Resource Center
Nightingale Practice Management (RidgeMark) FAQ's
- What is the difference between billing and rendering in the Provider ID table?
- What is the difference between the folders in SecureConnect? What’s the archive section for?
- I want to send electronic claims to a new payer that we haven’t sent claims to before. What do I need to do?
- I would like to send secondary electronic claims. How do I do that?
- What is the Revenue Management Meter?
- How do you print an encounter form for a selected appointment?
- Is there a way to verify Correct Coding Initiative (CCI) when you are posting charges?
- How can I manage my Accept Assignment exceptions?
- How does RidgeMark handle taxonomy code exceptions?
- How do you view future appointments for a patient?
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What is the difference between billing and rendering in the Provider ID table?
Answer: The Billing provider is your group ID number, or the number you would normally put in Box 33 of your HCFAA claim form. The Rendering provider is your individual ID number, or the number you would normally put in Box 24J of your HCFAA claim form.
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What is the difference between the folders in SecureConnect? What’s the archive section for?
Answer: The “New This Session” folder is the default folder when SecureConnect opens. This shows you any new claims or reports that you have not seen while previously in the program. The archive folders are there to store older information you don’t readily need to see in SecureConnect. This can be used to save reports, claims, etc in case the information is needed at a later time. You also have the capability of purging archived items using the archive wizard in SecureConnect. Keeping those folders cleaned up helps SecureConnect run more smoothly, and makes it easier to locate any stored/archived data.
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I want to send electronic claims to a new payer that we haven’t sent claims to before. What do I need to do?
Answer: Check your payer list in SecureConnect to see if the payer requires enrollment. If so, you will need to contact Nightingale’s Enrollment department to get set up. If the payer does not require enrollment, you will need to add the payer ID to the insurance in RidgeMark in the Organizational Payer ID field. Also, you will need to change the default form types to reflect electronic claims instead of paper claims.
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I would like to send secondary electronic claims. How do I do that?
Answer: Refer to the training materials for electronic secondary claims setup on our Training Campus website ( www.vmcampus.com ) to see what steps are necessary to send accurate claim information on electronic secondary claims.
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What is the Revenue Management Meter?
Answer: The Revenue Management Meter reflects your total payments and adjustments divided by total charges, which represents how well you are doing with your collections. The meter color will be blue unless the value falls below the Revenue Index Threshold (which can be set in the Site Setup area), in which case the color meter will be red to alert you of a low collections index. The default threshold will be set at 90%.
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How do you print an encounter form for a selected appointment?
Answer: You can print an Encounter form for any selected appointment by pressing the Ctrl+P key combination. This will open the Appointment Merge Letters/Forms screen (pre-populated with the patient’s name) to allow you to print Encounter forms for the selected time slot.
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Is there a way to verify Correct Coding Initiative (CCI) when you are posting charges?
Answer: CodeWizard allows users to verify Correct Coding Initiative (CCI) edits during Charge Posting. There may be occasions, however, when you would like to check the CCI edits after posting all charges for a given day. For instance, you may want to check all charges posted at the end of the day to catch any coding errors that were accidentally missed. The Code Validation Report allows you this flexibility. The Code Validation report, which requires the Claim Scrubbing module, allows users to run a report for all charges posted for a given date and given user. Users can select which CCI edits to apply: Procedure, Diagnosis, Modifier, or Place of Server (these are all checked by default).
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How can I manage my Accept Assignment exceptions?
Answer: To manage the accept assignment flags, you should use the Accept Assignment Exception table. When claims are generated, RidgeMark determines the value of the Accept Assignment Flag using a hierarchical logic. The patient level ‘Accept Assignment’ is the highest level in this hierarchy. If the Accept Assignment is set to either C or P, then there is no further analysis. If the patient level Accept Assignment flag is either A or B, then RidgeMark checks the Accept Assignment Exception logic to determine the value to place on the claim (Accept Assignment exceptions will overwrite the patient level Accept Assignment value).
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How does RidgeMark handle taxonomy code exceptions?
Answer: Taxonomy code exceptions work similar to the Accept Assignment exceptions. When a taxonomy code is required that is different from the default taxonomy code (located in the provider details screen), the Taxonomy Exceptions logic can be used. Exceptions at the lowest granular level (Insurance, Provider, and CPT codes are all defined) will take precedence over exceptions defined at higher levels of granularity. Any exception found will take precedence over the default value set in the Provider Details.
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How do you view future appointments for a patient?
Answer: While parked on a scheduled appointment, press the ‘Ctrl+F’ key combination. From this screen, you can print out a list of all future appointments for the patient.