Case Binder: Limits (Fusion Enterprise)

  Permissions! Clinic Staff must have Administrator, Billing Manager, Clinical Director, Front Office, Operations Manager, or Staff Therapist Permissions assigned in order to manage Case Binder.

Fusion Enterprise understands that managing all of your cases is a critical function of any practice. We have ensured that you can run all of your practices front office needs through Fusion Enterprise and make it as easy as we can. This series of introductory articles will cover the essential aspects of managing Case Binders with Fusion Enterprise.

Case Binder: Limits

Case Binders allow you to specify Visit or Dollar limits between multiple cases or when you have multiple limits on the same policy (i.e., an authorized number of visits along with a total yearly number of visits).

NOTE: When you have a single case and a policy with only one limit (an authorized number of visits or a yearly number of visits), you will continue to track this within the policy’s Visit Limit area. There is no need to go to the binder to enter it there.

For example, let’s say you have a patient who has 3 cases - 2 PT cases (Knee and Hip) and an OT case (Hand). The insurance for this patient will allow 20 PT visits and 20 OT visits but will only allow a total of 30 visits. The Binder Limits would allow you to define this combination and track it.

Above you see the three limits - 20 OT, 20 PT and 30 Overall.

NOTE: In the example above, the OT Limit would only need to be entered in the binder if the OT policy also had an authorized number of visits already being tracked in the OT policy’s Visit Limit area.

The right-click menu displays the following options:

Limit Menu

Add Visit Limit	Allows you to add a new Visit Limit
Edit Visit Limit	Allows you to edit the Visit Limit that your mouse was over when you right-clicked.
Delete Visit Limit	Allows you to delete the Visit Limit that your mouse was over when you right-clicked.
Add Dollar Limit	Allows you to add a new Dollar Limit
Edit Dollar Limit	Allows you to edit the Dollar Limit that your mouse was over when you right-clicked.
Delete Dollar Limit	Allows you to delete the Dollar Limit that your mouse was over when you right-clicked.
Refresh	Refreshes the current screen and brings in any changes another user may have made while you were looking at the screen.
Close	Closes the screen.

Adding and Editing a Visit or Dollar limit brings up the same screen.

VIsit Limit

Name	This is a name that you create. It is used to help you differentiate this limit from the other limits in the list..
Start Date	Date the limit goes into effect.
End Date	Date the limit expires.
Total Visit Limit	Total visits or dollars in the limit.
Alert when…	Allows you to specify when you will be alerted. In the example above, an alert will be triggered on the 28th, 29th and 30th visits, so you know you are getting close to your visit limit. The drop down allows you to set various conditions.
Cases	This is a list of all of the cases in the current binder. Check the box for each case to which this particular limit applies.
Message	The Message will be displayed when the alert is triggered on patient check-in. This message will be in addition to a standard Alert message indicating where in the limit a patient currently is.
Comment	The optional Comment allows you to specify more information about the alert, such as why it is necessary. This is only visible from this screen and does not appear in the Alert message.

Once you fill in this information and hit OK the limit will appear in the Limit list.