Skip to main content

Audit Manager Professional Release Notes 2023

Rahul Mishra
Updated

December 2023

Redesign of Claims Connect

We have revamped Claims Connect with two primary objectives in mind: 1) enhancing the user interface for improved efficiency, and 2) accelerating the return of search results. Here are the updated instructions to help you make the most of these improvements:

Streamlined User Interface

1. Filter Requirements:

Select a project to which claims will be appended.

  • Optionally, assign an auditor and QA Reviewer.
  • Apart from the date range, the provider is now the only other required field.

2. No More Preview Page:

  • Search results are directly displayed in a grid below the filters.
  • The date range defaults to a three-month period, with the end date set as today and the beginning date as three months before today.

3. Simplified Filters:

  • No need to select individual or range options anymore. Enter codes in a specified format, and the system will interpret your entry.

4. Payor Search Enabled.

5. No Row Limitations:

  • No restrictions on the number of rows returned. All rows meeting search criteria will be displayed.

6. Consistent Filter Application:

  • Any changes to the filters are applied across all pages where search results are displayed.

Efficient Data Search Instructions

1. Filter Relevance:

  • The only mandatory filters are the beginning and ending Date of Service (DOS), but you can adjust these dates as needed.
  • To retrieve claims with specific values in a field, input the desired value in the corresponding filter. For example, to find claims with ICD-10 Diagnosis code E785, enter "E785" in the diagnosis code filter.
  • To return claims with no value or a blank value in a specific field, leave that filter empty. For instance, leaving the Payer filter empty will include claims with blank payer information.

2. Speedier Results:

  • For quicker results, use filters that narrow down the data. The more filters you apply, the faster you'll find your desired information.

 3. Blank Value Retrieval:

  • If a filter is left empty, it will return all claims, including those with blank or missing values for that specific field.

4. Flexible Code Filters: The filters for CPT/HCPCS, diagnosis, and DRG support various input types.

  • Individual codes (e.g., 99212)
  • Multiple codes separated by commas (e.g., 99212, 99213, 99214, 999215)
  • Code ranges without spaces (e.g., 99212-99215)
  • Combining multiple codes and ranges (e.g., 99204, 99205, 99211-99215, 99221-99232)

5. Specific Value Searches:

  • For precise results, input specific values in filters. For example, to find claims with ICD-10 Diagnosis code E785, enter "E785" in the diagnosis code filter.

With these user instructions, you can efficiently and effectively navigate and filter data, ensuring that you find the information you need while optimizing the speed of your searches.

 

July 2023

1.   CMS 3rd Quarter updates will be applied on Friday, July 7th.

2. On Monday, July 10th we will apply several enhancements to Competency Scoring.  We have updated options related to the 2023 E/M changes.  We evaluated the values being frequently added using the "Modifier" and "Other" options and added them as standard options.  And finally, we alphabetized the list to reduce time searching.   We hope this provides greater efficiency.

3.  Our next user group meeting will be on Thursday, July 27th at 1pm EST.  The invitation will be displayed in Audit Manager and by email the week of July 17th.  During this session we will be discussing the new Audit Box for facility auditing, new micro training we are developing and our Learning Management System (LMS) which provides training with quizzes and attestations of completion.

 

May 2023

  1. Several users requested the removal of restrictions preventing the use of MDM or Time-Based sections without changing the Type of Service in the Patient Data section. Users can now access MDM or Time-Based sections and features even if they are not correct for the Type of Service. The primary reason for this change is to support multiple Types of Service codes within the same audit. If a second Type of Service needs to be audited, users can change the procedure code and Type of Service in the Patient Data section, which is inefficient for experienced Audit Manager users. Instead, users can now select the desired Level of Service feature, MDM or Time-Based sections, and proceed without going into the Patient Data section. However, for Audit Manager to recognize this action, you must clear the old Type of Service and suggested codes by clicking on the Clear button in both the Time and/or MDM sections. This resets the system and prepares it to make new recommendations. For example, if you use the MDM options for the first Type of Service audited and want to switch to using the Time-Based feature for a different Type of Service, you must clear the MDM section, or the system will continue to display previous selections.
  2. The logic for CMS Prolonged Code’s related to Hospital Inpatient and Observation Admit & Discharge (99236) have been updated with the minutes published in March 2023.
  3. When auditing prolonged Clinical Staff Time based related to Office or Outpatient Services, we changed the Type of Service title from “Clinical Staff Time (99202-99215)” to “Clinical Staff Time (99415, 99416 with 99202-99215)” to improve clarity.
  4. We reinstated the “Nurse Visit” Type of Service.  Since MDM or Time-Based principles do not apply Audit Manager will display the suggested code 99211 immediately without additional inputs from the user.
  5. An obsolete message directing users to select Type of Service “Time Based E/M Service” has been removed.  Users should select the Type of Service from the different coding categories.   MDM or Time can be used for any coding category. 
  6. We completed revisions to the MDM grid which removes the tip icons and displays the information in the tip directly in the grid.

March 2023

  1. The CMS final rules for prolonged codes for the 2023 E/M codes have been implemented within the Time-Based Coding section of the Audit Box. The rules are retroactive to 1/1/2023 so any DOS in 2023 will use these codes. Note: The number of minutes for when prolonged are allowed are different from the AMA rules. So CMS rules will be used when you select the CMS Standard option in the Time-Based Coding section.  Prolonged codes will now be suggested when appropriate for:
      • Home or Residence
      • Nursing Facility
      • Inpatient/Observation
      • Inpatient/Observation with Admit/Discharge
      • Cognitive Care Assessment

February 2023

  1. Reports are automatically deleted after being downloaded from the report Download Center (circle in the upper right corner which you click to download).  In addition, we deleted all existing reports.
  2. A problem with the Payer filter for Claims Connect has been resolved.
  3. All AMA copyright notices have been updated to 2023 in the application and reports.
  4. Errors occur when uploaded files do not display in the Manage Files list. The problem occurs when users upload additional files before the previous files have finished loading. A warning message will be displayed if this occurs. You can upload as many files as is needed at once but allow them to process before additional files are uploaded.
  5. We have fixed some issues identified with certain Types of Service (TOS).
    • For TOS Critical Care (99291-99292) users were asked to select a visit. The user is now directed to proceed directly to the time section. There needs to be one more fix with the prolonged codes calculation which will be fixed in the next few days.
    • A duplicate Type of Service for Inpatient Intensive Care Services (99291-99292) has been removed.
    • Complex Chronic Care Management Services (99490-99491) has been modified to be Chronic Care Management Services (99437, 99439, 99490, 99491). Logic has been added for prolonged services.
    • Issues with Transport Neonatal Critical Care (99485-99486) were resolved.

January 2023

  1. Updates to the codes, fee schedules, NCCI edits have been applied.
  2. Both the Provider Detail and Project Detail reports have been enhanced to accommodate 2023 changes. The Key Components field now has a breakdown of the values selected for Problems, Data and Risk.  There is a legend at the bottom of the report identifying what each value means.
  3. Suggested Code logic has been added for Medical Team Conferences. There are options for physicians and non-physicians.  Select the physician option for advanced practice providers such as nurse practitioners or physician assistants.  The non-physician option is for providers that cannot bill E/M services such as physical therapists, speech therapists, etc.

Related articles

Comments

0 comments

Please sign in to leave a comment.