Detailed Differences between CompuMedic and elligence

This document highlights the key differences between DSI's elligence and CompuMedic products. elligence is a totally new product, written "from the ground up." Although elligence contains many of the same general capabilities as CompuMedic, users are cautioned not to make any assumptions that features behave identically or that all CompuMedic features have a counterpart in elligence. This is not an exhaustive list - individual fields are not addressed and some changes may inadvertently have been omitted from this document. Most importantly, this document lists CompuMedic features, and describes the differences in those features, but it does not attempt to do the inverse - it does not list features that are only in elligence.

Database

CompuMedic	elligence
Microsoft Access 97	Microsoft SQL Server 2005 (or free copy of Microsoft SQL Server 2005 Express for up to 5-15 users)
Used for practices with fewer than 20-25 concurrent users	Virtually no limit on number of concurrent users of elligence
Limit of 1GB database	Virtually no limit
Designed for file server use	Designed for client/server use (see below)

Architecture

elligence is designed as a Client/Server application - two or more programs, possibly running on separate computers, work together to perform a task. The client makes a request and the server services the request. The client is a minimal program that is never directly connected to the server. elligence is a "three-tier" client/server application: presentation, business logic and data access are all separate processes that may run on different computers. elligence client machines do not have to be very powerful - they need only be able to run Internet Explorer 6.0 (or later) and a very small client program with almost no resource files.

CompuMedic is a file server application: each time CompuMedic is started, the application is loaded from the server to each client and executed on the client. Client machines must be powerful enough to run the application and must have all the necessary resource files installed; there is a constant connection to the database.

To review Microsoft's system requirements for Internet Explorer 6, please visit the Microsoft web site.

Key advantages of the elligence architecture include:

• A significantly lower chance of mismatched program and resource files
• Virtually no chance of data corruption due to power outages
• Each workstation added to the network has a minimal impact on the performance of the server.

Networking

CompuMedic operates over networks via File-Sharing protocols (this is usually Microsoft's "File and Printer Sharing" and "Client for Microsoft Networks" or Novell NetWare). Data is read and written in CompuMedic directly over this protocol.

elligence operates over http and TCP/IP - the same networking protocols used by your Web Browser, fully tested and used by millions of people worldwide. Data is never directly read or written over the network, which entirely eliminates the possibility for busy networks or faulty network cables to cause database corruption.

Application

CompuMedic, due to its size and the fact that the program is loaded into memory all at one time, is divided up into separate programs to handle aspects such as Define, EMC, Statements, Reports, Scheduling etc. The menus for these separate programs are not integrated together. In contrast, the entire elligence interface is presented to the user under one main window.

All open Windows in elligence are displayed as a series of Tabs across the top of the screen. This makes it easier to access and keep track of all of your open windows.

CompuMedic EDI (Electronic Data Interchange) transmissions are database specific, and EDI transmissions must be performed separately to each destination (payer). In addition, CompuMedic is specifically designed to submit claim files directly to Medicare, to Medicaid in select states, and via clearinghouses to other destinations.

In contrast, elligence has been designed with EDI at its core, streamlining and simplifying the process, and enables a healthcare organization to submit claims, obtain remittance advice electronically, and verify a patient's eligibility for benefits, directly - with virtually every payer in the United States. As part of that vision, elligence allows EDI transmissions to be performed for all databases and all destinations simultaneously, with a single click of a button.

Custom Reports

In CompuMedic, Microsoft Access 97 can be used to write custom reports, or to query a CompuMedic database. elligence features a Custom Query Report menu, which allows the user to run a SQL query against an elligence database to produce a report. In addition, Microsoft Access 2000 or XP can be used to write a custom report.

Since elligence uses the very popular Microsoft SQL Server database engine, custom reports can be generated using the built-in Custom Query Report feature. This extremely versatile utility allows anyone who is familiar with the SQL language to generate custom reports. elligence ships with over 60 Custom Query Reports (CQRs) pre-installed. Data Strategies frequently creates new reports and modifies existing CQRs for clients, although there is a fee for any modifications that require a significant amount of programming.

