HealthEMS®

RevNet User Guide - Provider Information

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Payer/Provider - Provider

Navigate to: Setup -> RevNet -> Payer/Provider -> Provider

Provider

This page allows for the setup of multiple providers and provider ids for different types of services. The number of providers setup depends on the number of providers IDs each agency has. For Example, there may be a different provider name/id number for Emergency Medical Services than for Wheelchair services.

The Current Providers section shows the Provider Name, Address, National Provider ID and Tax ID # of the listed providers.

Provider - Provider Info

Click on the Provider Name to see additional details regarding the provider.

Name: Name of the Provider.

Address 1: Address 1 of the Provider.

Address 2: Address 2 of the Provider.

City: City of the Provider.

State/Providence: State/Providence of the Provider.

Zip: Zip Code of the Provider

Country: Country of the Provider.

Phone: Phone Number of the Provider.

Direct Message Address: Address provided by PCDS during implementation of EMR to EMR.

Payable To: Checks should be marked Payable To this name.

Natl Provider ID: National Provider ID

Zirmed Account Number: Assigned by Zirmed.

Tax ID #: Tax ID # assigned to the Provider.

Invoice Prefix: Optional Invoice Prefix that can be added to the beginning of the invoice number for this provider. Example: EMS for EMS Services or W for Wheelchair (EMS1234, W1234)

Invoice Postfix: Optional Invoice Postfix that can be added to the end of the invoice number for this provider. Example: EMS for EMS Services or W for Wheelchair (1234EMS, 1234W)

Default Statement Delivery Method: Print or Electronic.

Select Print if the statements will be printed and mailed from the agency.

Select Electronic if the statements will be sent to Zirmed for statement printing and mailing. This is an additional service that must be subscribed to.

Balance Forward Minimum: Enter a remaining invoice amount that is the minimum to allow for a balance forward. Example: If 25 is entered, the remaining balance of an invoice, after payments, has to be at least $25.00 to balance forward to the next payer.

# of Days to Hide Invoices Without Activity: Enter the # of Days to hide invoices on the A/R Management page. Invoices have had an activity in this # of days will not be seen on the A/R Management pages. Example: If 30 Days are entered, if a payment is received on 5/1, it will not be seen on the A/R Management page until 5/31.

# of Days to Hide Final Dunning: Enter the # of Days to hide invoices on the A/R Management - Final Dunning page. Example: If 30 Days are entered, if the final dunning is sent on the statement dated5/1, it will not be seen on the A/R Management page until 5/31.

Wait Time Threshold (In Minutes): Enter the # of Minutes of Wait Time. A Warning will display on Claims Edit when this Wait Time has been exceeded. Example: If 30 Minutes are entered, and wait time is calculated at 45 minutes, a warning will be seen on the claims edit page.

Number of Crew Members Threshold: Enter the normal # of Crew Members. A Warning will display on Claims Edit when this Crew Member limit has been exceeded. Example: If 2 Crew are entered, and Crew on the ePCR is 3, a warning will be seen on the claims edit page.

Use Mileage: Use Geo-Coded Mileage or Use Documented Mileage. Select Use Geo-Coded Mileage to use the shortest distance between the Transport From and Transport To Facilities. Select Use Documented Mileage to use the mileage documented on the ePCR.

Max Allowed Group Code/Reason Code: CO, OA, or PR. Select the Group Code to use and Reason Code. This information will be used during the EDI of a Subsequent Invoice when the Primary Payment was NOT and ERA.

Example: If CO is selected as Group Code and 45 as Reason Code, when the EDI File is created the Primary Payers Max Allowed Adjustment will be included in the EDI file with this information.

Patient Responsibility Amount Code/Reason Code:  CO, OA, or PR. Select the Amount Code to use and Reason Code. This information will be used during the EDI of a Subsequent Invoice when the Primary Payment was NOT and ERA.

Example: If PR is selected as Amount Code and 2 as Reason Code, when the EDI File is created the Patient Responsibility (Difference between Primary Payment and Max Allowed Amount) will be included in the EDI file with this information.

RFI Text Message: Enter the text to appear on the Request for Information Report that is sent to patients.

RFI Return Address: Enter the address that the Request for Information should be sent to. This should only be added if different that Provider Address.

Corporate Provider: Provider assigned to non-invoice specific entries. For Example: CAR, Interest, Settlement, Penalty.

