Patient Charge Status

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Patient Charge Status (Classic)

The Patient Charge Status (Classic) report calculates the charge status of visits, indicating whether charges have been entered for each day of a visit, and if not, providing an easy mechanism to enter those charges. This report is designed primarily for providers, and is the default view for providers when they access the Charges tab. However, this report can also be useful for billing administrators, and is also available to them. When a provider views the report, it typically displays the charge status for all of the patient visits on any of the provider’s patient list(s). When an administrator views the report, they can usually see a broader range of visits and associated charge statuses, such as all visits in one or more departments, or all visits in the entire organization. As a result, administrators will see a few additional options that they can use to control the amount of data shown on the report. These options are not typically available to providers and are noted as such in the section entitled Using the Selection Criteria on Patient Charge Status (Classic). The left side of the Patient Charge Status screen contains a list of patient names along with age, gender, location, and either length of stay in days or hours (if stay is less than a day) at the hospital (inpatients) or scheduled visit date/time (outpatients). Visit numbers, charge status, and other information can also be displayed. The right side of the screen displays a table row for each type of visit or service that each patient has had at your healthcare organization. Each table cell indicates whether a charge transaction has been entered for that day, and if so, gives you information about that transaction. For example, you can see the category under which the charge transaction falls, whether the transaction is a draft, and whether there are multiple transactions for the same visit day (see Understanding the Statuses on Patient Charge Status (Classic) for further explanation). The contents of the Patient Charge Status screen can vary based on the following:

• The visit types that are included on the report are determined by your system administrator. For example, they might configure the report to calculate the charge status of inpatient and outpatient visits, while excluding pre-registration or recurring visits from the report.
• he number of cells on the right side of the screen can range from 1 to 15 days, as configured by your administrator, with 7 days as the initial range. A user can change the number of days to suit their personal preference via a setting on the Preferences tab.
• Your organization can include an additional column of visit information, such as Surgery Date, via an XML customization.

While viewing the Patient Charge Status (Classic) report, a provider or administrator can immediately view the details of each charge transaction, or entire charge histories for visits within the reporting period. Charges that fall outside the reporting period are indicated by broken lines to the left or right of a date cell. Users can add, edit, delete, or review charges. Users can also sort the report by clicking on either the Patient Name or Location column headers.

Settings that control this feature

• Admin - System Management - Commure Pro Visit Types - Charge Capture: Include in Patient Charge Status
• Admin - User - Charge Capture - # of Days to Display for Patient Charge Status (Web)
• Admin - User - Charge Capture - Set Patient List Charge View Access

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Using the Selection Criteria on Patient Charge Status (Classic)

The controls that are available to manage the patient visits on the report can differ for providers and administrators, based on the user’s individual access rights. Criteria Fields:

• Manage drop-down list:
  This drop-down list contains options that a provider can use to manage the contents of their patient lists, such as adding or removing patients. See Patient List at a Glance.
• Print drop-down list:
  This drop-down provides options to print the Patient Charge Status report for the currently selected patient list, or to print a standard rounding report.
  Depending upon your organization’s implementation, Print buttons may or may not be available.
• Refresh button:
  Click to redisplay their patient list with the most up-to-date information.
• Source drop-down list:
  Controls the sources from which a user can select visits to view. This field is not available to Level 3 users (typically, these are providers). For Level 1 or 2 users, this field is available only if their Set Patient List Charge View Access is set to either “Within the User’s Department,” or “All Charges.”
  • My Patients:
    Shows the charge status of only those visits on the user’s patient lists.
  • Provider’s Patients:
    Allows the user to select a provider and view the charge status for that provider’s visits. Two fields appear immediately to the right:
    • A search field for Provider that allows the user to search for and select the provider they want. If the user’s Set Patient List Charge View Access is set to “Within the User’s Department,” the user can select only those providers that belong to the same department(s) as themselves. If it is set to “All Charges,” they can select any provider.
    • An Include Charges For filter drop-down that allows the user to toggle between viewing:
      • Selected Provider:
        This shows the charges for only the visits that meet the criteria for the selected provider’s Patient List.
      • Provider’s Departments:
        This shows the charges for the visits with which the selected provider has a relationship, as well as the charges for any visits those same patients have in any of the departments to which the provider belongs.
        (Note that the Include All Visits box is automatically checked when you choose Provider’s Departments.)
      • All Departments:
        This shows the charges for the visits with which the selected provider has a relationship, as well as the charges for any visits those same patients have in any other department.
        (Note that the Include All Visits box is automatically checked when you choose All Departments.)
  • Department’s Patients:
    Allows the user to select a department and view the charge status for patient visits in that department (in other words, the visits for all providers who belong to that department). Two fields appear to the right:
    • A search field for Department that allows the user to search for and select the department they want. If the user’s Set Patient List Charge View Access is set to “Within the User’s Departments,” they can select only those departments to which they belong. If it is set to “All Charges,” they can select any department.
    • An Include Charges For drop-down that allows the user to toggle between viewing:
      • Selected Department:
        This shows the charges for patients whose visits are with providers that belong to the selected department.
      • All Departments:
        This shows the charges for patients whose visits are with providers that belong to the selected department, as well any charges those same patients have in any other department.
        (Note that the Include All Visits box is automatically checked when you choose All Departments.)
  • Medical Service’s Patients:
    Allows the user to select a medical service to view all visits for that service. Two fields appear immediately to the right:
    • A search field for Medical Service that allows the user to search for and select the service they want. If the user’s Set Patient List Charge View Access is set to “Within the User’s Department” or “No Other Charges,” they can select only those medical services enabled for the user’s department(s). If it is set to “All Charges,” they can select any medical service.
    • An Include Charges For drop-down that has only one choice: ALL.
      This shows charges for patients whose visits are associated with the selected medical service, as well as the charges those same patients have for any visit in any medical service or department.
      (Note that the Include All Visits box is automatically checked when you choose Medical Service’s Patients.)
• My Charges Only checkbox:
  When checked, this option shows only those charges that have the current user as the billing provider. This checkbox is available only when one of these criteria is also chosen: My Patients, Department’s Patients, or Medical Service’s Patients. So for example, if the user were looking at My Patients, they would see the charge status of those visits on their patient list. The charges shown in the individual cells would include any/all charges that the user had access to see, and could possibly include charges entered by other providers. If the user then also checked the My Charges Only checkbox, the same list of patients would be visible, but the charges shown in the cells would be only those charges that had the current user as the billing provider.
• Patient List drop-down list:
  This criteria is visible only if you have chosen My Patients or Provider’s Patients as the Source. It controls the patient lists that are available on the Patient Charge Status tab. If a Level 1 or 2 user has selected My Patients as the Source, the Patient List drop-down shows the current user’s patient lists. If they have selected Provider’s Patients as the Source, then the Patient List drop-down shows the patient lists that are available to the selected provider, resulting in the same list of patients that the provider would see.
• Include All Visits check box:
  This box can be used to show additional visits for patients.
  • If you have chosen My Patients or Provider’s Patients as the Source, and you do not check the Include All Visits checkbox, the report includes only those visits that meet the criteria of the current user’s or selected provider’s Patient List. This could include multiple visits for the same patient, such as an outpatient visit and the current InFacility inpatient visit. If you do check the Include All Visits box, the report also includes any additional visits that the patient might have, such as past InFacility visits or additional InFacility visits that might have been added manually.
  • If you have chosen Medical Service’s Patients or Department’s Patients as the Source, and you do not check the Include All Visits checkbox, only the visits with that Medical Service or that have a relationship with the providers in the selected department are shown. If you check the Include All Visits box, you can view additional visits for the patients that meet the selection criteria, even if the providers in the selected department do not have a relationship to those additional visits. This box is checked by default when you choose an item in the Include Charges For field that would require the system to show charges for more than one department.
• Only Patients with Missing Charges Since mm/dd/yy check box:
  Check this box to show only those patients who have missing charges since the report start date that is displayed.

