Welcome to the Experior EMS System Overview

Welcome to the Experior EMSSystem Overview

The Search Tab allows users to search for account/patient information using one of the following keys:

1.      Alpha Name Search

2.      Telephone Number

3.      Social Security Number

4.      Insurance Membership Number

5.      Date of Birth

6.      Chart Number

7.      Soundex

No matter how you search for the patient data the screen returned looks as above. Address information is displayed to assist in selecting correct patient. The highlighted box indicates that the account or patient has had the bad address flag set due to returned mail. Changing demographic information information on the Registration tab will automatically reset the bad address flag.

Pop-up allows for important information to be displayed for staff review. These alerts are user defined and can be for financial, scheduling and medical reasons. The pop-up only appears when you first enter an account. If you leave this account and come back to this account,the pop-up would display again.

This Patient Inquiry tab provides the user with the information to verify account and patient information eliminating the costly production of Patient Information Sheets. Account, Patient, Employer, Insurance, Problem and Appointment Information are shown. Review button allows staff to enter their password to indicate they reviewed information with patient. The system will date and time stamp the entry for display and auditing purposes.

Tabs make available:

  Insurance – Listing of insurance information for the patient

  Appointment – List of future appointments for the patient.

  Patient Data – User defined fields

Problems - Episodes of care

Selecting the PICTURE tab will make the picture appear.

The Registration tab is used to establish a new patient and account, add a new family member, or to update current information.

Drop down boxes, and field level help provide access to information at the touch of their fingers. Entering a zip code will auto fill the City and State information. The NPI provides for HIPAA compliancy. PIN numbers provide patients access to the Website for patient information and providers to the screen for access to scheduling information. Required fields are last name and sex indicator, however, client may define other fields as mandatory.

Responsible Party tab allows user to enter the guarantor information for the patient.

Patient Information tab provides the ability to enter patient information.

Account Information tab provides the ability to enter modify business office settings for this account.

Patient Data tab allows for entry of user defined fields.

INSURANCE tab is used to enter insurance information on a new account or patient, or to update existing information. The primary insurance number will be bold and brought forward, in the tab area. Insurance information for the patient is entered on this screen. Up to eight plans can be entered for each patient. Effective and terminate dates control claims production so that appropriate carriers are billed based on date of service.

The number of characters required in the ID Number can be entered in the carrier dictionary to make sure the correct number of digits are entered, I.e. If carrier ID is always 9 staff will be told when different number of carriers is entered.

Group and/or Benefit code can be made mandatory by carrier if needed.

Pop windows allow for entry of Insurance Override or the entry of or selection of a New Policy Holder.

Scanning of insurance cards eliminate the need to pull the medical record to confirm insurance information and also reduces employee and copying costs.

The APPOINTMENT tab is used as a lead in for all appointment scheduling functionality. This screen allows the user to define the method of scheduling desired. Example, by doctor, type, location, etc. User can enter as little or as much information as the screen allows.  Providers, equipment, rooms and other resources are available for scheduling.

Pop-up calendar allows for easy access to scheduling dates in the future.

This screen allows the user to scroll across, up or down to view the information requested. Open and booked appointments appear on this screen. Double clicking on a booked appointment allows the end user to view complete information on that appointment. Double clicking on an open slot will allow the user to book that patient for the appointment.

Dragging and dropping an appointment will move it to a new time and/or date.

Screen is very useful when working or fitting patient into multiple entities schedules. Up to 10 resources may be displayed for a given time period.

This pop-up screen the user to enter the information required to schedule an appointment.

Appointment Verification screen immediately appears after the completion of an appointment. Referral usage information along with appropriate warnings are displayed to trigger users policies depending on the warning. Authorization/Referral information appears.

Appointment specific information including reason, duration, type, and instructions are displayed. Services that were entered on the scheduling screen along with future appointments display.

Services entered will automatically integrate with the Order Entry Module from Experior.

For those user’s the clinic only wants to enter appointment information for openings a number of screens exist. The screen returned is identical for all only the data reflects the manner in which it was requested. User can inquire on:

1.      Open slots by doctor

2.      Open slots by doctor by type

3.      Open slots by group

4.      Open slots by group by type

5. Open slots by doctor by location

The Provider Appointment tab is used to inquire on an individual provider’s schedule. Screen displays all the appointments for a provider for the day. By selecting the box next to a patients appointment activates the buttons for the following:

1. Services - allows for charge entry

2. Orders - allows entry for any ancillary services

3. Medical – links to the patients medical record

4. Reschedule – links to screen that allows user to quickly reschedule an appointment

The Batch tab is used to enter the control totals for each batch you want to process. You can open a batch. Password access can limit users to entry of data in only batch types they have security access. Items to duplicate allow for entry once and the information will auto fill the data into appropriate fields during entry of data during the batch. Even though the system is on-line, real time, hash totals are useful in tracking for accurate information during batch entry.