Validate CAD Facility has HealthEMS Facility Transport Code: This option is checked to confirm that the Transport From/To Facility entered into CAD has a corresponding Facility Transport Code. This would be used when the Transport From/To is selected to come from CAD on the RevNet Configuration page (Navigate to Setup -> RevNet -> Configuration). Transport Codes are found under Setup -> Facility Transport Codes.

Skip RevNet Processing: Check this Box to Skip RevNet Processing for this Provider

RevNet Processing Start Date: Enter the Date of Service to start processing ePCRs into RevNet for this Provider.

Provider - Mileage Offered

The Mileage Offered tab shows the different types of mileage (Land, Fixed Wing Air, Rotary Wing Air, Other)offered by the provider, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

Provider - Services Offered

The Services Offered tab shows the different types of services (ALS1 Emergency, ALS1 Non-Emergency, ALS2 Emergency, BLS Emergency, BLS Non-Emergency, Canceled Wheelchair W Assist, Fixed Wing, Other, PI - Paramedic Intercept, Rotary Wing, SCT - Specialty Care Transport, Water Craft, Wheelchair W Assist, Wheelchair W/O Assist, BLS NE Treat-No Transport, BLS E Treat-No Transport, ALS NE Treat-No Transport, ALS E Treat-No Transport) offered by the provider, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

Provider - Medications Offered

The Medications Offered tab shows the different types of medications offered by the provider and they charge for, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

Provider - Supplies/Other Items Offered

The Supplies/Other Items Offered tab shows the different types of supplies/other items offered by the provider and they charge for, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

Add New Provider

To add a new Provider, click [Add Provider...] and complete the required fields. The provider will not be able to bill for services until all the billable items (marked by the $) are completed. Once the $ turn to $, the provider can bill.

Copy Existing Provider to New Provider

To use an existing provider as a template to add a new provider, use the action item list drop down and select Copy Provider to New. Update Provider Info as needed and click save. All Provider Info, Mileage Offered, Service Offered, Medication Offered and Supplies/Other Items Offered will copy to the newly created Provider.



		*Payer/Provider - Provider*
		Navigate to: Setup -> RevNet -> Payer/Provider -> Provider


		*Provider*
		This page allows for the setup of multiple providers and provider ids for different types of services. The number of providers setup depends on the number of providers IDs each agency has. For Example, there may be a different provider name/id number for Emergency Medical Services than for Wheelchair services. The Current Providers section shows the Provider Name, Address, National Provider ID and Tax ID # of the listed providers.


		*Provider - Provider Info*
		Click on the Provider Name to see additional details regarding the provider.

