New Features and Updates

General

Dashboards

• Update to The First Pass Resolution Rate Gadget Calculation:  We Updated the calculation within the First Pass Resolution Rate Gadget to exclude the last 14 days when viewing the Last 30 Days, and the last 30 days when viewing the Last 90 Days or longer. This will provide a more accurate FPRR, as the most recent days do not provide useful information because claims that were just submitted have not yet been paid and are therefore not resolved.

• New Report Fields Added Ahead of New Report for FPRR:  Added new report fields related to the First Pass Resolution Rate (FPRR) in preparation for an upcoming new Standard Report:
  • Claim Data → Primary Payer → Allowed Amount
  • Claim Data → Primary Payer → Times Billed
  • Activity Data → Claim Activity → Payer Priority
  • Activity Data → Claim Activity → Is First Submission?
  • Activity Data → Claim Activity → Is Resolved on the First Pass?

Eligibility

• Patient Eligibility Report Table Improvements:  We Improved the Patient Eligibility Report table by removing the redundant Service Types column, as there is already a Service Type column included. We also enhanced the view for rows with more than 12 lines of services. Previously, only the first 12 service lines were displayed. Now, the first 11 lines are shown with a link to "Show All (X Types)" at the bottom, which opens a dialog with the full list of service types.

Claim

• New Option to Print Open Negotiations Form:  Added a new print option within the Claim section that will allow a user to print an Open Negotiation Form (OMB 1210-0136) directly from the claim screen so that providers that are out-of-network can enter open negotiations with the insurance company to determine the amount that the insurance company will pay for emergency services.  Please visit our Help Article for more information.

• Claim Summary Side Panel Update:  Updated the Claim Summary (side panel) within the Claim Charges tab to automatically expand when the screen is wide enough (1440p, or 2560 x 1440 and above, or equivalent). Screens that are not wide enough will still automatically have the side panel collapse.

ERA

• New Option to Delete Multiple ERA Files at Once:  A new button has been added at the top of the ERA search screen, enabling the deletion of multiple uploaded ERA files simultaneously. The "Delete ERA Files" button will be visible only if at least one ERA in the search results is eligible for deletion. This feature allows users who accidentally upload multiple unwanted ERAs with a method to remove them without the need to delete them individually.

Providers

• Update to Identify Providers With an Existing Submitter ID:  Updated the application so that when a new NPI (Provider) is saved for an existing Tax ID (Submitter ID), we will now use the Submit Facility endpoint at the time the provider is created, rather than waiting until an agreement is started. This will allow ePS to register the NPI as associated with the current submitter ID and enable work on an ERA split before an ERA arrives.

Payers

• Update to The "HMO Medicare Risk" Payer Type Name:  We Updated the Payer Type name from "HMO Medicare Risk" to "Health Management Organization (HMO) Medicare Risk (Medicare Advantage)" within the Payer section to better represent its purpose. This option will now appear in the Payer Type dropdown menu under the new name.  For more information on setting up payers, visit our Help Article.