Data Conversions

Data Strategies has developed a data conversion utility to convert the data from an existing CompuMedic database in Access 97 format to an elligence SQL Server database. For more information on how the conversion works, and what it does and does not convert, please contact your elligence Sales Representative.

Interfaces with Third-Party Products

Existing interfaces with third-party products (EMR systems, handheld prescription writing systems) that are compatible with CompuMedic are being evaluated on a case-by-case basis to determine whether the interface will be implemented in elligence. DSI has adopted the widely-used HL7 (version 2.x) standard protocol for exchanging clinical and administrative data with other healthcare systems. For more information about HL7, please visit www.HL7.org or check out our

Here are some possibilities:

1. A WebDemo: We schedule these at least once per month. You will need a computer with a high-speed Internet connection running Internet Explorer 6.0 or later. You will be given a phone number to dial into and can place the Sales Rep on a speakerphone. During the Demo you will be able to see the Sales Rep's screen.
2. A connection into our server. You will be assigned an Operator name and password and can access elligence as if you were an actual user connecting from a remote location.
3. A visit to an existing client.

.

Each interface is a collaborative effort between DSI and a Partner company. At the time of this writing, elligence interfaces are available for the following Partner Applications:

• RISLogic CS
• JMJ EncounterPro
• SOAPWare
• ChartLogic
• MedicWare and MedicWare Mobile

More interfaces are planned for development. As with all other features described in this document, interfaces for elligence differ from those created for CompuMedic. Consult with DSI for details regarding any specific interface.

Features

Because the elligence architecture is different from that of CompuMedic, elligence uses a different user interface than CompuMedic - even in the many instances where the same or similar functionality exists.

Term	Feature(s)
[Future]	Currently not in elligence but to be added in future releases.
[New]	New in elligence, not previously available in CompuMedic.
[Not Available]	Not planned for elligence.

NOTE: The implementation of any [Future] items may differ significantly from the CompuMedic implementation.

File Menu
File> Open, File > Close

• CompuMedic : Establishes / Ends a connection to the database
• elligence : Logs in to / out of an elligence application Server.

File> Import
File > Export
File > Off-Line

• CompuMedic : Uses DSI's import specifications.
• elligence : elligence supports real-time importing and exporting of information using the industry-accepted HL7 Standard. For more information, please contact DSI.

File> File Maintenance

• CompuMedic : Performs database compact, repairs and rebuilds.
• elligence : No elligence database has ever been corrupted to date, so elligence has no Repair or Rebuild functionality. To ensure high performance in elligence, File Maintenance should be performed periodically within the elligence Database Manager under the Admin menu.

File> Run Exe

• CompuMedic : Allows a program to be launched from CompuMedic. Rarely used.
• elligence : [Not available]

File> Backup

• CompuMedic : Allows database to be backed up.
• elligence : Now under Admin > Database Manager

Define Menu
Define> System Options (referred to as "Database Options" in elligence)

Automatic Data Transfer	[Not Available] In elligence, interfaces are controlled via Admin> Interface Manager
AutoPost EOB, Interest	In elligence, Remittance Files are processed directly from the EDI Manager.
Common Text	For estimates and receipts and any other place that a pre-defined piece of text might save data entry time.
Correspondence Logs	Determines correspondence that is to be logged. CompuMedic displays log entries in the Correspondence Log. elligence logs all available correspondence and displays the results in the Ledger. Not all correspondence types will be available in elligence. Recall documents are logged, after printing, when the user indicates Yes to elligence's prompt: "Update Entries?" Superbills are automatically logged whenever they are printed.
Default Values	Most CompuMedic default values exist in elligence.
Installed Balances	[Not Available]
Late Charges	Available in elligence under Database Options> Billing> Statements
Printing Features	Default forms/statements; elligence "remembers" the user's last selection and uses that as the default value. The Report Practice Name is found under: Database Options> Reports
Default payment type for Transfer of Responsibility	[New] - Transaction> Patient Ledger: elligence allows transfers of responsibility from the Ledger. This is the default value used from the Ledger.
Retaining Data	[Not Available] - elligence does not purge out old data because of the much larger and better storage capacity of SQL Server.
Sales Tax	The procedure for sales tax is not used in elligence. Whereas CompuMedic stored sales tax as a separate procedure from the taxable charges, elligence stores sales tax with the charge. This improvement allows elligence to recalculate or delete sales tax whenever a charge amount is modified or a charge is deleted. ANSI 4010 specifications, mandated by the Administrative Simplification portions of the HIPAA legislation, also required this change. In elligence, the Sales Tax Rate is defined under Define> Primary Tables> ocations. This allows elligence to assess different rates based upon the location of the service.
User Fields	CompuMedic has a fixed number of user fields on each screen; elligence allows the user to have between 0 and 10 user fields on most screens, including EDI Destinations.
Test Results	[Not Available]

