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INCISIVE PM User Manual

1. Stmt Msg Li Kn 100 LU Wm IN JE 521 MTS RODDD21149083 Stmt Cmnt Unapplied amount 0 00 TotcjW 166 26 Tot Pdi 215 11 Tot adj 64 90 re Documents Other Actions Error Check Save Save Nent m In this Example the Patient was not seen on the Date of Service Billed Payments from the EOB are entered by creating a New Tab for Each Payment Create a Payment Id Enter Ins Co Transaction Type P EOB Payment or Pay w Adjust Enter the Pmnt Method Ck No and Amount of the Insurance Payment Create a Payment Entry by Entering the Charge ID Enter the Paid Amount as a Negative Dollar Amount Enter the Adjustment Amount with the Total Amount of the Claim Enter the Adjustment Type as a Recoupment You may need to create a New Adjustment Type a Click the drop down box in the Adjustment Type Field and select Data Entry b Create an Adjustment ID R and Enter the Description as a Recoupment c Enter a Comment for the Adjustment D After Entering All Payments verify the Unapplied Amount has a Zero Balance PN 4104 A O 2007 CrossCurrent Inc Page 58 INCISIVE PM User Manual Payment Entry Unapplied Payments CE E CE Charge Entry Information 79 PT HULL DANNIL DOS 6 4 2007 DOC DUNLOP DON dh 06 04 2007 02 04 PM EME te Hi bookup LJ Data Ey an Query PI Full Rights 2 Apply Psst Financial Mgmt
2. PN 4104 A O 2007 CrossCurrent Inc Appendix 9 INCISIVE PM User Manual Table Reference CNT Contacts oA Contacts Pc ERY madmin Gili rire Prd PM o tea JdOmtstEntry Stret LI eibteer FF a P mnes ib Laps parte ree Maral ete Maps Sem ie ium PE Fier Wee fe iiw Core NES TUE a CEDAR LR LOTS fo pt ie TA Hess Len ID Desi r b sze Eat JERRY GER cote meet Jg 4 pm zi ei ag zd d hice ZEE HT Exi F r Cad Terre dr irs Direm a l Fite T Cao H ke chap berech Modes Loccuments Cher Actions af Error Check djfaux Boeg Tee ed Contacts This is our version of an electronic address book you can store you phone numbers and addresses of frequently used contacts Ex your medical supply co restaurants employees facilities etc PN 4104 A 2007 CrossCurrent Inc Appendix 10 INCISIVE PM User Manual Table Reference CO Company 0j Campane 1 TOL a COMMIT Or COM it maar DAA PDA A 1 70 AMS LE petkum PLU FIL Stee A aw eeer F L mahig Cenia ot em Pima er Ki L a Had E ki Sie C ae TELE Coe Cae T ER EPTTEBIS NF p bier kt TARCOMMCONPUMER gt Eh d emnt leesch we ia Zeche Bp Ces ET ieee CA Ce ees ges Biar Fh bau G t nnn DO Eug fe soen LE ran a bf an EMO neit re CR CL Me T MR ON LAC PEE CP CRT VFATESENI POLE AGT OnE STATE HNT St SLA OPTS AE ML BC Ure RES PLE Pa TW SCI RE Cr Aias SIO Mee Meee tee eu ee CAN AU LONE Ae T a pr
3. Chef Remb paima on Pie Cant Aiwan ng amm Bel d ordre Mt Pl m Bake Shine Art SAk uneer Tyre Fs Pop id F HLT 0 99 HI 10 00 172 98 UK ELOT ob 1 Mo GG Pd Hm Adp ding insurance Patient Werte P Aert Accesk OWE Teno Compr let Clan De Titi Erem Siaha us m d E ate heat Pha k gis E iE Salih Cee hr aa oni n Lisipe d Pa eue id L P Tut Cf DEN Ted Pal pron Tob 348 Hab CH 5n cpDetusnerds E Dier Artan Sf Error Check 1 Save 1 Go to Payment Entry PE Create a new Payment ID 3 Enter the R Party ID that you would like to transfer the credit to Trans Type A Adjustment Only 4 Double check your Transaction and Deposit Dates a Classification AD Adjustment If you do not have this code in your table please add it b ChkNo Refer Credit transferred from your other practice management system c Amount nter the amount of the credit transfer d Adjustment Amount Enter e Enter the Adjustment Type V BS MIBS credit transfer If you do not have this code in your table please add it f Stmt Cmnt nter a description that the responsible party would understand PN 4104 A O 2007 CrossCurrent Inc Page 76 INCISIVE PM User Manual Payment Entry INCISIVE PM Recoupments CE If a recoupment was done on an INCISIVE PM account but the check needs to be entered into INCISIVE PM you will need to offset the recoupment with a negative charge so that nothing remains unapplied CF Cha
4. Payment Method Payment Classification Code U Print Preview For Report Format please select Payments by Classification Summary This report provides a breakdown by Insurance companies showing whether or not their payments were applied PAYMENT CLASSIFICATION SUMMARY Anytown Medical Clinic FOR DATES From 01 01 2005 Through 01 31 2005 FOR Al Users Al Methods AI Classifications All Billing Providers All Service Providers AI Ins Groups AI Ins Co FOR Posted and Unposted Payment Classification Transaction Amounts Applied Amounts ID Description Payment Adjustment Unapplied CWO Paid Adjust Total 2 Patient Payment 1 504 04 25 00 35 00 0 00 1 434 04 0 00 1 434 04 6 United Healthcare 45 00 0 00 0 00 5 00 45 00 0 00 50 00 REPORT TOTAL 1 799 04 25 00 172 40 44 40 1 651 64 0 00 1 696 04 The Accounts Receivable Analysis is equivalent to your aged receivables summary Your report format should be Total AR Aging by Billing Provider by Financial Classification Summary PN 4104 A 2007 CrossCurrent Inc Page 96 INCISIVE PM User Manual Day End Month End Outstanding Claims 1 Run the Accounts Receivable Analysis AR ReportsAccounts ReceivableAccounts Receivable Analysis 2 Select the report that you would like to run along with the criteria that you filtering for 7 AR Accounts Receivable Analysis dB Print Setup X Close Report Format Insurance AR Aging By Pr
5. Ph Number 951 688 8100 Ext Provider Group 1 HEMETMEDICALGROU Cell Phone Appt Provider Ive Mon persaorn Entiky UD Email idannig telecommcomputersystems cam Claim Coding Schedules E Claim coding Type Pre Num Provider Number Qualifier Group Mum Group Number Qualifier iD DEFAULT 770425723 Ge Provider Commercial Number _ mc MEDICARE OOAZ60211 1C Medicare Provider Number 227987827 1C Medicare Provider Number MCAL MEDICAL ODA260210 1D Medicaid Provider Number TRICHP TRIWEST CHAPPLIS 70425723 Hi CHAMPLIS Identification Number f WORKERS COM LP PEN 1 15 Provider LIPIM Murmber A26021 ivi DOAZ6D210 Le Comment Inactive E Disallow Lise im Documents 515 Other Actions je Error Check d Save Save Next Providers The DR screen enables users to enter practice identification data for each Physician Physicians Assistant and Nurse Practitioner in your practice This includes practice identification numbers for each claim coding type including Medicare Medicaid BC BS Worker s Compensation etc Include the NPI number and qualifiers for each provider number This screen is also used to setup the Provider s appointment schedule and schedule exceptions holidays vacations etc Name Last Last name of provider Appt Provider Check box if appointment will be scheduled for provider PN 4104 A 2007 CrossCurrent Inc Appendix 20 INCISIVE PM User Ma
6. Sbrerfherk A Save Seren Go back to your original Payment ID and re allocate the payment amount so that the unapplied is the amount that you wish to apply to your previous billing system Click on the red X on the right hand side of the screen to delete the original application of the payment Save Enter original payment entry ID and re apply the correct amount of the payment that should be applied to the INCISIVE PM charge leaving the balance of the amount to be applied in your previous billing system PN 4104 A 2007 CrossCurrent Inc Page 66 INCISIVE PM User Manual Payment Entry _ mi Les el MP he IE SAM Pr ir Cope Mn n ds Ae Forte dot Md dau area Re Cartas M rette uu pin e lam de er 4 ee ie fon won hie hap Aum limenewde 7 00 ek dr Ree Ll 5 Create a fictitious CPT code in which you will allocate the unapplied amount Be careful not to use a real CPT code as this will distort your reports P Lu Eu soU des AIS DIRK um balamcg BI DERI IUI BSLFESEEIUTAMRERTON TUM SEET SET Stance TI Query Pc General FrocedunnGroun Codes Codey Seheduie Cnenides fus Se er F oiik acies Coin cy Shar l 00 ww 1 wma 3 m PRE DE es a ll AS raie ts oe ee RR EE ME Geng LP Moreen Tt E 6 Create a charge with the fictitious CPT code for the unapplied amount PN 4104 A O 2007 CrossCurrent Inc Page 67 INCISIVE PM User Manu
7. date C hm a Fh did Ther ae F agy UT a oa Ate Clinic Pee BREUI xL LI Sh Other fia d posae m Error Check Er fave Saye tri aj Charge Classification Codes table maintenance This is a user defined code used to specify the type of service performed such as doctor billings hospital charges radiology laboratory charges balance forwards NSF s or Debit Memos The description of these codes is also separated by classification on some reports PN 4104 A 2007 CrossCurrent Inc Appendix 6 INCISIVE PM User Manual Table Reference CCT Claim Coding Types L CCF Clabn Caila Tyee DAC MIDNCANT n IET TONS OF 28 AM d bo kup Sietetntry Cbaemod E Aus Ai idee Cage amp al ce Claim Coding Types This tells the system what information to put on the claim When used in the PC screen it defines what CPT code to use or if the claim needs a TOS At a minimum most providers create D for default and MC for Medicare in the Claim Coding schedules Example you may use CPT code 364 b for your default but Medicare wants G0001on their claims This means that you would enter G000 lunder the procedure code for the claim coding type Medicare In the IC screen it also dictates what to put on the various claims It pulls the information from the DR screen Example Insurance 1wants the Dr s tax id and group number but Insurance 2 wants the Dr s provider number and UPIN printed in box 33 PN 4104 A 2
8. Cancel A q Query 7 Employer Id Employer Mame KH workstatus el Emergency Marital Status M Married Lol Job Related _ Symptoms Date Auto Accidenti PI LA mi Accident Date v other Accidenti _ LMP Date v Similar Con Date el ADDITIONAL INFORMATION ist Consult Date Hasp Frin Dier el Work Last Dte H ii fo H Return Date W Disabil Frm Date Disability Status AIF AIPO LI Employer Dan 18 RODOD251203795 RODDD15470735 PiClm Form SubscriberfInsured Rity Member No Y IE 034020 Akimoto Sher D E ani Wuemeore Matt SP EK Full Rights ES Save Save Next S Release SOF el Payment SOF m Patient Copay Champus Br Medically Unnecessary _ Patient Status Other Default Diagnosis Code Duty Status T Documents Other Actions 3 On the Coverage Case Info tab of the RI screen enter the disability status as AIPO PN 4104 A O 2007 CrossCurrent Inc ER fa Full Rights Grp Number Prior Wf Error Check ij Save Save Next mi Page 22 INCISIVE PM User Manual B CE Charge Entry Information 250 PT Akimoto Stephanie A DOS DOC Chun Bernard de H id Lookup l A ay Query 9 e General Ins Coveragel Service Detail Financial Mgnt Clair Stmts History Procedure Pay FILI Mates Apply Pmt Ip 250 lae Posted Patient 034020 Aki
9. Permanent Id 2160 RELATED INFO Reg Status Patient Id m E Patients Insured By Registrant RIParty Id 2160 Acct dm DE Smith Leialaha Subscriber Insured Id 2160 Lookup Ackive Only First Mame giw i Sch Sja Date Of Birth Primary Phone A Sw Se aa nn poe Nan mem mi e e gt 06 17 1970 Smith Mildred Address 2569 Ala Aloha Way 2s Address The name of the responsible party appears under Responsible Parties By Registrant on the patient s General tab PN 4104 A 2007 CrossCurrent Inc Page 8 Registration amp Related Information INCISIVE PM User Manual Adding a Responsible Party Subscriber a Hd Poe ee and elated ininrmatien IRAK jane Peele BREUI D LOG ATE SUSTITUIR TN okup jGatatmmy Ore f gen D l d amp X er te Ask Greg Me De An rarman tira paf ole Geeeepmgrg ALMAE anes DUPONT rames i era Cerca Tin cca tracer dd Cette M n Week Saus J mnb Sege J Fir gr Date Gids cw Tec e sf beet Pa Jones Debbie ma Core i o bo cmn m To Ralabed OM AR LIP Dee mE T ug al Prena Cis coma Cmn ciam Billie Proven cr Est Fachry i Yn Kel Datori kifi Camden Don al Sege Spam Cees LE Daine Loue ACCA ICA jte onis 10498 E brutal Treni Coran Ji Hos Fais Die P o aam ee Pre i If the patient is not the same as the Responsible Party you will ne
10. n Documents es ibe Ailes Sf ErrorCheck Save Save Next al When the Secondary Insurance comes in however their allowable for this charge is 40 00 instead of the 35 00 allowable paid by the Primary Insurance Because of this the Secondary Insurance pays 5 00 creating a 5 00 credit You will need to enter the 15 00 payment thus creating a 5 00 credit balance PN 4104 A 2007 CrossCurrent Inc Page V INCISIVE PM User Manual Insurance Topics B PE Payment Adjustment Entry Informatian 285 HMSA BEES f o d amp Lookup 2 Datafntrs Cancel Query 2j L Full Rights General Payment CES ai Trans Date 02 01 06 Den geg Posted From Ins Co HMSA HMSA Hi Classification 10 HMSA Amaunt 5 00 R Party ll Pot Methodi L vu j me i i Trans Type A Adjustment Adjustment Orl only ll CRE Mo Refer no check adj only Comment Secondary allowable higher than Primary Akasaka 01 15 2005 390 A Patient M pen en Charges Insurance Chra Id Patient DOS Charge Amt Balance Paid Amt Contract Wor Adjust Amt DIp Balanc charge 30 akasa lindo ad Akasaka Linda AP 308 79 amot senes lg nos em 15 00 en o 000 000 0 B e Wm erem EEN pong NE Ins Ca eme e HA el 892 Stoen et Els 11 01 05 pugo 115 00 0 00 0 00 0 001 0 EE LLLA area RJP Bal 0 00 IE SE Ip mm HMSA mI ia o ue dois 241 Set
11. Ogos2005 oz oajzooe 11 000 0 00 30 00 wth id 2 In Charge Entry CE Ins Coverage Service Detail tab this information is defaulted if this coverage case is selected Thus the charge is sitting at the Fin Resp Lvl Financial Responsible Level of Insurance e We Segen S CF Charge Entry Information 10 PT Akimoto Stephanie DOS 2 8 2006 DOC Tanji Troy madmin 02 08 2006 12 19 PM IS In Lookup 2DataEntry KiCancel A Query 2j Ful Rights General Insurance Information Insurance Company Inact Claim Type Pr Form Subscriber Insured Hm Member No Employer Grp Number Aje P k SP Ve _ Other Commercial N P 006996 in 8 575069634 Akamai Practice Mgmt ERE Kelease SOF Medically Unnecessary champus Branch Payment SOF Patient Status Other Duby Status Si SE en m Ins Payment Waiting Period d o ivi L Global Coverage fde ChrgId Exp Date Procedure Code Svc Date Days Addl Mod POS Fee Schedule Start Date End Date Ota De Line No Profile Amt Patient Amt Charge Amt Co Pay ax Fin Resp Lvl H1 JD al 02 08 2006 02 08 2006 11 0 00 0 00 50 00 ME aeo 3 Deselect the Payment SOF and the Financial Responsible Level drops to the patient NOTE If you forget to deselect the Payment SOF and have already entered a line of service go back and deselect the Payment SOF Th
12. Default Medicare Medi Cal etc P Clm Process Claims Choice of Yes No and Hold Form Claim Form Choice of Electronic or Paper CMS 500 NDC Req National Drug Code Required Box 24K Check box if Provider ID is required in box 24K Old CMS 1500 Form 24 New CMS Form Times 24 Check box to show 24K Old CMS 500 Form 24J New CMS Form Write Off Setting Not implemented leave blank Comments Loca Use does not populate data on electronic or paper claims Inactive Check box if the insurance company is now inactive Disallow Use Check box to disallow use of insurance company PN 4104 A 2007 CrossCurrent Inc Appendix 31 INCISIVE PM User Manual Table Reference IG Insurance Groups PK Inuuraonce Groowe fA ALTHA fmadtmin OwO TOs Oe a AM Giookup Gate Entre cancel 7 iser P or tenia B AE x X Dames m Ss Other Fia toe m Error imk Jj iarr Saye bau al Insurance Group Table Maintenance This screen allows you to group insurance companies together For example if you have several Aetna insurance companies you can put them in the same group It is helpful when running reports or doing various other tasks within the application where a group can be entered as opposed to an individual insurance company Also in the payment screen you may post a payment to one of the companies within the group regardless whether or not that is the billing insurance and INCISIVE PM will not give you an in
13. ERAP Electronic Remittance Advice Processing 6 rei I Ietookup P netsin Cancel Query y view Edit Delete cene Details PE Wa Selec zed Charge Chrg amt jAllowedAme Adjusted Pat Resp Paid Error Message ia i Iv 615 enn O0 142 15 fo 00 Za ep 699 50 Payment For service 76818 will result in a credit balance Zero payment amount on 81002 Thee a BS Select Details Cf Error Check LA Save X 7bUsece9s Preview o Save Next ro EET 3 Select the Details tab INCISIVE PM now displays the Charge ID Charge Amount Allowed Amount Adjusted Amount Patient Responsibility Amount Paid Amount and Any errors or messages 4 Click on the General Tab Note the Payment ID Process Batch HIR Preview savetet 5 Click Save appointments G jRegistration SCharg s Payments ClaimMgt Accounts Patient Admin Clinical Info M i 6 Atthe top of the screen click on Payments E PE Pawnant Adjustment Entry Infarmation EX A o iglookup Data Entry Cancel gd Afen 2 Li Ful Rights N _ ee 7 Select Lookup PN 4104 A O 2007 CrossCurrent Inc Page 64 INCISIVE PM User Manual Payment Entry Search for payment by Check Number Acct Trans Date or Payment Id Press Enter two times Pymt Method Enter the payment type e g check Paid Amt Verify the amount Bb P Click on the S
14. Employer J MUR Muni Po Det Payer p Bernaed k Ch 1 Bermaedk ch Empl Narrie Site Lee sl Is i Def ES D Pi m teg d J van Address PO Pamay Strat Hold KI Zip Code D B i el E ewe Bue ol Documents gt Other Actions je Error Check 4 Save Save Next L 1 In RI go to the Alerts screen and enter an Alert as AIP Accept Ins Payment Only PN 41004 A 2007 CrossCurrent Inc Page 21 INCISIVE PM User Manual E AL Alerts i Gg Eookup Lookup Descriptions AIPO Insurance Only madmin 10 26 2005 03 43 PM _ DataEntry PCancel Insurance Topics D Amer B General ID Aro Description Backgrd Color ERST Foregrd Color r L Comments Disallow Use E Inactive Mi Lookup Recent Select X Cancel Select 2 Documents amp Other Actions Error Check 2 Select a color that will catch your eye B RI Registration and Related Information 034020 Akimoto Stephanie 4 Stephanie 06 16 2005 02 45 PM E P T Lookup HMSA HMSA CoviCase Title HMSA HMS Description Cic EFF Date i Trm sl Resp Party 034020 Akimoto Stephanie Financial Class DAS HMS Billing Provider E Chun Bernard m Facility DO Doctor s ofc Ref Dactor Id PE Let Seen Supervising Doc PCP Doctor Gl Insurance Information Claim Type IHMSA ma Insurance SES Irma Hms IHMSA Hj SE Entry
15. Initial Trat Date Disability Frm Dte Facility Last sray Date Ta Financial Class ENDE vasl i eS a Pattee Gris Pesci ca Patient Alerts RJP Alerts Referring Doctor E Date PE Last Seen Hosp Fre De Ta Supervising Doc A Documents gt Other Actions Ef Error Check 5 Save Save Next Pi Please note your Acct Trans Dte Account Transaction Date is in essence your INCISIVE PM Posting Date Once a Coverage Case is selected the information for Coverage Case Description Resp Party Billing Provider Serv Provider Facility and Financial Class populate from the RI Registration screen For Charge Class Charge Classification Codes click on the ellipsis or F2 PN 4104 A 2007 CrossCurrent Inc Page 36 INCISIVE PM User Manual Charge Entry Charge Classification Codes CCC ES CCC Charge Classification Codes D Doctor Billines madmin 05 04 2006 09 17 AM ES i A Lookup gt DataEntry tancel aOQuery Full Rights Lookup Active cnl General Description Siw ee l Id Si li J Description Doctor Billings Id Description EE _ BF Balance Forward Comments Dm Debit Memo kb Doctor Billings lt DME DURABLE MEDICAL EGQUIPMEN H Hospital Charges jb Lab Charges _ PT Physical Therapy ORC Radiology Charges MSF Returned Check Fees Inackive CH Disallow Use d SOEUR Peagent
16. Post Dates do not affect what you have already posted It simply opens the date allowing you to continue using this transaction date PN 4104 A O 2007 CrossCurrent Inc Page 90 INCISIVE PM User Manual Day End Month End How do I Lock the Month for Payment Entries This prevents the user from entering charges and payments prior to your selected Transaction CutOff Date PREP Payment Register Edit Post Print Setup Close Process Format Past Payments el Transaction CutOff Date Here User s Leave blank Far all Print 4 Preview Locking the month for Payment entries 1 Select the PREP Payment Register Edit Post 2 Process Format Preview Verify that there are no Payments to be Posted and set Process Format to Post Payments Select the date for the Transaction Cutoff Date Set User to Blank Leaving the User name blank locks the date for all users in the provider s database Payments cannot be posted using a transaction date before the cutoff date entered PN 4104 A O 2007 CrossCurrent Inc Page 91 INCISIVE PM User Manual Day End Month End How do I Lock the Month for Charge Entries CREP Charge Register Edit Post Print Setup Xitlose Print 3 Preview Lists Locking the month for Charge Entries 1 Select the CREP Charge Register Edit Post 2 Process Format Preview Verify that there are no Charges to be Posted and set Process Format to
17. Procedure Code pos ES Charge AmE Patient Amt Profile Amt Allowed Amt Starting Bal Contract AO Paid Amc Balance Adjust Amt Adiustment Typ CAP TAFITATION ADS losestor 0 00 0 00 0 00 0 00 D 3 60 oo 60 oo Cap SAPITATI al vi Tiar 0 00 Pd 0 00 Adj 60 00 Insurance Patient Alerts R P Alerts Appeals Comment Ji Insurance Company Inact Claim Type UK PIC Pro SUBSE ES Stmt Msa Li L MMT Bro ETT vl Hr DEF Iw ip fe Strot Crmpt Unapplied Amount 0 00 Tok CD n op Tat Pd Son 0 00 Tot Adj 60 oo 2 Documents gt Other Actions Error Check j Save Save Next ie 7 Putthe payment in as an Adjustment the 0 00 amount and then the PE for the 0 00 amount 8 Click Save when done PN 4104 A 2007 CrossCurrent Inc Page 41 INCISIVE PM User Manual Claim Processing Claims Processing PN 4104 A O 2007 CrossCurrent Inc Page 42 INCISIVE PM User Manual Claim Processing CP Claim Processing Electronic TA a EP Claim Processing J62 mredmin OT 4 7O07 17 06 AMM i divekip eta gr wt met el ager Y aridi Pages Certes iudi P si Ced finem pee PTE lxx Dem eu us Lee Cr e Cham or errors Ers d erger Ch Cia lle Act Gran tee Rect Ered Ewe Poel Charge ec Liebe a ma z E Fremsss Cl oe Er ema Cac fg ie tok z 2 Less ira are lies fe a her a Fur Pasresdea Billig Pra Eh E Liesch F
18. Related Inform Reg Status Patient Lac Tdi z RjiPareys se dd z Subscriberfinsured s7 Id Mame LasE Capitation SE Mary s Choice Fermanent Id ae amp i RUP Bal RJ Bal First CAP mre nara Address alerts Address zip Code City RIP Default Payee 1 Bor GUBMLOE rap Date of Birthi ge Sender Social Security Mao RIP Def Fee Sch it RIP classification Primary Ph Mum ER ol peti i i Cell Ph rinm EEx IasziFicabion L Email Appointment Hold 1 Statement Hold C Date First Seen j L l i j L l Employer Last Seen i or Work Ph teint Empl Mamessite Lang Preference Eil Inactive 1 Disallow Lise De Inact IR Documents gt Other Actions EF Error Check D Sare Save Next El 5 You will also need to create a procedure code for capitation with a 0 00 amount for the charge PN 4104 A 2007 CrossCurrent Inc Page 40 INCISIVE PM User Manual Charge Entry amp PC Procedure Codes CAP CAPITATION ADJUSTMENT madmin 02 23 2007 03 15 PM Te Mix l lookup DataEntry Ctancel 23 a Query Pi Ej Full Rights General Procedure Group Codes Coding Schedule Overrides Fee
