IINSIGHT 6.6.5 brings you the below amazing key highlights:
PRODA Integration (AUS region)*Currently PRODA Integration only exists for Medicare and DVA services*
Historically providers delivering Medicare, receive the full payment from the client and the client then seeks their payment amount directly from Medicare (where you provide the invoice and payment record for their claiming purposes).
Using PRODA, Client claims for Gap Payments can be processed along with the Provider Claim, and paid directly to the client so that Providers do not have to do anything but simply invoice the Medicare billings.
With this release we now have the ability to connect iinsight® with PRODA, to be able to interact automatically with Medicare and DVA.
This article will cover the following areas relating to the setup and implementation of the PRODA Integration with iinsight®:
Setting up a "device" for iinsight® in PRODA
Before setting up anything in iinsight®, first a device will need to be created in your PRODA interface.
Should you not already have a PRODA account, this can be created and appropriate services selected via the following link:
In your PRODA interface under B2B Devices create a new device for your iinsight® PRODA Integration by clicking Register New B2B Device:
IMPORTANT: PRODA use the term device to describe a physical server, virtual server, or even a desktop computer; that is hosting software that utilises the PRODA authorization pattern. For your PRODA Integration, iinsight® will only need a single "device" to be created and registered.
Once creation is completed, make a note of the following PRODA values for this new device and your PRODA interface:
Device Activation Code
Device Name
PRODA RA (Registration Authority
Please note at the time of creating the new device this will show as "Inactive". This is ok and will be activated in the next stage when you connect your iinsight® platform.
Linking your PRODA device with iinsight®
In your iinsight® platform, in the Options > Financial Settings > PRODA tab, enable the checkbox for "Enable PRODA Connector":
And enter the settings gained from the new device created for iinsight® in PRODA (outlined above), into the Device Settings:
Once input correctly, select Activate Device:
If successful, a message stating "PRODA device was activated." should be displayed under the activate button:
Should you click Active Device again, once the connection is already activated, a message of "PRODA device is already activated" will be shown instead:
If there are any issues with the connection a warning message of "Unable to activate PRODA device, please check system logs" will be shown:
Should this occur, please check the details you have entered for the Device Activation Code, Device Name and PRODA RA are all correct (outlined here).
If this occurs on an already previously successfully activated connection, further information may also be found in the Message Center notifications and System Logs.
Device Expiry and Extended Date
Every so often PRODA needs to be informed that the device created in the PRODA interface is still in use.
The Device Expiry is shown under device settings in the and an additional 30 day warning, with the number of days remaining until expiry, will be displayed when this device is approaching the expiry date:
The only thing that needs to be done when this date is approaching, is to log into your PRODA interface and "extend" the Device Expiry Date of the device you are using to connect to iinsight® in the Device Details by clicking the button Extend B2B Device Expiry:
Should this date and the alerts be missed, the device will expire and the connection to you PRODA interface will be disabled.
In this instance the message shown will be different and request that a new Device Activation Code is created for the device in the PRODA interface:
Should this occur, log into your PRODA interface to generate a new Device Activation Code for the device you are using for your iinsight® connection, insert this into the Device Activation Code in the Options > Financial Settings > PRODA area, and click Activate Device to re-activate the connection:
Activating PRODA Services
Once you Create a PRODA login using the above link then, please see the attached Step by Step guide provided by PRODA to set up/ register your organization.
Click Here: PRODA Step by Step guide.pdf
Once Organization is activated in the PRODA portal, please link Medicare Online/ECLIPSE/DVA/AIR Service in the Service Provider section as shown in the above-attached guide.
NOTE: In order to activate Medicare Online/ECLIPSE/DVA/AIR Service, you are required to have a Minor ID, which will be provided by iinsight® while enabling the PRODA for you from the backend.
FYI: If you have multiple clinics/offices, each location will have a different Location ID/Minor ID.
IMPORTANT: As the PRODA team instructed, the provider must complete the “HW027.1709 - Online Claiming Provider Agreement” Paperwork to be registered for Webservices and the “HW052.2106 - Bank account details for Online Claiming” form based on location/s and Service Provider Number/s to be able to claim successfully.
If this paperwork has not been completed and submitted, then PRODA won’t be able to successfully complete the bulk bill claim. Please find those forms available in the links below:
Important Notes:
1. Only one “HW027.1709” form and a minimum of one “HW052.2106” form are required. However, many HW052.2106 forms are required for other/additional locations/clinics (e.g., for an organization that has five office locations, then five HW052.2106 forms are required with five different Location IDs/Minor IDs along with one HW027.1709).
2. Each Location Service Provider Number must be linked to the correct Location ID/Minor ID, otherwise, the claim will fail.
PRODA recommends completing those forms as soon as possible with the correct information as it can take up to 2- 4 weeks for this to be processed and confirmed. Once approved you can claim billings successfully.
Enable a Service Contract with the PRODA Services
Once you have linked your PRODA Connector successfully (outlined above), the appropriate PRODA service(s) can be linked to your Service Contract(s) in the Service Contract > Options tab via the PRODA Service drop-down menu:
Please Note: You can only link one PRODA service at a time to a Service Contract.
