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1. Client Type ch fall Visit History Criteria x Client Name fie Address a Select Employee z Select Zip Code 011 Springfield MA All Clients Select Client poe st aen Margaret Aldrich tders Status Ac ALL lt Phones 1 55 aa Date Range ii tid Birth Date SSN B Status ANY pe CSR Bi Comment Generate E per hour xempt ID V Show Times Referral any Banua WFS 0 amp 0 amp 2002 08 34 AM Indicate whether visits should be searched for all employees or a specific one 4 12PM e By default visits for the current client and all employees will be displayed You can choose one specific employee by clicking the Select Employee option and clicking the Select button This will cause the Employee List screen to be displayed Selecting an employee from this list will cause the Visit History Criteria screen to be redisplayed with the selected employee displayed e You can choose to view visits for all orders associated with the client or you can select one specific order from the Orders combo box e Optionally you can enter in the range of service dates for the visit history you wish to see in the Date Range fields e You can choose to look at visits of only a certain status by selecting it in the Status combo box e Click the Generate button to view the list of visits 01 18 06 3 13 PM Page 38 of 448 e The Visit History List screen is displayed containing all the c
2. Bie Administration Schedule AR Eoniauraton Mamtenance Logn Samlioto Reports Help Print List Copy _ Update Visits in fall gt Payer DEFAULT gt Default Select Employee Tanya Acevedo Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 Hours HHA 11 17 2001 10 30 10 30 10 30 11 00 11 00 11 00 C Visits HHA 07 22 2000 9 70 9 70 9 70 10 40 10 40 10 40 VI EW NA 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 G A NA 0772272000 9 40 9 40 9 40 10 10 10 10 10 10 a Cunent ORDER BY C Date Skill BILL Invoice ha Reimb Skil A Effective Date 77 Mon Tue Wed Thu Fri Sat Sun Update Rates 1 0 00 2 0 0 0 00 0 00 0 0 0 00 0 0 Stop i I f JM 11162001 11 48 AM Select the skill sub skill that the rate s represent 4 06 PM Select the pay unit for the rate Hours or Visits Select a skill sub skill or Any from the Skill combo box Enter the starting Effective Date of the new rate Use the Shifts and Rates buttons to select the shifts to which the rate is applied Then enter the rates per shift including weekends Click the Update button to add the new rate to the list e Continue to add rates until finished When finished click the Stop button to get out of add mode Deleting Pay Rates e Select the payer that is associated with the pay rates you are going to delete by clicking th
3. Seeth O E Select the primary physician s name by clicking on it in the list on the Select Physician screen and then click the Select button on that screen 01 18 06 3 13 PM Page 164 of 446 Users Manual SAM gt Melbourne GUEST fle E Edit Plan of Care Verbal Order Administiaton Schedule AE Eonnauraton Mamntenance logn Semiicto Reports Help Orders Rank kandi inntinnl Camnlianan Delan OOO M S Diagnoses PLAN OF CARE DEFN IO a AHMED MOHAMMED J AL MASHHARAWI ISSAM at BMC Heal ALFANO BARTHOLOMEW fz Primary Physici WJ ALIOTTA ARMAND A J ALLEN HOLLEY Select Secondary Phy ALLI MD MARY LOU RITTER GLEN a n Plan of Gare Printed N0 Verbal Start of Care Payer Start of Care GUE 08202005 04 31 PM Select the desired Physician The Edit Plan of Care Verbal Order screen will be redisplayed with the Prime Physician field filled in with your selection e Ifthe patient s physician is not in the list on the Select Physician screen e Click on the Physician DB button under the Select button on the Edit Plan of Care Verbal Order screen and create a new record in the Physician Database for the physician e Click on the Select button next to the Prime Physician field again e Select the primary physician s name by clicking on it in the list on the Select Physician screen and then click the S
4. 01 18 06 3 13 PM Page 414 of 448 Users Manual Recertification Due Report This Office level report provides a list of Plans of Care that have a certification end date that falls within the dates specified indicating that they are due for Recertification i Recertification Due Report gt Melbourne GUEST Recertification Due Report 01 18 06 3 13 PM Page 415 of 448 Users Manual Office Function Group Reports Census Episode Report Census Episode Report gt Melbourne GUEST lei File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Census Episode Report x Office 7 SARE et Case Manager Client Payer Class ALL C Case Manager Next Sup Visit Cert End C Client Name Affiliation Disaster Code C Next Sup ervisory Visit S 0672372005 0672372005 2 Pa M Show Continuous Care Patients Affiliation Client M Show Home Health Patients Status Client M Show Home Health Continuous Care Patients Race Client T Medicare Medicaid Only I Show Do Not Resuscitate Only I Show Patients with Active POCs Only Payer I Show Primary Diagnosis and Doctor Orders I Show Discharge Dates I Show Clients in Report l Show Race l Show Patient Address and Phone Number I Output Daily Census Spreadsheet T Show Allowed Skills Repost Option Select an Office 10 04 AM Based on the Cert Period Date entered the repor
5. Binsbacher Pamela JA IPT 555 596 9366 117 51 9352 Wilbraham e Select an employee from the generated list e The Edit Employee screen is redisplayed Adding an Employee e On the Edit Employee screen click the New button on the toolbar to add a new employee e The Add Employee screen is displayed 01 18 06 3 13 PM Page 59 of 448 SAM gt Melbourne GUEST Add Employee x File Administration Schedule AB Configuration Maintenance Login SamToGo Reports Help Emp Profile l Emp Taxes Emp Skills Attributes Emp Preferences B onuses Emp Photo Tracking Ayailabitity Visits Pay Rates ii 4 y Fal i fal lt gt g VITALS Emp PAYROLL BILLING Sees eee Feld Employee il SSN ay Federal ID j alee Primary Skill x License s j peer Zip Code e Bank z na 3 a Max Hours l Exempt from Overtime Affiliation None z Salaried Visits JDJ Phones 1 2 Merit Pay 0 00 per hour _ 0 00 per visit z D snokene 0 00 per hour 0 00 per visit Sex C Male Female Case M Birth Date MISCELLANEOUS Case Manager Referral Status Inactive Edit Status S Comment Hired ree Inactivated 7 7 Emil id g Enter the employee s first name 9 46 AM Profile Page The Profile page is used to enter general information about an employee Vitals Section e Enter the employee s first name middle initial and las
6. In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates You may choose to calculate overtime at anytime An overtime screen will pop up and display the overtime cases Overtime is calculated across all offices for ALL verified visits up to and including the last day of the previous week Only one person may close any office at any one time SAM now offers 2 ways to calculate overtime pay for your employees Algorithm A Overall Average Rate Algorithm A is the default overtime calculation This algorithm calculates an overtime rate based on the overall average pay rate of an employee per week The average rate is computed by dividing the total pay for the week by the total hours for the week of visits and or pay items that count towards overtime One half the average pay rate is then ADDED to each overtime hour Algorithm B Item Average Rate Algorithm B calculates n individual overtime rate per visit and or pay item The overtime rate is computed by determining the average rate of the individual visit pay item considering regular pay holiday pay etc then REPLACING the pay rate of the visit pay item with 1
7. 3 From report options choose the destination option of Excel file 4 Run the report and note the name and path of the Excel file that is created 5 Open Microsoft Word and create a new document 6 From the tools menu scroll down to the Letters and Mailings heading and a new box will appear From this box choose the heading Show Mail Merge Toolbar Once this is done a new toolbar should appear above your new document 7 Place your mouse pointer over any of the new buttons without clicking on the button and a display will appear saying what that button does Once you have found the button that says Open Data Source click on that button The window below should pop up Now find the Excel file you created earlier 01 18 06 3 13 PM Page 442 of 448 Users Manual Select Data Source Look in E Excel Files v IA X amp E Tooks cl010001 xls My Recent Documents My Network Places Files of type al Data Sources odc mdb mde Y LA 8 Once you have found the file you created click OPEN and the box below will appear Once this box appears and the highlighted file in the table is the one you selected click OK Select Table Name Description Modified Created Type cl010001 7 23 2004 11 30 06 AM 7 23 2004 11 30 06 AM TABLE j First row of data contains column headers 9 Next you want to find the button that says
8. PEP should be applied reports patients with RAP service items that have another RAP service item for the client for 01 18 06 3 13 PM Page 410 of 448 Users Manual any admission within the next 59 days The RAP detected should be coded as a PEP claim e Delinquent RAP and EOE invoices will report the following conditions for any episodes after the from date entered 1 Episode ended but RAP not created 2 Episode ended and RAP created but RAP not transmitted 3 Episode ended and RAP transmitted xxx days ago but EOE not created 4 Episode ended and RAP transmitted xxx days ago but EOE not transmitted You may optionally select that this feature only search o Medicare patient s with a client payer relationship to a Medicare payer that is not marked as DNU o Home Health Non Medicare patients without a client payer relationship to a Medicare payer that is not marked as DNU AND is marked as Home Health on the Edit Patient screen o Both Medicare or Home Health this would not include any patients marked as Continuous Care and are non Medicare You may select which problems to report print or send the results to any available report options screen preview printer excel etc select your sort option and select the office s to report on When this feature is searching for matching assessments there is a built in date tolerance of 14 days This is how many days the assessment s complete date can
9. ccccscccceesssceeseeceesenseeeeseneeecseaeeeecseaeeeseeeceseeecesseaeeecseneeeesneeeesseaeees 178 Modifying a Surgical Procedure ccsccccesseceeeenseeseneeeeeseseeeeseaeeeceseeeeecsaaeeeneaeeseseneeeeseaeeeseuseeeseneeeeseaees 180 Deleting a Surgical Procedure eccceccccccessscecesneeceesneeeeeseeeceseaaeeeeseaeecseeeeeesaeeceseeeeeseaeeesaeeeeseneeeensaees 180 Defining Plan of Care Verbal Order Supplics ssccccccssssscssseecssssccsssscceesssssccccssesscssscccssees 181 Entering a New Supply isierccscceele cece ach cos seed AEA seine sae ea as at eee eee eet 181 Modify a Supply seie aaa E E EN A N ie Han cig ie Nae Sean ee deen aa 183 Deletie a Supply a ccc cess a a eat od des nessa ee Ra caed veel a eh ee teeta cers 183 Defining Plan of Care Safety Measures Nutritional Requirements Allergies Functional Limitations Activities Permitted Mental Status Prognosis cssssssscscssscsssoeeesssscccssooeeee 184 Modifying a Plan of Care Verbal Order ccccccscsssssccsscccsssceeccsssccsccsccecssssccseeeescssscccscssoeee 186 Deleting a Plan of Care Verbal Order ssccccccsssscsssscccsssccccsscessssssscscccessssscccccssseesssssccoeees 187 Recertifying Copying a Plan of Care scccccccssscccsssccsssscccsssccecesssssccsscceeecescccessesessssssssccscoeeee 188 Printing Previewing and Exporting Plans of Care and Verbal Orders cscscsssssscsssseees 190 Printing
10. e Click the Save i button on the toolbar to save the Doctor Order e Ifthe new compliance rule overlaps an existing Doctor Order compliance rule the Overlapping Compliance Rules screen will be displayed 01 18 06 3 13 PM Page 215 of 446 Users Manual SAM gt Melbourne GUEST lel Ee Ble Administration schedule AD Eoniauaton Meantenance Login Senco Reports Help ial Overlapping Compliance Rules X Your new rule overlaps existing rules You may add the rule with overlaps or adjust the dates of the existing rules and replace them with the new rule Rule List if Addition Button is selected __ Compliance Rule Dates Status lt lt Save New Rule as SN 1V A Day 5 Days 05 23 2002 05 27 2002 feae N Rule List if Replacement Button is selected lt lt Save New Rule as Heplsosmeent Rules Save of the entered order will be cancelled If the new doctor order represents visits to be done in addition to what the doctor has already order choose Save New Rule as Addition to Existing Rules The rule will be saved as is If the doctor order replaces the current order choose Save New Rule as Replacement for Existing Rules This will cause the system to adjust the dates on the current order to end as the new rule begins For a complete discussion of compliance rules and compliance checking see the Compliance Checking presentation in the n users manuals folder of your server The comp
11. e Clicking the Update Cash Date button will change the date on all cash applications for this payment to be equal to the payment date Entering a Payment for One Invoice and Applying Cash e Make sure you are logged into the office to which the payment is to be credited on the bank reconciliation When payments are reported by office the office you are logged into at the time the payment is entered is associated with the payment If you enter a payment from a national payer that pays for invoices in several offices it is a good idea to be logged into the headquarters office so you can find the payment later To access the Edit Payment screen select menu option AR Enter Apply Payments The Edit Payment screen will be displayed Click the New button to create a new payment Select the payer who sent the payment this may be either a payer or a client by clicking the Identify Payer button The Identify Payer screen will be displayed e On the Identify Payer screen You can either type in some or all of the payer s name in the Name Starts With field or you can leave the field blank In the case of a client this is the client s last name 01 18 06 3 13 PM Page 278 of 448 Users Manual Check the Self Pay check box if you would like to generate a list of clients to choose from You may also specify other information about the payers that you would like in the list Click the Generate button to generate the lis
12. the new and save buttons are not displayed on the Phrases screen in the Admin office 0 AR if this option is off access to billing features will be disabled Billing features include Export Payroll Create Invoices View Invoices Claims Print Transmit Account Log Enter Apply Payments Apply Cash via 835 Make Adjustments Review Adjustments and Close Period 1 Close Week if this option is off the menu option Close Week will be disabled 2 Create Invoices if this option is off the menu option Create Invoices will be disabled 3 View Invoices if this option is off the menu option View Invoices Claims will be disabled 4 Print Transmit if this option is off the menu option Print Transmit will be disabled 5 Payments Apply Cash if this option is off the menu option Enter Apply Payments will be disabled 6 Request Adjustments if this option is off the menu option Make Adjustments will be disabled 7 Review Adjustments if this option is off the menu option Review Adjustments will be disabled Close Period if this option is off the menu option Close Period will be disabled 9 Export Payroll if this option is off the menu option Payroll Export will be disabled 2 01 18 06 3 13 PM Page 330 of 448 Users Manual 0 Configuration if this option is off access to
13. Using the Edit Supply Item Screen e Click the New m button to add a supply item 01 18 06 3 13 PM 3 29 PM Page 131 of 448 Master Supplies Section This section contains a list of supplies By default the list displays all supplies in the database e You have three options for listing supplies in the list Standard Click on this option if you want to list supplies that are standard across all offices Local Click on this option if you want to list supplies that are customized to your office All Click on this option to list standard and local supplies e Click the supply from the list and then click the Select button Or simply double click on the supply e Ifthe supply is selected correctly it will be displayed in the Supply field in the Supply Item section e The Supply Database button will take you to the supply database Supply Item Section This section defines the attributes of the supply item you want to add e The name of the supply is displayed in the Supply field e Ifthe supply has an SKU it is displayed in the SKU field e Ifthe supply has been assigned a Revenue Code UB92 HCPC UB92 amp HCFA 1500 or Modifier HCFA 1500 these will also be displayed e Default values for unit cost unit bill quantity and total sales tax of the supply item are displayed Edit these values appropriately Enter the date the supply was used Enter an invoice description for the supply Optional Select th
14. e Click the Accounts Receivable option e Select the Payment Log report and click the Proceed button g Payment Log X REPORT DATES SORT BY Week Ending Date C Date C Payer Name C Payer Class Check RA No Invoice No C Deposit No SELECT OFFICE PAYER Select Self Pay Select Payer PRINT OPTIONS Payment Log C Payment Cash Application Report C Payment Adjustments Report I Only Non Zero Unallocated Amounts e The Payment Log screen will be displayed e Enter the From and To payment dates this is the Payment Date entered when the payments were created or leave the fields blank for all payments regardless of date e Select the appropriate sort criteria e Select the Office for the payment this is the office logged into when the payments were created or select ALL for all offices e Make sure the Payment Log print option is selected e Click the Generate button This report can be used to reconcile the deposits made to your bank account The Payment Log report shows only the payments credited to the office for which the report is selected If you enter a payment from a national payer who pays for invoices in several offices it is a good idea to be logged into the headquarters office so you can find the payment later But don t despair On the payment screen you can ask to see payments for all offices That way you can find your payment by payer name and payment date 01 18 06 3 13
15. 002080 02 Start of Care 05 17 2001 Patier Date Status Reason 05 17 2001 Active ha Addre City State Phone Birth I Sex Status Active Status Date 05 17 2001 m Delete _ Ent Reason a PAI 0522 2001 01 51 PM Select Patient Status to edit or delete 12 43 PM e Click the New m button on the toolbar to add a new Patient Agency Status e Select the status of Hold in the Status combo box e Enter the hold date in the Status Date field 01 18 06 3 13 PM Page 155 of 446 Users Manual e Select the reason the patient is being placed on hold in the Reason combo box e Click the Save button on the toolbar to save the new status SAM gt Melbourne GUEST aton SCHeEcuIE AG Lontiguraticn Memnterence Loar samlima Geports Help Hospital Stays x x ojee ple Banned Unplanned Stay e If you had selected the Reason Hospitalized the Edit Hospital Stays screen will be displayed allowing you to enter the hospital stay start and end dates e Click the New button on the toolbar to add a hospital stay record e Enter the information if desired and then click the Save button e Click the Exit button to exit the Edit Hospital Stays screen e Click the Exit button on the toolbar to exit the Edit Patient Agency Status screen 01 18 06 3 13 PM Page 156 of 446 Users Manual SAM gt Melbourne GUEST HIETE istration schedule AG Eonnguaton Mantenance ogn semii
16. 01 18 06 3 13 PM Page 130 of 448 SAM gt Melbourne GUEST Scheduler lei ce Bie Administration Schedule AR Eoniauaton Mamtenance Login Seniicito Reports Help F Client List x ATTRIBUTES NAME 7 SCHEDULED SERVICE Type ALL Name Beginning With Status Active 7 I Has visits scheduled during selected week Payer ALL 10 12 2002 10 18 2002 Y Class l Has unassigned visits Refresh CSR ALL 0671672005 06 29 2005 Affiliation ALL x I Use Client Payer CSR _ Reset List_ Client Admit Status Entry Date Phone Abbey Helen 0571672001 555 739 0474 West Springfield Aldrich Margaret A 07 10 1999 555 781 5070 Springfield Alqawi Henry A 10 23 2001 555 525 0118 East Longmeadow Anders Israel Anderson Antoinette Anderson Edith Angeli Agnes Arzola Roberto Atwood Marjorie Auerbach Francis Barns Donald Select Client to process Client 002080 SAM gt Melbourne GUEST Scheduler Bile Administration schedule AR Lonfiguration Mamntenance logn Senlicto Reports Hep BE Edit Supply Item Client Related Helen Abbey MASTER SUPPLIES SUPPLY ITEM Sup t i S OO C sku Revenue Code x HEPES Modifier Unit Cost Unit Bill Quantity ooo Total Sales Tax 0 00 Date ALL x Invoice Description C Standard C Local All E MOOI P 5 Supply Database EA Select the type of the supplies to view
17. 06 20 2005 erie cl T 5720720 seta EE townie E e Click the Define Plan of Care Verbal Order button add a new Plan of Care 01 18 06 3 13 PM Page 161 of 446 Users Manual e The Add Plan of Care Verbal Order screen will be displayed e Press the New E button to create a new Plan of Care z SAM gt Melbourne GUEST lei Ea Bie Administration Schedule AR Lontauretion Memntenance Logam Senilicio Reports Help x Orders Goals Hedications Compliance Rules BRecert Copy Diagnoses Surg Procs Supplies Safety Etc j 4j 4j gt j Fal N E wlx Us PLAN OF CARE VERBAL ORDER Client A00571 01 VERBAL ORDER INFORMATION Verbal Order Date or POC MISCELLANEOUS Patient Name Joshua Adkins Agenc Agenc Start Gt Care 06 20 2005 Status Active Medical Rec No 400571 01 HI Claim No Type Plan of Care Cert Begin EE al Cert End i Provider No Payer Comment m Primary Physician E Ba I Select anniek ail Select Secondary Physician st ABU J Include Case Manager on Plan of Gare Select Physician DB Payer Payer Start of Care oe Status Payer Discharge Date a 22 Edit Payer Status Enter the Certification Begin date 4 31 PM Verbal STATUS Final D t Printed Start of Care O a inal Document Printed Created ra History e The Type field will contain Pl
18. 1 line summary for each employee including a column for average hours worked which is the average number of hours worked for the time frame selected SAM gt Melbourne GUEST i iol xj Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Payroll Report T x SELECTION CRITERIA DISPLAY OPTIONS Itera Status Closed C Verified MV Show Visits as Hours Dates Cals 3 77 3 Include Client Name Sorted By Service Dates C PayRates C Skill I Show Week Ending Totals Payroll Posted Status I Include Zero Pay Work Items Show only posted items I Create Quickbooks Report posted items and Spies within the date range I Print One E SPa Page C Show only unposted items siii items and adjustments not posted to payroll I Show Only 1st to 15th C Show all items and outstanding adjustments fi eA dote range andal lekamen l Show Only 16th to End of Month Show all items within date range I Summary Spreadsheet adjustments within the date range Employee ALL Emp Type N Field M Staff I Contractor Generate Report Options Exit Report items payrolled for this week ending date 8 38 4M 01 18 06 3 13 PM Page 401 of 448 Users Manual Salaried Visit Report This report summarizes the number of jobs and hours performed by Office Payer Class Week Ending Skill Pay Unit and Bill Unit and then provides totals by Office and Payer Class performed by your Salaried employees je Sal
19. Client Helen Abbey Payer No 7146 Employee NOT ASSIGNED Payer Set 01 Skill SN RN Sub S kill Visit 401293 40007 Payer Skill Date Tufts Associated HMO JSN Medicaid P D LPN Pedi High Tech Medicaid P D LPN Pedi HiT ech Hol Medicaid P D RN Pedi High Tech Medicaid P D RN Pedi HiT ech Hol Times Medicaid P D RN Supervisory Pay Tufts Associated HMO SN A01293 Type gure Rates Comment Invoice un 1 Desc Pay Per Visit pall 26 00 GOvenide 26 00 Bill Per Visit pal 80 00 Gvernide 80 00 Qual Qualified z S Verification w J Timeslip Verified Travel Pay 0 00 Total Sales Tax 0 00 I Already Paid Travel Bill 0 00 Payroll Date i To assign an Employee to the visit you may either assign a specific employee by clicking the Employee button or search for available employee s by clicking the Emp Match button press the Save i button to enable this feature If you click the Employee button the Employee List will be displayed displaying the skill of the visit You may then select the employee to be assigned to the visit If the visit is saved without choosing an employee the normal occurrence the visit is saved and displayed on the screen as an unassigned visit If the skill category SN skilled nursing has been selected you can assign a RN a LPN or a LVN type of skill If the skill category
20. E SAM gt Melbourne GUEST Ble Administration Scehectie AED Lonfiguraticn Memntenance logn Seniioto Reports Help fal Recert Plan of Care x Orders E Patient Helen Abbey Client 002080 02 Copy From Last Admit Copy From Admit Agency Start of Care 05 17 2001 Diagnoses Sun PLAN OF CARE Cert Period 09 09 2002 11 07 2002 POC A0001486 Patient Name f Paver Tufts Associated HMO Prime Physician Michael K Posner Agency Start of Care ji Type F New Cert Begin EEPREIPINE a sneer ays Cert Begin fi New Cert End 01 06 2003 Sf Payer for Tufts Asso NeowEayens z TE o Tufts Associated HMO N 05 17 2001 11 07 2002 z Primary Physicia Michael K Posner New Prime Physician Secondary Physi Michael K Posner Select Physician DB Verbal Start of Care New Payer Start of Care Jos 7 2001 Recert Enter the Certification Begin Date for the new Plan of Care New Payer Discharge Date ee Cancel Payer Start of Care Payer Discharge Date i Select on Plan of Care 1 OWOMN2Z002 12 04 PM e Verify that the information section at the top of the screen describes the Plan of Care you want to recertify or copy e Change any of the New field values so that they contain the values you want associated with the new Plan of Care These fields include New Cert Begin New Cert End New Payer and New Prime Physician e If you have
21. GUE 06212005 11 04 AM Enter the biling payer name to appear on invoices and claims 7 Mum After the client is selected use the Find button to select the payer the patient is to be readmitted to After the Edit Client Payer screen is redisplayed containing the correct payer modify the End Date to be the same as the Certification End Date of the last valid Plan of Care before the patient was discharged from the payer Click the Save a button to save the change Click the New m button to create a new payer set for the same payer Use the Select button next to the Payer field to select the payer the patient is to be readmitted to Enter the Insured s ID and any other information desired Fill in the Start End Date with the Certification Begin Date and the Certification End Date for the new Plan of Care that is going to be created for this patient for this payer 01 18 06 3 13 PM Page 206 of 446 Users Manual e Click the Save i button to save the new payer e A message will appear WARNING This Payer Has Already Been Assigned to the Current Client Continue Save e Click the Yes button Now create the new Plan of Care using the new payer set e Display the Edit Plan of Care Verbal Order screen e Once the Edit Plan of Care Verbal Order screen is displayed make sure the correct Patient Name is displayed on the screen e Use the Find button to select the last valid Plan of Care associated with the payer
22. Processing Weekly Payroll If an office has both a front and back office component the front office verification and close process must be performed Refer to section The Verification Process Weekly Payroll If there is no front office or the front office close has been performed the back office may be closed Closing the Week at Back Office In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates Early each week after each front office has verified their previous week s schedule the office s information is transmitted to the back office via Data Exchange Normally each front office is expected to close the previous week s information on a certain day and the payroll for that office is processed at the back office the next day Ifthe front office is late in closing the week the front office calls the back office when they have closed and the back office performs an immediate Data Exchange overriding the normal Data Exchange schedule Once the data is received at the back office this takes only a few minutes the back office can perform a re verification or can simply close the week Aft
23. Supply Item Report gt Melbourne GUEST lel Es File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help STATUS REPORT DATES Closed From 06 23 2005 2 C NotClosed to 77 4 C Any Item Dates C Payroll Dates SELECT CLIENT SUPPLY ITEM Client x bd Supply Item ALL z T Create text file of supplies instead of report generate A fot Options B E Indicate whether to sort the report by client supply or order 9 56 AM If you select to Create text file of supplies instead of report a text file will be created that could be used to send to your vendor for reordering of supplies The following is the text file format Start Length 1 6 Unique Office ID 7 6 PO Number 13 15 SKU Left Justify with hyphens 28 7 Quantity 0 Fill 35 10 Cost 0 Fill no decimal 5 decimal places 45 30 Description T 2 99 77 22 Space Fill 01 18 06 3 13 PM Page 405 of 448 Users Manual Supply List Report This report shows all supply items that may be chosen to add as supply items for clients You may select to report your Standard and Local services Standard only or Local only Supply List Report gt Melbourne GUEST Sle File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help E Select Report E Supply List Report X SELECT SUPPLY ATTRIBUTES Supply Type WANA Standard and Local C Standard Only C Local Only SORT OPTIONS Descripti
24. e Now on the Item List screen click the Generate button The item list screen requires a date and either employee or client payer information before you can generate a list of items This is done to keep the item list to a reasonable length e Select the row corresponding to the visit service supply or pay item you want to adjust e Ifyou want to change something about the item like changing the employee who did the visit or the number of hours or the pay and bill rate click the Adjust button Note that if the item is on an invoice that already has cash applied to it you will get a warning You may not adjust an item that is on an invoice that is the result of a shift payment In this case invoice adjustments will need to be done to change the value of the invoice 01 18 06 3 13 PM Page 302 of 448 Users Manual Visit Adjustment Adjust Visit gt Melbourne GUEST a x Ble Administration schedule AR Leonfiguration Memtenance logn samiomo Reports Help Order No 003732 VisitNo 00002 Date 05 17 2001 Before Adjustment After Adjustment Bill Units Per Visit Qual Per vist dua Skill RN RN x Service Location Home Home x BILLING ADJUSTMENT PAYROLL ADJUSTMENT Before After Before After Bill Rate 68 00 68 00 Multiple Pay Rate J 34 66 34 66 Multip le Bill Hours 075 J 075 Pay Hours 075 J of Bill Type Reg Reg gt
25. iz Agency Discharge Date aaa City Springfield fel Patient Type Home Health z State MA Zip Code 01118 Phone ft 655 796 6955 Birth Date 11202 1976 Sex Female Entry Date 10 02 2002 Disaster Code 7 Source of I O B Admission I Do Not Resuscitate MISCELLANEOUS Comment EDV a Enter the patient s Start of Care date 9 144M NOTE It is important to understand that admitting a patient into the agency is based on the first service that the patient is to receive from the agency no matter which payer is paying for the service The Agency Current Status the Agency Start of Care date and the Agency Admit Date fields on the Edit Patient screen are all based on the care date of the first service the patient receives from the agency It does not matter whether a private insurance company Medicare or Medicaid pays for the service or whether the patient pays for the service himself or herself as Self Pay Enter the patient s Agency Start of Care date This date should be the earliest date the patient receives care from the agency no matter which payer is paying for the service The Entry Date displayed on the screen is the date the patient information was first entered into the system using the Client function and may be used as a reference 01 18 06 3 13 PM Page 148 of 446 Users Manual Click the Edit button next to the Agency Current Status field in order to change the p
26. Authorization Code Clients Define Payer Sets Authorization 64 Employment Status Administration UB92 Employer Status Code Clients Insurance Info Employment 65 Employer Name N A UB92 Employer Name 66 Employer Location N A UB92 Location 67 Principal Diagnosis Clinical Information Clinical Diagnosis Codes Code Edit Patient Codes Principal Define Plan of Care Verbal Order Diagnoses ICD 9 CM 68 Other Diagnosis Clinical Information Clinical Diagnosis Codes 75 Codes Edit Patient Codes Other 1 8 Define Plan of Care Verbal Order Diagnoses ICD 9 CM 76 Admitting Diagnosis Same as principal Clinical Admit Diag Code diagnosis Codes 77 E Code N A Clinical E Code Codes 78 Untitled N A N A N A 79 Procedure Coding Default to 9 Clinical Code Meth Method Codes 80 Principal Procedure Clinical Information Clinical Procedure Codes Code and Date Edit Patient Codes Principal Define Plan of Care Verbal Order 01 18 06 3 13 PM Page 436 of 448 Users Manual UB92 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field Surg Procs ICD 9 CM 81 Other Procedure Clinical Information Clinical Procedure Codes Codes and Dates Edit Patient Codes Other 1 5 Define Plan of Care Verbal Order Surg Procs ICD 9 CM 82a Physician ID Administration Insurance ID No Under Physicians Physician Name UPIN 82b Physician Name Clinical Info
27. One half the average pay rate is then ADDED to each overtime hour Algorithm B Item Average Rate Algorithm B calculates n individual overtime rate per visit and or pay item The overtime rate is computed by determining the average rate of the individual visit pay item considering regular pay holiday pay etc then REPLACING the pay rate of the visit pay item with 1 5 times the average This algorithm is consistent with existing overtime laws Note All employees must agree to the use of this algorithm before its use To activate this overtime option add the following line to your n sam ini file Ini_ot_algorithm B If you choose to use overtime option B it will be important to update the n sam ini file for your back office and all of your front offices so that all of your offices are calculating overtime using the same option By default 40 hours of work by an employee in one week is what will trigger any additional hours in the week to go into overtime You can control the number of hours that will trigger overtime for an employee If you do not have this variable set SAM will use the default of 40 hours To use this feature enter the following line in your n sam ini file where is the number of hours that should trigger overtime example 48 Ini_weekly_ot 48 e Click on the Print button to print an overtime report e Click on the Cancel button to cancel the close week function 01 18 06 3 13 PM Page 142 of 448 sm Schedu
28. Pay Type Reg Reg Bill Travel 0 00 0 00 Pay Travel 0 00 J 0 00 SalesTax 0 00 0 00 T Sent to Payroll Employee Hutchinson Perron Mary Kal Before Hutchinson Perron Mary Kal After Select Invoice Description e Change any of the following fields bill units skill sub skill service location hours bill rate bill hours travel billed sales tax pay rate pay hours travel paid or employee If you want to change how the total hours are allocated click the Multiple button and change the regular holiday overtime and double time hours pay rates and bill rates e If you click on Sent to Payroll this will flag the payroll export to ignore this adjustment when exporting payroll e Type an Invoice description if you want a comment about the adjustment to appear on the invoice e Click the Save l button e Click the Exit Tl button The Invoice Description may be used to enter a description that describes why the adjustment was done Ifthe visit is not yet on an invoice this field will not be displayed Remember that adjustments are not actually applied until they are accepted Refer to section Accepting and Rejecting Adjustments 01 18 06 3 13 PM Page 303 of 448 Users Manual Service Item Adjustment Adjust Service Item gt Melbourne GUEST BIE Aaminstaton Screcguie Ata eoriiguraticn Memnterence Login Semiicta Geports Hep Adjust Service Item iMileage
