PCC EHR

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PM Window: Advanced Billing Functions and Configuration

Before PCC EHR, PCC developed and maintained the Partner practice management suite of tools for pediatric scheduling, billing, and other functions.

PCC EHR has replaced Partner except for some remaining advanced billing tasks and some under-the-hood configuration for your practice.

If you are a biller or your practice's PCC "super user", you can use the articles and videos in these sections to learn how to use the "Practice Management" window in PCC EHR to meet these needs.

If you would like documentation for deprecated software, such as our previous scheduler (SAM) or the Family and Patient Editors (fame, notjane), it is available upon request.

Training Videos

Open and Use the Practice Management (Partner) Window

7 minutes • 2019
Some advanced billing and "under-the-hood" functions are found the Practice Management window in PCC EHR. Watch this video to learn how to get around and perform operations in Practice Management.

Learn More

Open and Use the Practice Management (Partner) Window

Use the Practice Management window in PCC EHR to access various under-the-hood billing features and services in PCC’s Partner practice management suite.
Manage Insurance Plans on Your PCC System

Learn some under-the-hood tools for managing patients, accounts, and policies in your PCC system.

Read The Front Desk and PCC to learn more.
- Add an Insurance Plan to Your PCC System
  
  When a patient or parent brings in a new insurance card, you can update their insurance policies quickly and easily. However, what if the insurance plan is entirely new to your practice? Maybe it is an existing plan (like BCBS), but it has a new address, copay amount, or payer ID. Follow the steps in this article to add a new plan to your PCC system.
- Insurance Tables Reference
  
  This article is a reference to the Insurance Companies table and the Insurance Groups table used in PCC software. You can edit both tables in the Table Editor (ted), found in the Practice Management interface in PCC EHR. Insurance tables contain information about the insurance plans on your PCC system, which are used for billing and reporting.
- Configure Capitation and Capitated Plans
  
  Capitation payments are not like other income. How should you configure the PCC billing system so you can enter and track capitation payments over time? Read the steps below to learn how to create appropriate insurance groups, plans, and income accounts to record and track capitation. For this example, we will create a new capitated […]
- Add and Configure Insurance Plans to Your System
  
  Training Video
Correct Mistakes
After you enter charge and encounter information and Post Charges, you can review a patient's billing history in their chart.

When you need to change the responsible party for an encounter or alter encounter information that appears on a claim (such as diagnoses or prior authorization numbers), use the Correct Mistakes (oops) tool in the Practice Management window.
- Edit Encounter Charge Information and Generate a New Claim
  
  Training Video
- Change Diagnoses, Hospital, or Other Claim Information After Charges Are Posted
  
  If you need to update the diagnosis, hospital, or other visit information for a visit, follow the procedure below. Remember that you will also need to rebatch (or reprint) the insurance claim when you are finished.
- Adjust Charge Details and Claim History (Correct Mistakes)
  
  When you need to fix charge and claim details, change the responsible party for an encounter, or alter encounter information that appears on a claim (such as diagnoses or prior authorization numbers), use the Correct Mistakes tool in the Practice Management window. After you make changes, you can resubmit claims. You can also use oops to research the billing and payment history for each encounter on an account.
- Edit an Encounter’s Diagnoses, Billing Provider, and Other Claim Information
  
  Your practice can enter a diagnoses, adjust the billing provider, and add other claim information when you Post Charges in PCC EHR. If you need to make changes later (and resubmit a claim), use the Visit Status screens in Correct Mistakes (oops) in the Practice Management window. You can change diagnoses, the billing provider, and adjust other important encounter information for a charge.
- Assign a Billing Provider After Charges are Posted
  
  You may need to assign a billing provider to a charge or a visit after it has been posted. You can change the billing provider for a previously-posted charge on the Visit Status screen in the Correct Mistakes (oops) program.
- Change the Responsible Party and Copay for Charges
  
  Your practice can adjust the responsible party for a charge and edit copay amounts when you Post Charges in PCC EHR. If you find out the patient's policy has changed, you can edit the charges later in Correct Mistakes (oops), found in the Practice Management window. You can change the responsible payor for any charge on any encounter, and change the portion of the charge that is the copay.
- Enter and Review Encounter Visit Notes
  
  You can add and review visit notes for an encounter in Correct Mistakes (oops).
- Change an Encounter’s Billing Place of Service After Posting Charges
  
  You can adjust an encounter’s place of service when you Post Charges in PCC EHR. Sometimes you need to change the billing place of service of an encounter after the charges have already been posted. Read below to learn how to change the billing place of service of a phone note, portal message, or visit […]
- Change the Copay Due on a Charge After Charges are Posted
  
  Learn how to change the copay due on a charge. You may need to do this after charges have been posted and a claim has been filed.
Work On Unpaid Claims

After your practice submits claims, you must address claims that could not be submitted, post incoming adjudication that appears on ERAs and EOBs, and followup on unpaid claims. While many of these functions are performed in PCC EHR, a few of these tools still utilize the previous Practice Management interface.
- Create New Claims and Resubmit (maketags)
  
  Use Resubmit Claim Forms (maketags) to find and rebatch large groups of claims based on customizable criteria.
- Print Paper HCFA Claim Forms
  
  While most claims are transmitted to payors electronically, sometimes you may need to generate a paper 1500 HCFA form.
- Follow Up on Unpaid Claims and Insurance A/R
  
  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 track and work down your practice’s insurance A/R.
- Add an Attachment Code to a Claim
  
  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 can add attachment codes to a visit’s charges, generate a unique attachment ID, and specify the attachment type and method.
- Correct a Claim: How to Fix and Resubmit an Insurance Claim
  