19. Y E ate Son d ee Leet ened Front brin ia Lisi ia ae an Tut Pa anao MEI 5 Ci Deiimmerls S Diir Arte S Error Clech 2 Create a Payment Entry PE a R party Account you wish to have the credit applied to b Transaction Type A Adjustment c Classification A Adjustment d Amount amount to be transferred e Comment Reference note for you 1 If there is a charge that this could be applied to bring up the charge enter the amount of the credit on that charge and enter your ATC as the code you had created above 2 Save 3 Go back to your previous billing system and debit adjust the balance forwarded to INCISIVE PM PN 41004 A 2007 CrossCurrent Inc Page 75 INCISIVE PM User Manual Payment Entry Transferring Credit from Your Old System PE B PE Dog Adem Eniryntonmalhin 25 amp te Kennet Stephanie 10 0572005 03 09 FM Eookup JOstatniy Cancel T AQuerr Mi iris siis ener al Paire Mr H rans Date LUS el Der Lojustes el Dap Fran fhe Ci ud Clank ADT Aalen ad Amaris 400 Baty 201887 Ass Kemumt 3 S Fonte wk FER aie d Tras Tope A edd Cre E Ch bh tetes Tom Eam erred Fran ET Cm d Whe DDT 2UUS 1 1 X kani ons Hesse Party Ow Pete DO herve id B sse Paid Aud Diei AD Agatrt og HIE Eure 13 SALLE EF Toni Fri ez Fes oy Eau go mr fio Ho Part M Charge 3 hr kerreth lis zu Riesa Tun It bre D 2 4 Cir on
20. all Was ray Date el Tai a 7 lt lt PE Let Seen 06 05 2007 Ka Work Last Dte Ka Disabil Frm Date Description Pacificare Supervising Doc s Return Dte izl l Tai e D S Steere CH Etain Type Prclm Form Subsagber Insured Employer Grp Number Prior 4 peret 44 Mantes Anm TELECOMM COMPUTER SYSTEI DEFAULT 44 Montes Anm 5 709644444 TELECOMM COMPUTER SY5TE Release SOF Medically Unnecessary Default Diagnosis Code Payment SOF sc Patient Status Othert Patient Copay 25 00 y Documents Other Actions ff Error Check Save Save Next CH In the example shown here the patient has dual insurance coverage When the patient has insurance through more than one carrier you will need to verify two pieces of information 1 Willthe primary insurance company forward information to the secondary insurance company 2 Do you need to produce a secondary claim The answers to these questions determines whether to send out a claim to the secondary insurance For example Medicare can forward the claim directly to the secondary after they have paid their portion If the secondary carrier is unable to forward the claim you will need to generate the second claim Under Insurance Information P Clm would be set to Y if you want generate the second claim Select N if you do not require the second claim PN 4104 A 2007 CrossCurrent Inc Page 7 INCISIVE PM User Manual Registr
21. berr uri are a zi iay OS Dapoer Code Cera bt Expte Prmopdurg Codes ure Zeen i e Charrus Crarch ape DiS EN D buen US L s t YS nin Ir L 2 hHon Covered Charge Handling Al ot the procedure details on this charge are marked as non covered Claim processing cannot be run for non covered charges All insurance claim processing must be disabled on this charge to continue Please select one of the Following options Remove Insurance Coverage Disable Insurance Coverage Disable Claim Processing 3 The Non Covered Charge Handling box will appear select Disable Insurance Coverage PN 4104 A O 2007 CrossCurrent Inc Page 85 INCISIVE PM User Manual 4 Go to the next tab Apply Pymt Payment Entry fa E Lookup DataEntry KE E tancel 2 L Query General Ins Coverage Service MWe Pymt inancial Mgmt Claim Stmks History Procedure Pay 4ppeals Follow up ChrofRP Due CW Paid Adjust Amt Balance Total 0 00 0 00 0 00 0 00 0 00 Responsible Party 0 00 0 00 Account 116 Brown Lucy El LInapplied Payments Pymnt Id Pymt Dte LInapp d Amt Method Reference Trans Total p569 59 101 25 00 PE Payment Adjustment Entry TnFarmation Applv this payment to current charge Insurance Li Insurance Company n UHA University Health Alliance 5
22. e Amount the amount of the refund f Comment Enter the reason for the refund Q Charge Enter the charge ID of the 0 00 payment E Enter the Adjustment Amt D Enter the Adjustment Type Create an adjustment type that reflects the reason for the refund B Save the payment PN 4104 A O 2007 CrossCurrent Inc Page 87 INCISIVE PM User Manual Day End Month End Day End Month End CREP CO PREP PRA PRAR AR CE Recognizing that no two practices work alike INCISIVE PM was designed to allow a greater degree of flexibility With this flexibility however comes the need to evaluate current workflows thus ensuring INCISIVE PM can work as effectively as possible for your practice Before running your first series of reports we recommend you take a moment to briefly review the information in the following pages You will be asked to consider how your office is currently set up this will allow you to balance needs that sometimes seem to be in conflict e g security vs flexibility A number of screens will be accessed in order to provide the reports you may need to run Please note which screen is being used found in the upper left corner of the screen for which report PN 4104 A O 2007 CrossCurrent Inc Page 88 INCISIVE PM User Manual Day End Month End How do Lock the Day for Posting Charges CREP Charge Register Edit Pos gjsPrintSetup X Close Process Format Past Charges Transaction Cut ff Date 08
23. lt Less Than or Equal To search for a Diagnosis Code by Description right click on Has to prompt the search criteria menu The search narrows as you enter additional data If you enter hand in the Description entry box the search will narrow to include only those diagnosis codes with descriptions containing the word s entered If you want to search Diagnosis Codes by Id begin typing in the Id box e g if you type in 428 the search will narrow down to all ID s beginning with 428 Make your selection from the list Documents Ate Actions Error Check Save b When you are finished having selected the desired Diagnosis Code click Select found in the bottom left corner of the screen PN 4104 A O 2007 CrossCurrent Inc Page 28 INCISIVE PM User Manual Diagnosis amp Procedure Code Lookup amp Entry How do find and enter a Procedure Code PC Procedure Code Lookup amp Entry ES Pc Procedure Codes BF Balance Forward madmin 02 06 2007 04 48 PM EE gt be ch Lookup LJ Data Entry EP Cancel an Query IS 3 Full Rights Lookup Active conl General Procedure Group Codes Coding Schedule Overrides Fee Schedule Overrides Procedure Facility claim Coding Schedules aor y Has Id BF Siw Description SE Description Balance Forward Classification Description lion DUPLICATE Department BI Billin
24. ppa ICO1tLemnmsenckat demam Oh eae TO 20 AM Alash J Daba ery Steet F amy f e rides L tz T Ce gut Essen dud fie D Caen oc camem n pmi Peel ug Dages Sud Ciara mer Lil Cate t Lo Cham NIIT Liba epee MCI l Onscurennis Ze ber Actuum freon eak 10r aeem Soe Pest Claim Types Information in this screen determines the processing format of the claim The claim type is used in the insurance company screen Some of the most common types are Medicare Medicaid commercial group amp other BC BS Workers Comp and Federal Workers Comp and Default PN 4104 A 2007 CrossCurrent Inc Appendix 16 INCISIVE PM User Manual Table Reference CTY Counties B CTY Qoumiies 1 Riverside madmin 04 05 7006 09 74 AM Oasis Entre cancel M aguery Fi ect Er DEL eal Bez ae Bees Ci pie Lrekrar Fae Et l Dar umm ro Sh Other fia Linas gf Esser Breck d Save Counties This screen has been set up the standard US Census Bureau counties list PN 4104 A 2007 CrossCurrent Inc Appendix 77 INCISIVE PM User Manual Table Reference DC Diagnosis Codes PC Dltagnent Codes ra Ce 1T FE TE ap H j Rb inary tee DI nouer Y eu General Le hi bee ego epi Cone ee eed D mi n Lisa LEONE P cmd Ehe Oscar cher Actia teres eek Save aw mat Diagnosis Codes Table Maintenance This screen allows you to add or modify diagnosis codes ICD 9 Wi
25. 135 20 0 00 O05664 Milne Atina 375 UI A8 155 00 LU UU TOTAL MCD Medicaid 156 00 0 00 e The Patient s ID and Name makes it easy to locate the account in Patient Administration e The Transaction ID and DOS makes it easy to look up the Charge Entry e The total charge amount is listed under the Gross Amount column Each insurance company will have a grand total following the claims that are listed Payments Applied CWO Adjustment Unapplied 100 32 30 60 AU UU F 0 00 100 32 30 60 0 00 0 00 gu 0 00 0 00 0 00 0 00 0 00 0 00 0 00 LU UU 0 00 AU UU 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 LU UU gu 0 00 0 00 LU UU 0 00 0 00 0 00 0 00 EIER F6 6 82 0 00 0 00 37 37 186 82 0 00 0 00 LU UU 0 00 0 00 LU UU 0 00 0 00 0 00 0 00 e The report will also show any payments that have been applied towards the charge or unapplied payments that are sitting on the responsible party account e HINT If there is a CWO contractual write off listed this claim is a secondary or tertiary claim PN 4104 A O 2007 CrossCurrent Inc Page 98 INCISIVE PM User Manual Outstanding Balance Total RP Portion Ins Portion I 25 06 0 00 25 06 25 08 0 00 25 08 281 20 0 00 281 20 201 20 0 00 201 20 156 00 0 00 156 00 156 00 0 00 156 00 5 720 00 0 00 5 720 00 156 00 0 00 156 00 5 676 00 0 00 5 876 00 11 01 0 00 11 01 11 01 0 00 11 01 156 00 0 00 156 00 156 00 0 00
26. 156 00 Ins Paid D 85 05 1 2 091 205 1 Day End Month End e The Outstanding Balance shows the amount that is still owed either by the insurance company or the responsible party Total 2 R P Portion Ins Portion column indicates whether or not the Insurance has been filed Insurance has been filed 9o Insurance has not been filed The Ins Paid Count column shows the date that the primary insurance payment was entered transaction date It also displays the total number of outstanding claims per insurance company Insurance Portion Aging Over 90 Over 120 156 00 e The last portion of the report shows the actual aging of the claims Current Over 30 days Over 60 days Over 90 days and Over 20 days This is based on the transaction date not the date of service PN 4104 A O 2007 CrossCurrent Inc Page 99 INCISIVE PM User Manual Claim History Report This report helps determine if a claim has been filed for the charge It also includes the submission date and Insurance Company B CF Charge Entry Information 6 1 PT Jordan Judith DOS 7 8 2005 DOC Nakashizuka Mari Mari 08 24 2005 01 49 PM rs p GLookup j DataEntry Cancel ay Query EJ nas an ae e cm c rat ran Re ia A GE Claim Submission Detail Batch b B6 7 l Pull Submit Date Insurance Company Form Processing Center Claim Total Insured R ltn Member No 08
27. 1l INCISIVE PM User Manual Wins OT es fe lit TELE COMME COMPUTERE s TEE AS dkieokup Aas ny cancel DI bueen Pe M atin Erast e Folie Dared Fate dir Vas t free doe Cien Error Fe Cirque PI Chava Veigeg Fin Pater Miner PN 4104 A IC immedi OSA Sr DU 2007 CrossCurrent Inc Table Reference 17 28 AMY Duse Fecal Bemkeber Banga Cares amt LE Deen Pian Ia Chem ee Leh Harira i b a PTT c i ni ft Error Check Dp ave Save Aext Appendix 12 INCISIVE PM User Manual Table Reference PN 4104 A Company Table Maintenance Settings Tab Enable tax setting This is utilized by another region and is for taxing medical services Claim error check at charge This checks each charge entered at the time of entry to confirm there are no errors This is the same as doing a proof in the CP claims processing screen Insurance payment waiting period The number of days since the original filing date to wait for the insurance to pay before forcing the balance to the responsible party Deposit Future date max days are the maximum number of calendar days the deposit date can be set into the future based on the current date The allowable range is 0 7 days Close recall reminder If you have set a recall for the patient this is where you determine the number of days past and number of days future for the system to alert you e g If you havea recall set on a patie
28. 24 2005 AETMA p 41560087 dm SP 35334907 07 13 2005 AETMA ie 156 00 37 i SP 353349071 07 15 2005 TRI P 156 0037 mat 3 SP 35334007 up the charge by the ID 2 Goto the Claim Stmts History tab a Q O oco gt D m Batch Shows which Claim Processing Batch ID this claim was filed Submit Date The date the claim was processed Insurance Company the company that the claim was filed Form How the claim was processed electronic vs paper Claim Total The total amount of the claim Insured The subscriber for the plan R Itn Relationship to the insured Member number The membership number the claim was filed under Employer The employer of the insured Group Number The group number of the insurance plan A A Accept Assignment if payment should be coming to the office Prior Auth No Prior Authorization Number Claim Number Claim number Day End Month End DER Ly Full Rights ay Employer Se e 4 3 If the claim has been filed but you have not received a response contact the insurance company 4 Enter your notes in the F U Notes tab PN 4104 A 2007 CrossCurrent Inc Page 100 INCISIVE PM User Manual Day End Month End B CE Charge Entry Information 67 PT Jordan Judith DOS 7 8 2005 DOC Nakashizuka Mari Mari 08 24 2005 01 49 PM KBI is Lo l lookup 2DataEntry Cancel Bak Query Ki Ly Full Rights Gen
29. Center This table dictates which claim processing center to use when submitting electronic claims Below are the required fields that require data Sender ID Provider Group or Facility Tax ID Password Leave Blank Receiver ID Leave Blank Password Leave Blank Submitter Name Provider Group or Facility Name Sub Contact Name Provider or person doing the submission of the claims Sub Ph Number Provider Teleohone Number Save When all required fields are complete PN 4104 A 2007 CrossCurrent Inc Appendix 4 INCISIVE PM User Manual Table Reference CPR Claim Processing Rules CPR Claim Processing Rules CH Champus EEK Pi l tookup L2DateEntry cancel Query F E Full Rights Lookup active Only General Description ELS wef O de 5p EE Desctiption Champus Description charmpus Comments Commercial OWCP Federal Office of Workers Comp F MDCA Medicaid Califorria MC Medicare CTE workers Compensation Texas inactive _ Disallow Use _ 2lpecuments Other Actions Bf Error Check Save Save Next il Claim Processing Rules This is a view only screen that is maintained by INCISIVE PM It contains the various claim formatting options for the different types of companies listed PN 4104 A 2007 CrossCurrent Inc Appendix 5 INCISIVE PM User Manual Table Reference CT Claim Types Bit Clan
30. LB Cost remedii Lipe COTE esc eh EO ches partei Le ppc OS E Doreen T cher fete s few Cia Ep Save Jart mat User Table Maintenance Each user must log into the system with their individual user name and password The practice administrator or authorized person is responsible for the set up and maintenance of the User Table Each user can be authorized for individual or multiple databases and granted privileges for all tasks or limited to only specific tasks User groups can also be set up e g you can set the appointment schedulers up as a group providing access to information pertinent to scheduling and limiting access to other areas like charge and payment entry etc Each user at a minimum must have at least the default rights set up The restore login check box is used as a security measure If the box is checked and you maximize the application INCISIVE PM will ask you to re enter your password It then brings up the same screen you were using before the screen was minimized When a user is no longer authorized to access the system e g terminated employee the administrator must change the user to inactive status and disallow access The user should not be deleted from system as this affects the transaction history There is also a user access log that tracks the date and time when a user logs on and off If you want to look at the access log by either date range or user use UAL Please complete the following informa
31. MI roc ae ut mpi e L PT L pena aH KRISS E 2 If check number is not listed click Check Responses Select a Claim Processing Center from the menu Net Healthclain Services The Process Check begins Office Ally If there are no new payment transactions the following The Health Information Network screen appears PN 4104 A O 2007 CrossCurrent Inc Page 50 INCISIVE PM User Manual Claim Processing L information A A ho new payment transactions were downloaded If there is a new payment transaction the following information appears Information 1 1 new payment transaction s were downloaded 6 Click OK L ERAT Electronic Remittance Advice Retrieval 7 Click Lookup to locate your check number 8 Select the check you wish to process 9 Click Process Batch at the bottom right 10 After processing INCISIVE PM takes you to a second screen PN 4104 A O 2007 CrossCurrent Inc Page 51 INCISIVE PM User Manual ERAP Electronic Remittance Processing 69 5 zi Hhiunkop gbbatatntry epeancel Process Type Proof Batch Information Proc Center HMSA Data in Payer Name HAWAII MEDICAL SERVICE ASSOCIATION Payee Mame DOUGLAS L BROWN Do Payment act Dake 10 22 2005 Amount Paid IL Make sure Process Type is set to Proof 2 Double check the Amount Paid matches 3 Click EOB Preview at the bottom right Pub TUD Poi Base E POM
32. No Patient m Insurance mir k HRS Arey i Ins Ca Fin cls LA R P Bal ES Apply Distribution EEN Procedure Code DOS Charge Amt Patient Amt Profile Amt Allowed Amt Starting Bal Contract WO Paid mt Balance DjA Adj Amt Adjustment Ty k SEH eege cmnt Pi mink Lo eg Unapplied Total Total Total j AWE CNN Paid is r i EE st L ra RIES iki SE Other Actions rn bt King P 1 Payment Id is highlighted click F2 or the ellipse to create a new Payment Id 2 From ins Co You may click F2 which prompts INCISVE PM to open the IC Insurance Companies screen OR you can click the ellipsis which prompts the following screen NONE SERRE Xo NIS RENAN UR SERES 3 Select Insurance Company Selection via Charge Lookup which opens the Select Charge window 4 Enter Charge Enter the Charge ID from the EOB amp click OK SEE hae Enter Charge CH OR OK Cancel 5 Click the ellipsis to Lookup a charge select the Patient from the list and click Select and OK to return to the PE screen PN 4104 A O 2007 CrossCurrent Inc Page 54 INCISIVE PM User Manual Payment Entry amp PE Payment Adjustment Entry Information 97 PACIFICARE T EE Be FH e Lookup Data Entry aD Cancel P Lg Query ret UE Full Rights General ERA Attachments a k amp p Payment Id 9 ae P Ldar Trans Date 07 03 0
33. Payment or Pay w Adi Chk Ma Refer 79963 Comment Gi HULL DARII 10 00 7000 00 00 20 00 56 HULL DAMMI Sji 70 00 On Bel a 00 20 00 Fin cls Ed ee HULL Dat inn mn Di oo 1 00 20 06 Bie Bal E lez HULL DANNI OZ io 915 00 a00 000 00 00 20 00 LLL Fe i t 1 125 00 1 125 00 4 Charges PILIER Ins Co Auto BD Distribution Procedure Code bos charge Amt Patient Amt Profile Amt Allowed Amt Starting Bal Contract WO Paid Amt Balance PRP Adj Amt Adjustment Type ER tnt fram sq 21 CE d Unapplied ser aa Tata Debs D Toll aaa Amount 20 00 COM soon Faid A Adjust 0 00 eege EE Documents gt Other Actions G Error Che save 3 E ve Next a Verify that you are on the General Tab Payment Id will be highlighted Press F2 or click on the to create a new Payment Id From Ins Co Leave Blank R Party Click on the ellipsis or enter the Responsible Party ID Trans Type Select P EOB Payment or Pay w Agj Classification Co Payment Pymt Method Click on the ellipsis and choose your payment method type e g cash check visa etc Chk No Refer If payment is by check enter the check number Amount Enter the amount of the Co Pay made DEBES S e ee xm If Charge has not been created click the Save button This creates an Unapplied Amount PN 4104 A O 2007 CrossCurrent Inc Page 56 INCISIVE P
34. Post Charges Select the date for the Transaction Cutoff Date Set User to Blank Leaving the User name blank locks the date for all users in the provider s database Payments cannot be posted using a transaction date before the cutoff date entered PN 4104 A 2007 CrossCurrent Inc Page 92 INCISIVE PM User Manual Day End Month End End of Month Reports Because INCISIVE PM does not require a Month End the user has the flexibility to run any report at any time There are a couple of reports that we suggest you print once all payments and charges transaction dates are entered PN 4104 A O 2007 CrossCurrent Inc Page 93 INCISIVE PM User Manual Day End Month End PRA Charge Entry The Provider Revenue Analysis PRA is equivalent to a Production Report PRA Provider Revenue Analysis Print Setup x Close Report Formati By Company Detail gt Accounting Date Fram 01 01 2006 Thru 02128 2006 el Providers Leave Blank for Pravider all I radi mucARLL OL ITE Print Preview For Report Format please select By Company Detail This provides a break down by Classification and by CPT codes PN 4104 A O 2007 CrossCurrent Inc Page 94 INCISIVE PM User Manual Anytown Medical Clinic PROCEDURE ACTIVITY BY COMPANY FOR All Facilities All Billing Providers All Service Providers All Procedure Departments All Procedure Codes FOR DATES OF SERVICE F
35. REEL Tage Ce a AA Traore te Geer Wan J Genre Fr Zeus Pareet LA pont Em zept Ap TE Nee m um mm vu ma rere DOS haga pr PalentAPt Foe At Med ae Zetegfd L rra t WO Ba AD Jee Da A8 A PJ on Gm pm pm pm bn P ptm pm D Enter the paid amount and a comment to appear on the statement B Save PN 4104 A O 2007 CrossCurrent Inc Page 69 INCISIVE PM User Manual Payment Entry E LEFT Poor Fut pies proe ni Le E AER Laelio Dire EK 708 UT EI AUS dede aAaeekeg Em D Aer ie ics en s B MT Hum rd BLO 7 Mu 00 mx E errs Sure terran check PE D 4 Go back to your old billing system and credit adjust the amount of the fictitious charge that you had created PN 4104 A 2007 CrossCurrent Inc Page 70 INCISIVE PM User Manual Payment Entry Credit Balance Forward PCT Balance forwarding credits from your legacy system to INCISIVE PM B PCT Payment Classification Codes CBF j fei Hi Lookup 3DataEntry Cancel Query F Ful Rights E Comments Inactive Disallow Use 1 Documents fbs mirer Actions i Error Check dd Save Save Next Bl 1 Create a Payment Classification Code PCT for Credit Balance Forward This allows you to track the credit balances in your reports PN 4104 A 2007 CrossCurrent Inc Page 71 INCISIVE PM User Manual P
36. bod umo Rl mmm maia t ETE s nm IA CT Hamb TE E hi i TI Beitrag Eng SR d eum Re mi d LILI SI OEE LT reg Fi Eo dh pede SEs UE mie D wes Trer LINE a big e T RE beet FA d rab obese m rg PLI e NS 8 NE i em HB gt Uma H SS SE im ed EET aod QUE lee Somme a fi Claim Processing By view Edit Delete Hawaii Medical Service Associati eme mei Li f Error Check Process EUR Preview Save Next Lol the amount on your check mui IE m ge La bea LR Bien e CHEN SEH UL ged LS ve 3 EH Tee T in C SEN Bic PIPE H MFE Hi Mis be This prompts INCISIVE PM to display the EOB Explanation of Benefits on the screen PN 4104 A 2 007 CrossCurrent Inc Page 52 INCISIVE PM User Manual Payment Entry PN 4104 A O 2007 CrossCurrent Inc Page 53 INCISIVE PM User Manual Payment Entry Payment Entry for Insurance When entering an insurance payment go to PE Payment Adjustment Entry Insurance screen amp PE Payment Adjustment IE E jE x rei Fr l Lookup Data Entry KD Cancel 2 AQuery i7 B Full Rights General ERA Attachments ku Payment Id dar Trans Date r Dep Posted From Ins Co lassification CH Amount RiParkys el pit method RIP Bal Trans Type E Chk Mo jRefer Comment a Charge E Insurance Company Inact claim Type Pc Frm Subscriber Insured Member