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Understanding the Statuses on Patient Charge Status (Classic)

The Patient Charge Status (Classic) report displays a table cell for each visit day that the patient has been at your healthcare facility. Each table cell tells you the charge status of that visit day. If no charges have been entered for a visit day, Add is displayed in the visit day cell. If charges have been entered for a visit day, the category into which those charges fall is shown in the visit day cell. The categories are broadly defined groupings of charge codes used only for this report. These charge categories are defined by your institution and stored in an XML file (contact your Commure Pro representative to modify the charge categories). You can also see whether or not the transaction is a draft, and whether there are multiple transactions for the same visit day. The charge statuses that you might see on any given visit day cell include the following:

1. Cells that have an Add charge link indicate that a charge has not been entered for that visit day. Click Add to open the Charge Transaction window and add a charge for the patient. If no billable visits for this date exist, an alert message appears. For more information on entering charges, please refer to Basic Steps for Entering a New Charge Transaction. You may see a brief message after the Add link to warn you when the visit date is still within the global post-operative period after a surgical CPT code has been entered. For example, if a 10 day global period were in effect, the Add link might look like this: Add (Global 10). Typically, you should not enter an E&M code during a global period unless a modifier is used. The exact wording of the message is configured by your administrator.
2. A Category Name displayed in black indicates that there is a completed charge in a particular category. For example, if the cell says “IP Admit” or “Other,” it indicates that there are one or more completed charges in the “IP Admit” or “Other” category, respectively. Click the category name to open the visit summary window and display the charge history for the specified reporting period. The charges for that category are highlighted in blue.
   Since each institution defines their own categories, the ones you see on your screen may be different than those described here.
3. A Category Name followed by the word (Draft) in red parentheses and italics indicates that there are charges for a category that have not been finalized and submitted for a patient visit. For example, IP Admit (Draft) indicates a draft charge in the IP Admit category. Click on the draft cell to open the visit summary window that displays the charge history for the specified reporting period. The draft charge is shaded light blue.
4. -Multi- indicates that the charges in the transaction are from multiple categories. Click -Multi- to open the visit summary window that displays the charge history for the specified reporting period. These charges from multiple categories are shaded light blue.
5. A Plus Sign to the right of the category (for example Other+) indicates that there is more than one charge transaction for the same visit day. For example, two providers might each have entered a charge transaction for the same visit date. In many cases, this is a legitimate scenario, but in some cases it might indicate that duplicate charges have been posted.

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Viewing a Patient’s Visit Summary from Patient Charge Status (Classic)

You can view a summary of charge and visit information for a given patient during the specified reporting period:

• Click anywhere within a patient row on the left side of the screen, or click on any cell that already has charges entered.

Each visit summary consists of the following:

• Patient Header rows:
  Two rows that contain information about the patient, such as patient name, medical record number, date of birth, age, and most recent reason for visit.
• Visit Header row:
  Highlighted in light blue, it contains information about the patient visit, that can include the type of visit (inpatient, outpatient, emergency room, etc.), admit or appointment date, visit number, and the location of the visit.
• Visit Day row:
  Contains information about each day in the visit. For visits that last only one day, such as outpatient visits, there is only one Visit Day row per visit. For visits that span several days, such as inpatient visits, there may be several Visit Day rows—one row for each day in the hospital. Each visit day displays information about the charge status for that day.
  • If no charges have yet been added, it displays the date and an Add link.
  • If a draft or completed charge transaction has been posted, it displays:
    • A Copy button (click to copy the charge transaction)
    • A Delete button (click to delete the transaction)
    • The date as a clickable link (click the date to open the transaction for editing)
    • The type of day (Day 1, Day 2, etc., through Disch)
    • The Hold Reason (if the transaction is currently held for review)
    • The charge code(s) and description(s)
    • The quantity
    • The diagnosis code(s)
    • (Billing provider/team can be added to this display via an XML customization; contact your Commure Pro representative.)
  Also of note:
• Draft charges are displayed in red, completed charges in black.
• If an auto-added charge has been added, the charge code is displayed with an (A) appended at the end of the number.
• If a charge with a CPT II code associated with it has been added, the charge code is displayed with a (P) appended to the end of the code number.

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Patient Charge Status (Revenue Report)

This report lists all visits within the last 90 days, indicating whether charges have been entered for each day of a visit, and if not, provides an easy mechanism to enter those charges. The visit types that are included on the report can be modified within the report definition by your system administrator. For example, they might configure the report to calculate the charge status of inpatient and outpatient visits, while excluding pre-registration or recurring visits from the report. The Patient Charge Status (Revenue Report) is designed primarily for providers, who typically apply a Patient List Run-Time Filter, to view the charge status for all of the patients on their patient list.

Run-Time Filters

This report typically contains a series of Run-Time Filters, such as those below:

• Calendar: Click on any date on the calendar to select the entire week that contains the date, from Monday to Sunday.
• Location: Select one or more locations to view only visits in those locations.
• Patient List: Select a patient list to view charge status for only those visits that meet the criteria of that Patient List. If you leave this field blank, the report shows the charge status for all patients within the specified date range.
• Include All Visits: If you selected a patient list in the Patient List criteria field, the report includes only those visits that meet the criteria of the selected Patient List. This could include multiple visits for the same patient, such as an outpatient visit and the current InFacility inpatient visit. If you check the Include All Visits box, the report also includes any additional visits that the patient might have, such as past InFacility visits or additional InFacility visits that might have been added manually.

Display Columns

This report typically contains the following columns:

• Patient Info:
  The patient’s name, age, gender, and MRN. There is also a Details [icon] that you can click to view the Patient Data Display in a pop-up window.
• Date columns:
  Columns for seven consecutive dates, each of which tells you the charge status of that visit day. The charge statuses that you might see in any given visit day cell include the following:
  • Cells that have an Add charge link indicate that a charge has not been entered for that visit day. You can either:
    • Click Add to open the Charge Transaction screen and add a charge for the patient. For more information on entering charges, please see Basic Steps for Entering a New Charge Transaction.
    • Hover your mouse cursor over the link to expose the No Charge Expected [icon], and then click the icon to set a No Charge Expected flag for the visit date.
  • Cells that display a No Charge Expected flag in parenthesis, such as [No Charge Expected], indicate that the visit day is not billable for the reason that is displayed. You can:
    • Click directly on the flag itself to edit the flag or enter a new one for yourself or a different provider (depending on your user permissions).
    • Hover over the flag to expose an Add link, which you can then click to enter a charge despite the flag (if you determine that a charge is necessary after all).
    • Hover over the flag to expose a Delete [icon], which you can click to delete the No Charge Expected flag.
    • Hover over the flag to expose an Info [icon]. Then hover over the Info [icon] to see who entered the No Charge Expected flag, and also the provider from whom no charge is expected.
  • Cells that display a Global Period Message in parenthesis, such as [Global Period Message], are meant to warn you when the visit date is still within the global post-operative period after a surgical CPT code has been entered. For example, if a 10 day global period were in effect, then the ten visit day cells after the date of the surgical CPT might show this message: [Global Period Message] (the exact wording of the message is configured by your administrator). Typically, you should not enter an E&M code during a global period unless a modifier is used.
    • Click the Add [icon] to the right of the message to enter an E&M charge (with a modifier), or to enter a different type of charge code.
  • Cells that have either a Charge Code or Category Name displayed as a link indicate that there is either a completed or draft charge on that visit day. To edit the transaction, click the charge code or category name link. For example:
    • 99232 indicates a completed charge transaction using that charge code, while 99232 indicates a draft charge transaction.
    • IP Admit or Other indicates that there are one or more completed charges in the IP Admit or Other category, while IP Admit or Other indicates that there are one or more draft charges in those categories. The categories are broadly defined groupings of charge codes that are defined by your administrator within the report definition. Since each institution defines their own categories, the ones you see on your screen may be different than the examples listed here.
    You can hover your mouse cursor over the charge code or category name to expose these icons:
    • Copy [icon]: Click to copy the charge transaction in that visit day cell.
    • Delete [icon]: Click to delete the charge transaction in that visit day cell.
    • Add [icon]: Click to add a new charge transaction for that visit day.