  When you receive a rejection, or you have a claim or billing problem, how do you correct the encounter information and then resubmit the corrected claim? Read this article to learn how to update and resubmit a claim.
Account Billing Tools
PCC's Practice Management window includes some specialized account billing tools.
- Turn an Account Over to Collections
  
  Learn how to use PCC's tools to turn an account's charges over to a collections agency.
- Track Personal Balances (persview)
  
  The Personal Money Tracking Assistant helps you manage your personal accounts receivable. It creates an interactive list of accounts with personal balances. The list can contain all outstanding accounts or just a portion, depending on the criteria you enter when you first run the program.
- Work With Special Accounts (cfs)
  
  Use the Special Accounts Editor to work with all accounts with certain status flags or other specific characteristics. For example, you may want to list all accounts that your office put on a budget plan, or all accounts that were flagged as "Cash Only" for writing a bad check.
- Write Off Account Credits
  
  Sometimes a credit should be written off and counted as income to your practice. For example, if an account credit or insurance overpayment remains on your books for several years, your practice may decide to write it off and treat it as revenue.
Contact, Remind, and Recall Patients and Families
- Other Phone Vendor Integration Options
  
  Partner's built in Patient Notification Center interfaces with TeleVox and manages automatic notifications.
- Export Patient Lists for TeleVox (Intrado)
  
  TeleVox is a vendor that can automatically contact your patients by phone, text, or e-mail. The instructions below will show you how to create a list of patients and transfer them to your PC or directly to TeleVox.
- Recall Patients with the Partner Patient Recaller
  
  The Patient Recaller (recaller) is a report that can create custom call lists, form letters, and mailing labels for your patients and families. You can create custom searches using thousands of possible criteria combinations, and the Recaller will help you contact those different groups of patients.
- Export Patient Lists for PhoneTree
  
  PhoneTree is a vendor that can automatically contact your patients by phone. The instructions below will show you how to create a list of patients and transfer them to your PC for use with the PhoneTree program.
- Exclude Patients from Recaller and Notify
  
  Patients and families may request that you do not call them or send them e-mails with appointment reminders or recall reminders.
- Create Recurring Notifications for Patients and Families
  
  When you need more than Broadcast Messaging, you can use the Patient Notification Center (notify) to set up recurring or one-time notifications that will be sent automatically through a partnership with TeleVox (Intrado), either by phone call, text message, or e-mail.
Generate Reports in Practice Management
You can use the Report Library in PCC EHR for most reporting needs. The Practice Management window contains some additional reports, including customizable financial analysis reports. Check out the articles below to learn more.
- Run Reports in the Practice Management Window (Partner)
  
  PCC's Practice Management tool, Partner, includes a variety of specialized, customizable reports for billing and financial analysis. Partner's accurate and diverse reporting capabilities can help you with time management, inventory planning, insurance contract negotiations, and financial planning.
- SRS: the Report Engine in Practice Management
  
  The Smart Report Suite (srs) is a report library in PCC's previous Practice Management system.
- Demographic, Clinical, and Configuration Reports in Practice Management
  
  This article is a catalog of reports for demographics, diagnoses and procedures, and system configuration that are found in the under-the-hood Practice Management tools in PCC EHR.
- Export SRS Results to a Spreadsheet
  
  You or your practice's accountant may use financial data from reports to analyze profits and make policy decisions for the future of your practice. You may wish to export those reports to another program, such as a spreadsheet, in order to make graphs or combine the numbers with other information.
- ARRA Report
  
  The ARRA report calculates Medicaid plan utilization at your practice. You can use it to see the percentage of patient visits that are medicaid or medicaid eligible, broken out by physician. This report is designed to help your office determine if you may qualify for the ARRA incentive program. You can run the report from a command prompt or from a custom Partner window location.
- Financial Reports in Practice Management
  
  The Practice Management (Partner) tool in PCC EHR includes a wide array of financial reports. While many of these functions have been replaced with PCC EHR tools with modern interfaces, there are still many powerful, customizable reports that can help you track charges and payments and report on your practice's overall financial health.
- Review Posted Charges In Daily Check
  
  The Daily Check program (dailycheck) lists all the 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.
- Run Practice Management SRS Reports
  
  Training Video
Configure PM Tools
Read the help articles in this section to learn about configuring tools in your Practice Management windows.
- Choose Your Practice Management Printer
  
  Your office may have a front-desk printer for receipts, a chart room printer for encounter forms, and a back office printer for everything else. When you log in, you may have printer needs that are particular for you, or particular for where you are working today.
- Edit Your Practice’s Tables
  
  Tables are lists of items that your PCC system uses in various tools. For example, your practice's system has a list of insurance policies, clinicians, visit reasons, procedures, and more.
- Use Contract Fee Schedules (Allowables) to Monitor Reimbursement
  
  PCC can track your contract fee schedules, also known as "allowables", in the Contract Fee Schedule Editor (allowedit). You can create and manage multiple contract rates, make changes to expected fees that will occur after a specific date, and assign the completed contract fee schedules to specific insurance plans. The Post Insurance Payments (pip) program will then display the contracted fee or “Allowed” amount when posting payments for charges pending those insurance plans.
- The snomedmap Report
  
  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 code sets you use on your PCC system.
- Edit Your Practice’s Procedures, Codes, Adjustments, and Prices
  
  When you need to add a new CPT code to your PCC system, create a new version of a code that includes modifiers, or adjust your practice's prices for procedures, use the Table Editor found in PCC's under-the-hood Practice Management window.