29. SAM gt Melbourne GUEST File Administration Schedule AR Configuration Mainte X e Login SamIoGo Reports Help by F RiverSoft Select operation to perform 2 37 PM COPYRIGHT 1998 2006 Last Updated 1 18 2006 Build 3 0 68 Getting Started coase eones a E EAOa E S a o EiS 13 OALA AAA TAT A ETTE 13 Back VS Front Off1Ce ssccccssssccssssscsssssssccsssssescssssssccsssssessssssescssssescsssssssssssssscnssssscosssssesossssees 13 LOGON G A Mis csscieseccscvasesccsssetssesebcesecesevacapsscevdededuceancsaceaescdsdsccdedsesebesebassdsrebetbanssosccesosaseseoesesesosawssaeesesss 13 DD CFI IONS waits csisssh cfu cel ielsuh sabia cs uavaus dud stvae la Vidusvoa taba cussaseaueGadauss deste ioo seee r eer aea Sebai o oe Setovi Sa 14 Back O Ii E EE E E E E cisscteechecsenctinstacdeatecsdceeceneceececuboseocsecssddsdacssescudccsesouseenctscses 14 Front OTM CO cccccctcccccacccescosseneceststevenseicsacnsocecacbaesodeobsese dese sissoo sieas asees E eaaeo ss eose asooo ssas 14 Payel Scciscccsasscccsesesucesecedecesuevavavesesssecunasanve cssseeestesedecsdscvtecsdesestesecesbenssessoessvoesaetssddosesusesacsseossesawaneseres 14 CHOI ie scsi ceicacs deed cacascsanccss coscecosseocescseoncesiesadesaees seuessba oissadedeSessasassedsescddedcseutceesseusd cacdeacecisteedsecsececesezes 14 PAUIONE sssccececeseoncevescseiedecciecseceessessuutedecucndeci cased dcesbsececessdesecesuccsedseadetesecsbasceenasssecesasesesssasdesesdoiecdouseees 14 Facili
30. SAM has an option for valid users to change their own password To access the Change Password screen select menu option Login Change Password 01 18 06 3 13 PM Page 332 of 448 Users Manual SAM gt Melbourne GUEST lel Es Ble Administration schedule AED Lonfiauretcn Mentenance Login saniomo Reports Help fal Change Password x Old Password New Password a Confirm New Password SCS Enter your old password Enter you Old Password Enter your New Password Enter your New Password again to Confirm Click the OK button Your password for you User Name will be permanently changed to the new password 01 18 06 3 13 PM Page 333 of 448 Users Manual Copy Client Environment This feature will allow you to copy a client and associated information from one office to another After copying a client environment you should be all ready to start scheduling visits for the copied client in the target office Copy Client gt Melbourne GUEST Ble Achinistration Schedule AG Gontiauticn Mantenance loan Semiicto Hepots Help g Copy Client X From Office From Client Abair Meiko 01 v This feature is especially useful to copy client s from an existing office to a newly created office The client will be copied to the target office with a new client number same admission The following info will be copied for the client demographic compliance rules patient info poc most curr
31. SN Staffing has been selected you can assign a RN Staffing or LPN Staffing type skill The Skill Category SN is delivered with your software if you wish to have the Skill Category SN Staffing please contact your system support representative If you click the Emp Match button the Employee Matching screen will be displayed Please refer to the Employee Matching section in this manual for detailed information on how to use this feature When creating invoices if you have a SN skill identified on the client payer Skills amp Codes screen but the codes are blank SAM will search for the skill on the visit RN LPN etc for the appropriate codes 01 18 06 3 13 PM Page 97 of 448 If a sub skill should be assigned to the visit click the Sub Skill button and select the appropriate Sub Skill A sub skill is normally used if there is a specific bill or pay rate for the sub skill or if there is a different Revenue Code HCPC or Modifier billing claims for the sub skill The Date will default to the date that you performed the right click on this may be modified Right click on the date field to access a calendar for ease in choosing your date Press T to fill the field in with today s date or use the spin controls to spin through dates When creating a new visit the time will default to 9 00 am and the length will be determined by the number of hours assigned to a normal visit in the Skill database Ente
32. Select a payer by double clicking on the payer in the list OR by clicking on the payer and then clicking on the Select button The Edit Payment screen will be redisplayed with the Payer and Payer Office fields filled in with your selection Enter the date of the payment in the Payment Date field the default is today s date Enter the check or remittance advice number in the Check RA No field Enter the amount of the check or remittance advice in the Check Amount field The Adjusted Check Amount Unallocated Amount and Payment Balance fields will be filled in for you with the Check Amount value entered Click the Save button The Payment ID Payment Office and Status fields will be filled in for the payment Click the Apply Cash button to display the Apply Cash to Invoice screen Click the Add button on the Apply Cash to Invoice screen Based on information provided on a check or remittance advice you can select invoices to apply cash to by using the Invoice List button or the Identify Invoices button If the remittance advice contains any of the following fields click on the Invoice List button invoice number client name invoice date service dates or invoice amount On the Apply Cash to Invoice Selection List screen click either the Invoice Dates or Service Dates option based on the information on the remittance advice Enter Start and End dates If the remittance is for just one client select the client Clic
33. Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 a o Hours HHA 11 17 2001 10 30 10 30 10 30 11 00 11 00 11 00 C Visits NA 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 Vi EW C All Current ORDER BY Date Skill BILL Invoice ha Reimb skill CNA 7 Effective Date 11 17 2001 2 Hon Tue Wed Thu Fri Sat Sun Update Rates 1 _ 10 00 10 00 2 _ 10 00 10 00 _ 10 70 Remove 3 10 00 _ 10 00 10 00 10 70 10 70 JM 11162001 11 45 AM Pay Rates for specified Employee Payer Bil Unt MM Pay rates are created and edited from the Edit Pay Rates screen Depending on where in the system you called this screen level of hierarchy you may or may not be able to select the payer name For the purposes of this description we will assume that you can Adding Pay Rates e Select the payer that is associated with the pay rates you are going to define by clicking the Select button next to the Payer field then select a payer from the Payer List form Or click the Default button next to the Payer field to default to all payers e Note that either an Employee field or a Client field is displayed next to the Payer field depending on where you are in the system and the name in the field may be Default e Click the Add Mode E button to add a new rate 01 18 06 3 13 PM Page 51 of 448 SAM gt Melbourne QA Edit Employ
34. Squire Arlene Invoice Amount 1 190 00 Payer Medicaid Bill Amount 1 190 00 WFS 09192002 09 39 AM Date Service Description Quantity Rate Amount 08 31 02 RN 0 50 85 00 85 00 08 31 02 RN 0 50 85 00 85 00 09 01 02 RN 0 50 85 00 85 00 09 01 02 RN 0 50 85 00 85 00 09 02 02 RN 0 50 85 00 85 00 09 02 02 RN 0 50 85 00 85 00 09 03 02 RN 0 25 85 00 85 00 09 03 02 RN 0 25 85 00 85 00 09 04 02 RN 0 25 85 00 85 00 09 04 02 RN 0 50 85 00 85 00 09 05 02 RN 0 25 85 00 85 00 09 05 02 RN 0 25 85 00 85 00 09 06 02 RN 0 25 85 00 85 00 09 06 02 RN 0 25 85 00 85 00 z Move to next record 10 00 4M e To see what cash had been applied to this invoice press View Cash Applied button e DSO Ignore If an invoice has this option marked the invoice will be ignored in the calculations for DSO days sales outstanding and BPSO best possible days sales outstanding on the Invoice Aging report e On the Invoice Details screen click the Adjust Invoice button Invoice Adjustment gt Melbourne GUEST le ce Ble Administration schedule AR Lonfiguration Memtenance logn SenlioGo Reports Help Adiust Invoice Rebill Invoice lal il al tort dal ADJUSTMENT TYPE C Contractual Allowance C White Off Shift Payment Responsibility C Accrued Interest C Other O oe INVOICE TOTAL Before 1 190 00 os After 1 000 00 os of Apply To 092 Medicaid 0002
35. The episode patient Kaiser Mary for the 05 08 01 plan of care xl Service Dates Billing Dates Invoice Client Payer or Description Amount MV Show Open Invoices Only REN 04052003 11 33 AM 4 log of the account activity for this invoice right click F2 to zoom You can use this checklist to trouble shoot any problems reported on the billing log 1 What is the payer set for the client payer relationship to the Medicare payer 2 Are all of the Medicare visits on that payer set 3 Is the Plan of Care for that payer set 4 Is the OASIS Assessment associated with the correct plan of care 01 18 06 3 13 PM Page 257 of 448 Users Manual 5 Are all of the OASIS Assessments associated with the correct plan of care 6 Do you have a first skilled billable visit e For a 60 RAP must be equal to the cert begin date e Fora 50 RAP must be within cert period 7 Have you discharged the patient from the payer prior to the first billable visit If PPS billing has advised you to adjust your PPS payment you will need to adjust the PPS service item s Please refer to section Item and Invoice Adjustments The PPS service items that are created will have an invoice description that shows the percentage of the payment requested on the RAP the HHRG and HIPPS codes PPS billing uses the grouper dll provided by HCFA to derive these codes Per the Medicare instructions e PPS billing will set the RAP service item date equal to the first bi
36. This will take about a minute After the file is delivered the screen will wait 5 minutes to give the program in the front office time to process the received file and produce an export file of its own Then a connection with the office will be reestablished and the file will be pulled from the front office and imported into the back office database If you are using a modem and phone line to communicate with your front office s In order for the Remote Access Service modem connections to work it is imperative that the computer running AutoDEX is logged into the network with the RiverSoft username Also each RAS dialup entry should be manually tested meaning that you should be able to connect to the front office without being prompted for a password and successfully map to the remote database To exchange data to a front office a dialup entry must be added to your Dialup Networking folder named using the following format SAM 9999 FrontOfficeName where 9999 is the office code of your front office or DEX 9999 FrontOfficeName If you are using the network to communicate with your front office s Data Exchange will first try to locate either the server name or IP address defined for the office If located the data exchange will occur over the network If not located data exchange will then use RAS dialup to connect to the front offices To exchange data to a front office a dialup entry must be added to your Dialup Networking fol
37. To add new offices to your system you must call your software representative e To access the Edit Office screen select menu option Configuration Offices Edit Office gt Melbourne GUEST le x BIE Administration Schedule AR Lontaureton Meintenance Login samlioto Reports Office Profile l Office OASIS Header Info Office Logo OFFICE IDENTIFICATION gt gt eh Bao Be Office Name Melbourn Office Code TA GL Office Server Name Corporation Name M On Back Office Server Only Not Remote Federal ID 04 2544164 M Enter Times OFFICE ADDRESS PHONE LOCK BOX ADDRESS Office Address 123 Main Lock Box Address 123 Main Sees ale Office Zip Code 32901 Lock Box Zip Code 32901 Melbourne FL 7 Brevard 32901 7 Melbourne FL 7 32901 x Office Phone 321 779 0101 FAX Lock Box Phone 321 779 0101 COMPENSATION TAXES Week Ends On Friday 7 Shift 1 Start 07 00 AM Shift 1 End 03 00 PM nate i Overtime Shift 2 Start 03 00 PM Shift 2 End 11 00 PM ifferentials Holiday Shift 3 Start 11 00 PM gt Shift 3 End 07 00 4M Tl Daily Overtime 3UE 06 22 2005 11 35 AM 11 43 AM Enter the name of the office e Display the details of the office that needs modification by using the Navigation KIKIA buttons or the Find A button Many of the fields may be blacked out This means they are disabled and you cannot change t
38. and Codes Only new Pay and Bill rates and or new Skills and Codes will be copied to the other offices no modifications will be saved to the other offices You cannot change a National Payer back to a local payer so be careful when adding a payer as a National Payer e National Payers may not be edited or deleted while logged into a front office database e Enter the Provider Representative in your office for this payer This name will appear on UB92 Claims in Locator 85 on HCFA 1500 claims on FL 31 and Massachusetts 9 claim on FL 38 e Enter the Provider ID that applies to this payer e Enter the payer s address in the Address fields The first address line is for street address or PO Box numbers The second line is for apartment or suite numbers etc If a street address is long and will not fit in line one its okay to overlap it on line two avoid splitting a word in half when you use two lines for the address if you can because it is printed with a space where the split occurs e Enter a Zip Code If you do not know the entire zip code you must enter at least the first three digits After you enter the zip code a list of cities with the given zip code appears in the combo box below the zip code e Select the correct city from the combo box under the Zip Code field Use up or down arrows on the keyboard to find the city or click the down arrow on the combo box to display the list of cities and then click the city e If
39. e If you office is located in the state of Texas the option to print your Plan of Care using the Texas Medicaid format is displayed 01 18 06 3 13 PM Page 196 of 446 Users Manual e If you would like to print the Plan of Care Verbal Order click the Report Options button e Set the Default Printer option in the Destination section of the Report Options screen the default is Screen Preview Click the Exit T button to exit that screen s Care Manager gt Melbourne GUEST a E Plan of Care Verbal Order Report x SELECT ATTRIBUTES SORT ORDER TYPE G ji Name Beginning With Patient Pot I C Cert Begin C Yerbal Order Only Cert Begin Range C Payer Both g Report Options Destination Report Information C Default Printer _ a_ A C Specify Printer Pages Screen Preview iz Summary Information Only C Excel File C DBF file C Comma Delimitted ASCII e Select the Plan of Care or Verbal Order to print preview from the list e To select one Plan of Care Verbal Order click on the item in the list e To select multiple Plans of Care Verbal Orders control click on each item or shift click on the first and last item e Click the Generate Draft or Generate Final button e The Plan of Care Verbal Order will be sent to the printer or be displayed on the screen depending on the setting of the Destination option on the Report Options screen Exporting from the Edit Plan of Care Verbal Order Report screen T
40. ee Billing Supervisory S s O 4 EE Frequency Visit Freq Differentials Birth Date EMM Sex Hale C Female G Weekly rol Holiday SELF PAY BILLING INFO Name ES 2 SSN EE ciio M o i C Days a 07 CSR ont Weeks o Months BEG weekend z per hour e O Referral Display list screen to find desired client Tax Exempt ID fF O O _ Show Times Bill Notes gt 01 18 06 3 13 PM Page 16 of 448 You choose a client by using the Find al button This will cause the client list screen to appear SAM gt Melbourne GUEST Edit Client BIE Aaminstaton Screquie At eoriiauratcn Memnterence Log samiot Geports Hep ra Client List C active x ja fu CU A You create a list of clients by filling out the selection criteria fields and clicking the Generate button You find a client quickly by clicking on any client row and then typing the first few letters of the client s last name You select a client by double clicking on the client s row or by clicking on the client s row and then clicking the Select button This will cause the client screen to appear displaying information about the client you have chosen 01 18 06 3 13 PM Page 17 of 448 SAM gt Melbourne GUEST Edit Client Bie Administration Schedule AR Eoniguaton Memntenance lei Ea Loon SeniieGoe Reports Help Client Profile Client Skills amp Codes Se
41. in the Phone s field s Enter the client s Birth Date Enter the client s Sex Enter client SSN Enter client s Tax Territory This field is only used at installations using the ACCPAC SBT payroll accounting package This is a set of withholdings that you configure in SBT Normally only used if the payroll withholding for work done for this client is different than normal withholding for employee e Select the appropriate CSR for this client The Client List may be narrowed down to just those clients with a specific CSR assigned when scheduling visits e The Comments field is used to describe attributes about a client These comments will appear on the bottom of the schedule when viewing visits for this client e Ifthe client was referred select the desired referral source by clicking the Referral button When the Referral List screen appears click one of the list items and then click the Select button or simply double click one of the list items If the referral source does not appear in your list click the Cancel button The selected referral source will be displayed in the Referral field If you would like to clear the current referral selection click the Clear Selection button You may enter new referral sources to be displayed in the Referral List using the Referral Sources option on the Administration menu to display the Edit Referral Sources screen 01 18 06 3 13 PM Page 31 of 448 Self Pay Billing Info
42. select the appropriate Message Type e Enter any other information including a Message as needed e Click the Save button and then click the Exit button e Ifthe employee accepted clicking the Save button will not only save the phone log entry but will also assign the employee to the visit and redisplay the Scheduler screen If the employee refused the assignment the Employee Candidate List screen will be redisplayed and in the Called column for the employee just called you will see an This tells you that the employee has been called for this visit 01 18 06 3 13 PM Page 110 of 448 Visit Phone Log Canceling a Visit The Visit Phone Log is a powerful feature that allows you to track information regarding changes to visits It is especially useful when visits are cancelled e On the Scheduler screen right click on a visit normally an assigned visit e This will display the Visit Menu On this menu select the Visit Phone Log option e This will cause the Visit Phone Log screen to be displayed If any phone log entries exist the last one that was added will be displayed e To edit an existing phone log click the Find al button to select from a list of the existing phone logs e To add anew phone log click the New BI button SAM gt Melbourne GUEST Scheduler imix Bile Aciimistaton Schedule AE ontiauratch Memntenance logn samiono Reports Hep Edit Visit Phone Log Entry E V
43. will be 05 and the date will be date on the trauma ICD9 Payer Codes Occurrence Codes 1 8 36 Occurrence Span Codes and Dates N A Page Tab Payer Codes Fields Occurrence Span Dates 37 Internal Control Number N A N A N A 38 Provider Name and Address Administration Payers Payer Name Page Tab Fields Insurance Under Billing 39 41 Value Codes and Amounts Medicare Value Code 1 is MSA Code Client County where through date is lt 1 1 06 CBSA Code where through date is gt 1 1 06 Payer Codes Value Codes Dates 1 5 42 Revenue Code Visits Administration Client Payer Skills amp Codes or Payer Skills amp Codes Supplies Schedule Display Schedule Supply Items Client Related or Visit Related Revenue Code Detail Lines Revenue Code 43 Revenue Description Revenue Description by Payer and Skill Dr Orders Compliance Rules Authorization Number Detail Lines Desc 44 HCPCS Rates N A Detail Lines HCPCS Rates 01 18 06 3 13 PM Page 434 of 448 Users Manual UB92 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field 45 Service Date Schedule Detail Lines Date of Service Display Schedule Visit Right Click Edit Visit Date 46 Service Units Number of visits Detail Lines Days Units Qty f
44. you have the correct UPIN the export will not export Plans of Care for physicians without valid UPINs UPIN beginning with OTH VAD INT PHS RES and RET are not considered valid e Select the Plan of Care to export from the list e To select one Plan of Care click on the item in the list e To select multiple Plans of Cares control click on each item or shift click on the first and last item e Click the Generate Internet File 2 button to export the Plan of Care e You will be prompted for a path and filename for the file to be created The system will default to storing the files on the folder N XML Files ExportFiles and naming the file 01 18 06 3 13 PM Page 198 of 446 Users Manual with a unique name based on your Care Plan Oversight system and Provider ID in the SAM ini file and the current date and time This may be overwritten Save As HEI Save in E EspotFies ic al c XML file acm_river001 20030429143946 xml Save as type J xr x Cancel Help Bode Rage e After the file has been created and Plans of Care Verbal Orders exported to the file are updated in SAM as having bee mailed on that date They are also marked as having their final document printed e Once you have saved the XML file this file may be uploaded to the Care Plan Oversight website for signature Please refer to the Care Plan Oversight s documentation for the download process e After the Plans of Care Verbal Orders hav
45. you will be prompted to specify the path and filename for the dbf and dbt file if any comments are included that will be created Reports will default to N DBF Files e Comma Delimited ASCII you will be prompted to specify the path and filename for the csv file that will be created Reports will default to N CSV Files Using Microsoft Access to read Report DBF Report Files e Use the Report Options button on any report screen and select format DBF This creates a FoxPro free table in folder N DBF Files Open Microsoft Access Create Open an Access database with a name such as Report DBF Files Click the following menu items File gt Get External Data gt Link Tables From the Link screen field Files of Type select option ODBC Databases From the Select Data Source screen click the Machine Data Source tab If this is your first time using Access for Report DBF files you must create a data source Otherwise skip to the next bullet o Click the New button o From the Create New Data Source screen select the User Data Source option and then click the Next button 01 18 06 3 13 PM Page 357 of 448 Users Manual o Select diver Microsoft Visual FoxPro Driver read carefully click Next button and then the Finish button o From the ODBC Visual FoxPro Setup screen field Data Source Name type a name such as Report DBF Files On the Database Type option select Free Table Directory In the Path field type N DBF Files Then click
46. 01 18 06 3 13 PM Page 65 of 448 Preferences Bonuses Page The Preferences Bonuses page is used to provide a way to give an employee more or less priority in employee matching and premium pay on a client employee relationship basis SAM gt Melbourne QA Edit Employee lel x Bie Administration genede AR Eoniauaton Memtenance Loon Semioto Hepots Help Employee Profile Employee Taxes Employee Skills Attributes Employee Preferernces Bonuses Tanya Acevedo CLIENT PREFERENCES Client Kane Wayne Select Client Prefers to See Client Never Wants to See Employee Never Wants to See Comment Pr Update me Cancel BONUSES Client Select aa Amount per hour per visit Comment E Remove a ha Update List Cancel List of clients who specifically prefer to see don t want to see selected employee 3 00 PM R Client Preferences Section To add a client employee relationship Click the Add button Click the Select button next to the Client field This will display the Client List screen e Use the attributes to shorten the list of clients e Click the Generate button e Select a client from the generated list Choose from the three employee client relationships Client Prefers to See will give the employee more priority when employee matching is used to fill unassigned visits for this client Client Never Wants to See and Employee Never Wants to See will exclude the employee when e
47. 09 24 09 25 09 26 09 27 M Vis ad 09728 09729 Edit Visit o2 10703 10704 Delete Visit Move Visit View Order Specify Employee 10 706 10 05 10 06 Employee Match Visit Phone Log Copy Single Visit Copy Visit Wizard 10 12 10 13 Update Visit Wizard Employee View Compliance Set Model Week View Model Week Tie tee See 24 90H 10 008 02 00p 4 32 PM 01 18 06 3 13 PM Page 89 of 448 Changing the Text That Appears on a Visit e On the Scheduler screen click the Prefs button e The Schedule Preferences screen will be displayed SAM gt Melbourne GUEST Scheduler oy x Bie Admimistaton Schedule AED Eoniauaton Mamntenance Loon Semiicho Reports Help nt Employee Rules Prefs Phone Sum Legend Month z n gt fo T Clie E Client Beverly Case A 555 747 2191 25 50726 50 25 00 25 00 Hrs 2002 Sa Sun Mon T Wed Iw F 09721 09722 09 23 09724 09725 09726 09727 C Skill C Compliance C Status C Payer Visit No C CSR Text Size Use Small Font Indicate the type of information to be displayed on the visits that appear on the schedule e Choose one of the options Name client or employee name Skill Compliance Status Payer Visit No order number visit number CSR e If there is a problem with all text fitting within the boundaries of the visit box check the option Use Small Font e Clic
48. 1 Microsoft Visual FoxPro File Edit Window Help i 4m gt gt 3 A Discharged womAgency 3 Office Meb ourne for episodes ending between 01 01 2002 0201 2002 Medicare Episode Report Patlont Name IcD9 HPPS HHRG Episode Datos Type RAP Amt_ Orlg Amt Amount Pald Supply Cost Visit Cost EOE Amt Final Amt Check s MSA SOC Disch Dt Birth 01 Visks SN PT OT ST MSW HA OTH CBSA Avy Costs For Otice Cove 0002 00 71 SOD 75 09 NIA VII 0 40 5000 Vich Cost Based Gross On Entered Values Margin 31 711013 11182 113 02 RA OIE 2048 93 312 0 112 4 wiw 31020 01 p A 1229 34 210 60 Foplewood at AM ers 7 00 0 TEDPORDSIS NDS HBFN C1F130 014902 0201 Other BOOTH 012002 O21 A 101401 a 1 d 0 D a OJA Braconnier 000200101106 5119 PLEU RAL EFFUSION NOS HBHM CIFSS0_ 1171001 01071 Other BOOIAAI4O 1101 DIDTO A 120121 1 1 0 0 D a DJUPA 0o amp 47 00 7401 3 20 oo B10 4 21762 30 309 144 71 09 20 979 14 970 11 2 174 51 3 2086 Difstts Gimesnni 00 02 002754 01 7240 2 SP INAL HOG C2F2S0 01 1902 12002 Other BOOIAMH4O MIAMO MRL A 120922 1 0 0 o J LI OjUPA Giebner Christine 0 DDt 00257 401 6204 FX NECK OF FEMUR HBGI1 I CIF250 12 2401 01071 Other BOAI dA 10 0501 OTR d 120313 a 3 o oa D a OjWwPA 1 956 27 9 341 76 208 29 NRS 101005 193055 141 76 1110 RA 0B 191110 434 6 00 g 102 13 8 2745 oop 12 4 3 22902 32 28
49. 31 50 32 25 32 25 32 25 ORDER BY LPN Pediatric 11 17 2001 31 50 31 50 31 50 32 25 32 25 32 25 C Date NA 11 17 2001 19 75 19 75 19 75 19 75 19 75 19 75 Skill RN 0170672001 35 00 34 90 35 00 35 00 35 00 35 00 RN High Tech 01 06 2001 37 50 38 50 38 50 _ 38 50 38 50 38 50 BILL RN Pediatrics 1117 2001 37 50 37 50 37 50 38 50 38 50 38 50 Invoice ha C Reimb Skill CCA z Effective Date 11 17 2001 4 Mon Tue Wed Thu Fri Sat Sun Update Rates 1 15 5000 15 5000 15 5000 15 5000 75 5000 15 5000 15 5000 2 15 5000 15 5000 15 5000 15 5000 15 5000 75 5000 15 5000 3 15 5000 15 5000 15 5000 15 S000 15 5000 15 5000 75 5000 JM 1116 2001 08 06 AM 11 03 AM Remove Bill Rates for specified Client Payer Bill Unit Invoices are created with the invoice bill rates The Print Transmit screen allows the creation of automatic contractual allowance adjustments for any invoice selected In this way the difference between what a payer is billed and what they actually are expected to pay can be accounted for and the Invoice Aging report reflects invoices at the reimbursement amount via contractual allowance invoice adjustments Deleting Clients If you choose to delete a client click the Delete X button at the top right of the profile page When deleting a client they cannot have an invoice plan of care clin
50. 4 gt gt I Tel lt eH Client Baie Cee Case a 555 747 2191 24 00 25 50 26 50 25 00 Hrs zon gt tue Wed ee 09 17 09 18 09 19 eT 09 21 09 22 09 24 09 26 03 27 See 09 28 09 29 09 30 10 01 10 02 10 03 10 04 10 05 10 06 10 07 10 08 10 09 wa 10 11 es EE Move the schedule backward by a week 4 17PM Moving to a Different Week s Schedule e Inthe upper left corner of the Scheduler screen there is an arrow button pointing left Click this previous week button to view the previous week s schedule e Inthe upper right corner of the screen there is an arrow pointing right Click this next week button to view the next week s schedule e FAST REWIND If you RIGHT click on the previous week button the system searches for the first visit before the beginning of the current schedule skipping over empty weeks and displays the week of that visit at the top of the schedule If no visit was found the schedule does not move e FAST FORWARD If you RIGHT click on the next week button the system searches for the first visit after the end of the current schedule skipping over empty weeks and displays the week of that visit at the bottom of the schedule If no visit was found the schedule does not move 01 18 06 3 13 PM Page 82 of 448 e Above and to the left of the right arrow button there is a calendar button e Click on the calendar button to get the Change Schedule
51. Aetna US Healthcare 0002A02947 01 Tucker Luane Aetna US Healthcare 10 29 AM Select the invoices that need contractual allowances and then click the Create Contractual button Billing will create a contractual allowance invoice adjustment to account for the difference between the invoices invoice rates and reimbursement rates The contractual 01 18 06 3 13 PM Page 314 of 448 Users Manual allowance invoice adjustments then must be accepted in the Review Adjustments screen to be applied A contractual allowance will not be created where there is an item adjustment on the invoice Accepting and Rejecting Adjustments In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates Review Adjustments gt Melbourne GUEST OE xi Bie Acministaton schedule AR Gonfatratcn Mamntenance Loon Semiieto Hepots Help F Review Adjustments x Item ID Invoice Service Item A00011 0002A00275 02 Godaire Shari Visit 004789 00003 0002020151 01 Godaire Shari _Peiect f show Detail fii Ext Accept the adjustment 10 31 AM When item or invoice adjustments are requested the adjustments need to
52. C Item HOUR RANGE i Generate use Report Options Ext Select the type of tracking information to report on 4 11 PM 01 18 06 3 13 PM Page 383 of 448 Users Manual Pay Rate Report This report shows all defined pay rates in the system including default pay rates and pay rates defined for payers employees payer employee client payer client and client employee Pay Rate Report gt Melbourne GUEST Pay Rate Report eeeeeen 01 18 06 3 13 PM Page 384 of 448 Users Manual Potential Overtime Report This report shows employees that have potential overtime hours scheduled confirmed or verified Potential overtime includes hours from pay items that affect overtime and visits across all offices Employee schedules are examined from the current week forward The report includes the option to sort by Week Ending Date or by Employee SAM gt Melbourne GUEST Potential Overtime Report 01 18 06 3 13 PM Page 385 of 448 Users Manual Timesheets This report will report non closed visits from the saved model weeks or scheduled visits sorted by employee or client All Timesheets e Timesheets can be generated for all employees one employee or selected groups of employees e Timesheets can be generated for all payer programs or one specific payer program e Timesheets can be ordered by employee or by client alphabetically when generated e The source of the
53. Care including Medications Surgical Procedures Supplies Safety Etc Orders and Goals Refer to the section Defining Plan of Care Verbal Order Orders Paragraph etc 2 You may continue defining other Plans of Care using the Edit Plan of Care Verbal Order screen 3 You may exit the Edit Plan of Care Verbal Order screen by clicking the Exit Ae button on the toolbar New Plan of Care Notes A new Plan of Care can only be created for patients that have been admitted into the agency A new Plan of Care cannot be created for a patient with an Agency Current Status of Discharged A new Plan of Care cannot have the same Cert Begin Cert End Payer and Prime Physician as another Plan of Care This would make the Plan of Care not unique and you will not be allowed to save a Plan of Care that is not unique 01 18 06 3 13 PM Page 163 of 446 Users Manual Assigning the Primary Physician to the Plan of Care It is highly recommended when entering a new Plan of Care that the patient s Primary Physician be selected as soon as possible however this is not required to save the new Plan of Care e Click on the Select button next to the Prime Physician field E SAM gt Melbourne GUEST saminisiation Schedule Atl Lontiauraton Memntenance Loar Semiono kepots Help xl Becet Come Pll 7 E Al BMC Healthnet Plan N 10 02 2002 11 30 2 Select 5 Include Case Manager on Plan of Care
54. Delete Description JRESPRTRY SYNCYTIAL VIRUS Priority Order 1 Date 0372572001 2 Status Onset Exacerbation History Verbal Order Status C New Discontinued PAI 0904 2002 12 04 PM Select diagnosis to edit or delete 11 15 AM Entering a New Diagnosis e Verify that the information section at the top of the Edit Diagnoses screen describes the Plan of Care Verbal Order you want to enter new diagnoses for e Click the New m button on the toolbar on the Edit Diagnoses screen to add a new diagnosis to the Plan of Care Verbal Order e The Priority Order will be filled automatically The first diagnosis in the list is the patient s Primary Diagnosis for the Plan of Care e Fill in the ICD 9 CM field by entering the value or by clicking the Select button next to the field to select the value from the Select ICD9 Code Diagnosis screen 01 18 06 3 13 PM Page 167 of 446 Users Manual SAM gt Melbourne GUEST E RA Select ICDS Code Diagnosis pi Cert ICD9 CODE LIST CRITERIA i a Dum Te Description Containing Pi Dat allied e Either choose the Code option and enter a code range or choose the Description option and enter a verbal description of the diagnosis and click the Generate button Click a diagnosis in the list and then click the Select button The Description field will be filled in once a valid ICD 9 CM field value is entered Enter the onset or exacerbation date in the Date
55. Do Not Use Skill Sub Skill Pay Bill Rev Code1 HCPCS1 Modifier DNU Add Remove Update List z Cancel Skill Sub Skill pay unit in unit Rev Codes Mon Tue Wed Thu Fri Sat Sun 1 2 3 HCPCS Codes 1 2 3 Modifiers ul 3 45 PM e To add anew skill click Add button e For each Skill input the Pay Unit and Bill Unit Hours or Visits e For each Skill enter the Revenue Codes and HCPC Codes to be printed on a UB92 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e For each Skill enter the HCPC Codes and Modifiers to be printed on a HCFA 1500 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e Once you have entered the information for the skill click the Update List button to add it to the list e Ifthe skill is no longer valid you may remove the skill or mark it as Do Not Use Removing the skill will remove the Revenue Codes HCPC codes and Modifiers so if 01 18 06 3 13 PM Page 33 of 448 you still need these for billing we would recommend that you mark the skill as Do Not Use until you no longer need the codes and then remove the skill To remove a skill select the skill and click the Remove button To mark a skill as Do Not Use select the skill and click the Do Not Use check box e The system offers two special types of Skill Categories SN and SN Staf
56. E E E sl eee ea eee ees nee 64 City Section isscct ira les dk cade teens oe ees as ees aes acess Da eee eA 64 Additonal Tax Section e hr r tego Beck ck ev 2a Pa Sos oT AES 64 Miscellaneous Section yt ccc seca cee 856355 E Seek ka a eA BS os EE EAR EEA eak 65 SKIIS A tributes Page sacvcscssseccsescsecccosssceosssescasesssassensoseessdessdedebsaccccedecedecedesssecedecuseceaseosscaseaasanssoes cous 65 Skills amp S b Skills S Cto ON arisa a a E REE AE E a EEES EEE ar N i 65 Attributes Sect OM rananeenene e E E E E ae tes ees E ah ee eines 65 01 18 06 3 13 PM Page 3 of 448 Employee Skills amp Attributes Section eccescceescecsseeesseceseeeseeessaeecseecseecseesseeeesaeeesaeessatessaeessaeesseeeeeeees 65 Preferences Bonuses Page sisicississscccossscssseossesessnnscacecsanavsnanaseccecedetectsdcosseosasansnedessssesssasesssessensboucscsces 66 Client Preferences Section sonio ien aE as tees eae ease sere dec wee 66 Bonuses Section resnicno ee iia e e te nines aE E E E EERE EEA ENEAS 67 Employ e PROG viscicscscccscscssssacsscsesscsdevasscsessodenssesnsasosvsevbeseseccosecbscenasssseseseowesasdeededsanesicasccesscscndeusesse 67 Employee Tracking s3 cicccccsssacssscesececvnensssdeotevocnnnssesssssucsssecacdennsocesessssecednsosaascccessosdaasssssessesssasaasdeses 69 Specifying Employee Availability sccssssccsscscccssssccssssecsessscccsssceesssscccsseeesssssscccessseeessssees 70 Shift Availability lt csiscsisssss