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PQRS/MIPS Reporting Options for Registry Participants (Classic)

If your organization is using Commure Pro’s Registry, a provider or administrator can review quality information on the Charges > PQRS Reporting tab. This option shows how well each provider is doing in terms of completing the Commure Pro Clinical Metrics forms, and also for the forms that they did complete, how well he/she is meeting the performance criteria for each measure. Please note that this option shows quality information only for charge transactions that have a Sent to Billing charge status. Charge transactions that are still in the Holding Bin or Outbox are not included. The PQRS Reporting tab is enabled via an XML customization; contact your Commure Pro representative enable on this feature. With the XML customization, you can grant access to a specific set of users, to entire departments, or to all users of your system. Any user who has access to this option can view data for all providers participating in the Commure Pro Registry. In addition, Level 0 users (typically Commure Pro staff) can export the data to an XML file. When using the export option, it is important to note that the export always includes data for all providers for the selected Reporting Year. The Provider filter, as well as any report results that may be currently displayed on the screen, are disregarded. To view or print a report from the PQRS Reporting option, follow these steps:

1. Click the Charges tab followed by the PQRS Reporting tab.
   The PQRS Reporting screen is displayed.
2. Complete the criteria fields as follows:
   • Reporting Year: Select the reporting year for which you want to review data. The current reporting year is defaulted for you.
   • All Registry Users: Select this checkbox if you want the report to include data from all providers who are participating in the Registry (based on a setting in their user profile).
   • Provider: Enter any portion of a provider’s first or last name into the Provider field to see a list of providers with matching names, who are participating in the Registry. Select the provider you want from the search results. You can perform multiple searches and select multiple providers.
   • Roles: Click the Search icon to view a list of roles, select one or more from the list, and then click Ok.
3. Click the Run Report button.
   A “Loading…” message is displayed while the report generates. Depending on how much data needs to be reviewed, the report may take a few seconds to generate.

The report displays the following columns for each quality measure:

• Provider: The name of the billing provider.
• Measure: The quality measure number.
• Eligible: The total number times that a Commure Pro Clinical Metrics form was presented to the provider for this measure, and was therefore eligible for reporting.
• Met: The number of times that the provider met the performance criteria for this measure (the provider completed the form with a response that indicated that he/she met the standard of care for the patient, and therefore met the performance criteria for the measure).

• Not Met: The number of times that the provider did not meet the performance criteria for this measure (the provider completed the form with a response that indicated that he/she did not meet the standard of care for the patient, and therefore did not meet the performance criteria for the measure).
• Excluded: The number of times that the provider completed the form with a response that indicated that a quality action was not performed for a valid reason as defined by the measure specification.
• Unanswered: The number of times that the Commure Pro Clinical Metrics form was presented to the provider for this measure, but the provider did not complete the form.
• Reporting %: The percentage of times that the provider completed Commure Pro Clinical Metrics form, out of all of the eligible times that the form was presented to him/her.
• Performance %: The percentage of times that the provider met the performance criteria for this measure by providing the expected standard of care (out of all the times that he/she completed a Commure Pro Clinical Metrics form for this measure). This percentage does not include any Commure Pro Clinical Metrics forms that the provider did not complete.

4. (Optional) Click the Print button to print the displayed results.

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To export the data to an XML file for submission to the CMS

1. Click the Charges tab followed by the PQRS Reporting tab.
   The PQRS Reporting screen is displayed.
2. In the Reporting Year field, select the reporting year for which you want to export data. The current reporting year is defaulted for you.
3. Click the CMS Export button.
   An XML file is created. Save it to a local or shared drive, and then send it to the CMS.

Show Settings that control this feature

• Admin - User - Charge Capture - PQRS Registry Participant

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RVU (Classic)

The RVU tab displays summarized RVU (Relative Value Unit) information for yourself and your department(s) in both table and graph formats. Your overall access to this tab, as well as whether you can see RVU data for other individual providers in your department, are based on a setting in your user profile: The report shows Work RVU data for all charge transactions that have a charge status of Sent to Billing. It does not include data for charge transactions with any other status. The left side of the screen contains RVU data in table format, while the right side shows information in graph format. Please note that the filters on the left side of the screen are used to control the amount of data shown in the table only; they do not affect the graphs, which have fixed date ranges. In order to calculate RVU information for this report, your Commure Pro representative must load a data file of RVU values for each CPT code (and optionally each modifier). Once it is loaded, all charges entered from that point forward will store RVU data for reporting on the RVU tab. In addition, to calculate RVU information for charges that were entered prior to loading the data file, your representative must run an update utility. See Loading the RVU Data File for specific information on loading the RVU data file, and also Configuring RVU Management for information about the overall configuration of RVU Management.

Settings that control this feature

• Admin - User - Charge Capture - Set RVU Report Access

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Viewing the RVU Table

The table entitled “RVU Statistics for [Current Provider] Compared to Department” shows your personal WRVU (Work Relative Value Unit) information for charge transactions where you were the Billing Provider, WRVU information for the other providers in your department (if you have access to see this), and the average WRVU information for the department(s) to which you belong. The first time you access this option, the Timeframe 1 field defaults to “Current YTD” and the report is displayed automatically for this time period. However, once you select different values for the Timeframe 1 and Timeframe 2 fields, those settings are retained. The next time you access the RVU tab, the report is automatically displayed using the values you chose the last time you viewed the report. To use the report, follow the steps below:

