Overview of Enhancements

Release 6.0 of Physician Office Manager is an update that focuses on HIPAA mandates that will be taking affect shortly.

National Provider Identifier

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 signed into law on Aug. 21, 1996. Provisions comprised under the Administrative Simplification section of HIPAA are intended to improve the general functioning of the healthcare industry by simplifying specified administrative processes and reducing costs. One of these standards is the adoption of unique identifiers. Unique health identifiers provide consistency in identification codes regardless of transaction recipient. In order to simplify current identification practices, HIPAA requires the adoption of unique identifiers for healthcare providers and employers.

A National Provider Identifier (NPI) will be assigned by HCFA to each provider. The definition of a health care provider is limited to those entities that furnish, or bill and are paid for, health care services in the normal course of business. The NPI is 10 digits long. The provider could be an individual or organization. The NPI is similar in scope to (but will not replace) the UPIN.

You may now enter the National Provider Identification Number (NPI) on the Provider, Group and Referring Provider maintenance dialogs, as seen below.

You will also notice that the License Number fields on these dialogs have been renamed to Provider ID, Referring Provider ID, and Practice ID to avoid confusion of what number should be entered into these fields.

NPI on Carrier Dialog

The ‘Require NPI check box on the Carrier maintenance dialog identifies if this carrier requires an NPI number to be sent on insurance claims. Place a check mark in the box for all carriers that require NPI number on insurance claims.

If you have some carriers that will require NPI and others that will not require the new number, you should use the new claim variable NPI/Contract Number on all insurance type claim forms (paper and electronic). This new variable uses the ‘Require NPI’ check box at the carrier level to determine if the NPI number should be passed on insurance claims. If the carrier does not require the NPI be passed the insurance program will first look for the existence of a Provider, Referring Provider or Practice Cross-Reference ID number. If the respective cross-reference ID is not found the Provider ID, Referring Provider ID or Practice ID will be used.

National Provider Identifier and Employer Identifier

The Employer Identification Number (EIN) is issued and maintained by the Internal Revenue Service. Businesses that pay wages to employees already have an EIN. Under the proposed HIPAA rule, health care providers, health care clearinghouses, and health plans would use this number to identify the employer on electronic health transactions that require an employer identifier. The EIN is a 9-digit taxpayer identifier number currently used on the W2 form.

The Employer Identification Number (EIN) may be entered on the Employer maintenance dialog. Variables are available in Formsgen to print the EIN number on insurance claims if a Payor requires that it be passed.

Security

According to HIPAA, security standards must address reasonable and appropriate administrative, technical and physical safeguards to:

Facilitate the integrity and confidentiality of the information
Protect against any reasonably anticipated threats or hazards to the security or integrity of the information and unauthorized uses or disclosures of the information
Promote compliance by officers and employees of applicable entities

The security standards apply to health plans, and healthcare clearinghouses and providers that maintain or transmit health information.

This release of Physician Office Manager contains the security feature that will automatically log a user out of Manager based on a system default inactivity time period defined by the practice.

This, along with current Physician Office Manager security functionality, makes Physician Office Manager HIPAA-ready under the current guidelines.

In the new field ‘Inactivity Timeout’, enter the number of minutes Physician Office Manager is allowed to sit inactive before the system should automatically log the current user off of the system. In the event the program is automatically closed the System Login prompt will be displayed so that the user can quickly re-enter their user id and password to continue using Manager.

Patient Sear ch

The Select Patient list box gives you the ability to search the patient database by birth date.

Simply click the Birth Date radio button and then enter the birth date in month, day, century and year format (MMDDCCYY) and click the Search button or press Alt/S to invoke the search process.

Charge Slips Variables

The following Appointment information is now available to print on charge slips.

Appointment Arrival Time
Appointment Resource Name
Appointment Comments

These variables are in addition to other appointment information that you may already print, which includes:

Appointment Type Description
Appointment Resource ID Code
Appointment Instructions 1
Appointment Instructions 2
Appointment Date and Time

Recall Enhancements

The Future Recall process has been enhanced to track the number of recall letters sent to a patient. Each time a patient appears in the Future Recall run a new field ‘Letters Sent’ will be updated. The Letters Sent field is used by the Purge Recalls program (defined below) to determine when a patient should be removed from the recall letter generation process.

