Dream Factory by TruBridge Ideas Portal
Payment Posters should be able to perform the following all in one space without having to jump in and out of multiple screens just to post manual remits, process ERAs, apply adjustments, review parts of clinical chart, review parts of HIM Grouper, Insurance Screens, etc.
Update settings similar to HIM Grouper.
Create Navigation Panel
Insurance Receipting, Insurance Billing/Claims, Grouper Patient Summary, Diagnosis, Procedure, Charging, Order Chronology, Location, Notes, E-Form, Reports & Attachments, Clinical History, Vitals, MAR, Labs, PACS, Ins Tickler, Collections Tickler
Buttons
Update Work Area From ERA File, Review & Post - Unposted Payments, Print Edit List, Clear All, Delete, Create New Claim, Policy Information Screen, Prior Payments & EOB
Patient Account Display Panel Top of screen (Similar to Patient Display in charts)
Basic Account Info: Name, DOB, Services, Stay Type/Sub, Service, Attending phy
List of current claim status with dates.
Account Summary/ Status - Notes, Total Charges, Total Adjustment, Ins Payments, Patient Payments, AR Balance, Bad Debt Balance
Manual Remit Posting Entry Lines
Billed Amount, Contractual and Approved amount need to be available to overkey
Additional Lines to assign adjustments and write offs -System display new projected account balance
Reason Codes Assignment
Rejection Code Assignment
Create Unposted Payment Screen
Dropdown fields Change Remit Date, Change AR date,
Button Post, Delete, Clear All, PDF Print, CSV, Spool to File
Users have the ability to review and edit lines
Click to highlight display current account status and projected account status
list each remit per row
columns display
account, service date, receipt code, claim status, billed amount, approved amount, coinsurance, non covered, reimbursements, contractual GL contractuals, applied to detectable, Payment Status, Reason Codes, Rejection code, applied adjustments charge number, charge amount, charge qty
There has also been at least one request to have a link from the insurance receipt entry screen to the Claims by Patient screen on the account in case a claim needs to be reviewed or manipulated prior to entering the receipt information. This link would work similarly to the Add Claim button currently available via the Insurance Conversion Receipt Entry screen used for cross referencing account numbers when posting to a claim billed from the prior EHR.
I would like to see write-offs such as non-covered diagnosis moved from being a charge entry, which is causes discrepancies on total billed to insurance vs what the patient is going to see for total charges, and make this adjustment a true adjustment in receipting instead of a charge.