment, and then link the payment back to encounter charges.

Configure Transaction Types for an Insurance Payment Reversal

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 Tables tool. All procedures with an accounting type of “Receipt – Refund” are 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.

Reverse an Insurance Overpayment from an Overpayment Holding Account

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.

To learn more, read Post Capitation Checks, Incentive Payments, Interest Payments, Overpayments, and Withhold Payments.

Review Insurance Reversals on End-of-Day Reports

You can review aggregate data of all refunds over a period of time with the Total Charges and Payments by Provider and Month report.

To see line item details for insurance reversals, along with all payments and adjustments, run the the daysheet report. Run daysheet, choose the “wide” report, and review the NSF/Refunds 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.

Insurance Billing Overview

March 8, 2015/in Get Started Bill Insurance /by Douglas Beagley

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 processes and submits claims.

Process and Submit 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. If the payor responds with a rejection, you can review the rejection reason, correct the problem, and queue up a new claim.

Work on Claim Errors and Rejections

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.

Post Insurance Payments

Work on Outstanding Claims

While the above steps should ensure that every claim is accounted for, your practice also needs to track accounts receivable and follow-up on old unpaid claims and ongoing problems with payors.

Follow Up on Unpaid Encounters with Insurance Balances

Edit Encounter Details 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 an encounter’s charges or claim information and queue up a new claim.

Edit Encounter Charges and Claim Information and Resubmit a Claim

Check Patient Insurance Eligibility

March 8, 2015/in Update Insurance Policies and Check Eligibility, Check In a Patient Check In a Patient /by Douglas Beagley

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.

Insurance Eligibility Highlights

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.

Review Eligibility for Upcoming Appointments

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.

Where Else Can My Practice Confirm Eligibility?

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.

Check Insurance Eligibility Without an Appointment

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.

Confirm Eligibility During Patient Check-In

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.

Check Eligibility While Charting

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.

Check Insurance Eligibility While Posting Charges

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.

Select an Eligibility Status

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.

Resubmit After Making Changes

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.

Understand Eligibility Responses, Errors, and Reports

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.

Eligibility Response

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.

Alerts, Explanations, and Actions

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.

Summary and Full Report

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.

Requeue Large Numbers of Claims and Resubmit

March 8, 2015/in Work Insurance A/R and Personal A/R Work Insurance A/R and Personal A/R /by Douglas Beagley

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 by opening the Billing History in the patient’s chart and clicking “Edit Charges”. See Resubmit a Claim.

Video: Watch Requeue Large Numbers of Claims to learn more.

Sample Problems for `maketags`

Why would you need to find and resubmit a large batch of claims?

You have used the wrong tax ID number for the last three weeks of claim submissions. You received the rejections, you corrected your tax ID, and now you need to resubmit every claim from the last three weeks.
You have been working with an insurance company that has denied claims improperly. They have asked you to resubmit all claims for visits by their patients between January and October of last year.
You have billed a procedure using the wrong procedure code. After you correct the code in the Procedures table, you need to find every claim that had this procedure code and resubmit.
You submitted claims to a claim clearinghouse or payor, but never received an acknowledgement or response.

Use the Billing History section of the patient’s chart to resubmit single claims. Use maketags when you need to queue up claims for a large number of encounters.

Find Encounters and Create New Claims (Basic)

Follow the procedure below to create new claims for encounters.

Have You Fixed the Problem?: The maketags program does not address outstanding billing problems and will not increase revenue. Before you recreate a large number of 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.

Find Encounters and Create New Claims (Advanced)

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.

Resubmit Claims Criteria Reference

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.

Rebatch Charges by Age or Date Range

Use the “Age of Charges” options to select charges of a certain age. You can enter an age range, in days, using one of the top two options. Or, you can input a specific date range.

Rebatch Charges by Paid and Insurance Status

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:

Rebatch Charges by Insurance Plan

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.

Rebatch Charges by Provider

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.

Review Archived EDI Reports

March 8, 2015/in Bill Insurance Bill Insurance /by Douglas Beagley

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.

Read EDI Responses in the Billing History of the Chart

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.

Read ERAs in the Electronic Remittance Advice Tool

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.

Use EDI Reports (ecsreports) to Review Other Archived Communication

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.

Examples of Archived EDI Reports

Here are some reports you may find in the ecsreports program, along with sample text.

preptags/tagsplit Bad Claim Report

This report identifies claims that could not be approved for electronic submission. The PCC EHR Claims tool replaces this report. If you use the claims programs in Practice Management instead of PCC EHR, you will be prompted to print this report after you submit claims.