37. m NEC Insurance Patient i ER Id Belen BOS pone Amt EE Ins Cot 91 HMSA aes eg ewen T Aula ala loejozjos jc pos 107 19 0 00 SE 0 TN FF Bal 0 00 SU o HMS AMSA i 4 E i s Distribution oss Charge Amt Patient Amt Profile Dfnt Allowed Amt Start gBal Contract WO Paid Amt Balance Adjust Amt Adiustment Type E Di 19 3 am 0 mp 100 00 Ai ri19 7 19 75 i 0 oo 25 00 DAR ci Cul gm gas Pdi 75 00 Adj 25 00 Insurance Appeals Le ee Clin wm Amsa iia i r nsurarice oan nac aim Tvpe Picim Form Su scriber Insured Comment 1 Company d ra Type PiClm Fi Subscriber Insured Stmt Msq Lal SEmt Cmnt SS Sg oe a Unapplied Amount 0 00 Tok CIN F 19 Tot Pd a 75 on Tat Ach 1 28 00 25 a 5 Documents Ka irt neg de hme i Error Check Save Save Next d al 6 When entering the payment the Allowed Amt automatically defaults Change the Paid Amt to the correct amount 8 The difference between the original Paid Amt prior to updating this entry and the adjustment you just made to the Paid Amt Is entered in the Adjust Amt field 9 Change Adjustment Type to reflect the reason for this change WO Courtesy write off PN 4104 A O 2007 CrossCurrent Inc Page 25 INCISIVE PM User Manual Diagnosis amp Procedure Code Lookup amp Entry Diagnosis amp Procedure Code Lookup amp Entry
38. mob tape th Deis Entry cancel I Deer mu P Pull Righes fete Cru Gerad fa CHANT ares Char Mois For Cry pcne he other Fir EEE w ie Cle Sep fave ets Follow up Reasons This is a user defined table and Is used to indicate the reason a follow up is necessary PN 4104 A 2007 CrossCurrent Inc Appendix 28 INCISIVE PM User Manual Table Reference FY Facilities B FY Facilities 3 LOMA LINDA HOSPITAL madmin 03 12 2007 01 28 PM EE fe l lookup 4 Data Entry KD Cancel aO Query P i Full Rights General Coding Schedule Override ST a ks Facility Mame LOMA LINDA HOSPITAL Facility Type H Hospital Li Address Cla Number Nat l Pyid 9999999999 Address Social Security Tax Id s3 2655555 Zip Code 99999 ANYCITY CA Mammogrph cert City JanverTy SE fea GI Email Main Ph Num Ext Website fi Fax Mum Appt Location WW Claim Cadina clair Coding Type HCFA ID Coc Secdry ID Secondary Number Type schedules mc MEDICARE Mo LONGER Z2T3 03n00D Location Number aaa E Comments Inactive Disallow Use Documents 5s Other Actions Error Check Es Save Save Next L Facilities Table Maintenance This is where you set up each facility that the doctor performs services such as offices hospitals or other locations This information is utilized by the appointment schedule
39. nee fae tri al Recall Reason Codes RR is designed to record and track the reasons you want the patients to return If you save your reasons in the database they will be more readily available to you the next time PN 4104 A 2007 CrossCurrent Inc Appendix 53 INCISIVE PM User Manual Table Reference RS Referral Sources E R Restos al Soutenir of Orne ol ee ETA E Te ies WC KS OCT Ader P os le a Fins Jterwnents Shilthn Actions af feros Check J Save Save Pepe Referral Sources This field allows you to set up a database file that tells you how this patient was referred to you Examples include physician referral provider referral service or a friend PN 4104 A 2007 CrossCurrent Inc Appendix 54 INCISIVE PM User Manual Table Reference SAM Statement Aging Messages E SAM Sfoteroni Aging M eran en 1279 Thin in the mersags for over 170 day 3 d Lookup Gate Entry Sconce D A Query Fi cts y 10i nee Far EEI Corne Th o ite ree Che a OR hes Caer Fr m bbs immu opm Pom wwe mx Tax m tte sup Fon er Si pL Dn amend m Cher fia bee mf erer Cheek ner Sane Hd al Statement Aging Messages SAM messages appear on the statements if you choose to print your statements with the aging detail You will need to change the statement message prior to sending your statements for the first time since they are set with generic messages The messages can be changed anytime you just ca
40. payment is by check enter the check number 5 Enterthe amount of the entire check 6 Charge Enter the Charge ID from the EOB 7 Allowed Amt Enter the allowed amount 8 Paid Amt Enter the amount that was paid 9 R P Adj Amt Enter the amount adjusted if any 10 Adjustment Type Click on the ellipsis or enter the type of adjustment IL Fin Resp Lvl If the responsible party needs to pay their portion change the Financial Responsible Level to 8 Responsible Party 2 Stmt Msg Payment Statement Message B Stmt Cmnt Payment Statement Comment Important NOTE If there is more than one patient on the EOB DO NOT Save after applying the first payment Instead click on the blue plus symbol shown above far right which opens a new tab 1 Patient You will need to enter the Patient ID for the subsequent patient s from the EOB 2 Repeatthe steps outlined above 3 When all charges from the EOB have been applied and the amount is zero click the Save button PN 4104 A O 2007 CrossCurrent Inc Page 55 INCISIVE PM User Manual Payment Entry Co Pay Without a Charge PE Ei PE Payment Adjustment Entry Information 100 HULL DANNI AM 07 03 2007 11 47 AM Ere HP l Lookup gt Data Entry KD Cancel asy Query i ery Payment Id 100 PiLdar IS Trans Date oz rogo Ka Dep jor foo KZ Posted From Ins co RParby 10 HULL DAMMI L LI Pyme Method Ck Check LJ RP Bal 60 00 Trans Type P EOB
41. the responsible party on the General Tab f Financial Class Click on the ellipsis the majority of the classes are pre entered J ust pick and select g Billing Provider Click on the ellipsis and select the Billing Provider h Facility Click on the ellipsis and select the Facility i Ref Doctor Id Click on the ellipsis and select a Referring Physician if applicable j Pt Lst Seen Date patient last seen by referring physician if applicable k Supervising Doc Supervising Physician if applicable I PCP Doctor Primary Care Physician if applicable m Employer ID ID of employer if applicable n Employer Name If an Employer Id is selected the Employer Name is automatically populated o Work Status Click on the ellipsis and choose a work status if applicable p Marital Sts Marital Status if applicable q Symptoms Date Enter a symptom date if applicable This prints in box 4 of the CMS 1500 claim form r Similar Condition Dt Enter a similar condition date if applicable This prints in box 4 of the CMS 500 claim form s Accident Date Enter an accident date if applicable This prints in box 14 of the CMS1500 claim form PN 4104 A O 2007 CrossCurrent Inc Page 3 INCISIVE PM User Manual Registration amp Related Information t u v W x J ob Related Check Box Check box if accident is job related This prints in box Da of the CMS 500 claim form Oth Acdt Check Box Check box if t
42. to PC LAN Ke fee Abe eee Ted RT OR OICHT EK RTE RATS EEE A n mpieer Tui Cnm Farm Symptoms Date Beides Taie D Lei me D r Wick Cp n D o ee 2 1 E n Carat m EE Aiba cca Si T tioa faite ei E Citadel Prairie i SS el ZUM q ma bih Brigit om aur H T6 POR CARE KR DE an rent Ross Change the P Clm to process as N Leave the Member ID Number blank Payment Entry Create a case coverage Coverage Case Info tab for the insurance plan that you are correcting Note Y ou may create multiple case coverage for different insurances that may need corrections PN 4104 A O 2007 CrossCurrent Inc Page 80 INCISIVE PM User Manual Payment Entry a um eee Cede Abert a rent a CRT PM LENT REES rar jen Y Aen So WE i Bees Feonget free O O O OOOO Werl 2 md rl Nak Dag cde NEN L son soon E i cir Lt HI p KEN OO it D Ld Charge Jed Dion eh Patan del LI J o a loses Other Action Siren Det Ans eei 6 Create an IE incorrect entry procedure code This will not distort your reports since it is not a valid code 7 Goto CE 1 WL Ghee bien aru ha Miele Aen DOS 1E Mine Enr LE LO piste imapi ant hour ni Rd S B I RE d io ae tse umm m iecur R S MET e e p Habes
43. to select the type of classification and is used to group charges in a department for report analysis Enter the code click the box or press the F2 key to make your selection e g D for Doctors charges H for Hospital charges etc Referring Doctor This populates from the RI screen PN 4104 A O 2007 CrossCurrent Inc Page 33 29 30 3l INCISIVE PM User Manual Charge Entry Date Patient Last Seen This populates from the RI screen It may be changed if the date is incorrect Hospitalized From Date The beginning hospitalization date must be entered on hospital charges Hospitalized To Date The ending hospitalization date must be entered on hospital charges if known Supervising Doctor This populates from the RI screen Employer This populates from the RI screen Work Status This populates from the RI screen Marital Status This populates from the RI screen Symptoms Date This populates with today s date Accident Date This populates from the RI screen Last Menstrual Period This populates from the RI screen Similar Condition Date This populates from the RI screen J ob Related Other Accident Auto Accident Place These populates from the RI screen Patient Copay This populates from RI screen Initial Treatment Date This populates from the RI screen You may also manually enter the date Last X ray Date This populates from the RI screen You may also manually enter the d
44. 007 CrossCurrent Inc Appendix 7 INCISIVE PM User Manual Table Reference CD Clinical Documents iA ERI EMITIR TN Te OCT NC B Lu DIL OBI dT WK Ee AM K l le x EI o otppbuet 005a Entre po n Aer Fy Ly fed Mighes E Abbe General Coca ete Fe Las i rd Lien d i in i z J CF La Essen Den ell Eue Ciel m EE p j jeepin La TS Pt nmi pex Deeg Cora id T Sree turn oF DON Pi te ict Fais ler Later el Controi F CE RC eeqiate t HN Iesse Mote a Licha oct Mice a 1 Dirt m hun Pis Pics m itrror Check iar Stock iare Font sl Clinical Documents From this screen you have the ability to do medical transcription Once completed the document would be saved in the CI Clinical Information screen under the clinical documents tab Templates could also be set up in the DE if needed PN 4104 A 2007 CrossCurrent Inc Appendix 8 INCISIVE PM User Manual Table Reference CHL Chart Location B CHU Chart Ig ch 1 th get 2 Rama fre RE TEE PULL ivy i pni bar cow ere COTE Mee me e ei hr ial am z hao E Dc HORDE b CE Chat Enim perl ie De DS fe oe afte Ibi ncm ere j he Seti RE Forquoha ss Eam Lenbe ch tien T ihrer Aries m Pk Ai Chart Locations Chart Locations allows a practice to track where a patient s physical chart is located e g Chart Room Dr s Office Registration Desk Nurse Station etc from within the Appointment Scheduler
45. 04 A 2007 CrossCurrent Inc Page B INCISIVE PM User Manual Insurance Topics Insurance topics CE PE RI When working with patients and insurance carriers a number of variables come into play In the following pages we will cover the following topics What to do when the secondary insurance allowable is higher than the primary insurance allowable How do handle non participating insurance carriers How do manage AIPO Accept Insurance Payment Only patients Please note that the screen you use will depend on the task at hand The Charge Entry CE Payment Entry PE and Registration and Related Information RI screens are all used in the following examples PN 4104 A O 2007 CrossCurrent Inc Page 4 INCISIVE PM User Manual Insurance Topics What do do when the secondary insurance allowable is higher than the primary insurance B CE Charge Entry Information 390 PT Akasaka Linda DOS 1 16 2006 DOC Mahalo Carolyn Stephanie 02 14 2006 04 41 PM ek rs o L lookup 2DataEntry Cancel 5 jQuery 2 Lull Rights Insurance Information Insurance Company inatt Claim Type P Clm Form Subscriber Trisured R IEn Member No Employer Grp Number AJA P kHHMAA MaA Lj lCommercial Grou IN P 11i cassis pds Je 576986635 e Has N Wess Linds S HOODOLOz12951 Release SOF v Medically Unnecessary Champus Branch mI Ins Payment Waiting Period D dE s n LB Y j Payme
46. 2007 CrossCurrent Inc Appendix 34 INCISIVE PM User Manual MED Medications MED Me dboations Tor 1 LO PEEL pg AC OZ Tute tert Zi LS SOON Me EKRAN OT a gOaaEmmy Cancel EN Quen P team ge r ni bis gei Cae Te ADR ieee resp mr Long Fare cc Medications This screen allows you to set up a medications file PN 4104 A 2007 CrossCurrent Inc Table Reference Appendix 35 INCISIVE PM User Manual Table Reference MRL Medical Records Locations 7 RH Metical Record ocalona LA RS Medical Records madoin crkFlrftac OF 0 a BN TIC rs Loan poate E ng Caen 7 nouer LE Dana Pares PS iji Va Tee wa Gene al Peep ani Tha ins rmn hd Hm E ape gg Emmy bie ad Masc kt sec p DEGERE RE Lea bis Less i bm i Lyche Ficcumed ecc Dora e Cher Actos B Eror exce Ki Sare o ave Pure and Medical Records Locations This is where the code files for the medical records locations are maintained It is used to track medical records requested on a patient in the PA patient administration screen under the miscellaneous tab PN 4104 A O 2007 CrossCurrent Inc Appendix 36 INCISIVE PM User Manual Table Reference PC Procedure Codes BI wu F a hilar e Denpoo Ce Vea ae en s em Department EM Evaluation Manageme Rea Reason Bel Vake gr p Hutrgcde Ru Leg De pe Pscement f Central Versus C IT Cie obeak
47. 31 2005 Ka User s Leave blank For all iler Kik Print 5 Preview When you are running CREP or PREP INCISIVE PM ask you to provide the following information 1 Transaction CutOff you can only post changes for the date entered here if you enter a name in the User s Leave blank for all box 2 User s Leave blank for all If you enter a User Name with a Transaction CutOff Date you can Post Charges again for that same transaction date If you leave the User Name blank this LOCKs the date and you will be unable to post for this transaction date PN 4104 A 2007 CrossCurrent Inc Page 89 INCISIVE PM User Manual Day End Month End In the following example the screen shows that you cannot Post any services or payments with a transaction date prior to 8 31 05 S CO Company 1 Anytown Medical Clinic Diane 09 21 2005 04 41 PM El IF i Lookup 2DataEntry rancel qa Query KE General Settings 4 Co Name Anytown Medical Clinic Se Address P O Box 25668 Address Po Zip Code 96625 Honolulu HI m city Honolulu St HI ERI Main Ph Num 208 536 0314 Ext C 1 Fax Number 808 532 0320 Tild 1 Default Global Statement Message Transaction Past Befes Charges 08 31 2005 el Paymknts 06 31 2005 gt Lookup Recent Documents oe Actions Error Check d 5ave Save Next d Note If you have the rights and change these dates any change you make to the Transaction
48. 7 el Dep 07703107 Posted From Ins Ca PACIFICARE 3 imaunt RjP rEs Park e Trans Type ell 3 Fare Comment z HULL DANI L BE lt i Insurance Patient Alerts RIF Alerts Appeals Open Charges charge 79 HULL DAMMI CH Ins Co 1 PACIFICARE nsurance Company Inact Claim Type PIC Free 5ubscriberzIrisurec Meraber mo PACIFICARE I E DEFAULT M P ice HULL DANNMIL 2498281 01 RIP Bal 20 00 ALES Apply Distribution ees J Procedure Code Gos Xharge Amt Patient Amt Profile Amt Allowed Amt Farting Bal Zontrack wo Paid ame Balance ins Ady Ame Adjustment Type 99212 OFFICE VISIT FOcCLUSEHEOS 704 07 70 00 000 70 00 0 00 70 000 pn Totale 70 00 0 00 0 70 00 a 00 40 00 70 00 0 00 4 i b nome SI Se rant Uneppicd gag SEN aan Teta aa Total 7 aset 000 S ch 0 00 p sume ae 0 00 ML s Documents Other Actions E Error Check ave NexE I me 1 The Trans Date Dep and Classification load automatically 2 Trans Type Click on the ellipsis and choose P EOB Payment or Pay w Adj or A Adjustment Only if you are making an adjustment and click Select 3 Payment Method e g Cash Check MasterCard Refund Capitation Payment etc 4 ChkNo Refer If
49. Al Cell PA Mum i Fax Pt Classification Eoo I Email Appomtment Hold Statement Hold Employer i TELECOMM COMP UTER SYSTEMS J Empl Name Site TELECOMM COMPUTER SYSTEMS Date First Seen 03 23707 Last Seen 05124107 Work Ph Num 951 688 8100 Ext Lang Preference Ll Inartive Dteinact Disallow Use 4 Documents Other Actions e Error Check Save Save Next LI 1 When registering a Workmens Comp patient confirm that you are on the General tab and select WC Workmens Comp R P Def Fee Sch 2 Enter the following information Twel LI lo Pease Tikhe wfc a C C Eff Date Enter the Coverage Case Effective Berne Date cic EFF Date Trm Trm Enter the Termination Date if applicable sand E Financial Class fe we OEE PS Corl Billing Provider 1 DCUPLoePr LT OU Financial Class Select Workers Comp Facility j c3Erric E Billing Provider Name of Physician Ref Doctor Id ESS VDAN PE LSE Seer Facility Enter location where patient was treated Supervising Doc P FPF Cor f Ref Doctor ID Name of referring physician if applicable PN 4104 A 2007 CrossCurrent Inc Page 1l INCISIVE PM User Manual Registration amp Related Information 3 Under the Coverage Case Info tab enter the following information Employer ID An Employer ID MUST be entere Work Status A7 TIME OF ACCIDENT The work status of the employe
50. B be Lime a Te mms die Pa ams meri itan Frmkss En eee Ce SW General tab 1 Charge ID Click the sign to receive the Charge Id for a new charge If you want to look at an existing charge enter that charge number Patient Enter the patient or look up the patient by last name by clicking on the ellipsis or pressing the F2 key Coverage Case If the patient has only one coverage case the data defaults into this field If they have more than one you will be given the option to select from the list Responsible Party This populates from the RI screen Billing Provider This populates from the RI screen but may be changed if another Provider within the clinic saw the patient Service Provider This populates from the RI screen but may be changed if another provider within the clinic saw the patient This field may be also used to report services provided by a NP PA nurse or other technical personnel Facility Location where services were performed This defaults to Office and may be changed as needed You may look up the facilities by clicking on the box or pressing the F2 key Accounting Transaction Date This is the date the charges are being entered You may press enter to accept the date that appears in the display or you may key in the appropriate date You may change the date by pressing the plus or minus keys Financial Class This populates from the RI screen Charge Class This is used
51. Claim Stmts History Procedure Pay Appeals Follew up Attachments ZE X CHER Bue EME si Adjust Amt Balance Total j e eg P 0007 70 00 Responsible Party 20 00 Trans Total dos 420 00 Check 78963 20 00 Os 07 20 00 Check 758863 20 00 Forals 40 00 40 00 Print Id iun iui Insurance PACIFICARE Documents Other Actions CF Error Check Ka E Save Save Next 1 Lookup the Charge Id for the Unapplied Payment s 2 Select Apply Pymt Tab 3 If there are unapplied payments the Information Bubble appears next to the Apply Pymt Tab 4 The Unapplied Payments are listed 5 Click on the Pymnt Id you wish to apply to this Charge 6 Click on the ellipsis PE Payment Adiustment Entry Information 7 Click Apply this payment to current charge Apply this payment to current charge This prompts the PE Payment Adjustment Entry Information screen 9 Paid Amt Enter the unapplied amount 10 Click on the Save button at the bottom right corner PN 4104 A O 2007 CrossCurrent Inc Page 59 INCISIVE PM User Manual Payment Entry Electronic Remittance Advice Retrieval ERA L ERA Electronic Henttage ebhriwtre Hetrzgsai oko Daka im Canoe aQuery Fl pete Cee General iip LAN i i te F 1 Click Lookup to locate your check number 2 f check number is not listed click Check Responses Met Healthelainy Ser
52. CrossCurrent Inc Page 78 INCISIVE PM User Manual Payment Entry Handling Incorrect Payment Entries that are Posted RI di DUB pale ef cs dent ed ee ere eee ki ELF 1 U ber Ke e dl emails erie pf d pos es Los T Carpet KT MERC P PLATT cess Parte ren mrad Posee Pa i ha bep Biin Piom Li m E pite rr fer e Bir Mr Ee BLA er i a t K ke gi K Fame o Ball r das Tir Eh city d Bai Ze EC TONI KR i es E LAS DSL A dud Heal Leura d deh Wey a 5 St i ii hirie PIG Ex PEEHI SCHT ORT FT WTYR Ih Lenker zi Nc Hia Dei eee D rep El e agence Mi a E DE de i mt Nar sg EN Hig so Bii E Create a Miscellaneous account This Miscellaneous account should be the patient responsible party and subscriber insured Create a case coverage Coverage Case Info tab for the insurance plan that you are correcting Change the P Clm to process as N Leave the Member ID Number blank Save NOTE You may create multiple case coverage for different insurances that may need corrections PN 4104 A 2007 CrossCurrent Inc Page 79 INCISIVE PM User Manual T i E i Ft EET E RS ERHTEERS DELL Dod CHEESE EE TEE STET ER ETT fo demus ibaminuy erg Gene Coverage Come Lie Ao okap opor mwenrc Area gra Document mn T 1 1 Ck Df Dre ei time Hem Farb MISC enter Gon fermo Caen ee ae Pe Lu Been Speer semrng Doc Cp Doer Save Go
53. D iim HIT ar ma 1 gm See eria Bea nimi E LA K d dem po haee prog bes CLR HIE rA LL ER Pala g xxx ee Zeg Pig Dead rii Eam UE i i EMI S cales EC EIE X3 O G xj I T inp Wi Po Ehia dei FAAI Cru 0 aay E D a EC re d Shier Actos D Ecce Dni J Trasr eieg Cd ee Once electronic claims are processed you will see the detail of all claims and errors if any Claims containing errors will be listed under Error Message From this screen you can go directly to the charge and make your corrections eee Clee amp uA Chips Fra GAR KS mig n remuant BIZ Af MOOD IR hf FER ex ie n e dA tees Casta Tener Ca eher Fe a Pull agnis ei i Es a ter La Zeen Encens d uf erun Cas Aert in free Leer ec Of lee dy Acct shat Daim Acct End D ss Poshad Charger we LUrgegte wi ame Facet re K Proc es Claw Clam Types B Modhe Charges Change TEPIH S b toi es bbw Less kipi for al fum ai i Las Doi d Pow adi Jro eg rmm Hesse Copa Feriaj Pee haa a CET Careers kwai HI dns 1l i Linc ue pisi For ali For ei IL i hs iher pre ep af fro om a A Sae l6 Having completed your corrections click the General Tab to Process the claims PN 4104 A O 2007 CrossCurrent Inc Page 44 INCISIVE PM User Manual Claim Processing V Process Type e 18 Change the Process Type from Proof to Final Proof D Click on Process at the bottom of the screen Se
54. DC PC CE Two fundamental activities involve the ability to lookup and enter both diagnosis and procedure codes In the following pages we will cover the following topics How do find a diagnosis code Diagnosis Code Lookup amp Entry How do find and enter a Procedure Code Procedure code Lookup amp Entry As you probably suspected information on diagnosis codes is accessed through the DC Diagnosis Codes screen while procedure codes can be found on the PC Procedure Codes screen When entering these codes you will use the CE Charge Entry screen PN 4104 A O 2007 CrossCurrent Inc Page 26 INCISIVE PM User Manual Diagnosis amp Procedure Code Lookup amp Entry How do I find a diagnosis code DC Diagnosis Codes DCI Diagnosis Codes 296 82 Depression Hill 05 15 2006 11 21 AM i l amp tookup Data Entry EP Cancel LAQuery Pl 24 Full Rights Lookup Description Has tdi 296 82 id Sha SSS SSS Description Depression id Description i lis51i 9 Malignant neoplasm oF sto SS d LS E GE Sere ee A d T 278 07 Overweight eet Sien m e Long k EEE Ort j ter sl SAFIB 428 1 aZHF LF HEART 585 6 End stage renal disease Age From Gender Limiti il 1616 10 aginibis Tuo Mot Specific Comment Inactive _ Disallaiy Use y Select Cancel Select Documents gt Other Actions Je Error Check Lip save A Diagnosis Codes search c
