Online Eligibility

Surely, there are better things to do than verify a patient's insurance eligibility over the telephone, or by logging into and navigating the web pages of an insurance company's website. But, that's where Rexpert's Online Eligibility query comes in!

The Rexpert™ system automates the whole insurance eligibility-checking process for you by communicating with the Change Healthcare clearinghouse, behind the scenes, to determine insurance coverage. The Online Eligibility function saves time in what was formerly a labor-intensive process, allowing for easy verification with just a mouse-click or two.

Unlike most things in life, the process is fairly straightforward. You simply press the green Eligibility button on an Account Payor and within seconds, you will receive a full report. Just be aware that while patient/account online eligibility verification is managed within the Rexpert™ system, the actual eligiblity information is obtained from a third-party website. The information on the report cannot be changed or updated by Rexpert nor can we verify the accuracy of the information contained in the report. The information provided is based on the Payor's name and the interpretation thereof by the third-party and care should be taken that provider names and inputs are accurate as possible.

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The report provides a summary of the patient's insurance coverage, while also providing detailed information about specific types of insurance benefits that may or may not be included in the coverage. For instance, Jill Doe is on her father John Doe's insurance, and Mr. Doe is not sure how much of his deductible is left. You run an Online Eligibility query and a quick read shows Jill has a $1,000 deductible of which $497.84 has been met, leaving $502.16 still remaining.

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On the upper left corner of the report is a column of coverage and benefit categories; clicking on one of these categories will display the corresponding summary for the category selected. For instance, in the example above, if you need to know what the co-pay is for a chiropractic appointment, clicking on the Chiropractic link will bring up the chiropractic benefits in her coverage, where you will readily note the co-payment is $35.00.

Also note the Rexpert logo at the top of the report. The logo can be replaced with your own practice logo if you so desire.

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If you'd like to have your practice use Online Eligibility, contact Client Services via the Feedback button and we'll be happy to discuss the implementation process and costs.

Novitas PSA

Just thought we'd pass this on as a public service announcement of sorts:

Effective April 16, 2018, Novitas Solutions has made some changes to their credentialing process. Luckily, it will not affect anything in your Rexpert day-to-day shenanigans.

Effective April 16, 2018, group suffixes will no longer be issued to newly-enrolling group practices, and individuals reassigning benefits to a group will no longer be assigned a suffix.  (Note: Existing suffixes will not be deleted from enrollment records.) Providers who reassign their benefits will be provided a separate PTAN for each reassignment. This affects new reassignments for physicians only; current reassignments will not change. For further questions, please contact Novitas Solution’s provider enrollment department.

New Medicare ID's

Beginning last month, Medicare has started mailing new Medicare cards with new Medicare numbers (hereafter referred to as an MBI, which is the acronym for Medicare Beneficiary Identifier).  However, beneficiaries are not all receiving their cards at same time because the mailing is phased between April 1st and June 30th, based on geographic location.

In the mailing, beneficiaries are instructed to let their providers know about their new MBI, so providers should expect an influx of patients bearing new Medicare cards and numbers. However, there are several other ways for providers to  obtain the new MBI when they don't yet have the number :

• The simplest and most direct method is to ask the patient for the number.
• Use CMS's MBI look-up tool, which is accessed via your Medicare Administrative Contractor (MAC)'s provider  portal.. Note the tool will only provide an MPI after, and not before, the new Card gets mailed to the patient.
• Beginning October 1, 2018, the MBI will be posted on Remittance Advice(s) when a claim is submitted with the old Medicare claim number.

Note that there is a transition period from April 1, 2018 to December 31, 2019 where providers can submit claims using either the old Medicare Claim number or the new MBI. Beginning January 1, 2020, the gig is up and claims will be processed using the MBI only. Rexpert currently will accept either number format for processing Medicare claims.

Task View Screen

AuroraEHR - Task View is kind of a jack-of-all-trades screen for patient accounts. From this screen, clients who use AuroraEHR can select and view messages, notifications, reports, lab results, and tasks. Filtering options such as type of note, reports, results, responsibility, priority, and dates can produce a customized list that helps AuroraEHR users organize and access various tasks associated with the patient or practice.

However, Task View also has some functionality available to all clients that will help create lists based on the type of notes on an account.

There are three types of notes involved here:  To Do Notes, Collection Notes, and CallTrack Entries. To Do Notes and Collection Notes are accessed by pressing the Notes button on the right side of the Account Registration screen. The CallTrack screen, used to document phone calls, is likewise accessed via its button in Account Registration.

To generate a list of notes, select either or both of the note types, and enter a date range. Press the Refresh button and you will have a list of patients with the criteria you specified.

You can then work through the list, making sure patients get their needs met and questions answered. Using Task View will, from a practice's perspective, help keep the work load organized and the processing efficient. Glad we could help!