Important Note: The large majority of iinsight customers will be delivering Medicare and DVA Services as Specialist Providers and not Generalist Providers. As such iinsight Service Contracts should be set up under either the "Medicare - Specialist" or "DVA - Specialist" PRODA Service Type depending on whether the provider delivers Medicare and/or DVA services.
After successfully linking a PRODA Service to your contract, additional buttons for Show/Hide fields and PRODA templates will be displayed:
Show/Hide PRODA Fields
In the Show/Hide Fields window, you have the ability to set with PRODA Fields are displayed in certain areas of your iinsight® platform:
Case List
Invoices
Billing
Users
These can be enabled / disabled per PRODA service per Service Contract using the checkboxes next to each field:
IMPORTANT: Mandatory fields marked with an Asterix "*" cannot be disabled.
As an example, please find below how these new PRODA related fields, if enabled, would show up at the bottom of the Billing window for users when creating their costs:
PRODA Templates
Templates for each of the PRODA-related transaction types can be uploaded and managed in the main Templates area under the PRODA Templates tab:
+New will open the "New Finance Template" window allowing you to upload a new template for a transaction type.
Open will open the selected finance template in MS Word for editing
IMPORTANT: please note this requires the Office add-on for Windows or for Mac to be installed.
Edit will open the "Edit PRODA Template" allowing the details and certain settings of the PRODA template selected to be edited.
Delete will delete the selected PRODA template from IINSIGHT.
Once created and uploaded in the templates as outlined above, the PRODA Templates can be assigned to a Service Contract in the Options tab using the PRODA Templates button:
This will open the PRODA Templates window where the templates from the PRODA Transactions can be selected for use:
In addition to setting the PRODA Template globally for all cases under the service contract, these can also be set uniquely, should it be required, at the Case level in the Case List > Accounts tab via the new PRODA Templates:
For specific PRODA services, the PRODA Payment Report and Processing Report can also be accessed and printed via the PRODA process and PRODA report buttons in the Case List > Accounts tab:
PRODA Connection Send Logs
All created invoices will be sent as an individual PRODA Service claim and the results for these can be checked in the Finance > Financial Integrations tab:
Any rejected or failed claims will also be displayed in this table, and following corrections, can be resent using the Resend button for the line item:
Case List > PRODA tab and Medicare Patient Verification
In the Case List > PRODA tab you can check whether the patient is eligible for the Medicare claim or not by clicking on the Check Patient button:
In the Case List > PRODA tab to be able to lodge a claim successfully you are required to fill all the mandatory fields with “*” Asterix:
Additionally, the Gender, Service Provider No. and Company Time Zone (Only for DVA service) is mandatory to fill out to lodge a claim successfully.
Gender:
The Gender field will be under the Case Add… tab on Case List.
Service Provider No.:
The Service Provider No. of each user will be under each team and can be added via Menu > Admin > Manage Teams.
Note: Service Provider Numbers are location-based identifiers for staff delivering services claimable through PRODA. E.g., A staff member delivering services at multiple office locations will need to have multiple Service Provider Numbers (registered with Medicare/DVA) across multiple teams added as per below:
Company Time Zone (Only for DVA service):
Company Time Zone can be added via Options > Financial Settings > Company Time Zone.
FYI: With the Medicare Specialist service type it is Mandatory to fill in “Referral override Code” which will be in the PRODA tab or “Self Deemed Code” which will be in the billing window when you enable this field in the service contract.
Note: Both “Referral override Code” and “Self Deemed Code” must not be filled together for a case. Self Deemed Code must not be set when the Referral override Code is set in the PRODA tab. If data exists in both areas claim will fail.
Tyro Integration
Tyro integration allows for accepting payments easily using the Tyro terminals, with no need to type the amount to be paid the invoice number, or other values. For this integration, we have used “Medipass”.
https://support.iinsight.biz/hc/en-us/articles/5704429845135-TYRO-INTEGRATION-FEATURE-
NDIS Bulk File Report Enhancements (AUS Region)
2 new fields have been added to the NDIS Bulk File Report for Claim Type and Cancellation Reason, to use when making claims to the NDIA via the NDIS Portal.
The list of codes for Claim Type and Cancellation Reason will be initially prepopulated according to the current NDIS requirements. Should you need to add your own values to the list, this can be done in the Options > Common List area, via the Claim Type and Cancellation Reason list types area:
The Claim Type and Cancellation Reason can be set against your activities/items in the Charges > Service Contracts area by using the associated columns in the standard list table:
IMPORTANT: Please note there is a setting in the Service Contract > Options area called for Enable NDIS Services Selection which will need to be enabled before you can use the Claim Type and Cancellation Reason fields.
Outlook Calendar Integration Enhancements and Fixes
Several Outlook Calendar Sync enhancements have been made in 6.6.5 to aid in recognition of organisers vs attendees of events created.
These changes have been made to resolve issues reported by some users where outlook appointment duplications were being created after synchronisation.
External Forms Enhancements
In External Forms 2 new field types have been added specifically for Phone and Email, to allow for more fluid population and validation of this data more in your forms:
HR Module
A reminder that there is an awesome and very versatile HR Module now available for the HR Staff to use (which is locked down by specific user permissions).
Please see the below link for full details: