TELCOR Releases Version 12.7.0 of Revenue Cycle Management and Lab Outreach Business Pro

Lincoln, Nebraska — November 18, 2011 — TELCOR Inc announces the release of version 12.7.0 of the OIS® Revenue Cycle Management solution and Lab Outreach Business Pro.

Version 12.7.0 features include:

Account Required Field Checking was enhanced to provide the ability to define and perform required field checks at the account payer level, in addition to existing required field checking at the Financial Class level. This means that, by payer, customers can define the required fields that will be used when the payer is assigned to a patient’s account.

Error Workqueue processing for auto-correct was enhanced to make Date of Service an optional matching criterion. If Date of Service is not defined to use, then errors that are corrected for the same patient will be updated across dates of service. A customer may want to match across dates of service, for example, when billing to hospitals for service provided to patients within the same hospital stay.

Requisition Charge Review Workqueue was changed to include:

• The ability to Mark As Reviewed or Mark As Reviewed with Financial Class Update to streamline Part B to Part A updates.
• Number of requisitions, number of transactions and number of transactions with a missing diagnosis error were added to the Summary view.

The Transaction Processing Rules function was expanded to include:

• The ability to add a diagnosis code, such as a screening “v” code, to a transaction when the diagnosis is missing, if the payer contract allows it. This is controlled in Payer Configuration.
• The ability to define the duplicate procedure modifier assignment by both procedure and payer instead of by payer only.
• A rule to automatically add a procedure based on PSC location. A PSC configuration controls whether the rule is used or not and what procedure, such as venipuncture/specimen collection, is added for the encounter.
• Payer-specific CPT grouping rules for the number of service lines per CPT allowed. Parameters to use include: wait days for a transaction to process to pricing, how the same CPT is presented on a claim, if grouping can cross procedures and any CPT exceptions to the grouping rule.
• Medically Unlikely Edit (MUE) rules that allow overrides by payer. The rules can be performed based on CPT or be payer specific. Rules can be defined to indicate an automatic no bill of excess quantity or split to multiple service lines.
• Automatic client reassignment based upon client, company, procedure, gender and age range. This rule can be implemented in situations where state-mandated testing for public health is performed and the client responsible for payment is based on a state agency, not necessarily the ordering client.
• The ability to validate bill eligibility for all financial classes for clients or client bill with procedure overrides. This enhancement provides the ability to define financial classes that need to be excluded from billing for a client and automatically update to bill the client. This rule could be used, for example, when financial classes should not be billed to their assigned payers due to payer contracts that define that the ancillary service was included with the service paid to the client and should be client billed instead.
• The ability in the Procedure Not Eligible For Client Bill rule to automatically No Bill. This is in addition to the existing rule that fails the transaction to the Error Workqueue for end-user management.

Pricing enhancements were added to meet additional customer-requested billing requirements, including the ability to:

• Price services for self-pay patients using Client Contract Pricing. True self-pay transactions can be priced based upon a client’s contract (e.g., instead of using the self-pay fee schedule price).
• Price by Analyte Quantity for selected procedures and contract for pricing by project code or financial class. This feature is designed for use by environmental labs.
• Define contract limits for clients. When contract limits are reached, transactions will error to the Error Workqueue and an optional client attention level can be set up for when this milestone has been achieved for management follow-up.

Business Management was changed to include:

• The Alternate Fiscal Year Reporting Methods application was enhanced to allow each organization to select the Financial Reporting Basis used. Therefore, customers can elect to use either the current Monthly Financial Reporting basis or Alternate Fiscal Year Reporting Methods (e.g., 13 reporting periods). When reporting periods are elected, the organization must define each reporting period and fiscal year with start and end dates. All management reporting, except those functions available with Profitability and Compliance, are updated to report financial data based upon the Financial Reporting Basis elected.
• The Sales Analysis function was redesigned to allow end users to select the time frame by post date range, companies and data groups to present statistical amounts to determine the contribution of clients. The data filters and groups include: Company, Procedure, Client, Location, Territory, Region, Financial Class Category, Financial Class and Sales Representative. Additionally, the amounts presented for each data group defined include: Quantity, Revenue, Expected Reimbursement, Payments, Refunds, Contractual Adjustments, Other Adjustments, Small Balance Write Offs and Amounts Transferred to Bad Debt.
• Account AR Aging was enhanced to allow the user to retrieve only credit balance transactions or all AR.
• View System Balances is a new function that provides the ability to review the entire system’s balances by primary GL Account by account and for client data. This feature was added to eliminate the need to generate the GL Data Capture for all dates, but instead streamline GL Data Capture to only capture the period or fiscal year in use.

Collection agency reporting enhancements were added to provide customers with the ability to configure the data that is exported to Microsoft Excel for reporting to agencies. These changes were implemented for the Agency Transfer Notification exports and the Agency Collected Funds Notifications. Another feature added is the ability to include account attention levels for export.

The claim form alignment was changed to allow customers to control the field alignment for both the CMS-1500 and UB-04 by printer. This new feature eliminates the dependency on customer service to realign claim forms when version upgrades include changes to either of these forms. This feature also provides the ability to use multiple claim printers.

The Scheduler function was updated to allow automation of Close Financial Period. This process can be defined as both date and time based.

For more information, please contact Marketing Director Jennifer Schultz at 402-489-1207 or web@telcor.com.

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