1. Using Task Manager to Work EDI/ERA Posting Lori Phillips CHUG at Centricity Live April 29 – May 2,2015

2. Legal The content of this presentation represents the views of the author and presenters. GE, the GE Monogram, Centricity and Imagination at Work are trademarks of General Electric Company.

3. Introduction This session will identify how to use Task Manager with your Electronic Remittance Advice (ERA) to create a work list of claims needing to be worked by your team. Identify and separate the various types of rejections so that the appropriate actions can be taken. Using the Task Manager reports will assist you in measuring if you are getting “better" at sending out claims or if you are getting the same volume of rejections. Managers can use the reports to monitor user productivity to the tasks assigned.

4. ERA Settings Response Processor settings can be set to reject visits that receive denials for specific Claim Adjustment Reason Codes (http://www.wpc- edi.com/reference/codelists/healthcare/claim-adjustment-reason- codes/).http://www.wpc- edi.com/reference/codelists/healthcare/claim-adjustment-reason- codes/ Response Processor settings can also be set to assign specific Visit Owners, based on the denial reason. When used in conjunction with each other, the Reject Visit and Visit owner, make locating visits that need further review easier.

5. ERA Settings In these examples we have created Non-Payment Reason Code ‘rules’ that will reject the visit and assign a specific visit owner, based on common denial reasons received. Other common denial codes seen by the practice can be set up, as desired, to function similarly.

6. Task Manager Task Manager allows you to manage tasks associated with insurance and patient collections on visits. A task is a container associated with visits that allow you to sort and assign insurance and patient workflow actions to individual users. When used in conjunction with ERA denials, Task Manager can help identify claims that have been denied by the insurance carrier in the remittance file (and on the EOB) in a more efficient manner.

7. Task Manager The Task Management window allows the end user to identify visits that require some form of follow-up. These visits are identified by inclusion into a queue, built by the administrator. – Queue: Selected Criteria used to identify visits, i.e. Insurance Balance, Patient Balance, Company, etc. determined by the administrator. – Tasks: Visits that have met the criteria in a queue. – Status: Once the visits (Tasks) have been “worked”, the user can change the status of the Task to Complete, Follow-up, Hold, In- Progress or Manager Review.

8. Task Manager

9. Enabling Task Manager Enabling Task Management and Assigning Security – Task Manager is part of the base Centricity package and only requires ‘activation’ through enabling in Administration. – Before Task Management is utilized in your database, it must be enabled. This is accomplished through Administration – System – Advanced Features – check the box to Enable Task Management. – After enabling Task Management, Security permissions must be assigned to those users that will utilize the module. Security can be assigned by Group, User, or Permission.

10. Enabling Task Manager

11. Task Manager Security In Administration, select System>User and Resource Management>Users>Security>Security by User or Security by Group. – Task Management – Allows access to the module. – Assign Tasks to Other users – Allows the user(s) to assign tasks to others. – View Completed Tasks – Allows the user to view all completed tasks. Modify Queue – Allows the user to edit existing task queues. (for example: add users, add or delete criteria, change criteria values).

12. Task Manager Security – Build Task Queues – Allows the user to build task queues. The user must have permission to build task queues in order to obtain permission to perform any of the sub-tasks. Add/Copy Task – Allows the user to create new tasks queues and copy existing task queues from the list. Remove Queue – Allows the user to remove existing task queues from the list.

13. Task Manager Security Note: The Administrator of the queues must be given permission as well. Note: It is not recommended that all users be given access to View Completed Tasks. This queue is inherent to the product and is used by administrators to ensure that Tasks that are marked Completed are accurate and can be reassigned from here, if necessary. Note: Any permission changes made for individual users are considered overrides, and are not affected by changes made to the users’ security groups.

14. Task Manager Security

15. Task Manager Setup In Task Management > Queue Administration, click Build Queues. The queue administration view appears. In the Queues pane, click (New). Type in the new queue name in the highlighted line. The name is entered in the Queue Name list as you type. When you finish, the name auto-selects.

16. Task Manager Setup Queue names should indicate the type of queue it is. – For our examples, we have named the queues to match the denial reasons. To have tasks exit the queue when it no longer meets the queue criteria, check the box for Automatically exit tasks when they no longer meet criteria box.

17. Task Manager Setup Click the to add users to the queue. Select the user(s) from the Find User window and click OK. Note: The user designated as the queue manager can be added to all queues in order to easily view the progress on them at any time from within Task Manager.