Bad 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 using Edit Charges in the Billing History in the patient’s chart.

ECS Batch Log

This report is a log, sorted by insurance batch and patient name, of all the claims sent out on a certain date. The PCC EHR Claims tool replaces this report. Your PCC system generates this report when it finishes processing and submitting claims.

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.

PCC Daily Submission Summary

This is a record showing that PCC has received your claims and sent them on to the clearinghouse or payor. The Billing History in the patient’s chart jumps directly to the correct segment of this report, but you can also review the full log in 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.

Payor Electronic Batch, Acknowledgement, Response, Summary, Rejection, Status, Unprocessed, and Exclusion Reports

PCC works to ensure that all claims route through the most efficient claim clearinghouse and reach the payor. In some cases, PCC builds a direct claim submission connection to a payor. As your claims travel from PCC, to a clearinghouse, and to a payor, the organizations involved send reports back to your practice. PCC parses these reports automatically and updates account histories. You can access specific replies in the Billing History section of a patient’s chart. The full reports are archived in ecsreports.

RelayHealth ebills Reports

If your practices uses a third-party bill printing service, you can review acknowledgements and other reports in the 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.”

Print Paper HCFA Claim Forms

March 8, 2015/in Bill Insurance, Work Insurance A/R and Personal A/R Bill Insurance, Work Insurance A/R and Personal A/R /by Douglas Beagley

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 provides additional details about generating paper claims.

What Claims Require a Paper HCFA 1500 Form?

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.

Print a Single Paper Claim

When you need to print a single paper claim for a single encounter, use the Correct Mistakes (oops) program.

Press F2 – Generate Claim and then select charges to appear on the claim.

You can use this same key to print a single paper claim or queue up an electronic claim, but the Edit Charges functionality of PCC EHR is a better tool for queueing up claims to a batch.

Print Batches of HCFA 1500 Claim Forms

When claims cannot be submitted electronically, your PCC system will queue them to a “paper batch” for printing. Use the HCFA program to print batches of paper claims.

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.

Reprinting Batches

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.

Force a Large Number of Claims to Requeue

If you need to requeue a large number of claims for some reason, contact PCC Support for help. This is not a common need. For more information, read Requeue Large Numbers of Claims.

The Claim Journey Explained

March 8, 2015/in Get Started Bill Insurance Bill Insurance /by Douglas Beagley

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.

Your Practice Posts Charges for Each Encounter, Creating a Claim Tag

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.

Your Practice Prepares and Submits Claims, Which PCC Sends to Clearinghouses and Payers

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), provides you with a list of stuck claims that need corrections before they can be sent out (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.

Usually, the clearinghouse and payer acknowledge receipt of the claim, which your practice can see in the encounter’s claim history (learn more).

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 payers. Your practice’s billers review those logs and other “EDI responses” (learn more).

Finally, billers use PCC tools to respond to rejected claims (learn more). If the payer never responds to a claim or an appeal, or an encounter was not billed correctly, billers can track the entire insurance A/R and create custom worklists of all unpaid encounters with insurance balances. (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 drop-in sessions 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.

Create Worklists of Unpaid Claims (insaging, inscoar)

March 8, 2015/in /by Douglas Beagley

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.

Replaced By Newer Software: This article refers to deprecated software. To learn how to review insurance A/R summaries and create worklists of unpaid claims, read Follow Up on Unpaid Encounters with Insurance Balances.

Review a Summary of Your Practice’s A/R By Payor (insaging)

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.

Run and Review the `insaging` Report

You 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 each 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).

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.

Configure and Customize insaging

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.

Understanding and Configuring Insurance Groups

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 insurance group with no assigned plans in your practice’s Insurance Groups table.

Use the Tables tool to review the plans your practice bills. You can sort by group and make changes to improve reporting, and as needed you can edit the Insurance Groups table to create new groups and make reporting more informative. 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.

Create a Worklist of Unpaid Claims (inscoar)

While you can use PCC EHR’s many 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 includes an optional interactive mode, which allows you to research billing history, make changes, and then resubmit claims all from the same screen.

You can find the inscoar report in your Practice Management window.

Run and Review the `inscoar` Report

From the configuration screen, press F1 – Generate Report.

Based on your selected criteria, the report displays every encounter with an unpaid insurance balance. The encounters 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.

You can use the information on the report to contact the payor or the family and take action to resolve the issue.