1. Complete the filter fields as follows:
   • Timeframe 1: You must select a time frame from the drop-down list, in order to view WRVU data for that time period. You can choose from the following values:
     • Current YTD
     • Last YTD
     • Last Year
     • Current Month
     • Last Month
     • R12: Select this option to see a rolling 12 months worth of data, where the first day of the date range is the first day of the month (12 months ago), and today is the last date in the date range. For example, if today were 7/15/15, then the first date would be 8/1/14, and the last date would be today, 7/15/15.
     • Last R12: Select this option to see the last rolling 12 months worth of data. This uses the same date range as R12 above, except that it is for the preceding year. If today were 7/15/15, then the Last R12 date range would be 8/1/13 to 7/15/14.
     • Custom Date Range: Select this option to specify a custom beginning and ending date for the report.
   • Timeframe 2: You can leave this field blank, or select a second time frame from the drop-down list. This adds a second column of WRVU data to the table for the time period that you specify, as well as a third column that calculates the percentage of change between the first two columns.
2. Select the Go button to generate the report. The “RVU Statistics for [Current Provider] Compared to Department” table is displayed. It contains the following columns of information, from left to right:
   • Total WRVU: The total WRVU values for all charges on transactions with a service date within the corresponding Timeframe value. This information is broken into three possible columns:
     • Timeframe 1: The WRVU for the time period selected in the Timeframe 1 field, such as “Current YTD” or “Last Year.”
     • Timeframe 2: The WRVU for the time period selected in the Timeframe 2 field, such as “Current YTD” or “Last Year.” This column is not displayed if no value was chosen in the Timeframe 2 field.
     • % Change: The percentage of change between the WRVU in the Timeframe 1 and Timeframe 2 columns. This column is not displayed if no value was chosen in the Timeframe 2 field.
   • Average WRVU per Transaction: The average WRVU value for all charges in a single transaction, for all charge transactions with a service date within the corresponding Timeframe value. This information is broken into the same three columns as described above for Total RVU (Timeframe 1, Timeframe 2, and % Change).
   The six columns above are displayed in three possible sections, from top to bottom:
   • Current Provider: Lists the six columns above for the provider (user) that is currently logged into the system, for all charge transactions on which he/she is the Billing Provider.
   • Department Avg: Lists the six columns above for all departments to which the current provider belongs. It shows the average of all WRVU data for charges transactions with a Billing Area in the corresponding department. If a department does not have any WRVU data, it is not listed on the report.
   Only those departments that have the following preference set to No are included in the report:Admin - Department - Charge Capture - Exclude from Department Checks When Sharing Data between Users
   • Other Providers: Lists the six columns above for all providers that belong to the same department(s) as the current provider, for all charge transactions on which the other provider(s) are the Billing Provider. If a provider does not have any WRVU data, he/she is not listed on the report. Note that this section is present only if the current user has permission to view it.
3. You may repeat Step 1 and Step 2 above as many times as necessary to view the information you want to see.
4. (Optional) Once the report shows the desired information, you can click either the Print or Export buttons to print the report or export it to Microsoft Excel^® spreadsheet, respectively.

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Viewing the RVU Graphs

The right side of the screen shows two graphs, entitled “[Current Provider] Overview, Current Year vs. Last Year” and “Trend: Total WRVU for Past Year, [Current Provider] vs. Dept Avg.” These graphs have a fixed date range and always show the information below. You can click on any graph to enlarge it.

• [Current Provider] Overview, Current Year vs. Last Year: This bar graph shows the following data:
  • Total WRVU: The graph shows the total WRVU for all charges where the current provider is the Billing Provider. It contains a bar for the current calendar year, and one for the last calendar year.
  • Total Charges: This graph shows the total number of charge transactions where the current provider is the Billing Provider. It contains a bar for the current calendar year, and one for the last calendar year.
• Trend: Total WRVU for Past Year, [Current Provider] vs. Dept Avg: This line graph that shows the following lines:
  • A single line for the current provider, representing the total WRVU for all charges where that person is the Billing Provider, and where the service date is in the past twelve months. The line shows a plot point for each month’s total.
  • A line for each department to which the current provider belongs, representing that department’s average WRVU (based on charge transactions with a Billing Area in the corresponding department, and where the service date is in the past twelve months). Each department’s line shows a plot point for each month’s average.

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Search (Classic)

The Search (Classic) report allows you to view detailed information for charges entered within a specific time range. You can also use other search criteria, such as error type and charge status, to narrow your search. Once you have generated a report, you can edit or delete the charges on it, determine if a missing charge should be entered, or if you are a reviewing provider, you can mark them as reviewed. Finally, you can print the report results, or export them to a text file. Although the Search tab is very flexible, some organizations prefer to create their own queries and report formats using third party reporting tools. To facilitate this process, a de-normalized table containing charge data can be generated and accessed from outside the application. Only system administrators have access to the charge reporting table. The use of this table is fully described in Using Third Party Reporting Tools.

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Viewing Charges on the Search Tab

To create a report of charges using the Search option, click the Search tab under Charges. Use the criteria fields to define the charges you want to see and then click Show Charges.

Criteria Fields

• Choose a Timeframe, such as Today, Yesterday, Current Week, Last Week, Current Month, Last Month, or Last n Days, where n indicates the number of days to include. Or configure either of the following pairs of settings to define a range of dates:
  • The Start Date and End Date fields. Use these fields to define a range of charge transactions by their service date.
  • The Commit Start Date and Commit End Date fields: Use these fields to define a range of charge transactions by their commit date (the date sent from the Outbox to final billing).
• Batch ID: Enter a batch ID number to display only those charges that are part of a specific batch that has been sent to final billing. The Batch ID field is useful for administrators, who need to return a particular set of charge transactions to the Holding Bin because the charges caused submission errors when they were initially sent to final billing. Administrators should refer to Returning Charges to the Holding Bin from a Report for more information.
• Charge Statuses: Check the box for each charge status you want to include. Available options are:
  • All: All charges.
  • Draft: Non-expired draft charges.
  • Holding Bin: Charges still in the Holding Bin, and therefore editable (this includes expired draft charges).
  • Outbox: Charges that were batched for billing. You cannot edit these charges unless your administrator has configured them to be editable.
  • Sent to Billing: Charges that were committed to billing (no longer editable).
  • Not Coded [visit type]: Visits for which charges have not yet been entered. Your system administrator can determine which types of visits should have a “Not Coded” status calculated for them when they do not have charges entered against them. For example, they may decide to calculate Not Coded status for ER and outpatient visits, but not for recurring visits. For each visit type that has a not coded status calculated, a criteria field is present here on the Search tab. The criteria are typically named “Not Coded [visit type],” as in “Not Coded ER” and “Not Coded Outpatient.” When you select a Not Coded status, you cannot also select a Department or Billing area, since not coded visits are not affiliated with a department/billing area (only charge transactions are affiliated with departments/billing areas).
  • Cancelled: Outpatient appointments that have been cancelled. (Note: this filter may not be available, depending on how your system administrator configures the system.)
• Imported Charges Only: Check this box to view only those charges that have been imported from a third party charge capture system. This is an optional feature that your organization may or may not use. Please refer to Importing Charges from Third Party Systems for more information.
• Error Types: Check the box for the types of charges you want to see, based on their error status. All of the error type filters are described in Definitions of Charge Errors, with the exception of the Without Errors filter, which is described below.
  • Without Errors displays any visits or charges that do not have any errors, nor are the charges held for any type of review.
• Filter Departments: The choices available under the Department field are based on your user profile, as described in the introduction to this chapter. If you have access to other department’s charges, you will be able to select them here. Otherwise, you may only select your own department(s). Check the Departments you wish to include. When you select a department, the system automatically selects all of the billing areas within that department. Uncheck any billing areas that you do not wish to include on your report.
• Filter Locations: The behavior of the Filter Locations field is based on your user profile. Only those locations that are associated with the departments to which you belong are listed here.
  • If you do not select any locations at all, then the patient’s location is not taken into account, and charges for patients in all locations are included in the report results.
  • If you select All, then all of the locations to which you have access are selected for the criteria, and only the charges for patients in those locations are included in the report results.
  • If you select one or more specific locations, then only the charges for patients in those specific locations are included in the report results.
• Select Providers: The behavior of the Select Provider fields are based on your user profile. If you have access to other physicians’ charges, you will be able to select those providers here. If you do not have access to other providers’ charges, the provider field does not even appear on the screen. Select the providers whose charges you wish to include. You can search for all providers that are classified as Billing, Scheduled, or both (Billing or Scheduled) using the drop-down filter next to Select Providers. In addition to filtering by the classification of provider (Billing, Scheduled, or Billing or Scheduled), you can search for a provider by name by entering the first few letters of the last name in the field under Select Providers, and then clicking on the magnifying glass. To view a complete list of providers, leave this field blank and click on the magnifying glass. Leaving this field completely blank selects all providers within the department you have selected and the provider classification (Billing, Scheduled, or Billing or Scheduled).
• Select Services: The behavior of the Select Service field is similar to the Select Provider search field. You may be able to choose only the medical services enabled for your department(s) if you only have access to your own charges, or your own department’s charges. Select the services whose charges you wish to include.
• Select Visit Types: Select the Commure Pro Visit Types you wish to include. Only transactions associated with visits of those types are included on the report results.
• Hold Reasons: Select the Hold Reasons that you wish to include. Only transactions that are held for review for those particular reasons are included on the report results.
• Result Limit: This field is useful to system administrators who have access to a large number of charges. They can choose to limit the number of charge transactions shown in the display, which in turn limits the amount of time it takes to compile the Charge Search report. A maximum of 500 results is allowed.
• My Charges Only: This check box may or may not be visible on the screen, depending on whether a) you are a provider, and b) you have permission to view other providers’ charges. If you are a provider and you do have access to view charges other than your own, you can use the My Charges Only check box to filter out those charges, and view just the charges on which you are the billing provider.
• Auto-Added Charges/Diagnoses Only: Check this box to view only those charge transactions that have auto-added charges or diagnoses. This includes transactions that have the correct auto-added charges, as well as those in which the master charge or the auto-added charges or diagnoses were removed or changed by a user, resulting in a Technical Mismatch error status. You can also use the “Technical Mismatch” option under the Error Type criteria to find only those transactions with the error status. Both this checkbox and the filter are available only if you have permission to view auto-added charges. See Managing Charge Transactions with Auto-Added Codes for more information.
• Charges with Comments Only: Check this box to view only those charge transactions that have either a provider or biller comment. The checkbox is available only if enabled in the user’s profile.
• Report Fields: Check the fields that you want to appear as columns on your custom report. These data fields are printed for each charge transaction that matches your search criteria. You can choose from many fields. Some of the more commonly used fields include patient identifiers (name, financial info, patient internal ID), visit information (visit number, visit type, visit internal ID, admit date, discharge date, appointment date/time, reason for visit), billing information (charge status, charge codes, quantity, modifiers, work RVU, diagnoses, hold reason, provider comments, biller comments, billing provider), and audit information (created date/time, created by, modified date/time, submission date/time). Of special note is the Edits field. Selecting this field as a column makes the charge transactions editable from the resulting report. Also of note is the Proc Text field, which providers can use to add CPT descriptions from the department picker list. This enables them to see this description when they print their patient list from Charge Search.