57. Employment Status combo box 01 18 06 3 13 PM Page 35 of 448 e Select an accident type from the Accident combo box if appropriate If a patient s Accident field has been set SAM fills in the UB92 occurrence code as follows along with the injury date e Auto Accident 01 e Employment 04 e Other 05 If an accident type is selected enter the date of injury in the Injury Date field If an accident type of Automobile is selected enter the state code for client s automobile insurance in the Auto Insurance State field Client Race The Client Race page is used to define the race of the client This is an optional entry SAM gt Melbourne GUEST Edit Client Ble Aoministiation Screatie AG Bonticutaton Maintenance Loon SemliciG Reports Hep Note you may select more than one race Click the Client Profile tab to return to the first page Click the Save button to save your data Click the Readmit button to create a new admission for a client This button is only enabled for a client who s current Status is Discharged or Non Admitted See section Readmitting a Client 01 18 06 3 13 PM Page 36 of 448 e Click the Payers button to add payer sets for this client Payer sets associate a client to a payer for visits plans of care invoices and claims See section Defining Client Payer Sets e Click the Visits button to view a history of visits scheduled for this client See s
58. J Borowiec Select Secondary Physician Select I Include Case Manager on Verbal Order Physician DB Payer Payer Start of Care 06 08 2002 Status Active Received Payer a Discharge Date 3j A Edit Payer Status Signed PIE Enter the date the Verbal Order was Ordered 11 17 AM Verbal Start of Care STATUS Final Document Printed Created ate History Mailed The Type field will contain Verbal Order The Cert Begin date will be filled in with the Cert Begin date of the Plan of Care The Cert End date will be filled in with the Cert End date of the Plan of Care The Payer combo box will display the Payer of the Plan of Care The Prime Physician field will be filled in with the Prime Physician of the Plan of Care The See Physician field will be filled in with the Sec Physician of the Plan of Care The Verbal Start of Care date will be filled in with the Verbal Start of Care date of the Plan of Care The Case Manager field will be filled in with the Case Manager of the Plan of Care Enter the Verbal Order Date associated with the new Verbal Order Make sure that all of the information displayed on the Edit Plan of Care Verbal Order screen is correct Click the Save fl button on the toolbar to save the Verbal Order 01 18 06 3 13 PM Page 210 of 446 Users Manual e The POC will be filled in with a unique number that the system assigns to the Verbal Order e Yo
59. JANIE 0014408864 PHC 154 08 154 08 12 25 00 12 29 00 PD 516379240 BRAVO VICENTE 0014208865 PHC 158 36 158 36 12 25 00 12 31 00 PD 518181146 xl For Help press F1 EE 01 18 06 3 13 PM Page 292 of 448 Users Manual Payment Adjustments Once a payment is closed by the closed period function it cannot be changed However closed and non closed payments may be adjusted There are two types of adjustment adjustment of payment check amounts and refunds If an error was made when the payment was originally entered the check amount of the payment can be changed using an adjustment A refund adjustment is entered when part of the original payment is to be refunded to the payer The Adjust Payment function is available via the Adjust button the Edit Payment screen Adjust Payment gt Melbourne GUEST Ble Acministatcn Sschectie At bontiguratcn Mamntenance Log samoto Reports Hep djust Payment REMOVE Adjustment Refund sted ova m 01 18 06 3 13 PM Page 293 of 448 Users Manual Entering a Fix to a Payment Check Amount If the check amount of a payment was entered in error it can be fixed after the payment is closed by creating a payment adjustment of the type Adjustment and entering the correct check amount e On the Edit Payment screen display the payment whose check amount is to be adjusted Edit Adjust Payment gt Melbourne GUEST lel Ee Bile Administration schedule AR Lonfiguretion
60. Login SamloGo Reports Help Client Payer Profile Client Payer Requirements Client Payer Skills amp Codes Donald Barns Medicare N Units I Do Not Use Skill Sub Skill Pay Bill Rev Codel HCPCS1 Modifier DNU d iii i c aa Remove Update List zl Cancel Skill Sub Skill Pay Unit Bill Unit Rey Codes Mon Tue Wed Thu Fri Sat Sun 2 29 PM e To add a new skill click Add button e Select from the Skill Sub Skill Pay Unit Bill Unit pick list entered for the Payer those that are valid for this client payer relationship e For each Skill if different from the Payer enter the Revenue Codes and HCPC Codes to be printed on a UB92 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e For each Skill if different from the Payer enter the HCPC Codes and Modifiers to be printed on a HCFA 1500 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e Once you have entered the information for the skill click the Update List button to add it to the list e Ifthe skill is no longer valid you may remove the skill or mark it as Do Not Use Removing the skill will remove the Revenue Codes HCPC codes and Modifiers so if you still need these for billing we would recommend that you mark the skill as Do Not Use until you no longer need the codes and then remove the skill To remove a skill select the s
61. Main document setup by once again placing your mouse pointer over the buttons without clicking the button Once you have found the Main document setup button click on it and the window below will appear Select the Labels tabs and click OK 01 18 06 3 13 PM Page 443 of 448 Users Manual Main Document Type Document type Letters E mail messages O Directory Normal Word document 10 Once you click OK the window below will appear Once this window appears select the type of label you want We suggest you choose one of the Avery Standard labels Once you pick the label you want click OR Label Options Printer information Dot matrix Laser and ink jet Tray Manual Feed Label information Label products Avery standard Product number Label information 5998 Audio Cassette 6460 Remove Em Type Address 6464 Remove Em Height 1 6466 Remove Em s 2 6467 Remove Em y width 2 63 6490 Diskette Page size Letter 8 44 x 11 in 160 Address Mi 11 Once you have clicked OK a bunch of lines will appear forming the layout of the labels but there will be no information in the labels and the cursor will be in the top left label Now you want to find the button Insert Merge Fields in the same manner you did before and click on it Once you have clicked it the window below will appear 01 18 06 3 13 PM Page 444 of 448 Users Manua
62. Measures Nutritional Requirements Allergies Functional Limitations Mental Status and Prognosis Entering a New Plan of Care A Plan of Care may only be entered for patients that have been admitted into the agency and whose Agency Current Status is not Discharged Refer to section Admitting a Patient into the Agency in this manual Entering a new Plan of Care is essentially the same as entering a new Verbal Order They are both created using the Edit Plan of Care Verbal Order screen The main difference between the two is that the Type field will contain Plan of Care instead of Verbal Order on the screen The information entered for a new Plan of Care will result in the creation of a HCFA 485 form refer to the end of this section for a HCFA 485 Locator Mapping The information entered for a new Verbal Order will result in the creation of a Revision to Plan of Care form There are two New buttons on the Edit Plan of Care Verbal Order screen to assist in entering a new Plan of Care vs a new Verbal Order The New Plan of Care m button is the button containing the blank piece of paper icon The New Verbal Order Di button contains an icon of a piece of paper with a V on it In order to create a new Plan of Care for a patient you are required at a minimum to select the New Plan of Care button enter the Cert Begin and Cert End dates and select a Payer Once this information is saved you have created a Plan of Care shell A
63. Melbourne GUEST Edit Payer Bie Adminstration Schedule AG bonhaureton Meintenance Loon samico Reports Hep Payer Profile orea Payer Skills amp Codes Payer Calendar Blue Cross Blue Shield of Florida PAYER REQUIREMENTS UB92 Claim Locator 6 Billing Period Service Dates HCFA 1500 Claim Locator 24G 0 Decimals 2 Decimals IV Signed Plan of Care and billable visit M Summarize Supplies 3 12 PM The Requirements page is used to define the payer s billing requirements e For Claim requirements select one of the following e UB92 required Used for payers that require UB92 claims e Selecting Billing Period will show billing period dates in locator 6 e Selecting Service Dates will show the span of service dates for the work items on the claim locator 6 e HCFA 1500 required Used for payers that require HCFA 1500 claims e Selecting 0 Decimals will report 0 decimal places for the work item units e Selecting 2 Decimals will attempt to report 2 decimals for the work item units The space for work units is very small and if the unit is greater than or equal to 10 only 1 decimal place will be printed e Signed Plan of Care and billable visit If this is turned on and if the payer is Medicare SAM will not create a EOE if it finds that the Plan of Care or Verbal Orders during the certification period do not have a date in the received signed field In addition if a billable visit is
64. PM Page 285 of 448 Users Manual The Payment Log may also be generated for a specific payer e Select ALL in the Office combo box e Click the Select Self Pay button if the payer you wish to select is a client The Select Client screen will be displayed Generate the list and select the desired client The client s name will appear in the Payer field on the Payment Log screen e Click the Select Payer button if the payer you wish to select is a payer The Select Payer screen will be displayed Generate the list and select the desired payer To select multiple contiguous payers click on the first payer and then while holding down the Shift key click on the last payer then click the OK button To select multiple non contiguous payers hold down the Ctrl key and click on each payer then click the OK button The payer s name will appear in the Payer field on the Payment Log screen e If you wish to create the Payment Log for payments only associated with a specific office for the selected payer change the Office combo box to display the office name e Make sure the Payment Log print option is selected e Click the Generate button Payment Cash Application Report Option on Payment Log screen A Payment Cash Application Report may be generated using the Payment Log screen This option produces a report of cash applied for payments depending on the selection criteria On the Payment Log screen e Ent
65. Page 53 of 448 SAM gt Melbourne QA Edit Employee OE x Ble Administration schedule AED Eoniauaton Meintenance Login Senco Reports Help E Add Pay Rates Print List _ cf Payer DEFAULT COPY RATES TO Skill 7 Sub Skill UNIT Office Hours Hoa Visits 4 VIEW NA All Cunent ORDER BY C Date Skill BILL Invoice Beimb Employee lt DEFAULT gt Select Skill a Payer KDEFAULT gt Select Mc Rates 1 Unit Hours C Visits e Select the Office option Current Office The front office cannot copy pay rates to other offices e Select the employee to which the rates are to be copied by clicking the Select button next to the Employee field Select the employee from the Employee List screen e Select the payer to which the rates are to be copied by clicking the Select button next to the Payer field Select the payer from the Payer List screen e Select which rates by pay unit you want to copy Hours or Visits e Click the Copy button Updating Visits This feature should be used when you have been made a rate change and you would like to update all visits affected by the rate change or any other rate changes made since midnight last night It is important to remember to press the Save i button after your rate changes and before pressing the Update Visits button e Click the Update Visits Button 01 18 06 3 13 PM Page 54
66. REDON Gio vsiscisivecinszieviutdsvesicussidutedescshousssiessossbacdsvidiessSsaedeneadenbeacs osvesvebubucs euts 322 Administration and CONPISUTOTION voce sscivscscicssccsspitscecepiniasivbincesdcdesbuasseracevdussacsdertodtiusousdicisdesss 323 Maintaining Off ies issiisisisisicassseccceccessasassissssvvanascscssscscustcnssdescevosensssecseoscoscetessedesecsscasscddsseuesvooassses 323 Office OASIS Header IMO ss 2 oss ce cves igs tard a taba set ged tevati sede a ae e a ea 324 OPCS O80 se t 25 sees AEEA EAAS E A E T 325 M intaining Users i s lt cciccessscasscdesshsscscccscesesennsonnessessssbnobienasedsonassaassaesdessenecesesssesserneccasceesseccssasasesee 327 Creating a New Users octe n a a a A a E ae E N 327 Modifying User Information eisor enie aane ina aa E a PS E E EEE E A RE dks 332 Deleting A D EEE E EEA E EE EEA EEEE 332 Change Password sccsccccrsecasosocedecesenaveveseccscsoscssccececensesasessdessvvberssescdessenecavess cssedvesesedcsoessnssaeasesesoes 332 Copy Client Environment 0rccsssscossssoscsessovsssenscscssesonoessnscessoeseassssessscesosensenssssoseosasessssoseees 334 COPY Employee sicssscccicccisssdissceissesateentecssssssosesassoesosdesscesedecsecuvebenevesessseuossedededsssassccsscedsasswsesseecssnsens 335 Check Login Count isccciscsccssecccccccevencoocesscvensnnodsessesenetetsdsasscccvecnsoccesscenaseasnesssssosennossdssstetnsseussecesseee 336 Clear Function LOcKS csccccssssssscsssssccssssseccsssss
67. Reports Help E Edit Supply x gt or alo AL Be M Standard Supply Type Description SKU Number Revenue Code HCPCS Code sd Modifier ey Unit Cost Unit Bill oft GUE 0622 2005 02 22 PM Select the type of the supply 2 22 PM Click the New BI button to add a new supply Select a type for the new supply from the Type combo box Enter a Description for the new supply Enter the SKU Number for the supply if a vender is providing the supply information This field is optional Enter a Revenue Code UB92 for the new supply Enter the HCPCS Code UB92 amp HCFA 1500 that should appear on claim forms for the supply Enter a Modifier HCFA 1500 that should appear on claim forms for the supply Enter the cost of the supply in the Unit Cost field Enter the amount to bill for the supply in the Unit Bill field Only the back office can specify that a supply is standard by checking the Standard Supply check box Extra care should be taken in defining standard supplies because they cannot be deleted after they are saved Once entered at the back office standard supplies are copied to all front offices e Click the Save a button e Click the Exit Ae button to exit the Edit Supply screen 01 18 06 3 13 PM Page 344 of 448 Users Manual Defining Services Services are billable services provided to a client but are not employee specific i e Urine Analysis or Patient M
68. Section The billing fields are used for addressing Self Pay invoices If the billing name and address is the same as the client s name and address click the Same button to automatically fill the billing fields Otherwise enter the name address zip code and city to where invoices should be mailed Select the appropriate Payer Class to be assigned to this client for any Self Pay billing from the Payer Class combo box Select the appropriate Payer Program to be assigned to this client for any Self Pay billing from the Payer Program combo box Select the appropriate service location from the Service Location combo box This is the location where a client was treated or a service was rendered Choose the Billing Frequency options Weekly Invoicing for this client for self pay services will occur at the end of each week Bi Weekly Invoicing for this client for self pay services will occur at the end of each two weeks Monthly Invoicing for this client for self pay services will occur at the end of each month The Supervisory Visit Frequency should be entered if the client pays for their own services and supervised visits are required If supervisory visits are scheduled the Census Episode report will tell you when the last and next supervisory visit for all clients The Differentials fields define the custom employee pay rate differentials for this client Typically the default values are used but for special clients you may want
69. Service Location Description C Service Applies only to sales and cost zz summary discipline and worker s compensation reports Selected Period Only MV Qualified Unqualified by Discipline I Cash Entries C Quarter to Date I Adjustment Entries C Year to Date I Report Worker s Compensation Summary Only I Create Excel Files Instead of Reports I Weekly Licensed Unlicensed Sales I Create SBT GL Import File 06 17 2005 aj I Create Excel GL Import File __ Generate ff Report Options f Ext Select office 11 37 AM Upon clicking the Save key the file that you will import into the SBT general ledger is automatically created If entries are found without associated account numbers in the SBT general ledger a report will be generated that can be printed It is suggested that the created import file not be imported into the SBT general ledger until these accounts exist To verify this it is good practice not to import any file that was created if ANY accounts where found to be missing 01 18 06 3 13 PM Page 321 of 448 Users Manual Unemployment Reporting Enik File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help si Unemployment Reporting F i Create Unemployement Report and Data File for the seleced office s OR company s Password Office Company State C 1st gtr 2005 C 2nd qtr C 3rd qtr C 4th qtr Wage Base z The data file will St Fe
70. Settings RiverSoft My Documents Pocket_PC My Documents Business Ini_Payroll_Vendor Directs SAM to use a specific version of the SBT ACCPAC files when exporting payroll and running the 401 and Paycheck report Specifically used when using ACCPAC version 7 1 Ini_Payroll_Vendor ACCPA C 7 1 Ini ACCPAC_Company Directs SAM to create the posting with the correct company name in the filename of the posting file Ini ACCPAC_Company 01 01 18 06 3 13 PM Page 447 of 448 Users Manual Ini_Payroll_ Path Directs SAM to read write to SBT ACCPAC files in this network path Ini_Payroll_Vendor n pro50 p rdata Ini_PCL_UB92_red Directs SAM to print the UB92 red form to a printer that is using a non postscript printer driver Ini PCL_UB92_red Y Ini Comp Rules Purge Months Directs the SAM_DLL to keep compliance rules in the SAM database for the number of months specified based on end date older records are purged when the database when a FoxPro database is reindexed at midnight for SQL databases By default compliance rules older than 1 year will be deleted Ini Comp Rules Purge Mon ths 24 Ini_FBV_visit_status_list Directs SAM s Medicare PPS Billing to only look for closed and verified visits when looking for the first billable visit Ini_FBV_visit_status_list T V Ini_Self Pay Invoice Net Days Directs SAM to print on Self Pay invoices Number of days to use when
71. This will add the entry in the window Al A Dates 06726 1999 To 0770371993 Spe ae ae press the Restore button to exit New Mode MB 06071999 12 23 PM e Click the New BI button to add an entry e Enter the dates of the employee s non standard availability in the Dates fields This may be because the employee is going on vacation a training class or any situation that falls outside of their normal availability e Enter the times during the days of the employee s non standard availability in the Times fields e Choose the Availability type Always Maybe or Never e Optionally enter a comment in the Comment field e Click the Save i button e Add additional entries as needed by repeating the above steps e To add availability single days quickly to the Employee Availability screen use the following method 1 Click the New m button 2 Enter availability information 3 Right click on the Date Field 4 Using the Calendar double click on the date This will add the entry in the window This method will leave you in New Mode press the Restore button to exit New Mode e Click the Exit Ae button The Employee Availability Calendar screen will be redisplayed 01 18 06 3 13 PM Page 72 of 448 Viewing Employee Visit History An Employee Visit History may be generated using the Visit History Criteria screen This list is very useful to view all or a subset of visits scheduled for the employee To access the Vi
72. Type Employee Type Week Ending Dates Within Period F Bill Unit 067072005 06 30 2005 2 Service Location Description pore S R Applies only to sales and cost ervice EEM EE amiki neh andr poner nt I Sales and Cost Entries compensation reports M Summary Sales Selected Period Only Qualified Unqualified by Discipline I Cash Entries Quarter to Date I Adjustment Entries Year to Date IT Report Worker s Compensation Summary Only I Create Excel Files Instead of Reports I Weekly Licensed Unlicensed Sales I Create SBT GL Import File 06 17 2005 a Create Excel GL Import File Rover Onions Beak Select office 01 18 06 3 13 PM Page 363 of 448 Users Manual Invoice Aging Report This report shows invoice aging information Receivables are aged into seven separate buckets The total amount outstanding for each invoice is displayed as well as any cash applied to the invoice and collection comments Invoice Aging Report gt Melbourne GUEST Of x Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Invoice Aging Report SELECTION Office ALL PRINT OPTIONS ATTRIBUTES MV Payment Information Payer Info at inlaid Collection Logs All Classes Payers Programs V Account Logs IV Adjustments Orig Amt amp Service Creation and Last Xmit dates Client Show Logs From 77 2 SORT BY Tina with bala ONLY Office Class Payer Client putes DE
73. Users Manual e To sort the list click on the field that you would like to sort from in the Sort Order section e Click the Generate button To select assessments to be exported e Click the Select All button to select all assessments displayed in the list e Click the Select None button to un select all assessments displayed in the list e Click the single assessment to be exported e To select multiple invoices control click on each invoice or shift click on the first and last invoice SAM gt Melbourne GUEST BIE Baminstaton scnedule At lortiguratcn Memnterance Log Senmlicto kepate E fea Export OASIS Assessments Berta Neung 01 4 Recertification follow up as 08 21 2002 10 01 02 Hall April 01 1 Start of Care further visits 09 28 2002 10 03 02 _ L Ao000493 Salois Barbara 01 4 Recertification follow up as 0972872002 10702702 IL A0000492 01 18 06 3 13 PM Page 226 of 448 Users Manual To export the selected OASIS Assessments click the Export Normal button The OASIS Submission Option screen will be displayed SAM gt Melbourne GUEST Bie Aoministetcn Screcvie AG Lortiqureicn Mentenence oor Seniicho Reports Hep Berta Neung Hall April Salois Barbara e Click on the Production Submission button the Test Submission button will export but not change the status to exported to export the OASIS Assessments selected and change their sta
74. also be used to print a list of all employees start dates or birth dates To track an employee required in service training credits or hours refer to section Employee Tracking This report will show an employee s tracking items as well as itemized sub tracking items like the titles of individual in service courses attended by the employee You can use this report to delete hours credits tracking items from your employee s by using the Purge option You must select Select Individual Item and select the tracking item to be deleted Then enter the date range that you wish to delete For example Selecting Inservice Hours 2004 with date range of 01 01 2004 12 31 2004 SAM will delete ALL occurrences of this tracking item within the selected date range for all employees in the current office Employee Tracking Report gt Melbourne GUEST imix File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Employee Tracking Report x REPORT TYPE REPORT OPTIONS Employee ALL x Status Active x C Birth Date month amp day only pies vv T Include Birth Date on Report ES T Page Break on Emp Skill ALL TRACKING INFORMATION TE RANGE Certification Date zi Start Date 7 Select Individual Item ITY Al C Select All Dates EndDate 77 Select All Hours Credits T Only Show Empty Required Items 2 5 SORT ORDER Sek oui Employee Max Hours EEE C Skill
75. be changed by the rate changes will be changed Note that if you have modified a rate for an ANY skill or have deleted any rates if you press the Update Visits button no changes will be made to any visits Only visits occurring on or after the effective date on any rate modified today will be updated Only those visits that have the same skill and any sub skills for that skill as any rate modified today will be updated Visits marked with override s will not be updated Closed visits are not changed 01 18 06 3 13 PM Page 55 of 448 Defining Bill Rates This works exactly the same as defining payer rates with one exception When entering a bill rate type of invoice or reimbursement SAM gt Melbourne QA Op x Ble Administration Schectie AED Eoniauaton Metntenance ogm Seniioto Reports Help Print List Copy Update Visits Payer kDEFAULT gt Client lt DEFAULT gt Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 11 17 2001 1 5 50 15 50 15 50 15 50 15 50 15 50 ol Hours CNA 11 17 2001 19 75 19 75 19 75 19 75 19 75 19 75 C Visits Companion 11 17 2001 14 25 14 25 14 25 14 25 14 25 14 25 mea FCW 01 01 1999 14 00 14 00 14 00 14 00 14 00 14 00 A HHA 1171772001 24 90 24 90 24 90 24 90 24 90 24 90 li LPN 01 06 2001 29 00 29 00 29 00 29 00 29 00 29 00 Current LPN High Tech 11 17 2001 31 50 31 50
76. be displayed on the Edit Visit screen For each client the To address must be entered in the non scheduling comments field on the client s Ancillary Info screen Example 2067to Jane Doe 123 Main Street Suite 4 San Antonio TX 12345 On the visit screen enter into the visit comment 2067 text goes here Up to 300 characters will fit SAM will do the word wrapping automatically so don t hit the enter key when keying the comment The Verification Process Weekly Payroll Visits are verified against documents submitted by employees that reflect what services were actually performed for a given week For the purposes of training we will call these documents timesheets Perform the following steps to verify visits for an employee e To verify visits select menu option Schedule Display Schedule e The Scheduler screen is displayed e Adjust the Scheduler screen to display the week for the visits listed on the timesheet 01 18 06 3 13 PM Page 100 of 448 If your timesheets have information by employee you will probably want to verify visits by employee but if your timesheets have information by client you will probably want to verify visits by client Verifying Visits by Employee e Click the Employee button to display the Employee List screen e Click the checkbox labeled Has visits scheduled during the selected week Click on the Generate Refresh button to generate a list of all employees that have sched
77. box e Ifthe Info Type is Number and Restriction for Scheduling and Employee Matching is checked enter the value of the number that will cause scheduling and employee matching to allow the employee to be scheduled e Ifthe tracking item should be a required item for the office you are logged into check the Always Required for this Office checkbox It will not be possible now to delete these tracking items for employees in this office In addition the Employee Tracking report offers an option to report Only Show Empty Required Items e Ifthe tracking item should not be used anymore for the office you are logged into check the Do Not Use checkbox This item will no longer be listed for any employee s in this office e Click the Save button e Click the Exit Tl button to exit the Edit Employee Tracking Item screen Defining Supplies Supplies are billable items used during a visit with a client such as a 10 cc Syringe SAM is delivered with a standard set of predefined supplies but an organization may define additional supplies or replace the supplies database completely if a supply vendor is being used and the vendor has its own database e To access the Supplies screen select menu option Configuration Supplies e The Edit Supply screen is displayed 01 18 06 3 13 PM Page 343 of 448 Users Manual Edit Supply gt Back Office GUEST lel Es Ble Administration schedule AED Eoniauaton Mentenance Login Senco
78. button next to the Employee field Select the employee from the Employee List screen e Select the payer to which the rates are to be copied by clicking the Select button next to the Payer field Select the payer from the Payer List screen e Select which rates by pay unit you want to copy Hours or Visits e Click the Copy button 01 18 06 3 13 PM Page 79 of 448 Scheduling Getting to the Scheduler Screen e To access the Scheduling screen select menu option Schedule Display Schedule e The Month view of the Scheduler screen is displayed for the current week SAM gt Melbourne QA Scheduler lel x Ble Administration Schectie AED Eoniauaton Mentenance Loch Seniictoe Reports Help Client enere Rules Prefs Phone Sum CONN T 4 gt JELI e gt Mon aan ar 06 27 06 28 R Select operation to perform 01 18 06 3 13 PM Page 80 of 448 Viewing a Client s Schedule Click the Client button The Client List screen will be displayed SAM gt Melbourne QA Scheduler lei Bie Aammistaton schedule AR Eoniguaton Memterence Loan Semieio Reports Help ATTRIBUTES NAME SCHEDULED SERVICE Type JALL 7 Name Beginning With Status Active 7 I Has visits scheduled during selected week 06 11 2005 0671772005 I Has unassigned visits 06 15 2005 06 28 2005 I Use Client Payer CSR Reset List Admit Status Entry Date Phone Generate refresh the list based on t
79. by payer F Show Un Allocated Gash Statements To access the Statements Report screen select menu option Reports The Select Report screen will be displayed Click the Application Group Billing Click the Accounts Receivable option Click the Statements report name Click the Proceed button To print statements for self pay clients select ALL clients and Self Pay payer To print a statement for a payer select the payer To print statements for all payers select ALL payers Click the Generate button The Account Log Screen The account log screen gives an on line look at all accounts across all offices for an agency It is an instant reference and documentation tool for users performing collection duties From the detail screen a statement for the account being viewed can be printed in the standard statement format Note that Creating Medicare PPS invoices will place PPS information in the account log comment field for each patient To access the Account Log screen select menu option AR Account Log 01 18 06 3 13 PM Page 298 of 448 Users Manual Account List gt Melbourne GUEST M Hle Administration Schedule AR Eoniguaton Meintenence Loam Senilicko Reports Help F Account List x SELECTION ATTRIBUTES Client Client Status A L M Mutual Insurance A M Mutual Insurance A M Mutual Insurance A M Mutual Insurance A I M Mutual Insurance A 1 M Mutual Insurance A M Mutual Insurance A I M Mutual Insur
80. claims the Patient status locator 22 will be populated as follows 01 discharged to home or self care 30 still patient or expected to return for outpatient services if the cert end date is the end of episode Note A transfer is a type of discharge Do not use the transfer patient status as this means transfer within the organization and not to another agency 01 18 06 3 13 PM Page 258 of 448 Users Manual The Claim created for End of Episode EOE contains line items for visits and supplies closed at the time the episode is detected to be over e PPS billing will default to code 270 for Medicare Supplies If those supplies are wound care the claim must be edited and the code for the wound care supplies changed to 623 Please refer to section View Invoices Claim on how to edit the UB92 claim The Sales item report can be used to show PPS sales activity for Medicare On the report selection screen choose your Medicare payer then un select all but service type items Enter the service dates that cover the episode dates for the sales you wish to see The report will show all PPS service items and all adjustments to these service items It will also indicate what type of adjustment was done PEP LUPA SCIC and Outlier By exporting this to Excel the adjustment description can be used to create sums for PEP LUPA SCIC and Outlier adjustments The General Ledger reports will show cost and sales from Medicare v
81. configuration features will be disabled Configuration features include Offices Users Supplies Services Attributes Skills Sub Skills Employee Tracking Items Accounting Periods Worker s Comp Rates Data Exchange Reindex 1 Add Standard Supply if this option is off when adding a new supply in the Admin office it will default to a non standard supply and the standard check box is disabled 2 Add Standard Service if this option is off when adding a new service in the Admin office it will default to a non standard service and the standard check box is disabled 3 Edit Attributes if this option is off the new and save buttons are not displayed on the Attributes screen in the Admin office 4 Edit Sub Skills if this option is off the new and save buttons are not displayed on the Sub Skills screens in the Admin office 5 Edit Tracking Items if this option is off the save button is not displayed on the Employee Tracking Items screen in the Admin office This option must be on to set the Add Delete Tracking Items option on 6 Add Delete Tracking Items if this option is off the new and delete buttons are not displayed on the Employee Tracking Items screen in the Admin office 7 Data Exchange Reindex if this option is off the menu option Data Exchange Reindex will be disabled 0 Maint if
82. correct This should be the name of a person at the insurance company e Confirm that the payer s Address fields are correct e Confirm that the payer s Zip Code and City fields are correct e Confirm that the payer s Phone s and Extension fields are correct e You may assign a different CSR to a specific Client Payer relationship than what was assigned to the client Generally the default information that is provided in the fields of the Payer Information section should NOT be changed Some clients however have special cases where some fields need to be changed such as Contact Address etc If the default information is simply wrong the data should be corrected on the Edit Payer screen See section Defining Payers Otherwise you will have to change it here every time the payer is added to a payer set e Ifyou have made modifications to the payer information on this screen and would like to replace it with the default information for the payer click the Payer Default button This will set the payer information back to the information that was defined for the payer 01 18 06 3 13 PM Page 42 of 448 Insured s Information Section e Confirm that the insured s Relation field is correct e Confirm that the insured s Name field is correct e Confirm that the insured s DOB Date of Birth field is correct e Confirm that the insured s Sex field is correct e Confirm that the insured s Employer field is
83. create a text file that you may then send to your state s OASIS website Entering a New OASIS Assessment An OASIS Assessment may only be entered for patients that have been admitted into the agency Refer to section Admitting a Patient into the Agency in this manual To access the OASIS Assessment screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new OASIS Assessment for Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical Information section of the screen Refer to section Admitting a Patient into the Agency in this manual Click on the Define OASIS Assessment button The Edit OASIS screen will be displayed with the Patient Name field filled in with the name of the patient selected Once the Edit OASIS screen is displayed make sure the correct Patient Name is displayed on the screen Click the New m button to create a new OASIS Assessment Answer Yes or No to the prompt Associate Assessment with a Plan of Care Associating an OASIS Assessment to a Plan of Care will copy any information available from the Plan of Care to the new OASIS Assessment For Medicare PPS billing it is important to associate the OASIS Assessment with the correct Plan of Care If you answer Yes to this que
84. episodes total episodes active within the specified date range This will include clients if they were included in the report 2 Active patients includes hold s as of xx xx xx date Cert Active During end date total number of patients that were active as of xx xx xx including those patients that were on hold as of xx xx xx Patient admitted during date range patients with admit status date within the date range 4 Patients non admitted during date range patients with non admitted status date within the date range 5 Patients discharged during date range patients with discharge status date within the date range Discharged from the agency 6 Active patients does not include holds as of xx xx xx date Cert Active During end date patients that were active as of xx xx xx not including those patients that were on hold as of xx xx xx 7 Incomplete patients as of xx xx xx date Cert Active During end date patients that were incomplete as of xx xx xx 8 Number of patients on hold as of xx xx xx date Cert Active During end date patients that were on hold as of xx xx xx p 01 18 06 3 13 PM Page 418 of 448 Users Manual 9 Patients active at any time during the date range patients that were active at any time during the date range Difference between Duplicated and Unduplicated Census Summary Unduplicated counts will only count the first admit not subsequent admit s for the client Duplicated