Notes and Billing History: If there are any Encounter Billing 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.

Configure and Customize `inscoar`

You 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:

Output Options for `inscoar`

Send report to:

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.

Criteria Options for `inscoar`

Age of Receivables:

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.
All Insurances?

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.
All Servicing Providers?

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.
All Places of Service?

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.
Include Personal 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.

Formatting Options for `inscoar`

Show Visit Notes?

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.
Show Billing History

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.
List Insurances with no pending charges?

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.
Suppress page breaks when printing?

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.
Extra Information To Show:

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.

CARC and RARC Values in PCC

March 8, 2015/in Post Insurance Payments Post Insurance Payments /by Douglas Beagley

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.

CARC Workflow Example

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.

Common CARCs

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.

How CARC Codes Get Into the Account Record in PCC

CARC values enter your PCC system through autoposting or when you post an insurance response manually.

Autoposting ERAs Imports the CARC to the Account Record

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.

Enter CARC As You Manually Post Payments

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.

Where Can I Review CARC and RARC Values in PCC?

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?

CARC and RARC Values Appear on ERAs

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.

CARC in Encounter and Account Histories

CARC values appear in the Billing History and Account History, both found in the patient’s chart.

CARC Values Appear on Personal Bills

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 in the Logs tab of the Bills tool.

Report on the CARC Values Used By Payers

PCC can help you create reports based on CARCs and amounts in order to understand trends in payer responses. Contact PCC Support for help.

Refund or Write-Off Account Credits

March 8, 2015/in Post Personal Payments Post Personal Payments /by Douglas Beagley

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 decide to issue them a refund.

If you have a credit that cannot be refunded, or it is on an insurance holding account and will not be taken back, you may sometimes need to write off that credit and count it as revenue.

Read the procedure below to learn how to refund or write off a credit on an account.

Watch a Video: Watch a video to learn how to refund personal credits in PCC EHR.

Refund or Write Off a Credit

When you need to refund or write off a credit on a 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 post a refund or write-off.

Enter the Transaction Date

Optionally adjust the transaction date (which defaults to today).

Select the Refund Type

Select your practice’s credit refund type. If you are refunding the credit to the family, the default option on PCC’s systems is “Personal Refund”.

If you are writing off a credit, the default option is “Credit Write-Off”.

Your practice can customize what refund types are available on your system.

Enter the Amount

Enter an amount to be refunded or written off, up to the total credit balance on the account.

After you enter the 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 amount. Or, if you are posting a write off, you’ve now indicated that the amount is revenue.

Review Results in the Payment History

After you refund or write off a credit, you can see the change in the Account Balances component. You can also review your payments in the Payment History index to see the linked adjustment.

Refunding or Writing Off a Payment Posts an Adjustment: When you post a refund or write off, you create an adjustment that links to the original payment. The adjustment behaves like any charge or procedure on your PCC system, and it is associated with the provider of the original charge or charges paid off by the payment.

Optionally Enter an Account Note Explaining the Refund

After you refund or write-off a credit, you can visit the Posting tab and enter an account note explaining the steps you took.

If this is an insurance overpayment account, for example, your practice can use the Notes component to track details of the patient and date of service for each overpayment and when it was written off or refunded.

Undo a Refund or Write-Off

If you refund or write off an account credit incorrectly, and need to delete the adjustment, first use the Payments tool to edit the payment and unlink the adjustment. Then use the Correct Mistakes (oops) program in PCC’s under-the-hood Practice Management tools to delete the refund or write-off adjustment procedure.

Configure Your Practice’s Refund and Write-Off Adjustment Types

When you post a refund or a write-off, it appears as an adjustment that offsets a payment or credit on an account. By default, this is done with a “Personal Refund”, “Refund – Personal”, or “Credit Write-Off” 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 Tables tool. Any adjustment procedure with an accounting type of “Receipt – Refund” or “Revenue – Credit W/O” 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.

Post a Returned Check or Other Personal Payment Reversal

March 8, 2015/in Post Personal Payments Post Personal Payments /by Douglas Beagley

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.

Post a Returned Check or Other Personal Payment Reversal

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.

Remove a Payment Reversal

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.

Configure Your Practice’s Payment Reversal Adjustments and Fees

PCC software includes a Returned Check adjustment and Returned Check Fee procedure by default. Your practice can customize the adjustment and the name of the fee in the Procedures table in the Tables tool, found in the Configuration menu.

You could also create distinct adjustments to handle stopped credit cards, 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.

