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If your organization uses Cerner® as a source system, you can implement the Commure Pro-Cerner Charge Capture app. This app allows providers to access charge information that resides in Commure Pro, directly from the Cerner application, without having to log out of one application and into another. The Commure Pro-Cerner Charge Capture app is a plug-in that resides within the Cerner application, and provides a familiar summary of charges entered thus far for a given patient visit. From this summary screen, providers can add a new charge, or take a variety of actions against charges that have already been entered. New or edited charge transactions, along with their associated diagnoses and charge details, are immediately saved in the Commure Pro system, and are also visible in the Commure Pro-Cerner Charge Capture app within Cerner. This chapter reviews how to configure the Commure Pro-Cerner Charge Capture app. For instructions on the daily usage, such as actually entering charges using the app, see Using the Commure Pro-Cerner Charge Capture App.

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Availability of the Commure Pro-Cerner Charge Capture App on Web versus Handheld Platforms

Once configured, the Commure Pro-Cerner Charge Capture app is available as follows:
  • On the Cerner® web platform, users can enter, copy, edit, mark as reviewed, or delete charges.
  • This feature is not available on mobile devices.

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Using the Commure Pro-Cerner Charge Capture App with Other Charge Capture Features

The Commure Pro-Cerner Charge Capture app can be used in conjunction with all of the features below. All of these features are used when entering or modifying charges, and the source of the charge (from the app) does not impede these functions in any way.
  • Automated Code Entry. If a user enters a master code and then submits the transaction, the appropriate auto-added charges, modifiers, and/or diagnoses are automatically added to the charge transaction. See Configuring Automated Code Entry.
  • Charge Data Master (CDM). Upon submitting a charge transaction, the appropriate CDM codes will be retrieved for the transaction, if the charge code is mapped in the CDM, and the transaction meets all of the criteria for applying CDM codes. See Implementing a Charge Data Master (CDM).
  • Custom Charge Capture Workflows. Charges can be generated via a Custom Charge Capture Workflow screen. See Configuring Custom Charge Capture Screens.
  • Hold for Review. Charges can be held for review. See Configuring the Hold for Review Workflow.
  • PQRS. Once a transaction is submitted, it is evaluated to see if it meets the quality reporting criteria, and if so, the appropriate quality measure questions are presented to the provider. See Configuring PQRS/MIPS.
  • RVU Management. Upon submitting a charge transaction, the charges are saved with the appropriate RVU values (including auto-sorting those codes, possibly multiplying the RVU values, and possibly adding modifiers after saving the transaction). See Configuring RVU Management.
  • Selection of NDC Codes. Charge transactions can include NDC codes. See Configuring the Selection of NDC Codes During Charge Capture. The Commure Pro-Cerner Charge Capture app cannot be used in conjunction with the following feature:
  • Batch Charge Entry. See Configuring Batch Charge Entry.

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How Diagnosis Information Flows Between Commure Pro and Cerner