85. fields The first address line is for street address or PO Box numbers The second line is for apartment or suite numbers etc If a street address is long and will not fit in line one its okay to overlap it on line two avoid splitting a word in half when you use two lines for the address if you can because it is printed with a space where the split occurs Enter a Zip Code If you do not know the entire zip code you must enter at least the first three digits After you enter the zip code a list of cities with the given zip code appears in the combo box below the zip code Select the correct city from the combo box under the Zip Code field Use up or down arrows on the keyboard to find the city or click the down arrow on the combo box to display the list of cities and then click the city Enter the physician s telephone numbers in the Phone and Fax fields if known Enter the physician s License Number Licenses Date and Date Verified if known Enter the physician s Email address in the General Email Addr field if known If the Plan of Care or Verbal Orders are to be sent to the physician using the XML interface the POC VO Email Addr field should be populated with one or more character strings describing the Care Plan Oversight system that will be used acm eclickmd or alacare Select whether the Plan of Care and Verbal Orders should be sent to the physician via Mail or Email if known If the phys
86. for a Medicare or Episodic Insurance payer that has a Cert Begin date that is equal to or after 9 1 2000 A billing log report will be displayed on the screen This log will report any errors or warnings regarding the creating of the PPS invoices This report will sort entries based on the Plan of Care certification begin date Some of the types of errors or warnings that will be reported include Although the episode has ended the week the episode ended within has not been closed so a PPS EOE service item and final claim will not yet be created First skilled billable visit for Doe John not found on xx xx xxxx Initial RAP PPS bill will not be created where xx xx xxxx is the certification begin date for the Plan of Care Note For a 60 RAP the first billable visit date must match the certification begin date for the Plan of Care or you will get a rejection RAP created for patient name on date falls within previous episode for patient PEP coding is required 01 18 06 3 13 PM Page 255 of 448 Users Manual You do not need to adjust your claim Medicare is aware of PEPs and will pay accordingly You will only be paid short if a LUPA occurs or if another agency picks up your patient within your original cert period After you receive your payment for the episode you will need to adjust your EOE service item to match the remittance e Patient is qualified for OUTLIER payment You do not need to adjust your claim Medicare counts y
87. if the n sam ini file contains the following line Ini CBA_PHC Client Signature T Timesheets gt Melbourne GUEST imix File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Timesheets x SELECT ATTRIBUTES Date Range 0672572005 0770172005 S Order Employee Client Source Model Visits E Select R Employee Name Timesheet Format PHC CBA 3670 CLASS Other Dates Format Entered C 1 15 16 EOM Generate f Report Options J Ext Indicate whether to use all employees or generate a list 01 18 06 3 13 PM Page 387 of 448 Users Manual Client Payer Function Group Reports Bill Rate Report This Client Payer type report shows defined bill rates in the system including default bill rates and bill rates defined for payers clients and payer client relationships ex Bill Rate Report gt Melbourne GUEST 01 18 06 3 13 PM Bill Rate Report E Select All Page 388 of 448 Users Manual Client Dispatch Report This Client Payer type report consists of a list of visits in the specified date range that is scheduled for the specified client s The visit information on the report includes the client s name the employee s name and the visit date start time and end time You may optionally generate the report in Report and or Calendar format If you select the Report format the visit i
88. ini file INI Self Pay Invoice _Net_Days being the number of days to be added to the last day of service on the invoice Perform the following steps to print self pay invoices To access the Print Transmit screen select menu option AR Print Transmit The Print Transmit screen will be displayed In the FORMS section select the Invoices option and check the Self Pay check box Click the Generate button To select one invoice click on the invoice in the list To select multiple invoices control click on each invoice or shift click on the first and last invoice Click the Print button to print the invoice s or the Preview button to see the invoice s on the screen Each time you print an invoice the Print Options screen will appear 01 18 06 3 13 PM Page 261 of 448 Users Manual fal Print Options x PRINT OPTIONS Print C Do Not Print I Convert Draft copies to Final copies I Print Clean Invoices no adjustment lines T Print Client Copy Invoices excluding self pays IT Print Invoices without Employee Names Cancel e Print vs Do Not Print This option is used in conjunction with the Convert Draft copies to Final copies You may choose to actually print the invoice or not print the invoice while converting it to a final copy or not converting it to a final copy e Convert Draft copies to Final copies This option if selected will convert all Draft copies of invoices
89. kee eed eee 405 Supply List REport 224 ccc ece cs ieee ae elds E eee 406 WAST Reports e sachet cated a a a a E tan eved ete deuec eevee Ace cca a ie iu Beneteau eaten eas 408 Clinical Application Group Reports sssccccccsscscssssssccsssssssscseccccssssscccsssceeccssscssssceessssssesseees 409 Patient Function Group Reports ccsssssssccsssscsssseccsssscccsseceessssscccccceseesssscccssossessssscccessoeens 409 Blank 48 5 487 S AT E EE peteousddseesnausaesaedusteutevus E T E 409 Blank Verbal Order nnper i a iae A wee E a e E i i ie 409 OASIS Potential Problem Lops onssa a AE E E E EE OE O cess 409 QASIS Tracking Report in E T R TE A A E 412 Plan of Care Verbal Ordet ineoniiii ai EE tad ae ne E EE E ETE EEE 413 Plan of Gare Tracking Report arroan ea eed A E cece E E E A AE A 414 Recertification D ue Reporte n a a A A a a ee 415 Office Function Group Reports sesssssssssoccssssssssooossssssooceseessssooceessssssoooessssssoocssssssssooeeessssssoosessss 416 Census Episode Report ccc deccccevccs seveveielinciuviessctavelapeeds E EENE RENEE IET eiiis 416 If clients are included in the report any clients that have an entry date after the to date in the selected date range for the report will not be included eecceccceeesccesesneeseeneceeeeneeeeseneeeeeseeeeesneeeessaseeeeseneeeenenneeess 419 Medication Profile Report ccccccccciscs pceveesavecaisedcdi E E E A A AS EVE EEPE N ETES ETE 420 Phrases Repor
90. log entry along with the creation date and time These logs may optionally be printed on the Invoice Aging report Delete a Account Log e To delete an account log click the Find A button A screen will be displayed of all of the account logs for the current account Click on the account log you wish to delete and click the Select button e Once the account log you wish to delete is displayed click the Delete X button and answer Yes to the prompt Are you sure you want to delete this log 01 18 06 3 13 PM Page 300 of 448 Users Manual Item and Invoice Adjustments Individual adjustments can be made to items on an invoice such as visits pay items services and supplies Adjustments can be made to entire invoices to change the outstanding amounts due to contractual allowances write offs payment shifts accrued interest or other Item Adjustments In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates Item List gt Melbourne GUEST lei ce Bie Acninistaton schedule AE Eoniauaton Mamntenance Loon Semniete Hepots Help fal Item List x m CARE DATE EMPLOYEE OR CLIENT PAYER Start 01
91. logged into a front office database you may not make any changes to the employee tracking items e To access the Employee Tracking Items screen select menu option Configuration Employee Tracking Items e In this example we are logged into the back office Edit Employee Tracking Item gt Back Office GUEST Bie Administration Schedule AR Eoniguaton Mamtenance Loan Senlicio Reports Help ujala aol fa Xo Os Description Eire Date Number Info Type Associated Skill Ind IV Restriction for Scheduling and Employee Matching Date Item is an expiration date and employees will not be scheduled after that date Number Employees will not be scheduled until their hours credits are lt C gt I Always Required for this Office I Do Not Use in this Office WFS OM0S82003 11 33 AM Enter description of tracking item 2 20PM e The Edit Employee Tracking Item screen is displayed 01 18 06 3 13 PM Page 342 of 448 Users Manual Click the New m button to add a new tracking item Enter a Description for the new tracking item Select the Info Type of Date or Number Select a skill from the Associated Skill combo box or select ALL If the tracking item is to be used in scheduling warnings will be given when creating modifying moving or copying a visit and for employee matching check the Restriction for Scheduling and Employee Matching check
92. n The General and Verified Visit report will not include pay rates o When Calculating Overtime the report for showing visits for salaried employee will not include pay rates 4 Edit Bill Rates if this option is off the buttons for new remove and save are disabled on the bill rate screens and the bill rate field on editing a visit is disabled 5 Edit Clients if this option is off the menu option Clients will be disabled 6 View Client SSN if this option is off the display of the Client SSN from the screen preview of reports is disabled If the user has the permit Edit Client enabled they will be able to view the Client SSN In addition if the user has the permit View and Print OASIS enabled he is able to view the Client SSN 7 Edit Employees if this option is off the menu option Employees will be disabled 8 Edit Employee Statuses if this option is off the button edit status on the Employee screen is disabled 9 View Employee SSN if this option is off the display of the Employee SSN from the screen preview of reports is disabled If the user has the permit Edit Employee enabled they will be able to view the Employee SSN 10 not currently used 11 Edit Payers if this option is off the menu option Payers will be disabled 12 View Payers if this option is off the Save and Delete button
93. needs employees that have certain of skills The skills of the employee and the needed skills on a client are used by the Employee Matching function Because Skills are such a important part of the infrastructure for your SAM setup adding and saving Skills have been restricted to the RiverSoft login Please contact RiverSoft for access Refer to the Defining Clients and Defining Employees for information on associating skills with employees and clients Skills are also associated with doctor orders schedule orders and visits to determine the type of service that is being requested The Employee Matching function on visits matches the desired skill on a visit with employees who have the skill Each predefined skill delivered has an associated account used in the General Ledger These accounts are used in tracking cost and sales information for visits associated with the skills Other skills may be defined by an office and added to the skills database using the Edit Skill screen These new skills will be grouped into one default General Ledger account If it is necessary to track these skills individually in the General Ledger your software representative must be contacted to set up the General Ledger accounts 01 18 06 3 13 PM Page 338 of 448 Users Manual Skill gt Melbourne GUEST le x Bie Administration Schedule AR Eoniguaton Meintenance Logn Seniicito Reports Help gt aa Bl Skill Code Visit
94. not have one The type of claim created is the type required by the invoice 01 18 06 3 13 PM Page 267 of 448 Users Manual Transmitting Claims to Electronic Bulletin Board Systems In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates The Print Transmit screen may be used to transmit claims to an electronic bulletin board system BBS Ifa payer has an electronic claims submission interface this option may be used to send electronic claims to the payer via a modem directly from this system Perform the following steps to transmit claims e To access the Print Transmit screen select menu option AR Print Transmit e The Print Transmit screen will be displayed e If you would like to submit claims for a specific ECS style that will support the submission of multiple payers on one transmission file select the ECS style from the ESC drop down Ifthe ECS style supports the submission of multiple payers on one transmission file the Transmit button will be enabled Follow the instructions in the Printing Claims for Payers section except it is important to select a payer so transmitting will know what format
95. of the adjustment e Enter the description of the adjustment that will appear on the new invoice e Click the Save fl button e Now on the Invoice Details screen click the Exit T button e On the Review Adjustments screen accept the adjustment In the case of a shift payment adjustment you will see two adjustments on the review screen Accepting either one accepts them both e Click the Exit Tl button e Ifyou use the All Versions option on the Print Transmit screen you will see an invoice showing the original payer s invoice has been reduced and a new invoice has been created for the new payer Invoice adjustments are used to correct the amount of money expected to be paid by a payer Adjustments may be needed because the original payer is denying payment and passing responsibility to another payer shift in payment responsibility when a payer has negotiated a discount contractual allowance or when the payer decides that they are simply not responsible for payment write off If the payer finds a problem with the invoice that is not covered by one of the above adjustments see the section on Item Adjustments 01 18 06 3 13 PM Page 311 of 448 Users Manual Invoice Rebills To access the Rebill Invoice screen select menu option AR Make Adjustments Invoices The Invoice Details screen will be displayed On the Invoice Details screen click the Find 44 button Enter the date range payer and c
96. only one model area Ini_Path_Model N Model Ini DLL Visit On Or Before Directs the SAM_DLL ToSAMVisit function to only verify existing visits on or before the imported visit s care_date Ini DLL Visit On Or Befor e T or blank Ini _ DII Files Days _To_ Keep Directs the SAM_DLL to keep the SAM_DLL log files on n dIl for the number of days specified older files are purged Ini_Dll_ Files Days _To Keep 7 Ini_DllLog Days_To Keep Directs the SAM_DLL to keep the records in the n database DLLLOG dbf for the number of days specified older records are purged The DLL Error Report reports records from this file Ini_DllLog Days_To Keep 6 0 Ini_DllReg Days _To Keep Directs the SAM_DLL to keep the records in the n database DLLREG dbf for the number of days specified older records are purged The DLL Transaction Register Report reports records from this file Ini_DlIReg Days _To_Keep 6 0 Ini_ACM_ProviderID Identifies the ACM Provider ID for export Plans of Care to an XML file that may then be used to import to a Care Plan Oversight and eSignature System CPOS Ini_ACM_ProviderID RIVEROO1 Ini_Alacare_ProviderID Identifies the Alacare Provider ID for export Plans of Care to an XML file that may then be used to import to a Care Plan Oversight and eSignature System CPOS Ini_Alacare_ProviderID RIVEROO1 Ini_EclickMD_ProviderID Id
97. option Administration Employees use the Find 4 button to find your employee click the Tracking button e The Tracking Information screen is displayed SAM gt Melbourne QA Edit Employee Of XI Ble Adhinstration schedule AR Lonfiguration Memtenance logn Senco Reports Help eo Se Sas See a 1 fal Tracking Information X ER Date z Tanya Acevedo a Remove Refresh Default Remove Refresh D e EE CPR EA HHA Education Hours 13 00 Next eval Gmo s 03 17 2003 E Osha Hazcomm Update 09 17 2003 05 10 2003 09 1 7 2003 3 13 PM e The master list of tracking items is created and maintained in Employee Tracking Items accessible from the Configuration menu To track each item for an employee select the tracking item from the pull down list and click the Add button on the left of the screen e Ifthe item has sub tracking items like classes attended that make up In Service hours click the add button on the right of the screen while the tracking item pointer is pointing to the correct parent tracking item e Fill in the description number of units value and date of the sub tracking item The total of the sub tracking items will show in the value of the parent Tracking Item e To remove a tracking item from an employee click on the row of the tracking item and then click the Remove button e To keep the changes you have made click the Keep button e To discard the changes yo
98. payment Press the tab key to accept the default value 01 18 06 3 13 PM Page 281 of 448 Users Manual Apply Cash to Invoice gt Melbourne GUEST Ble Administaten Schectie AR leentiguraton Maintenance logn Sanilioua Reports E Apply Cash to Invoice x Adjusted Payer ATM Mutual Insurance Chock AMOUR 2 000 00 fe T Check RA No 1022 Unallocated Amount 1 915 00 Payment ID 01273 Check Amount 2 000 00 Payment Balance 2 000 00 Payment Office Melbou Invoice Invoice Net Due Cash Amount Amount Applied Date C 06 22 05 B Invoice No Client Name Date 0002A03513 Lockhart Susan 08730702 Invoice List Identity invoices Add Remove Date 06 22 2005 S Update List Comment n GA HA Select record to edit e The Date field will be filled in with the Payment Date Press the tab key to accept the default date e The Comment field may be filled in with any information desired This field is optional Information in this field will show on the aging report if you select to include payment information If an invoice is short paid and you want to record what wasn t paid and why use this field e Click the Update List button to see the new cash application item displayed in the list e Click the Save a button to save the changes e Click the Exit T button If the invoice number you enter in the Invoice No field on the Apply Cash to Inv
99. per Calendar Period option Select the payer and the period s you want to bill by clicking on the payer and calendar period in the list If the period has been billed previously the date will appear in the column next to the period dates e Click the Create Invoices button Closed items that have not been billed which have care dates between the selected billing dates will be billed The invoice date will be the date of last week s ending date SAM gt Melbourne GUEST imix Bie Achinistaton schedule AE Gonfiattaton Memntenence Loon Semiicho Hepots Help inl Create Invoices x CREATE INVOICE SELECTION Office PRR Payer C Billed Weekly Bi Weekly or Monthly Billed per Calendar Period C PPS Payer Name Calendar Period Date Billed MONTHLY BILLING 1120172000 1173072000 MONTHLY BILLING MONTHLY BILLING MONTHLY BILLING MONTHLY BILLING MONTHLY BILLING 0620172000 0673072000 MONTHLY BILLING 05270172000 05731 p MONTHLY BILLING 0470172000 0473072000 MONTHLY BILLING 0370172000 0373172000 0470672000 MONTHLY BILLING MONTHLY BILLING 0170172000 0173172000 0271072000 xl Client ALL z m Create Invoices Exit 01 18 06 3 13 PM Page 254 of 448 Users Manual Creating Invoices Medicare PPS Before you generate PPS Invoices make sure you have the following 1 A Medicare or Episodic Insurance payer Branch ID entered for the office Clients associated with the Medicare or Episodic I
100. permissions equal to the permissions for the user you are copying from e There is a screen for each module with detailed permission for features within each module Press on each screen s title and select the module name to give the user permission to that module Once you have turned on permission to the module you will have access to optionally give permission to each feature within the module e The following are the features for each module that you may selectively give access to by user 0 Scheduling if this option is off access to Scheduling features will be disabled Scheduling features include Clients Employees Payers Pay Rates Bill Rates Referral Sources Affiliations Display Schedule Copy Model Week Search Phone Log Visit History Reassign CSR Clients Supplies Services Attributes Skills Sub Skills and Employee Tracking Items 1 Close Week if this option is off the menu option Close Week will be disabled Edit Pay Rates if this option is off the buttons for new remove and save are disabled on the pay rate screens and the pay rate field on editing a visit is disabled View Pay Rates must be on to select to Edit Pay Rates 3 View Pay Rates If this option is turned off for a user the following will apply for that user in SAM a The Pay Rates button will be disabled on the Edit Client Edit Client Payer Edit Employee and Edit Payer screens BOSON
101. refund amount can be entered by creating a payment adjustment of the type Refund In this way the total payment balance from the payer can be maintained e On the Edit Payment screen display the payment whose portion of is to be refunded Edit Adjust Payment gt Melbourne GUEST Bie aninisieton schedule AG Bontiguraticn Mamtenance logn Semniioio Reports Help Adjusted Payer JAce Property and Casualty Check Amount 193 75 ae N Payment ID 401238 Check RA No CN45302569 Unallocated Amount 25 75 Check Amount 193 75 Payment Balance 118 75 Payment Office Melbou Type Amount Date Comment C Refund 75 00 06722705 Type Refund v AP Check Written Add Remove Refund Amount 75 00 Date 0672272005 2 Update List Comment Cancel GUE 06222005 09 26 AM f Select record to edit e Click the Adjust button on the Edit Payment screen to display the Apply Payment screen e Click the Add button on the Adjust Payment screen e Select the Type of Refund e Check the AP Check Written checkbox if a refund check has been written from Accounts Payable e Enter the amount of the payment to be refunded the Refund Amount field Note The refund amount cannot be greater than the unallocated amount of the payment e Enter the date of the adjustment in the Date field the default is today s date e Enter acomment in t
102. screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click on the Safety Etc button The Plan of Care Safety Etc screen will be displayed SAM gt Melbourne GUEST ox Ble Administration schedule AR Lonfiguration Mamntenance logn SenlicGo Reports Hep af asures Nutritional Allergies Functional Limitations Activities Mental Status Prognosis Patient Helen Abbey Sent o02080 02 fl gt l Cert Period 09 03 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Safety Measures UNIVERSAL PRECAUTIONS CHILD SAFE ENVIRONMENT Nutritional Requirements G TUBE FEEDINGS PEDIASURE 70CC AN HOUR X 8 HOURS ADDITIONAL PEDIATRIC PEDIASURE BOLUSES OF 120CC TID FLUSH BEFORE AFTER EACH FEEDING WITH 30 60CC H20 Allergies ZITHROMAX AMOXICILLIN PAI OWO42002 12 04 PM Enter Safety Measures right click F2 to zoom The screen consists of three pages of information to be placed on the HCFA 485 e Safety Nutritional Measures Allergies e Functional Limitations Activities e Mental Status Prognosis The Safety Nutri
103. selected correctly it will be displayed in the Service field in the Service Item section The Service Database button will take you to the service database Service ltem Section This section defines the attributes of the service item you want to add The name of the service is displayed in the Service field Default values for unit cost unit bill quantity and total sales tax of the service item are displayed Edit these values appropriately Enter the date the service was rendered Enter an invoice description for the service Optional Select the appropriate payer set from the combo box who is to pay for the service Note that the list of available payer sets is dependent on the date the service was used Click the Save a button to save the service item Click the New BI button again to add another one Click the Find al button to view existing service items NOTE When creating Medicare PPS invoices the system will automatically create PPS RAP and PSP EOE type service items These types of service items maybe viewed but you cannot delete them Click the Exit Tl button to leave the screen 01 18 06 3 13 PM Page 134 of 448 Adding Pay Items Pay items are entries that record special tasks performed by an employee not related to visits how much is paid to the employee and how much is billed to payers Pay items are always associated with employees Perform the following steps to get to the Edit Pay Item scr
104. services to be provided to the client on the timesheets can be gathered from either the pre scheduled confirmed visits in the date range chosen or a client s pre defined model week e Your software vendor must set up the attributes for the assigned tasks to be displayed on the timesheets in advance in order for the timesheets to automatically populate the values represented in the client profile s attributes Other Timesheet e Must be run for 1 or 2 full week range No partial weeks are allowed e Ifa time sheet is generated for a 1 week date range the total hours displayed will represent 1 week only not 2 weeks If a day has two visits the timesheet will correctly display the total hours If more than two visits are found on a day there will be a second timesheet generated with the additional visit e Ifa date range containing two weeks is chosen the correct unique visits will appear on the first and second week Note If more than 1 visit is scheduled for a day in either week the timesheet may not represent the correct totals and week s schedule because of the way this timesheet is formatted e The Other timesheet cannot be generated for the 1 15 or 16 EOM end of month date format options 3670 Timesheet e This timesheet may be generated with all three date format options entered 1 15 or 16 EOM e All date ranges entered must fall within the same month e Up to two vis
105. that you rebilled the invoice to in order to see the new invoice claim 01 18 06 3 13 PM Page 312 of 448 Users Manual Creating Contractual Allowance Invoice Adjustment In Batch In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates Because SAM can record the difference between the rates that a payer will be invoiced invoice bill rates and the rates that a payer will pay reimbursement bill rates billing can automatically create contractual adjustments for groups of invoices Although the invoices sent to the payer will be for the invoice bill rates after creating and accepting your contractual allowance adjustment your AR will show what is actually owed on each invoice We recommend that you create the contractual allowance adjustments after you have sent the invoice to the payer But before running it is important to make sure that the invoice rates and the reimbursement rates have been defined correctly This information is entered for the payer on the Bill Rates screen The screen below shows a HHA Invoice rate Edit Bill Rates gt Melbourne GUEST lel Es Ble Ad
106. the Calendar format the visit information will include the employee s name the client s name in calendar format including the start and end times of the visit The End of Week will default to the end of week defined for the office however you may change this for the calendar format In addition you can control the vertical size of each calendar week The size will be the minimum of either the value you enter or the number of visits that occur on each day You may optionally select to Show Time or Show Only AM PM or to not show times This will affect the report and calendar output Employee Dispatch Report gt Melbourne GUEST imix File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help E Employee Dispatch Report x i j Greate List C Name Beginning With M Visit Date Range ws 77 A Past Affiliation L V Report F Include Client Comment Show Times Show Only AM PM Don t Show Times M Calendar End of Week Friday v Min Week Size Employee Name SSN Emp No Je Report Options Indicate whether 01 18 06 3 13 PM Page 380 of 448 Users Manual Employee List Report This Employee report is a list of employees defined in the system It can be run for all office or one office in particular office If you select to report shared employees only those employees that exist in more than one office will be reported If ALL offices is selected t
107. the OK button e Back on the Select Data Source screen select data source Report DBF Files and then click the OK button e Back on the Link screen select one or more of the DBF files and then click the OK button e Access likes to have unique fields on the tables to allow it to update records properly When asked for a unique field look for field names beginning with primekey e At this time the DBF files should be listed in the Access database Weekly Reviews The following reports are good reports to run weekly Client Payer List Use this report to review newly entered client payer relationships for the week The most important thing to check is that each relationship is correctly entered and that valid skills and their associated codes are entered correctly These valid skill s are what determines what type of visits can be scheduled This report is available in the Scheduling application group under the Client Payer function group Employee Tax Withholding Report Run this report each week to determine if any employee s withholding information has changed Any changes in the comment area must be manually entered into your payroll system such as SBT Garnishments are tracked in the comment area and any changes to these must be manually updated before payroll checks are generated This report is available in the Scheduling application group under the Employee function group Visit Compliance Report This report will show
108. the client payer or client for self pay situations This report will show the last supervisory visit done for a client payer or client the supervisory visit frequency and the date the next supervisory visit is due If Supervisory Frequency information has been entered for a patient in the Self Pay Billing Info area of the Client screen an additional line will be reported for the patient The Census Episode report also offers an Output Daily Census Spreadsheet If this option is On after the report is generated an Excel spreadsheet file will be generated it will prompt you for the path and filename The xls file will report how many of the patients on the census report were active each day of the report range Once you have this spreadsheet using Excel you can calculate the average median and mode daily census You may even graph it It is important to note that if you have a patient that is admitted and discharged on the day they are not counted in the daily active count in the spreadsheet 01 18 06 3 13 PM Page 417 of 448 Users Manual The last page of this report shows a summary of calculated census information Report Designer utilcensus frx Page 6 Microsoft Visual FoxPro Fie Edit Window Help 2 x 14 4 gt gt i 200m Me S Payer ALL Date Range 06 24 03 06 2403 Census Episode Report Affiliation ALL Sorted By Case Manager Client Medicare Medicaid O
109. this option is off access to the maintenance features will be disabled Maintenance features include Run Delivery Program Run Maintenance Program Command Window Copy Client Environment Copy Employee Delete Invoice Check Login Count Clear Function Locks and Split Office 1 Run Delivery if this option is off the menu option Run Delivery Program will be disabled 0 Misc if this option is off access to the miscellaneous features will be disabled Misc features include Change Password 1 Change Password if this option is off the menu option Change Password will be disabled 0 Reports if this option is off access to Reports will be disabled In order for a user to be given access to Reports at least one of the following must be permitted Scheduling Clinical or AR 01 18 06 3 13 PM Page 331 of 448 Users Manual 1 401K and Paycheck Reporting if this option is off the Reports menu option 401K and Paycheck Reporting will be disabled 2 State Unemployment Reporting if this option is off the Reports menu option State Unemployment Reporting will be disabled 3 Payroll Report if this option is off the Reports menu option Payroll Report will be disabled 4 Payroll Interface Postings Report if this option is off the Reports menu option Payroll Interface Postings Report will be disabled 5 Pay Rate Report if this optio
110. to Locked and click the SAVE button Submit the corrected assessment to the state system in the usual way 01 18 06 3 13 PM Page 230 of 448 Users Manual Importing OASIS Assessments You may import OASIS Assessments into SAM The import file must be in the standard format that is submitted to the state for OASIS Note that it is important that the header information in the import file match the OASIS Agency Info in this system You can locate this information on the Edit OASIS screen by pressing the Agency Info button The information can be entered using the Offices feature To access the OASIS Import Options screen select menu option File Import OASIS Assessment The Import OASIS Assessments screen will be displayed SAM gt Melbourne GUEST file AG Gonfigureston Mentenance logn SeniioGo Reports Help n A A WI OASIS Import Option X Edministeton Schedule IMPORT OPTION C Test Import Production Import Select Test Import if you would like to process the file first to see any errors that may occur no assessments are actually imported We recommend that you run this option first and correct any errors before importing with the Production Import option It is important to note that all records will be processed in the file even if you have imported the file previously However SAM will not import duplicate assessments It is recommended that you only im
111. to Final copies of invoices Invoices are created in the draft state and are printed with the word DRAFT on them Final copies do not print with the word DRAFT Final copies may be mailed to the payers e Print Clean Invoices no adjustment lines When invoices have items with adjustments the adjusted items appear on the invoice as gray lines If this option is selected any invoice with adjustments will print only the final adjusted values with no gray items e Print Client Copy Invoices excluding self pays Sometimes a client wants a copy of an invoice that was mailed to their insurance company sent to them for their records This option prints invoices with the client s mailing address and the caption Client Copy For Your Records Only e Print Invoices without Employee Names This option if selected will print the invoices without the employee name on the work items If you do not choose any of these options invoices will print according to their current state e Click on the Continue button e The invoice will be printed If you select multiple invoices and then click the Preview button each invoice will be shown to you on the screen When each invoice is displayed you must select the Exit T button to view the next invoice Printing Invoices for Payers The Print Transmit screen may be used to print multiple invoices for payers at once 01 18 06 3 13 PM Page 262 of 448 Users Man
112. to find potential issues with your OASIS Assessments OASIS and Billing Potential Problem Log gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help OASIS Potential Problem Log Offices Back Office 0001 From io 0672372005 2 Patient Type Medicare Home Health Non Medicare oth Office Date Type Office Patient Date o 9 9 Sort By Refresh Office Type Date c E j l 0 Entries Office Type Patient Admit No Date Description v Select Problems Sea OO E e Currently you may report the following problems 1 Patient admitted without Start of Care Assessment reports patients that were admitted to the agency on or after the date you specify but they do not have a start of care assessment 01 18 06 3 13 PM Page 409 of 448 Users Manual 2 Patient changed from hold to active without Resumption of Care Assessment reports patients that were placed on hold on or after the date you specify but there is not a corresponding resumption of care assessment 3 Patient hold done without a Transfer Assessment locking within 7 days reports patients that were placed on hold on or after the date you specify there is a corresponding transfer assessment but it was not locked within 7 days of the date that the assessment was completed 4 Patient hold done without a Transfer Assessment reports patients that were placed on hold on or after the d