PCC Annual Users’ Conference

March 8, 2015/in Get Started PCC User's Conference Materials /by Douglas Beagley

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!

Conferences and Training In Your Area

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.

Archived Handouts

You can access some of the handouts from past Users’ Conferences here:

PCC-ers Living it Up w/ Donald and Goofy at UC 2012!

Turn an Account Over to Collections

March 8, 2015/in Bill the Family, Work Insurance A/R and Personal A/R Work Insurance A/R and Personal A/R /by Douglas Beagley

With a solid practice financial policy and ongoing personal A/R management, you may 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 different recommended procedures for turning an account over to a collection agency. Your office can consider these options and create your own collection policy.

Which Accounts Should a Practice Turned Over to Collection?: You can review accounts with high, old personal balances using the Personal Money Tracking Assistant (persview), and many other PCC reports can produce lists of accounts with old, outstanding charges. Contact PCC support for help learning these reports.

Option A: Turn An Account Over to Collections and Adjust Off Their Charges

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 Tables tool in PCC EHR. 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 Account Balances component to produce a summary of outstanding charges for the collection agency. You may want to print to a PDF file and keep a copy for your practice’s records as well.

Use the Payments Tool to Write Off the Charges

Open the Payments tool for the account and post a debt adjustment, applying it towards the overdue charges.
To learn how, read Write Off Charges and Bad Debt.

Add Status Flag(s) and Record Your Actions

Add account and/or patient status flags to indicate the account is in collection. Your practice can configure certain status flags to prevent scheduling for the patient or any dependents on an account. To learn more, read Use Custom Flags for Scheduling, Alerts, and Reporting.

Use the Notes component to record information about your process, including the total amount sent to collection, dates of service, or any other information that may be useful.

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 then post the payment using a payment type that indicates the payment was from a collection agency.
Post a “Collection Income” administrative encounter from the Billing History, then post a collection payment against that procedure.

Whichever method you use, be sure and carefully note your actions in the notes for the account.

Option B: Pend the Charges to a Collection Agency

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:

An insurance group named “Collections” or similar. You can add this group in the Tables tool in PCC EHR.
An insurance plan named “Collections” or similar. You can add this plan in the Tables tool in PCC EHR.

Follow these steps when an account is turned over to collection:

Print Charge Information for the Collection Agency

Use the Account Balances component to produce a summary of outstanding charges for the collection agency. You may want to print to a PDF file and keep a copy for your practice’s records as well.

Add the Collections Agency as a Policy for the Patient(s)

Use “Edit Charges” to Change the Responsible Party for Each Encounter

In the Billing History in the patient’s chart, select an encounter, click “Edit Charges” and then use the Procedures component to change the responsible party to the Collections policy on the account.

To learn how to change the responsible party for charges on an encounter, read Change the Copay and Responsible Party for Posted Charges.

Add Status Flag(s) and Record Your Actions

Use the Notes component to record information about your process, including the total amount sent to collection, dates of service, or any other information that may be useful.

If you use the method above to pend charges to a collection agency as you would an insurance policy, you can:

Track the Total Amount in Collection: Use the Insurance Balances tool to review the outstanding totals in collections. The amount will appear in the Collections insurance group.
Follow Up on Unpaid Encounters: Use the Insurance Balances tool to review all unpaid encounters that are in collections.

When you receive a payment from the collection agency, you can use the Insurance Payments tool to post it just as you would manually post an insurance payment. You can then update the status flags and add account notes clarifying that the family is no longer in collection.

Post Personal Payments

March 8, 2015/in Get Started Check Out a Patient, Post Personal Payments Post Personal Payments /by Douglas Beagley

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.

Where Can You Post Personal Payments and Adjustments?

How do personal payments enter your PCC system?

Post Payments and Write-Offs in the Payments Tool: 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.
Personal Balances Worklist: When you need to find accounts with outstanding personal balances, create a worklist with your preferred criteria in the Personal Balances tool. From your worklist you can hop into the Payments tool to work with the account.

The Payments tool 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.

Post a Personal Payment

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.

Write Off a Charge

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.

Specify How to Apply a Payment (or Adjustment)

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.

Leave Part or All of a Payment Unapplied

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.

Apply a Payment (or Adjustment) to Specific Charges

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.

Apply a Payment or Adjustment to Charges That Are Already Paid By Unapplied Payments

When you use the Distribution section to apply payments to charges, you may see more charges than you expect. The Distribution list can include charges that are paid off by unapplied payments.