55. GO e M l ihanaan Changa Is ie tract Fieri as Bee 1 D r e Es RB JAMES POS Tee sie erte EU s eme frai ere rat Ane em pm Chetan Tur Di n b Ge ume w gum Ae Sal r an El mt gba che ei 3 7 8 Create a Charge ID and enter your Miscellaneous Account as the patient PN 4104 A 2007 CrossCurrent Inc Page 81 INCISIVE PM User Manual Payment Entry 9 Select the Coverage Service Detail tab Enter the IE procedure code you created with a zero charge Write down the Charge ID number Save IL Goto PE Payment Entry e LU j fend Aller 1 d fat LITT eee tee OO ERT a Wa Y te aede Apgepet eng Dem M larum Foret WK 70 lied ie p MITA lente Fem Pras Pee pra pe Pa nm Carte T NU PER mum yon m kar hm xj e rhet CES Lien jes Te EO Paemeht OR T nan Eod adn pencc omn cae rrr edt G nz etaneecn 01 711 PJ S bent LL n i IMgb Fami mr Gere a b sse Fa art raid dee ae eee i a i r LN ET Ama E L ee yenit bam mam deron bs iu Rm n bul i e a O O O EE Lage LI guine ron pum oun ie Ed k ks pna I YT hz Le CR hil Wo om ifr RT au pes Ka si S D CT TIE doni To EN 1 A repaire oe ET eus omis Fos deel bes Setrote Coco e Def do mera ih Sit Hes aliie aun e deo hoo M po bo po E Iech pa b fens G diei Seenen ed Bag ra geg 1 geng Leg pg es Hart em rom pin pn becs rines regen He at at e ne r
56. Goto the Unapplied payment ID and drill down on the ellipse 6 Select Apply this payment to current charge B PE Payment Adjustment Entry Information 250 Brown Lucy Stephanie 01 10 2006 03 33 PM fe Ia id beokup Dala Enty MCancel Query F General Payment Id 250 From Ins Cor Trans Date 01 10 06 xl Dep 01 10 06 ibis e Posted Li Classification PP Personal Payment Amount s 32500 Aute ee mn Bi CE Charge Entry Information 355 PT Brown Lucy DOS 1 10 2006 DOC Mahalo Carolyn pu Rights Trans Type P EOB Payment or Pay wad LI Chk No jRefer deene A9 Comment Brown 01 10 2006 355 Patient L al Charge 355 Brown Lucy eal Ins Co RIP Bal 000 Eure Ip Hmsa LL Distribution DOS Charge Amt Kongs 06 00 Open Charges Responsible Party Chrald Patient BOS charge Amt Balance Patient Amt Prafile Amt Allowed Amt Starting Bal Contract WO Paid Amt mom 0 1 om 0 1 oo E Balance Com am 4 CHW n 0 00 Pd 25 Em Adi 0 00 0 an Comment Stmt Msa Stmt Cmnt Unapplied Amaunet 0 00 Insurance Insurance Patient Alerts RJP Alerts Insurance Company E EIS 22 wj jue Tat ciw 0 00 Tat Pd 25 00 Tot Adj A Paid Amt Dip Adjust Amt Jl Pic Frm Subscriber Insured o o de 12890 FA Contract WO Adjust Amt RJP A
57. INCISIVE PM User Manual 10 December 2007 CrossCurrent Incorporated 1200 NW Naito Parkway Suite 200 Portland OR 97209 PN 4104 Release A 10 Dec 2007 INCISIVE is a trademark of CrossCurrent Inc Copyright 2007 CrossCurrent Incorporated All Rights Reserved This reference manual Manual has been created by CrossCurrent Incorporated CrossCurrent for use with the INCISIVE PM software and or database Software described in this manual The Software is subject to the terms of the End User License Agreement EULA accompanying the Software and may be used or copied only in accordance with the EULA Federal law prohibits the copy of the Software or this manual except as specifically allowed in the EULA No part of the Software or this Manual may be reproduced or transmitted in any forms or by any means electronic or mechanical except as provided in the EULA or with the express written permission of CrossCurrent Microsoft Windows are registered trademarks of the Microsoft Corporation Copyright 1998 Microsoft Corporate All Rights Reserved CPT copyright 2006 American Medical Association All rights reserved CPT is a registered trademark of the American Medical Association Applicable FARS DFARS Restrictions Apply to Government Use All other trade and brandmarks are the respective property of their owners INCISIVE PM User Manual Contents Section ROOI CA Lo E 1 RP TODI ruini T on tu an 2 Diagnos
58. Insurance Company ar Hole Inact Claim Type Pfam Form Subscriber Insured Rlta Member Mo Employer DEFAULT jM IP E LAT FAR E 1467435276 Release SOF e Medically Unnecessary El Ins Payment waiting Periodi o Payment SOF P Patient SEakus Other tte nt IMEEM Diagnosis Code Chra Id k 1244 9 3k Exp Date Procedure iade Procedures Procedure Code Gd mad Fee Schedule ki992i2 FA ET FER iD z Ed Start Date End Date 02 21 07 QE Dx Line Ma 02 2107 1 1 Profile amt Patient Amt Charge Amt CoPay Fin Resp L 10 00 70 00 a al Patient Copas Tot Prf 0 00 Tot Pat 10 00 Tot cha 70 00 A Documents gt Other Actions Error Check Ee Save Save Next A Enter the charge for the patient Create a payment PE from the payment screen for the patient co pay if any Apply the payment as an adjustment to the charge as if the insurance company paid PUND When you receive the cap check you will need to set up the Capitation Insurance Company in the RI Registration screen e g Capitation St Mary s Choice _ 2 Capitation St Mary s Choice CAP madmin 03 19 2007 05 00 PMJ E E LR Lookup fy sy Full Rights o ox Rr Parties Patients Insured Patients Registrant s Responsible Parties Capitation Store Choice CaP ES Ri Reeistration and Related Information eu Es a Data Entry ED Cancel a Query
59. Lanc GI oae Ye i ueni ups harsa Cowie Cep Emeh NHN Lis Er ii e Carpet Caster Che LE Hi ulus cp b db See KP LE a Frejaa Gg EU Felgen ricespeh al em argo eer donc a ei Bem asm i Hos Longs cmd ce Drees ws T Other Actin ef Error ieee SEN Lave mai aad Place of Service Codes This screen has been set up usino the standard HIPAA Place of Service codes PN 4104 A 2007 CrossCurrent Inc Appendix 47 INCISIVE PM User Manual Table Reference PRP Print Registration Profiles PHP Mrima raio rfi tes alle d cedens zs Cogniel W Chose Dem eee z JI Ferrer fast Gr coser aan IER Cerat adm Eed Pe Hen wien Fed Ma Creer i Patna E rer ew Cie Cent Saba HE I Dum Feder EC TR Thea SO EDEN Paci Prowler Les de oe Peeper Breen er m a Pres Print Registration Profiles From this screen you can print your registration summaries either by patient or by appointment You can get to the PRP by either right clicking on the appointment day provider or facility in the AS screen or you can hit F2 and type in PRP PN 4104 A 2007 CrossCurrent Inc Appendix 48 INCISIVE PM User Manual Table Reference PTC Patient Classifications i Le Peedi Chee el ee AERE COGERET Sar Lena tf Kik FACE PA Al Fe Le x e A Leshi 2 Gate teure Saat 7 aqeew F hui Pages Boden dr 1 As Tzu ww arret id Loptirg n ih Er CE pg ud Ve z F j Cap Care E
60. M User Manual Payment Entry Co Pay With a Charge PE PS PE Payment Adjustment Entry Information 102 HULL DANNI AM 07 03 7007 01 06 PM F je EH l lookup gt Data Entry KD Cancel asy Query PI EXFul Rights General ER j ttachments Payment Id 102 Pildar Trans Date 07 03 07 e Dep jo7 o3 O7 Posted From Ins Co 7 El Classification TOF TO PAYMENT Amount si EE an amp amp auro pots siis sica m lt Patt Method ex heck d RIP Bali 20 00 y CK Check Trans Type vip EOB Payment or Pay wfAdi EOE Payment or Pay vifAdi d ThE Ma Refer EET Comment HULL 05 10 2007 61 A Patient 10 HL GANT L ll pert t harme 3 Insurance Patient Alerts R P Alerts Appeals Charge 6i POLL DANNI JW mS Id Patent ovs Charge Amt Balance Paid Art ContracE WO Adjust mt R P Balance R P Pi a ML EI IINE E EI UNES 10 HULL DANNI 05 10707 470 00 5000 420 00 0 00 0 00 0 00 ks i HULL PANMI 05 17707 70 00 70 00 40 00 0 00 0 00 20 00 Ein cla col COMMERCIAL IB E HULL DAMMI D6I04 07 470 00 70 00 40 00 n na 0 00 2000 Et 40 00 s HULL DANNI 07 02 07 915 00 915 00 amp n nn 0 00 0 00 20 00 F Totals 1 125 00 1 105 00 20 00 0 00 0 00 460 00 x AUS Apply B _ NE E Distribution Sr He Procedure Code bos L I ma Arabes Patient Art Profile Amt Allowed Amt Star
61. Models w Select Cancel Select Documents Other Actions f Error Check Ga Save 1 The CCCs Charge Classification Codes are setup on an individual office by office basis and are used for reporting purposes and charge breakdowns Most offices track Hospital charges vs Office charges 2 After making your selection click Select PN 4104 A 2007 CrossCurrent Inc Page 37 INCISIVE PM User Manual Charge Entry Insurance Coverage Service Detail tab CE After locating the patient you may want to access the insurance information This can be done directly from the CE Charge Entry screen CE Charge tnireiiniprmgton Mela ERC d Ludo Das En Cancel ary EI PE a Pull R ghes ferens d i Aa So aca Cm peer fg Pee gee Clee eo Pee Par BEES lior Ap 9g mm Ph sg i Port raters z zi Feige Mama A dii TR IM ig Frais Ha Pte Seti ve K i Epika aver ge ee o Dype Dust Tias iA Desscptiam gehen vil Ze fo Go tie Fi Le Chae a Pe Io mede Lis Care Pt tul ey hie ai Prier AT Pa Se T pl ze Ena Irgtal Trid Lan Cassel Fre C e Facit L t kass Can rt Tran e ah Last Bow dee nna s LE De per Purba r Casta d Frs age Actives Arraila E eweg B ss o TL dera Posi rama Dect ce Entri Da EI CCR ser fe ar meme d cxi die Pa p ans Samen ten Frm ifs te ravir Ce asd i i Ta Otierr Arbis a pen el Click on the Ins Coverage Service Detail tab Insurance Coverage Se
62. Process Claims Should almost always be Yes Form Claim Form Select Electronic or Paper Subscriber Insured Defaults if this person is checked as the subscriber on the General Tab R Itn Relationship Relationship of the subscriber to the patient If the subscriber is someone other than the patient you will need to register the subscriber as a person Member No Enter the membership number employer and group number Employer Automatically entered when an Employer Name is entered above Grp Number Enter the group number if applicable Prior Auth No Enter the Prior Authorization Number if applicable This prints in box 23 of the CMS 1500 claim form Claim Number Enter claim number for worker comp if applicable Block 19 Local Use Enter information that needs to print in box 19 of the CMS 1500 claim form if applicable Block 10d Local Use Enter information that needs to print in box 10d of the CMS 500 claim form if applicable Comments Enter any comments if needed Release SOF Check Box Release of Signature on File This prints in box 2 of the CMS 500 claim form Payment SOF Check Box Payment of Signature on File This prints in box B of the CMS 500 claim form Patient Co Pay Enter patient co pay if applicable PN 4104 A O 2007 CrossCurrent Inc Page4 INCISIVE PM User Manual Registration amp Related Information r Medically Unnecessary Check Box Leave blank S Patient Status Other Ch
63. SIVE PM User Manual Table Reference PIR Primary Insurance Reflag Primary Insurance Reflag This function when run goes through your system and resets all claim flags to yes for claims not paid in the specified period of time specified The next time you process claims it picks up those claims PN 4104 A O 2007 CrossCurrent Inc Appendix 45 INCISIVE PM User Manual Table Reference PMC Payment Methods E PMC Payman Methods C0 Cah modmin 101 742006 10 59 AM Gicokup hamis fmiry Cancel Query Fi caca Yo i l Gagt gal Ei er dn i j D fe fa a j H al ee Lan id Leri eE em E Lisch i crm besteed biss r er dcm Era Bet ai Decor m Ss Other fia ieee m erer Check ina Seyen al Payment Methods Table Maintenance PMC allows you to set up the different codes describing how the payment was made It is part of the payment screen PE and identifies the method of payment cash check non cash adjustments credit cards etc You also have the ability to decide whether or not the method prints on the daily deposit slip by checking the include in deposit box For example if you do a non cash adjustment you may not want it to print on your deposit slip PN 4104 A 2007 CrossCurrent Inc Appendix 46 INCISIVE PM User Manual Table Reference POS Place of Service Codes a PL ES D eee of LR uu Lore 77 Doctors Office finmodmin FSM Riss OF FP Pa pot ipoh j Oa Entry T
64. Schedule Overrides Procedure Facility Claim Coding Schedules Id cAP in Recall Reason Rel value Units Mat Drug Cde KH Lag Days Age From D Ta Sender Limit i claim Coding Procedure Code Type of Service PrE Desc Pin SfUnit Black 19 Local Use Schedules L Medical Care Fee Schedules Fee Schedule Type Co Pay Charge Amt Protile Amt Patient Amt Pak Sec Ob Lei Days 100 Mon Cov DEFAULT HN Comment Inackive Disallow User Documents lt Other Actions Ef Error Check LD Save Save Next Li 6 Add your 0 00 charge Then go to the payment screen PE Payment Entry S PET Payment Adjustment Entry Information 5 CHOICE AETMA madmin 027 2372007 03 35 PM iei HH L lookup Data Entry Cancel aO Query tz T 5 Full Rights General ERG Attachments 4 FR Payment Id s PILdar Imi Trans Dabe ozpzanmz el Ii Dep ne zsyo7 Ka ii Posted From Ins Co CHOTCEs SETNAS Classification CHP CHOICE PAYMENT CHOICE PAYMENT Amount 60 00 RJParEy i Psymt Method rd Li Chk Ma Refer BO 0 1 Comment Trans Type 4 Adjustment Only hra Id Patient Charge Amt Balance Paid Amt Contract Wa Adjust Amt RP Balance Capitation St Mary s Choice 9 Ins Co CEE CEHRORCEZAE TRO hacer ii RP Bal 0 00 aus EFA cae CAPITATI pp bm Distribution
65. Sep GA De ee Poe en fae Pat TO EAT SERTEPEN T EAT Tp eer Pont De PEL s gm Tage RE Lookup jiasi Pioa trounced ors a bel cf new albis riori mrs iT e SOI aer Give Phe Company Table maintenance General Tab The clinic name appears on the blue title bar and on the heading of reports The CO screen also displays the most current posted date for charges and payments If you decide to go back and add transactions for prior dates you can change the date here and run edit post again to close This is also where the default statement message is managed for your statements see the statement processing section for more information Please complete the following for each practice or database Co Name Name of the doctor or group Address Address of the doctor or group Zip Code Zip code of the doctor or group City State City and State of doctor or group Main Phone Number and extension Main phone number and extension of the doctor or group Fax Number Fax number of the doctor or group T Id Tax ID Default Global Statement Message This is where the default statement message is managed for our statements Transaction Post Dates This displays the most current posted date for charges and payments Note If you have made a posting error and need to correct it you must either make adjusting entries or contact your support personnel to un post the charge or payment for you PN 4104 A O 2007 CrossCurrent Inc Appendix
66. Surgery age From Ter aia d MOBARHAS Greet Surgery Clam Cover CamCodngT Can Coding Type Procedure Code Type of Serve 3000 EX Seier y we EYE OS Pr 212 Fitabisfwnt Paler Waal igazis emu da m Shoes Vater ChargeAnt Profle Ant Patent Amt Pal Sec O8 G Days Corr p L sm m E i d ke EH 6500 6500 P d3 noc mants Other Actions D Error Check Seve Sete m PN 4104 A O 2007 CrossCurrent Inc Appendix 37 INCISIVE PM User Manual Table Reference PC Procedure Codes Table Maintenance General Tab This is one of the most important screens It not only has an impact on financial settings but on the reporting of productivity as well In addition to entering basic procedure codes you will need to enter procedure codes with a modifier too Example After entering procedure code 93320 you will want to enter 93320 26 to include occasions when the modifier is used Id Procedure Code Description Description of procedure code Classification This is hard coded by INCISIVE PM Click on the ellipsis to make your selection The user must make the appropriate selection e g Iimmunization 22 Laboratory in order for the CLIA to print on claims that have lab work you must select laboratory for all CPT codes relating to lab work etc Department Once the department is set up yo
67. ael ly Py si neil OPN ri i CL EUR hice Balers ile eset ss iher Actions frre Liegeb H Tire Bave P Taxonomy Codes This screen has been set up using the standard HIPAA Taxonomy codes also known as Specialty Codes these 9 digit numbers are assigned under the HIPAA provisions to health care providers digitally encoding their specialty thus facilitating electronic billing PN 4104 A 2007 CrossCurrent Inc Appendix 60 INCISIVE PM User Manual Table Reference TD To Do C TD Te Po BT Samus ata Tor Puli tap dene nores OTL el Lo pets remm sc Ma N i thie Tins Lue lll Posee ID e Getfec t Fret di mees Dal Lal i E Begreep LIC PTE LLE ID Pups wi Foo Fr i A oe ee T a Polos sp hemp Asa To Dip Coste Clos LIRE EK rege 5icoes acte ELE ED stare duct pes 7 ornari LEE Cape patie Ls a era Brang Te ee Lal D dates ae Charge Ferd diens fa mre Fan PAU Cie Aer ed To med Dobe Cia L ti PL d s Damm i dfe P TER rare Mier diets ab uf la I E Ce fhi Bea Dess Ban BI Basan lo Chara Cen Cond Comet A D Preis To Do Follow up activities can be set thru the charge registration account management and patient administration screens they can be assigned to individual users and tracked from here if they have a follow up date assigned to it If you have administrative documents e g collection letters clinical documents recalls or follow up letters they
68. al Payment Entry YT LE Mk Lil ig att eles TI Emm Li te ded m ep vg Ee gtRrer Lie chau We fe SE EST LE dos bied fo Four xo ty en reg be Leg Get E pro mum l Z nn better Arer vemm A On the third tab of the Charge Entry screen Apply Pymt you should see the information symbol alerting you that there is an unapplied payment 8 Click on the Apply Pymt tab 7 ER HE MEER EN CP PET maa Et GEB ee ri ILR 7 PR UT Lo TU a E Ati Mee tire css TES qe rera raieragui sent beini i Apok Prnt Francis Ham Oe leader PSE Cu donne yee CH 5 a Pee Ga Image Mas heu TC NN Bhif Lr 4 TLC HA nh and CH Marx FPE rarere autant Ere fireman MOSS IR Be Up pe Ho Loe age 9 Drill down on the payment ID and select Apply this payment to current charge 10 A pop up message will appear select Disable Insurance Coverage Page 68 PN 4104 A O 2007 CrossCurrent Inc INCISIVE PM User Manual Payment Entry E JLE Citiis HTC T Pl apaiia la TOT TUUS m ok Alki jDaaknty Manuel Amer Y mme ga AE H a med bs Center bna Soir freti Sem rey feet ba 1 tege UTC Mo Per Check H Line iSneten IL This opens the original payment entry screen with the unapplied amount A tab with the DOS and CE you had just entered will be created for you Be careful to select this tab PATE etant Eni RENE fod ste ben iid So I IDE
69. an be initiated in two ways 1 Select from the Diagnosis Codes Lookup table a Use the DC shortcut F2 DC which prompts the DC screen seen above b Confirm that the Lookup screen is active left column of the DC screen 2 Starting at the Diagnosis Code entry click on the Ellipsis to prompt the DC Lookup screen PN 4104 A 2007 CrossCurrent Inc Page 27 INCISIVE PM User Manual DC Diagnosis Codes 296 87 Depression Hill 05 15 2006 11 21 AM Diagnosis amp Procedure Code Lookup amp Entry i Feil amp lookup ax Data Entry PCancel 57 ARuery F bs Zap Rights Depression Lookup Cactive only General Description Hs Ran ide 296 82 Td Sv A e aS mt Description Id Description 151 5 Malignant neoplasm of sta Ciyervaeight 585 6 End stage renal disease Age From 616 10 Madginitis Tat b 4i Mot Specific Comment Inactive _ Il Lookup Recent Models Select X Cancel Select Disall is Use D Ges Description PLUS m 0 i a E 1 D i Longi k Fatze an d __ 427 51 GAFIE 4289 1 HEJLFE HEART Gender Limiti LEE A Documents Se Other Actions Error Check Lip awe 3 Once you ve confirmed that the Lookup screen is active you may select your own search criteria Active Only Gw Starts With Eh Ends with Equals gt Greater Than gt Greater Than or Equal Less Than
70. ance carriers B RI Registration and Related Information 006996 Akimoto Stephanie 11 18 2005 12 00 AM IE zc Ir l lookup 2DataEntry Cancel LAQuery 2 Ful Rights Lookup Active Only General Last Name Shin Akimato Le HMSA es 4 E y A First Name Sin SF te Siw 3 Cov Case Title SP Employer Eo a o A D Sch Sin Ma d Employer Marne AkamaiPractice Mgmt 0 Practice Mgmt i Le Work status m Marital ste M Married fu Married e Date OF Birth gt Primary Phone Siw d Symptoms Date Similar Condition DE el rs Resp Parts ie 006996 Akimoto Stephanie Eed e Pt 1d DOB Mame pu M dAeddent Date I Job Related Oth Acdt 006923 04 15 1925 Akimoto Barbara Financial Classo other Commercial a LMP Date Auto Accidenti Pl LL T 006995 01 26 1965 Akimoto Matt Billing Provider Do Tan Troy ADDITIONAL INFORMATION e 05 04 1970 Akimato Stephanie Facility DO Doctor s Office m Initial Tmt Dtei e Hosp Frm Dte Oo e Ref Doctor Id L Last ray Pals E To HERE FEESE Seen tid Work Last Dte l Disabil Frm Date ui Supervising Doc Eoo F m Return Dite Ri el To fs DCH Doctor NM e Disability saus S sl Insurance Information Farm Subseriber Insured Bin Member Na Employer Grp Number Prior Auth No Claim kr o 006996 Amoco Stephan 5 575069634 Akamai Practice Mgmt Re
71. ate Work Last Date This populates from the RI screen You may also manually enter the date Return to work Date This populates from the RI screen You have the option to enter the date the patient is advised he she is able to resume work Disability from Date and to Date This populates from the RI screen You may also manually enter the date Disability Status This populates from the RI screen You have the option to click on the boxto look up the status options Active Recalls Patient Alerts Responsible Party Alerts These populate from the RI screen though you may enter new ones at this time PN 4104 A O 2007 CrossCurrent Inc Page 34 INCISIVE PM User Manual Charge Entry F WW LEE E rea ips mtr POmpom TDi pri TE seal bet EE piii j _ LEER a E EI os Sa ebe Achten gen CES hero ET DI Sent M aed Hiz ete ad docs anri lela Minne FLUG Cub Ft fem Ta P or a Leet moons erste z n Een ros al epep mu mnc m fiet a oe a djiga Curva geizatp1s LS ee ty marines Gece ace Sees vest EE ULJDi TUON Duni HD rinan Per bam ex J PAA hottes tas jpeztajos oe ew mi O panne ep dl jh En M Medeem OOOO O HHIB TSIB FLINT CH Ut 0 006 OSA are gamboa Ema apeere mie sement r Du IVSe dz EI AN ar El amar Ey al
72. ation amp Related Information Registration Patient Different than Responsible Party Subscriber DK Jet ation an Hinin DE intone teen heey LOUE Foret deren Pe MO PERC E DE E IE E o orto duode Osta mare TUE rece FA P owed qu irae Pagras eneral Corse be deck Ierd eegen eent cei Z s 4 PT errant La bor Easereci ferm tli Prag Stab Patent thine O O Maeporsable Partis Poe Fee ard Bm Sail B pod Sete pred Jul Mate Ld Deere Pent tacit lil La H Actes SATI Adam ve Mens Add sgr je Dp e Sint erch A Rey Bugs wica LJ Gate od tbe tie el bs Gei ef Fare a rue Eeer Ser mia Wege a dri Der Pas Eech Tocha EL Porra Fit hersi ains ra Poney Ph mm 9e e ID Et HIPAA Mores Dis Disc Mine Wi ef te blam Pa Fa Clearer Cond B esdemgeg dipl Tiamani Mod gesellt CR Marmi e bisbe Mies im Rm Le ts sic ks IPS Pm Exi i permet Cher Acton sf Error Cheerk 3 awe Sauver m In some cases e g child amp parent the registered patient is not the responsible party When this is the case you will need to register additional individuals responsible party subscriber in order to complete the patient registration This is accomplished by drilling down in the R Parties and Subscriber Insured fields RI Registration and Related Information 7160 Smith Mildred Stephanie 08 07 2005 10 02 AM d EA Lookup Data Entry TCancel El A Query
73. ave button PN 4104 A O 2007 CrossCurrent Inc Page 65 INCISIVE PM User Manual Payment Entry Solutions for possible Payment Entry scenarios encountered when transitioning from the former PMS to INCISIVE PM Erroneous personal Payment entered into INCISIVE PM In this scenario a personal payment has been entered and posted in a responsible party account in INCISIVE PM The total check has been applied to a charge leaving a zero amount unapplied A portion of this payment should have been applied to your previous billing system fi nl HESSE DITE EBERT pl ia mn Ir doigts ir Ceurral m tity Aion i Se n ULT ZA GI Oe a APA a a p Stan A ierg Fi Ayr magus Payment der EXE mes Chane APR Deme FLA Pina x ns on PE Seemed Buymert Amari Epwi HI dissss Lrds sl Pmt Method ok d sch 7 es lxi Type P LOU Pase vh Pld 2 CN Me RE unies 101 Domp Aha eaha TEF LEURS SFG oo EL 7 Lee Leg 2 Berg Vat Chu M Fami paw Dag APO b ssen En dur Corel KO EU uw CBE ar d ry F m Chge mA Auhainh Hii dre cat Er CT j un rn rir FPE map es NR zi b ire til be cx A Les eg der Homme a ege Ane G Deg Series ConmacoXwD Fei me Pam Qm muet ferg D s LA 5 00 Cp 0 0 a ou HS 3 Ji Ed FU pe TX Mn WOO Mndxrance Pasos den HUP kt Appeal tuus onpam Dat Cam True brem PIC Em dubeuibes fired beste B hi M ut ACO TASSE Dal Taria XL O Tat Adi PLA