The system automatically selects a standard set of fields for all reports. However, you may uncheck any fields that you are not interested in viewing.

Display Columns

The columns of the report are those that you selected as Report Fields. Some fields are selected by default such as:

• Patient information
• Financial Info
• Date of service
• Visit #
• Status (charge status)
• Edits (error status)
• Hold Reason
• Provider Info (billing provider, department, and billing area)
• Proc (charge code)
• Qty (quantity)
• Modifier
• Work RVU
• Diag (diagnosis)
• Work RVU Total
• Visit Type
• Reviewing Provider
• Reviewed Date/Time
• Your organization may opt to always display the Visit Status as well, so that users can see whether a visit was cancelled. This option requires an XML customization, please consult your Commure Pro representative to implement this feature.
• If your organization uses a Charge Data Master (CDM), they can opt to display the CDM codes in addition to the charge codes. This option also requires an XML customization.

Other Available Actions

• To return to the search criteria screen, click Back to Criteria.
• The items you selected on the Charge Search screen become the defaults for your next search. To run a new search using different criteria, change one or more items in your search criteria. Or click the Reset Criteria button to clear the search criteria fields and start over (all criteria are cleared except for the Report Fields).

Show Settings that control this feature

• Admin - User - Charge Capture - Set Charge Desktop View Access
• Admin - User - Charge Capture - Show Biller Comments (Web only)

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Summary (Classic)

The Summary (Classic) report gives you a quick way to view the total number of charge transactions that are currently in the Holding Bin and Outbox for each department. System administrators with institution-wide privileges can view totals for all departments on the Summary tab. Billing administrators can view totals for only those departments in which they have access for viewing charges (based on their user settings, as described in Understanding Access Restrictions to Patients and Their Data). The Holding Bin totals are broken down by the age of the charge based on its service date, such as less than 15 days, greater than 15 days but less than or equal to 30 days, and greater than 30 days. Click the numbered links to go to the Holding Bin or the Outbox to view and possibly edit the charges in a given department. In addition, any errors found when committing batches from the Outbox to final billing (whether manual commits or automatic commits) are listed in a Notices section on the right side of this screen. Please note that the Notices section is present only if there are errors. See Troubleshooting Issues with Batches (Reprocessing/Ignoring Batches) for guidance on dealing with batch errors. Once an error is detected and has been resolved, you can select it and click the Acknowledge button to clear it from the screen.

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Worklist (Classic)

The Worklist (Classic) report is used as a tickler file to identify charge transactions with potential or actual billing errors, charge transactions that have been held for review, and visits for which charges have not yet been posted. It shows only visits with charge states of Draft, Holding Bin, or Not Coded (a Not Coded visit is one that has not yet had charges posted against it). The Worklist does not show charges that are in the Outbox, or those that have been sent to billing. When a healthcare provider uses this option, their user preferences usually limit them to seeing just their own charge transactions and visits. So for a healthcare provider, the resulting Worklist is essentially their file of work to be done. When an administrator uses this option, they generally have privileges to see information for a broader range of departments and users. But again, even for this broad span, the Worklist report is a list of charge transactions or visits that require attention for one reason or another. While viewing the Worklist report, a provider or administrator can immediately add, edit, delete, or review charges. As each problem is corrected, or marked as reviewed, the status of the charge transaction or visit is updated.

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Viewing Charges or Not Coded Visits on the Worklist (Classic)

The first time you access the Worklist tab, the system automatically displays all of the charge transactions with potential or actual billing errors, charge transactions that have been held for review, and not-coded visits that you have permission to see. If you change the criteria at the top of the screen, those criteria are recalled the next time you access the Worklist.