In PCC, unapplied (or “unlinked”) payments on an account are automatically included in personal balance totals. So a charge can be paid off by unapplied money on an account. For example, if a family paid a $25 copay in error, and the copay due was later changed, they may end up with a $25 credit on their account. The $25 will be an unapplied payment. Personal balance totals will automatically consider that $25, and reduce the amount due on personal charges.

When you use Distribution, you will see all personal charges not paid off by an applied payment. The list may include charges that are paid off by unapplied payments, such as an old credit on the account. You can review and clean up unapplied payments on the Payment History tab.

By displaying all charges that are not already paid off by applied payments, your practice can use the Distribution section to control to which charges a payment applies.

Enter and Review Account Notes

As you post payments and account adjustments, you may want to enter notes. Read Enter and Review Account Notes to learn more.

Generate or Print Account Forms

As you post payments and review balances, you may want to generate or print past due letters and other forms for a single account. Use the Account Forms component to generate a form.

For general information on how to generate a form, read Generate Forms in PCC EHR. For more information on how to configure account forms, read Configure Forms in PCC EHR.

Review Posted Payments and Edit Personal Payments

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:

Review Payment History and Edit Personal Payments (7 min • 08-2022)
Review Payment History and Edit Payments

Reconcile Personal Payments and Prove Out at the End of the Day

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.

What Payment Types Can I Post In Different PCC Tools?

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. Use the Payment Types table in the Tables tool. For each payment 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”.

Generate Personal Account Bills

March 8, 2015/in Get Started Bill the Family Bill the Family /by Douglas Beagley

Use the Bills tool in PCC EHR to generate personal bills for families. Use the Payments tool to print a single account statement.

Video: Watch Generate Personal Account Bills and Print a Single Account Statement to learn more.

Billing Codes and Descriptions Include Confidential Information: When you print or export billing records, including receipts, bills, and histories, the output includes procedures and diagnoses from patient encounters. These codes and descriptions may reflect clinical information that was marked confidential in the chart.

Generate Bills

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.

Work Unpaid Personal Balances

You can work down a list of accounts with unpaid personal balances using the Personal Balances tool.

Review a Log of Bills

You can review a log of all bill submissions. Read Review the Bill Log to learn more.

Customize the Messages that Appear on a Personal Bill

Your practice can customize the messages that appear on your bills. Read Customize the Messages on Personal Bills to learn how.

Print a Single Account Statement

When you need to generate a single bill for an account, open the Payments tool, find the family, and click “Print Statement”.

If your practice’s custom paper bill includes room for an account note, you can enter one and it will appear on the bill.

You can print the bill or use your workstation’s print window to save it as a PDF.

Printing a statement updates the family’s “Last Bill Sent” date. If your practice uses a billing cycle (such as 28 days), then when you next run bills, a new bill will not be generated within the cycle unless the family has new charges. For more information, read Generate Personal Account Bills.

Custom Message Tips: The custom message you enter when you generate a single statement is not saved; it appears only on the bill you are generating. Your practice can use Snap Text to define useful re-usable custom messages for bills. Use the Bills tool to define your age-based practice-wide billing messages that appear on every bill.

My Bill Looks Different: The single bill form printed from PCC EHR is not the same format as bills printed by a third-party printing service. The “Print Statement” button prints the default paper bill form on your PCC system.

Personal Billing Overview

March 8, 2015/in Get Started Bill the Family Bill the Family /by Douglas Beagley

From collecting copays to generating bills, to bill follow-up and sending accounts to collections, PCC tools can help you keep your practice’s personal A/R under control.

Here’s an overview:

Collect the Payment and Family 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, explain old balances to the family, and post copays and other payments. Everything you collect while the patient is still in the building saves you time and money.

Financial Policy: 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 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 work down a list of accounts with personal balances using the Personal Balances tool.

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 enter account notes and add appropriate status flags for reporting and tracking.

Work With Special Accounts (cfs)

March 8, 2015/in /by Douglas Beagley

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 for whom your practice is holding back personal bills until a certain date. You can view and work with all of these types of accounts by using the cfs report.

Run `cfs` and Select Criteria

You 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 Flags on your system. 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.

View the Report and Work With Accounts

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.

Explain Account Balances

March 8, 2015/in Bill the Family, Post Personal Payments, Work Insurance A/R and Personal A/R Bill the Family, Post Personal Payments, Work Insurance A/R and Personal A/R /by Douglas Beagley

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.

