Finance Update

Here is an update on the latest changes and enhancements to the IMA Finance  modules. As usual, if you have questions on any of this, please contact the helpdesk

IMA Claim Grouper

1. An new exception message was added for claims missing a diagnosis code. Please note that in APG billing, the diagnosis is taken from the grouped claim and if missing must be added there and not just in the client's program enrollment.
2. The expected amount calculated for a service can now be edited on the claim detail services tab. 

 

APG Billing Batches 

1. If your agency has multiple payer sequences for Medicaid, the claims for these will now be sent in a single claim file if the payer sequences share the same  "Receiver", version (i.e. 5010), and claim format (i.e. Institutional). We hope this will reduce the number of files that need to be transmitted to Medicaid.
2. The billing provider location information included in the claim file will now come from the payer provider tab instead of the service location record. This is because APG billing requires a separate payer sequence for each location. In service billing this information will continue to come from the service location record.  
3. A new M error was added parallel to the service billing M95 error (ATI Programs) 
4. A G/L function was added to APG billing. This is only applicable to agencies that use the IMA G/L posting feature. The postings will match those made in the service billing module. 

 

Remittance

 

A new "MD Retro" report button has been added. This report will look at all remittances processed on a specific day and match up reversals to repayments to show what Medicaid has done in a retroactive adjustment.

 

Billing Suspense Management Tool

 

Over 90 reason codes: Using this tool to set the "Over 90" reason code for services now also updates the Claim grouper for APG billing. It is no longer necessary to enter the reason code in two places.

 

Denial/Exclusion Management Tool 

 

The "reopen" tool has been renamed the "Denial/Exclusion Management Tool" and many new features were added to allow full denial management from this module. The details of each denial can now be viewed along with insurance company contact information and billing notes.

 

Services Lookup

 

The versatile Services Lookup Module has one more new feature. We had recently added a new column displaying the payers involved in each service listed. The latest feature is to allow the list of services to be filtered by payer. Services covered by a specific payer can now easily be displayed and reviewed.  

 

Version 5010 Reminder 

 

The final deadline for 5010 is coming soon. Please review your "Payer" records to confirm that all have been switched to version 5010.