Criteria Fields

• Select a Timeframe, such as Today, Yesterday, Current Week, Last Week, Current Month, Last Month, Custom, or Last n Days, where n indicates the number of days to include. The default is Last 90 Days, but if necessary, the default number of days can be changed via an XML customization; contact your Commure Pro representative for more information. If you choose Custom and do not include start/end dates, all holding bin charges will be displayed. If you would rather select a specific date range, select a Start Date, End Date, or both, using the pop-up calendars. When retrieving not-coded visits, the report selects visits whose active date range fall anywhere within the date range that you enter here. For example, let’s say we have a visit with no charges posted, that was admitted on June 1 and discharged on June 5. If you enter a date range of June 3 to June 6 as the Worklist criteria, the not coded visit would be included on the report (listed with an admit date of June 1), since the active date range of the visit overlaps the date range entered in the report criteria. The active date range is based on the charge capture activate and deactivate settings defined in the Commure Pro Visit Types option for the particular type of visit.
• Limit Results: This field is useful to system administrators who have access to a large number of charges. They can limit the number of charge transactions shown in the display, which in turn limits the amount of time it takes to compile the Worklist. A maximum of 500 results is allowed.
• Facility: The behavior of the Facility field is based on your user profile, as described in the introduction to this chapter. You can select only those facilities that are associated with the departments to which you have access. If you do not select a facility, the default is -All-.
• Department: The behavior of the Department field is based on your user profile, as described in the introduction to this chapter. If you have access to other department’s charges, you will be able to select them here. Otherwise, you can only select your own department(s). Only active departments are listed, departments that are inactive are not listed. If you do not select a department, the default is -All-.
• Bill. Area: After you select a department, the Billing Area drop-down list now contains only those billing areas associated with the selected department. Select a billing area from the list. The default, if you do not select a billing area, is -All-.
• Filter: Select a filter to identify the type(s) of charge transactions you want to see on the Worklist. This criteria field includes a mix of charge status filters and charge error type filters.
  • All displays all charge transactions or visits that require your attention. This includes charge transactions with outstanding billing issues, as well as “not coded” visits (visits for which charges have not yet been entered).
  • Cancelled displays only outpatient appointments that have been cancelled. Note: This filter may not be available, depending on how your system administrator configures the system.
  • Draft Charges displays non-expired draft charges.
  • Not Coded [name] displays visits for which charges have not yet been entered, or visits for which the charges are still in a draft state (so not fully coded). Your system administrator can determine which types of visits should be included on the Worklist report as not coded visits. For example, they may decide to include ER and outpatient visits on the report if they are not coded, but not to include recurring visits (even when they are not coded). For each visit type that is included on the report when it is not coded, a filter is present, so that you can selectively view just those visits. The filters are typically named “Not Coded [visit type],” or “Not Coded ER” and “Not Coded Outpatient” in our example.
  • Without Errors displays those charges that do not have any errors, nor are the charges held for any type of review. See also the Include Charges with No Edits checkbox, as it has related functionality.
  The remaining filters are charge error types, all of which are described in Definitions of Charge Errors.
• Provider: The behavior of the Provider fields are based on your user profile. If you have access to other physicians’ charges, you will be able to select those providers here. If you do not have access to other physicians’ charges, the provider field does not even appear on the screen. You can search for all providers that are classified as Billing, Scheduled, or both (Billing or Scheduled) using the drop-down filter under Provider. In addition to filtering by the classification of provider (Billing, Scheduled, or Billing or Scheduled), you can search for a provider by name by entering the first few letters of the last name in the field next to the Provider filter drop-down, and then clicking on the magnifying glass. To view a complete list of providers, leave this field blank and click on the magnifying glass. Leaving this field completely blank selects all providers within the department you have selected and the provider classification (Billing, Scheduled, or Billing or Scheduled).
• Service: The behavior of the Service field is similar to the Provider search field. You may be able to choose only the services to which you belong, or others, depending on your user profile. To search for a specific service, enter the first letter of the service code and click on the magnifying glass. To see a list of all service codes, leave this field blank and click on the magnifying glass.
• Include Today’s Appts: The default is checked, allowing you to see visits from today. Uncheck this check box if you prefer to see only those visits from yesterday and prior dates. In most cases, you will select All in the Timeframe field because you wish to see all charges with outstanding issues, as well as all visits for which charges have not yet been posted. However, you may or may not wish to see the today’s visits, depending on the time of day that you happen to be reviewing the Worklist report. For example, if you are viewing the report early in the morning, you may not want to see today’s not coded visits on the list, since the visits have not yet transpired, and you can’t possibly enter charges for them yet.
• Show Group/Service Appts: This checkbox may or may not be visible on the screen, depending on whether you have permission to view other providers’ charges. If you do have access to charges other than your own, the checkbox is displayed. By default the checkbox is checked, allowing you to include group/service appointments. Uncheck this checkbox, if you do not wish to see other provider’s appointments. If checked, and the providers you selected above are part of one or more services, the system displays the charges for all of those services, without your having to specifically select each of them in the Service field.
• Auto-Added Charges/Diagnoses Only: Check this box to view only those charge transactions that have auto-added charges or diagnoses. This includes transactions that have the correct auto-added charges, as well as those in which the master charge or the auto-added charges or diagnoses were removed or changed by a user, resulting in a Technical Mismatch error status. You can also use the “Technical Mismatch” option under the Error Type criteria to find only those transactions with the error status. Both this checkbox and the filter are available only if you have permission to view auto-added charges. See Viewing Charges with Auto-Added Codes for more information.
• My Charges Only: This check box may or may not be visible on the screen, depending on whether a) you are a provider, and b) you have permission to view other providers’ charges. If you are a provider and you do have access to view charges other than your own, you can use the My Charges Only check box to filter out those charges, and view just the charges on which you are the billing provider.
• Include Charges with No Edits: This checkbox enables you to differentiate posted transactions that require edits (those with billing or coding issues), from those that do not require edits (“clean” transactions that have no billing issues and are not held for review).
  • Leave the box unchecked to view only those items that require some action on your part: visits for which charges have not yet been entered, and posted transactions that have billing issues.
  • Check the box to view all transactions: visits for which charges have not yet been entered, posted transactions with billing issues, and also those without billing issues.
  You may note that the Without Errors filter and the Include Charges with No Edits option are somewhat related in functionality, but with subtle differences. Here are the most common ways you might utilize these two selection criteria:
  • Select the Without Errors filter to display only those posted charge transactions that have no billing or coding issues. This does not include visits that have not yet had charges entered; there are separate Not Coded filters for viewing these types of visits. You may also note that when using the Without Errors filter, checking or unchecking the Include Charges with No Edits option has no effect.
  • Select the All filter and uncheck the Include Charges with No Edits option to display those posted charge transactions that have errors or coding issues, as well as visits for which charges have not yet been entered.
  • Select the All filter and check the Include Charges with No Edits option to see everything: posted charge transactions with errors, posted charge transactions without errors, and visits for which charges have not yet been entered.

Display Columns

After changing any of the criteria above, click the Refresh Worklist button to refresh the display in the bottom portion of the screen. The results include columns for:

• Patient information
• Financial Info
• Date of service
• Edits (error status)
• Provider Info (billing provider, department, and billing area)
• Proc (charge codes)
• Charge Headers
• Qty (quantity)
• Modifier
• Diag (diagnoses)
• Your organization may opt to also display the Visit Status, so that users can see whether a visit was cancelled. This option requires an XML customization, please consult your Commure Pro representative to implement this feature.
• If your organization uses a Charge Data Master (CDM), they can opt to display the CDM codes in addition to the charge codes. This option also requires an XML customization.

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Definitions of Charge Errors

A given charge transaction can have one or more types of errors associated with it, such as Code Edits or Validity Error.

• When viewing a report that lists charge transactions, the report might contain an Edits column (Classic Reports) or a Charge Errors column (Revenue Reports) that displays the error type(s) associated with each charge transaction. If a charge has no errors then None is displayed instead.
• When viewing a report, you might see a Filter or Error Type criteria field (Classic Reports) or a Charge Errors filter (Revenue Reports) that allows you to select one or more of these error types, so that the report shows only charge transactions with those errors.