When using the Commure Pro-Cerner Charge Capture app, diagnosis information flows from Cerner® to the Commure Pro, and vice versa, as follows:
  • When entering a new charge transaction, diagnoses from Cerner are defaulted into the Commure Pro Charge Transaction screen in the same order that they are listed on the Cerner visit, as follows:
    • For multi-day visits (such as inpatient visits), an administrator configures each user to either default or not default the visit diagnoses into the Selected Codes section. The administrator also determines the maximum number of diagnoses that will be defaulted, if enabled for a particular user. In the examples below, we will assume that this feature is enabled for the user and that the maximum is set to 12.
      • If there are 1 to 12 unique diagnoses on the Cerner visit, all of them are defaulted.
      • If there are more then 12 unique diagnoses on the Cerner visit…
    • and some of them are prioritized, then up to 12 of the prioritized diagnoses are defaulted (no unprioritized diagnoses are retrieved).
    • and none of them are prioritized, then no diagnoses are defaulted. However, the application may retrieve diagnoses from a prior charge transaction, depending on how the user’s profile is configured.
      • For single-day visits (such as outpatient visits), an administrator configures each user to either default or not default the visit diagnoses into the Selected Codes section. If defaulting is enabled for a user, there is no limit to the number of diagnoses that are defaulted.
      • If the same diagnosis code is used more than once, but with different descriptions, the diagnosis is retrieved only once, using the description that has the higher priority (or if no priorities are assigned, then the description with most recent last used date). This is true for both the Selected Codes section and the Existing list on the Charge Transaction screen. (If the charge transaction is subsequently saved with the diagnosis, then the higher priority/most recently used description is also used in the Commure Pro Problem List.)
      • If an annotated description is entered for a diagnosis in the “Display as” field in Cerner, that description is used when the diagnosis is retrieved. This is true for both the Selected Codes section and the Existing list on the Charge Transaction screen. (If the charge transaction is subsequently saved with the diagnosis, then the alternate description is also used in the Commure Pro Problem List.)
      • For the Existing list, by default all visit diagnoses from Cerner are added to this list, regardless of the type of visit (single-day versus multi-day), or whether the diagnosis is prioritized or not. However, the total number of diagnoses shown on the Existing list might be limited depending on how the user’s profile is configured.
  • When editing an existing charge, an administrator can configure the app to either leave the selected diagnoses on the charge transaction unchanged, or to replace them with the current list of diagnoses associated with the Cerner visit, using the logic described above.
  • When saving a new or edited charge, any new diagnoses that are entered on the charge are sent back to Cerner, with the following exceptions:
    • New diagnoses that are entered on draft transactions are not sent back to Cerner.
    • New free text diagnoses are not sent back to Cerner.
    • Custom diagnoses that exist in Commure Pro, but not in Cerner, are not sent back to Cerner.

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Steps for Configuring the Commure Pro-Cerner Charge Capture App

To implement the Commure Pro-Cerner Charge Capture app, contact your Commure Pro representative, who will facilitate integrating the app with your Cerner® system. In addition to the technical configuration within Cerner, several institution and user level settings must be configured in Commure Pro:
StepWhere Documented
1. Review your Commure Pro Visit Types to:- Ensure that each visit type is properly configured as a single-day or multi-day visit. - Determine for which visit types the app should fully update the selected diagnoses when editing an existing charge transaction.Configuring Commure Pro Visit Types for the Commure Pro-Cerner Charge Capture App
2. Determine the maximum number of diagnoses that should automatically default when creating a new charge for a multi-day visit.Configuring the Number of Diagnoses to Default onto a Charge Transaction
3. For each user:- Determine whether diagnoses should automatically default when creating a new charge for a multi-day visit and/or single-day visit. - Determine whether there should be a limit to the number of diagnoses shown in the Existing list on the Charge Transaction screen.Configuring User Settings Related to Diagnosis Defaulting
4. As needed: enable or disable additional logging if your organization is experiencing problems with the app.Troubleshooting the Commure Pro-Cerner Charge Capture App

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Configuring Commure Pro Visit Types for the Commure Pro-Cerner Charge Capture App

There are two properties of Commure Pro Visit Types that affect the Commure Pro-Cerner Charge Capture app. Note that these properties are defined for each Commure Pro Visit Type, thereby allowing you to specify different behavior for different visit types. The setting below determines whether, when creating a new charge, the visit is considered a “single-day” or a “multi-day” visit. For each type of visit (single-day or multi-day), you can enable or disable diagnosis defaulting on a per-user basis (see Configuring User Settings Related to Diagnosis Defaulting). In addition, when defaulting is enabled, the number of diagnosis that are defaulted also depends on whether the visit is single-day or multi-day. See How Diagnosis Information Flows Between Commure Pro and Cerner for more information on diagnosis defaulting. Admin - System Management - Commure Pro Visit Types - [select a visit type] - Charge Capture: Check Per Day The setting below determines whether, when editing an existing charge, the diagnoses listed in the Selected Codes section of the Charge Transaction screen are replaced with the current list of diagnoses associated with the Cerner® visit. This can be helpful when multiple providers are involved in entering the charge, and there is a time lag between when the charge is initially created by one person, and later edited by another person. However, if a charge is edited days into an Inpatient stay, the current diagnosis list in Cerner may not reflect the appropriate diagnoses for the service date of the charge. Therefore, it is recommended that this setting be enabled only for visits that last a single day, such as Outpatient or Day Surgery. This setting does not affect how diagnoses are handled when creating a new charge transaction. Admin - System Management - Commure Pro Visit Types - [select a visit type] - Charge Capture: Update Charge Diagnoses When Editing Charge in Cerner App