113. to make any adjustments necessary to your visits to correct any payroll or scheduling issues with regard to Daylight Savings Time For example In the spring when we lose an hour on a day that spans across midnight when the time changes the shift might be modified to reflect that the employee physically worked only 7 hours by changing the end time with a visit comment Shift spans daylight savings The result should be that the visit hours should be equal to the hours physically worked by the employee Editing a Visit To edit a visit right click on the visit and select the Edit Visit option SAM gt Melbourne GUEST Scheduler Ble Administration Scheciie AED Eoniauaton Mentenance Login SeniicGe Reports Help Client Employee Rules Prefs Phone Sum Legend Month E Bel ia 4 d l a o lt Cin Client Helen eea de EE L 555 739 aa 29 50 29 50 1 00 0 00 Hrs 2002 J Er Thu i a 10713 He 10 15 a 10 17 10 18 St ere ee es 10 19 10 20 10 22 10 24 10 25 _ L SN RN 10 27 RN 10727 10729 10730 10 31 SN RN 10 27 i 09 0 mz Visit D m Visit 11 02 Move Visit I 11 05 11 06 11 07 a Specify Employee jated HMO Reg Rates 26 00 80 00 09 00a 10 00a _ Employee Match Visit Phone Log Copy Single Visit Copy Visit Wizard Status Not Assigned Sk This will cause the Edit Visit screen to
114. weekly bi weekly or monthly It displays only those payers that do not have billing calendars Invoices and claims for the payers that require claims are created at the same time Perform the following steps to creating invoices and claims for payers billed weekly bi weekly or monthly e To access the Create Invoices screen select menu option AR Create Invoices The Create Invoices screen will be displayed Select the Billed Weekly Bi Weekly or Monthly option Select the payer to invoice by clicking on the payer in the list If you want to invoice just one client related to the selected payer select the client from the Client combo box Otherwise just click the Create Invoices button 01 18 06 3 13 PM Page 253 of 448 Users Manual Creating Invoices Claims for Payers Billing per Calendar Period To invoice for payers that are not billed weekly every two weeks or monthly click on the Billed per Calendar Period option on the Create Invoices screen The payer list box changes to display only those payers that have billing calendars Billing calendars for a payer are defined in using the Payers function Invoices and claims for the payers that require claims are created at the same time Perform the following steps to creating invoices and claims for payers billed per payer calendar To access the Create Invoices screen select menu option AR Create Invoices The Create Invoices screen will be displayed Select the Billed
115. weeks or months Enter the Start Date and End Date of the insurance authorization Click the Save button If the new compliance rule overlaps an existing Insurance Authorization compliance rule the Overlapping Compliance Rules screen will be displayed 01 18 06 3 13 PM Page 48 of 448 SAM gt Melbourne QA Edit Client Payer lel Es Ble Administration schedule AED Lonfiguretion Mantenance Login sanmiomo Reports Help fal Overlapping Compliance Rules x Your new rule overlaps existing rules You may add the rule with overlaps or adjust the dates of the existing rules and replace them with the new rule Rule List if Addition Button is selected cO o a A ce Save Wer SN 1 A Week 1 Months 08 30 2005 09 29 2005 Rule as SN 1V A Day 43 Days 08 30 2005 10 11 2005 Addition to BBS ee Sea eee Existing Rules _ SS _ _ a E SSS ed ES See Rule List if Replacement Button is selected Compliance Rule ___Dates__ _Statusy lt lt Save New Rule as Heplocomont E ee ene Save of the entered order will be cancelled If the new insurance authorization represents visits to be done in addition to what is already authorized choose Save New Rule as Addition to Existing Rules The system will save the tule as is If the insurance authorization replaces what is currently authorized choose Save New Rule as Replacement for Existing Rules This will cause the system to adjust
116. when the payments were created or select ALL for all offices Make sure the Payment Adjustments Report print option is selected Click the Generate button The Payment Adjustments Report may also be generated for a specific payer as described above for the Payment Log Logging Collection Comments at the Invoice Level To access the Edit Collection Log screen select menu option AR View Invoices and Claims The Invoice Details screen will be displayed On the Invoice Details screen click the Find button Enter Start and End dates Either select a payer or leave the payer field blank See the Printing Invoices for Payers section for instruction for selecting a payer Either select a client or leave the client field blank See the Printing Invoices for Payers section for instruction for selecting a client Click the Generate button Select the invoice on which you want to place the comment Click the Collection Log button 01 18 06 3 13 PM Page 287 of 448 Users Manual Edit Collection Log gt Melbourne GUEST le Ee Bie Administration schedule AR onficureticn Mentenance Login sanmiomo Reports Help x Edit Claim Collection Log SII gt aa T View CathAnoied O reece x Office Melbourne 0002 i 4 gt ri lo ixl e Payer Medicaid 7147 Client Squire Arlene 000001 02 Invoice No 0002403577 Create Date 06 22 2005 08 59 AM Spoke w Elizabeth who said claim will be p
117. will cause the sales item report to include adjustments made during the date range even if the adjustment was to visit that is not in the date range Because the reports assimilate data in very different ways it is not unusual that the dollar totals on the two reports will be off by a few pennies Balancing Sales Item Report Royalty Report GL Sales Report Worker s Compensation Report The Sales item report and the GL Sales and Cost Entries Report will agree when they are both run for the same date range within an open period The Sales item report options All Transactions and Payroll Dates must be selected The total count sales and cost should match the GL Sales Report the transportation component of sales and cost must be summed on the GL Sales Report The Weekly Licensed Unlicensed Sales report will match the sales of either of the sales item reports if the sales item reports are run for the specific week date range matching the Weekly Licensed Unlicensed Sales report and any service items are subtracted from the sales item report However if the GL Sales and Weekly Licensed Unlicensed reports are run for the last week in a period they will not balance by the amount of item adjustments made after the last week ending date and before the end of the period If the GL Sales report is run for the last week 01 18 06 3 13 PM Page 243 of 448 Users Manual of the period and the first week of the next period and a
118. withheld per paycheck enter the amount in the Additional Amt field e Ifan additional percentage is to be withheld per paycheck enter the percentage in the Additional field State Section e Select the employee s state Filing Status e Enter the employee s resident and non resident state of Exemptions e Enter the amount that should be subtracted from the gross before the state withholding calculations are performed into the Exempt Amount field e Ifan additional amount is to be withheld per paycheck enter the amount in the Additional Amt field e Ifan additional percentage is to be withheld per paycheck enter the percentage in the Additional field City Section e Ifan additional amount is to be withheld per paycheck enter the amount in the Additional Amt field e Ifan additional percentage is to be withheld per paycheck enter the percentage in the Additional field Additional Tax Section e Ifthe employee has any other taxes to be withheld like garnishments enter the information here This information will print on the Employee Tax Withholding Report 01 18 06 3 13 PM Page 64 of 448 Miscellaneous Section e These fields are used for interfaces to payroll systems e Click the Skills Attributes tab to go to the next page Skills Attributes Page The Skills Attributes page is used to define skills and attributes that an employee has These skills and attributes are used in the employee matching function of sche
119. you selected e Make sure that the OASIS Assessment displayed is the one you want to delete e Click the Delete x button on the toolbar to delete the OASIS Assessment e Click on the Yes button in the popup screen that asks Delete displayed OASIS Assessment e The detailed information about the deleted OASIS Assessment will be removed from the Edit OASIS Assessment screen and from the OASIS Assessment List screen e At this point you may delete other OASIS Assessments by repeating the steps above e Click the Exit Tl button on the toolbar to exit the Edit OASIS Assessment screen Printing a OASIS Assessment You may print OASIS Assessments to a printer or to a pdf formatted files to be stored electronically e To access the OASIS Assessment screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like print an OASIS Assessment for e Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical 01 18 06 3 13 PM Page 223 of 448 Users Manual Information section of the screen Refer to section Admitting a Patient into the Agency in this manual e Click on the Define OASIS Assessment button e The Edit OASIS screen will be displayed with the Patient Name field filled in with the name of the patient selected Once t
120. 0 Patient Name Clients Profile Client Name 10 Recipient ID Administration Insurance ID Number Client Payers Insured s ID 11 Date Of Birth Administration HCFAI1500 DOB Clients Profile Birth Date 01 18 06 3 13 PM Page 438 of 448 Users Manual Form 9 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field 12 Sex Administration HCFA 1500 Sex Clients Profile Sex 13 Other Insur N A N A N A 14 Patient Account Defaults to Last 4 letters N A N A Number of client last name last 4 digits of invoice number amp a letter equal to page number 15 Place Of Service Defaults to 02 N A N A 16A_ Is Recipient Being Defaults to No N A N A Treated As A Result Of An Accident 16B_ If Yes Type N A N A N A 16C_ Date Of Accident N A N A N A 17 Is Recipient Being Defaults to No Treated As A Result Of A PGH Screening 18 L O F N A N A N A 19 Patient Status Administration Insurance Policy Clients Payers Policy Number 20 Discharge Date N A N A N A 21 Diagnosis Code Clinical Information Physician Diagnosis Code 1 Edit Patient Diagnosis Define Plan Of Care Verbal Order Diagnoses ICD 9 CM Primary 22 Diagnosis Name Clinical Information Physician Diagnosis Code 1 Edit Patient Diagnosis Define Plan of Care Verbal Order Diagnoses Diagnosis Description 23 Diagnosis Code Clinical Info
121. 018 01 Order List By Assessment Reason Date Completed Doc Recertification follow up assessment 04721799 Cakes 4702 IL o0000056 a i 9 0970 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 Select the desired OASIS Assessment The Edit OASIS screen is then displayed with the OASIS Assessment that you selected e You may modify any of the assessment fields displayed on the screen e Make sure all the information on the screen is correct e Click the Save i button on the toolbar to save the changes made to the OASIS Assessment e Click on any of the available buttons at the top of the screen to modify the remaining OASIS assessment information e Modify the assessment information as necessary You may notice that some fields are not available for input The disabling enabling of fields is based on your answers to other fields This is defined by the OASIS Specification provided by Medicare e The screen may include multiple tabs multiple screens To access another tab click on the title of the tab e Once all of the assessment information has been entered press the Save i button to save the information If the screen is comprised of multiple tab multiple screens click on the title of the first tab to access the Save button Warning messages will be displayed if any required information has not been entered e Press the Exit A button to return to the initial OASIS Assessment screen e If you have alre
122. 03 11 04 11 05 11 06 11 07 11 08 aia 11 10 11 11 11 12 11 13 11 14 a Move the schedule forward by a week oN AN 09 00a 1 0 00a 11704 11705 Deleting a Visit Deleting a visit can be done three ways 1 By using the delete option on the visit menu 2 Clicking the Delete x button while editing a visit 3 Update visit wizard to delete multiple visits at one time Moving a Visit Moving a visit can be done three ways 1 Ifyou want to move one visit to another time during the same week click and drag the visit to the desired location This method is not available in list mode 01 18 06 3 13 PM Page 105 of 448 2 If you want to move one visit to another time frame right click on the visit The Visit Menu will appear e Select the Move Visit option e The Move Visit screen will appear SAM gt Melbourne GUEST Scheduler Olx Ble Acmnimistration Schedule AR Eoniauaton Memntenance logn Seniicko Reports Hep nt Employee Rules Prefs Phone Sum Legend Month x ri 4 d J Clie T A 555 739 0474 29 5071 0070 0070 00 Hrs 2002 Sun Mon T Wed _ Th 10 19 10 20 10721 10 22 107233 e 10 24 10 25 _ New Visit Start Date New Visit ld 11 10 11 11 1171 11713 e Enter the New Visit Start Date and New Visit Start Time You may input in 12 hour or 24 hour military format e Click the X in the upper right corner of the screen to exit e The Scheduler scre
123. 06 3 13 PM Page 242 of 448 Users Manual Reports Available for Closed Weeks Payroll Report This report shows the detail items paid to an employee It can even be used to create detailed employee check stubs This report shows only closed or verified visits and pay items This report can be used to instruct your payroll vendor how to cut your payroll Sales Item Report The sales item report has many functions It can report sales and cost by date payer payer class payer program skill bill unit Medicare like and non Medicare like visits location and referral source It can be sorted multiple ways and can output its results to an Excel spreadsheet for further manipulation It can be run by either date of service or the week ending date associated with an item when it was paid billed Combined Sales Report The combined sales report allows reporting across offices It is normally run by accounting period or for certain weeks within an accounting period It can be found with the other general ledger reports by choosing the Sales and Cost Entries option See General Ledger Reporting Balancing the Sales Item Report with the Combined Sales Report The sales item report will agree with the combined sales report if the sales item report is run in the following manner 1 Use the same date range as the combined sales 2 Choose the Payroll Dates option 3 Choose the All Transactions option The all transactions option
124. 1 11 00 10 0000 Posti 0002000 6 0000 03 0 11 00 10 0000 0602000 3 0000 93 29 03 0 2 00 2 2500 01 18 06 3 13 PM Page 241 of 448 Users Manual To get a list of the payroll adjustments done for each office follow these instructions to print the adjustment report To access the Adjustment Report screen select menu option Reports The Select Report screen will be displayed Click the Billing application group Click the Accounts Receivable option Click the Adjustment Report and press the Proceed button Enter the start and end dates of the adjustment you want to see Set the start date far enough back to include any payroll adjustments that were entered prior to last week s payroll Select the completed adjustment status Select Adjustment Type s Visits and Pay Items Select the Payroll Only option Select Any Employee or Client Payer Note 1 If you are using the SBT ACCPAC payroll system and are using a version later than 7 1 you should put the following lines in your n sam ini file Ini_Payroll_Vendor ACCPAC 7 1 to designate you are using the new version Ini_Payroll_ Vendor n pro50 prdata to designate where SAM should send export the postings files to 2 If you are using the SQL version of the SBT ACCPAC payroll system you should put the following line in your n sam ini file where companyname is the name of the company in SBT Ini_ ACCPAC_Company companyname 01 18
125. 2 50H 37 50H 09 00a 03 00p 2 26PM 01 18 06 3 13 PM Page 121 of 448 In the employee view of the schedule a function called assignment matching is available This function allows a scheduler to find an assignment for an employee when an employee calls in To use the function display the employee s schedule and right click on any white space Selecting the Assignment Match option of the short visit menu causes the following screen to appear CE SAM gt Melbourne GUEST Scheduler BIE Aammnistaton senedle A ontiaureticon Mentenence Log semitai Gepots Hep L fal Assignment Match CEA This screen will allow a search for all unassigned visits to which the current employee could be assigned Clicking the Search button causes the list of visit assignments to be displayed 01 18 06 3 13 PM Page 122 of 448 SAM gt Melbourne GUEST Scheduler Bie Acministaton Schedule AE Eonniauaton Maintenance login Seniicto Reports Help Client D5 Vickie Dillon RN ial Assignment List Non Spec Client Skill Needed Visit No Date Time Hours Prefers 004679 A0655 ii 0 16 2002 07 00 AM Salois Barbara Tower Michele Employee Bonus for Client I 0 00 per hour 0 00 per visit Default Reg Rate for Emp Visit 26 00 Hours Scheduled visits 19 50 week 6 00 day Visit Hours 7 00 regular 555 596 3281 Dbl click assigns employee to selected visit The scheduler may then v
126. 2002 Godaire Shari a 62 00 20 60 0171972002 Godaire Shari Thompson 07 00 AM 62 00 22 00 xl Adut nein A E Select the payer set to bill e Ifthe item was billed to the wrong payer click the Rebill button The Rebill Item screen is displayed Select the appropriate payer to bill the item to from the After Rebill payer list e Make sure you have the correct payer with the correct dates e Click the Save al button Click the Yes button when asked Re bill this item to the selected Payer Set On the Item List screen click the Exit button When you rebill an item to a new payer the work items will be refreshed with the new payer s bill rates Rebilling individual Medicare PPS RAP EOE service items is not allowed however you may rebill the entire PPS invoice All Item rebills are processed together when you exit the Item List screen They do not need to be reviewed or accepted However you will need to create invoices for the payer that you rebilled the items to in order to see these items on an invoice claim 01 18 06 3 13 PM Page 308 of 448 Users Manual Invoice Adjustments In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accep
127. 2004 Down Arrow Move forward one week Left Arrow Move back one day Right Arrow Move forward one day Page Up Move back one month Page Down Move forward one month Ctrl Page Up Move back one year Ctrl Page Down Move forward one year Home Move to beginning of month End Move to end of month 01 18 06 3 13 PM Page 15 of 448 Explanation When working with information regarding clients employees physicians skills plans of care doctor orders etc the user interface uses the windows standard of data and list screens The data screen will show you one record within a list of records for instance one client within a list of clients When you choose a screen from a menu the data screen will display the last record you were looking at If it is the first time you have entered the screen the fields on the screen may be disabled because no record is current For instance the first time the Client menu option is chosen the following screen appears SAM gt Melbourne GUEST Edit Client Bie amp ation Schedule AH Donfigureticn Memtenance log Gamlioao Reports Hep Client Profile l Client Skills amp Codes Self Pay Client Attributes Client Ancillary Into Client Race Beadmit Payers Visits Pay Rates Bill Rates Auth ia 4 gt yi Blo Elx 5 Us ITALS Client Client Type Entry Date 7 7 aa Zin Code N O M Payer Class Status O Service OO Phones 1 M 2
128. 3 2002 09 00 AM 03 00 PM Wed A01188 A0090 H 10 24 2002 09 30 AM 03 00 PM Thu A01188 A0104 H T 10 25 2002 09 00 AM 02 00 PM Fri A01188 A0100 H P T P B Q Travel Pay 0 00 Travel Bill 0 00 Update List k MB 08282002 03 18 PM Regular Pay Bill Rates 20 50 37 50 3 53 4M 01 18 06 3 13 PM Page 104 of 448 e Click the Save El button The verified visit is saved and the screen advances to the next unverified visit for this client e Repeat the steps above for each visit until they are all verified e Click the Exit Tl button to return to the schedule e Click the Client button to select the next client or Click the Right Arrow Hla LI button to advance the schedule to the next client in the current list e Repeat until all visits for all clients have been verified e Visits that are alike same Payer Skill may be verified together using the verify week screen Once the visit or visits have been verified the visit s status will change to verified and the visit or visits will turn light blue on the schedule SAM gt Melbourne GUEST Scheduler Bie Administration Schedule AR Wonfiguratcn Mentenance Login semono Reports Help Employee Rules Prefs Phone Sum Legend Month z ml ia 4 d l 1 gt ge ee Helen eale AEN EE 555 739 Mata 29 50 1 00 0 00 0 00 Hrs aa Tue Thu 3 3 10 20 in 10 22 10 24 Sm mm 10726 10 27 10 28 10 29 10 30 10 31 nm EEE 11
129. 4 00 14 00 oy Hours C Visits VIEW All Cunent ORDER BY C Date Skill BILL C Invoice a Reimb Skill HHA 7 Effective Date 08 01 2002 2 Mon Iue Wed Ihu Fri Sat Sun Update Rates 1 14 0000 _ 14 0000 14 0000 14 0000 _ 14 0000 _ 14 0000 _ 14 0000 2 _ 14 0000 414 0000 14 0000 _ 14 0000 _ 14 0000 14 0000 _ 14 0000 Stop 3 _ 14 0000 14 0000 _ 14 0000 _ 14 0000 14 0000 14 0000 L 14 0000 GUE 06282005 10 26 AM Bill Rates for specified Client Payer Bill Unit 10 28 AM Once the rate information has been added you can create the Contractual Allowances on the Print Transmit screen Print Transmit gt Melbourne GUEST ie Ea File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help F Print Transmit x FORMS STATES DATES ORDER BY Invoices C All Creation Dates From 01 01 2002 ig EE Invoice T Self Pay C Rea m C Invoice Dates D C Client CLIENT 7 PAYER C UB 92 C Suspended Payer r Aetna Us Healthcare a C HCFA1500 C Draft C Final Client I All Versions C Not Transmitted ECS ALL v _Reset List RFT Invoice No i Mi 4 contractual allowance will be created for all selected invoices s Do you want to continue T e one oarase ar 0002020334 02 Okun Heather Aetna US Healthcare 0002A400325 01 Gongora William
130. 418 13 498 12 413 12 PZ 3 191 00 472275 2 601 60 3 73a Mert Barbars 0002 002700 01 71648 0STEDARTHRO HBHL1 CI FAB 12 2401 011 Other eoan RAN MAA d 01323 g 10 g o g o Popa htarilyn 0002 DD0029 D2 B040 OPEN WOUND DF LEG HOGJ1 J C2F2SD 11 1601 01131 Other LLALUKS 34 0 0 D D 4 0 fauter 4 723 75 NA 0IOD 100734 RA 01099 oo 623 04 1 124 36 74 07 4 21105 2 190 20 5 050 16 12 52 BOOT MABI ft Tomas Ama DD02 002525 0 1 8020 0PEN WOUND DF FDOT HCEN C2FORO 11 2701 1 26 Other 1 000 00 462230 OIGE 4 0 0 0 D a BOOTH W OIRE ff gm0 2 160 35 5 340 17 0 54 Paid Amt Supply Cost Visit Cost 1 140247 E Wiener Rahaldo 0003 002743 01 1539 MALIGNANT NED COLON HEGKI CIFIS1 M1300107 Othar BOOTH AN DT A OSAD 1 0 0 J 2 ojscre Vits SN PT OT ST MSW HA OTH Orig Amt Final Amt 108122 140247 Totals I e o o o s Oo 4 952 20 129020 192147 PA 01006 RNA 150 17 RA 020g 191006 RA 02020 3203 Visit Cost 2 Based On Selection Screen Costs by Skill p 640d 972 64 54 49154 2 53 ooo 3 9905 3 4101 04 11 774 40 Unduplicated Census 6 00 Episode Averages Average E plsode Length Average Number of Vk ts Average Total Cost Average Supply Portion of Cost Average Reimbursement Average Daily Reimbursement Average Weekly Reimb urse ment Average Episodes per Patient Average Case Mix Weight Net Sales 97452 Episode Totals Co
131. 448 Users Manual Workstation Environment Size If your workstation PC gets the error Out of Environment Space while running Update Software from Server perform the following steps then restart your computer Click Start Button Click Run Type sysedit in the Open box then click OK Click the Config sys file Add the following Shell command at the bottom of the file or replace any existing Shell command with the following line SHELL C WINDOWS COMMAND COM E 4096 P 01 18 06 3 13 PM Page 356 of 448 Users Manual Reports Report Options g Report Options x Destination Report Information C Default Printer User Tite C Specify Printer Pages Screen Preview Excel File C DBF file C Comma Delimitted ASCII J Summary Information Only Exit All of the Reports may be conditioned using the Report Options feature to output to any of the following Destinations e Default Printer the report will print on the printer that has been defined as the default for the current workstation e Specify Printer Pages this option will display a screen where you may specify the printer and or define what pages you would like printed e Screen Preview the report will be previewed on your screen and may be printed from the print preview e Excel File you will be prompted to specify the path and filename for the xls file that will be created Reports will default to N Excel Files e DBF File
132. 48 Users Manual If a claim does not exist for the displayed invoice the Claim Options screen is displayed This screen notifies you that no claim exists for this invoice and tells you if a claim is required for the invoice and if so which kind UB92 or HCFA1500 Even though an invoice may require one type you may choose to create either type or cancel Choose the UB92 button to create a UB92 claim Choose the HCFA1500 button to create a HCFA1500 claim Choose the Cancel button to cancel the claim creation fal Edit Claim Options EDIT CLAIM OPTIONS A claim does not exist for this invoice This invoice requires a HCFA1500 claim What kind of claim do you want to create Cancel e Ifa claim does exist based on the claim type either the Edit UB92 Claim or the Edit HCFA1500 Claim screen set will be displayed e Make the necessary edits to the claim and click the Save button Add HCFA1500 Claim for Wesolowski Kendra gt Melbourne GUEST lei ce Bie Acministaton schedule AE Eonigauaton Mantenance Loon Semiicho Hepots Help HCFA1500 l Insurance Physician Diagnosis Detail Lines INVOICE 0002403587 01 Eal wlx T PATIENT Name Wesolowski Kendra Marital Status x Address Wilbraham Commons Employment Status z fa 205 Building G4 z City pen Accident zi St Zip JMA Z jm 095 Phone 2 555 599 6630 Auto State DOB 10706 1943 Sex Female z M Signature on
133. 5 times the average This algorithm is consistent with existing overtime laws Note All employees must agree to the use of this algorithm before its use To activate this overtime option add the following line to your n sam ini file Ini_ot_algorithm B If you choose to use overtime option B it will be important to update the n sam ini file for your back office and all of your front offices so that all of your offices are calculating overtime using the same option By default 40 hours of work by an employee in one week is what will trigger any additional hours in the week to go into overtime You can control the number of hours that will trigger overtime for an employee If you do not have this variable set SAM will use the default of 40 hours To use this feature enter the following line in your n sam ini file where is the number of hours that should trigger overtime example 48 Ini_weekly_ot 48 01 18 06 3 13 PM Page 233 of 448 Users Manual e To Calculate Overtime select menu option AR Calc Overtime e If any overtime is found Click on the Print button to print an overtime report SAM gt Melbourne GUEST Bie Acministeton Schecvie AG Lontiqureich Mentenence Lorn samote Reports Hep fal Information The following visits pay items contain overtime hours They are displayed as overtime double time e Click on the Cancel button to exit from this screen 01 18 06 3 13 PM Page 234 of 448 Users Manual
134. 701 2001 S _Employee_ a m 4 Client Payer JAbbey Helen teh att OT Tufts Associated HMO N 05 17 01 11 07 Reset List ITEM TYPE S V Visit M Pay V Supply V Service Adjustment Costs Pending Hutchinson Perron 01 00 PM Bennett 04 00 PM Crepeau 04 00 PM No Adjustments are Pending or Transmitted 3 34 AM The Item List screen is used to display items that are closed and available for adjustments A user generates a list of items based on selection criteria and then selects the items to be adjusted To access the Item List screen select menu option AR Make Adjustments Items The Item List screen will be displayed Enter the Start date for the date range date of care for the item s you are looking for Optionally enter the End date If you know the employee click the employee option and the Select button by the employee field Enter in the first few letters of the employee s last name and click the Generate button Select the employee from the list 01 18 06 3 13 PM Page 301 of 448 Users Manual e If you know the client and payer click the client payer option and the Select button by the client payer field Enter the first few letters of the client s last name Or you may select by client number if you know the client number in the system Select the client from the list Once selected the client s payer sets will appear in the Payer Set select box Select the correct payer from this list
135. 7164 KHER AAAARARAAAAARARARAARARAA AAR ARAL ALAA ARARARAAAARE RARER ALARA RAL ARARARA RARER ERAT ARAREEAEAS Warrants are included in this reporting period Total Amount of Warrants 131043 66 R amp S Report Number 20010119 R amp S Report Start Date 01 12 2001 RS Report End Date 01 19 2001 Production Run Date 01 19 2001 Provider Number 000089200 Provider Number 000089200 ist Warrant Number DD5723196 Warrant Date 01 12 2001 Warrant Status Direct Deposit Warrant Amount 17906 29 Client Name Invoice ID Grp Billed Paid From To EOB Insurance ID ADAME GUADALUPE 0014408951 PHC 8 56 8 56 12 28 00 12 28 00 PD 519623473 ALEMAN MARIANO 0014408925 PHC 94 16 94 16 12 25 00 12 29 00 PD 503977728 ALVAREZ LILIA 0014408861 PHC 111 28 111 28 12 25 00 12 29 00 PD 509866023 ANDERSON BOBBIE 0014408959 PHC 65 60 85 60 12 25 00 12 28 00 PD 509410312 ANTHONY GILBERT 0014409009 PHC 96 30 96 30 12 26 00 12 29 00 PD 518292174 ARELLANO REYES 0014408862 PHC 98 44 98 44 12 25 00 12 29 00 PD 518326109 ARREDONDO VICTO 0014208960 PHC 102 72 102 72 12 25 00 12 29 00 PD 506958538 ARRINGTON WILLI 0014408863 PHC 42 80 42 80 12 27 00 12 29 00 PD 508128457 ATKIN BENNE 0014208907 PHC 94 16 94 16 12 25 00 12 29 00 PD 516946739 AVILA LUPE 0014408961 PHC 119 84 119 84 12 25 00 12 30 00 PD 505244395 BARBER ALTHEA 0014209022 PHC 149 80 149 80 12 25 00 12 29 00 PD 500449999 BENAVIDES CARME 0014209031 PHC 68 48 68 48 12 25 00 12 28 00 PD 238629801 BOTELLO
136. 7PM e To view earlier or later weeks click the left arrow and right arrow buttons e To go directly to a calendar that contains a certain date click the calendar button and choose the date e To exit and return to the Profile page of the Edit Employee screen click the Exit Tl button 01 18 06 3 13 PM Page 70 of 448 Shift Availability e To define the days of the week and the shifts that an employee is available to work click the Shift Availability button SAM gt Melbourne QA Employee Availability Calendar Bie Administration Schedule AR Eoniguaton Memntenance Logn Se ia G T x v 2 Shift Avail lity Day Availability E Edit Shift Availability Duplicate 1st Day Hl Tl Sat Sun Mon Tue Wed Thu Fri CARIS C BRIE C AeIE C AE Shift Maybe Maybe Maybe C Maybe Maybe C Maybe C Maybe C W E Oe Oe o C Always C awas C aea C ea C Always O Always Aea Shift2 Maybe C Maybe Maybe Maybe c vem Reem O ee ee O M lt lt M Shift3 Maybe Maybe C Maybe C Maybe Maybe C Maybe Maybe QA 06192005 03 17 PM Shift Availability E Always C Maybe HE Never Day Availability EE Always E Maybe EE Never Specify the employee s availability for each day shift this information repeats each week e The Edit Shift Availability screen will be displayed e For each day and shift of the workweek clic
137. A403577 of os Shift To Squire Arlene Not Inyoiced v of oc Invoice oc Description of oc of 85 00 z 10 01 AM 09706702 01 18 06 3 13 PM Page 310 of 448 Users Manual Adjusting individual Medicare PPS RAP EOE invoices is not allowed however you may adjust individual items on the invoice Note that if the invoice has cash applied to it you will get a warning Note that if there is any pending adjustment for any invoices on the same bill such as shift payments adjusting will not allow invoice adjustments until the pending adjustments are accepted e Choose the appropriate adjustment type e Ifyou want to apply a contractual allowance or discount to the invoice choose the Contractual Allowance option e Ifyou want to write some or the entire invoice off as a bad debt choose the Write Off option e Ifyou want to shift responsibility for payment from one payer to another or the patient choose the Shift Payment Responsibility option If you select the Shift Payment Responsibility option you must choose the payer to shift the responsibility to in the Shift To list e Ifyou want to adjust the invoice to increase the invoice amount for accrued interest choose the Accrued Interest option e Ifyou want to adjust the invoice for reason other than those above choose the Other option e Enter the adjusted amount of the invoice The difference between the Before and After amounts is the amount
138. ATE A0000992 06 08 2002 Plan 06 08 2002 08 06 2002 A1 Medicare JONATHAN SLATE A000093 Select the desired Plan of Care or Verbal Order 11 16 AM 01 18 06 3 13 PM Page 209 of 446 Users Manual Click on the Plan of Care you would like to associate the new Verbal Order with and click the Select button The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care Make sure that the Plan of Care displayed is the one you want to create the Verbal Order for Click the New Verbal Order Ql button on the toolbar to add a new Verbal Order The Add Plan of Care Verbal Order screen is displayed SAM gt Melbourne GUEST lel Es Fil Bie Achinistiaton Schedule AG Gontiauraton Memntenence Loon Semiioto Reports Ll ot Ae je ii Log i jz x Orders Goals Hedications Compliance Rules Becert Copy Diagnoses Surg Proce Supplies TERA JEE 14 41 amp 1 Fal E a fal x Us PLAN OF CARE VERBAL ORDER Client A00145 A2 VERBAL ORDER INFORMATION Verbal Order Date WE E POC MISCELLANEOUS Patient Name Michael Wilson Agenc Agenc Stat AA Care 0670872002 SE Active Medical Rec No eon 45 42 HI Claim No 0321249064 Type Verbal Order 60 Days Cert Begin 0 06 2002 a Cert End 1270472002 al Hareik 227213 Payer Comment Primary Physician c f KRISHNAN A BABU ase KRISHNAN A BABU Select Manager Marilyn
139. After HyperTerm starts note the session name at the top window label It should read North Carolina Medicaid HyperTerminal If it is correct continue otherwise click the Cancel button on the Connect window exit out of HyperTerm and call your support personnel 2 If you can print from your workstation and you would like to print a copy of you HyperTerm session to your default printer continue with step 3 otherwise go to step 6 Click the Cancel button on the Connect window Select Transfer from the HyperTerm menu and then click Capture to Printer Select Call from the HyperTerm menu and then click Connect Click the Dial button on the Connect window At this time the modem on your workstation will dial into the bulletin board If the modem does not connect properly click the Cancel button and go back to step 5 to try again 7 Ifthe modem connects correctly you will see the bulletin board banner Type in your ECS Authorization Number 8 Type in your password 9 Type the S command Send Transactions to place the bulletin board in a mode to receive your ECS file 10 When the bulletin board is ready to receive your file select Transfer on the HyperTerm menu and then click Send File 11 The Send File window now appears Click the Browse button on the Send File window and locate the file to transmit The file should be in the default directory N Claims Transmission 12 After the file is located click the Se
140. As Needed 5 Days 1 2 As Needed 2 Weeks 1 2 As Needed 2 Weeks 1 2 As Needed 10 Days 1 2 As Needed 2 Weeks 01 18 06 3 13 PM Page 94 of 448 Viewing the Visit Legend e By clicking the Legend button you can see the legend explaining the different colors etc used to denote important information CE SAM gt Melbourne GUEST Scheduler Ble ABanmnistaton sceneddle At Gortiguration Mentenence Log Semlicto Gepots Hep Schedule Legend 01 18 06 3 13 PM Page 95 of 448 Creating a Visit To create a visit click on any white space in any view of the schedule screen The schedule screen will look like this SAM gt Melbourne GUEST Scheduler lei Ee Bile Adminstration schedule AR Lonfiguretion Mamntenance logn Senlicho Reports Help Client Employee Rules Prefs Phone Sum Legend Month El HE gt nt ae lt N Helen Ss ae 555 739 0474 29 50 29 50 0 00 0 00 Hrs 2002 i a yam i 10 13 a 10 717 1078 ier a 10 19 10 20 10 21 10 22 10 23 10 24 10 25 see A a 10 30 10 31 11 01 View Order an 11705 11 06 11 07 11 08 View Model Week Clear Model Week 8 50 4M Choose the Create Visit option and the Create Visit screen will appear SAM gt Melbourne GUEST Scheduler le Ez Adninistaton schedule AB Bontiguretion Mer mee Login Senioto Reports Hep Create Visit x Split Hours Employee Emp Match Sup