74. ayment Entry E PMC Payment Methods NCA Seles isen LpoataEntry reegt Aen 9 aut rates Description Mon cash Adjustment Z tteg Comm nts Inactive Disallow Use i Jl mjaa g es Steenem Anne Are W s Geh mme seg 3 Create a payment entry PE PN 4104 A O 2007 CrossCurrent Inc Page 72 INCISIVE PM User Manual Payment Entry Payment ID assign an ID Enter the Responsible Party ID financial information in APM is based on the responsible party Trans Type P for EOB Payment or Pay wl Adj Classification the payment classification code that you had created Pymt Method the payment method code that you had created Chk no Refer enter a description of the credit balance E 9 D Ox IUE uw Amount enter the amount of the credit If there are no outstanding charges in the system that you need to apply this credit to this will remain unapplied I Save the transaction If you need to apply the credit to a charge continue to the middle of the screen enter the Charge ID and apply the credit accordingly PN 4104 A O 2007 CrossCurrent Inc Page 73 INCISIVE PM User Manual Payment Entry Balance Forwarding Credit into INCISIVE PM ATC In this scenario a credit exists in your previous billing system that could be applied towards an existing charge in INCISIVE PM or left unapplied for future use EB ATC Adjustment Type Codes CABC
75. b If the amount that you charge the patient is different from the amount you charge the carrier you will need to set up a Fee Schedule Type for Cash Enter the charge Amt Profile Amt and Patient Amt If you check Non Covered Charge by checking the box the claim will not print A F nnef Tangles S PR RE RS CN UC er M E s ERES SESE So SEAL RESIS as Procedure Group Codes tab This tab is used when grouping the procedure codes together e g suppose you want to group procedure code 99233 with 93325 93307 After setting up procedure 992 B go to Procedure Group Codes and enter the corresponding codes PN 4104 A 2007 CrossCurrent Inc Appendix 39 INCISIVE PM User Manual Table Reference PCD Procedure Code Departments E PED Procedure Code Dep rinente AN Anesthesia madmin DI 22005 10735 AM 3 Lgr tkup Cats Entre cameli 7 gp Query P Er Es apa fa Pup T Ira Prr ices Ex Inm mi pus BnF Pre ga id arre un D Sep ae q ul pl Dn amens m Sh Other fia pras m Error Check amp e Gaver fares Hi aj Procedure Code Department Table Maintenance This is where you can set department for each area of the practice such as pediatrics cardiology x rays laboratory and others It allows you to get procedure analysis by department PN 4104 A 2007 CrossCurrent Inc Appendix 40 INCISIVE PM User Manual Table Reference PCT Payment Classification Codes Ni BELLO uL ri Classificati
76. can be integrated from here by right clicking highlighting the row and selecting the document you want to print These documents are then recorded in the appropriate history listing There are also generic fields available for selection when creating a document using the DE Document Editor form to allow proper merging from the TD form PN 4104 A 2007 CrossCurrent Inc Appendix 61 INCISIVE PM User Manual Table Reference TRT Treatment Referral Types TRAT Trouver kofirni lees fo CCE TS riedi OF PAF POA NO AM Ku gt Data Entry Cancel LEI Query Y Ec UT XL Orde Teen capp rcs El i cM h his bera OC CS EL TS i a Er COM CORRE 000000 Comment Pag Eee LS TTD Ix Emir ThE MIT lim ram nb d ron Lacie Fc Fins Loccswents h Otter Actions a trroe Cheech GO Sege Love Monk Treatment Referral Types Used in PA patient administration to determine what type of referral is being issued Examples would be consults evaluation and treatment follow up care etc PN 4104 A 2007 CrossCurrent Inc Appendix 62 INCISIVE PM User Manual Table Reference USR Users E USR Lives dh madmin TE TEE a TT i Lioadooge bia Eiry tea m rer T7 su Name Boc Beye Lines Access Lo ibi de Eime gt d e Cart hot Hang 4 Pree teg Cara lil SE ee Eher wi EF acad Ca Pic aira PLE Eg Fe Ps Zeck Le TE Css Fos lr rires Beck im Lui ia dl iac som
77. ce Company Inact Claim Type Picim Form Subscriber Insured Riin Member No Insurance Topics DER n Full Rights Employer Grp Number Ai P Release SOF Ive Medically Unnecessary _ Payment SOF w Patient Status Other Global Coverage Diagnosis Code ChrgId Exp Date EGS Procedures diMad POS Fee Schedule Start Date End Date 1 D rer meisten bo joz 2005 111 2 40 00 4 Patient topay kuen 0 Il uwen JE mamm ie 8 R000025120379 5 mme Hi Hmsa w E Joe Alt De SP RDDD015470735 Procedure Code ty De Line Mo Profile Amt Patient Amt Charge Amt Tax Fin Resp Lvl CET Champ s Branch L Duty Status el Suc Date p 107 19 fel 1 Treurance 0 00 D Tot Prf 0 00 Tot Pat 0 00 rat Ch 107 19 Documents Other Actions i ErrorCheck Be Save Save Next Li 5 When entering the charge be sure to check the 00 box PN 4104 A O 2007 CrossCurrent Inc Page 24 INCISIVE PM User Manual Insurance Topics B PE Payment Adjustment Entry Information 10 HMSA Bme o Qtookup jnataentry cancel Query ij Full Rights Trans Dater 06 16 05 el Dep ostres v Posted aig HMSA e Classification HMS HMSA L amp mount 475 00 RiParty E Prat Method L ee Akimoto 06 02 2005 250 Patient ies mast Akimoto Stephanie A
78. ct Electronic or Paper Subscriber Insured Defaults if this person is checked as the subscriber on the General Tab R Itn Relationship Relationship of the subscriber to the patient If the subscriber is someone other than the patient you will need to register the subscriber as a person Member No Enter the membership number employer and group number Employer Automatically entered if an Employer Name is entered above Grp Number Enter the group number if applicable Prior Auth No Enter the Prior Authorization Number if applicable This prints in Box 23 of the CMS 500 claim form Claim Number Enter claim number for Workers Comp Block 19 Local Use Enter information that needs to print in box 9 of the CMS 500 claim form if applicable Block 10d Local Use Enter information that needs to print in box 10d of the CMS 1500 claim form if applicable Comments Enter any comments if needed Release SOF Check Box Release of Signature on File This prints in box 2 of a CMS 500 claim form PN 4104 A 2007 CrossCurrent Inc Page 2 INCISIVE PM User Manual Registration amp Related Information p Payment SOF Check Box Payment of Signature on File This prints in box B of the CMS 1500 claim form q Patient Co Pay Enter patient co pay if applicable r Medically Unnecessary Check Box Leave blank S Patient Status Other Check Box Leave Blank 5 Click the Save button in the lower right corner of the screen PN 41
79. d from system as this affects the transaction history There is also a user access log that tracks the date and time the user access the application For a specific date use the UAL O 2007 CrossCurrent Inc Appendix 64 INCISIVE PM User Manual Table Reference ZC Zip Codes E Leto dl Rei VFRGLIBHD gib A froedruin CAA CRIE 11255 AM JOabadntry Cancel JI Query Fi ets EC y Cennard dE H 4 COR FLE ACC HET ECS LOFI d ES lions nci mft Warn pee t ZC e techbs Clg Baden aei 8 Bere ink n nm buo m erty oi b ere Pee tere Eipre Anke SIVERTICE lee ve iran P we fam LE Lon anb Em dni s CHICO eee es Poor eh IRI bP ob RE a E Lpekear Gace Mise pL Dn amens m Sh Other fia fae m Error Check B Save Gane ri al Zip Codes This screen has been set up the standard US Postal Service list of Zip PN 4104 A 2007 CrossCurrent Inc Appendix 65 yE LEA SEDIS ni
80. ding type Set up D for default as your regular fee schedule Medicare Worker s Comp and other insurance companies may require their own fee schedules Fee schedules are used in the insurance company screen and on the individual procedure codes PN 4104 A 2007 CrossCurrent Inc Appendix 26 INCISIVE PM User Manual Table Reference FT Facility Types OV Fecility NE CH ecto office Cr e DGf 2Z reo 03 04 P g ns IIR Lookup jOaakEmry Cancel GB A Query m Lutgen Coral Pike L gege Far mien so J bd Facility Type Table Maintenance This is where you classify the place of service for the facility For example your ID could be H for hospital the description would then be hospital and your place of services would be 21 IP Hospital 22 OP Hospital and 23 ER If your hospitals have different NPI numbers for each area of the hospital you will need to set up a facility for each one e g Providence Hospital inpatient and Providence Hospital outpatient This is only needed if there are separate NPI numbers within one location Overrides You also have the ability to override Example say the insurance wants you to start using something different for this place of service on J une 1 2006 PN 4104 A 2007 CrossCurrent Inc Appendix 27 INCISIVE PM User Manual Table Reference FUR Follow up Reasons FL Folle wp Dong FOI It Chainer Addeess for billing rmadenin OB DECHE 02 41 FM E dt
81. djustment Type Member Na 0 om Documents Other Actions WErrorCheck l Save Save Next LU PN 4104 A O 2007 CrossCurrent Inc Page 86 INCISIVE PM User Manual Payment Entry 7 This takes you to the original payment entry that was unapplied Enter the payment amount to the 0 00 charge which will create a credit balance 8 Save the entry and save the charge 9 Goto the PE screen amp Are Tn eee Lee Ee E UC DOE ek erm IT TTER ZUCHS A Aios 2 Daatrgre Steel 7 Amny F crnerat I RS OC De puum oe ae Free Katar gy Defender Bc Refund pd emet TES esos ort Air bower Luce w pat bie O zl DEn mor ben er B art cy co Po DO Comment Brower 10 2008 355 m eegen ee 7 r geg mm Changes Hepara Party bati zi u Vakares ao SUMA DE Chwgelur D se Pei ber one WO Ach And CRPENTCS Chargac 22 D em AH zi F O pe wei Fish TU eee ap ise se Mb fra neits ipa 1 CR C st DII pm a A 7 LEER a o Cer pp Change Ant Patent ex Pri oe Mod Ant Starry iad est wo fl t bana OAS Aa e CS IS TJA Eran ndr mr win Cem DE HER DU de Eat Wues baut Setz Dr Aen pe Metro Carnot sim EA mic WI Hits afew Trim CES re n tth boaa Tai Feli 10 Create a new payment entry a Assign a Payment ID b Bring up the patient c Trans Type Payment d Classification Refund
82. e Fin Resp Lvl does not change until you Save the charge If you are entering the VSP information for the first time in the RI Registration Related Information screen you may want to deselect the Payment SOF at that time PN 4104 A 2007 CrossCurrent Inc Page 20 INCISIVE PM User Manual Insurance Topics How do manage AIPO Accept Insurance Payment Only patients Temporary Work Around E Ri Registration and Related Information 034020 Akimoto Stephanie A Stephanie 06 16 2005 02 45 PM ES e Is Lookup _ DataEntry KiCancel JI gQuery 2 Full Rights General Coverage Case Info NoteslFollow Up Permanent e BER INFORM R Parties Patients Insured Patients Pat Admin L Id 034020 GE hi Responsible Parties For Registrant Nus Id 034020 acmadan Wise see Sea a Subscriber Insuredi w Idi Clinical info Mame Last Akimoto First Stephanie latest Address 34 748 Lumiauau Street 5 misuau Street 5 x Address Lg Zip Code 96787 Waipahu HI EE WE Ph No SE 300 7666 pel 00000 0 City Waipahu St kr E Ref 5rc d El County e l Sal Cell Ph P Lang Pref Se Primary Ph Num 808 67 676 1166 505 676 1166 Ext 0 Fax Appt Hald Date of Birth Age pen e s 4 1970 35 Gender F m MIS M Married Social Security Mo 575 06 9634 575 06 9634 Dr Lic mm PATIENT SPECIFIC DATA RJPARTY SPECIFIC DATA
83. e MUST be entered Symptoms Date Leave blank he du CREES im MERE S ASH t E om adu ebe SEIT Similar Condition Dt Leave blank Re SES i hse cmd eem m mobi TOR Masse ROSE ms gr Accident Date Enter the date the job related e OoN a E incident occurred This prints in box 4 ofthe CMS m ss D Miun O gt I TA EE 500 claim form ASE ESTAS US SEES MD ADM C SSS Be E J ob Related Check Box Check box This prints in Do S e SCH box 10a of a CMS 1500 claim form ae a sess nage Oth Acdt Check Box Leave blank n B E Cc Ka TRID ii SSE RS D LMP Date Leave blank Auto Accident Check Box Leave blank Pl Leave blank SEN Insurance Information Insurance Company Claim Type P Clm Form Subscriber Insured R lEm Member Mo Employer Grp Number Prior A WIORKMEN COMP WORKER COMP Y GUZMAN RAUL 5 1125533 Release SOF Medically Unnecessary _ Default Diagnosis Code Payment SOF Patient Status Other LJ 244 HYPOTHYROID Patient Copay EEN EE 1 Documents Other Actions amp Error Check eNext Le 4 Under Insurance Information you will need to enter the following information a o C d e Insurance Company Enter the Workers Comp Insurance Claim Type Defaults accordingly with the insurance company P Clm Process Claims Should almost always be Yes Form Claim Form Sele
84. e Trm Date this will italicize that Insurance Tab 2 To add the new coverage click the sign in the top right corner 3 Updating the effective date is optional As a general rule if the Coverage Case Info changed but the insurance company remained the same do not enter a termination date keep the same Coverage Case Info If necessary enter your notes in the description field Enter a termination date if a Workers Comp case is closed so you don t accidentally enter charges under that coverage PN 4104 A O 2007 CrossCurrent Inc Page 10 INCISIVE PM User Manual Registration amp Related Information Registration Workers Compensation E RI Registration and Related Information 12 GUZMAN RAUL madmin 05 23 2007 06 50 AM I Ie 3x3 Lookup gt Data Entry Cancel Cl Query 21 Full Rights Sage Case Info Add Information Notes Follow Up Appointments Administrative Documents Attachments rit Idi 12 Related Inform LA R Parties Patients Insured Patients FS G Reg Status Patient 1d 12 RIP Bal uen Response Parties RIP Bal RiParty x Td 12 soo TES GUZIMAM RAUL 0 00 Subscriber Insured Id 12 Name Last GUZMAN First RAUL pem run Address 11933 TAYLOR CT Zip Code 92507 RIVERSIDE CA Date of Birkh Age 01 01 1975 Hills RIP Default Pa Gender male Is Single Li Social Security Ma Dr Lic i rte PrmaryPhNum LI Ext HIPAA Notice Dte
85. e ee Eua Wy narii t e ee eur 123088 aw coco had Cocoon P rierar deg La m n n mil Pree Flassam pc pa Fori am IL e d Print Preview Print Encounter Forms From this screen you can print your encounter forms either by patient or by appointment You can get to the PEF by either right clicking on the appointment day provider or facility in the AS screen or you can hit FP and type in PEF PN 4104 A 2007 CrossCurrent Inc Appendix 42 INCISIVE PM User Manual Table Reference PG Provider Groups PCI Prowda Groupe ft RIALTO MEDAL Geo Lir OF ase 1 3 a PA Eoo oon ee a Cancel 7 Query F oe fum d aec KI Cao BAG ENS Qe RUNI Contes Eu Emt ii lO amens m Sh Other fia fia m Error Check nee Sane ai aj Provider Groups In a large clinic setting you may wish to group your providers together by specialty e g general ortho spinal neuro etc PN 4104 A 2007 CrossCurrent Inc Appendix 43 INCISIVE PM User Manual Table Reference PH Pharmacies Ni Phases eg CR onsec pe 2 Data Bryr Cancel L on mdp Ctrl himas h ie lars P i bhiun ie care set 1 Eim ba Af Sho peche Te gut it Prag ree Lae A inokeg Recere cdo Pharmacies This screen allows you to set up a pharmacy database file with the pharmacies name location ohone number and other relevant information PN 4104 A 2007 CrossCurrent Inc Appendix 44 INCI
86. eck Box Leave Blank 4 Click the Save button in the lower right corner of the screen PN 4104 A O 2007 CrossCurrent Inc Page 5 INCISIVE PM User Manual Registration amp Related Information Registration Patient Responsible Party amp Subscriber Single Insurance amp Ri Registration and Related Information 44 Montes Ann AM 07 05 2007 03 19 PM Iz Ex Ur HP l Lookup gt Data Entry tCancel E Query IS Full Rights Add Information Notes Follow Uip Appointments Administrative Documents Attachments a oF S PC Covf ase Title E Employer Id 1 TELECOMM COMPUTER SYSTEMS LA Description Pacificare Employer Marre TELECOMM COMPUTER SYSTEMS work Status E Employed PE Marital Sts im Married Ej eg 44 Montes mm f Symptoms Date Similar Condition DE A E Resp Farby EEN Montes Ann Te j I F Accident Datei l Job Relatedi Oth Acdt _ Fi Lc Him Po T FERRER LMP Date l Auto Accident Pl Billing Provider 1 DUNLOP DON Lel DUNLOP porn CH ADDITIONAL INFORMATION Facility D OFFICE SE LI Initial Trmt Ge e Hosp Frm Dte RefDocter Id DUNLOP SALEMI DON Last ray Date el tan T r D ei mmm Lal PE Lst Seen 5610512007 EA Work Last Dre ee Disabil Frm Dates wl Supervising Doc LA Return tei l To DCH Doctor Disability Status i HM Claim Type P lm Form es cribeer Insured Rn Member No Employer Grp Numb
87. ed Diagnosis Code click Select found in the bottom left corner of the screen amp CE Charge Entryfinformation 130 PT Cole Roberta DOS 2747 2007 DOC DUNLOP DON TBR ic He t Lookup Data Entry KP Cancel Ti Lag Query F Full Rights General Ins Coverage Service Detail Apply Pm Financial Marat Claim Stmts History Procedure Pay Sppeals Follav up Insurance Information Insurance Company Inact Claim Type Piclm Form Subscriber Insured R IEn Member Ma Employer Grp Number AfA P me MEDI AHA MEDICARE JE fpo ile Motieres 5 ozezesse4 CRE i D Default E jeu zie oberts E xdol 569871 Tele Comm Computer Syste e DH k Release SOF lw Medically Unnecessary Iris Payment waiting Period Payment Sry Patient Status Other L be st i Diagnosis Code Cchra Id Exp Date Procedure tode 151 9 Procedures Procedure Code Add Mod POS Fee Schedule Start Date End Date Qty D Line Ne Profile Amt Patient Amt Charge Amt CoPay D A Fi Initial Inpatient Consul PR 11 MiZ E D IC ab 02 07 fo 0207 ro 1 E 0 00 175 00 CH Patient Copa Tot PrF 0 00 Tot Pat 0 00 Tot Cha 175 00 pp ee A Documents Other Actions ff Error Check ave MNext ES PN A UA A 2007 CrossCurrent Inc Page 30 INCISIVE PM User Manual Diagnosis amp Procedure Code Lookup amp Entry Considerations before clicking you Save your ent
88. ed to add an additional registration to complete the registration of the patient This is done by clicking on the ellipsis in the Resp Party and Subscriber Insured fields unerthe Coverage Case Info tab After you have entered the data the Responsible Party name appears on the Patient s General tab in both the Resp Party and Subscriber Insured fields PN 4104 A 2007 CrossCurrent Inc Page 9 INCISIVE PM User Manual Registration amp Related Information Registration Patient Responsible Party amp Subscriber Dual Coverage that Changes L3 HT Foist alinm EDS Sb im orrat bori ir Conte Roberta L imodenin UT a AF OTa FM Perge we ul Fem cem oan fge Zut gre Au Pipis ss deis lye i Lesen geg pop i Tie gt Work Maden a Mia me 5 omis Dee wel bam Coie DR Heo Panty ZU Coa P nn V Ime S Aen Dee Zei Mon emer Fran rS Pied rnt UO f ER Zei odmh TEE h ar DES ADEI ALE TENTE Peay cres Praed Toni De hipa Pen CES Ce EN Dae ero ef Had Locter Ji 1 Dunes i CET ih Lut Loes j weert c pat Ces AER eru Tee Beggen ge PEP Dico i aud Fest Zeta DCR eal BES M em HIC RIT Brema accom C mo mee T Fem Cen Og er Se P Chn ferm ego ip impir Pide Sr LP aE il Pustuerd tem Cher llOesunments H ber Aitaa Gf tere Check da Saeep ave Parmi If a patient s insurance coverage terminates you will need to modify the registration under the Coverage Case Info tab Enter th
89. eds to be checked v 44 Claim Process Yes 45 Process Claim Types Leave blank for ALL 46 Process Charges Leave blank for ALL 47 Billing Providers Leave blank for ALL 48 Insurance Companies Leave blank for ALL 49 Insurance Groups Leave blank for ALL 50 To process claims click Process PN 4104 A 2007 CrossCurrent Inc Page 47 INCISIVE PM User Manual Claim Processing 51 The Claim Detail Tab will open and list claims to be printed This will also list errors on the claims if any amp CP Claim Processing 507 AM 07 07 2007 10 39 AM Charge Insurance Company Insured xchrar SmnE Error Message i 1 CHOICE AETMA a MARY BALAT 70 00 Missing Referring Provider National Payer Identifier CHOICE AE THA a MARY BALAT 370 00 Totals Batch Amt 140 00 cnt 2 Error Amt 0 00 cnt a WHO Error Amt 140 00 Cnt 3j EX Select Details Other Actions Ef Error Check Es Process Preview Save Next Em 52 Correct errors if applicable 53 Click on the General Tab 54 Change Process Type to Final 55 Click Process Print Claims 6 The process completed with D failed and 2 successful claims generated Would vau like to print the claims now 56 When the following message appears click Yes to print the claims This prompts the Print Preview screen 57 Put claim forms in your printer E Print Preview CER Print Print Setup jZoom M 4 Pagelof2 H K
90. en Ba Cech HH rm lt Domar 7 CE or a ee Shane al Me dm Fanmi oe Cees bg Log gece eege Doc ere her Drtseug is Error ich i Sage Tarr nat isl Patient Classifications This is a user defined field It can be utilized for anything that the client wants to note on a patients RI screen Some offices that have multiple locations use it to identify which location the patient is seen at quickly while others use it to identify the insurance account type they may have PN 4104 A 2007 CrossCurrent Inc Appendix 49 INCISIVE PM User Manual Table Reference PY Payees PV Payers Di 000 OP PON Imodmin O SOS 700 10 95 AM dicokup Oaatmry Csel 7 Avery 91 LETT bora audi bd a Bare Le X 1 imam Finde dideess DO ADMIS STREET PM pO OOo Tores I VE CUm EE ET IE ipod stia Erpranr pcr CA cs eee ET LM biais n5 bg atc Ed dre ds Pann Eat Gap Hat Esseg ad Tit eeh d GC da Pacer eM ee M paccm Don m EF app ee ep us Leem s pL Des el m Sh Other fia foe uf Error Cheek ij ipren hae bag al Payee Table Maintenance PY allows you to set up the name and address of the doctor clinic or organization to direct payment This information will print out on box 33 of the CMS 500 form It is also where the electronic statement s customer code and password are stored Statements also pull the pay to and return address from the PY screen If you have a multi physicia
91. er Prior PACIFICARE perse Ki E t Montes Ann 5 1265964 TELE OMIM COMPUTER SYSTEI Release SOF v Medically Unnecessary RE Diagnosis Code Payment SOF Patient Status Other Patient copay 25 00 Documents gt Other Actions m Error Check GI Save Save Next Li In the example shown here the patient has a single Insurance Company Pacific Care PN 4104 A 2007 CrossCurrent Inc Page 6 INCISIVE PM User Manual Registration amp Related Information Registration Patient Responsible Party amp Subscriber Dual Insurance amp RI Registration and Related Information 44 Montes Ann AM 07 05 2007 03 19 PM ee x j ipe Kapi i Sur Entry rancel SHE Fr Full Rights Add Information Metes Fallow Lp Appointments Administrative Documents Attachments eee rc PC L pa 8 CoviCase Title c Co 1 Employer Id t 1 TELECOMM COMPUTER SYSTEMS UE Employer Mame TELECOMM COMPUTER SYSTEMS TELECOMM COMPUTER SYSTEMS PSS ae e E Work Statusi E Employed Cic EFF Date 07 05 2007 ei Trm EC lire Date Similar Condition DE Resp Party M ntes mm Montes Ann Er Accident Date Job Related m GE oth h Acdt S AMIE C HTC ge feta pet east rime ete LMP Date i Auto Accident I Pl L EE ADDITIONAL INFORMATION Facility ir OFFICE e Initial Trmt Dte ES Hosp Frm Dte Ref Doctor Id 2 DEIRMEOP SALEIMI DON
