Home Forums Discussions Feedback and Recommendations Highlight if patient has secondary insurance

My office staff brought this up on v5 today. It has been a pretty uneventful transition so far. Of course, eRx isn't up and running yet and changing the way we enter medications and allergies is much more time consuming.

Apparently in v4, the primary and secondary insurances were easily visible from the demographics screen without any extra clicks. Now, they have to click on secondary insurance on every patient to make sure they don't have one. She was just wondering if they could have highlighted secondary insurance, or made it a different color, or put some symbol on the tab to let you know that information has been entered in the secondary insurance fields. I guess during clinic today, they forgot about it until the patient told them that they had a secondary (which they did and it was already entered in AC).

Sure, it's very simple but just a little thing to make the flow better for the staff. I told them to suck it up and just make the extra click everytime to make sure they don't have a secondary.

1. Being able to add the allergies at the visit, is a great improvement. Why is it more time consuming?

2. You will love ePrescribe.

3. How is this for a workaround? While in Demographics, click on Miscellaneous Info. This will show you the Set Flags on the right. Click that, and click on Set Up Categories. That will take you to the admin section (because Jon knows how you like the extra clicks ). Once there, add a flag like "2nd Insurance or even just 2nd." Save it and go back to Demographics. (You will only need to set that flag once) Now, if they enter a secondary insurance, they should click on Miscellaneous Info. Click on the flag and select the box next to 2nd Insurance. This will put a flag on the Miscellaneous Info tab AND at the top left. Simply hovering over the flag at the top, will show you what was selected, i.e. <<2nd Insurance>>.

If you have no other reason to set flags in demographics, the mere presence of the flag would indicate a secondary insurance. The strange thing is if you have other flags selected such as "Patient doesn't like to pay co-pays," there is no new flag. You just have to hover over it or click on it to see what is there. So, this can put a hole in the system, but if you decide to only put one flag there, you will be all set. The whole process is pretty quick and takes four clicks.

It will also put the same flag on the little information window at the bottom left of the MAIN window. This is where the patient's name, DOB, and last seen information is. His or her primary insurance is there. So, you can hover over that flag and see that he or she has secondary insurance. Finally, when you get in the chart, there will be a flag at the top left. Again, hovering over it will show that he or she has secondary insurance. So, there will be three places that should warn you. In the demographics, at the main window when the patient's name is highlighted in the Patient List or in your Inbox.

I actually kind of like the idea of letting me know the insurances when I am in the chart. Hovering over it to see it is Aetna/Mainecare or Mainecare will save me from having to lean over, grab the clipboard, lift up the WCC form and see what the insurance is underneath. Plus, I tend to miss the secondary insurance, although ironically, my staff does highlight the secondary insurance in yellow. The only thing now would be if we could change the colors of the flags.

good workaround overall. I'll throw it at the staff and see what they think. They're just going to whine about extra steps because we just got our PM system to transfer all of the demographics data into AC by .hl7. Now after they do that, they will have to open the pt in AC and add the flag. They are never happy (and neither am I).

Allergies? Your right, not much more time at all but getting the staff to remember to click the "A", then click the allergies or enter them has been more difficult than it should be. If the patient doesn't have allergies, they just forget to put that in because there is not a blank box. They'll get used to it. Orders on the other hand are a major work in progress.

Orders has made me forget about the letter writer.

I do like the fact that the allergies show the exact time it was entered. Very important. <sarcasm>

I think the date would have been sufficient.

Agreed. The orders section is mind-numbing. For the life of me I can not figure out really smooth way to do orders yet. Does the "reconcile to order" even work?

I guess it took the orders section to make me appreciate the letter writer in it's simplicity.

How long does sure scripts take after faxing them a sheet to get going with eRX? It's been 5 business days and no word.

At least I am saving me and my patients a lot of money, because any time I put the mouse pointer over the Orders icon, my hand trembles, and I think, "Do I really need this test?" Then, I take the point off and take a deep breath.

v4's orders were SOOOOO much easier.

As far as SureScripts, it should not be taking this long. First thing I should ask you is, are you going by the Interfaces screen? I have been ePrescribing for weeks, and it still says that NewCrop is inactive, and it always will. So, don't judge it by that.

Once you get your verification code, enter it and activate. Make sure your Practice Name is identical, and you abbreviate your state name.

I also am assuming you are subscribed to Maintenance & Support.

If it doesn't work, then 1) email them tomorrow asking for a phone call in the morning. Put your phone number in the email and tell them any time between 8am and 9am is convenient for you. Try pinging them at 9am. I usually have pretty good luck getting through that way. Once you get through to support, they WILL be able to get it set up. For me, it meant support talking to New Crop. It never would have gone through otherwise.

Now, from what you are saying, it may be that you have not received your verification code. Don't go through New Crop or Sure Scripts. Put this all on AC.

Once you enter some orders in the screens it really is easy...people are initimidated, but once you enter CBC, BMP, CMP, PT, PTT, ETC then all you do is go into orders, choose labs, check the ones you want and print/save or send. Reconciliation is still cumbersome and I assume will get better, but orders themselves are really not bad.

In regards to e prescribing - ping support and find out what the hold up is as it should be easy.

I guess we just differ. The orders are horrid. Too many tabs, too many names to change, no matter how well you set it up in admin section. And, the ICD-9 code can be ridiculous as often there is no good ICD-9 code. I then have to go to a website to find it. I doubt I will ever like it.