Define> Security

CompuMedic	elligence
Operators are defined and stored on a per-database level. If a new employee is hired or an existing employee leaves, it is necessary to go into each CompuMedic database and use Define > Security to add or remove that operator.	elligence handles operators globally; only one visit to the Define > Security menu is necessary to configure an operator for all databases. However, you may still allow for different Security Permissions for different elligence databases.

Define> Revise Fees

• CompuMedic : Allows for mathematical changes to be applied to an entire Insurance fee schedule.
• elligence : Similar functionality is available by using Microsoft Excel 97 or higher to edit fee schedules. This is available via the Import/Export buttons under Define > Secondary Tables > Insurance Plans > Procedure Settings.

Define> Locations, Facilities, Labs

CompuMedic	elligence
These three tables are defined separately	These are all defined under the one category of Locations. The "Facility" and "Location" entities in CompuMedic are now merged into one entity called "Location" in elligence.
Users must often enter both a Location and a Facility on a charge	In Post Charges, there are two fields where a Location may be entered: the "Location" field and the "Outside Lab" field.
	New Fields: "Scheduler Color," enables a new appointment schedule view by Location. Sales Tax Percentage: Allows different sales tax rates for multi-office practices. UB-92: Type of Bill - Characters 1 and 2
	CLIA Number: When posting a charge you may indicate a Location of service for the charge as well as an Outside Lab. When transmitting a claim electronically, elligence will report the CLIA number for any charge whose Type of Service is set to "Diagnostic Lab." If "Outside Lab" is specified, then the outside laboratory's CLIA number is used; otherwise, the CLIA Number for the location of the service is used.

Define> Fee Schedules

CompuMedic	elligence
Fee schedules contain both provider's fees as well as insurance company approved amounts.	There are separate tables for provider fees (default values for Post Charges) and for approved amounts (used in Post Insurance Payments). Provider fees are stored in Fee Schedules and patients may be assigned to a Fee Schedule.
The Fee Schedule Name and default values are defined and then a procedure is tied to one or more fee schedules for both fees and allowed amounts.	As charges are posted, the Fee Schedule is filled in and updated "on the fly." For example, if a patient is assigned to a particular fee schedule and a charge is posted to that patient, elligence automatically updates the patient's fee schedule to include the amount associated with the charge. Allowed amounts are defined under Define > Secondary Tables > Insurance Plans > Procedure-Specific Settings. elligence reads and writes these values automatically whenever Post Insurance Payments is used.
Fee for Service vs. Capitated: Define> Insurance Company: Capitation Tab	Define > Secondary Tables > Insurance Plans > Procedure-Specific Settings.
Accept Assignment: Define> Secondary Table > Insurance Company provided the default value for Patient> Insurance, which in turn provided the default value for the user when posting charges. Applicable only to the patient's primary coverage.	Define > Secondary Tables > Insurance Plans > Procedure-Specific Settings. A separate value also allowed for Supplemental coverages. Stored whenever Post Insurance Payments is used.
Crossovers: Define> Insurance Company provides the default values for Medicare Crossover claims.	Stores crossover information with the patient's coverage whenever Post Insurance Payments is used. That setting is remembered and used as the default value when the next primary insurance payment is posted using that coverage.

Define> Locations, Providers, Referring Doctors

CompuMedic	elligence
Allows a variety of identifiers to be defined and then makes an "educated guess" as to which identifier to use for Medicare, Medicaid or other payer. This worked well when the primary focus is Medicare and Medicaid, and prior to the ANSI 4010 specification for EDI transactions mandated by HIPAA. This caused some practices to have to define the same provider more than once in CompuMedic.	ANSI 4010 mandates the use of a primary identifier (the National Provider Identifier - NPI - when that becomes available) and a secondary identifier that is insurance plan- specific. Provider identification has been re- designed in order to: a) handle direct electronic claims and certain other EDI transactions remittance, eligibility) to any payer b) ensure compliance with the HIPAA-mandated ANSI 4010 file specification; and c) handle the case where a provider may be assigned different identifiers by the same carrier for different locations.
	Allows key identifiers to be defined for each entity - Location, Provider and Referring Doctor. When using the Define > Secondary Tables > Insurance Plans screen, you may indicate which of those identifiers to use for each entity under different circumstances. You may also indicate the Secondary Identifier to use, as well as any overriding value if the plan uses its own identifiers.
	If the operator checks "Use Different Rendering Secondary Provider Numbers for Different Locations," elligence allows the practice to define separate identification numbers for each provider and location for any insurance plan.

Unit Value Billing

In CompuMedic, this feature allows you to specify a Unit Value for a procedure instead of billing by an actual dollar amount. Currently, this is not available in elligence.

Define> Insurance Company

In elligence, this is Define > Secondary Tables > Insurance Plans.

You may now define the Insurance Form template to be used for primary coverage, as well as the template to be used for supplemental coverage. When printing paper forms, elligence will know which form to use based on the Level of Coverage. You may indicate the default value for Accept Assignment when the plan is primary coverage, as well as when it is Supplemental coverage.

CompuMedic	elligence
Courtesy Billing: Has both an Accept Assignment and a Courtesy setting for the balance on any charge.	Now defines "courtesy" as "responsibility" of "insurance" and "does not accept assignment." As a result, elligence does not include a "Courtesy" field. In elligence, Accept Assignment determines whether to include a charge in the "Patient Responsible" column on statements and the elligence Ledger. Therefore, a charge with financial responsibility set to "Insurance," but with Accept Assignment set to "No" will result in a patient-responsible charge displayed on the statement and ledger.
Parent vs. Secondary Companies: Supported under CompuMedic	elligence employs the same concept as CompuMedic. One difference is that elligence only permits entering a limited amount of data for a "child" insurance company (a subsidiary), e.g. the address information. All other data is derived from the "Parent" company.
Unit Value Payment Rates: Yes	Unit Value Payment Rates: No

Billing> Electronic Media Claims> Subscriber Definitions

In elligence this is found under Define> Primary Tables> EDI Destinations. You may edit the settings for any available Destination. Due to the Administrative Simplification portions of the HIPAA legislation, elligence does not employ Translation Tables (for Place of Service, Type of Service, etc.) or Exception Tables (procedures that cannot be billed electronically to specific carriers). However, exclusion of certain procedures can be accomplished via the Electronic Billing screen's Advanced Selections and may be "remembered" for the next claims run by saving the choices as a "Profile" (see below).

File Generation is performed under Billing> Electronic. File Transmission is performed via Billing> EDI Manager

Define> Procedures

To ensure strict compliance with the Administrative Simplification portions of HIPAA, elligence permits an AMA Code, NDC Code, UB-92 Revenue Code and Universal Product Number. Additional procedure codes are not definable at this time.

Default to Patient Responsibility [New]

During Post Charges, sets the default value for financial responsibility to "Patient," regardless of whether the patient has insurance coverages.

Standard Approved:

Stored via Define> Secondary Tables> Insurance Plans: Procedure Specific Settings

Default Diagnoses,
Test Ranges:

[Not Available]

Define> Recalls

In elligence, these are managed under Define> Schedule> Recall Reasons.

Define> Post-op Messages

In elligence, many different kinds of patient messages and alerts are handled in Patient> Messages, Patient> Medical Alerts, and Patient> Notes.

Define> Payments/Adjustments

CompuMedic	elligence
Allows for only one type of adjustment to be used: one that in Period Close reports, debits Adjustments and credits Accounts Receivable (A/R). Based on feedback from some DSI clients, the selection of the payment category is less than intuitive.	Provides a simple list of categories for the payment/adjustment type (cash, check, adjustment, etc).
	Permits an additional category of adjustment to be defined - a so-called "Charge Adjustment." In Period Close reports, this adjustment debits Income and credits A/R. The Charge Adjustment is significant, as it allows for corrections in general ledger totals - if the wrong G/L department is credited with a charge, the user can adjust-off the charge amount to the incorrect department, and add it to the correct department.

Define> Drugs

[Not Available]

Define> Ethnicities

elligence still permits ethnicities to be entered on patient demographics but the selection is made in a pre-filled dropdown box.

Define> Tracer Text

The Insurance Tracer feature has been replaced by a full-featured Collections module.

Define> Format ...

Available in elligence under Define> Primary Tables> Printed Formats. The techniques for formatting in elligence differ somewhat from formatting in CompuMedic. They are described in detail via elligence online Help (Serial number required to access web help.)

Define> Format> Documents
General Documents: Recall Documents:

General documents are created and used via Reports> Correspondence> Patient Recall documents are created and used via Reports> Correspondence> Recall. In both cases, this feature requires that MS Word be installed on the client computer. A Word template is created and then data from elligence is merged into that document as part of a mail merge.

Delinquent Documents:

The elligence Collections Module replaces all of CompuMedic's delinquency follow-up features.

Define> Format> Forms

The forms formatter in elligence is form-specific. Currently the following forms may be formatted: CMS (formerly HCFA) 1500, CMS 1450 (UB-92), Statements, Superbills and a few local forms. Formatting of other types of forms is currently not supported.

Insurance Forms:

Formatting of a CMS 1500 form is supported.

UB-92 Forms:

Formatting of a UB-92 form is supported.

Define> Format> Statements

Available under Define > Primary Tables > Printed Formats

Define> Format> Superbills

Available under Define > Primary Tables > Printed Formats

Define > Scheduler menus

Define commands for the appointment scheduling system are available in elligence directly from the Main menu under Define> Schedule.

CompuMedic	elligence
Supports multiple appointment books per database	Supports only one book - time intervals may be set down to 5 minute intervals.
Could NOT search across multiple books	Not applicable
Possible to inadvertently overbook the same provider/resource	Not applicable

Patient Menu
Patient> Demographics

CompuMedic opens a separate window when different sections of the patient's data -- demographics, illness and insurance coverages - are accessed. Viewing all parts of the patient's information in CompuMedic meant opening up a series of windows. In significant contrast, elligence features a more streamlined Patient Folder interface: When a patient folder is opened, each section is readily accessible via a navigation bar. Of course, Security Permissions can still be used to prevent access to certain (or all) sections if desired.

CompuMedic	elligence
Allows a 6-digit account number	Allows a 9-digit account number
Co-pay is entered on demographic screen; can support only 1 co-pay amount per patient	Co-pay is entered on the insurance coverage screen - separately for each insurance coverage
Inactive patients cannot be deleted from system	Allows patients to be deleted if they do not have any activity - a past charge, payment, pending (future) appointment or a queued charge (i.e., a charge that is contained in a batch but has not yet been posted to elligence).

Patient> Insurance Coverages

CompuMedic	elligence
Allows up to nine levels of insurance coverage (i.e., primary, secondary, tertiary and six more) within a coverage group.	Since it was exceptionally rare that insurance coverages 4-9 were used with CompuMedic, elligence allows three.
	When setting up an insurance coverage within elligence, if the patient relationship to the insured is set to "Self," elligence "copies-and- pastes" the relevant information on the patient demographic screen to the insurance coverage being defined. This information is also updated automatically in the insurance coverage if the relevant information on the patient demographic screen is changed.
Employment Coverage checkbox: If checked, CompuMedic retrieves the information regarding the employer as specified in Demographics.	If the insurance carrier selected matches the employer's insurance carrier, then elligence automatically fills in the employer's Group Name, Group Number and Policy Number into the new coverage.