Customize the Messages on Personal Bills

March 8, 2015/in Bill the Family Bill the Family /by Douglas Beagley

Account bills include a text area that displays a custom billing message from your practice. You can adjust the billing message that appears for bills printed by a third-party service and bills you print at your office. You can add a one-time note when you print a single bill at your practice. Additionally, PCC support can add a custom “Pay Your Bill” website address.

Sample Billing Message on a Bill

When you generate bills, your practice’s billing message appears as shown in this example:

Edit Your Practice’s Billing Messages

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.

Add a One-Time Note to an Account Statement

When you print a single statement at your practice, you can optionally add a one-time note to the family.

See Print a Single Statement to learn more.

Billing Message Examples

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).

Change Your “Pay Your Bill On Line At” Website URL Address

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.

Use Cycle Billing

March 8, 2015/in Bill the Family /by Douglas Beagley

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.

What is “Cycle Billing”?

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.

Review Checkin Status: Who Checked a Patient In?

March 8, 2015/in Check In a Patient /by Douglas Beagley

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.

Read EDI Responses to Claim Submissions

March 7, 2015/in Bill Insurance Bill Insurance /by Douglas Beagley

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.

What EDI Responses Are Sent To Your PCC System?

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 EDI Responses Should a Practice Review?

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 Claims That Cannot Be Submitted to learn more.
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 Insurance Balances tool or review them in the encounter’s Claim History in the Billing History in the chart. Read Work on Claim 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.

How Do I Review the Archived Copy of any EDI Response?

As described above, PCC includes tools and reports for addressing claim and billing problems as part of your daily workflow. You can also read EDI responses for any encounter.

Claim History: You can review original acknowledgements and other responses using the Claim History for any encounter. The Claim History is available on the Posting Exceptions detail view, but you can find it at any time for any encounter in the Billing History section of the patient’s chart.
All ERAs: As described above, you can read the full ERA in the Electronic Remittance Advice tool.
System Archive: If you don’t know the patient, check number, or payor you can also read archived EDI communication that arrives on your PCC system in the under-the-hood EDI Reports (ecsreports) program. In addition to claim responses, the archive includes acknowledgements from your third-party bill printing service, batch reports for a day’s submission, and copies of other archived output from electronic transactions.

Run Reports in the PCC EHR Report Library

June 20, 2014/in Get Started Generate Clinical Reports Generate Reports /by Nate Venet

The Report Library in PCC EHR is a suite of reports designed to give you access to information about your practice.

Run a Report

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.

Work with Report Categories and Locate Reports

The Report Library organizes reports into categories that are accessible to users with specific roles.

Review Category Contents

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.

Search Categories

Use the Search field in any category to find a specific report by name or description.

Manage Category Permissions

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.

Special Categories

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.

Choose Report Criteria

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.

Pick Date Ranges

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.

Posting Date: Posting date for both payments and charges is the date that information was entered into PCC. Some financial reports allow for sorting by posting date, available during customization. However, PCC recommends running financial reports by transaction date, rather than posting date.

Transaction Date: Transaction date is the date found on the check, EOB, or ERA. Transaction date is the most common default date range for PCC’s financial reports. Both payments and charges have transaction dates.

The payment transaction Date is the date found on the check, EOB, or ERA.
The charge transaction date is the Date of Service (DOS). This is the date on which the patient received care.

Include Criteria

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.

Exclude Criteria

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.

Example: Select Criteria to Report on Asthma Patients with a Flovent Prescription

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.

Navigate the Report Output

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.

The Back button takes you to the previous screen so that you can select different report criteria and generate the report again. PCC EHR will remember your most recent criteria choices while you work with the report.
To return to the Report Library home screen with the full list of reports, click the “Report Library” button.
The Close button closes the Report Library window. Your selections will not be saved when you click “Close”.

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. A tally of your search results out of the total displays below the search results.

Adjust Report Output

You can organize your report output to display the information most relevant to your needs.

Arrange, Hide, or Show Columns

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.

Group and Subtotal Report Output

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.

Sort Report Output

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.

Export a Report

In the Report Library, you can export to PDF, CSV, or send batch messages to patients via email or text message.

Export to PDF for a digital version of the printed report. Report output cannot be adjusted once exported to PDF.
Export to CSV to work with your report output in a spreadsheet. Totals and sorting using Group By do not transfer to CSV.
Once you build a patient list in the Report Library, you can compose batch messages and text or email them to patients and families. To learn how, read Send Batch Messages to Patients and Families.

Build a Custom Report

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.

Schedule Reports

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.