		Name: Name of the Provider. Address 1: Address 1 of the Provider. Address 2: Address 2 of the Provider. City: City of the Provider. State/Providence: State/Providence of the Provider. Zip: Zip Code of the Provider Country: Country of the Provider. Phone: Phone Number of the Provider. Direct Message Address: Address provided by PCDS during implementation of EMR to EMR. Payable To: Checks should be marked Payable To this name. Natl Provider ID: National Provider ID Zirmed Account Number: Assigned by Zirmed. Tax ID #: Tax ID # assigned to the Provider. Invoice Prefix: Optional Invoice Prefix that can be added to the beginning of the invoice number for this provider. Example: EMS for EMS Services or W for Wheelchair (EMS1234, W1234) Invoice Postfix: Optional Invoice Postfix that can be added to the end of the invoice number for this provider. Example: EMS for EMS Services or W for Wheelchair (1234EMS, 1234W) Default Statement Delivery Method: Print or Electronic. Select Print if the statements will be printed and mailed from the agency. Select Electronic if the statements will be sent to Zirmed for statement printing and mailing. This is an additional service that must be subscribed to. Balance Forward Minimum: Enter a remaining invoice amount that is the minimum to allow for a balance forward. Example: If 25 is entered, the remaining balance of an invoice, after payments, has to be at least $25.00 to balance forward to the next payer. # of Days to Hide Invoices Without Activity: Enter the # of Days to hide invoices on the A/R Management page. Invoices have had an activity in this # of days will not be seen on the A/R Management pages. Example: If 30 Days are entered, if a payment is received on 5/1, it will not be seen on the A/R Management page until 5/31. # of Days to Hide Final Dunning: Enter the # of Days to hide invoices on the A/R Management - Final Dunning page. Example: If 30 Days are entered, if the final dunning is sent on the statement dated5/1, it will not be seen on the A/R Management page until 5/31. Wait Time Threshold (In Minutes): Enter the # of Minutes of Wait Time. A Warning will display on Claims Edit when this Wait Time has been exceeded. Example: If 30 Minutes are entered, and wait time is calculated at 45 minutes, a warning will be seen on the claims edit page. Number of Crew Members Threshold: Enter the normal # of Crew Members. A Warning will display on Claims Edit when this Crew Member limit has been exceeded. Example: If 2 Crew are entered, and Crew on the ePCR is 3, a warning will be seen on the claims edit page. Use Mileage: Use Geo-Coded Mileage or Use Documented Mileage. Select Use Geo-Coded Mileage to use the shortest distance between the Transport From and Transport To Facilities. Select Use Documented Mileage to use the mileage documented on the ePCR. Max Allowed Group Code/Reason Code: CO, OA, or PR. Select the Group Code to use and Reason Code. This information will be used during the EDI of a Subsequent Invoice when the Primary Payment was NOT and ERA. *Example: If CO is selected as Group* Code and 45 as Reason Code, when the EDI File is created the Primary Payers Max Allowed Adjustment will be included in the EDI file with this information. Patient Responsibility Amount Code/Reason Code: CO, OA, or PR. Select the Amount Code to use and Reason Code. This information will be used during the EDI of a Subsequent Invoice when the Primary Payment was NOT and ERA. *Example: If PR is selected as Amount* Code and 2 as Reason Code, when the EDI File is created the Patient Responsibility (Difference between Primary Payment and Max Allowed Amount) will be included in the EDI file with this information. RFI Text Message: Enter the text to appear on the Request for Information Report that is sent to patients. RFI Return Address: Enter the address that the Request for Information should be sent to. This should only be added if different that Provider Address. Corporate Provider: Provider assigned to non-invoice specific entries. For Example: CAR, Interest, Settlement, Penalty. Validate CAD Facility has HealthEMS Facility Transport Code: This option is checked to confirm that the Transport From/To Facility entered into CAD has a corresponding Facility Transport Code. This would be used when the Transport From/To is selected to come from CAD on the RevNet Configuration page (Navigate to Setup -> RevNet -> Configuration). Transport Codes are found under Setup -> Facility Transport Codes. Skip RevNet Processing: Check this Box to Skip RevNet Processing for this Provider RevNet Processing Start Date: Enter the Date of Service to start processing ePCRs into RevNet for this Provider.

		*Provider - Mileage Offered*
		The Mileage Offered tab shows the different types of mileage (Land, Fixed Wing Air, Rotary Wing Air, Other)offered by the provider, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

		*Provider - Services Offered*
		The Services Offered tab shows the different types of services (ALS1 Emergency, ALS1 Non-Emergency, ALS2 Emergency, BLS Emergency, BLS Non-Emergency, Canceled Wheelchair W Assist, Fixed Wing, Other, PI - Paramedic Intercept, Rotary Wing, SCT - Specialty Care Transport, Water Craft, Wheelchair W Assist, Wheelchair W/O Assist, BLS NE Treat-No Transport, BLS E Treat-No Transport, ALS NE Treat-No Transport, ALS E Treat-No Transport) offered by the provider, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

		*Provider - Medications Offered*
		The Medications Offered tab shows the different types of medications offered by the provider and they charge for, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

		*Provider - Supplies/Other Items Offered*
		The Supplies/Other Items Offered tab shows the different types of supplies/other items offered by the provider and they charge for, the Usual and Customary Rate charged by the provider and the Effective Date of that rate. It is important to note that this is not any kind of negotiated rate or a rate that is expected to be received, but the usual and customary charge that goes for all payers.

		*Add New Provider*
		To add a new Provider, click [Add Provider...] and complete the required fields. The provider will not be able to bill for services until all the billable items (marked by the $) are completed. Once the $ turn to $, the provider can bill.

		*Copy Existing Provider to New Provider*
		To use an existing provider as a template to add a new provider, use the action item list drop down and select Copy Provider to New. Update Provider Info as needed and click save. All Provider Info, Mileage Offered, Service Offered, Medication Offered and Supplies/Other Items Offered will copy to the newly created Provider.