9.2 March 2007
This release includes multiple feature enhancements to the Plan Modeler as well as a variety of bug fixes and minor enhancements related to features introduced in the Release 2.8.
General
Added support for removing users entirely. Clicking the trash can icon in the user list disables the user entirely. A user record is maintained in the system for HIPAA auditing purposes but is not displayed in the user list.
More information on each report is now included on the Recent Report and Company Report lists. All reports include information on coverage areas, plan, and division selections. Plan Models include some basic global plan settings, such as deductible and coinsurance settings.
Added support for running reports on both paid and incurred dates. Any of the date range fields may be left blank to indicate that the time period should not be limited but at least one starting date and one ending date must be specified.
Added ability to edit report settings, including time periods, coverage area and plan selections. Use the Edit Report Settings link in the sidebar to access the configuration screen.
The date range selection and Regenerate button previously available in the sidebar on all reports has been removed as it does not work properly with paid and incurred ranges. The Edit Report Settings page provides equivalent functionality.
Fixed # Claims being displayed as 0 on title page of all Claims Review reports.
All Enrollee Counts ("# Enrollees") on Claims Review Member Demographic reports are now rounded to the nearest integer. Multiple clients reported that using a decimal number caused confusion.
Plan Modeler
Added support for "Deductible Carry-over" ("Rolling Deductible"). When this option is selected on the Global Settings screen, monies paid by the member to deductible in the three months prior to the model's starting date go to the initial deductible accumulator.
Added support for readjudicating charges in the order they were actually processed based on a processed / adjudicated date. The adjudication order is important because it determines which charges receive deductible and can effect which charges received coinsurance based on out-of-pocket maximums.
Added support for readjudicated ineligible amounts. Previously, benefits that were not covered and dollars exceeding coverage maximums would go to the member's coinsurance. This caused out-of-pocket maximums to be reached with ineligible dollars and resulted in incorrect coinsurance reporting.
The amount of ineligible dollars is now reported on comparison charts and graphs as well.
Added negative charge accumulator adjustments to the Plan Modeler. Previously, negative charges were passed through and included in reports but did not effect deductible and maximum accumulators.
Fixed an issue with deductibles not being processed properly when a copay was set on a benefit category but the deductible was not waived.
Fixed an issue with certain combinations of coverage maximums being calculated on the individual instead of family level. All coverage maximums are now calculated on the family as a whole.
Fixed an issue with deductible being assigned incorrectly on inactive members. This only effected members whose termination date was previous to the first day of the model's reporting date.
Fixed an issue with coverage maximums not being hit properly when the maximum amount is exceeded by deductible assignment. The maximum would not be registered properly until the subsequent charge.