Helper Version 7.1. Product Bulletin. Release Notes Copyright 2006 VantageMed Corporation. All rights reserved.

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1 Product Bulletin Helper Version 7.1 Release Notes Copyright 2006 VantageMed Corporation. All rights reserved The information in this document is subject to change without notice and should not be construed as a commitment by VantageMed Corporation. VantageMed Corporation assumes no responsibility for any errors that may appear in this document. The software described in this document is furnished to the purchaser under a license and may be used or copied only in accordance with the terms of such license. Any reproduction of this document in whole or in part, by any means, for any purpose whatsoever, is strictly prohibited. Additional copies may be obtained from VantageMed Corporation. Helper and SecureConnect, and are registered trademarks of VantageMed Corporation. All other trademarks are the property of their respective owners.

2 Table of Contents SECONDARY INSURANCE EDI...3 PROVIDER IDS...4 HAWAII TAX...5 ERA ELECTRONIC REMITTANCE ADVICE...7 ENCOUNTER BILLING TAB CALCULATIONS...7 NATIONAL DRUG CODE BILLING SUPPORT of 7

3 This document describes new features and enhancements available in Helper Version 7.1. These include enhanced tax functionality for Hawaii users and enhanced capacities for ERA and secondary insurance EDI via SecureConnect. Secondary Insurance EDI Helper 7.1 has the ability to send electronic claims to secondary insurance companies via SecureConnect. Several changes have been made to Helper to facilitate sending electronic secondary claims. These changes include: The Insurance Company Library screen has been split from two tabs to three: General, Billing, and Provider IDs. The Billing tab is new and contains much of the information pertaining to billing that was formerly on the General tab. The Insurance Company Library screen below shows a fourth Tax tab. This tab is specific to Hawaii users. There is a new facesheet default check box field on the Insurance Company Library > Billing tab called When Secondary Insurance, hold claim until primary makes payment. This value and the associated Billing Method field defaults to the How Will We Bill tab of the patient facesheet. The Billing Method drop down box in the Facesheet > Billing > How Will We Bill for secondary insurance companies has been updated to include SecureConnect. The Facesheet > Billing > How Will We Bill tab contains a Hold the claim until the primary makes a payment check box. 3 of 7

4 The Hold Claim check box works in the following manner: When the check box is selected, claims will appear as Delay Submit on the Billing Ledger until the Primary makes payment. When the Primary makes payment, the billing method for the claim will be automatically updated to the value entered in the Patient Facesheet > Billing > How Will We Bill > Sec. Ins. field. The Insurance Type Code field has been moved from the Insurance Company Library > EC Fields to the Facesheet > Insurance Company Screen. The data that was contained in the EC Fields entry has been transferred to the Facesheet. The Insurance Type Code field was also enhanced with a drop down list of available type codes. This change was made because the Insurance Type Code may vary based on a patient s specific primary and secondary insurance. The Type of Insurance field on the Facesheet > Insurance Company Screen has been changed from a check box field to a drop down field. Provider IDs Helper now allows an NPI Provider ID. While it is not expected that this value will need to be overridden, it functions similarly to PIN as it can be overridden by Insurance Company and Facility. NPI will not currently display in the HCFA 1500 layout included in Helper. A new CMS 1500 layout that includes NPI support will be included in a future release. NPI is included in electronic claims sent through SecureConnect. 4 of 7

5 You can now use a Tax ID Provider ID to enter SSN and EIN for claims processing. The SSN and EIN fields in the Provider Library SSN/EIN fields are now for informational purposes. The Tax ID Provider ID has the following fields: Tax Id The Id number itself. This could be the SSN or EIN. Tax Id Type SSN or EIN. HCFA Box 25 A check box labeled Don t check HCFA Box 25 - only used for paper claims. Hawaii Tax Helper 7.1 enhances Helper s existing tax functionality for our Hawaii users. The following enhancements have been made. In the Procedures Library, a new check box field Charge Tax on this Procedure is used to specify if tax will or will not be charged for a procedure. 5 of 7

6 Preferences > Defaults > Encounter, contains a new Tax Rate field that sets the default tax rate for Helper. A new Tax tab has been added to the Insurance Company Library that allows you to set tax defaults. This tab allows you to specify if tax will be included on a HCFA form for a specific insurance company. You can also specify if you would like tax rolled up into the Procedure Charge or broken out as the sixth service. The screen also lets you specify the CPT code to be used if you choose that tax should be shown as the sixth service. This information formerly resided in the HCFA Layout. There is no need to specify the tax information described above when submitting claims electronically. Tax information will be included for each procedure and broken out tax information will also be included. Based on the requirements of the Payer, the SecureConnect Server will complete the proper tax information and submit it for you. The Encounter > Billing screen now includes a line for tax amount and a field for the tax rate. Helper now has the capability to show tax on the following report groups: Overall Summary, Transaction Summary, Payment Tracking Summary, Patient Transactions, Patient Payment Tracking, Market Analysis, Export to Excel, and Billing. 6 of 7

7 ERA Electronic Remittance Advice Release Notes Helper 7.1 Helper now has the capacity to accept Electronic Remittance Advice (ERA) through SecureConnect. Helper s Main screen contains a new ERA button which opens the new ERA ledger. Please review Helper s documentation for more information about using ERA. Encounter Billing Tab Calculations Helper 7.1 changes how calculations are performed for Total Charge, Writeoff, Total Billed, and Billable Parties on the Encounter Screen s Billing Tab. The following examples illustrate this change: In previous versions, if you added an encounter for $100 (with the patient owing $20 and the primary owing $80) and the insurance amount was modified to $75, the total charge would be changed to $95. In version 7.1, $5 is added to the writeoff and the total charge remains $100. In previous versions, if you added an encounter for $100 with a writeoff of $10 (patient owing $20, and primary owing $70) and the insurance amount was changed to $75, the total charge would be changed to $105. In version 7.1, the writeoff will be decreased to $5 and the total charge remains $100. In previous versions, if you added an encounter for $100 with a writeoff of $5 (patient owing $20 and primary owing $75) and the insurance amount was changed to $85, the total charge would be changed to $110 and $5 would be left as writeoff. In version 7.1, the writeoff would change to $0 and, because the change cannot be completely absorbed by the writeoff, the total charge changes to $105. National Drug Code Billing Support The Medical Helper unlock of Helper 7.1 contains support for billing National Drug Codes for printed and electronic claims. There are two new fields that allow the entry of a National Drug Code (NDC) NDC can be added in the Procedure Library. NDC can be added on the Encounter > Other tab. When NDC is present in the Procedure Library, the value will default into the Encounter > Other > NDC field when the procedure is question is selected. For printed claims, NDC will appear in the Modifier section of Box 24D. For electronic claims, NDC will appear in the LIN segment of the ANSI 837 message and in NSF FB of 7