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This release was focused on payment reconciliation and denial management.
🌟New or Affected Features
Auto-create and assign tasks for eligibility-related issues
When a denial is received for ineligible patients, a task is created and assigned to the practice with the denial details. Additionally, the related insurance coverage is updated and set to active.
Denial codes included in this update are:
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PR-27: Expenses incurred after patient’s insurance coverage terminated
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PR 31: Patient cannot be identified as our insured
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PR 33: Insured has no dependent coverage
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PR140/CO 140: Patient/Insured health identification number and name do not match.
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PR 200/ CO 200: Expenses incurred during lapse in coverage
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PR 227/CO 227: Information requested from the patient/insured/responsible party was not provided or was
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Task details include:
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Assigned To: Practice Admins
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Task Owner: Practice
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All claims related to that denial are attached
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Fixed Bugs
When adding transactions to an EOB they were appearing show up under the first claim/transaction rather than 2 separate claims.
If you find this EOB in the list of EOBs you will see the number of claims as 2 but you only see 1 in the details. This issue has been resolved so that transactions are appearing under separate claims.
Enhancements & Filled Gaps
Patient Statement Enhancements
Patient statements were enhanced so that:
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Statements with $0.00 balance do not display a Past Due message
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If the balance is $0.00, the Stripe payment form is hidden
Updated claim submission logic to include the secondary payer address
Secondary claims were being rejected for Payer Name, Address, City, State, and Zip being required in the claim submission. The claim submission logic was updated to include the secondary payer’s physical address.
Added ability to manually mark EOBs as posted
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Payments posted in SimplePractice can now be reconciled with the Gentem Portal Payments. A summary of the updates includes:
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Post Transaction button added.
- When the user selects Mark as Posted a pop-up message is displayed to allow the user to select which payment they want to mark.
- A success alert is displayed when the EOB is successfully posted.