Below is a list of all possible error types that you might encounter in the scenarios above, with a definition of each.

• Code Edits: Charge transactions that have triggered an Error Message code edit, and hence have a Code Edits error status. These types of code edits are typically designed to find coding errors in the transaction. For example, this type of code edit might be triggered when a procedure that can be performed only on a female patient is entered for a male patient, or when a procedure that should be performed only on a child is entered for an adult. This includes both standard code edits loaded by Commure Pro staff as well as any custom code edits created at the organization. On Revenue Reports, you can use the Code Edit Name Run-Time Filter to view just those charges for which the Code Edits error was triggered by one or more specific code edit types.
• Code Held: Charge transactions that have triggered a Codes Held code edit, and hence have a Code Held error status. These types of code edits are used when an organization wants certain CPT, diagnosis, or modifier codes to be reviewed by billers before being sent to final billing. For example, flu vaccines may need to be reviewed for an accompanying injection code, or Level 5 Consults (highest level) may need to be reviewed to ensure proper billing. This type of code edit is often configured as a role-based code edit, which means that it might fire behind the scenes only when the charge transaction is entered by users with a certain role (such as the Provider role), and the resulting Code Held error status can be seen only by users with a different role (such as the Biller or Administrator roles).
• Expired Draft: Draft charge transactions that have expired.
• Free Text: Charge transactions with free text items such as diagnoses, CPT codes, NDC codes, or provider header fields (such as referring provider) where the user is allowed to enter free text, but for which a free text error is triggered.
• Held for Review: Charges that have been held for review by a user for a particular reason. You can use the Hold Reasons criteria field (Classic Reports) or the Hold for Review Reasons Run-Time Filter (Revenue Reports) to view just those charges that are held for one or more specific Hold Reasons.
• Measure Mismatch: Charge transactions that triggered the Commure Pro Clinical Metrics screen (with required or non-required questions), but for which the auto-added CPT II codes have since been deleted. This could happen if the user entered their original charges for service, answered the clinical metrics questions and submitted their responses, and then edited the transaction and deleted one or more of the auto-added CPT II codes. (CPT II codes that were added as a result of a provider completing the Commure Pro Clinical Metrics screen are displayed with (P) appended to the code number.) See Managing Charge Transactions with PQRS/MIPS Data for more information.
• Technical Mismatch: Charge transactions in which a user has deleted a master charge or an auto-added charge or diagnosis code, causing this error status to be assigned to the transaction. Charge codes that were added as a result Automated Code Entry are displayed with an (A) appended to the code number. This filter is available only if you have permission to view auto-added charges. See Managing Charge Transactions with Auto-Added Codes for more information.
• Missing Measure: Charge transactions that triggered the Commure Pro Clinical Metrics screen with required primary questions, but for which the expected responses are missing. The only way this could happen is if a connectivity issue occurred while saving or submitting the responses (a web user closed the browser window before submitting their responses, or a handheld user lost connectivity before or during submission of their responses). See Managing Charge Transactions with PQRS/MIPS Data for more information.
• Missing Professional CDM: For organizations that use a Charge Data Master (CDM), this error identifies charge transactions in which the system cannot find a mapped Professional CDM code when the rules dictate that it should. See Managing Charge Transactions with CDM Codes for more information.
• Missing Technical CDM: For organizations that use a Charge Data Master (CDM), this error identifies charge transactions in which the system cannot find a mapped Technical CDM code when the rules dictate that it should. See Managing Charge Transactions with CDM Codes for more information.
• NDC Errors: Charge transactions that are missing either the NDC code or quantity, or that have an invalid NDC code, for charge codes that are mapped to NDC codes (typically these are charges for drug administrations, such as vaccines). You can use the Invalid NDC option under the Error Types criteria field (Classic Reports) or Charge Errors run-time filter (Revenue Reports) to find transactions with this error. See Entering NDC Codes for a Specific Charge Code. How can an invalid NDC code occur? If a user enters a valid NDC code initially, but then changes the service date or the visit associated with the transaction, it could possibly make the selected code invalid. Or, if an administrator changed the NDC mapping after some codes had already been entered by users (such as a change to the Effective or Expiration dates), those previously entered codes might become invalid.
  A Level 0/1/2 user can override the NDC Errors error status and send the transaction to the Outbox.
• Unverified Patient: Charge transactions for patients who were manually registered, but who are not yet verified.
• Returned from Batch: Charge transaction that were returned from final billing by a billing administrator. See Returning Charges to the Holding Bin from a Report for more information.
• Validity Error: Charge transactions that your organization has designated as not valid. Depending on your system configuration, certain types of errors can be classed as a Validity Error, such as charges for patient/visits that are missing an account number or MRN, charges with free text errors, charges missing header information such as an admitting or referring provider, or charges with an invalid Service Date.
  • Validity Error with a Date Warning: The Date Warning error means that the Service Date of the charge falls outside one of the following settings:
  Admin - System Management - Visit Types - (Charge Capture, NoteWriter): Activate Date and (Charge Capture, NoteWriter): Activate Days Admin - System Management - Visit Types - (Charge Capture, NoteWriter): Deactivate Date and (Charge Capture, NoteWriter): Deactivate Days Admin - User - Charge Capture - Allow Editing a Charge “n” Days after Visit End Admin - User - Charge Capture - Allow Setting Service Date “n” Days before Today Admin - Institution - Charge Capture - Check Validity of Service Date
• Verified Man Reg Patients: Charge transactions for patients who were manually registered and are verified.

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Using Third Party Reporting Tools

Although there are a variety of standard billing reports within the Commure Pro application, some organizations prefer to create their own queries and report formats using third party reporting tools. To facilitate this process, de-normalized tables containing charge data can be generated by Commure Pro staff and made available for use with the third party reporting tools. In addition, ad-hoc reports can be created for clients from the reporting tables on an as needed basis. These reporting tables should not be used for generating patient bills, but rather for general reporting purposes. And finally, these same reporting tables can be used to generate charge data that is sent to Commure Pro’s Charge Analytics application. The charge report tables can be generated on an as needed basis by your Commure Pro representative. When generating the report, the representative can specify a beginning and ending date range for the charges you wish to include. The system retrieves a snapshot of all the charges within that date range, including those with a variety of charge statuses (Draft (HH),Draft (web) , Holding Bin, Outbox, and Sent to Billing). It is important to note that the details of a charge included in report generated today, may not be the same as those for the same charge when it is included in a report at a later date, as the charge could be edited in the interim.