The Charge tab is used to enter charges, patient payments or co-payments, and adjustments,

Cashiering functionality is provided utilizing this screen. Data entered at the top of the screen flows to all fields without additional entry. User would only enter items that were different from the information entered at the top. Using the ticket number will auto fill demographic, provider and location information from what was entered for the appointment. Entry of information for patient accounts, workers compensation, business accounts, hospital, dental, anesthesiology and other specialties can be entered from this screen

The Insurance tab on the Data Entry menu allows you to post insurance payments to each claim line item. Payment and disallowance codes will automatically appear if entered on the Insurance Carrier Dictionary for that carrier

This screen is used for the posting of insurance payments to an invoice. An invoice can have 36 line items on it and be filed manually or electronically. Staff enters information by line item unless the EOB payment is a lump sum payment. In this case the system will calculate and post to each line item on a percentage basis.

Posting by line item is necessary to be able to accurately report what is owed by line item for the patient.

Electronic remittance is posted by line item eliminating the need to post items by staff.

AutoMatch will print your secondary claims followed by the EOB payment advice for the primary carrier immediately following the claim. No more pulling, photocopying, blacking out, re-filing, or collating of EOB's.

AutoMatch comes with support for Medicare electronic remittances, but you can add Medicaid, Blue Shield, or any commercial insurance that can provide electronic remittance files. And, when combined with the filEOB product, paper remittances from primary insurance can also be matched to your secondary claims.

With AutoMatch, statements may be viewed as mailed out when needed to assist in patient receivable conversations. This is a COLD application, overlaying text on the statement form which is scanned in once. The requires minimal disk storage space.

Claims tab on the Insurance Billing line is used to view information concerning a patient’s insurance claims filed and insurance claims paid on a patient account. On a family account all family members invoices will appear with summary information discussing invoice amount, estimated coverage, amount paid, and amount written off.

This screen can also be used to view information concerning workers compensation claims or Business Account claims.

By selecting the CLAIM button at the bottom the detail of the claim displays.

Claims Detail shows all the detail regarding a particular insurance claim.. All services filed on the claim along with all insurance payments and disallowances are displayed. Other buttons at the bottom of the screen are used to enter notes or maintain information.

The Transaction tab is used to view detail information on charges, payments, and adjustments posted to the account. Colors notate type of transaction:

Procedure – Tan

Today’s Procedure - Brown

Insurance payment – bright green

Personal Payment – Light green

Insurance Disallowance – Red

Statement Line - Yellow

This screen provides a chronological list of activity whether charges, payments or adjustments. A statement line appears showing when a statement was generated. Inquiry screen search can be narrowed to show only payments, adjustments, disallowances, interest, etc.

By marking the radio button next to the detail line you can choose a button at the bottom of the screen to go to an associated activity.

The Allocate tab on the Transaction tab allows staff to inquire on debit and credit items. A debit item shows credits posted to it. A credit item shows where the credit was allocated.

This display shows a procedure and all insurance payments, disallowances along with any personal payments.

This display shows an insurance payment and the procedures that it paid towards along with the amounts.

The Detail button is used to view detail information on charges, payments, and adjustments posted to an account. The detail information displayed will vary depending on the type of transaction.

On a charge item the invoices that have been generated display for ease of researching claim activity.

Batch number, date and sequence number display on this screen for use in researching data entry documentation if necessary.

The Visit tab is used to inquire on the balance by visit date.

This screen shows a summary of information on a visit. It is used by staff to look for a date of service so that information can be provided to a patient on what has transpired on a visit.

When selecting the box next to a visit date the DETAIL screen would be used to look at all detail activity for the selected visit.

The Visit Detail tab is used to inquire on visit transactions by date of service. This screen allows staff to answer patient questions regarding charge, payment and adjustment activity for a visit date. Patient amount due appears at bottom of displayed information.

The Insurance Queue tab is used to inquire on and update claims assigned to a claims collector.

This display is used to document and track any activity done in collection for a claim. Claim notes, (10,000 per claim), date information, reprinting forms, contact codes and review date can be used to control activity on an invoice. Payments made will remove an invoice from a queue when input into the system.

Instead of working off of paper staff can use the electronic collection queue to track and collect invoice revenue.

The Accounts Queue tab is used to contact accounts and update collection activity. The screen is also used to enter account recall codes and dates.

Clients can set up definitions of when an account collection status qualifies the account to be turned over to an electronic collection queue. Multiple queues can be defined so that a collector would sign on with their queue id and immediately see the above screen with the first account to work.

All fields that are boxed allow for entry while all other information is display only. Account notes, payment plans, contact codes and recall codes can be entered on this screen. User can navigate to any other screen for research purposes and then can come back to input information.

Management reports are available to track collection activity and results by collector.

All reports are delivered on your own local intranet so reports can be viewed on-line rather than printing to paper. Reports are stored in a text format so that reports may be archived for the past “N” months so they are easily accessed by the end user.

Reports may also be viewed using standard text editors allowing for the printing of only the pages required to be distributed.

Using any ODBC data base compliant product reports may be viewed or graphed as your organization requires.

Experior help is field level and all documentation is available in a Windows standard lookup format as seen above.

Documentation includes not only typed information but forms as well to make it very informative for users.

Please contact us at: 1-800-595-2020

Or visit us at www.Experior.com