In preparation for the 5.32 Release in July, 2023, CareStack has implemented essential features significantly across Medical Claim Forms to enhance user experience and reduce probable instances of claim rejection. Additionally, there are a few UI modifications and inclusion of pivotal features within Clinical CareNotes as well as Production goals to enable users to save time and increase productivity.
Clinical
- Smart Phrases
Building narratives for a successful claim submission could not get any easier for oral surgery practices!
The best part is that you need not switch between tabs anymore or lose time searching for and selecting the required portion from multiple dental narratives. You can now efficiently pre-set templates of clinical narratives within Practice Settings as well as have the ability to pull up a list; select the intended narrative; and incorporate it within CareNotes while raising insurance claims.
a. Set Up
Here’s a quick look at the incredible CareStack Smart Phrases feature integrated within the PMS to aid practices quickly set up narratives that aptly describe patient specific dental problems and procedures.
Enabling this feature within the system, lets users create and save a stock of easy-to-use, built-in narrative templates within Practice Settings > Clinical > CareNotes > where users need to select the Templates tab on the top left to get started.
Once that is done, go ahead and input a relevant name for the narrative > select Smart Phrases for the category > choose the location(s) from the dropdown for which the narrative should be enabled for > type in and format the body text of the descriptive paragraph(s) using text settings > click the Save button.
Note: Practices can view the newly included Smart Phrases category by selecting the Template Categories under CareNotes section within Practice Settings.
b. Execution
The advantage is that users can select from among the stock of pre-written templates by simply typing the plus symbol +. This will open up a smart phrases menu from which users can instantly select the check mark against the desired template.
Tip: Choose from among the preset templates available that comprises necessary information which the user is looking to incorporate into the patient’s CareNote.
To accomplish this task, let’s walk you through a familiar scenario:
Navigate to the Patient’s Clinical Chart > click the + Note > select Template > Add Note > Edit > type in the plus symbol +> browse through the Smart Phrases menu and select the check symbol against the desired narrative > click the Update Note button.
Tip: The selected narrative will appear on the right of the CareNote slideout right below the Carenote Properties section.
Note: To view and select narratives from the Smart Phrases menu, make sure they are enabled for that location.
Refer to the illustration below to view the representation of the Smart Phrases feature:
1 highlights what happens when you select the + and choices for smart
phrases.
2 demonstrates what smart phrases look like.
3 shows the inclusion of the smart phrase under the property section post its
editing.
Note: You can also add graphics in a smartphrase.
2. Smart Answers
Clinical forms filled out for surgeries have been made easier! You can pre-set answers to the main clinical assessment question(s) within the CareNotes so that the desired option for the questions grouped under it shall be automatically selected. To have this automated, you need to select the right options for each of those questions within Practice Settings.
a. Set-up
For the efficient use of this functionality, it is necessary that an output is selected for the primary question which will trigger the set of questions tagged under it to be pre-populated with the expected option based on the setting.
i. To set it up, navigate to Practice Settings > Clinical > CareNotes >
Templates > select a Template.
ii. Click on the More options tab > select Field Rules.
iii. Set the IF condition with the answer for the primary question.
iv. Select the dropdown under the IF condition > Choose SMART ANSWER.
v. Set the answers for the sub group of questions attached to it.
vi. Click Save.
- Execution
Once you have saved the SMART ANSWERS, navigate to the Patient’s Clinical Chart > click + Note > select the Template > Add Note. Choose the main answer to the primary question for which the IF condition was set. Immediately all the sub questions tagged to the main question for which you had set the smart answer for will be auto selected.
- Example
For Anesthetic as a smart answer: if you select no anesthetic, your rule would be question one is
Anesthetic 1: answered no anesthetic used then question 2 would auto answer as no anesthetic.
Another scenario question one Anesthetic 1: answered as Septocaine 4% with epi 1:200,000 then the question two the smart answer would be set as 1 carpules. (see screenshot below)
Patient Engagement/Patient Services
1. Provider Signature
a. Save Function
CareStack has brought in a workaround for providers when it comes to signing documents. Providers can now save their signature and use it for signing the documents instead of manually signing every single doc.
There are two ways to save your signature:
i. Navigate to Dashboard > Lists > Pending Signature Forms. Choose a form you want to sign. Click on the Sign button under Provider Signature.
Once you sign the form, checkmark the ‘Save signature for future use’ box. Your signature will now be saved for future use in other forms, eliminating the need to sign each form manually. When unchecked, it does not save the signature.
Note: The checkbox Save Signature for Future Use will only appear when the logged-in user matches the provider who is signing the form.
The provider can remove the signature by clicking on the Clear button at the bottom left. When the next document is pulled up by the provider to sign, the saved signature will automatically be populated, provided that the logged-in user and the provider name match.
ii. Navigate to the System Menu > User Settings.
In the Provider Signature section, you can Add New Signature or remove the existing one. The saved signature will appear on the document when the provider pulls it up to sign.
Revenue Cycle Management
Medical Claim Form
1. When insurance is for the self-subscriber, patient detail segments in claim Fields 2, 3, 5 & 6 will
not be sent out in EDI and printed claim form. This is to avoid duplication as patient and subscriber details are the same in such a scenario.