I just use the other button and then use my templates. The only issue is the ICD-9 code. I am thinking about just writing it in, yuk, or typing it in which leaves the ICD-9 field blank.

I have just resorted to doing ICD 9 codes as a force of habit to make coding easier (wife is coder, trying to keep her happy), unfortunately more and more facilities want you to code it before they will do it - I love prior auths that want me to put down CPT code of MRI Brain with and without contrast to get approval ---- not my specialty. In regards to just putting in diagnoses - uncheck at top and after the lab you want just type in symptom/reason EG CBC ANEMIA SCREEN, or whatever. If your facility takes it then that is okay. I just like how the orders are put in the plan other than the fact that line 1 does not line up (I know - many versions all with poor formatting issue - I did talk with programmer about it).

If you want to just go to custom orders and template orders that is fine. Just some type of method of standardized orders is a help and will eventually make it so some method of reconciliation can be done.

I never did templates for orders so I found myself just typing out a long list of lab orders each time and so this is better in my mind.

Besides - no one is going to get mad at you Bert about not using orders, it is up to you.

Fair enough. My issue is mainly why can't we get ICD-9 codes that are accurate and helpful. It is just difficult to sit there and try to find an ICD-9 code and finally just give up. I can search for it in an online site and find it immediately, so I know they exist.

For the CPT codes of the tests, I have entered those in at the end of the order. So: CT Abdomen with IV/Oral Contrast (74160). Works for the common tests that I have in the orders.

The ICD-9 thing is the painful part. Just painful. I have no clue what the ICD-9 code is and don't want to spend my clinic day searching for it. I enter it off my paper superbill if it's on there but often times I don't have the superbill after the appointment.

I also don't like to have to use the drop down menu to select someone to send it to, especially when I never send it to anyone.

Still, why can't a common list of ICD-9 codes be put in so you could just click "quick list" and your most commone 30 codes be there. Need that for the encouter note as well.

I got the activation code this morning so I should be up and running with eRX. We'll see how that goes.

One more gripe (I know I have a lot of them but my office staff keeps coming up with things that I didn't notice.

When putting in PMHx, my M.A. will right click in the box and we have all PMHx templated for common things. In v5, if she types something in the box first (in the template section) such as Wolf-Parkinson White Syndrome (or something that I don't have a template for), she can't then click on templated items without it deleting the thing she typed. That's annoying. This didn't happen in v4. It would just keep adding things to the list.

Of course the fix is to click on all the templated items first, then add on the things that don't have a template at the end. But she usually enters these in alphabetical order so she has to remember to go back and add it to the list.

These little things just get annoying to me. Why would they make it where it replaces anything that you type?

I'm just a grumpy surgeon I guess but there just seems to be changes in v5 that no one ever complained about yet the things we commonly complain about aren't touched.

So no "save and send" on imports, can only type stuff in at the end if your trying to use templates, secondary insurance and referring provider are hidden from the demographics screen without an extra click (I despise extra clicks).

Also, why is the dosage absolutely necessary when entering medications? Patients rarely know their dosages when coming to my office even though they know their medications most of the time. I would like the ability to be able to put "Lisinopril" into their med list and still allow the checker to assure no meds interact with it even though I may not know the exact dosage. Just typing it in defeats the purpose and guessing a dosage is terrible medicine as the hospital may use my list to assist in knowing which medications the patient is on.

Travis,

I can't duplicate your error on the PMH. If I type in Cellulitis and then come back and put the cursor underneath it and use a template, I get:

Cellulitis
Template

Bert. It works that way as well.

What I mean is if you start off with a right click in the PMH and the templates come up. My M.A. was used to having that come up and enter all the data from there. Can't do it there any longer.

Hey Bert, is the import items utility available for v5? I can't seem to find it.

I don't think it is.

Well crap. I've imported in files which suddenly aren't there any longer and it tells me to run the import items utility which doesn't exist. v5 is driving me a little crazy this week.

OK. Anyway I can manually go into imported items and get rid of the empty folders and quit having AC warn me that those files aren't there?

Sorry Travis, I misunderstood your question. I don't know why you couldn't find it. It's right out in the open.

Go to:

CTRL + A -> Login to Administrative Options -> In the Administrative Options window choose Tools at the top left. They will be in the bottom section of the drop down menu.

Awesome. Thanks Bert. Don't let anyone tell you that you're not good for something. I didn't even notice the "tools" at the top of the screen. I'm an idiot sometimes.

Travis, you're a surgon. You can't come out and tell someone, "Ahh...I didn't even notice that little mass up there."

Hey, I think a self-deprecating surgeon is a rare and wonderful thing. It is the docs among us who see themselves as infallible that I worry about.

I agree. Travis is the best. In my many years of Windows, though, I have always taught myself to look up for those tiny Advanced and Tools, lol.

I would hope that I'm a better surgeon than AC user. I did 5 pretty long years of residency to be a surgeon. I'm learning AC on the fly and still less than a year (and I haven't ever spent 140 hours in a week on AC)

I spend 140 hours a week on AC routinely. But, then again, I have never done a hernia repair.

Somehow Bert, I'm sure you figure out a way to spend 140 hours on AC. I prefer to use it in clinic and get out of there.

Of course, lately I've gotten sucked into the EMR world and interfaces and trying to figure out how to make it work and work well (or better than paper). It's pretty interesting once you start figuring out the basics. I'll never be as advanced as you or Indy (but I do have a Droid X)