Edit the Insurance Plans on Your PCC System

Use the Tables tool in the Configuration menu in PCC EHR to update the list of plans that your practice bills.

Your practices receives many different electronic responses to claim submissions and billing. Read this article to learn the different EDI responses, which responses require attention, and how to use PCC's tools to review and respond.

Use the Claims tool to process and submit claims to insurance companies and other payers, work on claims that could not be submitted, and review a log of submissions.

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 insurance reimbursement.

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.

While most claims are transmitted to payors electronically, sometimes you may need to generate paper 1500 HCFA forms, or print a single paper claim.

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 after you post charges into PCC EHR.

You can use PCC to track your payor contract fee schedule amounts, also known as "allowables" or the "allowed amount" for each procedure. Then, when autoposting insurance payments, you can review any responses on the ERA that did not match the fee schedule. When you manually post insurance payments, you can see whether or not the payment amount you enter matches the fee schedule. Later, you can report on whether or not payors are honoring their contracts.

Use the Tables tool and other configuration tools in PCC EHR to define what vaccines and other medications your practice administers and how they will be ordered, tracked, and displayed. PCC Support can help you with any part of this configuration.

The CDC maintains lists of vaccines, their manufacturers, VIS publications, and NDC codes. With each immunization you administer, PCC stores this information and validates it based on the CDC's lists.

PCC EHR can enter your default Normal or Abnormal notes at the click of a button while you chart.

You can configure how long an inactive PCC EHR window will remain open. Set the session timeout length in the Practice Preferences window in the Tools menu.

Nurses and physicians measure vitals and enter them quickly into a patient's chart. To make this process match your office's workflow, you can configure PCC EHR's temperature and blood pressure method defaults (oral, tympanic, right arm, etc.) as well as whether you use English or Metric measurements for other vitals.

Use the Billing Configuration tool to configure billing behaviors of procedures and diagnoses and the Billing screen in PCC EHR. Follow the procedures below to open the Billing Configuration tool and make changes.

If your practice is located in California, you can use PCC software to submit your patients' immunization records to CAIR, the California Immunization Registry.

If your practice needs some visits signed and co-signed, you can turn on co-signing and then require it for specific users.

You can configure PCC EHR to match your workflow and charting style. You can change how many screens behave in order to help your office find what they need quickly. The help articles below include procedures and references to make changes to PCC EHR's behavior.

You can turn on and off some of the columns on the Schedule screen.

PCC EHR's labs can contain several result fields, have default facilities, initiate tasks for the tasks queue, and use numerous other features. Your common labs can automatically appear for selection on appropriate chart notes. Read the sections below to understand everything you need to know about lab configuration.

Use the Professional Contact Manager tool to manage the list of your practice's professional contacts, school medical personnel, and other professionals who may be part of care plans for many different patients.

Clinicians can select diagnoses on a chart note, or add a new diagnosis to a patient's Problem List. Read the sections below to learn how to configure how diagnoses are recorded.

PCC EHR can alert you about specific clinical concerns, based on a patient's demographics, diagnoses, or other complex criteria combinations.

PCC EHR can automatically send completed immunization orders to your local immunization registry.

EHR user drop-down lists can be configured to sort in numerous ways.

If a secondary insurance requires the EOB from the primary, or any claim requires a certificate of medical necessity, discharge summary, or other clinical documentation, you need to send an attachment to the payor. You can edit the encounter and add an attachment code to an encounter, generate a unique attachment ID, and specify the attachment type and method. Attachment information will then be sent with the electronic claim.

Contents1 Customize Your Practice’s Visit Statuses2 Customize Your Visit Status Counters PCC comes with a set of visit statuses that you can use to indicate patient status on the schedule screen. PCC encourages each practice to configure its own visit statuses to compliment the practice’s workflow. Customize Your Practice’s Visit Statuses You can add any […]

Learn special techniques for searching for patient and account records.

Capitation payments are not like other income. How should you configure PCC EHR in order to track payments you receive as part of your participation with a capitation insurance plan? PCC Support will complete the steps in this article for you, but you may find the instructions helpful if you are a system administrator or practice manager and make updates to your PCC tables.

PCC EHR enables you to pull in documents from various sources and attach them to charts, visits and orders. Use the Document Administration tool to configure defaults and options for how PCC EHR handles these documents.

Contents1 Create Telemedicine Visit Reasons for Scheduling2 Select Your Telemedicine Vendor3 Configure Telemedicine Links for Your Providers and Patients4 Add New Visit Statuses to Help Manage Telemedicine Visits5 Create a Telemedicine Visit Protocol6 Add Telemedicine Procedure Codes and Prices to Your PCC System6.1 Create a Telemedicine Procedure Group6.2 Add Telemedicine Procedures, Codes, and Prices7 Update […]

When you need to add a new billing code to your PCC system, create a new version of a code that includes modifiers, or adjust your practice’s prices for procedures or adjustment types, use the Tables tool in the Configuration menu.

When your practice needs to prevent certain claims from being submitted, you can create a claim hold. A claim hold prevents claims from going out for specific dates of service, billing providers, places of service, and insurance plans. You can also configure your practice’s claim delay, which prevents any claim from going out until a certain number of days after the date of service.

Switch to a new forms solution in PCC EHR that empowers you to create and manage your own auto-filling forms, handouts, policies, and letters.

After you prepare and submit claims, you must deal with claims that could not be submitted or were rejected.

What kinds of pre-submission processing does your PCC system do on claims? What errors can it find, and how do you fix them?

Manage your practice’s exam room list using the Rooms configuration tool in PCC EHR. Users with permission will find “Rooms” under the Configuration menu. Click “Add” to create a new room. Room names can be between 1 and 4 characters, and can use any letter, number, or symbol. Names must be unique. Click “Save” to […]