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Generating the Charge Report Tables

Depending on your system’s configuration, the charge report tables may reside in the same schema as the Commure Pro databases, or they may reside in a separate schema. Your Commure Pro representative can send the command to populate a report table by accessing the specified URL within the client system. In prior Commure Pro versions, there was one servlet that created or updated a single table called PK_CHARGEREPORT. There were limitations to using this servlet, as various consumers had conflicting reporting needs, and often overwrote each other’s report data. Although the PK_CHARGEREPORT table can still be generated in the same manner as in the past, starting in version 8.1.7.89 there are two new servlets: one for creating a report table, and another for updating a report table (commonly referred to as the Create servlet and the Update servlet, respectively). If specified by the user, the Update servlet can also automatically purge older data after it populates the new data during a run. The user must specify whether to purge the data based on the modified date, the service date, or the billing batch date, as well as the number of days of data to retain based on that date (any record that is not within the specified number of days to retain is purged). In addition, the user can specify that the report results be saved with any of four different table names, each of which represents a different consumer of the report. This allows the different consumers to create and update the report data according to their own needs, without overriding the needs of others. Each table name should be used as follows:

• DI: This table name stands for Dimensional Insight, and is reserved solely for use by the Charge Analytics application. Charge Analytics scripts determine whether to use the Create or Update servlet based on whether the initial data set is being populated. There is a Charge Analytics configuration (IS_FIRST_RUN) that specifies whether this is true that is used for this purpose. When populating the initial data set, the Create servlet is called and data is populated based on the desired amount of data. There is an existing Charge Analytics configuration where this is specified (INIT_BEGIN_DATE). Once the initial data set is populated, the Update servlet is called and only data that has been modified within a specified timeframe is populated. The Update servlet populates data based on the existing MONTHS2PULL parameter (for example, any changes made during the last 3 months). The purge function is configured to purge any data older than the same time period, but based on billing batch date. Once data is populated by the servlet, the full dataset is downloaded and the Charge Analytics data files are updated.
  If Charge Analytics is currently using the original charge servlet, there is no immediate need to switch to the Create and Update servlets. This change can be made at the client’s convenience.
• INTEGRATIONS: Integrations creates extracts for clients who want a charge data dump for their own reporting systems. Below are several use cases typically covered by the Integrations charge report extract, and how they would be handled with the Create and Update servlets.
  • All charges batched within the last day: Initially, the Create servlet is used to create the table and populate an initial data set. Following this, the Update servlet is used to populate charges based on billing batch date for the previous day, and to purge any data that is older based on billing batch date.
  • Charges created in the last week: Initially, the Create servlet is used to create the table and populate an initial data set. Following this, the Update servlet is used to populate charges based on modified date for the last week, and to purge any data that is older based on modified date.
  • Charges updated in the last day: Initially, the Create servlet is used to create the table and populate an initial data set. Following this, the Update servlet is used to populate charges based on modified date for the previous day, and to purge any data that is older based on modified date.
• SUPPORT: Clients often request ad-hoc queries from support that have no relation to a previous request. Support uses the Create servlet to truncate any existing table and populate it with parameters specific to the current query.
• CLIENT: An additional table available for client data or reporting requests.

As mentioned above, there are three possible servlets that can be run: Definitions for the report parameters are as follows: The parameters below were available for use with the original servlet, but are either no longer used at all, or now use a hard-coded value. Threads, Queue Size, and Batch Size are all hard-coded for the Update and Create servlets.

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Scheduling the Update Servlet

The Update servlet can be configured to run according to a defined schedule, based on two settings in the Configuration.properties file. The servlet jobs are run every day, at specific hours of the day that are defined in the schedule (for example, every day at 5:00 AM and 11:00 PM). The servlet jobs will continue to run at the specified hours, regardless of the success or failure of a previous scheduled run. If maintenance is being performed on the server at the same time as a scheduled run, the servlet will simply run again at the next hour specified in the schedule. Contact your Commure Pro representative to set up a schedule for the Update servlet.

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Checking the Status of the Charge Servlets

Please note that the charge report table is only populated when a Commure Pro staff member accesses the URL using the above commands. Once a command to run a report is executed, the user must wait two hours before attempting to run another report (if the user tries to execute the command a second time within the two hour window, the report will not run). The data is retrieved at a rate of 30 to 60 charges per second, depending on your system’s hardware configuration. Therefore, if your database contained 100,000 charges, it would take several hours for the table to be populated. For the original servlet, the PK_CHARGEREPORTSTATUS table is used to record each job initiated by the servlet, as well as the status of the job. For the Update and Create servlets, the same status table is used to record similar information. The columns of the table include:

• SYNCREPOSITORYID: The primary ID for the row in the PK_CHARGEREPORTSTATUS table, used as an identification number for a specific servlet job.
• SYNCCREATEDTIME: The date/time the row was created in the PK_CHARGEREPORTSTATUS table.
• SYNCMODIFIEDTIME: The date/time the row was modified in the PK_CHARGEREPORTSTATUS table.
• SYNCVERSION: The sync version of the row in the PK_CHARGEREPORTSTATUS table.
• SYNCDELETED: A deleted flag for the row in the PK_CHARGEREPORTSTATUS table.
• PARAMS: The URL parameters used to run the servlet job.
• HOST: The host where the servlet job was run.
• REPORT_COUNT: The number of records written to the report table.
• TABLE_NAME: The name of the report table that was populated (PK_CHARGEREPORT_SUPPORT, PK_CHARGEREPORT_DI, PK_CHARGEREPORT_INTEGRATIONS, or PK_CHARGEREPORT_CLIENT). For the PK_CHARGEREPORT table, this column will be null.
• JOB_TYPE: The type of job (CREATE or UPDATE). For the PK_CHARGEREPORT table, this column will be null.
• REPORT_STATUS: The status of each servlet job (PROCESSING, SUCCESS, FAILURE).
• STATUS: The status of each servlet job, with an additional possible value of EXPIRED (PROCESSING, SUCCESS, FAILURE, EXPIRED). When a new job is started, the STATUS of all previous processing or successful jobs is set to EXPIRED.
• REPORT_END_DATE: The date/time when the servlet job completed. For the PK_CHARGEREPORT table, this column will be null.
• PURGE_STATUS: The purge status (NO_PURGE, SUCCESS, or FAILURE) of the servlet job. For the PK_CHARGEREPORT table, this column will be null.
• PURGE_COUNT: The number of records purged. By default, the value will be null if a purge is not executed. For the PK_CHARGEREPORT table, this column will be null.

When you execute the command to start a new report, the ID number of the report is displayed, as in the example below where nnnn is the report ID number: JOB STARTED:nnnn Using that report ID number, you can check the status of the report by entering the command below (replace nnnn with the report ID number): http://Host:port/ChargeReportStatusServlet?refNum=nnnn This command returns the status of the report that has the specified report ID. For example:

• PROCESSING:nnnn (the report is still being executed)
• SUCCESS:nnnn (the report completed successfully)
• FAILURE:nnnn (the report did not complete successfully)
• EXPIRED:nnnn (when the next report starts, all previous reports are marked as EXPIRED)

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Data Elements Included in the Report Tables

The report table includes all of the data elements that represent the charge transaction. These elements include patient information, provider information, detailed charge transaction information, and administrative information. Each row or record in the report table corresponds to one charge. Keep in mind that a charge transaction for given patient visit might contain several charges, resulting in several rows in the report table. Deleted charges are included in the table, and are flagged as such. The table below lists all of the columns in the report table, and the corresponding definition for each item. If your organization had defined any custom charge transaction headers, these are also included for each charge (see headerValue and headerName in the table below). Each time you generate the report table, the custom headers are listed in the order in which they were originally created. If you create new headers, or if you upgrade from version 4.0.4 or less to a newer version of Commure Pro software, the next time you run the report you should run it with the newtable parameter set to true (newtable=TRUE). This ensures that the header columns are re-organized appropriately.

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Report Column Names and Descriptions

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Monitoring Billing Activity

Authorized administrators can view all billing thread activity directly from the System Management screen. To access the billing monitor logs, click Admin > System Management > Billing Monitor Thread. The administrative interface displays the following information about each billing area:

• Billing Area ID
• Last Batch Created Time (Dept)
• Last Dept Batch Name
• Next Scheduled Time
• Time Until Next Run
• Billing Area name
• Department name