Note: Users can view this information by hovering over the i icon in field 2.
2. Addition of a new checkbox in the Medical Claim Form at the bottom of the claim form lets you, ‘Exclude Service Location while Claim Submission’. The inclusion of this option enables users to decide if field 32 needs to be submitted in the claim.
Note: When the Billing Provider Information in field 32 and the Service Facility Location in field 33 are the same, this causes duplicate submission of data leading to claim rejection.
3. The Provider dropdown sorting in both Dental and Medical Claim Forms will have inactive providers at the bottom of the provider list assigned with a gray inactive tag.
4. The Other Coverage section is not mandatory and therefore requires not to be sent in the Medical Claim Form, as medical payers do not coordinate with dental insurance carriers. Hence, the Other Coverage section becomes non-mandatory when the Billing Order is set as MD i.e. when the primary insurance is Medical while the secondary insurance is Dental.
5. Sorting of Codes will be based on the descending order of the individual Code Fee when submitting the claim in EDI. The same will be reflected on the print version of the claim form.
Note: The sorting of codes will not be visible on the actual claim form.
6. For a seamless user experience, CareStack has brought in the Merge Code Functionality. Users can make use of this feature along with the previously existing feature for Cross Coding of Dental Codes. Both of these are made available within the Take Action button on the middle right-hand side as illustrated in the screenshot below.
a. The Take Action button once selected will open up a modal that performs a dual purpose. It allows users the flexibility to Cross Code Codes as well as Merge Codes. Opting for Cross Code Codes enables users to select Add Medical Codes to convert dental codes into medical codes.
i.Choose the Skip functionality to proceed to the next step i.e. Merge Codes if you do not wish to take action on the cross coding section.
ii. Select Apply & Proceed to apply the cross coded process to the claim form and continue to the next step of Merging codes.
iii. There is also the option to Apply & Close which applies the cross code process to the claim form and closes the modal.
iv. If you choose Cancel it will cancel the whole process and close the window. Selecting the cancel action with any changes done inside the modal, will be prompted with the following warning as shown below.
b. Merging of Codes offers users the flexibility to merge treatment (Tx) codes that are grouped under
the same criteria such as DOS, Tooth Area, Surface, or ICD Codes. Based on the requirement, you
can make use of Skip & Apply or Merge & Complete. If you choose to Cancel, a warning modal same as the one prompted for Cross Codes Code will appear.
c. Once an action is performed using the Take Action button, you will see it replaced by the option
to Reset. Choosing Reset reverts all actions that were performed via the Take Action button.
d. Upon selecting Tx, the respective modal will present a preview of the Procedures Codes as they were initially i.e. the status of procedure codes prior to applying the changes via Take Action.
i. Selecting Reset will revert the procedure codes as displayed in the Tx (Treatment Procedure) modal.
7. Fee Calculation: System automatically calculates the product of UCR with the Quantity and therefore populates the Charges field. As for Total Charges, it will display the total of the individual charges.
8. The Diagnosis Pointer fields which are relatable to Field No 21: Diagnosis or Nature of Illness or Injury have been made editable. This allows users to configure any value from field 21 against this Diagnosis Pointer making use of the respective drop-down action.
9. Users have the flexibility to pre-set Qualifier within the Medical Claim Form to reflect accordingly in Field No:14. Once a Qualifier is set, the corresponding Date of Current Illness, Injury or Pregnancy becomes mandatory.
To configure the same, navigate to Practice Settings > Payments > Claim Form Defaults > Medical > Edit > Select the relevant option from the dropdown for Qualifier for Date of Current Illness, Injury, or Pregnancy > This will auto trigger the Date of Current Illness, Injury or Pregnancy for you to select the desired option > click Save.
Reporting and Analytics
1. Practices can now decide whether to keep the monthly provider goal fixed or flexible. Navigate to Dashboard > Production Goals. Choose the provider for whom you want to make the edits. Choose
the day on which you want to change the Production Goal.
Assuming that you checked the ‘Keep Monthly Provider Goal Fixed’ box. There are three scenarios that can happen. Let’s go through each one of them.
a. In the monthly calendar, if the production goal is increased for future days and the total production goal for the modified days is less than the total production goals for the remaining days, then the goal is decreased for the remaining days accordingly to keep the total monthly goal fixed.
b. In the monthly calendar, If a day(s) is marked as a non-working day or the production goal is reduced, then the production goals for the current day to the last working day of the month will be increased accordingly on the basis of working hours to keep the monthly provider goal constant.
c. In the monthly calendar, if the production goal is increased for future days and the total production goal for the modified days is more than the total production goals for the remaining days, then the fixed button is overridden, and the total monthly goal is increased to the new value.
2. Yet another incredible helpful update CareStack implemented in the analytics module is that users can now set the location and provider goals for the current month even after the month has begun.
Click on Edit Monthly Provider Goal and update the entries. A warning will pop-up when you click on Save Goal. Click on Update Provider Goal.
Users can also edit the goals for past days even after the month has begun.
Note: This is valid only for the current month. Past month’s location goals and daily goals will not be editable.