Idaho Patient Act Integration

*Idaho Patient Act Clients Only*

With the Idaho Patient Act Integration function, you can configure CGM webPRACTICE to support compliance with the Idaho Patient Act, which became effective January 1, 2021. This function defines the Billing Entities, Table Codes, and Default Billing Entities that determine when the Idaho Patient Act Attachment is triggered during Procedure Entry, and the adjustment codes used by the Print/Reprint Idaho Patient Act CSS Letters functions.

Data Field Information

Prompt	Response	Len
Enabled	Select this check box to enable the Idaho Patient Act Integration for your practice. When enabled, the attachment will trigger in Procedure Entry based on the Table Codes and Default Billing Entities configured below.
Adj Code for Letters	Type the adjustment code to be applied when an Idaho Patient Act CSS Letter is printed, or click the magnifying glass to search for the code. The description of the selected code displays to the right of the field.	10
Adj Code for Reprinted Letters	Type the adjustment code to be applied when an Idaho Patient Act CSS Letter is reprinted, or click the magnifying glass to search for the code. The description of the selected code displays to the right of the field.	10

Action Column Functions

Billing Entities - Define the Billing Entities that can be assigned as the Default Billing Entity for Place of Service / Type of Service / Location Code combinations.

Table Codes - Define the Place of Service codes and Type of Service codes that should trigger the Idaho Patient Act Attachment in Procedure Entry. When a procedure is entered with a matching Place of Service and/or Type of Service code, the attachment is triggered.

Default Billing Entities - Define the Default Billing Entity for each Place of Service / Type of Service code combination. The optional Location Code field allows you to define different Default Billing Entities for the same Place of Service / Type of Service code based on the Location Code. For example, if a physician provides surgical services at multiple hospitals, you can define a separate Default Billing Entity for the surgical Place of Service code and each applicable Location Code.

Default Billing Entity Precedence

When determining which Default Billing Entity to populate on the Idaho Patient Act Attachment, CGM webPRACTICE applies the following order of precedence:

Matching Type of Service, Insurance code, and Location code
Matching Type of Service, Insurance plan, and Location code
Matching Type of Service and Location code
Matching Type of Service and Insurance code
Matching Type of Service

The Idaho Patient Act Attachment can default with up to two Billing Entities (one by Type of Service and one by Place of Service).

NOTE: If you use Expanded Procedure Entry, the Location Code entered on any individual line items will also be taken into account when triggering the Attachment.

NOTE: If there are matching Place of Service and/or Type of Service codes defined in Table Codes, but no matching Default Billing Entity, the Idaho Patient Act Attachment will still trigger with a yellow warning icon in Procedure Entry.

Related Functions

Idaho Patient Act Setup & Instructions - Detailed setup steps and sample printed statement in PDF format (Introduction > System Processes).
Procedure Entry - Where the Idaho Patient Act Attachment is triggered for matching procedures.
Generate/Print Patient Statements - Idaho Patient Act statement program.
Print History Statements - Idaho Pt Bal Statements (Type 10) for Idaho Patient Act Clients.
Print Idaho Patient Act CSS Letters - Initial printing of the Consolidated Summary of Service letters.
Reprint Idaho Patient Act CSS Letters - Reprint of previously printed CSS letters.