141. Be tor 01 18 06 3 13 PM Page 328 of 448 Users Manual b The following fields on the Edit Employee screen are not displayed Merit Pay per hour per visit Weekend Differential per hour per visit and Bonus Amount per hour per visit c The Visit Summary screen will not display the skill s pay rates d The Edit Visit screen will not display the pay rate for the visit In addition the Split Hours screen accessible from the Edit Visit Screen will not display the pay rates e The Employee Matching Employee Candidate list screen display and printed list will not display the pay rates In addition the Other Unassigned Visits screen will not display the pay rates f The Visit Phone Log Entry screen will not display the pay rates The List mode of the display of the schedule will not display the pay rates The Assignment Match screen will not display the merit pay rates In addition the Assignment Match Assignment List screen will not show the employee bonus rates or pay rates i The Update Visit Wizard will not display the pay rates or allow the user to change the pay rate The Phone Log Search results phone log report will not display pay rates The Pay Items button on the Employee List in Display Schedule is disabled When viewing a Client or Employee schedule the display of summary information for the visit at the bottom of the screen will not include pay rates m The On Call report will not include pay rates
142. Ble Administration schedule AD Donfiguretion Metntenance logn Seniiota reports Ban Edit Patient Agency Status _Define Hospital Stays D ml amp PATIE apenas Patient Joshua Adkins Client A00571 01 Start of Care 06 17 2005 Patier Date Status i Reason i i i X 06 17 2005 Active K Addre City State Phone Birth Sex Status Active z Status Date 5 17 2005 S Delete Ent O Reason RS Of202005 11 24 AM Select Patient Status to edit or delete 11 25 AM e Click the Exit T button on the toolbar to exit the Edit Patient Agency Status screen The Edit Patient screen will be redisplayed You will notice that the Clinical Information section now contains an Agency Start of Care date the Agency Current Status is now Active and the Agency Admit Date is filled in At this time you may finish entering the patient s clinical information e Make sure the Patient Type combo box value is correct e Select the patient s Disaster Code value this field is not required e Select the appropriate Source of Admission for any Medicare patients This will be included on Medicare RAP and EOE UB92 claims e Select the appropriate choice for Do Not Resuscitate if this box is checked it will print in Locator 21 Orders on the Plan of Care e Click the Save i button on the toolbar to save the patient s clinical information The patient is now admitted into the agency You now have several opt
143. Case Manager Referral Status Active Edit Status Comment ONLY HHA a Hired fi 0 22 1990 Inactivated J A g Email SS RM 06262002 01 21 PM Enter the employee s first name 3 45 AM The Edit Employee screen contains tabs for pages of related information The pages on the Edit Employee screen are Employee Profile Employee Taxes Employee Skills Attributes Employee Preferences Bonuses and Emp Photo The Profile page is the first page displayed upon entry to the Edit Employee screen 01 18 06 3 13 PM Page 57 of 448 Finding an Employee e Click the Find Al button e The Employee List screen will be displayed SAM gt Melbourne QA Edit Employee BIE Aanmnistaton senedle At Rontiauraticn Menterence Login samiot Gepots Hep F Employee List Select a Skill of the employee you want to see Select the Type of employee you want to see Select the Status of the employee you want to see Select the Affiliation of the employee you want to see If you wish to shorten the list you can type in the first few characters of a last name in the Name Beginning With field e Also to shorten the list you can click on the option Has visits scheduled during selected week e Click the Generate button 01 18 06 3 13 PM Page 58 of 448 SAM gt Melbourne QA Edit Employee BIE Aaministaton Screcvie At Iecriiguratcn Memnterence Log Semlicto Reports Hep oF Employee List
144. Charge Ey e Change any of the following fields service item quantity unit cost unit bill and total sales tax e Click the Save Hal button e Click the Exit button 01 18 06 3 13 PM Page 304 of 448 Users Manual If you are adjusting a Medicare PPS service item the screen will look slightly different E Adjust Service Item gt Melbourne GUEST BIE Aoministaton Scheckie At Lontiauratch Mantenance Loan semiicto Reports Hen Adjust Service Item Change the unit bill amount Select an Adjustment Type based on the type of PPS adjustment that is appropriate This is a required field e Type an Invoice description if you want a comment about the adjustment to appear on the invoice e Click the Save button e Click the Exit button Remember that adjustments are not actually applied until they are accepted Refer to section Accepting and Rejecting Adjustments 01 18 06 3 13 PM Page 305 of 448 Users Manual Supply Item Adjustment Adjust Supply Item gt Melbourne GUEST BIE ABammnistaton scneddle A Eoniguaten Menterence Login Semlicto Gepots Hep A E Adjust Supply Item e Change any of the following fields supply item quantity unit cost unit bill and total sales tax e Click the Save button e Click the Exit button Remember that adjustments are not actually applied until they are accepted Refer to section Accepting and Rejecti
145. Cross Blue Shield of Florida Units I Do Not Use Skill Sub Skill Pay Bill Rev Codel HCPCS1 Modifier DNU Add Vi VIV Remove Vi _Bemove RN OASIS Vi Update list RN Supervisory ViV SN Viv xl Cancel Skill Sub Skill Pay Unit TE ei uni P Rev Codes Mon Tue Wed Thu Fri Sat Sun 3 14 PM 01 18 06 3 13 PM Page 25 of 448 Note that when a claim is created if service codes have not been defined the following will be used as the default Visit Hour Skill Skill Rev Code 0571 0572 PCA Personal Care Assistant e To add anew skill click Add button e For each Skill input the Pay Unit and Bill Unit Hours or Visits e For each Skill enter the Revenue Codes and HCPC Codes to be printed on a UB92 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e For each Skill enter the HCPC Codes and Modifiers to be printed on a HCFA 1500 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc e Once you have entered the information for the skill click the Update List button to add it to the list e If the skill is no longer valid you may remove the skill or mark it as Do Not Use Removing the skill will remove the Revenue Codes HCPC codes and Modifiers so if you still need these for billing we would recommend that you mark the skill as Do Not Use until you no longer need the codes and then rem
146. Date screen e The Change Schedule Date screen is displayed e Double click on a day contained within the week of the schedule you wish to view or click the day and then the X in the upper right corner You may have to change the month or year to view the appropriate month SAM gt Melbourne QA Scheduler lel Ee Bie Administration Schedule AR Eoniguaton Mamtenance Login Seniicito Reports Help a A Rules Prefs Phone Sum Legend 3 A 4 b l gt I Client e Case nee 36 Change Schedule Date a 26 50 Hrs 2002 eo Cn a 7 3 a ia September 2002 fz 09713 ria S 13 7 3 4 im 8 9 10 1 15 16 17 18 09714 09 15 09 16 22 23 24 25 29 30 1 2 3 5 6 d 8 9 ZD Today 06 15 2005 sat m 09722 09723 09724 0o92 09726 a ian 09 29 m 10 04 Change the start date of the displayed schedule 4 20 PM 01 18 06 3 13 PM Page 83 of 448 Moving to a Different Client s Schedule e Inthe upper right corner of the Scheduler screen there are four buttons with red arrows called the Navigation KIKIA buttons two pointing left and two pointing right e The button pointing left to a line will take you to the first client in the list you generated when you entered the scheduling screen and used the client list screen to select your client The other left pointer button will take you to the previous client in the list you generated when you entered the scheduling screen e The button poin
147. Dortiauraton Memntenance Loan Sencha Reports Help ial XML Import Option This function will import signed plan of care and verbal order data from an XML file that has been downloaded from the Care Plan Oversight System Click the Continue button to be prompted for an input file 10 05 AM e Click on the Continue button on the XML Import Option screen 01 18 06 3 13 PM Page 200 of 446 Users Manual Look in E ImpotFiess o wl c acm_river001__ signed ml File name acm _river001 signed xml Files of type Files hd Cancel Help Bode Rage e Select the file to be imported on the Open screen e SAM will import each Plan of Care or Verbal Order in the xml file and then display a processing results log on your screen You may print this log Click the Exit button to exit e The file that you chose to import will be moved to the n xml files importfiles imported folder so that you can maintain a history of the files imported The processing results log file is also stored in this directory and its filename begins with the name of the file you imported followed by log e For each signed Plan of Care Verbal Order SAM will fill in the Received Signed date based on the date that was in the XML file Admitting Discharging Readmitting a Patient to from a Payer SAM gives the user the capability to admit discharge and readmit a patient at both the agency level and the payer l
148. File Date E Insured Relation Patient is Insured z OFFICE DATES Name HealthCare of Melbourne Melbou Start of aj Illness a N a 10272871994 pa 1 E imiar l Address 123 Main Date 7 Date 06 22 2005 3 City Melbourne Unable St Zip FL Z320 Phone 621773001 toWork 8 77 3 Hospital Fed ID 04 2544164 PIN a E Locator 2 Enter the patient s name 8 33 4M 01 18 06 3 13 PM Page 273 of 448 Users Manual Add UB92 Claim for Wesolowski Kendra gt Melbourne GUEST le Ee Bie Administration Schedule AR Eoniguaton Mamtenance Login Seniicito Reports Help UBS2 Insurance Payer Codes Clinical Codes Detail Lines OFFICE aw mlx m ooo N INVOICE DATE 0002A03587 01 Address fe Main Dates foe 31 2002 S 09 06 2002 2 Days Covered 7 Not Covered 3 0 City Melboume i i Suzpe FL A320 PROE 2700 Coins Daysi 0 Life Res Days f 0 Corp s B3 Name HealthCare of Melbourne Bill Type 323 Fed ID 04 2544164 Dept 0002 _ EMPLOYER Name PATIENT Location Name Wesolowski Kendra Status E Address fwilbraham Commons 3 el 205 Building G4 J Auth Gade City Wibraham ADMISSION DISCHARGE St Zip MA s 01095 DOB 10 06 1943 E Marital Date Hr 02 28 1 994 4 7 eesres Status x Sex Female x rar Status 30 Medical Record 00002701 Type Dischg Hr TEnter the name o
149. Florida BILLING PERIOD PAYER BILLING PERIODS 01 01 2005 01 31 2005 Ad Begin Date 03 01 2008 02 01 2005 02 28 2005 Remove End Date 03 31 2005 4 Remove Anj Enter begining date for billing period 3 22PM Billing Period Section e Enter the begin date for a billing period e Enter the end date for a billing period e Click the Add gt gt button to add the billing period to the Payer Billing Periods list Payer Billing Periods Section e Click a billing period then click the Remove button to delete it from the Payer Billing Periods list e Click the Remove All button to delete all billing periods from the Payer Billing Periods list Note that billing periods cannot overlap Also note that if a payer is not billed weekly bi weekly or monthly and no billing periods are defined no invoices will be created for the payer e Click the Profile tab to go back to the first page e Click the Save button to save your data e Click the Pay Rates button to add custom pay rates for this payer See section Defining Pay Rates and Bill Rates 01 18 06 3 13 PM Page 28 of 448 e Click the Bill Rates button to add custom bill rates for this payer See section Defining Pay Rates and Bill Rates Defining Clients To access the Client screen select menu option Administration Clients SAM gt Melbourne GUEST Edit Client lel Ez File Administration schedule AR Lonfigura
150. Generate button to get a list of all payers Or you may select by Payer Number if you know the payer number in the system Select a payer by double clicking on the payer in the list OR by clicking on the payer and clicking on the Select button To select multiple payers control click on each payer or shift click on the first and last payer e To retrieve only invoices for a particular client click the Select button next to the Client field This will cause the Select Client screen to be displayed On this screen you can either type in some or all of the client s name and click the Generate button or you can leave the name blank and click the Generate button to get a list of all clients Or you may select by Client Number if you know the client number in the system Select a client by double clicking on the client in the list OR by clicking on the client and clicking on the Select button e If you would like to select invoices for a particular Electronic Claims Submission type select from ECS drop down the ECS style that applies Ifthe ECS style selected supports multiple payers in one transmission file the Transmit button will be enabled e Click the Generate button e To select one invoice click on the invoice in the list e To select multiple invoices control click on each invoice or shift click on the first and last invoice e Click the Print button to print or the Preview button to see the invoices on the screen e Fach time you print a
151. Hours Skill Description e M Skilled RS 0827 1999 09 56 AM RiverSoft Enter description of skill Skills can only be added or modified at the back office To access the Skills screen select menu option Configuration Skills The Edit Skill screen is displayed Click the New m button to add a new skill Enter a unique Skill Code for the new skill Enter a Skill Description for the new skill This description is used in all skill lists and combo boxes Enter the amount of time that a visit represents for this new skill in the Visit Hours field This is the number of credit hours an employee receives per visit for this skill This is important because these default hours per visit will count towards the employee hours for the week and may effect when they go into overtime Check the Skilled checkbox if doctor orders should be present for visits for this new skill Be very careful to review the skill information on the screen before saving because new skills cannot be deleted after they are saved Click the Save al button Click the Exit Tl button to exit the Edit Skill screen Defining Sub Skills Sub skills are associated with skills and help further describe the type of work related to the skills i e Registered Nurse sub skill of Cardiac Rehab Sub skills may be associated with the predefined skills delivered with this system or they may be added to new skills defined by an organization Sub skills are normally ad
152. Invoices with Find Invoices with balance due that balance due that belong to payment belong to payment Apply cash to invoices Apply cash to invoices 01 18 06 3 13 PM Page 252 of 448 Users Manual Creating Invoices Claims In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates The Create Invoices screen is used to create invoices and claims for closed visits Invoices are created for the office you are currently logged into SAM gt Melbourne GUEST lel Es Bile Administration Schecule AR Configuration Wemntenance login Seniicto Reports Help fal Create Invoices x CREATE INVOICE SELECTION Office PRRs ly C Billed per Calendar Period PPS Payer Name A 1 M Mutual Insurance AARP Health Care Options AccessOne Health Care Systems Inc Ace Property and Casualty American Disease Management American Travelers Life Insurance Co APWU Health Plan Care Programs Client ALL m Create Invoices 3 31 PM Creating Invoices Claims for Payers Billed Weekly By default the Create Invoices screen is set to create invoices claims for payers that are billed
153. It is not necessary to enter the patient s Agency Start of Care date since care is not to be provided Click the Edit button next to the Agency Current Status field in order to change the patient s status to Non Admitted 01 18 06 3 13 PM Page 152 of 446 Users Manual The Edit Patient Agency Status screen will be displayed SAM gt Melbourne GUEST Iof x Bie Acrinistaton Schedule AEN Eonigauaton Memntenance Loon Seniicto Reports Help Defne Hospital Stays DQ Ne PATIE Agency Patient Connie Aseltine Client A00272 A2 Start of Care jar 01 1800 Patier Date Status Reason Addre City State Phone Birth I Sex Status O Status Date rr C Deire Reason O 12 29 PM Add a new item e Click the New LOI button on the toolbar to add a new Patient Agency Status A message will be displayed Patient does not have a Start of Care date Only status available is Non Admitted Press any key to clear this message e The status of Non Admitted will be automatically filled in the Status combo box e Enter a date in the Status Date field This date should be the date it was determined the patient is not to be admitted into the agency e Select a Reason that is appropriate 01 18 06 3 13 PM Page 153 of 446 Users Manual e Click the Save fl button on the toolbar to save the new status SAM gt Melbourn
154. Mamntenance logn samiono Reports Hep x m Adjusted Payer JAM Mutual Insurance Check Auni 1 500 00 Check RA No 1022 Unallocated Amount 1 500 00 Payment ID Jani273 Check Amount 2 000 00 1 500 00 Payment Office Melbou Payment Balance Type Amount Date Comment C Adjustment 1500 00 06722705 Type Adjustment 7 Add Remove Adjusted Check Amount 1 500 00 Date 0672272005 2 E Update Lis C t ante Cancel oH GUE 0622 2005 09 25 AM Select record to edit e Click the Adjust button on the Edit Payment screen to display the Apply Payment screen e Click the Add button on the Adjust Payment screen e Select the Type of Adjustment e Enter the correct check amount for the payment in the Adjusted Check Amount field Note The adjusted check amount cannot be less than the amount already allocated from the payment e Enter the date of the adjustment in the Date field the default is today s date e Enter acomment in the Comment field if desired this comment appears on the Payment Adjustment Report e Click the Update List button to see the new adjustment item displayed in the list e Click the Save a button to save the changes e Click the Exit Tl button 01 18 06 3 13 PM Page 294 of 448 Users Manual Entering a Refund of a Payment If all or a portion of a payment is to be refunded to a payer after a payment is closed the
155. NS Payment Log Payment Cash Application Report Payment Adjustments Report T Only Non Zero Unallocated Amounts Sea Enter the start Payment Date of the Payment records to report on 11 05 4M 01 18 06 3 13 PM Page 368 of 448 Users Manual Payroll Interface Report This report will list postings created when a Payroll Export was processed to a payroll system Payroll Posting Log gt Melbourne GUEST 3 A Payroll Posting Log 01 18 06 3 13 PM Page 369 of 448 Users Manual Payroll Report This report can be used to send to an outside payroll vender to perform your agency s payroll When run for just an agency s contractor employees this report can be used to check against invoices received by the accounts receivable department If a comment exists for a pay item it will be included on this report Payroll Report gt Melbourne GUEST Og x Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help Ey Payroll Report SELECTION CRITERIA DISPLAY OPTIONS ee Closed C Verified MV Show Visits as Hours Dates EE W Include Client Name Sorted By Service Dates PayRates Skill F Show Week Ending Totals Payroll P ene I Include Zero Pay Work Items C Show only posted items F Create Quickbooks Report posted items and adjustments within the date range Show only unposted items items and adjustments not posted to payroll Show all items and outstanding ad
156. ORDER Employee Affiliation Client Skill C Employee Affiliation Skill Client C Client Employee Affiliation Skill 01 18 06 3 13 PM Page 396 of 448 Users Manual On Call Report This report shows detailed information about visits within a specified date range that have not been verified or closed This report is generated and given to the on call person so that they have the information they need to record scheduling changes after the agency office hours On Call Report gt Melbourne GUEST ag x File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help FJ Select Report C Employee IT Not Assigned Visits Only Standard On Call Spreadsheets Enter begining visit date for report 4 53 PM The On Call Spreadsheets are specifically designed to report all information that On Call might need These spreadsheets can then be copied to a PDA device or Pocket PC for use by On Call If you choose this option and you do not have an Ini_oncall_ file path defined in your n sam ini file SAM will by default place the spreadsheet files in your n excel files folder If wish to have these files saved elsewhere edit your n sam ini and define an Ini_oncall_file path Example Ini Oncall File Path C Documents and Settings RiverSoft My Documents Pocket_PC My Documents Business 01 18 06 3 13 PM Page 397 of 448 Users Manual The following spreadsheets are created 1 C
157. Payer Tufts Associated HMO Type Plan of Care Supply Description O Status P Benzoin Tincture Swabs Ac St Ts Ce P fo Pr M l Se E Description Benzoin Tincture Swabs Select Delete Ve ist Verbal Order Status C New C Discontinued GUE 06212005 09 03 AM Pz St Additional wheelchair oxygen Pulse oximeter kangaroo pump in exsufflator suction Pe Supply Information machine 10 fr cath w NS suction cups Di a Select supply to edit or delete Entering a New Supply Verify that the information section at the top of the Edit Supplies screen describes the Plan of Care Verbal Order you want to enter new supply for Click the New m button on the toolbar on the Edit Supplies screen to add a new supply to the Plan of Care Verbal Order Fill in the Description field by clicking the Select button The Select Supply screen is displayed 01 18 06 3 13 PM Page 181 of 446 Users Manual SAM gt Melbourne GUEST Adaptic NADH Dsg 3x16 o Adaptic NADH Dsg 3x3 Pr JM Se ia Descriptio Ve B Verbal Orc J eusrarsesesss St Additional P Supply Inf Di Select desired supply e Select a Type of supply from the combo box e Select a supply category Standard Local or All Standard Click on this option if you want to list supplies that are standard across all offices Local Click on this option if you want to list supplies that are customized to your office All Clic
158. Previewing from the Edit Plan of Care Verbal Order screen eeeceescceeseeceseeeseeceeneeeseecesaeeesaee 191 Exporting from the Edit Plan of Care Verbal Order screen c cccecesscceeesneeeeeneeeeeeneeeeeseeeeecsuaeeeeseneeeseeaeees 192 Printing Previewing or Exporting from the Plan of Care Verbal Order Report screet eeeeeeseeeneeeeees 195 Exporting from the Edit Plan of Care Verbal Order Report SCreeth eeceeesccesseeceseeeseetsneeesneesseeesaeeesaee 197 Importing Signed Plans of Care and Verbal Orders ssscccsccssssccsseeccesssscccssceeeccsssscecesooeess 199 Admitting Discharging Readmitting a Patient to from a Payer ssccccssssscsssssecssssssessscees 201 Modifying the Payer Start of Care for a Payer c cccccceccccsssseceeeeeeseeeeeeseceeeeceaeeeeseseeeenaeeesseueeeeseeeeensenees 202 Discharging a Patient from a Payer rasani ae pest a potted osega dou csvie E ERS E ES 204 Readmitting a Patient to a Payer enir devs hig es OAs evi sed Hee eh hab deen Levene de tered eos alte S E S 206 Verbal Order MONG Gemenih cis csvcvcstinseviahescuiscsacestinveteupies sistessovakavedesbabevieasiesdadsoddvesusiwastecedebess 208 Entering a New Verbal Order cccssscsscssssscssccccsseccccssscccssccesscsssccccscessessssccccseesesssssscocsceeeess 208 Defining Verbal Order Content ccccsssscsssccsccssssseecsssssccccscceesessssscccceesssssscccssseesssssscooceee 211 Modifying
159. Reports Help x IY gt gt aol axi T CLIENT INFORMATION Client 002512 A3 COMPLIANCE RULE z Chent Donie wiks Rule Type Doctor Order Auth Payer Health New England i Skill Subskill SN b Cert Period Dates 09 20 2002 11 18 2002 Min Max O Hons Frequency 1 00 to 1 00 Visits a Day x Days Duration for 5 Weeks Months Days Interval every 0 Weeks COMPLIANCE RULE COMMENT Months Start Date 0572372002 S End Date 05 27 2002 F PAI 09282002 09 56 AM e Click the New m button on the toolbar to add a new doctor order type compliance rule e The Add Doctor Order screen is displayed 01 18 06 3 13 PM Page 214 of 446 Users Manual SAM gt Melbourne GUEST lel x Hie Administration senedle AR Lontiauretcn Memntenence logam Seaniioto Hepots Hep x A A ax Os E Add Compliance Rule CLIENT INFORMATION Client 002512 A3 COMPLIANCE RULE z Client Denia Wike Rule Type Doctor Order Auth Payer Health New England E Skill Subskill e A Cert Period Dates 09 20 2002 11 18 2002 m aX C Hours Frequency 1 00 to 1 00 G Visits a Week z Days Duration for 1 Weeks Months Days Interval every 0 Weeks C Months COMPLIANCE RULE COMMENT Start Date E End Date E Select the skill and subskill e Notice that the Rule Type defaults to Doctor Order e Se
160. S C Office Client Payer Age Invoice Date Age Creation Date C Office Class Payer Summary AGING BUCKETS DAYS SALES ONLY SHOW CLIENT S 7 PAYER S WHO Age as of 0672272005 2 OUTSTANDING DSO Have any balance i Period 1 End Period Credit Sales C Have balance older than period 1 eno n includes invoices C Have balance older than period 2 Period 2 End between C Have balance older than period 3 Period 3 End mas C Have balance older than period 4 Period 4 End 03 1 8 2005 sf C Have balance older than period 5 Period 5 End and x Have balance older than period 6 i 0671772005 e Period 6 End 3 AND BALANCE IS OVER 0 00 Report Options J Ext Payer Based Aging By choosing the Office Class Payer Client sort option a payer based aging may be produced This report will show all invoices for a given class payer sorted by each payer The Invoice Aging report by payer will report a Best Possible Days Sales Outstanding value in addition to the Days Sales Outstanding DSO value Enter a date range used to calculate the period days This date range will default to the last 13 weeks ending with the last week ending date You may optionally change this date range The following is the calculation for both values Days Sales Outstanding DSO Total AR period sales period days Best Possible Day Outstanding BPDSO Period AR period sales period days Client Based Aging By choosing
161. Select Manager Marlyn J Borowiec Select Secondary Physician Select IV Include Case Manager on Plan of Care Verbal STATUS Final Document Printed Start of Care 77 4 Physician DB inal Do tinted NO Created 0372372002 History Mailed 77 4 Received Signed GUE 068212005 11 16 AM Payer Payer Start of Care 06 08 2002 Status Active Payer Discharge Date aj ray Edit Payer Status Click the Find button on the Edit Plan of Care Verbal Order screen The Plan of Care Verbal Order List screen will be displayed Enter the Certification Begin date 11 16 AM SAM gt Melbourne GUEST lel x Ble Administration schedule AED Eonnauaton Metntenance ogm sanmiomo Reports Help F Plan of Care Verbal Order List E PATIENT LIST ORDER LIST DIRECTION Cert Dates Patient Michael Wilson Sa C Ascending Client 20014542 C Physician Descending POC Type Cert Begin Cert End Payer Physician POC YO Date 10 06 2002 12 04 2002 A1 Medicare Verbal 08 07 2002 10 05 2002 A1 Medicare KRISHNAN A BABUA0001699 09 08 2002 Verbal 08 07 2002 10 05 2002 A1 Medicare JONATHAN SLATE A0001594 09 09 2002 Verbal 08 07 2002 10 05 2002 A1 Medicare KRISHNAN A BABUA000136 Plan 08 07 2002 10 05 2002 A1 Medicare KRISHNAN A BABUA000120 Verbal 06 08 2002 08 06 2002 A1 Medicare JONATHAN SLATE A000105 Verbal 06 08 2002 08 06 2002 A1 Medicare JONATHAN SL
162. Self Pay gt Ready C Invoice Dates To 7 Client CLIENT 7 PAYER C UB 92 Suspended Generate HCFA 1500 C Draft Final i Generate C Not Transmitted Reset List 0002A04073 01 Standen Gladys 783 31 0172772003 E Select the desired item 3 38 PM If you would like to view Invoices not Claims select the Invoices option If you would like to view Self Pay Invoices check the Self Pay box If you would like to view UB92 Claims select the UB92 option If you would like to view HCFA 1500 Claims select the HCFA 1500 option If you would like to see All Versions of the Form that you have selected select the All Versions option Making adjustments creates additional versions Selecting Creation Dates the date that the invoice was created or Invoice Dates the week ending date that the invoice was created will control which items are displayed and what date type is displayed in the date column 01 18 06 3 13 PM Page 260 of 448 Users Manual Printing Self Pay Invoices The Print Transmit screen may be used to print multiple self pay invoices at once When creating Self Pay invoices you now have the option to direct SAM to print Terms Due by xx xx xxxx The date printed will be the last day of service on the invoice of days If that date is before the current date then the current date will be printed instead To enable this feature add the following line to your n sam
163. Specific Times option should be unchecked This will cause the text of the visit box on the schedule to appear in italics If the visit represents a supervisory visit or an assessment visit in addition to the normal service provided check the Supervisory Visit and or the Assessment Included options Supervisory visits are reported on the Census Episode report You can enter a comment specifically for this visit and a short message which will print on the invoice underneath the normal invoice line for the visit If the visit is a Confirmed status the Timeslip Verified check box will be enabled Note that checking this box changes the status of the visit to Verified If the employee has already been paid for this visit or the employee has a salary check the Already Paid check box This prevents the payroll entry for this visit to be exported to the payroll system Enter any travel money to be paid to the employee this information may not be known until after the visit has occurred Enter any travel money to be billed to the payer this information may not be known until after the visit has occurred Enter any sales tax this information may not be known until after the visit has occurred To save the unassigned visit click on the Save i button and press the Exit Tl button to return to the schedule screen The new visit will be displayed on the schedule screen 01 18 06 3 13 PM Page 98 of 448 Daylight Savings Time Remember
164. Summary Selection gt Melbourne GUEST TE File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help E Select Report Select office 3 18PM 01 18 06 3 13 PM g GL Summary Selection _ Generate f Report Options J Ext Select the office and period range to report cash applied and change in AR totals by payer class Period s selected should be closed or must have K GL reporting done at least once Office 1 i From 2005 06 06 01 2005 to 06 30 2005 gt To 2005 06 06 01 2005 to 06 30 2005 gt I Report only for Week Ending EENEN T For Medicare show PPS sales instead of visits Page 362 of 448 Users Manual General Ledger Reports These reports show cost and sales unqualified qualified sales and cost by discipline payments and cash invoice adjustments and workers compensation information for past periods the current period or a date range for one or multiple offices For Interim agencies we recommend running the Weekly Licensed Unlicensed Sales report to report weekly royalty sales to Interim Corporate Period Sales Cash Adjustment and Worker s Compensation Reports gt Melbourne GUEST lel Ee File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help ai Period Sales Cash Adjustment and Worker s Compensation Reports otice z SORT SALES REPORT BY Payer Class Period 2005 06 06 01 2005 to 06 30 2005 x __ Transaction
165. Times Invoice No All Include Item Adjustments C Client Payer Invoice MV Include Employee Names c C Payer Client Invoice C Daft I Include Skill Totals Report C Transmitted I Include Only Invoices C Not Transmitted Missing Claims SELECT CLIENT PAYER Client JALL zl Payer JALL 7 I Show only DSO Ignore Invoices Generate Report Options Ext 01 18 06 3 13 PM Page 270 of 448 Users Manual View Invoices Claims The View Invoices Claims screen lets you view the details of an invoice print or preview an invoice and create view edit print or preview a claim associated with the invoice SAM gt Melbourne GUEST lel x Ble Administration schedule AED Eoniauaton Metntenance ogm sanmiomo Reports Help Invoice List X To Office Suspended Payer C Draft Final Client Not Transmitted SELECTION CRITERIA 6 17 200 Invoice Date 77 aj C Service Date All C Ready m INVOICE STATES ORDER BY Invoice C Client RFT Invoice Number Enter a starting date for list of invoices by invoice date 4 39 PM Viewing or Printing an Invoice e To access the View Invoices and Claims screen select menu option AR View Invoices Claims Invoice Inyoi Amount Date The Invoice Details screen will be displayed Click the Find button Enter From and To dates of the invoice associated with the claim you want to edit Either select a payer or
166. V rbal Order scicscsdsccdesscesset sstesesecscccasavengnassncdscdecedeacannosesenedeaadoosecsssupscscscsossbeseeessess 212 Deleting a Verbal Ord er siiscsiscscesscccccccensvessssscsnnssvesssosssedsesdocsscseovsestessocecoseevuseaaseseecoesentacsdcdeseoscveces 212 Doctor Order MANAGEMNENL ienscitiasadesiniSivieuintnass shvcescoisusntepsaniebedasbivsepouctpuspapbeaetsiebdeetdduisdenvesnsue 213 Entering Plan of Care Verbal Order Doctor Orders cccssssssccssssscssssssecssssscescsssseesosseeees 213 01 18 06 3 13 PM Page 6 of 448 HCFA ASS Locator Mapping csivosivivedeivasstassredececuskesivestuasvedivsassbosesdsuuvauedsce eaususuawavevesiaieneateess 217 OASIS Assessment Management vesissscnvcssscsassssavasciavsecsssacsevesneenuayersseveneseessoasecenasavssasooeessdouuees 218 Entering a New OASIS Assessment sssssoecssesssssooocssssoocecesssssooocesssssssoceesesssooocssesssssoceesessssossse 218 Modifying a OASIS Assessment ccccccsssssssccsssccsssseeccsssccccssccesessssccecccesssssssccessceessssssccccsssoeess 221 Deleting a OASIS Assessment ssscccccsssssscsssccssscccccsscecessscccsssccesssssccsscsceeesssssccssssesessssscssoes 223 Printing a OASIS Assessment cccssccscsssssscssscccsssecccsssccccsscceecssssccscccessssssccccsseesssssssscoseeeeess 223 Exporting OASIS ASSCSSINCHUIS ciccssssccssscvessvnessosesdesiocecosssdsesivesnecsielodecsderassotsbesoderieeniassedssecedene 225 How to Submit an Inactiv
167. a user that has been designated as a System Administrator Command Window This feature gives access to a Visual Fox Pro command window and has been added for troubleshooting purposes 01 18 06 3 13 PM Page 336 of 448 Users Manual Defining Accounting Periods The accounting periods your company uses must be entered into so that all the information for a period may be locked down and transferred to the General Ledger Accounting periods are defined using the Edit Accounting Periods screen e To access the Edit Accounting Periods screen select menu option Configuration Accounting Periods Edit Accounting Periods gt Melbourne GUEST Bie Administration schedule AED sontauratch Memntenance loan Seniiicio Heports Hep x D mixli Period Quarter Number Start Date End Date Closed 0272972004 0373172004 Fiscal Year 0473072004 05 31 2004 Quarter 06 30 2004 07 31 2004 Period Number 08 31 2004 09 30 2004 Start Date 10 31 2004 11 30 2004 End Date 12 31 2004 01 31 2005 02 28 2005 03 31 2005 04 30 2005 05 31 2005 06 30 2005 07 01 2005 07 31 2005 ete eA Rea List of fiscal periods for the company 1 57 PM e The Edit Accounting Periods screen is displayed e If no accounting periods have been defined you must add them e Click the New m button e Type in the Fiscal Year four digits e The Quarter will default to 1 press the tab key to accept this default or type ov
168. aageeesaacehds a e a TL 132 Addins Service Items s c cccsccecsnesssecesecevenenncedsdecectcsedesessscosossesasdcsenvanenesssosssadeonsnccecesoscteaasssesseseensonse 132 Adding Pay Items siccscccsccccecsseswasccs cdccssessenssscecevevessenssseessscnvdbessesosdsunseecsscsdsdecsnwacasdssssseneecsoncsessdesnnses 135 SHOW COMPliances c ccssecesssssesecerevensvncdcscvsecacscaccossnsascdasssedervevessssscosssenscusessdesesesceteddosssenseeassesesoses 138 SHOW Employee OT C iscsssisscisscdescesecosesossesscssessesssnspsgessaassdssovacdecceseasivcadvasecssesesesedesdedceovabacesesesseses 138 Printing Post Verification Reports csscccscsssssccssssecsssscccssseesessssssccssesessscccesssesesssssccsscesoeee 138 Calculating Overtime at the Front Offi Ce ccccccccssssssscccssscsccsscccscsssccccssscecsscsssssssssesscsssssssesoes 139 Closing the Week after Verification at the Front Office ccccscsssssscccssccsssceeccsssscccssoeeesesees 141 OVETTME REPOME siciiscccccesecssccssscstvbuonceescescsvesaasesesoscenasdaascccendeacasdsUessSewsdensecceseseessessscsseesnsaoaseseeseess 142 Salaried Visits Information ccccccscsssscsssssscssssssccssssssccsssssecsssssscssssssesssssssessssssssssssssscssosssees 144 Verified Visit Report with Overtime csssccccccsssscessssccsssssccsssceesssssscccccsescsssssccssseseesssssooeees 144 Patient Management soass sas scuctibisecsss be sscdiaesesiccecveitesstdes ciatouertivsiseeis sovuialisu
