We are currently updating the OP Help Center content for the release of OP 14.19 or "OP 19". OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Update Insurance Contract

Version 14.19

About Update Insurance Contract

Path: Billing tab > Electronic Billing Center > ERA Payments tab > Edit button

The Update Insurance Contract window manages your Insurance Contracts.  The CPT and Modifier columns match the adjudication and the contract.  The Effective Date and Contract Amount come from the Insurance Contract.    

It also displays the difference between the contract amount and the ERA amount.  The Difference column is calculated and color coded for quick reference to show you how much the ERA allowable has increased or decreased from the rate in your Contract. 

  • Green indicates an increase from the Contract amount to the ERA allowable.
  • Yellow indicates that the original Contract amount was zero (a Contract may not have been linked).  If a contract does exist, the specific CPT code and mod do not have values.
  • Red indicates a decrease from the Contract amount to the ERA allowable.

The Update Insurance grid can be printed and exported.

Update Insurance Contract Map

Number

SectionDescription

1

Update Insurance Contract gridThe Update Insurance Contract grid displays the CPT codes and indicates the difference between the contract and ERA amounts for an insurance contract.  Like other grids in OP, you have the ability to organize the information you see and save the settings for your future use.

2

Accept checkboxThe Accept checkbox accepts the adjudication.  By accepting the adjudication, OP will add the new allowable rates to the Contract for that Payer.

3

Hide Zero Contract ValuesThe Hide Zero Contract Values checkbox hides the contracts that are indicated with a yellow difference identifier.  These contracts have a contract amount of zero.

4

Export buttonThe Export button exports the Update Insurance Contract grid as an .xls or .csv file.

5

Print Grid buttonThe Print Grid button opens the NewReport- Print Preview window.  You can export to PDF or print the grid as it appears.
Version 14.10

About Update Insurance Contract

Path: Smart Toolbar > Billing button > Adjudications tab > Contracts button

The Update Insurance Contract window manages your Insurance Contracts.  The CPT and Modifier columns match the adjudication and the contract.  The Effective Date and Contract Amount come from the Insurance Contract.    

It also displays the difference between the contract amount and the ERA amount.  The Difference column is calculated and color coded for quick reference to show you how much the ERA allowable has increased or decreased from the rate in your Contract. 

  • Green indicates an increase from the Contract amount to the ERA allowable.
  • Yellow indicates that the original Contract amount was zero (a Contract may not have been linked).  If a contract does exist, the specific CPT code and mod do not have values.
  • Red indicates a decrease from the Contract amount to the ERA allowable.

The Update Insurance grid can be printed and exported.

Update Insurance Contract Map

Number

SectionDescription

1

Update Insurance Contract gridThe Update Insurance Contract grid displays the CPT codes and indicates the difference between the contract and ERA amounts for an insurance contract.  Like other grids in OP, you have the ability to organize the information you see and save the settings for your future use.

2

Accept checkboxThe Accept checkbox accepts the adjudication.  By accepting the adjudication, OP will add the new allowable rates to the Contract for that Payer.

3

Hide Zero Contract ValuesThe Hide Zero Contract Values checkbox hides the contracts that are indicated with a yellow difference identifier.  These contracts have a contract amount of zero.

4

Export buttonThe Export button exports the Update Insurance Contract grid as an .xls or .csv file.

5

Print Grid buttonThe Print Grid button opens the NewReport- Print Preview window.  You can export to PDF or print the grid as it appears.