Patient> Illness and Visits

CompuMedic	elligence
There can be many charges related to one Illness, and many Visits related to one Illness.	Visits are called Encounters in elligence.
In CompuMedic, there is no direct relationship between Visits and charges.	There may be many charges related to an encounter, and many encounters may be related to an illness.
Date of Illness	Date of Onset
	A new illness automatically inserts the current date for the Date First Consulted and makes no assumptions about the date of Onset.
Allows 15 diagnoses per illness	Limits the number of diagnoses on an illness to eight (the maximum number allowed in the ANSI 4010 file specification mandated by the Administrative Simplification portions of HIPAA).

Patient>Optometric
Patient>Prescriptions
Patient>Images

[Not Available]

Patient>Correspondence Log

In elligence, instead of a separate Correspondence Log, correspondence is intermixed with other data in the Ledger, in chronological order.

Transaction Menu

Transactions> Post Charges

CompuMedic	elligence
Charge batches may not be saved for later on.	Places each Saved entry into a batch. You may exit the batch and continue later. That batch is then placed into a Charge Queue, which may contain any number of batches. The Charge Queue is an intermediate storage area for un- posted batches which can then be reviewed by a billing supervisor or someone else, prior to posting. In addition, Interfaces that accept charges into elligence, place those charges into files that appear in the Charge Queue.
Authorization Number: CompuMedic stores authorization numbers on the illness; if an illness is used for a charge, then the authorization number is assumed to apply.	elligence allows an authorization number to be entered on each charge; elligence stores a default authorization number on an illness. If that illness is selected, that authorization number is used as the default value for the charge - but may be erased or changed as needed.
Facility and Location are separate fields	Facility and Location are combined into one field, called Location.
Bill insurance as a courtesy is available	Bill insurance as a Courtesy does not exist in elligence. Instead, if financial responsibility for a charge is set to "insurance," then elligence will bill the charge electronically or on an appropriate paper insurance form template. If Accept Assignment is set to "No," then elligence will assume the charge is patient responsibility, and will be displayed as such on statements and the ledger.
Charges in a panel cannot be edited separately	Once selected, each individual charge becomes a part of the batch and may be edited separately (e.g., a modifier added to one charge, but not the others in the panel).
	elligence allows an Outside Lab (a "Purchased Service facility") and an amount equal to or different than the fee to be posted as the cost. The charge amount posted for an Outside Lab represents the "Purchased Service" amount.
	elligence stores the Sales Tax amount, if any, on the charge; if the charge amount changes, the Sales Tax amount is recalculated automatically.
EPSDT, Family Planning and Emergency Fields available on Post Charges screen	In elligence, specialty fields are entered using the "More" button.
Discount - supported in CompuMedic	[Not Available]
Unit Calculator (for anesthesia billing) - supported in CompuMedic	[Not Available]
Treatment Plans - supported (but very rarely used) in CompuMedic	[Not Available]
Recalls - supported in CompuMedic	elligence implements a more sophisticated recall system than CompuMedic. See the elligence Help File: Schedule> Recall Manager.

Transaction > Post Payments
Transaction > Post Group Payments

In elligence, these screens are instead referred to as Post Patient Payments and Post Insurance Payments, and each is specialized for posting different kinds of payments. (The same distinction is made for Unapplied Credits.) In CompuMedic, Post Payments and Post Group Payments could be used for either a patient or an insurance payment. By making a clear distinction between Patient Payments and Insurance Payments, elligence can make each of these features more powerful than before. Here are some of the improvements that result:

• The user can simply click on a checkbox to apply the payment to individual charges; only deductible amounts, changes to allowed amounts and percentages need be entered. The posting process is streamlined.
• AutoPost - the process of posting electronic remittance files ends at the Post Insurance Payments screen. You need only review the data, then click on Post. This dramatically increases the amount of control over the payments and adjustments being posted electronically into elligence.
• Both Post Payments and Post Insurance Payments may be "continued later" for any reason.
• Accept assignment may be entered differently each time a payment is applied against a charge.