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Configuring the Number of Diagnoses to Default onto a Charge Transaction

When creating a new charge for a multi-day visit, the institution-level setting below determines the maximum number of diagnoses that will be retrieved from Cerner® and automatically added to the Selected Codes section on the Charge Transaction screen. This setting affects all users for whom the multi-day diagnosis defaulting feature is enabled. Admin - Institution - Charge Capture - Commure Pro-Cerner Integration: Number of Visit Diagnoses to Select upon IP Charge Creation Note that when creating a new charge for single-day visits, there is no limit to the number of diagnoses retrieved for the Selected Codes section. However, when submitting the charge, if the number of diagnoses exceeds the value in the setting below, an error message is displayed. Admin - Department - Charge Capture - Max # Diagnoses Allowed per Transaction You may want to ensure that the value of the Commure Pro-Cerner Integration: Number of Visit Diagnoses to Select upon IP Charge Creation setting is not greater than the value of the Max # Diagnoses Allowed per Transaction setting, so that your users do not encounter the error mentioned above when entering charges for multi-day visits. The user-level settings below determine whether, when a specific user creates a new charge transaction for a multi-day or single-day visit respectively, diagnoses for the visit are retrieved from Cerner® and automatically added to the Selected Codes section on the Charge Transaction screen. Admin - User - Charge Capture - Commure Pro-Cerner Integration: Default Ranked Diagnoses to Multi-Day Visits Admin - User - Charge Capture - Commure Pro-Cerner Integration: Default All Diagnoses to Single-Day Visits Please note that if either of the settings above are set to No, or in certain cases where the logic described in How Diagnosis Information Flows Between Commure Pro and Cerner cannot retrieve any diagnoses from Cerner, then the diagnoses may instead be copied from elsewhere, depending on the settings below: Admin - User - Charge Capture - Copy Diagnoses on New Transactions Admin - User - Charge Capture - Populate Diagnoses From By default, all diagnoses from Cerner are retrieved and displayed in the Existing list on the Charge Transaction screen. However, please note that you can configure the user settings below to limit total the number of diagnoses allowed on the Existing list, if desired: Admin - User - Charge Capture - Limit problems displayed on Web charge edit/add screen based on date last used/date last billed Admin - User - Charge Capture - Most Recent Problems

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Troubleshooting the Commure Pro-Cerner Charge Capture App

If your organization is experiencing issues with the Commure Pro-Cerner Charge Capture app, Commure Pro support staff can enable or disable on additional logging on a temporary basis via the settings below to assist in troubleshooting:
  • If a specific user is experiencing issues using the app, advanced logging for that one user can be turned on via the setting below. When using the DEBUG feature, Commure Pro support staff should turn it on just before a troubleshooting session with the client, and then turn it off again immediately after, as it is extremely verbose and could cause performance issues if left on for an extended period of time Admin - User - Charge Capture - Commure Pro-Cerner Integration: Log DEBUG Messages
  • Performance metrics for the Commure Pro-Cerner Charge Capture app are logged by default. However, Commure Pro support staff can turn off the logging via the setting below, thereby reducing the amount of calls made by the system for that purpose, which can be useful in some troubleshooting scenarios. Admin - User - Charge Capture - Commure Pro-Cerner Integration: Log Performance Messages