Purge Recalls

The new Purge Recalls process allows you to remove patients from the recall process once they have made an appointment or have not responded to a practice specified number of attempted notifications to make another appointment.

Select the Purge Recall option from the Logging menu to bring up the Purge Recall Notices dialog.

The Purge Recalls process will remove patients from the recall process under two conditions.

If the patient has made an appointment after the recall date that was established.
If the patient has been notified and has not made an appointment after the practice specified number of attempted notifications. (For example, if you run the Purge Recall Notices with ‘Purge Recall Notices with no response after 3 attempted notifications’, any patient that has been sent 3 or more recall letters will be removed from the recall process.)

You may perform a Preview Run only if you want to review the list of patient’s prior to performing an actual purge run. The report that prints will show you who will be purged and for what reason so that you may review the list and make decisions on how to proceed. (For example, to keep the list of recall letters manageable, perform the preview run, identify those patients you want to continue contacting and then run the actual purge process to remove the bulk of those patient’s you will not contact again. After the purge process has been performed, simply create new recall records for those patients you want to contact again. You may also want to use the Tickler module to create records for those patients you want to contact again, but would prefer to contact them by phone, as they have not responded to your recall letters.

The date range you enter on the purge recall notices dialog identifies the dates associated with recall records entered from the Recall dialog. After you enter the input criteria click the OK button to begin the purge process. You will notice that the report generated is sent directly to the printer. This is to ensure that you have a hard copy of the patient’s who will be removed from the recall process.

An example of the Purge Recall Notices report is listed below. The first section of the report identifies patient’s who were entered in the recall module and the date of each recall. The second section of the report identifies why the patient recall record will be removed (i.e. an Appointment was made or the Recall Limit was met). In the case where the patient made an appointment the appointment date and time and provider the appointment was made with is printed. When no appointment was scheduled you will simply see the number or recall letters that were sent and a reason code of ‘Recall Limit Met’.

By reviewing the information on this report you will be able to track the success rates for patient’s scheduling appointments as a result of recall letters your practice has sent.

Appointments

There is a new master resource report that prints appointment comments for each patient’s appointment. If you would rather use the old master report a copy of the report template (master.rav) is available in the Support directory that you may copy back into the Appt2000\Reports directory.
Appointment Scheduling ensures that only User’s with the Hold Time Make/Edit or Block Time Make/Edit security option enabled to delete hold or block times.
The Utility Order block/hold time records (Orblkhld.exe) is available for users to run on their appointment data if multiples are being displayed when they were not desired. The conversion from 3.4 to 2000 converted records in such a manner that if hold times are in the same cell as an appointment or block, the cell is displaying the M for multiple. Generally what occurs is block or appointments are placed on top of hold times and this is what the conversion will correct. The utility also removes records that are currently displaying with a blank status on the patient check in screen or the appointment history dialog. These were secondary appointment records from the previous version of appointments that indicated an appointment was moved.
The conversion program was updated to ensure hold, block and appointment records are ordered in the new appointment table in the fashion users intended them to be. The conversion will also correct the moved records issue the utility is adjusting for.
The Find Appointment wizard will now ignore resources that are marked as inactive to ensure the user does not book an appointment for an inactive practitioner.
The Calendar component also now correctly shows 6 rows in the calendar to ensure all days of each month can be seen.
Changes made to patient information within Appointments will now update trigger tables. In order for this to occur you must copy the pomtrig.ini that resides in the PPM program directory into the Appointment directory, so that the path to trigger tables can be found by both PPManager and Appointments.

You may now delete Appointment Types and Resource codes as long as no appointments are associated with them. You are not allowed to delete codes that are already associated with an appointment as it would cause appointment statistical reports to be skewed. Deleting codes is allowed from the Data menu option.