92. eral Ins Coverage Service Detail Apply Pymt Financial Mgmt Claim Stmts History Procedure Pay F U Notes aby Follow Up Date e Reason Statement Message m Comment Comment Notes Activities Date By Contacted Phone Comment 10 04 2005 Stephanie Merx Loo 948 6330 Spoke wj Mary claim is currently in process l e The notes will automatically be date stamped You will need to enter who you spoke with and the status of the claim Also enter any follow up action that may have taken place PN 4104 A 2007 CrossCurrent Inc Page 101 INCISIVE PM User Manual Attachments ATACHMNS The Attachments feature is used when you have physical documents e g insurance cards that need to be included with the patient s files Together with your scanner you can simply and easily scan your documents for inclusion in the patient s file PN 4104 A O 2007 CrossCurrent Inc Page 102 INCISIVE PM User Manual Attachments Insurance cards or other ID E jni Fargiaiiathens and Heiaipt Inioanaiion 70 Cole Roberta i medm OFT OUT 0 29 PM mz umm fe DRE CC NME l abs SEEE Come mms 1 Ad oS e 2 ee Trs Lookup patient responsible party subscriber insured Click on Attachments Tab Place front side of Insurance Card Drivers License or other document on scanner Single click on Attachment single click on the ellipsis Click on Scan Image W
93. erence AL Alerts ALI Alors MALANGE Balance Durs retin COTES OFS AM Ir gwXEeohkep 3ADatatrgerg stees 7 Ammy F D E S dicrum Ri Biet Site 1 21 12 sls am ia Eee rw Wan k AOC Adian Cherie seche a E bohALAMC eere Cum 8 8 8 Fonegrd Cole E ud ee D Pee eee ee eee NL Li Rey cea Mers 1 Drac aen eel a Cher Ae Eire ET fee Leck Qj Sere awe eel Alerts This is a user defined field which is used for internal purposes only and can be used by the billing collections and the clinical side of the office The information appears on several screens including RI registration AE appointment entry AA account management PA patient administration and Cl clinical information You can also view account alerts on the ADS appointment day sheets PN 4104 A 2007 CrossCurrent Inc Appendix 3 INCISIVE PM User Manual Table Reference ATC Adjustment Type Codes I ATC Adjusiment se ee ng a ot ee ee ee n i 3 E I r o rr dicokup Jj Rate Dery Cancel f Garr F pF al agens apuliaidr ete Dey d prr Peed 1 a RT D tes iTi pu I1 um Ia B ss Fort Dee eter P ER Saaweafoe ed 8 8 lini IPA EF Ap M LE ue D DPC ET ROAR LE CA ds Brie ited Pec p sul Pru i aed Palas Joho at ee Lag Aer Se A feces her dia Tunis md Error imak ave r Rd Adjustment Type Codes Allows you to create different types of adjustments NOT to be used fo
94. g Department Recall Reason GJ 32000 Hospital Rel Value Units Mat Drug cde Lag Days z 36459 Placement of Central Venous c 143646 Obesity Surgery Age From Ta Gender timit 43846 45 Obesity Surgery Claim Coding clair Coding Type Procedure code Type of Service Prt Desc Pronk Sinit B 93000 EKG et TN Fae BF EJ d I E 93000 59 EKG MC C 99212 Established Patient CA 99213 Office Visit Expanded EST 59214 Office or other outpatient visit jsszis FOLLOWUP VISIT COMPLEX O loaazgt Mew or Established Patient Fee Schedules j Fee Schedule Type izo Faywy Charge Amt Profile Amt Patient Amt Pat Sec OIR Gi Days 100 N n Co 990233 Subsequent hospital care ice isti Bes om 0 00 l BLU LJ gaz38 Hospital discharge day manag D EE 0 00 m 1 L _ _ 99253 Initial Inpatient Consultation M AL H 0 00 wl E Loge Inpatient Consult Moderate 80 me SI 0 00 iel DI mil laszai Pediatric Critical Care 3e E Balance Forward D Delivery ziusz initial OB Visit Medical Only Z1032GYM Initial OB Visit 21034 Antepartum Visit Medi Cal Onl 4 Comment Inactive Disallow User i Lookup Recent Models ww Select Cancel Select Documents 1 Other Actions EX Error Check ES Save After selecting the appropriate Diagnostic code you may proceed to Procedure Code entry A Procedure Codes
95. ghts General Payment Idi 755 Trans Date 02 14 06 Dep nzrt4f06 Posted From InsCo HMSA HMSA Classification H HMSA Amoun 215 11 RiParty ERN Pymt Method Ick Check nel Trans Type IP EOE Payment or Pay wj Adj LJ ChE Na Refer Ck MN01341176 Comment IHMSA 56 07 recoupment for Linda Dixon chrg 576 acct 521 Dixon 07 12 2005 576 Kawarmura 9 17 2005 858 Maedo 06 16 2005 1028 UEF S Patient ere etae i e Chrg Id Patient pos Charge Amt Balance Paid Art Contract WO Adjust Amt RIP Balance a 1 1 LEE CET 4 ta ur udi RSS PALM te Bees Jk SE 876 fron tinds ka 49 iue Karan Uggs 184 92 20 20 81 15 83 40 0 00 n e 4 te G a Ps Qn Ins Co 1 HMSA x 70 oe OU WENA 03 22 05 4407 10 4467 178 65 183 78 0 00 0 t ea p A OU Ik E Eres T RIP Bal 0 00 Aut H HMSA Ld er An i REG IAA 02 amp 2n a HA 15 ERT 4m En nn n WI ute Apply a Distribution Procedure Code DOS Charge Amt Patient Amt Profile Amt Allowed Amt Starting Ba Contract Paid Amt Balance Adjust Amt Adjustment Type Kam oanl 18492 40 00 000 46490 2 83 Den 000 6490R SCHER 4 H SON 0 00 Pdi 55 07 adi 64 90 Insurance Patient Alerts R F Alerts Appeals a ks Comment IHMSA Recoupment Insurance Compariy Inact Claim Type BIC Fro Subscriber Insured Member Mo
96. hat do you wani to scan M e a ie Rid ee Ee id p bn pins mmh ar Ce mee e Eegen echte MEME UT t Sr ee or dium do mam B cec ipu mares rg les Dor Barba Corn 6 Click Preview PN 4104 A O 2007 CrossCurrent Inc Page 103 INCISIVE PM User Manual Attachments What do you wani to scan Pit Eee na um ad Puabdbace Pig ee bum idi iab Fidem si rs russe eee es paies i o Via sal at ast ds bat 7 Click on Scan WU TIBET SL RT LED and Holani Infor KG AT Lol Hoberta L semer B BE cud Pe Em o rr book JOmas Fniry in Ary ER crus a Geess Inte Addi born pa tees T oi ME d Biber wrcg LI 4 Attaches 1 p rem bape i 8 Selecta Type e g Insurance Card Back Insurance Card Front Picture Picture2 9 Follow the same instructions for the back side of the Insurance card D Click Save PN 4104 A O 2007 CrossCurrent Inc Page 104 INCISIVE PM User Manual Table Reference Using Shortcuts INCISIVE PM was designed to allow you to use shortcuts which provide quick access to the various screens you will be utilizing In the following pages we have provided explanations of how and where the information is used In some cases you will find task based descriptions in this section When you strike the F2 key this action prompts INCISIVE PM to display the Menu Shortcut box Menu Shortcut E Menu Id Type the Menu ID that you for the screen you would like e g DC take
97. he accident is not job related This prints in box 10c of the CMS1500 claim form LMP Date Enter Last Menstrual Period Date if applicable This prints in box 14 of the CMS 15500 claim form Auto Accident Check Box Check box if accident is auto related if applicable This prints in box 10b of the CMS 500 claim form PI Enter the state the auto accident occurred if applicable This prints in box 10b of a CMS 500 claim form 2 Click Page Down to go to the Additional Information tab to fill in the following information a Oo C C e f g Initial Trmt Dte Enter an initial treatment date if applicable Last Xray Date Enter the last x ray date if applicable Work Last Date Enter last date worked if applicable This prints in box 16 of the CMS B00 claim form Return Dte Enter date authorized to return to work if applicable Disability Status Enter disability status code if applicable Hosp Frm and To Date Enter hospitalization from and to date if applicable This prints in box 18 of the CMS 500 claim form Disability Frm and To Date Enter disability from and to date if applicable 3 Click Page Down to go to the Insurance Information tab to fill in the following information a Oo C e e Insurance Company Enter the Insurance Company or click on the ellipsis to select Insurance Company Claim Type Defaults accordingly with the insurance company P Clm
98. hould match for single units Block 19 Local Use Information to print in box 19 on a CMS 3500 claim form Fee Schedules Grid Also FST Fee Schedule Types Table Maintenance Fee Schedules E Fee Schedule Type Co Pay Charge Amt Profile Amt Patient Amt Pat Sec GR G Days 100 Non Cov CASH BASIS L 500 00 200 00 DEFAULT 500 00 MEDI CAL 500 00 MEDICARE 500 00 TRIWESTJCHAPPLIS 500 00 WORKMENS COMP 500 00 Fee Schedule Type Type of fee e g cash basis default Medi Cal Medicare etc Co Pay Leave blank Charge Amount What you charge for the procedure To be determined by your office Profile Amount What the insurance company pays for the procedure Patient Amount What the patient is expected to pay Generally used for cash patients Patient Leave blank PN 4104 A 2007 CrossCurrent Inc Appendix 38 INCISIVE PM User Manual Table Reference Sec O R Secondary Override Let default to a checked box G Days Global Days Days allowed between procedures Generates error at charge entry if within global days 100 This box MUST be checked if you DO NOT want any patients to get a statement e g Medicaid and workers comp patients the 10096 box must be checked off on the individual fee schedule for the procedure code Non Cov Not Covered No insurance coverage Comments For Internal Use does not populate data on electronic or paper claims For Fee Schedules see FST Cash Patients General Ta
99. iClnse 58 Click the Print button PN 4104 A O 2007 CrossCurrent Inc Page 48 INCISIVE PM User Manual Claim Processing Print claims to a disk E Print Preview Gi nw Print Setup doom M 4 Pagelof2 b M X tlose NE 1 Click on the Print Setup button BEFORE clicking the Print button Print Setup d 2 Change the printer to Microsoft Office Document me Page rn Image Writer a Click OK Properties Insert your CD or floppy IT Print Rage p Copies iv Al Number of Copies EN Pages From 3 Thru Collate wi Restore Defaults E Print Preview saPrint Setup Zoom M 4 Pagelof2 M X close 5 Click the Print button 6 When the Save As screen appears select the appropriate format e g 3 7 Floppy in the Save In field 7 Assign a name to your document in the File Name field e g HCMG CPMG St Mary etc 8 Click Save WO This prompts Microsoft Office Document Image Writer 10 This shows you your claims without the CMS 500 red boxes IL You may now exit out of that screen remove your storage device e g floppy CD and submit to the IPA PN 4104 A O 2007 CrossCurrent Inc Page 49 INCISIVE PM User Manual Claim Processing Electronic Remittance Transactions ERA B ERA Electronic Remittance Advice Retrieval dee ostatny ted Aen 2 gt etc Stance Query Fj e brem reet amarai j Chr Dean Teese tats
100. id 2 945 03 Unapplied 0 00 ails Ef Error Check 2 Proces 4 EOB Preview Save Next m 9 Make sure Process Type is set to Proof 10 Double check that the Amount Paid matches the amount on your check IL Atthis time you may set the Payment Act Date this date is reflected in the PE Payment Adjustment Entry Information screen for Trans Date and Dep Date 2 Click EOB Preview at the bottom right PN 4104 A 2007 CrossCurrent Inc Page 62 INCISIVE PM User Manual Payment Entry This prompts INCISIVE PM to display the EOB Explanation of Benefits on the screen UE SRE US GS us D I ea E iai Tu Chun DIS WwuE uB St SS ee em ee us 15 em o wn EE Rett asd FH Ae de adii Ait iem 1 i ave si 1 You have the option to Print this for your records 2 Click Close when you are finished This returns you to ERAP Electronic Remittance Advice Processing screen ERAF Electronic Remittance Processing 89 B ECH ostatnwy ptancet H Query 9 yviessEdi Delete Suo NS Ce SE Payer Mame HAWAI MEDICAL SERVICE ASSOCIATION Payee Mame DOUGLAS L BROW Do Payment Act Date 10 22 2005 w Amount Paid 2 945 03 Unapplied 0 00 ess JEOBPreview Save Next PN 4104 A 2007 CrossCurrent Inc Page 63 INCISIVE PM User Manual Payment Entry 1 Change Process Type to Final 2 Click Process E
101. ien dal HAT po amp n nr E Distribution DOS Charge Amt Patient Amt Profile Amt Allowed Amt Starting Bal Contract WO Paid Amt Balance Dia Adjust Amt Adjustment Type P 0116 06 65 01 on 0 00 o 0 oo 85 00 mm x mm 0 00 gs mm SEC Saturi 4 Cw 0 00 0 00 Pdi 0 00 Adj emm 5 00 4 Comment RS Insurance Company Inact Claim Type PIE Pm Subscriber Insured Member Ma m ECH IE sint Sen DE TI ERR Lu LEI JE ams N P IH six Lis 576986635 4 Hab H urea IN E mu l uu Honggiog1295t Stmt Cmnt D S JH TL PA aie eS LInapplied Amount 0 00 Tot cy 0 00 Tot Pdi 0 00 Tat adi 5 00 EL 3 Documents Mb isen Ar Gums Error Check 1 Save Save Next al 1 On the PE screen create a Payment Entry that reflects the Secondary Insurance a Transaction Type Adjustment Only o Check No Reference no Check adj only U U O amount reflecting the credit balance 5 00 e Charge ID Enter Adjustment Amt enter overpayment as a negative U 44 Amount enter overpayment as a negative e amount reflecting the credit balance f Adjustment Type select SEC Secondary allowable is higher than the Primary Ins 2 Goto AA to verify that the adjustment has been done properly PN 4104 A 2007 CrossCurrent Inc Page 18 INCISIVE PM User Manual Insurance Topics How do handle non participating insur
102. iens IC TR A Date re zeen NAR DR e Last Seen Gy ON IL Pome ay mue tz i a Ws nir SIL ESA lDecmwente other Actions aftrrortheck dise 2 Click on the ellipsis or F2 this prompts the RI Registration and Related Information screen PN 4104 A 2007 CrossCurrent Inc Page 35 INCISIVE PM User Manual Charge Entry Enter the patient s Last Name the list shortens as the name becomes more specific Once you find the patient select the correct Name and the patient information populates the charge entry If a patient has more than one Coverage Case you will need to select the appropriate file for this visit B CF Charge Entryfinformation 124 PT Cole Robertal DOS 12 00 00 AM DOC EC KC H otookupn Data Entry lt Cancel Ti cay Query i T Full Rights General Iii aea SS a vie Lu il ALU THe Purana Im ESL LEE it Frist Lu RIZZI we Fay H e 5 p ai p SE Charge Id 124 jae Cildar Posted Patient zD ole Roberta L Emplaver Mame Last Cole Mork Status PS S RE l T be T Ces lf 4 First Roberta MEL arital Status Job Related C1 Symptoms Date Other Accident Accident Date Auto Accident Fli T LMF Date Resp Parky tl Similar Con Date l Patient Copay Biling Provider A ADDITIONAL INFORMATION Coverage Description Money MOBT 0510106 SH _ a
103. ification 10 HMS A J Amount 15 00 RJParty E CK Check Ls Trans Type P EOB Payment or Pay wide LI Chk No Refer datN2556332 Comment Akasaka 01 15 2006 390 Patient Li Open Char Charges Insurance chrag Id Pati jent nos Charge Amt Balance Paid Amt Contract WO Adjust Amt RIP Balanc 4 ie SE TE el at T ge 90 Akasaka Linda Akasaka Linda m b 308 78 namora epp 19 0405 65 0D 15 00 450 00 0 00 a Bn 4o Ins Co hez HMSA CO 1292 trag Shamal Haie pe EH 115 00 0 00 0 00 0 ei Mr zl a vs ES 4 RL TII eese Ur queer m RIT o c RIP Bal 0 00 I Bus Ip Hw HMSA al nine 07 mn Alle Taine amp 78 12 tdi R5 LIFE al ez sa n mb Distribution Procedure Code DOG Charge Amt Patient Amt Profile Amt Allowed Amt Starting Bal Contract WO Paid Amt Balance D A Adjust Amt amp djustm kon 0 mee 465 00 gowo 0 00 Fam 10 00 sowol mem 4 C 40 00 Pal 15 00 Adi 0 00 Insurance Patient Alerts R F Alerts Appeals Comment Insurance Compariy dnact Claim Type ER Pm Subscriber Insured rl mna d aktig VIN m ER 7 T Wuel 3 if Simt Msg Ld AIT ad a E iCommertii nn beet Lilia ENH 4 IFE ue I I al aal nist DOIT 35 Stmt Cmnt AMSA i tr Ne DU 2 il Unapplied Amount 0 00 Tot fw 40 00 TotPdi 15 TotAdj 2009
104. imary Insurance Group By Primary Insurance Company D tail el Cutoff Date 10 04 2005 v Aging Field By Accounting Transaction Date el Min Days Aging 45 Max Davs Aging Minimum Balance 5 00 Leave blank For all Charge Data Providers Insurance Responsible Parties Facilities Leave blank For all Financial Class Leave blank For all Facility Financial Classification Print Preview Select Preview lower left corner to view the report prior to printing 4 If after the Preview this is not the criteria that you wanted in the report click Close and reselect the criteria on the General screen 5 Print the report PN 4104 A 2007 CrossCurrent Inc Page 97 INCISIVE PM User Manual Day End Month End Understanding the Report The A R report contains pertinent information that is useful in following up on claims Patient Transaction Charges ld Hame ld Date Gross Amt Profile Amt 000479 Jordan Judith 67 Ur 08 05 156 00 0 00 TOTAL AETHA Aetna 156 00 0 00 1341 Stephens C Anne 232 07 20 05 281 20 0 00 TOTAL BCHI Blue Card 291 20 0 00 002881 Dumas Lorraine 500 8 1 05 156 00 0 00 TOTAL FEP Federal Employees Plan 156 00 0 00 008879 Kamano Marylou 4 070605 5 720 00 0 00 007759 Balbas Eugenia 382 US8 D03 05 155 00 0 00 TOTAL HMA HMA Inc 5 876 00 0 00 005554 Mizusawa Tashie Ann 5611 08 1305 135 20 0 00 TOTAL HIMAA HMAA
105. ing all the data a Name Last Enter the person s last name oO First Enter the person s first name Q O Address Enter the person s address Per Medicare EDI Department NO commas periods or symbols Date of Birth Age Enter the person s date of birth age and gender e Social Security No Enter the person s social security number f Primary Ph Number Enter the person s primary phone number and any additional contact information PN 4104 A 2007 CrossCurrent Inc Page 2 INCISIVE PM User Manual Registration amp Related Information g R P Default Payee Automatically fills in h R P Def Fee Sch Choose if Default Medicare Medi Cal etc i R P Classification This allows you to group R P for statement processing purposes UU HIPAA Notice Dte The date the paperwork was sign in office k Pt Classification You can identify the insurance account type e g HMO PPO etc Lire rmruerrg m Sy Choux Ay des e epee d Kuzer hi 1 Click Page Down to go to the Coverage Case Info tab to fill in the following information a Cov Case Title Enter the Insurance Name Code b Description Enter a description of the insurance if necessary C C C Eff Date Coverage Case Effective Date provides the opportunity to enter coverage Effective Date d Trm Coverage Case Termination Date enter the termination date of coverage if applicable e Resp Party Defaults if the person is checked as
106. is and Procedure Code Lookup 3 i igei daida PTT 4 Claims Processing un 5 Payment Entry nn 6 D ENO PE EG man 7 hee ef nn immune dei O Table Reference mener mme 9 NOTCS nn E HO REP ER 10 PN 41004 A 2007 CrossCurrent Inc Page INCISIVE PM User Manual Registration amp Related Information Registration amp Related Information CUS Before registering a new patient we recommend confirming whether or not that person is already in the system This can be done via the Lookup tab on the RI screen or by clicking F3 to prompt the Lookup screen where you can verify whether or not the patient is already in the system If the patient is not yet entered in the system follow the instructions outlined in the following pages PN 4104 A O 2007 CrossCurrent Inc Pagel INCISIVE PM User Manual Registration amp Related Information RI Registration amp Related Information Patient Responsible Party amp Subscriber Insured E ij Hogiration and fetated boomin OR Montes ner Aer F Dapp Bugs YEr ameita oore Ue bof yon Er peer Ackbmaramd Arum ey ge ee i SS Marti r eae Paige Pusat pes edt an F RE d e s Ter derer pen Daa n Cep Pren y Pe E res p pj Er fil pig LISLE i Bea EHT iTA Toe ee Te HOHTO Cirat Posie DES ate WOT A Lit mt ER Ci Ci SE CH unies Lir LR al Fao UE 441090 sori a WEIGL DIEN been DO LC Cire Panne Ciotat fe Cure he ESL Cid dene Care Saee Desso
107. le Reference FC Financial Classes L EC Financial Clases CR Cant Masis enedieenien OS TOR 1 1 31 AM ta n come T AT F wu 1 Correa ti ce arts Cu Es La Le iran st Cortera g GG G t ss 0 dE mu ni Er Seck lee eg ghee C rg premeny other Fir EHI uM Error Cie Dg iere ewe unxit Financial Class Table Maintenance This is referenced when in the RI Registration and Related Information screen The financial class set up allows you to separate the financial responsibility type such as private pay Medicare Medicaid HMO PPO Commercial Cash Basis or Worker s comp for internal reporting purposes PN 4104 A 2007 CrossCurrent Inc Appendix 24 INCISIVE PM User Manual Table Reference FG Financial Groups POI Fienncoini Groupe qwa T iN deine feet OS LA Oh TS FM 1 PN 4104 A Cancel f aen D W I OCT vg egen Rare im cow Financial Group Table Maintenance This allows you to the financial classes together 2007 CrossCurrent Inc Appendix 25 INCISIVE PM User Manual Table Reference FST Fee Schedule Types L PST Fee cheduile Types A Amina madinin CS 7 7008 04101 Pa i Gate Entre Cancel 2 Query TE Lan dome apri Hirt d CRE I erie Caii asi IL free Ladies Faces RD D amm rst m Other dattes m erer Check By Save Save Bini A Fee Schedules Types This screen allows you to set up different fee rates for each claim co
108. lease SOF Medically Unnecessary Default Diagnosis Code Payment SOF lvl Patient Status Other E t hampus Br Duty Status Lookup Recent Select X Lancel Select 2 A Documents Other Actions MErrorCheck Save Save Next LI 1 In Registration and Related Information RI INCISIVE PM automatically defaults both the Release Signature on File and Payment Signature on File to Yes PN 4104 A O 2007 CrossCurrent Inc Page 9 INCISIVE PM User Manual Insurance Topics B CE Charge Entry Infarmatian 10 PT Akimoto Stephanie A DOS DOC Tanji Troy Ce ei l lookup 2DataEntry K Cance jg Query e Full Rights General Ins Coverage Service Detail Apply Pymt Financial Mgmt Claim Stmts History Procedure Pay poeals Follow up iry Insurance Information Insurance Company In ct Claim Type PiE Form Subscriber Insured Riltn Member No Employer Grp Number AJA gt VSP E _ Other Commercial N P 006996 a han 5 575069634 Akarnai Practice Mgmt LEA d Nedicall Unnecessary E Champus Branch BI Ins Payment Waiting Period al Duty Status Je Global Coverage r E ge le D et ChrgId Exo Date Procedure Code Sve Date Days Dhtient Status Other Add Maod Dos Fee Schedule Start Date End Date Qty Dx Line Ho Profile Amt Patient Amt Charge Amt Co Pa Tax Fin Resp Lvl Eloge purchase m D es
109. lection Criteria Transfer File d The process completed with 0 Failed and 1 successful claims generated Would you like bo EpansFar the File ta the processing center now 20 To transfer the file to the processing center click Yes Information A gt File transferred successfully 21 Click OK ot TELE COMM COMPUTER SYSTEMS INC Master Administrator TC X Med 22 Minimize INCISIVE PM and go to your Windows Desktop 23 Double click on your internet browser e g Firefox Netscape or Internet Explorer 24 Go to www nethealthclaimservices com or www officeally com 25 Login with your User Id and Password Claims Claims Upload Claims View a Claim Upload a Batch Received Files P Claim Fix Upload HCF A Upload UBS 26 Click on Upload Batch for NHS or Upload Claims for Office Ally 27 Upload HCFA for Office Ally PN 4104 A O 2007 CrossCurrent Inc Page 45 INCISIVE PM User Manual Claim Processing Click on Desktop Click on the WHS or Office Ally Folder Select your most recent batch Click Open Click Upload You have now uploaded your claims to WHS or Office Ally Print the page with the File ID for your records e ES 3 ERT LL V Tha FS Le i Ts wr Fan EN rum PESTE OAKEESKE ECK 31 Wait 24 hours and log back into www nethealthclaimservices com or www officeally com and click Download File Sum
