PM & EMR Tips and Tricks

Splitting a Sequence

Did you ever wish you could split a sequence to send one or two line items to one insurance and the other to another? Maybe you want to send some of the line items to Insurance Responsible and some lines to Patient Responsible, below are steps to follow to achieve this.

Create a new sequence, put all procedure codes in and save.

This Created Sequence 30 with 3 entries:

Place a checkmark in the newly created sequence and click on Split on the left task pane.

The Split Sequence window opens.

Place a checkmark in ‘Create Sequence’.

From there, you can choose the new Plan Set and new Plan in the right side of the window and move the line items you want to go in the new sequence by left clicking and dragging to the right side as well and click Accept.

Now there are two sequences: Sequence 30 now only has one entry and the newly created sequence 31 has two entries. One line out to Cigna and one line out to Aetna.

If you want to split out these items because they need to go to patient responsible you can do that as well simply by checking Create New Sequence, put the radio bullet in Patient in the Responsibility field and uncheck Create Claim.

The newly created sequence will then be out to patient.

Keep in mind – you can’t split a sequence and leave a payment in one of the sequences alone.

Setting up Provider/Specialists to take advantage of the ‘Transition of Care OUT’ process improvements:

• From Tools
• Contact Managers
• Provider/Specialist Manager
  
• Select a Provider – Edit
• Confirm that Direct Address is entered
  • Utilize the Surescript Provider search to find address, if needed
• Check mark Automatically Send CDA with referrals

Click OK – repeat for all providers the practice refers to