18. Task Manager Setup Click the Add Criteria button to choose the desired criteria. – For our example, we have selected Visit Status and Visit Owner. – Other criteria could be selected as well if desired. For our purposes, we are leaving the criteria more broad in order to ensure all visits rejected during remittance processing are captured. If creating a queue for collections purposes, patient and or visit insurance balances would be used as well as any other desired criteria. Note: The more criteria selected, the smaller the results for the queue.

19. Task Manager Setup

20. Once all criteria is selected, click Preview Queue. This will allow you to see how many visits meet the selected criteria, etc. so you can make any adjustments necessary to the criteria to increase or reduce the queue size. Once satisfied with the results, Click Save Queue. Click Run Queue to update the queue immediately with selections. There is a synchronizer process that runs nightly to automatically update the content in all queues.

21. Using Task Manager When a user is associated with a task queue, they can select the task(s) and assign it to themselves, or the administrator of the task queues can assign the tasks. Users will see tasks that have been assigned to them in Task Manager in the My Tasks area. Tasks are assigned by highlighting the task(s) (a multi-select can be done here) and then right click and click Assign the user from the Find Users window.

22. Using Task Manager When selecting My Tasks, all tasks assigned to the user will be displayed, regardless of the queue. – Note: Columns can be re-ordered for display purposes, if desired, by selecting the heading of the column to move and dragging it to the left or right.

23. Using Task Manager The assigned user will double click on the task to review the visit and make any corrections needed. If all information is located, and the patient account and visit have been updated, the Visit Owner needs to be removed. The visit should then be approved and resubmitted. Right click on the task in Task Manager and Change the Task Status to Complete. NOTE: It is recommended that the Correspondence tab of the Visit be used to document any notes related to research and corrections done.

24. Using Task Manager If further work is needed on a task, the Task Status should be changed accordingly. This is done by right clicking and selecting Change Status. – Follow Up – Indicates that the user assigned has further follow up that they need to do on this visit – Hold – Indicates that the task is on hold (possibly waiting for return call from patient or carrier, etc)

25. Using Task Manager – In Progress – Indicates that the user assigned is actively working this task. – Manager Review – Indicates that the user feels that the manager needs to review the situation with the particular task/visit and determine the next step.

26. Using Task Manager There are some Task Statuses that are assigned by the system and cannot be changed by the user. – Archived -- Reserved for tasks once the associated visits no longer meet queue criteria and have exited the queue. – Assigned – Indicates that the visit has been assigned to a user. – Unassigned -- Default status for newly created tasks that have not been assigned to a user. – Exited Queue – Associated visit no longer meets queue criteria and is archived by the application by Run Queue or nightly job.

27. Task Manager Reports There are reports in Centricity that can be used to review denial volume, as well as productivity related to the Queues. – Queue Volume Report: Displays summary queue information, including the number of tasks in the queue, average number of assigned days, and the total visit balance for visits associated to tasks within the queue. This report is useful for identifying high dollar queues, managing group workload, and assessing productivity through turnaround time. – Task History: Displays the history of tasks, grouped by ticket number or patient, and included the task queues, queue entry date and completion date, when and to whom the task was assigned, the task status when it was modified, and the status of the corresponding visit whenever the user modified the task. This report is useful for troubleshooting a workflow for a specific patient or visit. – Task Volume by User: Displays the tasks assigned to a user within a specific date range, as well as the balances for the associated visits at the time the task was assigned.

28. Task Manager And ERA Tips You must have the Assign Tasks to Others permission if you need to be able to assign tasks to anyone other than yourself. Tasks may be assigned to other users for additional follow-up work as long as user permissions in Security allow. When a task is Complete, it will disappear from your ‘My Tasks’ list. However, it will show in the Queue area in the ‘Completed Tasks’ queue. This queue is only accessible with security permission. From the Completed Tasks queue, visits may be reassigned to other users’ tasks if necessary and if the criteria for the queue still applies to that task.

29. Task Manager And ERA Tips The column sort feature in Task Manager can be used to move oldest dates of service or largest balances to the top so they can be worked first. Use the EOB’s from insurance carriers to determine your most common denial codes. Set these codes up to Reject Visit and be assigned to a specific visit owner. In the Response Processor settings, multiple codes having the same or similar denial reasons can be set up on one line and assigned to a specific visit owner. Up to 10 codes can be used per line. Visit owners can be less specific or very detailed to fit your practice needs.

30. Questions?