Phase 2

Phase 2 Introduction

Phase 2 provides an overview of the Interface section followed by training in the PatientClaim, and Appointment sections (If Applicable). We will check the status of Payer Agreements, and confirm if there are any questions in regards to payer agreements.  

In addition, Included service features will be reviewed along with the current account pricing and we will discuss how to configure the settings of the included service features.  For example, our Integrated Payment Processing is a feature that is included with all plans and customers that will help drive increased revenue. 

In Phase 2 when going over the Interface Section, we will confirm if notification was received by the customer for submitting the integration request within CollaborateMD and/or on the Interface vendor’s website (Practice Fusion ex.) (if Applicable).  We will review how the interface functions along with set up and confirm if they are submitting encounters/charges.  The Patient Section will then be reviewed and discussed on how to add patients, add insurance information, check eligibility, patient billing information/utilization, print patient ledger/statements and claims defaults. 

We will transition over to the Claim section and discuss Real-Time Claim Submissions including Claim settings at the customer level, how to add a claim, discuss How invoicing is affected by the Rendering Provider Name on the claim, point out the COPAY field needed when utilizing the Unapplied Copay Feature, Claim fields and their functionality, How Claim Scrubbing/Review works (If Applicable), and Batch Printing of claims.  We will then turn our attention to the Status Control section where we will go over reviewing and submitting of interface claims, submitting a batch of claims in test, and lastly review Appointments (if applicable).

Phase 2 Entrance Criteria

  • Dashboard(s) have been explained, added and configured.

  • The Trainee’s user profile has been properly configured

    • Profile

    • Security Questions & Call-In Pin

    • Communication Preferences 

  • Trainee understands Customer Relationship eXperience Management (CRXM) and how to submit feedback.

  • Owner of the account is listed as the Auth Rep in CollaborateMD as a user.

  • Customer Setup completed.

    • Practice(s) have been added with any Defaults configured.

    • Provider(s) have been added with appropriate bill mode configured.

    • Referring(s) have been added. 

    • Facility(s) have been added. 

    • Payer(s) have been added and configured as electronic (where applicable).

    • Completed payer agreement(s) for applicable payers (may be continued in additional phases). 

    • Code(s) and fee schedules have been created as necessary.

      • Procedure Codes

      • Diagnosis Codes

      • ICD Procedure Codes

      • Revenue Codes

      • Remittance Codes

    • Alerts have been explained and how they can be leveraged within the business workflow.

    • Discussion held on how to add / edit Superbills (If Applicable)

      • The limitation of this feature only works with files that are saved as a Word 2003 XML Document and Excel files or PDF uploads are not supported.

    • Discussion held on label management. (If Applicable)

  • Interface activation process has begun (If Applicable).

  • Customer(s) have been added 

  • Default payment profile has been configured 

  • Phase 2 call planned and scheduled

Phase 2 Exit Criteria

  • Understand Look-up Payer Agreements in CollaborateMD and Connect Center

  • Document Storage (If Applicable)

  • Create and Manage Patients

    • Able to add new patients

    • Understand Insurance Information, adding of copays to 

    • Understand How to check eligibility

    • Understand How to print patient Ledger & Statement

    • Understand Billing Info & Claim defaults

    • Understand Print & Patient Merge Options

    • Understand More Options

  • Perform batch level items

    • Interface Tracking for interface claims

    • Status Control for interface claims

    • Batch Print Claims

    • Batch Eligibility

  • Add and Manage Claims

    • Understand Claim Settings and enabling of RTCS

    • Understand Enabling of Unapplied Copays when claims entered

    • Understand invoicing by Rendering Provider Name

    • Understand COPAY field when associated with the Unapplied Copay and functions

    • Understand Charges and Other field for NDC and CLIA numbers

    • Understand benefits of fee schedule

    • Understand Claim Summary vs. Activity, benefits of Alerts

    • Understand Print Options, Show Preview

    • Understand More Options

    • Understand How Claims Scrubbing/Review works (if applicable)

    • Understand Batch Print Claims

    • Understand to submit Test Claims

  • Managing claims using Status Control

    • Understand how to locate/review and submit interface claims

    • Understand claims in a batch for test

    • Understand Waiting for Review/Incomplete claims and save filters

    • Understand Right click capabilities: Show Details or Open Claim/Patient

    • Understand Submitting claims (Default billing status for payer/code)

  • Create and manage appointments (if applicable)

    • Configuration requirements: Resources, Appt Types, and Custom Status & Settings

    • Create and modify appointments

    • Create and Manage Block Schedule

    • Understanding searching for appointments

    • Understand benefit of Appointment Reminders

Phase 2 Training Actions/Homework

Action 1. Enable and configure your included services in preparation of Patient & Claim setup. These settings will be applied when creating or managing patients, claims and appointments. Be sure to log into Services in Account Administration to locate the features included in your plan or consider add-ons

Action 2. Begin adding your Patients in preparation of creating claims and appointments. Want to skip data entry? Talk to your Implementation Specialist regarding importing Patient using an Interface or Data Conversion

Action 3. Begin adding your claims for patients to begin billing claims and understand CMD Best Practices. During Phase 3 we will discuss batch options and how to track claims

Action 4. Maximize the use of your CMD using our scheduler for appointments. If using an EMR/EHR Interface, CMD may be able to automatically create your appointments to remain in sync with your EMR/EHR

Action 5. Monitor the success of your CMD Interface Integration by reviewing Interface Messages in the form of patient, appointments and claims.

In order to successfully complete Phase 2 of your training and move into Phase 3, you must complete all of your assignments indicated above. During Phase 3 you will learn how to track LIVE claims, address rejections and payer denials as well as determine claim follow-up best practices for your business using the application.