110. mary Print or view your File Summary Report for any errors PN 4104 A O 2007 CrossCurrent Inc Page 46 INCISIVE PM User Manual Claim Processing Claim Processing Paper CP E CP Claim Processing 507 AM 07 02 2007 10 33 AM TANS E A Lookup Data Entry EP Cancel I4 Lag Query rei EN view Edit Her 4 y Process Type Proof Selection Criteria Claim Format Paper Ii Proc Ctr Ka Paper Form iNew CM51500 Cl Acct Start Date E Acct End Date cl Posted Charges vl Lnposted Claim Process Yes Gel Process Clair j Claim Type Process Charges no s Charge Types p Leave blank EES blank ra r alb Bill bronda a Provider BinaProvide Leave blank Far ally Insurance Insurance Company Exclude Insurance Insurance Group Exclude a Companies F KE eee CHOICEJAETMA m Groups al Leave blank Leave blank For alb For alb gt Other Actions sf Error Check an Ici LAN Save Nent 35 The symbol generates the next Claim ID 36 Process Type Proof This will check the claims for errors but not process them 37 Claim Form Paper 38 Proc Center Should be left blank 39 Paper Form You have a choice between Old CMS 500 12 90 or New CMS 500 08 05 40 Acct Start Date Should be left blank 41 Acct End Date Should be left blank 42 Posted Charges Needs to be checked v 43 Unposted Ne
111. mk IER 4 Lookup Data Entry Cancel I7 AQuery EJ Ep Rights General ID CABC ei Description Credit From ABC Comments Inactive Disallow Use Bi Select X Cancel Select Documents Ve Other cons Ef ErrorCheck Save Save Neut a 1 Create an Adjustment Type Code ATC PN 4104 A 2007 CrossCurrent Inc Page 74 INCISIVE PM User Manual Payment Entry E PE Piment Au urmieni Entry nlormalkin 25 Abe Kenmetlr Stephanie 1070572005 03 0 PM w le ibook Datetnrg Cancel 7 acuey Y Tiener l Everett di Le irn bhabe Loss el page Lujo wi Reste Fam cie Gt Ta Cessation AG arr D Amis 008 Bate 201587 Ms bnar M TS rte man Tiga Tope A damen Cr im Chi ha Belle Ce Doe edere frees AB Camm i Abe TUO US 13 X Ten thacaes eerie Party Keess e Ok Faire Do herve id B sse Paid And Thiet AD fat og HIE E chg 3 Ahr kerreth s daanin zi eut roseis gra bas bm 0 00 No Ho Faire les Cu King ee l ea Peale el hc LP 5 l SS Chem eet Paim Am Foie ont dled Omg CramuEeb ont tz Pub Dog be tir mt Sdiri Type Ep Passt F FLN 0 99 ON 10 00 172 928 Bir 10 00 ABC l i 22054 LE ds Ch re Pat Dm At i040 pnaurance Patient Gert R Alerts Aetesk onim haurire Come drevr Clem nya Piim Erem dirine Ita eg Stet hag J ERUS m
112. moto Stephanie 4 m Symptoms Date Mame Lask Akimoto Accident Date LMF Date e Other Accident First Stephanie MI a Les A i Similar Con Date iv Patient copay Coverage Case HMSA HMSA D EN D SS ADDITIONAL INFORMATION Resp Party 034020 Akimoto Stephanie A m SS pue Disability Status Billing Provider i Chum Bernard M D el Churi Bernard MC d meae AIPO Work Last Dte Ger Provider 1 Chun Bernard M D m o Ue Faclliby bok Doctor s Ofc ecu E Acct Trans Dte D6 02 2005 v M ee LES NNI oi d Financial Class HMS HMSA m Disabil Frm Dte ZS Charge Class LA Ta e Referring Dactor W Rezal ecalls p Date Date Pt Last Seen Data Entry MCancel JobRelated Emerg Auto Accident E PI H Reason Supervisna Doc Le Employer Work Status all Marital Status M Married I B Documents Ww Other Act 4 Onthe CE Charge Entry screen Disability Status should show the AIPO PN 4104 A O 2007 CrossCurrent Inc Insurance Topics BASIL G Full Rights MErrorCheck 2 Save Save Next LI Page 23 INCISIVE PM User Manual amp CE Charge Entry Information 250 PT Akimoto Stephanie DOS 6 2 2005 DOC Chun Bernard Stephanie 06 16 2005 03 12 PM Us Br L Lookup 2 Data Entry Cancel 2 Query Insurance Information Insuran
113. n t change the ID If you still want the aging to print but do not want a message delete the description PN 4104 A 2007 CrossCurrent Inc Appendix 55 INCISIVE PM User Manual Table Reference SB Service Branches A on Service Arancies Al AIR TORCE maimin GUJ kan OFF Frs a P c Leder sis here mere TA an eee Fa E iun OT ES Charmes Cou 17 Genersl Eph Ha 1h nr or iT id d V Caps IBEOECE bt Cherri k r AMFORE A are Ce am ere a ia MARINES gegart lana Bt issir Ho I Longs cmd eem Doc ere her Sc EE ef Error Check E Sare Tart Pon Service Branches This screen has been set up using the standard list of uniform services This information is used for CHAMPUS and CHAMPVA claims Army Navy Air Force Marines etc PN 4104 A 2007 CrossCurrent Inc Appendix 56 INCISIVE PM User Manual Table Reference SMC Statement Message Codes EI IMNEBOTI uL bezzaepg Cada A SL To FHE OEE pE TIELE MER PCL PSSA COA middi Ob PPOs OF 4 9 Ri us m reren Vista re er Te m uem y iit Bet raie us A Eege ARIE FC CX CER RC TEIM PER POS BALANCE I YOUR EE SECHER L ED S Ls K pert TER APCE CO PATENI k cei i Bees Prise Lberunsents Ch ihs Act mns af Berne Check d Rave Saee Zeg Statement Message Codes SMC allows you to enter messages that you to include on the statements Example a message informing the patient that his insurance com
114. n office and you want the patient to receive only one statement from your office even though they have seen different doctors at you facility the payee id s must be the same on the DR screen for all the physicians involved The group NPI number goes on this screen Un applied payments use the Payee in the Registration screen All others use the Payee in the Provider screen PN 4104 A 2007 CrossCurrent Inc Appendix 50 INCISIVE PM User Manual Table Reference RD Referring Doctors eee ee RD Roferring Goctors 1 Cun op Gon M madmi OF 20 7006 OK FD Ads talca Loba Dais Err Cucaecel i m eew 7 QT Le ictum Contes Cal en org Creme ne amp ist farm je Lara eg ES Lk Peer ALT Pis Doe i i Ip MUR ZS TE Fach aie LEE Te HY Prod dt nn TL PAM T MATE Tool Pertes Esp pes a a Core hrs ele boites eral mrs 2 iro Check z Sege Save Fav Referring Doctors The RD screen is used to record providers who refer patients This information populates in the referring doctor field on both printed and electronic claim forms You need to include the UPIN Name Last and First Last and first name of referring physician Address City State and Zip Address information of referring physician Pro Lic Type Professional License Type Click on the ellipsis to choose from the License Type Table e g MD DO NP etc UPIN Override Schedule Grid The override values and ID
115. nactive Check box if the provider is inactive Disallow Use Check box to disallow use of the provider PN 4104 A O 2007 CrossCurrent Inc Appendix 21 INCISIVE PM User Manual Table Reference DSC Disability Status Code Wir uBEr rni Statin Code 4 Gabliliv ciate codes frrmdmin G r OS OF EN o Ge gQiokwp jOstefwry cancel D I Awer P Ee r r CE A Ra e L Dez amies m Sh Other C EST LS m Pera Cheek Pe nee Saree iHi Disability Status Code This screen allows you to add the disability status code of a Worker s Comp patient PN 4104 A 2007 CrossCurrent Inc Appendix 22 INCISIVE PM User Manual Table Reference EM Employers LEMI frepiogers 3 Tele Comer Compuier EC NM Inc madmin OM 82006 11 49 Bi N Lookup Geta Dir Cancel Er Query FE role XD LE eT Crabe den d i i finn hiere Tam Caen ape Seer tre di a Aud gs ete pe Da TD kremaj LA Breed mila LI Van Pme 9651 H 0 Ea Est Ga Par Mais bi Ap pat Cuba d Rams ST 4 em ee om Lbckrgr feces ic p Des ames m Sh Other icd bee Error Tera e Zi Tare Shane tri aj Employers This screen allows you to set up an employer information file Once it is set up in the database the information is available for you the next time you are working in the system This is especially helpful when you have several patients from one employer PN 4104 A 2007 CrossCurrent Inc Appendix 23 INCISIVE PM User Manual Tab
116. ng Center Leave blank when sending on paper claims to the insurance company Medigap Code Medigap number for insurance Medigap numbers can be obtained from www nhicmedicare com PN 4104 A 2007 CrossCurrent Inc Appendix 30 INCISIVE PM User Manual Table Reference NPI St Paper NPI Status Choice between No Supported Legacy Number amp NPI or NPI Only Per CMS guidelines submissions should contain both legacy number and NPI until further notice Elect NPI Status Choice between Not Supported Legacy number amp NPI or NPI only Per CMS guidelines Submissions should contain both legacy number and NPI until further notice Payer Ids Grid Box Processing Center NHS or OAX Submission Id Payer id from Processing Center published payer list Remittance Id The number land tax id from the 9 1950587677 Payment Only Leave box blank Indicates that this insurance company is to be used only for the entry of payments Claim Type Schedules Grid Box Claim Type If the Insurance Company has not assigned PIN GRP numbers you will want to use the default D which should use the Tax ID as the provider number e g Aetna insurance falls under your Default If insurance is Medicare Medi Cal or Worker Comp choose the appropriate Claim Type Fee Schedule Type Choose the appropriate Fee Schedule e g Cash Basis Co Pay Default Medicare Medi Cal etc Claim Coding Type Choose the appropriate Claim Coding Type e g Co Pay
117. nt and the recall is within your date range the system alerts you when making an appointment so you can close the recall Discretionary Allowance DA Used to allow for the auto discounting of R P balances In order to utilize this tool it must first be activated in this screen Once activated an additional field on the RI screen called D A96 appears you need to enter the percentage amount for the courtesy adjustment The amount entered must be a whole number not to exceed 100 This only applies when setting up the DA When setting up the classification statement message and adjustment type defaults we suggest that you select a unique code for your automatic allowances This is so they can be differentiated from your manually entered adjustments O 2007 CrossCurrent Inc Appendix B INCISIVE PM User Manual Table Reference CPC Claim Processing Center a EM Claim Processi te Cantons OA Office Ale EG n udbl blrFlu gu SF AM a Te gibh 06ers tae FF Gers F e B Vpreuernd T Cet adr bet Sa hime rg Ay iea up ator ep Th AP eee cee Aest LES 5 Come eee Fej rre em Aditi Feray ri r Fest el Cp or umm Lauren fee Ee x Surreal tue Pieces Donum Pare Ly Lape Fest S tz AR k Tk ibo CE his oad m l si PP der ed ie bi Evt FA Tut Ft Fearless SED ND QE E r Mam Pra Fi RE i BETwXamr i EEE Desi 7 fear T other Kir EEE ror a Fan part Claim Processing
118. nt Entry B CE Charge Entry Information 462 PT ABC Refund Account anything DOS 8 19 2005 DOC Nakashizuka Mari Diane 08 19 200 fe ic l lookup jDataEntry KCancel aQuery E Full Rights General Insurance Information Insurance Company inact Claim Type Rity Member No Employer arp Number b HMSA swa Metical Services HMSA 5 1 EN Release SOF Iv Medically Unnecessary Champus Branch Ld Ins Payment Waiting Period t ig x d Payment SOF Patient Status Other _ Duty Status Mel Coverage Diagnosis Code ChrgId Exp Date Procedure Code Sve Date Procedure Code Add Mad POS Fee Schedule Start Date End Date Qty Ox Line No Profile Amt Patient Amt Charge Amt Tax gt BF Suns jaune ii jp ne josjief2005 pBff9f20 4 000 000 505 Patient Copa Tot Prf 0 00 Tot Pat 0 00 Tat Cha 45 00 A amp Documents Other Actions Error Check dH Save Save Next R Insurance Information Select the insurance company that is doing the recoupment Do a balance forward charge and enter the deposit date into the Start Date and End Date fields The charge amount will be a negative recoupment amount Save the charge Enter your payments NOUR WN Enter a negative recoupment amount on the INCISIVE PM account This will create a positive payment amount offsetting the negative charge PN 4104 A 2007
119. nt SOF w Patient Status Gther Duty Status E eee Diagnosis Code Chrg Id Exp Date Pracedure Code Syc Date Days b 465 9 Procedure Code ddd Mod POS Fee Schedule Start Date End Date Oty De Une No Profile Amt Patient Amt Charge Amt Co Pay Tax Di He aties ji jp ne mum iin zt oo soo em ell Patient Copay il Tot Prf 0 00 Tot Pat 0 00 Tot Chg 65 00 1 Documents 5 55e 6 sf Error Check Save Save Nent al In this case the office visit was filed with dual insurance coverage as seen on the Charge Entry Information CE screen shown above Please note that the Charge Amt is 65 00 PN 4104 A 2007 CrossCurrent Inc Page b INCISIVE PM User Manual Insurance Topics E PE Payment Adjustment Entry information 283 AMAA Stephanie 07 14 2006 04 38 PM fs He Lookup 2DataEntry Kitancel LA Query Ki M s Full Rights General Payment dr 283 jes Trans Date 02 01 06 v Den ozjo1o6 v Posted From Ins Co SERE HMAA Classification HMe HMAA Le Amount 25 00 RIParty E Pyme Method ck Check pl L Trans Type HP gt EOB Payment or or Pay w Adj Pay wlAdj ChE Ma Refer ck 569635 Comment Akasaka 01 16 2006 390 A Patient eg err Charges Insurance F E T Ee I pu SE f LL 1 m DS dn Chra d Patient DOS Charge Amt Balance Paid Amt Contrac
120. nual Table Reference Claim Coding Schedule Grid Box Claim Coding Type Click on the ellipsis to choose from the Claim Coding Type Table e g Default Medicare Medi Cal Workers Comp etc Prov Num Enter the provider number for the specific Claim Coding Type Provider Number Qualifier Click on the down arrow to choose from the following drop down Organization Mumbkber Boa Health Maintenance Organization code Phomber Group Num Enter the group number for the indiv individual Claim Coding Type if applicable Group Number Qualifier Click on the down arrow to choose from the above drop down menu GRP NPI Check box when provider belongs to a group with an NPI number for the individual Claim Coding Type e g you are a group with Medicare but not with any other insurance company If you have a group NPI but no group legacy ID you will need to fill in the Provider Group Number Grp field with the Provider Number PIN Credentials Enter the provider crendentials P Agmt Participating Agreement Check this box if the provider is participating for the individual Claim Coding Type A Assign Accept Assignment Check this box if the provider has signed a contract with the individual Claim Coding Type to accept assignment of payment SOF Signature on File check this box if the provider has a signature on file with the pa Comments For Internal Use does not populate data on electronic or paper claims I
121. og ws og imr ig i d Hic m Km Ba Cf TES ua du pne a im oon A oe sf Form Tech Rae base Wen E D Enter the Payment ID of the incorrect payment B In the Charge field enter the Charge ID number of your IE charge you created or press CTRL and Down Arrow to pull up the last Charge entry 4 Apply the erroneous payment to the zero charge 5 Save Create a new payment with the exact same payment characteristics as the incorrect payment but make the amount a negative in both the amount and paid amount fields to correct previous payment entry PN 4104 A 2007 CrossCurrent Inc Page 82 INCISIVE PM User Manual Payment Entry A I BELT a A IT In Perna FT 4 STRA Them r a A a BL T ell E Leg Joubert PA Liter 2 rer am Fleet si sae e sem isipin 3 Ferd aiani wen SC CUT Te thee ee 3 em ou TEEN ke 4 wl m par Dar SR Ug F e Lc Gupit baee Foie Carne Wi DN a CC He pa we man sg Se ia Din a EES ie eg HIE Mm bm D J SE J Mu TC ST An e Area ua EEN HANE Vm Weer K ma wa Er ay goma LUS By using the same payment characteristics payment method payment classifications etc the two payments will zero each other out and there will be no effect on the reports D Be sure to enter a comment for your reference PN 4104 A 2007 CrossCurrent Inc Page 83 INCISIVE PM User Manual Payment Entry Refunding Unapplied Payments PC B PC Procedure Code
122. on Codes AIF AIHA Su Eu ri Ona G a T A N T KS EE F i phra JO not cancel aiser 7 LIU y inia Disa Candy era amp eae ei he ii jt dam T ia Desc Rae RE SR CT a E Hra KAF APIMAVATPENT O oO Counet OLA The Cece of Cf B nf ASO A TER PAIRE HIE Pal eye ilr CWE T SY ALL CAP MED oa PAn PAIIEMT Pay PATIENT ee Peta rcu PEDE AE cer PCM arses pL Dn amens m Sh Other fia bee mf ere Chere amp B Save Save Fu Payment Classification Codes This allows you to describe the type of payment you are entering For example Medicare payment Medicaid payment patient payment insurance payment etc the information can be entered on the IC insurance company screen in the payment classification field If you entered a default payment classification in the IC screen when you enter a payment from that insurance company it will default that information for you This saves time and eliminates the need to search for it when you are entering a payment NOTE Because Payment Classification Codes also print out on the statements to allow for easier reading you should keep this in mind when entering the description PN 4104 A 2007 CrossCurrent Inc Appendix 41 INCISIVE PM User Manual Table Reference PEF Print Encounter Forms PRE Prini Crocouurter Por D x LU heels Cancel Mese Life Teale LII RIES AU us Erexariber Pere rare fe Fa Pai aop Tet Apt Dwbe Apex fane Ponde meus dul m lan bar
123. os Al Zug See Peper Re ru ni Fock Iron ere Tease wwe Gee Errat Lara EN e Wd TI sg Ha Lam Has bow al fre b Th Otherr Pin rer Error Chima d Lave Ampt Process Type Proof This will check the claims for errors but not process them The symbol generates the next Claim ID Claim Form Electronic Proc Center Click on the ellipsis and choose NHS or Office Ally from the list of Claim Processing Centers Acct Start Date Should be left blank Acct End Date Should be left blank Posted Charges Needs to be checked v Unposted Needs to be checked v Claim Process Yes Process Claim Types Leave blank for ALL Process Charges Leave blank for ALL Billing Providers Leave blank for ALL E RE B I Ue M aes ge DO IS E Insurance Companies Leave blank for ALL IR Insurance Groups Leave blank for ALL Ui To process claims click on Process PN 4104 A O 2007 CrossCurrent Inc Page 43 INCISIVE PM User Manual Claim Processing ti CCR EE aes RS SC Pm Fous Base Te Tales ss CVS Sa kal Aff Graser a Road SS Cherees passer Clee Et Ir dase CD Ea ier Adie Cricel rd zo ADD zech En PE Lie dream TID a FA F in uad BR Ah FU US Pte oe RER e rr aMbuembenam Jai fee Stare FE this Wi ms las IL Fb Seto eun amu re Export TT ee ae T dra lia Bret sis 8 me frg aen E Er I daw e E 7E 1 we m Pretty aa ini ARE LE i wa x1 mU ns pred Es pn Lives MTHS m K e m
124. pany has paid and the remaining balance is his responsibility Select this message to print on the statement when you post the payment It can also be used for the individual procedure code lines thru the charge entry screen under the financial management tab PN 4104 A 2007 CrossCurrent Inc Appendix 57 INCISIVE PM User Manual Table Reference SP Specialties EB EF Sprclaiiiee CDI ESHIIIL RG neds O70 OO 7 30 EM yt omi gp hate tintin H4 areal ES an Umm em Les i Ws Laws al Mes i telco het Demmerik T RE a uu Cet parece k E ii hdi Y omm M nr later Lent FACE E Thea PAET CY Pee TUE SILA PES FAZIT lDorurnmesis ter Actions Le fire Cheek ng ere ewe Posch Specialties This screen has been set up using the standard list of specialists and is accessed from the DR Providers screen amp the RD Referring Doctors screen PN 4104 A 2007 CrossCurrent Inc Appendix 58 INCISIVE PM User Manual Table Reference ST States M STI States CA Callers ai a 17 707 OO 10 73 AM ts rb ri 2 Uaa Pinte E E Amy F T TII Ama Pomcam Fade Lear We kb C aum Emma r p ppc P SN i a I Teepe T Ca rts eset thes Aereo a few Check bare Eve Hg States This screen has been set up the standard US Postal Service list and state codes PN 4104 A 2007 CrossCurrent Inc Appendix 59 INCISIVE PM User Manual Table Reference TC Taxonomy Codes BR PTC Tamim Conk FO POCO C
125. qualifiers are taken from the corresponding Ovr Num and Override Number Identification columns PN 4104 A 2007 CrossCurrent Inc Appendix 51 INCISIVE PM User Manual Table Reference RPC Responsible Party Classification E Ni Rosgonaeite Marty Claes e Eg a Tin NE NER TELE CEO RES oem OPO PONT OF 710 Di E Le fx to rr gibe pusia rry Steet T ours Y ru Pages i aprum hara Cru Geral EHEH Lites r cT lid idm emri M VIAGTEUNI ncs Gera m am ta T IIT z cda A I Caesar d ICT TE I asma i om Leone Pech ecc A icem miis cher Drtseua w Error Cesk iy fae haw Pets id Responsible Party Classification This allows you to group responsible parties for statement processing purposes For example You could create a classification for people in Collections Then when processing statements you could exclude these people from the normal statement run and review run them differently If you do employee physicals you could classify employers as different responsible parties than people PN 4104 A O 2007 CrossCurrent Inc Appendix 52 INCISIVE PM User Manual Table Reference RR Recall Reason Codes Fi RE Recall Remon Codes PIPL 3 FEAR FOLLOW LP rome OFF OC SO PO ei Po be dicokup Osa Ente Cancel 7 Query Fi cto Cay ell Capi Dies 1 ict pnmo hid ion Dep H EA GELD LS Bot DHT r PES ee CNRS MEREAT LAB LE THAS D LCT Fore Bi D ames m Sh Other fia fo m Pera Cheek Pe
126. r and also printed in box 32 of the CMS 1500 In order to have the facility show on the appointment scheduler the appt location check box must be checked Entries in the Claim Coding Schedules grid override the Tax Id value based on the Claim Coding Type The override value and id qualifier is taken from the corresponding Secdry Id and Secondary Number Type columns The HCFA Id Code column while it continues to be visible is for reference purposes only and is no longer utilized by any claim processing Claim Coding Type Co Pay Default Medi Cal Medicare Workers Comp HCFA ID Code No Longer Used Secdry ID The specific number for facility prints in box 32b of a claim form Secondary Number Type From the drop down menu select the type of number you have entered in the Secdry ID field PN 4104 A O 2007 CrossCurrent Inc Appendix 29 INCISIVE PM User Manual Table Reference IC Insurance Companies 3 IC Insurance Companies 6 WORKMEN COMP madmin 05 23 2007 08 49 AM ac Ir lookup Data Entry T Cancel Lg Query EJ t3 Full Rights Expand Data F7 E je Insurance trp 2 WORKERS COMP Co Mame WORKMEN COMP Celle Fyrmt Class WCP WORK COMP PAYMENT fuu Address 2356 WORKER STREET RemitPymtclass lWCP WORK COMP PAYMENT Address Processing Ctr oax Office Ally Zip Code 32504 RIVERSIDE CA M Medigap Code Nat l Payer Id City Riverside st cA Lol Paper Cim Fo
127. r your insurance adjustments contractual write offs This is a user defined code that is utilized in the payment entry screen For example if you have already received payments from both the insurance company and the responsible party and you have a small balance remaining you can create a small balance adjustment code Enter the amount you want to write off in the adjustment amount column and select small balance adjustment as your adjustment type PN 4104 A O 2007 CrossCurrent Inc Appendix 4 INCISIVE PM User Manual Table Reference CC Claim Categories a CC Claim Categories PRC Pion Cros e rr dicokup qa fray Cancel 7 Query eo D TL mdr G r sal Dies Es Bei item s Laconia Em Crowe Cesare bec bate Conti P Charges RTE pr FECA Der Lier TRS rl ta Flat Pc a1 Pip ice 7 denen e MR aman rst m Ss Other ALi m Error Beek Qj fave Aaye Anri al Claim Categories This information is generally used to determine which box is checked off in Box lof the CMS 500 It is also used to determine claim type on electronic claims This information is entered in the Claim Type Screen CCT for the insurance company PN 4104 A 2007 CrossCurrent Inc Appendix 5 INCISIVE PM User Manual Table Reference CCC Charge Classification Codes ECCI Charet Classification Cocks IHT Galance Forward radmin P5 04 7008 O8 TE S Lobo Lena Entry cancel 7 ogg ery 7 Desa Timigi D er iip and Pa