169. abeauneinessteaiuddesuusines 296 Invoice Aging Report ccsssccsscccssccssccssseeecscssssccesccesessssssssccesscssssccecccessecsssscceccessssssccoesssosees 296 THVOICE A GIO ose feved cde seenssac e e Sevsiveg Sevensnalecsgueaceoes siescdovngunc suede we ieeessiad a E E T 296 Generating Statements iiss cssscdesidccscnassscescvesacossessdsouoseadsddessoesssvevecesecenasacesocesdecesesensasdecdunsdcasssceassses 297 RIENE E dees ods ids Sans wees S T E T AAE E AEA 298 01 18 06 3 13 PM Page 8 of 448 The Account Log Screeiiicccssscscsevesasesosesescsesccsssdecscesonasessesscsctstcacedesessobenssesesevosesssecasacdcestvouaweseses 298 Adda Account Lotes renere tens cevsanueeh ute E EE E AE ceedevstten TERE 300 Modify a Account LOP seresa a an a a a i e e TEE 300 Delete d Account LOS zirrin a a a r daR E EEEE 300 Item and Invoice Adjustments sseoosoessssssoocessessososessssssoocesssssssoooesssssoocessssssssoocssssssssososesssssseese 301 Item Adjustments 2 0 5 csecesesasasesscevecensvaissesdsodcscsacscossessedsccdessdsdsennseasssccdescsnandavsssdsenededssssesssssasceonsnses 301 Visit AC JUSEMENE ccccsscessscdscosssessucsisc scebeaasceseccsceovocevevevevescnsanscocesceuntaueioSdcssedessenaascestesssadesesesevsoasoons 303 Service Item AdjUsttnient s csscesossecsscesesesssoscsesnsaccccccossseececessscsensecasoessosceessdenssecesoossanssseoosens 304 Supply Item Adjustment ccccccssccscssssccsssccccssscccsssssccssccesecss
170. access the Physicians screen select menu option Administration Physicians e The Edit Physicians screen is displayed Edit Physician gt Melbourne GUEST Bie Administration Schedule AE ontiguratcn Maintenance logn samico Reports Help E E na Bong i Log p nl Edit Physician x lt gt Alo fall 9 Be UPIN Gti i Select Physician Name aS I Do Not Use ABDELKADER Title JMD o g Addess pemn Zip Code 01069 Palmer MA 01069 yi Phone 413 267 9101 FAX License Number es oo License Date 0472072003 S Date Verified 057017200 2 General EMail dd POCAVOEMailAdd POC VO Submission C Mail EMail Claim ID a Enter physician s UPIN PAI 0182002 09 41 AM e Click the New m button to add a new physician e Enter a unique UPIN for the new physician Click the Select button to search for the physicians UPIN e A physician UPIN may be up to 12 characters The UPIN must be unique per physician SAM only allows input of UPINs where first character is alpha followed by 11 alpha numeric characters Special characters and punctuation characters are not allowed e How UPINs appear on claims e A standard UPIN begins with an alpha letter and is followed by 5 numeric digits e Ifa UPIN has less than 3 characters therefore not standard the claim will show OTHO000 e If you do not know the UPIN for the physician you may use one of the follo
171. ady exported the OASIS Assessment the status is equal Exported be sure to input a new correction number on the initial OASIS Assessment screen The Edit OASIS screen will be redisplayed 01 18 06 3 13 PM Page 222 of 448 Users Manual Deleting a OASIS Assessment You may need to make modification to an existing OASIS Assessment due to a rejection etc e To access the OASIS Assessment screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like delete an OASIS Assessment for e Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical Information section of the screen Refer to section Admitting a Patient into the Agency in this manual e Click on the Define OASIS Assessment button e The Edit OASIS screen will be displayed with the Patient Name field filled in with the name of the patient selected Once the Edit OASIS screen is displayed make sure the correct Patient Name is displayed on the screen e Press the Find al button to locate the OASIS Assessment you want to Delete A screen will be displayed that lists the OASIS Assessments for the patient Highlight the assessment you want to delete and either double click or click on the Select button The Edit OASIS screen is then displayed with the OASIS Assessment that
172. agram sssecsesssssossccssssoocesesessssoocesesssssosoosssssosesee 248 Billing Medicare PPS Diagram ccccsssssssscsssccssssecccssssscsssceessssscccsccescssssocccssceeesssssscccsorsees 249 Medicare PPS Invoices amp Claims Diagram ssscccccssscsssssecccssssccsssceesesssssccscceesssscscsssseeeees 250 Entering Medicare PPS Payments amp Cash Applications Diagram ccccccsssssssecssssssseeeeees 252 01 18 06 3 13 PM Page 7 of 448 Creating Invoices Claims cccccsscsscssssccssscccsssceeccssssccccssceseccsccssecseecssssscccsceeesesssssessseseesssoees 253 Creating Invoices Claims for Payers Billed WeeklJ sscccssssssscssssscssssssecssssssscssssssecsssseees 253 Creating Invoices Claims for Payers Billing per Calendar Period ssscssssssscssssseessssseees 254 Creating Invoices Medicare PPS ssscccsssssscsssssccsssssecsssssscsssssssssssssscsssssescsssssescssssssesossesees 255 Print Transmit Sereen visuciscovucicuuscs ccaspvunusciyssesissansasaneavsiueaoouadeanssscrsoupbespeasessdeoebuatenspissaaseaaaasite 260 Printing Self Pay Invoices vssicicscssvcccscedvsctsscsarsvenascssadensanananacecdccstoasccossosssonananssesdecsucssasssssosseessescsees 261 Printing Invoices for Payers csscosscesssessccccdessecccsseccssscesdeccessenasssccesuansecosecevesensvecessecescsensasnsdees 262 Printing Claims for Payers secssscsdsdecsdedesssccsccccssesssccesscovenasnna
173. all Point of Care information if this is the single payer that should be used for any clinical information or visits that may be imported by a Point of Care system that is interfacing with SAM Invoicing Information Section e Select an invoice method Percent f the insurance policy pays a percentage of the cost of service select this invoice method and enter the percentage that the insurance company pays may be as much as 100 Co Pay if the insurance policy requires that the client co pay a portion of the cost of visits select this invoice method and enter the dollar amount per visit the client is to co pay e Enter the frequency of supervisory visits for this client in the Supervisory Visit Freq field The payer s default value is displayed 01 18 06 3 13 PM Page 43 of 448 e The Bill Notes field is used to customize how a bill is created for this client payer relationship You only need to populate this field if directed by RiverSoft e Click the i button to save the new client payer relationship Adding Client Payer Requirements Client Payer requirements are used to override the payer s default billing requirements Certain clients may have different billing requirements than that is normal for this payer Normally the payer s default requirements are sufficient e Click the Client Payer Requirements tab on the Edit Client Payer screen to override the payer s default requirements The Client Payer Requirement
174. all schedule orders and how many weeks or months or schedule are to be created SAM gt Melbourne GUEST Scheduler Ble Administration schedule AED Lonfiauratcn Meintenance logn samomo Fepots Help ENI Copy Visit Wizard Step 2 Copy Current Schedule Week Month Forward Copy Which Orders and How Far Forward Copy Same Week C Month as Selected Visit Which Orders Selected Orders Only C All Schedule Orders RN Pedi Hig of Weeks M onths 14 stating 170272002 2 Interval Copy Every 1 a Weeks Months selected week month will be copied with the specified interval Keep 2 Days Between Visits specified number of days between visits will be maintained Go back to the previous page 2 19 PM This screen also allows monthly weekly and daily intervals to be inserted into the created schedules The Next button will invoke the standard copy wizard configuration screen and the screen after that is the copy wizard finish screen Update Visit Wizard The update visit wizard allows a set of visits to be updated at the same time To do this the system must first be told what visits should be updated This is done using the Step 1 screen 01 18 06 3 13 PM Page 116 of 448 SAM gt Melbourne GUEST Scheduler BIE Barmnastreatit Boule Ai Leontiguraton Memnterance Login semota Heports Update Visit Wizard Once the system knows what visits are to be updated it must be told what informa
175. amtenance Loan Senco Reports Help x Orders Goals Medications Compliance Rules Recert Copy Diagnoses Surg Procs Supplies Safety Ete JEJ 4 E gt I aoli fal x gt Us PLAN OF CARE VERBAL ORDER Client 002512 A3 VERBAL ORDER INFORMATION Verbal Order Date or Final Document Printed POC A0001548 MISCELLANEOUS Patient Name Jennifer willse Agenc Agenc Start of Care 0572372002 Status Aoive Medical Rec No O02512A3 HI Claim No 022324598 02 Type Plan of Care 60 Days Cert Begin MAMA a Cert End 14 1 8 2002 2 Diggers 73308 Payer Comment a fal Health New England N 05 23 2002 11 18 2 z Primary Physician c f DARRENONEIL SCS ase DARREN O NEIL Select Manager Charissa Rose Select Secondary Physician Select IV Include Case Manager on Plan of Care Start of Care 77 4 Physician DB Payer Payer Start of Care 05 23 2002 Status Active Payer Discharge Date aj ie Edit Payer Status Verbal STATUS Final Document Printed YES Created 03710 2002 History Mailed 09 23 2002 2 Received Signed 09 25 2002 E PAI 09262002 09 04 AM Enter the Certification Begin date 12 36 PM e Click on the Compliance Rules button e The Edit Compliance Rule screen will be displayed SAM gt Melbourne GUEST lel Ea Ble Administration schedule AR Lonfiguration Memtenance logn samiono
176. an of Care e Enter the Cert Begin date for the Plan of Care This date must be equal to or greater than the patient s Agency Start of Care date displayed on the screen The Cert End date is automatically filled in with the date 60 days after the Cert Begin date you entered if you are not editing an existing Plan of Care The Cert End may be modified The Payer combo box is positioned to no payer but it is filled in with Self Pay and other valid payers for this patient for the certification period entered e Make sure the Cert End date contains the date you want for the Plan of Care e Select the correct payer for the Plan of Care in the Payer combo box e Enter the Verbal Start of Care optional this date will be placed in Locator 23 on the HCFA 485 At this time you have entered the preliminary information for a new Plan of Care shell Make sure that all of the information displayed on the Edit Plan of Care Verbal Order screen is correct This includes the fields Type Cert Begin Cert End and Payer e Click the Save i button on the toolbar to save the patient s new Plan of Care shell e The POC will be filled in with a unique number that the system assigns to the Plan of Care 01 18 06 3 13 PM Page 162 of 446 Users Manual NOTE The Start of Care date on the HCFA 485 Locator 2 associated with a Plan of Care is filled in with the contents of the Payer Start of Care field on the Edit Plan of Care Verbal O
177. ance A I M Mutual Insurance A 1 M Mutual Insurance cc a Payer ALL x Pay Class ALL z Account Name Generate Office Name Back Office Sub Account Name All Clients All Clients Cox Andrew 01 DeForge Pearl 01 Flores Robert 01 Griswold Celia 02 Jensen Magdalena 01 Kastarakis Yelena 01 Lockhart Susan A2 Stop amp Shop Christine 01 Melbourne Melbourne Melbourne Melbourne Melbourne ALM Mutual Insurance AARP Health Care Options AARP Health Care Options 9 30AM e To select the appropriate account log you may choose by any combination of office payer pay class client or client status Click the Generate button e Each account name is listed based on how you defined the attributes at the top of the screen Then each sub account name is listed followed by the office name Select the account sub account that you wish to add modify or delete an account log for Edit Account Log gt Melbourne GUEST oy x Aarinistaton Sehedule AE onfauratcn Memtenence logn Samoo Reports Help SB s gt aD Gi x gt Be Select all or a particular office dit Account Log Office 0002 Melbourne Account No 002658 01 7203 Account Name A I M Mutual Insurance Total Charges 184 43 Sub Account Cox Andrew 01 Total Adjustments 19 18 Contact Total Applied Cash 165 25 Phone 800 788 5520 EXT Account Balance 0 00 Cr
178. and click the Close Week button Overtime Report If the close week function detects that some employee have overtime an overtime screen will pop up and display the overtime cases It is a good practice to print this overtime list every time it is displayed then cancel the close week process to correct any overtime problems and or print a new verified visit report that shows the overtime information 01 18 06 3 13 PM Page 236 of 448 Users Manual SAM gt Melbourne GUEST BIE aton scnedule At configuration Mantenance Logit semlicto Reports Hep fal Information The following visits pay items contain overtime hours They are displayed as overtime double time No Update Print the contents ofthelist SBP e Click on the Print button to print an overtime report e Click on the Cancel button to cancel the close week function We cancel the close week function when we encounter overtime so that we can print a new Verified Visit Report that includes the overtime calculations Or you could Calc OT then print the Verified Visits Report and then Close the week 01 18 06 3 13 PM Page 237 of 448 Users Manual Salaried Visits Information The following visits are beyond their respective employees salaried visits Pressing Continue causes close week to continue Cancel allows rates and or hours to be modified before closing the week If verified visits exist for salaried employee and t
179. ar based on the end date of the rule will be purged nightly by default If you wish to modify this default time frame add the following line to your n sam ini file where is the number of months back to keep compliance rules Ini Comp Rules Purge Month The Edit Compliance Rule screen may be displayed in one of two ways 1 If you are building compliance rules for Self Pay clients including facilities select menu option Administration Clients click the Auth button The Auth button will only be enabled if you have entered valid skills for the client on the Client Skills and Codes Self Pay screen because compliance rules may only be added for valid skills 2 If you are building compliance rules for Client Payer relationships not Self Pay select menu option Administration Clients click the Payer button and click the Ins Auth button The Ins Auth button will only be enabled if you have entered valid skills for the client on the Client Payer Skills and Codes screen because compliance rules may only be added for valid skills e The Edit Compliance Rule screen is displayed 01 18 06 3 13 PM Page 47 of 448 SAM gt Melbourne GUEST Edit Client Payer ile x Bie Administration Schedule AR Dontaureton Mamtenance Login Seniicito Reports Help E Edit Compliance Rule x ii 4 gt J AlO Elx Ws CLIENT INFORMATION Client 002499 A2 COMPLIANCE RULE Client Andrew Benson Rule Type Insurance Authorizat
180. aried Visits Report gt Melbourne GUEST lel Ee File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help x APPLICATION GROUP Billing Manager C Care Ma amp Salaried Visits Report x Schedul From EX To ra Ls l Generate ff Repor Onions Est Enter the from Invoice date 4 54 PM 01 18 06 3 13 PM Page 402 of 448 Users Manual Service Item Report This report shows all service items in the system within a specified date range A specific client and or service may also be specified ii Service ltem Report gt Melbourne GUEST Service Item Report PORT DATE ni DA 06 23 2005 y 01 18 06 3 13 PM Page 403 of 448 Users Manual Service List Report This report shows all service items that may be chosen to add as service items for clients You may select to report your Standard and Local services Standard only or Local only Service List Report gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help x APPLICATION GROUP Report Name bima become Compliance Summary Report Standard Only C Local Only recae B enert Onions eat Select standard and local supplies 9 55 AM 01 18 06 3 13 PM Page 404 of 448 Users Manual Supply Item Report This report shows all supply items in the system within a specified date range A specific client and or supply may also be specified
181. associated with defining each of these parts of the i e Defining Plan of Care Verbal Order Orders Fill out the contents of the Verbal Order as follows e Click on any of the following buttons to enter the Verbal Order associated information Orders Goals Medications Diagnosis Verbal Order Surg Procs Supplies 01 18 06 3 13 PM Page 211 of 446 Users Manual e Each of these buttons will display a screen on which you can define the associated Verbal Order information e Make sure all the information on the screen is correct e Click the Save a button on the toolbar to save changes made on the screen e Click the Exit T button on the toolbar to exit the screen The Edit Plan of Care Verbal Order screen will be redisplayed You may preview the Verbal Order contents at any time by clicking the Preview Al button above the toolbar on the Edit Plan of Care Verbal Order screen You may also print the Verbal Order by clicking the Print Ej button above the toolbar on the Edit Plan of Care Verbal Order screen Modifying a Verbal Order Refer to section Modifying a Plan of Care Verbal Order Deleting a Verbal Order Refer to section Deleting a Plan of Care Verbal Order 01 18 06 3 13 PM Page 212 of 446 Users Manual Doctor Order Management Entering Plan of Care Verbal Order Doctor Orders A Doctor Order describes a type of service the patient is to receive as prescribed by the physician The Doctor Order becomes a rule governi
182. astedteebeswigosabecsouiapives 145 Defining a Patient Scccccesscissesestacesssscsssssosasssscccesesovacaccvevevesenatescotstevesasaisdeoosedennesanicdssebasedasssesossosseees 145 Finding a Patents cicsccccestissteasasstecessesvesccccccecdevenasssesessssseasbueseseccestennssecessesunadavedesesanseccasdedssesesmoannsen 145 Admitting a Patient into the ABENCY iisisccsscesisriosssoesiersceasassssierecersousssedecsosverisocssrisocnesvenassobsdeces 148 Modifying a Patient s Agency Status ssseessssssssooocesessoocccssssssooocessessssoceesesssooecsssssssoocesssssssoosee 151 Non Admitting a Patient into the Agency ssessssssssssoccessssssoecssssssoocesssessssooessessssssessssssssoseessssssoo 151 Placing a Patient on Hold in the AgenCy sesssssssseoooeesssssssosssssssoooessesssssoceccessssssosesssssoocessssssssooee 154 Discharging a Patient from the Agency s sssssssocssesssssocosssesscosessssssseococsesssssooeessssooeeesessssssseessssssss 157 Plan OF Care Management sicsgie soak tes caiccsekudasendinarsensicoesdashceuekuddsssecsptaludsuste rossos sasons aeeiio rosies 160 Entering a New Plan Of Care sscccssssssssssssesssccccssceeccsssscccssceeesssssccssccessessssccccssesessssssoceseeseess 160 Assigning the Primary Physician to the Plan Of Care cssscccssssssscssssscsssssescssssescscssseesooees 164 01 18 06 3 13 PM Page 5 of 448 Assigning the Case Manager to the Plan of Care ssccssssssssssscssssscc
183. ate you specify but there is not a corresponding transfer assessment 5 Patient discharged without Discharge or Transfer Assessment reports patients that were discharged on or after the date you specify but there is not a corresponding discharge or transfer assessment 6 Plan of Care without related OASIS assessment reports patients that have a Plan of Care with a cert begin date on or after the date you specify but there is not an assessment associated with the Plan of Care 7 MO825 answered No EOE created yet 10 or more therapy visits closed reports patients that have the Therapy Need question on the OASIS Equip Therapy screen answered as No an EOE has been created for the associated Plan of Care on or after the date you specify yet 10 or more closed therapy visits skills PT OT ST PN PT Assistant PE PT Eval OA OT Assistant OE OT Eval SA ST Assistant and SE ST Eval were found between the Plan of Care s cert begin and cert end dates MO825 answered Yes EOE created yet less than 10 therapy visits closed reports patients that have the Therapy Need question on the OASIS Equip Therapy screen answered as Yes an EOE has been created for the associated Plan of Care on or after the date you specify yet less than 10 closed therapy visits skills PT OT ST PN PT Assistant PE PT Eval OA OT Assistant OE OT Eval SA ST Assistant and SE ST Eval were found between the Plan of Ca
184. atient s status The Edit Patient Agency Status screen will be displayed SAM gt Melbourne GUEST x Bie Acministaton Schedule AG Configuration Memntenence Loan Semiiote Reports Help i Bi 1a GTI sh Log IE p ERD Define Hospital Stays ol j ge PATIE Agency Patient Joshua Adkins Client A00571 01 Start of Care Joe 7 2005 Patier Date Status Reason Addre City State Phone Birth I Sex Status Status Date or CDe Reason Add a new item 9 18AM e Click the New m button on the toolbar to add a new Patient Agency Status e Make sure the status of Active is displayed in the Status combo box e Enter a date in the Status Date field This date should be the date the patient is admitted into the agency This date will become the patient s Agency Admit Date The Agency Start of Care date displayed at the top of the screen may be used as a reference for this value e The Reason field is disabled for a status of Active but will be enabled for other statuses 01 18 06 3 13 PM Page 149 of 446 Users Manual e Click the Save i button on the toolbar to save the new status e Verify that the list on the Edit Patient Agency Status screen now displays a row with the Date column containing the correct Agency Admit Date value and the Status column containing Active for the Agency Current Status value SAM gt Melbourne GUEST lel Ea
185. ation The pages on the Edit Payer screen are Payer Profile Payer Requirements Payer Skills amp Codes and Payer Calendar The Profile page is the first page displayed upon entry to the Edit Payer screen SAM gt Melbourne GUEST Edit Payer el x Bie Administration Schedule AR Eoniguaton Mentenance Loon Seniictto Reports Hep Payer Profile l Payer Requirements Payer Skills amp Codes Payer Calendar Pay Rates _BillRates N VITALS Payer 7102 Payer Name feo TT ID 120213 Address Attn Provider Claims PO Box 9197 Bill Type z Zip Code 32905 5197 Mask Moian Melbourne FL 32905 Bill Site Front Office Back Office ey Billing Supervisory Update Client Payer Frequ Vie Freq Differentials Phones 1 111 111 1111 Extension Weekly 1 00 Holiday 2 o M a a Sema Service Skill Employee Skill Invoice Comment ee 3 Blue Cross Blue Shield of Florida Payer Class Insurance z i M National Payer I Do Not Use P Praa J None hi f BILLING CLINICAL REQUIREMENTS Submitter 1D ECS Style No Electronic Interface z C Bi Weekly Days 1 00 Overtime C Monthly C Weeks 2 00 Double Calendar C Months __0 00 Weekend BillNotes C O y n gt alol axlo Ws V 15 Min Units Net Due Upon Receipt GUE 06132005 03 02 PM Enter the payer name 3 02 PM Profile Page The Profile page is used to en
186. ation Group Reports Accounts Receivable Function Group Reports 401k and Paycheck Reporting This report uses the SBT data to report 401k eligibility contributions paycheck information and State W2 currently for Massachusetts only information If you are not using SBT this report will not report any information 401k and Paycheck Reporting gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help i 401k and Paycheck Reporting x 01 18 06 3 13 PM Select the offices or company to report for Code Office 0001 Back Office 0002 Melbourne Company State ik MA FL Company St Fed Tax ID Password l From Date or As Of Date 06 22 2005 2 C 4 To Date Report Type Eligibility T All Employees V New Eligible Only Contribution Paychecks Sort By Name Sort By Check No ord Only C Mass W2 C Wilmington W2 Page 360 of 448 Users Manual Adjustment Report This report shows all item and invoice adjustments in the system T AAAI Add 00004 01 18 06 3 13 PM Page 361 of 448 Users Manual General Ledger Cash AR Summary This report will show cost sales adjusted sales payments cash applications AR sales cash applied hours and shifts It is important to run one of the General Ledger Reports to populate the general ledger table for the period selected prior to running this report G
187. ation Record ssscssssssscsssssscsssssscssssseccsssssescssssssesssssesesssssessscseeee 229 Importing OASIS ASSESSINENIS cincsissiessscncsevnessosersersocesoossdecdivecnedsdetececsceuasdessbetederisensesdecesaveuens 231 Calculating Overtime at the Back OffiCe cccccccccssssssscccssscsscsccccssssssccsssceccsscsscsssseessssssesssssees 233 Processing Weekly Payrol sscisssiiscssisseievsswads anitovascban sibs sssasdads snasedavsicsavenigacsseassbestavadsnaseeaadaeiees 235 Closing the Week at Back Office ccccccccscsccsssscosccessnsscessccevooncssscesssensetensssscoesesenssssessssenseavscseosssee 235 COVETFIME REPOFE ssccccccsasedecescccsicsctcsesescsssstesecccccccessecouavanescevsessencesededescNeusanascedseesesecesesssesenswouensseosese 236 Salaried Visits Information cccccsssssscsssssscsssssseccsssssecssssssecsssssscssssssssssssssessssssssssssssscssssseees 238 Exporting Payroll Interface sccccssssssssssscsssscccssseecccssscccsscceescssscsscccessssssscccssseessssssoccsceseess 239 Reports Available for Closed Week S iscsesescvvacoussndvccessevetewertenaspesiccvivecsccsdvoediieduanassepedivssvadsces 242 Reports Available for Closed Weeks cccccccccsssssssccccsscsssssccccccsscssccssseeescsssssscsseeesssssessseees 243 Payroll Report siisicicss eceisdeseseaasssossiescnsscccdesedeassvadesecevedeiscensdedsesecsvensssscessosenadavsacssseessscessedsdeseanseaenons 243 SEITA AEKA IID ROPOPrissccccssscsssscss
188. ation can be exported by office or by all offices at once If an employee is shared among two or more offices and you would like the employee to receive one paycheck you must process the checks for all the employee s offices together SAM gt Melbourne GUEST lei Ea Bile Administration schedule At ontiguraticn Memntenance loan Seanilicko Reports Hep fal Export Payroll x Create Payroll Postings for the selected office s Back Office a T Create ACCPAC Posting Import File Melbourne I Create Paychex Preview Import File I Create ADP Paydata file CSV format I Create Millenium file CSV format I Create Ultipro file CS format I Create MAS 200 file CS format I Create Advanced Payroll Systems file I Create Primepay Payroll file I Create ADP Autopay file CS format I Create Simple Payroll file CSV format I Create Time Clock Import file Export 2 32PM 01 18 06 3 13 PM Page 239 of 448 Users Manual Perform the following steps to export payroll To access the Export Payroll screen select menu option File Export Payroll The Export Payroll screen will be displayed Select the office s to export from the list Choose when interface option you wish and click the Export button If you are exporting to ACCPAC SBT all employee profile and tax information will be exported to SBT For all payroll posting file options all visits pay items and adjustments will be expo
189. be after the status date that you have entered to be considered 01 18 06 3 13 PM Page 411 of 448 Users Manual OASIS Tracking Report This Office level report provides the capability to get a listing of clients with an OASIS Assessment by assessment type and or status You may also optionally select to report patients that do not have an OASIS Assessment defined OASIS Tracking Report gt Melbourne GUEST T OASIS Tracking Report eeee co 01 18 06 3 13 PM Page 412 of 448 Users Manual Plan of Care Verbal Order This report prints a Plan of Care HCFA 485 form and Addendum to the Plan of Care HCFA 497 form for the selected patient s or a Revision to Plan of Care physician s verbal order form for the selected patient s depending on the selection criteria You may also export Plans of Care Verbal Orders to a XML file to be sent to a Care Plan Oversight system for signature Plan of Care Verbal Order Report gt Melbourne GUEST Plan of Care Verbal Order Report 01 18 06 3 13 PM Page 413 of 448 Users Manual Plan of Care Tracking Report This Office level report provides the capability to get a listing of Plans of Care or Verbal Orders that have not been mailed or that have been mailed but have not been received signed ii Plan of Care Tracking Report gt Melbourne GUEST Plan of Care Tracking Report eeeeenee
190. be displayed 01 18 06 3 13 PM Page 99 of 448 SAM gt Melbourne GUEST Scheduler lel x Ble Administration Schectie AD Eoniauaton Mentenance logn samiono Reports Hep x Split Hours Employee Emp Match Supplies Wenty week n 4 gt gt I a fl x l Client Helen Abbey Payer No 7146 Employee NOT ASSIGNED Payer Set 01 Skill SN RAN Sub S kill Visit 401293 40007 Payer Tufts Associated HMO SN x Skil 1 T ts Associate SN Date 10 27 2002 Sunday 1 0000 total hours i nee Lees I Supervisory Visit Start Break Start Break End I Assessment Included End Times 03 00 AMi i Status Not Assigned J Ew z Computed Out of Compliance Ins Authorization Li ies Rates Comment Pe Pay Per Visit zj 26 00 Override H Bill Per Visit 7 0 00 gt Gyernide m I nvoice Qual Qualified z Desc GUE 06162005 08 57 AM Verification Ep gt Timeslip Verified Travel Pay __ 0 00 Total Sales Tax 0 00 I Already Paid Travel Bill 0 00 Payroll Date fie Enter the start time of the visit 8 58 4M Visits may be edited until they are Closed as a part of the weekly payroll processing Once a visit is closed it may not be edited It may however be adjusted If you modify the Payer Skill the Payer No Payer Set and Visit Number will automatically be changed for you e Ifthe office is a Texas office a 2067 button will
191. be reviewed and processed accepted or rejected before the adjustments take effect and invoices are revised This process is done from the Review Adjustment screen To access the Review Adjustments screen select menu option AR Review Adjustments The Review Adjustments screen will be displayed Select an adjustment from the list To look at the details of an adjustment select the adjustment and then click the Show Detail button This will display the details of the adjustment in a read only mode Information that 01 18 06 3 13 PM Page 315 of 448 Users Manual will change due to the adjustment will appear in yellow Use the Exit T button to leave the screen e To accept the adjustment click the Accept button The screen will refresh and the selected adjustment will disappear e To reject the adjustment click the Reject button The screen will refresh and the selected adjustment will disappear e Upon exiting the screen all adjustments that have been accepted will be processed into new invoices No adjustment is processed until the Review Adjustment screen is used to accept or reject the adjustment Rebill adjustments do not need to be reviewed or accepted 01 18 06 3 13 PM Page 316 of 448 Users Manual Adding Missing items to invoices If visits supplies services and or pay items are missing from an invoice the following steps will add items to an invoice Add the missing visits supplies services and or
192. box Enter the amount of time that a visit represents for this new sub skill in the Visit Hours field After making sure the information is correct click the a Save button The newly selected skill and hours will be added to the Related Skills list Click the Exit A button to exit the Edit Sub Skill screen 01 18 06 3 13 PM Page 340 of 448 Users Manual Defining Attributes SAM is delivered with a standard set of predefined attributes but an organization may define additional attributes Attributes are associated with employees just as skills are and they usually describe something the employee is capable of doing i e Able to Lift Over 150 Lbs Spanish Speaking Attributes can also be associated with a client in that the client needs employees that have certain attributes The attributes of the employee and the needed attributes on a client are used by the Employee Matching function Refer to the Defining Clients and Defining Employees for information on associating attributes with employees and clients Attributes can only be added or modified at the back office e To access the Attributes screen select menu option Configuration Attributes Edit Attribute gt Back Office GUEST le Ee Bie Acministaton schedule AE Gonfiattaton Mamtenance Loon Semiiche Reports Help AM E Edit Attribute x ufal anl mlo al Description AMAUTA O CNY 08201998 08 13 PM RiverSoft Enter description
193. c not available on a Verbal Order e Each of these buttons will display a screen on which you can modify the associated Plan of Care Verbal Order information e Make sure all the information on the screen is correct e Click the Save a button on the toolbar to save changes made on the screen e Click the Exit Ae button on the toolbar to exit the screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying Plan of Care Verbal Order Notes A modified Plan of Care cannot have the same Type Cert Begin Cert End Payer and Prime Physician as another Plan of Care This would make the Plan of Care not unique and you will not be allowed to save it You will be given a warning and asked if you want to continue when you modify a Plan of Care Verbal Order that has had its Final Document printed Deleting a Plan of Care Verbal Order Deleting a Plan of Care or a Verbal Order is done in essentially the same way They are both deleted using the Edit Plan of Care Verbal Order screen The main difference between the two is that the Type field will contain Plan of Care for Plans of Care and Verbal Order for Verbal Orders 01 18 06 3 13 PM Page 187 of 446 Users Manual e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Plan of Care
194. cccsesessssssccccsseeeeeseees 388 Bill Rate ROO i ccitend testes ise tes ated va ee eget ae ee hPL ave ere eee EiS 388 Client Dispatch R epottion c ack ich eh nen eae Roh eel as Baa LS a eR 389 Client List RAE 010 K ccohsttee tessa sete Bete de vada tees Hable ee E ech sae eos OE Behe va saaates Tu aout ae oagasE eS Baw eet ehaves 390 Client Payer Lis Repor sect cesses a as Reese awe ea Te ae A I eee es 392 Payer List Reports 22 2 sfcsieees cea ate eere teed Seton ihe ol cas ach do rat conte GaSe ease Ses E 393 Work Sales Function Group Report ccccssscccsssssecssscccsssseecesssscccsssscescsssccsceesessssscosssssoeee 394 Compliance Summary Report 2 cccesccegccsacceycceciassesteccasseucvesscesecevaeedevsecdessesacevgucstceseusvecsvascedevecueeessedaeeees 394 Expiring Compliance Rules Report cccccecsscccesssseeeseeeeesenceeceseneeecseeeeeeseaeceseaeeeseeeeesseaeeecseneeeeseeeeessnaeees 395 Filled Visit Repoti e E REEE A RE EE EA O RER E 396 On Call Reports sceninius naini ns E EE EE EEES EEE AE EEEE E ER R E RE 397 Pay Item Report ienen a n E ERE A O O E CE R G OE E E A E O 399 Payroll Interface Report innrcoircniereni nn rinn o a E ERE E EE EEE ERR SEES 400 Payroll Report serinin E E E REE EE EN AN E E TER EO AE 401 Salaried Vist Repoti nenei E R E E cous Sans EE tapes erento oe A EA E 402 Service tem Reportes E a E E A OAE 403 Service List Report eonen n ee leds hee es eee 404 Supply Item Reporte E eae E cans ie ee
195. ce Affiliations can also describe a care team in which clients belong to the care team and certain employees provide services to the members of the care team The affiliation associated with an employee and or a client is used by the Employee Matching function and on some reports for filtering purposes e To access the Affiliations screen select menu option Administrations Affiliations e The Edit Affiliation screen is displayed Edit Affiliation gt Back Office GUEST Bile Administration schedule AED Lonfiguretcn Meintenance logn SeniicGo Reports Help AM E Edit Affiliation x gt lo qix el Description MENEMA GUE 0622 2005 02 27 PM lt Q RiverSoft Enter description of location e Click the New 0l button to add a new affiliation e Enter a Description for the new affiliation e Click the Save al button e Click the Exit Tl button to exit the Edit Affiliation screen 01 18 06 3 13 PM Page 346 of 448 Users Manual Defining Referral Sources A referral source is an agency that refers clients and or employees to the organization for service Referral sources are associated with a client and or employee when the client or employee is initially defined An option is available on the Sales Item Report to report on sales based on referral sources for clients Refer to the Defining Clients for information on associating a referral source with a client Refer to the Defining Employee
196. ce with a new employee number The following employee information is copied e Employee demographic information excluding client preferences and bonuses e Employee availability information e Employee tracking information e Employees pay rates The copy feature will not allow the copy of the employee in the following circumstances e You may not copy an employee to the same office e The employee will not be copied if the employee already exists in the target office with the SSN social security number 01 18 06 3 13 PM Page 335 of 448 Users Manual Check Login Count This feature will allow you to see how many users are logged in at any given time To access the Check Login Count screen select menu option Maintenance Check Login Count and select the Check Login Count menu item A screen will be displayed that will show the e Distinct Network Users by network login e Distinct Workstations by workstation name e Actual SAM Login Entries an occurrence for each SAM application logged into e For SQL databases only current SQL connections are displayed Clear Function Locks This feature may be used to clear functions that are locked from running due to SAM reporting that another user is running that function If in fact that user is not running the function you can select this option to clear the function locks Note that ALL function locks are cleared when this option is selected This feature may only be run by
