The Claim Review Tab of your Documentation Process – The Final Step

The Claim Review Tab

1. If you do NOT see the ICD-10 codes automatically, click the Refresh button.

2. The list of CPT codes entered from the Flowsheet section would also appear once the refresh button is clicked.

Note: PQRS and G-codes will also appear under CPT code list if you have added some on the patient document.

3. Click on ‘X’ if you want to delete CPT components from the list.

Click on ‘Add Row’ if you wanted to add more CPT codes on the ‘Claim Review’ section.

Note: Add Row option is NOT AVAILABLE for MEDICARE patients.

Adding Modifiers

1. Click the ‘M’ button to pull up the Modifier menu.

2. A pop-up bow with the list of Modifier will appear.

3. Search by Modifier code using the Modifier search box.

You can also edit the Place of Service for this billing.

Supporting Diagnosis

Entering in the Supporting Diagnosis for this billing is required by In Touch EMR as a safety measure to ensure depth-of-claim.

You are essentially telling the insurance company that you are perfoming the exercises you are charging for the specified diagnosis.

You must enter the supporting diagnosis for each CPT code from LEFT TO RIGHT.

You are required to add at least one Supporting Diagnosis for each CPT code.

Units

Please also note that our system automatically assigns a Unit of at least 1 to your CPT code lines.

Please note that when your G codes populate they will also have a unit of 1.

Our Billing software will NOT charge G codes as billable units.

YOU MUST MANUALLY ADJUST THE UNITS OF THESE CODE LINES.

If the charge is a timed charge, like hot pack therapy, you must manually adjust the units.

Automatic unit adjustments will be a feature released in the next edition of In Touch EMR.

 

When you are done, click Save Billing.

Finalizing Your Claim

A Blue confirmation message will appear once your claim is ready to be finalized and sent out to In Touch Biller Pro.

When you click Finalize, you will be asked to put your Initial in the document.

Once you finalize and send the claim out to In Touch Biller Pro, it can no longer be edited by you in In Touch EMR.

The subsequent claim that is created in In Touch Biller Pro can be edited from start to finish; however, this document cannot be edited.

It will also move into the Completed Documents section of the patient dashboard, where it can be viewed as a PDF and also faxed out to physicians in your physicians list.

If you wish to make any changes after that, you will have to click on the Amendment button on the Completed Documents section.

A pop up box will appear that has the servicing and the rendering provider name. It will ask for the initials of the Rendering proivider before continuing.

Click on Finalize Document to continue

Finalize/Print/Fax Option in Initial Evaluation, Progress Note and Discharge

In the past, after finalizing a document, users had to revisit the patient dashboard to be able to fax and download Initial Evaluation, Progress Note and Discharge’s PDF.

In Touch EMR has now added the following options when finalizing a document:

Finalize and Print

This option allow user to print the PDF document before finalizing it.

Note: This options available on Re-evalution and Daily Note

Finalize, Fax, Print or Fax and Print

This option allow user to print, fax or print and fax (at the same time) the PDF document before finalizing it.

Note: These options are only given when you are about to finalize an IE, PR and DC. When using the finalize and fax and finalize, fax and print option, please keep in mind that: a) a referring physician has already been assigned to the patient and b) a referring physician has an assigned fax number on his profile.

Submit Claim (Prior to Finalize Note)

This feature has to be enabled by the clinic administrator in able for the option to be available to a user.

When enabled (set to YES), all document types (for that user) will now show an additional button under the ‘claims’ tab, called

(1) ‘Submit Claim’

When this button is clicked, the user has the ability to submit the claim to the billing software / clearinghouse / payer, without finalizing the document.In other words, the claim can be submitted for payment, while the document remains ‘in progress’. In this scenario, it is entirely the clinician’s responsibility to return to the note ‘in progress’ and finalize it as soon as possible.

This is ideal when clinicians want to transmit claims immediately, to facilitate cash-flow for the practice, and plan on finalizing notes ‘after the fact’. In other words, you submit a claim even though the note is not finalized yet. Although this adds flexibility to the documentation and billing process, it increases the risk of non-compliance and the probability of missed / incomplete documentation.

By using this feature, you understand that In Touch EMR is not responsible for any claim denials, and it is entirely your ethical responsibility and professional obligation to complete clinical documentation in a timely manner. You also understand and acknowledge that you are submitting claims with an increased risk of denials / refund requests, in the event that notes are not finalized on time / do not match what is billed out / changes are made to a document after the claim is billed out.

Once the claim is submitted using the ‘SUBMIT CLAIM’ button, the user will be redirected to the patient Dashboard.

Under ‘Document in Progress’, the note that undergone the ‘SUBMIT CLAIM’ process, will turn the ($) icon into green color which is an indication that In Touch Biller Pro received the said claim already. This is also a notification to the system to not show the ‘SUBMIT CLAIM’ button anymore on the CLAIM REVIEW’ section of the note. This leaves the note with only 2 options: Save Billing and Finalized Documents.