128. rge Entry information 482 PT ABC Refund Account DOS DOC Makashizuka Mari BR E B Lookup Data Entry fCancel 3 Query Ki T OS Full Rights General Ins Coverage Service Detail Apply Pmt Financial Mgmt Claim Stmts History Procedure Pay FILI Mates mg 482 P Posted Patient ABC ABC Refund Account a Symptoms Date E Job Related Name Last ABC RefundAccount Accident Date Other Accident First j uc Kl v to ecient E ol dad Similar Con Date ke Patient Copa Coverage Case NONE el PAR ADDITIONAL INFORMATION Resp Party ABC ABC Refund Account Billing Pravider f Nakashizuka Mari MO mi Last ra Date Serv Provider i Nakashizuka Mari MD z Initial Trmt Date 2 Disability Frm Der To ill none ral CR Deere d de L SERRES oo x D Acct Trans Dte 08 24 2005 el PHP LS M Hosp Frm Dte Financial Class LI Cash m EE To EN Charge Class Active Recalls Referring Doctor 8 RecDate Cls Date Reason Comment Date Pt Last Seen E Supervising Doc m Employer RENE Work Status SS a Marital Status O mi Documents e TiHsei Actos W Error Check j Save Save Next mM 1 Create a charge for patient INCISIVE PM CE Notice that the Coverage Case shows as NONE PN 4104 A 2007 CrossCurrent Inc Page 77 INCISIVE PM User Manual Payme
129. rm New 1500 ell vi st Legacy NPI v Main Ph Num Ext Elect NPI Status Legacy NET el Fax Number OAX Office Ally 12345 vert Ph Num Ext Payer Ids SSS e Processing Chr Submission IH Remittance Id I Email Cain Type Schedules a m Claim Type Fee Schedule Type Claim Coding Type Picim Form NDC Req Box 24k Times Z4k Write OFF Setting nei apajdue BEE eh C WORKER COM INC WORE MENS comp WC WORKERS COMME Website Payment Onh Pu Comments Inactive Disallow Use E Documents 5 Other Actions m Error Check Save Save Next CH Insurance Companies Table Maintenance The IC screen is used to set up or modify the insurance company s information name address phone number claims processing center control ID and other related information It is also used for specifying which paper form to use and to record the NPI or legacy numbers for specific carriers When using paper forms Processing center and the payer id are not required To print claims that are transmitted to THIN the control ID should be Print instead of Paper Insurance Group Def lt Pymt Class Default Payment Class Payment Type e g if Aetna is the insurance company the Aetna payment would be the Default Payment Class Remit Pymt Class Remit Payment Class Remittance Type e g if Aetna is the insurance company the Aetna payment would be the Remit Payment Class Processi
130. rom 11 01 2005 Through 11 30 2005 Procedure Description Code 12001 13151 E1 1 4060 E1 65440 E1 69440 E 2 EIN 90474 HUDD 43000 99203 99213 99214 99222 99232 Fepair of eyelid Repair oftissue Punctum snipilul Punctum snipilll Lipid Panel Immunization administration Flu vaccine ECG routine wrat least leads Office visit new Office visit estab pt Office visit estab pt Hospital admitii Hospital follow up ii PN 4104 A Simple repair of superficial wounds afscalp neck axillae Quantity DER Charge 5230 00 547 81 1 015 10 487 50 487 50 15 62 10 42 18 00 55 00 5105 00 541 58 390 00 277 08 488 53 0 3 0 2 UA 1 4 2 2 11 5 CN 5 4 10 5 Profile 9357 46 0 00 AU UU 0 00 Day End Month End REPORT TOTAL had na 2007 CrossCurrent Inc 4 669 34 100 0 357 46 Page 95 INCISIVE PM User Manual Day End Month End PRAR Charge Entry The Payment Classification Summary is similar to your collection report PRAR Payment Register And Transaction Reports gaPrint Setup X Close Report Format Payments By Classification Summary el Accounting Date From 01 01 2005 ell Thru 01 31 2005 m Posted Payment Criteria Both el Payment Types Both sd Payment Data Providers Insurance a FY User s Leave blank Far all Payment Methods Leave blank for all Pymt Classif Codes Leave blank For all
131. rror Civeck ij Sage Sep bet ech Document Editor Document templates are created and stored here After creating the document in Word you import it into the system where you can then populate it with the fields you want to show For example if you want Patient Name to print on the encounter form you would need to put the patient s name in the merge field where the name should print The Description list left column of the screen includes examples of other documents that could be set up in the DE e g encounter forms return to work school forms prescriptions pre and post operative instructions patient phone calls nurses notes medical records request etc PN 4104 A 2007 CrossCurrent Inc Appendix 19 INCISIVE PM User Manual Table Reference DR Providers DR Providers 1 DUNLOP DON MD madmin 05 24 7007 08 03 AM l lookup Data Entry Cancel ayQuery PI Belt 13 Full Rights General Claim Coding Overrides Schedules Schedule Exceptions Provider Facility Claim Coding Schedules Sender Identifiers Trading Partner Idsi td 1 Name Last DUNLOP Prof Lic Type IM zdl Lic Mur azenz1 First DON MI Social Security Tax Id 77 0425723 Address 2900 ADAMS STREET Address SUITE 11 Payee 1 DONDUNOPMD Zip Code 92504 RIVERSIDE CA eal Specialty FP Family Practices City Riverside SE CA d Taxonomy Cde 207000000 Family Practice
132. rvice Detail 1 Insurance Company Information This populates from the RI screen and from the Coverage Case you choose on the General tab of the charge You should check all of the boxes for accuracy 2 Release signature on file payment signature on file Medically Unnecessary Patient Status Other Champus Branch Duty Status These populate from the RI screen and may be changed if needed Insurance Payment Waiting Period This populates from the CO settings screen 4 Medicare Secondary Payor Type This requires you to choose from the pull down box if Medicare is the secondary insurance 5 Diagnosis Code This populates from the RI screen You may enter a new diagnosis code delete or change the existing codes Enter the code or look up by clicking on the box or pressing the F2 key 6 Procedure Code Enter each procedure code by the number or look up by clicking on the box or pressing the F2 key Enter as many procedures codes as you need If you need to add a modifier you may enter up to two modifiers with a dash between them The place of service populates from the facility in the case of a hospital you will need to choose from the list e g select 21for inpatient hospital 22 for outpatient hospital 23 for emergency room etc The fee schedule populates from the Insurance Screen PN 4104 A 2007 CrossCurrent Inc Page 38 INCISIVE PM User Manual Charge Entry Dual Insurance Coverage Click on the Ins Coverage Service Detail
133. ry INCISIVE PM pulls data from various locations within the system to auto populate this screen 1 Once a Procedure Code is entered the POS Place of Service defaults accordingly Start Date defaults from the Account Transaction Date entered on the General Tab 3 If the patient needs to be billed prior to entering the insurance payments that amount should be entered in the Patient Amt Patient Amounts Most offices however leave this blank You may change the Procedure Code on the charge only if 1 If Charge is not posted posted in stone 2 No payment is entered on the charge PN 4104 A 2007 CrossCurrent Inc Page 31 INCISIVE PM User Manual Charge Entry Charge Entry PN 4104 A O 2007 CrossCurrent Inc Page 32 INCISIVE PM User Manual Charge Entry Charge Entry CE A ji BETILIEJ La linn in En II e K l hy inha Data rary ni es muerg Tj e PL Pat Piguet eS hee rad MEET Fer Pra sn CERTES SR ECN e Te rege Fan POLE ch p dagh iris Pons as Far zx Fermer imam Lan alfa Sii Fast iti Fina ein W LES TEE rice r AC aem omg ceres oam ie di cuc Disan paliar hacer adi Ze Een cc ga UMP Dele Lan he ECH 5 ewe lor Le Br iit ee Wie Proven ST aa a bei ee Leda Tara Dain megudy Pri Ce TE E ay Lia hrar Ce Acct Tee D se COTES LEE MORE PROC TE RE Part ci Faim asi Foro Clan Attia Arraila Papers Bismi FT alerts hs Cal rares Center mal Foi Dae
134. s R Refund Hk de Hi Qlookup jDataEntry K Cancel Query Full Rights General Procedure Group Codes Coding Schedule Overrides Fee Schedule Overrides Procedure Facility Claim Coding Schedules 2 ks dere Description Refund Classification LJ Department sal Recall Reason Ej Rel Value Units Nat Drug Cds Lag Days H Age Fron Ta ma Gender Limit i Taxable Claim Coding Claim Coding Type Procedure Code Type of Service Prt Desc Pfnlly Unit Black 19 Local Use Schedules d tat p Par Provider R E Other Medical tems or q jT TTL Fee Schedules Fee Schedule Type Co Pay Charge Amt Profile Amt Patient Amt Pat Sec O R Gf Days 100 Non Cov E fault i 9 00 LI 0O B Comment Inactive Disallow Use Select X Cancel Select Documents h Other Actions WErrorCheck i Save Save Next I Create a Procedure Code for Refunds PN 4104 A O 2007 CrossCurrent Inc Page 84 INCISIVE PM User Manual Payment Entry D if here Melita rib fL I ao Eil f ren Les RK LS uf Late mm gleskup jDataEnry Cancel avery m Cepa Ins Cowernge Service Detail AM Spri Pymk Fruxsesidd med Disma Hetery nemesis Pay apea Tiie SR TH mein u mini Como Ome Y lit iO Am HioereMecule d i Es Parent vesting Pend 0 Pagea SOP vw Parent See C
135. s you to the Diagnosis Codes screen Strike Run or the NTER gt Kkey INCISIVE PM takes you to directly to the screen you requested PN 4104 A O 2007 CrossCurrent Inc Appendix 1 INCISIVE PM User Manual Table Reference AD Administrative Documents D AD Adengrigirentep Decisis 1 CPG CHENE PCR ae en e rr Oigpokuap JOstesUntre Came IO Query Fi rs ges TTD ij Saree MRABAT 9 8 id Lies ES Bu CEN ode AZ ee RE Acca ZU Dear B dberia Cole Here s a frerilly reminder that your account haz part due balance of E299 50 Phrase bring this Coop current to eo any futher collecngen Herts LE you need to make payment nmerangernentr please contact Mary Beth in oor billing department 6 9551 623 2100 e If sou bayr already met in a parano please disregard this Better arsi we thank you for your payman i KI a E i EL 1 Beserg Moe a m ti d e d Crecimiento Otter ME rer af Error Check d ave Zeck Rave ao aj all Administrative Documents From this screen you can send collection letters correspondence or any other type of letter that you want to keep track Once the document has been set up in DE you can have the information needed on the document merged in automatically Once completed the document would be saved in the administrative documents tab that is seen in the RI AA and PA screens PN 4104 A 2007 CrossCurrent Inc Appendix 2 INCISIVE PM User Manual Table Ref
136. search can be initiated in two ways 1 Usethe PC shortcut F2 PC which prompts the PC screen seen above Confirm that the Lookup screen is active left column of the PC screen Procedures Procedure Code oe Start Date End Date Qty Dx Line Ma Profile Amt Patient Amt Charge Amt CoPay D A Fi DejDe nz 02 06 07 11 C a Starting at the Procedure Codes entry b Click on the Ellipsis to prompt the DC Lookup screen PN 4104 A 2007 CrossCurrent Inc Page 29 INCISIVE PM User Manual Diagnosis amp Procedure Code Lookup amp Entry 2 To search for a Procedure Code by Description right click on Has to prompt the search criteria menu a The search narrows as you enter additional data onkun Active Only Ge 5 Ifyou enter stenosis in the Description entry box the Rescriptiop search will narrow to include only those diagnosis codes with Id descriptions containing the word s entered Id D C If you want to search Procedure Codes by Id begin typing 100 Eh Eine Win in the Id box e g if you type in 630 the search will narrow 32000 teil down to all ID s beginning with 630 e489 i gt Greater Than ascac Greater Than or Equal d Make your selection from the list la3846 AS Less Than 93000 lt Less Than or Equal d Select X Cancel Select A Documents Other Actions amp Error Check Save 3 When you are finished having selected the desir
137. surance company mismatch error The system automatically posts the payment to the appropriate insurance on the charge PN 4104 A 2007 CrossCurrent Inc Appendix 32 INCISIVE PM User Manual Table Reference LAN Languages M ji AMI lanpusges 19 English REG EE E TE Te AE 79 Ni fe ad elcome j Date tatry cancel DI there Fo Lea gees Ceres Cadre eral Ue Ferre 0 Fiches Owonaaments y Other Actions w fro Cie VI Save Save mpwfr Languages This screen has been set up using the ISO 639 language tables When you pull up the patient in the RI screen you can identify which language he she speaks using the information that has been populated here PN 4104 A 2007 CrossCurrent Inc Appendix 33 INCISIVE PM User Manual Table Reference LT License Types I amp LT License Typen GOOD IO CE OS ROP aT iY Ieetaggdrsrim CAF APOE D As PA Pi Le dboekoap tate Enr rae Di Aer Fy fol Pogres LET I ijja hemes Coy Gerad Carlie Hu Lites D Carpe Ces VOS QI Cr TEST Pr coi T DEDI a nem Soir Car z LE sg rama mace TC Er HE FRAL Tea dus my LATE ASAH TAA Longs gece Hi Doraus her Drtseua w free Desk Co Bsp aremt License Types This screen has been set up using the standard list of provider credentials and licensing types This is used when setting up DR and RD screens It identifies the provider s credentials e g MD DO NP and PA PN 4104 A
138. t Wor Adjust Amt RIP Balance charge 390 Akasaka Linda Ins Co jf1 HMAA el DI n mp Auto Uu Len RAP Bal soo In Hw Ji istribution Procedure Code DOS Charge Amt Patient Amt Profile AmE Allowed Amt Starting Bal Contract Wo Paid Amit Balance DJA Adjust Amt Adjust b SE Wie delt t i D1j15 06 65 00 gl 0 01 oo 0 go o 35 o0 65 00 30 op 425 6 00 eu 00 m CI 30 00 Pd sm Adj 0 00 Insurance Patient Alerts R P Alerts Appeals kx Comment Insurance Company Inact Claim Type Pye Frm Subscriber Insured Member Mo Stmt Msg E ea o e C mmer Biese LE SEH jo hin TN 4 D0O010212951 Stmt Cmnt i o MOR R E nd em ME S y Unapplied Amount Tat cj d 30 on Tot Pdi 25 00 B Tot Adi 0 00 Documents Other Actions Error Check Save Save Next H When the payment from the Primary Insurance comes in as seen in the Payment Entry PE screen above the Allowed Amt is 35 00 the Primary Insurance paid is 25 00 which leaves a 10 00 balance for the Secondary Insurance PN 4104 A 2007 CrossCurrent Inc Page 16 INCISIVE PM User Manual Insurance Topics amp PF Payment Adjustment Entry Informatinn 284 HMSA PRESE la In lookup 2DataEntry Cancel Query F ul Rights General Payment Idi 264 i Trans Date 02 01 06 el Dep mine v Posted From Ins Co HMSA HA LI Class
139. tab B CE Charge Entrylinformation 127 PT Cole Roberta L DOS 12 00 00 DOC DUNLOP DON EX riis iby ER qlookup jDatatntry Cancel wey 3 Insurance Company lnat Claim Type wn Subscriber Insured S petiti Palos Du PEG Bu TU rc da T EAS SE VEINE Timur qe eur _ eum ha om 1 Dal d Rin le Dog Gplinber AA F DO Gels S In Mi n ie 5 Ml Tek Con Computer Syste Mi If the patient has dual insurance coverage you may need to check P Clm Process Claim Status General Ins Coverage Service Detail Apply Pynt Fiance Mat Cli Stns History et Pay peal UO Insurance Intormation CN hu Company at Cin Dr ke Subset D Mente fi Dis D We A mw prag ces mm 4 Bue Cross of CA Cat ARE Cole Roberta Tele Comm Computer Syste Ni fs a The secondary insurance can be set to Hold indicating you will wait until the primary insurance has been processed PN 4104 A O 2007 CrossCurrent Inc Page 39 INCISIVE PM User Manual Charge Entry Charge Payments for Miscellaneous Accounts Capitation Payment and or Adjustments CE BE f Full Rights DOS 2 21 2007 DOC DUNLOP DOM madmin 03 19 2007 10 16 AM EJ r il Apply Pyrmt Financial Mgmt Claims Stmts History Procedure Pay ka AppealsiFollow iip E CE Charge Entry Information 1 PT BALAT MARY Tei Ek Lookup 2 Data Entry Cancel 1 Lag Query Insurance Information 1 i Grp Number AA PI
140. thin the diagnosis code setup you can also limit age and gender as appropriate You also have the ability to mark the code as non specific this alerts the user during charge entry that a more specific code Is required These codes may also be marked inactive or disallow use if they change the next year or become invalid Default diagnosis can also be set up thru the case coverage tab in the RI screen automatically appearing on the charge entry screen It is the user s responsibility to keep up to date with all diagnosis codes ID Diagnosis Code Description Description of diagnosis code ICD 9 code descriptions are limited to 51characters Description Long Extended description of diagnosis code ICD 9 Long descriptions may use up to 251characters PN 4104 A O 2007 CrossCurrent Inc Appendix 18 INCISIVE PM User Manual Table Reference DE Document Editor E WINE XT LB Lacounianr madi Risse 11270 AM e ja dGicokup jivieintry Came j other Fi dag Pul gres E Lenig Koss ahy nera Cegn AL dE Eee en er Lies MENT Te T Pines rv ater Geese racc anita 11 d s EF Lier Pal Enpe est poe Eire Fons j m Tepes fre n P Lice Deed J Cross Pa E mta Lamar ES Err char Pecan ad hs armor a Li e ER HH ami DT inme nr Poste ee Pee ares ni er aa n irae A rg ES Sr boa rar d OF ree LE DI ER LT LS resp Fret Lost aces Ein pl Des amens m Se Other fate mf E
141. ting Bal Contract vO Paid Amt Balance R P Adj Amt Adjustment Type 99212 OFFICE VISIT FOcusins 10 07 70 00 0 00 i 70 00 i 20 00 d 70 00 j 420 00 d Lee SEE SEET CRE sq SI mine L ER T EE T tal 4a TO Total Amount IE cnl 990 pad P Adjust L Documents gt Other Actions Error Che ave Mext L Li Verify that you are on the General Tab Payment Id will be highlighted Press F2 or click on the to create a new Payment Id From Ins Co Leave Blank R Party Click on the ellipsis or enter the Responsible Party ID Trans Type Select P EOB Payment or Pay w Agj Classification Co Payment Pymt Method Click on the ellipsis and choose your payment method type e g cash check visa etc Chk No Refer If payment is by check enter the check number Amount Enter the amount of the Co Pay made Charge Enter the Charge ID for the Co Pay Tip Open Charge Tab lists open charges for the patient double click on the Charge ID and it will populate the fields IL Paid Amt Enter the paid amount D Clickthe Save button B DON DH RB UwN c PN 4104 A 2007 CrossCurrent Inc Page 57 INCISIVE PM User Manual Payment Entry Insurance Recoupment PE 3 d 5 mt at em B PE Payment Adjustment Entry Information 755 HMSA Judy 02 14 2006 11 48 AM EIS IG otogokup 2DataEntry Cancel A Query 7 Ful Ri
142. tion for each user ID Generally the first and last initials of the individual s name PN 4104 A 2007 CrossCurrent Inc Appendix 63 INCISIVE PM User Manual Table Reference PN 4104 A Default Rights To be determined on an individual bases Each user at a minimum must have at least the default rights set up Restore Login Checked This box can be used as a security measure If the box is checked and the application is minimized and then maximized you will be asked to re enter your password It will then bring up the same screen you were at before you minimized it Authorized Databases Each user can be authorized for individual or multiple databases and granted privileges for all tasks or limited to only specific tasks Comments For Internal Use Menu exception s to default rights e g you want a user to only have View Only rights on everything but be able to have Administrator Rights to the RI Registrations and Related Information screen User Group exception s to default rights e g a user groups can be set up for appointment schedulers so that they can only have access to information pertinent to scheduling and not have or have limited access to other areas like charge and payment entry etc Inactive and Disallow Use Check Boxes When a user is no longer authorized to access the system e g terminated employee the administrator needs to change the user to inactive status and disallow use The user should not be delete
143. u can assign procedure codes to appropriate departments such as office visit x ray or laboratory for reporting purpose Recall Reason Why the patient would need to come back for follow up after specific procedure Relative Value Units Not implemented at this time National Drug Code this is the NDC for medication Lag Days How many days in between the time the initial procedure is done and the time the recall is sent out ge From To Ability to enter an age limit for specific procedure codes Gender Limit Ability to enter an select Male or Female only for specific procedure codes Claim Coding Schedules Grid This grid is used when specific insurance companies require unique information Also see CCT Claim Coding Schedules Table Maintenance Cem shes Ne Ces sius S nibns CURES retos EST NEM ES ETES Merle SEES OS KC CS oh SOMMER EMER SOSA mn ESL SE vi ENEE wm wee sem Mb ENE S eps NENDA Scan nm NEMNGESSNMENSSS NOR meim em Wi ENTREES CN d Claim Coding Type e g Default Medi Cal Medicare Triwes etc Procedure Code Procedure code specific for insurance Type of Service NO LONGER USED view only Prt Description Print Description If box is checked description will print out on the claim form P Only Paper Only If box is checked claim must be filed on paper only S Unit Single Units If box is checked can only be filed as single units The contract settings in INCISIVE MD s
144. us NES Dua Parr Vemm prol EE Dan of Cheri f e a in he Cages Dh Mir Cad E b s Errem RIP Dad at Pacem Sieg dae Sch nf i Lac e a Wr uu bot icem Diese Re Lip dt LT Se Pow LE LS Se AO Ml CLR CEE SE peri Seth Lm TEN S D pu sl bE Fi Wibe E Fred Pare Sage Cate Tee sn Years FF Paley pee l e ap P el en mln ai Diver there Dat m feu ocre Los Lookup i feces Models Sekt Cancel Febect A att puer w Cher Ae ie i treo Check du Sage What do I do if the person is not registered 1 Click Data Entry to initiate the Registration process 2 Clickthe or F2 to assign the Permanent ID this is an internal used by INCISIVE PM which has no affect on the patient record s assigned by your clinic VOTE INCISIVE PM defaults the permanent ID number but you have the option to change it 3 Depending on the classification of the person Responsible Party Patient Subscriber Insured certain fields are required fields that are not required will be grayed out 4 RegStatus Patient Check if the person you are registering is seeing the physician R Party Check if the person you are registering is responsible for the account Subscriber Insured Check if the person you are registering is a subscriber of an insurance plan that is billed for services VOTE If there are multiple subscribers you will need to register each subscriber separately 6 Continue until you have finished enter
145. vices 3 Select the appropriate Claim Processing Center from the menu Office Ally The Health Information Network 4 This initiates the Process Check procedure If there are no new payment transactions the following screen appears information ij PN 4104 A 2007 CrossCurrent Inc Page 60 INCISIVE PM User Manual Payment Entry If there is a new payment transaction the following information appears Information A d 1 new payment Erarisackion s Were downloaded 5 Click OK B ERA Electronic Remittance Advice Retrieval Cit dime tg red Aen 2 BK ee HE 6 Click on Lookup to try to locate your check number Other Actions PET A Process Batch Hp Preview ag 7 Select the check you wish to process 8 Click on Process Batch at the bottom right PN 4104 A 2007 CrossCurrent Inc Page 61 INCISIVE PM User Manual Payment Entry When processing is complete INCISIVE PM takes you to the ERAP Electronic Remittance Processing screen B ERAP Electronic Remittance Processing 89 Leit eis E amp Lancel Ba aa Query 2 B views Edit Delete a ey Id Process Type Proof el m Batch Information Proc Center IHMSA Hawaii Medical Service Associati Era Txn Id 111 Chk EFT 4 NO133743 Payer Name HAWAIT MEDICAL SERVICE ASSOCIATION Payee Mame DOUGLAS L BROWN Dir Payment Id Payment Act Date 10 22 200 Lei cl Amount Pa

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