Practice Fusion (New) Bi-Directional Interface Ongoing Maintenance

The Practice Fusion Bi-Directional Interface is now available for new activations. All new interface connection requests will be activated on the new bi-directional interface.  All existing interfaces will be able to upgrade to a Bi-Directional integration in the future.

Flow of Data in the new PF Bi-Directional Interface 


New Appointments, Patients, and Superbills (Claims) are sent from Practice Fusion to CollaborateMD through the interface messages and will create (or update) a new record in CMD. Once a patient record already exists in CMD, it can be updated in CMD and the data will flow back to PF.


Manage Appointments


New appointments that are entered in Practice Fusion are automatically created in CollaborateMD. Before any appointment interface messages (SIU) can be sent from PF, the scheduler configuration must be completed in CMD.

At a bare minimum, the Resource(s) and Appointment Type(s) need to be added and configured in CMD before appointments can be sent from PF.

The appointment message (SIU) sent from PF to create an appointment will also create a new patient record in CMD if it doesn't yet exist.

Appointment updates cannot be sent from CMD to PF, they will only flow from PF to CMD.


Manage Facilities & Providers


New Facilities entered into CollaborateMD must be added to Practice Fusion. Failing to add the new Facility into Practice Fusion will result in the claim not having a Facility listed on it. 

You can manually update the claim within the Claim section of the program with the correct Facility information. 

Follow the steps below to manage new Facilities or Providers:

  1. Add the Facility/Provider into CollaborateMD. Please see Add Facility or the Add Provider Help Article. 

  2. Once the Facility/Provider is entered, please see the Sync Providers and Facilities Help Page and follow the steps to sync your Facility/Provider. 

Existing Facilities & Providers

Updates that need to be made to an existing Facility or Provider (i.e. Name, Address, Id Numbers, etc) must be done within CollaborateMD. Please see the Find/Edit Facility or the Find/Edit Provider Help Page for additional information.

 

Manage Patients


New Patients

New patients that are entered in Practice Fusion are automatically created in CollaborateMD at the time you submit the superbill from Practice Fusion to CollaborateMD. The following fields will be sent from Practice Fusion to CollaborateMD when a new patient is created:

First NameCell Phone NumberInsured ID
Last NameGuarantor RelationshipSubscriber Relationship
Middle NameGuarantor First NameSubscriber First Name
GenderGuarantor Last NameSubscriber Last Name
SSNGuarantor Address Line 1Subscriber Middle Initial
Date of BirthGuarantor Address Line 2Subscriber Address Line 1
EmailGuarantor CitySubscriber Address Line 2
Date of DeathGuarantor StateSubscriber City
Address Line 1Guarantor Zip CodeSubscriber State
Address Line 2Guarantor Home Phone NumberSubscriber Zip Code
CityGuarantor Work Phone NumberSubscriber Phone 1
StateInsurance Information (Up to 3 Insurances)Subscriber Phone 2
Zip Code
Co-pay / Co-insurance
Home Phone Number
Payer
Work Phone Number
Insurance Effective Date
Work Extension
Group ID


Existing Patients

If a patient entered in Practice Fusion already exists within CollaborateMD when you submit a superbill , the superbill will automatically search for the patient's record. The fields used to match Practice Fusion patients to pre-existing CollaborateMD patients are: 

  • First Name, Last Name, and Date of Birth (All Exact Matches) 

  • SSN and Last Name (Both Exact Matches) 

  • SSN and Date of Birth (Both Exact Matches) 

In the event a patient’s record needs to be updated you have the following options: 

  1. Update the patient's record within Practice Fusion. This will automatically update the patient's demographics in CMD. Patient Data is not dependent on the superbill to update anymore. It will flow over immediately from PF.

  2. Or, update the patient's record in CollaborateMD. This will automatically update the patient's demographics in PF to ensure both systems are up to date with the most recent patient information. 

Patients will not flow from CMD to PF but updates to patients will.  Patient updates will only be sent from CMD to PF if the patient has been already sent from PF to CMD at some point (even using the old interface).


Manage Claims & Charges


This information explains how to edit a claim that has already been sent over from the interface, whether that means you want to add or remove CPT Codes, ICD Codes, Modifiers, etc.

Charges

Here are some important things to be aware of: 

  • Users are unable to add codes into Practice Fusion.

  • Although not required, it's highly recommended that users configure their Codes within CollaborateMD. Please see the Codes Help Article for additional assistance. 

  •  ICD codes that aren't in your personal code list will automatically be added from the CollaborateMD code list once retrieved from Practice Fusion.

  • Claims will be marked as incomplete in the event a code is missing from your personal list and CMD’s code list. If the code is missing:

    • You will either have to manually open the claim and save it so the system can save the claim as complete.

    • Or, manually add the code to your personal list. 

Please see the Managing Incomplete Claims Help Page for additional assistance. 

In the event you need to add additional procedure codes to a Claim/Superbill once it’s been sent over to CollaborateMD please see the Find/Edit Claim Help Article for additional assistance. You can right click on the Claim via Claim Status Control and choose the option to open the Claim. Please reference our Status Control Help Article for more information.  


Claims

This information explains how claim and insurance information for patients is managed between CollaborateMD and Practice Fusion once you've integrated your CollaborateMD account.

Here are some important things to be aware of: 

  • Practice Fusions insurance companies will be matched to CollaborateMD insurance companies by comparing the Payer Address or Name in both systems. 

  • If the Payer in Practice Fusion does not match a Payer in CollaborateMD, the Superbill will be rejected.

  • The address and name will have to match exactly. Please review the Synchronizing Payers Help Article for more information.

    If the Payer’s Address sent from Practice Fusion matches multiple payers within CMD the system will use the insurance associated with the patient’s record and add that payer to the claim.

  • In the event a Superbill is rejected for this reason please make sure that the payer record has a match in both systems (name, address) and resubmit the superbill. This will create a new claim. Please delete the initial claim prior to resubmitting the second one. Please see the Delete Claim Help Article for additional assistance.

  • In the event you do not want to submit another Superbill you can manually update the claim or patients record within CollaborateMD and/or Practice Fusion