Ledger

CompuMedic: The Ledger lists individual events not necessarily in chronological order, e.g., the payment summary.

elligence: A true chronology of events relating to an account - including complete payment and charge detail. Other major improvements include:

• Complete tracking of each billing, payment, adjustment, change of responsibility for each charge.
• Payments appearing when they occurred.
• Integrated correspondence entries.
• Ledger Notes (user entered memos not directly linked to any transaction)
• Transfers of Responsibility, Rebilling, and Refunds are now possible from the Ledger screen.
• Reset a billing by simply deleting the billing item on the charge. It will default back to the previous responsibility.
• Right-click on a payment to see all the accounts and charges that the payment was applied against.
• Expand individual items or all items to see the detail behind them, e.g. expand a charge and see all payment and billing details for the charge; expand a payment to see all charges that the payment was applied against and the amount applied.
• Collapse individual items to remove detail from view.
• Use Options to limit the data that is shown.

Billing Menu

General Differences in elligence:

• Provides for output to a printer or to a file stored in HTML or ASCII format.
• All Billing commands make use of Profiles - the ability to store and retrieve previous settings so that they do not have to be remembered from time to time.
• All Billing menus and reports make use of a common interface for Advanced Selections - criteria that may be used to filter out patients and/or charges.
• Insurance Forms and Electronic Claims make use of an Exceptions Report with hyperlinks available to expedite correction of missing or erroneous data.

Billing> Insurance Forms

CompuMedic	elligence
Allows resetting of charges from the Billing screen	Resetting of any type of billing is performed from the Ledger; when the last billing item on a charge is deleted, the user is asked whether the billing item should be deleted for: Just the charge All billings that relate to the patient The entire billing Removing a billing item "resets" the charge, i.e., tells elligence that the charge was not billed. The responsibility for the charge moves to the prior responsible party and the charge becomes available again for billing to that entity.
Has an "individual" and a "batch" mode. These modes have slightly different behaviors, which is not always obvious to the user.	Currently makes no differentiation between individual and batch. One or more individuals may be selected via Advanced Patient Selections.
	Some New features: You may bill charges that were crossed-over before a specified date A cross-over means that an insurance carrier indicated that it was forwarding the claim on to one of the patient's supplemental coverages. After a certain time period has passed you may wish to bill that insurance carrier yourself. You may exclude Primary Coverages whose carrier may be billed via EMC If checked, elligence will skip any charges that can go out electronically. These would be charges whose current responsible party is to a primary coverage having an insurance carrier with an EDI Destination set. This is the recommended setting.

Billing> Receipts

Found in elligence under Billing> Walk-Out Statements Many of the features that were previously stored as part of the format in CompuMedic are, in elligence, available via the Billing dialog. These features may then be stored as part of a Profile for future use.

elligence creates a more readable explanation of each feature. The user is advised to examine how statements are being printed in CompuMedic or how the user would like them to print and then match those requirements with the capabilities available in elligence.

Billing> Data Entry : [Future]

elligence supports data entry forms, but they're not quite the same as CompuMedic's Billing > Data Entry menu. In elligence, a "Data Entry" form is a billing form (like a CMS 1500 or UB92) that is specialized. In some cases, a payer may require information on the form that is not contained in the elligence database. Of course, it would be impossible for elligence to print that information on the form directly, but Data Entry forms allow the user to type the required information in the boxes "on the fly."

Billing> AutoPost

In elligence, AutoPost is not a separate feature but is instead a core component of the elligence EDI Manager. Remittance files, as well as other types of EDI files from a Destination, are retrieved when the user chooses Send/Receive from the EDI Manager. All files from each destination and for all databases - are retrieved at once and placed into the appropriate folders on the Server. They may then be found in the EDI Manager's Inbox. Electronic Remittance (ANSI 835) files are processed by:

1. Double-clicking on the file or by clicking once on the file and choosing Process. The file is placed into the EDI Manager's In Use folder
2. A Pre-processing report in the layout of an EOB is displayed and may be printed.
3. Clicking Next displays an Exception report if there are any problems with the file or any of its entries.
4. If the file can be processed, clicking Next places the Use