Insurance Management

Summary

This enhancement to Insurance Eligibility allows the National Payer Database (NPD) endpoint to be configurable for all carriers or for a specific set of carriers.

Previously, all NPD calls were made to the URL specified in the System Configuration setting NPDServiceAddress.

With this change, NPDServiceAddress continues to function as the default NPD endpoint, but the Organization Add/Edit Site screen has been reorganized and updated to include configuration for overriding the NPD URL per carrier:

When Applies to all carriers is checked, the control for specifying specific carrier codes becomes disabled. Otherwise, the user can enter the carrier codes for which the alternate NPD URL will apply.

When the NPD call is made as the user works on the studies via View/Edit, Registration or Scheduling screens, details of the NPD call can be viewed via the Help » Console Messages, e.g.:

Configuration Instructions

No System Administrator actions are necessary to enable this feature; however, optional configuration is available:

·         To override the default System Configuration NPDServiceAddress value, use Add/Edit Site to enter the alternate NPD URL and optionally specify specific carrier codes.

This enhancement to the InsuranceServiceTypeRule RIS Lookup Table Editor adds a new Order column to indicate the display order of the rules in an easily readable manner.

Previously, Feature #27832 introduced a new right-click option for the Rule editor to directly insert a new row at a specific location without having to manually adjust the Display Order column. However, the values that appeared in the Display Order column were internal values, used to space out the entries to minimize row changes in the database, which was confusing for administrators of this table.

With this change, the new Order column shows the display order of the rules as a simple 1..n sequence. The existing Display Order column still exists, but no longer needs to be displayed.

Configuration Instructions

No System Administrator actions are necessary to enable this feature.

Summary

This enhancement to Insurance improves the background handling of the A.I. and WebService calls that are part of the Amount to Collect calculation to improve the response time when displaying the results to users once the external data becomes available. Some user actions are also blocked while processing is in progress.

Previously, the only indication to users that something was processing was the hourglass cursor; and users were not prevented from scheduling or saving values while the operation was in progress. These actions must be prevented as the outcome of the AI can change PreCerts that the user has to act upon; and the Scheduling Notes dialog can display an inaccurate Amount to Collect while the operation is in progress.

With this change, a new "Calculating Amount to Collect" label is displayed over the Insurance Policies grid on the Order tab while the Amount to Collect calculation is executing:

While this operation is in progress, users are now prevented from:

·         Clicking the Amount to Collect Details button.

·         Clicking Manage Policies.

·         Clicking Verify Insurance.

·         Entering a manual Amount to Collect.

Configuration Instructions

No System Administrator actions are necessary to enable this feature.