197. ce you are logged into at the time the payment is entered is associated with the payment If you enter a payment from a national payer that pays for invoices in several offices it is a good idea to be logged into the headquarters office so you can find the payment later e To access the Edit Payment screen select menu option AR Enter Apply Payments e The Edit Payment screen will be displayed 01 18 06 3 13 PM Page 276 of 448 Users Manual SAM gt Melbourne GUEST lel Bie Edmnistaton Schedule AR Wonfiguraton Memntenance Login samoto Hepots Hep x lt gt Gi l PAYMENT SOURCE Identity Payer Payer E Payer Offise Payment ID Payment Offise Status a Apply Gash Adjust PAYMENT DETAILS Payment Date re Check RA No E Deposit Moo Check Amount Comment Cheek Amount 0 00 Unallocated Amount 000 Payment Balance 000 Update Cash Dates Display list screen to find desired item 10 53 AM e Click the New m button to create a new payment e Select the payer who sent the payment this may be either a payer or a client by clicking the Identify Payer button The Identify Payer screen will be displayed Ble Administration gchedule AED Eoniauaton Metntenance Login SeniicGe Reports Help vil Name Starts With I Self Pay Payer Office ALL ee ls Generate 2 Reset List City O e Phone Il ae Ente
198. company sent to them for their records This option prints invoices with the client s mailing address and the caption Client Copy For Your Records Only e Print Invoices without Employee Names This option if selected will print the invoices without the employee name on the work items If you do not choose any of these options invoices will print according to their current state e Click on the Continue button e The invoice will be printed If you select multiple invoices and then select preview each invoice will be shown to you on the screen When each invoice is displayed you must select the Exit T button to view the next invoice 01 18 06 3 13 PM Page 264 of 448 Users Manual Printing Claims for Payers The Print Transmit screen may be used to print multiple claims at once Selecting claims and clicking the Print button will print claims Perform the following steps to print claims e To access the Print Transmit screen select menu option AR Print Transmit e The Print Transmit screen will be displayed e Inthe FORMS panel select the UB 92 or HCFA 1500 option specifying the type of claim you wish to print preview e Make sure that the Self Pay check box is NOT checked e Inthe STATE section Select the All option to list all claims regardless of the progress within the billing cycle Select the Ready option to list claims that have satisfied their invoice requirements Select th
199. correct Policy Information Section e Ifthe payer is not to be used anymore for the client click on the Do Not Use check box Marking this client payer relationship as Do Not Use will also mark the skills and codes and schedule orders for this client payer relationship as Do Not Use e Enter the Insured s ID of the insured party This field is set to upper case automatically e Enter the Authorization given by the insurance company if required This field is set to upper case automatically e Enter the Group Name of the insurance policy if there is one e Enter the Group Number of the insurance policy if there is one This field is set to upper case automatically e Enter the Policy Number of the insurance policy This field is set to upper case automatically e Enter the Authorized Dates of the insurance policy Changing the Payer Authorization end date on a client payer relationship may only be done if the date is after any verified or closed visits It is important that these fields are completed as much as possible Many of these fields appear on claims that are submitted to insurance companies The Insured s ID is used to fill in Locator 1 Patient s HI Claim No on a HCFA 485 when the client has a plan of care The Authorized Dates information is used to determine if the visit paid by this payer for a client are in compliance see section on Compliance Checking e Click on Use this payer for
200. counts will count all admits for the client Number of Duplicated client episodes due to recerts and multiple payer sources each patient recert or another episode for an additional payer within the date range will be counted If clients are included in the report any clients that have an entry date after the to date in the selected date range for the report will not be included 01 18 06 3 13 PM Page 419 of 448 Users Manual Medication Profile Report You provide a As Of date and SAM will report all medications found in plans of care and verbal orders that are current as of the date entered You may also select by Physician Payer and or Client Medication Profile Report gt Melbourne GUEST e x File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help E Medication Profile Report X SELECTION ATTRIBUTES Office meea 7 Physician ALL bi Payer ALL x Client ALL X 0672372005 S Generate S Deport On one M Ea Select an Office 10 08 AM 01 18 06 3 13 PM Page 420 of 448 Users Manual Phrases Report This report is a list of intervention goal rehabilitation potential and discharge plan phrases defined in this system Phrases Report gt Melbourne GUEST Phrases Report 01 18 06 3 13 PM Page 421 of 448 Users Manual Physician List Report This Office level report is a list of physicians in the ph
201. cscessssccssoseeses 347 Defining PHYSICia nS ss cscissccccccctesccasidecctcensensosesososensasesesesodoetssadssessessansaesesecdsecessavacesesescunstaassededssesseees 348 Managing Standard Plan of Care Phrases cssssssssccssssssssceccsssscccsceeeccsssccccsceessssscscssseoeeees 351 Data EXCHANGE ROIN DON isscssiiseiessscascnicsbeieisanadavceteueiwtoa sada sacbstwinaenss keee Eitin aerae 352 Exchange NOW s ccssssssccssscstevssassssccssoncecsessscsssccsvnausesesesseondeseceseseceteonsseceseseunsdanesdosesusesanecesssseusnseusesee 352 VIEW EXCHANGE LO Gissacscadssessscssadsisc sscessecsesccosesvevavesccsvsscananscosedenwUeacdocesesedennseasessnesseedassasesesssoess 353 Reindex Fox Pro Databases Onlly ssssssssccssscccssseesssssccccsoceescsssssccccscsesssscccccscesecssssccccessoees 354 View Remind ex L0G scisicscecccscesstecssscsscssesesasesecesosetetoondoccesoesenssascesssseusssaseseedecesensnatesesdeansdeasssasesesscssees 355 Workstation Environment Size ccccccsscssscccssccsssssecccssscccsssceecssscccsceeesesssscccssceesssssssccssorsess 356 WR CDOTIS scccasisssscvcpubcmcieswssesvuis teens vavewiusechveleutusvendesvestiatine Coldesesdsuauseloeevdpuocicaescetegebenvivewiveniaeemeutuve 357 Report Options oci cccscccscscevevasessvesecensaccscdccecessesacorocccosevssesecessdesvvvscussssessdevasedesdssesenvssceasedsdesesssedasse 357 Weekly ROVICWS tscvestsscudiceiensessuedexaates cpsdestvesuchatessessguversenvebsnceudvevisev
202. csseceeccsssscccsceeessssccssoes 165 Defining Plan of Care Verbal Order Diagnoses scccssscccsssccssssccccsscesecsssssccsceeesessscssoes 166 Entering a New Diagnosis nieis a a a aa vas see eg de ee AaS 167 Modifying a Dia SnOsis o e e Se scaaec ts E E AE bos A E Gas A tee ecto anniek ae eee 168 Deleting a Diagnosis 2 cies pier as bee cbse cde Os oe E eas Bans eee AEs zea E E Ea 169 Modifying Diagnoses Priorities onns aea aes eng dee oe eee eed teed Lh etee he sede Lowe thee acs E a taceceseest 170 Defining Plan of Care Verbal Order Orders Paragraph sssccccccsssccsssseccsssscscsssceeessssscceees 170 Defining Plan of Care Verbal Order Goals Paragraph cccsssscsssccsssssssceeccssssscccssoeeessssssceees 173 Defining Plan of Care Verbal Order Medications cccccccssssssssscccssssceccesssscccssseeessssccessoes 174 Entering a New Medication 2 coi ccccezsececescasetevsenscepcegevbbvccticaus ae e Er p a OK A ERS EN er nEs aet 174 Modifying a Medication 22 2 cccieccvcdivccs vesgecees nain E E E EA AE ENEE A Eas 176 Deleting a Medications ccc ceseicee cess cxg nni a cats ie E R G E E E E E EEEa as 177 Modifying Medication Priorities cccccecessccesencceseneeeeeseceeeeseneecesseeeessseeeeseaaecesseeeessnaeeeeseeeeseneeessnaeees 177 Defining Plan of Care Verbal Order Surgical Procedures scccssssssccssocssssscccssseeessssscoeess 178 Entering a New Surgical Procedure
203. cta Hegats Hi 5 Hoss sar Dj lol wf a 05 17 2001 A 06 20 2005 Hold Hospitalized Hod waa a The Edit Patient screen will be redisplayed You will notice that the patient s Agency Current Status is now Hold Discharging a Patient from the Agency If all of the patient s services from the agency are to be ended and the patient is to be discharged from the agency the patient s Agency Current Status may be changed to Discharged Once you have discharged a patient from the agency you cannot add any other new statuses for the patient e To access the Edit Patient screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Display the details of the patient you want to discharge See section Finding a Patient 01 18 06 3 13 PM Page 157 of 446 Users Manual SAM gt Melbourne GUEST Bcrinistieion ScChEGUIE At sontiquretcn Mamntenance Login Senilicko Reports Hep wh ta ae z ELSI tele gt or aa a xo IgG infusion q month Verona a e Click the Edit button next to the Agency Current Status field in order to change the patient s status to Discharged e The Edit Patient Agency Status screen is displayed e Click the New button on the toolbar to add a new Patient Agency Status e Select the status of Discharged in the Status combo box e Enter the discharged date in the Statu
204. d Tax ID be created after the report is generated I NetProfit File You may generate both state and federal unemployment reports The report does this by accessing the SBT database Besides providing a report this function will also generate an electronic file suitable for submission to the state unemployment agency Current states supported are North Carolina Florida and Texas Maine Massachusetts Connecticut Rhode Island and the city of Wilmington This screen will allow the selection of one or multiple offices as long as they are in the same state and company It will also alternatively allow the selection of a company for reporting You must enter the year and the quarter you wish the report for The report will show total wages non taxable wages and taxable wages on a quarter to date and year to date basis Once the report is done another screen allowing the entry of state specific items will appear Entering information into this screen will allow cause the generation of the state specific electronic file 01 18 06 3 13 PM Page 322 of 448 Users Manual Administration and Configuration Maintaining Offices SAM allows you to maintain information about your organization s offices Only users with an access level of System Administrator have the authority to log into the Offices screen These users may modify certain portions of office information as needed This is accomplished using the Edit Office screen NOTE
205. d be created containing the new patient status In this way a history of the change in the patient s status is maintained The following sections describe how to add a new patient status record whenever the patient s status changes Non Admitting a Patient into the Agency Patients are defined as clients with a client type of Patient using the Client function All new patients will have a default status of Incomplete If it is decided that a patient is not to be admitted into the agency for services and therefore does not need a Plan of Care defined the patient s Agency Current Status may be changed to Non Admitted This is accomplished using the Edit Patient screen associated with the Clinical Information function e To access the Edit Patient screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Display the details of the patient you want to Non Admit See section Finding a Patient 01 18 06 3 13 PM Page 151 of 446 Users Manual SAM gt Melbourne GUEST BIE Aaministaton Screcuie At ieoriiguraticn Memnterence Loon semitai Geports Hep E sessment aef gt o a mdo We You will notice that the Patient Vitals section is filled in with the selected patient s information that was entered in Client screen The Clinical Information will be blank except the Agency Current Status field will display Incomplete
206. d no scheduling conflict or employee tracking warnings will be displayed 01 18 06 3 13 PM Page 107 of 448 Employee Matching e On the Scheduler screen right click on a visit normally an unassigned visit e This will display the Visit Menu On this menu select either the Edit Visit or the Employee Match option e If you select the Edit Visit option when the Edit Visit screen is displayed click the Emp Match button e This will cause the Employee Match screen to be displayed SAM gt Melbourne GUEST Scheduler Of x Ble Administration Scheciie AED Eoniauaton Mentenance ogm saniomo Reports Help ial Employee Match x Helen Abbey RN Visit on 10 27 2002 at 09 00 AM SKILLS amp ATTRIBUTES Primary Skill X Employee Skills amp Attributes Other A EP _AddSkil gt gt T CNA JE Companion Dietician aj e Attributes Able to Lift Over 150 Lbs F Remove xn Able to Transport F Able to Use Sign Language Add Attribute gt gt Adverse to Cats Dogs xi Add Reverse gt gt ha AVAILABILITY SCHEDULE TRACKING MISCELLANEOUS C Any M Employee Not Type ALL ies ke In Overtime Situation ays Uni i FV lEmiosos Nat Status Active Only z Always amp Maybe Scheduled Elsewhere Affiliation Smal z C Day Avail Only V Use Tracking Info Either Search Exit Select the primary skill of the employees to search for 10 04 AM e If you click the Search button the sys
207. d tells SAM how to create an electronic claims file for the payer Enter the Bill Type Mask to determine what is printed on the UB92 Locator 4 Type of Bill field e Ifthe first character of the Bill Mask field is not numeric the system will place a 3 in the first character of the Bill Field If it is numeric the numeric value is what will be placed in the first character of the Bill Field e Ifthe second character of the Bill Mask field is not numeric the system will place a 2 in the second character of the Bill Field If it is numeric the numeric value is what will be placed in the second character of the Bill Field e Ifthe third character of the Bill Mask field is not numeric the following applies If it is numeric the numeric value is what will be placed in the third character of the Bill Field 1 If patient is admitted and discharged during the period of the claim 2 If patient is admitted during the period of the claim 3 If patient is continuing service 4 If patient is discharged during the period of the claim Note For Medicare PPS Claims the third character is 2 for RAPs and 9 for EOEs e The Payer s Bill Mask s 3 character will also determine what is placed in the UB92 claim status field locator 22 If it is not numeric the patient s status will be used If it is numeric the numeric value is what will be placed in the status field on the UB92 claim Check the 15 Min U
208. dded together it will balance with the summed royalty reports run for these two week endings The total pay on the Worker s Compensation report will match the total cost on the GL Sales Report if the following things are subtracted from the GL Sales Report Cost 1 Contractor Costs 2 Services and Supplies Costs 3 All pay item costs that have 0 hours reimbursements bonuses show ups etc Balancing Receivables Against Sales The total receivables for an office plus the total cash applied for an office should equal the total sales billed The aging report prints the total receivables for an office The Payment Cash Application Report on the Payment Log report prints total cash applied Totals sales billed are calculated by running the sales item report for the entire year billed items only and subtracting out any invoice adjustment made during the time period Royalty Report We recommend that you use the Weekly Licensed Unlicensed Sales report This format will report licensed and unlicensed information by payer class This information may then be used to report royalty information It can be found with the other general ledger reports See General Ledger Reporting The body of the report includes visit information for the Medicare Payer Class this is information only and should not be used for reporting royalties Medicare PPS RAP and EOE information is included at the bottom of the report and this is the informa
209. ded to provide specific service codes for billing on claim forms or specific bill rates for specific types of skills 01 18 06 3 13 PM Page 339 of 448 Users Manual Sub skills can only be added or modified at the back office To access the Sub Skills screen select menu option Configuration Sub Skills Sub Skill gt Melbourne GUEST lei ce Hile Edmmsteton Schedule AR Eoniauaton Mamntenance logn samico Reports Hep Sub Skill Description L S Related Skills Skill RN z Visit Hours RS 03271999 09 56 AM Enter description of sub skill leave blank to define a skill 206 PM The Edit Sub Skill screen is displayed Click the New m button to add a new sub skill Enter a Sub Skill Description for the new sub skill This description is used in all skill sub skill lists and combo boxes throughout the system Select a skill to associate the new sub skill to from the Skill combo box Enter the amount of time that a visit represents for this new sub skill in the Visit Hours field Be very careful to review the sub skill information on the screen before saving because new sub skills and their skill sub skill associations cannot be deleted after they are saved Click the Save button The selected skill and hours will be displayed in the Related Skills list If the sub skill is to be associated with another skill Select the other skill to associate the new sub skill to from the Skill combo
210. dent 10d Reserved For Local N A Physician D Local Use 1 Use iagnosis 11 Insured s Policy Administration Insurance Policy Group or FECA Clients Number Define Payer Sets Policy Number lla Insured s Date of Administration Insurance DOB Birth Sex Clients Sex Define Payer Sets DOB Sex llb Employer s Name N A Insurance Employer llc Insurance Plan or Administration Insurance Group Name Program Name Clients Define Payer Sets Group Name lld Another Health N A N A N A Benefit Plan 12 Patient Release of Default to Signature on HCFA1500 Signature on Medical File File Date Information Signature Date or Signature on File 13 Insured Default to Signature on Insurance Signature on File Authorization of File Payment Signature or Signature on File 14a _ Date of Illness N A HCFA1500 Illness Date Injury or Pregnancy 14b Illness Injury or N A Physician Care Reason Pregnancy Diagnosis 15 First Date of Similar N A HCFA1500 Similar Date Illness 16 Unable to Work N A HCFA1500 Unable to Work Dates Dates 01 18 06 3 13 PM Page 428 of 448 Users Manual HCFA 1500 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field 17 Name of Referring Clinical Information Physician Physician Physician Edit Patient Diagnosis Define Plan of Care Verbal Order Prime Physician 17a_ Physician ID Administratio
211. der named using the following format SAM 9999 FrontOfficeName where 9999 is the office code of your front office or DEX 9999 FrontOfficeName The dialup entries are still required in the Dialup Networking folder to inform Data Exchange of the offices to exchange with however the phone numbers are not used View Exchange Log This function allows you to see what Data Exchange has been doing In it you will see when offices were called what files were sent where and dial up connection errors This log keeps the last seven days of entries 01 18 06 3 13 PM Page 353 of 448 Users Manual Reindex Fox Pro Databases Only SAM gt Melbourne GUEST lei cE Bie Administration schedule AH sontiguraton Meintenence Logn Senlicio Heports Help fal Data Exchange Reindex Configuration x Data Exchange Reindex Reindexing Option X Reindexing occurs at the selected time above f you would like to reindex immediately click the Reindex How button Reindex Now View Reindex Log Set Defaults Restore Defaults Exit 9 23AM To setup Reindexing to process automatically in your back or front office 1 Access the Data Exchange Reindex Configuration screen 2 On the Reindex screen mark the times you would like SAM to reindex your data 3 Click the Set Defaults button 4 Exit the screen SAM s RiverSoft Process Monitor service which is automatically running continually on your server s will automa
212. ders Israel Anderson Antoinette Anderson Edith Angeli Agnes Arzola Roberto Atwood Marjorie Auerbach Francis Barns Donald Select Client to process Client 002080 Click the client to whom you want to associate a service item and then click the Service Items button to go to the Edit Service Item screen Fle Al Al Al Al Ai Ai Al Al Al B Schedule A Lontiguretth Meintenance Loon samoco Reports Help Edit Service Item Helen Abbey MASTER SERVICES Select SERVICE ITEM Service Se Unit Cost Unit Bil Quantity I Total Sales Tax bate v Invoice Description Payer Standard Local All SAM gt Melbourne GUEST Scheduler Sle Acrministration Go to Service Definition form to define a new supply Click the New D button to add a service item 01 18 06 3 13 PM 3 33PM Page 133 of 448 Master Services Section This section contains a list of services By default the list displays all services in the database You have three options for listing services in the list Standard Click on this option if you want to list services that are standard across all offices Local Click on this option if you want to list services that are customized to your office AllClick on this option to list standard and local services Click the service from the list and then click the Select button Or simply double click on the service If the service is
213. dit Plan of Care Verbal Order screen will be redisplayed with the Case Manager field filled in with your selection Defining Plan of Care Verbal Order Diagnoses e To access the Edit Plan of Care Verbal Order Diagnoses screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Plan of Care for e Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical Information section of the screen Refer to section Admitting a Patient into the Agency in this manual e Click on the Define Plan of Care Verbal Order button e Confirm that you are editing the correct Plan of Care Verbal Order e Click on the Diagnoses button 01 18 06 3 13 PM Page 166 of 446 Users Manual The Edit Diagnoses screen will be displayed SAM gt Melbourne GUEST le x Bie Aammnistaton schedule AE Eoniguaton Memterence Loon Samioto Hepots Help E Edit Diagnoses Patient Helen Abbey Client 002080 02 BO BS Cert Period 0703 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Type Plan of Care Reorder osis Description Date 07E VO Status RESPRTRY SMICYTIAL VIRUS ICD 3 CM Diag 33510 SPINAL MUSCL ATROPHY NOS 06 24 1999 0 53081 ESOPHAGEAL REFLUX 04 01 2001 0 ICD 9 CM 0736 Select
214. dministration Insurance Type Type Payers Profile Payer Class la Insured s ID Administration Insurance I D Number Clients Define Payer Sets Insured s ID 2 Patient s Name Administration HCFA1500 Patient Name Clients Client Profile Client Name 3 Patient s Birth Administration HCFA1500 DOB Sex Date Sex Clients Client Profile Birth Date Sex 4 Insured s Name Administration Insurance Insured Name Clients Define Payer Sets Name 5 Patient s Administration HCFAI1500 Under Patient Name Address Telephone Clients Street Client City Profile State Zip Code Under Client Name Telephone 6 Patient s Administration HCFA1500 Insured Relation Relationship to Clients Insured Define Payer Sets Relation 7 Insured s Address Administration Insurance Under Insured Clients Name Only if patient is Profile the insured party Under Billing Name 8 Patient Status Administration HCFA1500 Marital Status Clients Employment Status Marital Insurance Info Employment Marital Employment 9a d_ Other Insured s Info N A Insurance Under Other 01 18 06 3 13 PM Page 427 of 448 Users Manual HCFA 1500 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field Insured 10a Patient s Condition Administration HCFA1500 Accident c Related To Clients Ancillary Info Employment Accident Auto Accident Other Acci
215. dsdessdacedassesccestansascssccsesenddasescedessveasesasees 265 Creating Claims Manually for Multiple Invoices sccccccssssscssssecsssssccssceeeseessscccesssesssseees 267 Transmitting Claims to Electronic Bulletin Board Systems sccccscsccssssscssssceccsssssessscseees 268 Sendingan ECS File via Hyper Terns lt sece ceesovshe cessed ne e ess sensdisees E N ces ced decneds valet 268 Invoice Register Report Tracking Which Bills Were Sent Finalized ssssccsssssscssseeees 270 View Invoices Claims scccssssccssssssccsssccssssssccscsssecessssseccsssssscssssssesssssssssssssssssssessssssssessosseees 271 Viewing or Printing an INVOICC cccccccccscssscsssssccsssssscssssssscsssssscssssscssssesesssesescssssescoenee 271 Viewing Editing Creating or Deleting a Claim for an INVOiCC ssccsssssccsssscsssssssescsssseees 272 Payments and Cash Application sssssocsssscssssscssseccccsssscccssccccssccsssscossscesesssssccssccesssssssssccees 276 Entering a Payment for One Invoice and Applying Cash ccccssssscsssssecsscccsssceeesssssccscseoeeee 278 Entering a Payment for Multiple Invoices and Applying Cashb sscccssssssssssrccssssscsseeeeees 282 Payment and Cash Applications and Adjustments for Medicare PPS sscccsssscssssssesssseeees 284 Payment Log and Bank Reconciliation cccccccsssssssssscccssseescsssscscsscccessssscccsccesesssssscss
216. duling when assigning an employee to a visit SAM gt Melbourne QA Edit Employee Ree Bie Administration Schedule AR Eoniguaton Mamtenance Login Seniictto Reports Hep Employee Profile Employee Taxes Employee Skills Attributes Employee Preferences Bonuses Tanya Acevedo SKILLS amp SUB SKILLS EMPLOYEE SKILLS amp ATTRIBUTES Remove IV Primary Skills Only Remove Anj ATTRIBUTES Able to Lift Over 150 Lbs a Add gt gt Able to Transport Able to Use Sign Language Adverse to Cats Dogs Adverse to Smoking Back Rubs Care of House Plants Master list of skills 7 sub skills double click or Add to add selected entry to list 3 00 PM Skills amp Sub Skills Section e Click any skill in the list then click the top Add gt gt button next to the list to add it to the Employee Skills amp Attributes selection list e Click the Primary Skills Only check box so that it is unchecked to see all sub skills Attributes Section e Click any attribute in the list then click the bottom Add gt gt button next to the list to add it to the Employee Skills amp Attributes selection list Employee Skills amp Attributes Section e When a skill or attribute is selected in this section you may click the Remove button to delete it from the list e You may click the Remove All button to remove all skills and attributes from the list Click the Preferences Bonuses tab to go to the next page
217. e Edit the paragraph so that it contains exactly what you would like to see in the Orders paragraph for the Plan of Care or Verbal Order e Click the Save a button on the toolbar to save the Orders paragraph e Click the Exit T button on the toolbar to exit the Edit Orders Paragraph screen The Edit Plan of Care Verbal Order screen will be redisplayed 01 18 06 3 13 PM Page 172 of 446 Users Manual Defining Plan of Care Verbal Order Goals Paragraph The Goals button on the Edit Plan of Care Verbal Order screen is used to create the paragraph corresponding to the HCFA 485 Locator 22 paragraph Goals Rehabilitation Potential Discharge Plans This paragraph typically contains goals rehabilitation potentials and discharge plans associated with the skills of the service being provided e To access the Edit Plan of Care Verbal Order Goals screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click on the Goals button The Edit Goals Paragraph screen will be displayed SAM gt Melbourne GUEST lel X Ble Administration schedule AED ecnfiquretcn Meint
218. e GUEST lel Es Bie Administration Schectie AED Eoniauaton Mantenance ogm samiomo Reports Help Ba Detine Hospital Stays D Bly Tl PATIE Agency Patient Connie Aseltine Client A00272 A2 Start of Care oi 01 1800 Patier Date Status Reason 06 20 2005 Non Admitted Appropriate Services Not Available Addre City State Phone Birth I Sex Status Non Admitted B Status Date 06720720052 Delete Entry 5 z Reason Appropriate Services Not Available 7 GUE 06202005 12 33 PM Select Patient Status to edit or delete 12 33 PM e Verify that the list on the Edit Patient Agency Status screen now displays a row with the Date column containing the correct date value and the Status column containing the value Non Admitted e Click the Exit T button on the toolbar to exit the Edit Patient Agency Status screen The Edit Patient screen will be redisplayed You will notice that the patient s Agency Current Status is now Non Admitted Placing a Patient on Hold in the Agency If all of the patient s services from the agency are to be put on hold the patient s Agency Current Status may be changed to Hold e To access the Edit Patient screen select menu option Administration Clinical Information e The Edit Patient screen is displayed e Display the details of the patient you want to place on hold See section Finding a Patient 01 18 06 3 13 PM Page 154 of 446 User
219. e Print DLL Reports DLL Error Report This report will include any error message generated by attempt to import into this systems database E SAM gt Melbourne QA lel Es Hie Aoministeaton Schedule AR Eoniauaton Mantenance Loam Seniicto Hepots Help ey SAM_DLL Error Report X SELECTION CRITERIA REPORT DATES ce aaa h From 06723 2005 21 To l ff Dil Call ALL x Vendor ALL SORT BY Import Date Result ALL C DII Method C Result I Include Details Vendor Generate Report Options Exit Generate Report Options Exit Detail Report Destination Screen Preview Title NONE 10 20 AM 01 18 06 3 13 PM Page 425 of 448 Users Manual DLL Transaction Register This report will include transactions of data that have been imported into this systems database SAM gt Melbourne QA Bie Administration schedule AR Eoniaueton Meintenance Loon SeniicGo Reports Help g SAM_DLL Transaction Report X SELECTION CRITERIA REPORT DATES 7 From 06 23 2005 To 77 m Employee as SORT BY DII Method ALL C Only New Records G Import Date C Client Vendor ALL x T Include Details C Employee C Vendor C DLL Method 01 18 06 3 13 PM Page 426 of 448 Users Manual HCFA 1500 Locator Mapping HCFA 1500 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field 1 Health Insurance A
220. e Select button next to the Payer field then select a payer from the Payer List form Or click the Default button next to the Payer field to default to all payers e Note that the Employee field displayed next to the Payer field contains the name of the employee the pay rates are being deleted for e Click the rate that you want to delete from the list e Click the Remove button Note that every rate for the selected skill and effective date is removed regardless of shift Printing Pay Rates e Click the Print List button to print a list of the pay rates 01 18 06 3 13 PM Page 78 of 448 Copying Pay Rates to Employee within Current Office e Click the Copy button to copy rates to other employees e The Copy Pay Rates screen is displayed SAM gt Melbourne QA Edit Employee lel es Ble Administration schedule AR Lonfiguration Memtenance Login Senco Reports Help oe Payer KDEFAULT COPY RATES TO Skill 7 Sub Skill Office UNIT Hours HHA C Visits HA VIEW NA All Current ORDER BY C Date Skill BILL Invoice id Beimb Employee lt DEFAULT gt Select Skill ro Payer lt DEFAULT gt Select Mc Rates 1 1 Unit Hours Visits Select the office to copy rates to 4 06 PM e Select the Office option Current Office The front office cannot copy pay rates to other offices e Select the employee to which the rates are to be copied by clicking the Select
221. e Exit button to exit the Visit History List screen e Click the Exit button to exit the Visit History Criteria screen to return to the Profile page of the Edit Employee screen Defining Employee Pay Rates Hierarchies of pay and bill rates for visits are supported When determining a pay rate for a visit the hierarchy of pay rates is read beginning with Employee Payer rates per skill sub skill shift down to default rates per skill sub skill shift When determining a bill rate for a visit the hierarchy of bill rates is read beginning with Client Payer rates per skill sub skill shift down to default rates per skill sub skill shift 01 18 06 3 13 PM Page 75 of 448 2j How SAM Computes Pay and Bill Rates X At each level a rate for the skill sub skill is searched for If not found rates for just the skill are searched for If not found the any rate is used If there is no any rate the next level of rates is searched How SAM Computes a Visit s Pay Rate Self Pay Visit All Other Visits Are there client employee rates Are there client employee rates Are there employee rates Are there employee payer rates Are there client rates Are there employee rates Are there agency default rates Are there client payer rates If all answers are no rate is 0 00 Are there client rates Are there payer rates Are there agency default rates If all answers are no rate is 0 00 How SAM Computes a Visit s Bill Rate Self Pay Visit All Oth
222. e List Identify Invoices 2 Remove Cash Applied MEE mM E Update List C t B O ni Enter invoice number to apply cash to 8 48 AM On this screen you can sort the invoices listed by clicking on the Invoice No or Client Name buttons The column labeled C will have display a if the cash application occurs in a Closed Period 01 18 06 3 13 PM Page 279 of 448 Users Manual e Enter the invoice number of the invoice you would like to apply cash to in the Invoice No field or you may select the invoice number by clicking on the Invoice List or Identify Invoice buttons The Invoice List button displays a screen from which you can select the invoice from a generated list of invoices You may also select multiple invoices at one time from this list Apply Cash Invoice Selection List gt Melbourne GUEST Ble Adminstration Sci AG lorniguratcn Maintenance Logit samiot Reports Hep nw Apply Cash Invoice Selection List 01 18 06 3 13 PM Page 280 of 448 Users Manual The Identify Invoice button displays a screen from which you can select the invoice once you have seen the details of the invoice Invoice List gt Melbourne GUEST 0002400226 DeForge Pearl A M Mutual Insurand 609 74 02 08 02 02 05 02 08 IC E e The Cash Applied field will be filled in with the maximum amount that can be applied to the invoice that is available from the
223. e Report ne a cg esheets yest A A E E E 369 Payroll Rp Ott ae n E E A A E E A 370 Sales invoice Reportera E E E E E cates A E A O A 371 Sales Item REDOT arn ae a E A O E coe seen eae ede wee 374 State Unemployment Reporting and Electronic File Creation cesceesceseseestecesceeeeeeesseeessaeessaeeesaeeeseeees 376 Statements ioaea Sees AE E E A E A E EE A E E E useawvabne so ucvevaystee ners eaws 378 01 18 06 3 13 PM Page 10 of 448 Client Payer Function Group Reports ccccccsssscsssccscccssseeccssssscccssceeescsssscssceessssssccccssseseeseees 379 Client Payer List Report s lt 23 052 eeadesneedudSecctasreec na R al cxes abbas dewsesaigt ER EER E 379 Scheduling Application Group RePorts cccccceceesssrsccccscccsscssccccsssccsccsssecccssssccscsssesscsssssssseses 380 Employee Function Group Reports ssccccccssscccssssccsssscsccssseescssssscccsscessssscccesccsssssssssccsssoeee 380 Employee Dispatch Reports seco nsei a EE E E E T E E E sts 380 Employee List Report occ enin a a a a e a e e eiei 381 Employee Tax Withholding Reportteri a see a re a E E EE NETES 382 Employee Tracking Rep rt Seere eia R E R EE E e fuses EEEE 383 INE AAL 00 EEE A EA A EA T E 384 Potential Overtine REPOrt 2 423 eee E E E hess 385 Wimiesheets ss fos eia2 ade teste ed tinted hohe teats hate tert Blech eMail Siete teak See ted 386 Client Payer Function Group Reports ccccsssssssscsssccssceccsssscccsssoeeeccsss
224. e Select an employee from the generated list e The Scheduler screen will be displayed with the employee s schedule for the current week SAM gt Melbourne QA Scheduler le x File Edmir fif E a Loan Bj Rules ANE Prefs ATS Sum Legend Tanya Acevedo al 800 538 a7 M ae o 09715 09716 09717 09 22 09 24 09 26 09723 0924 09 29 10 01 10 02 10 03 pu 7 nile al ale Put schedule in employee view and specify employee 4 24 PM Viewing the Scheduler in Different Modes e The schedule may be view in four different modes Time Visit is represented by box positioned and sized by date and time and color coded for status List Each visit is represented by one row of information and color coded for status Month Four weeks of visits is displayed at one time Within each day visits are stacked and color coded for status If a day has more visits than can be viewed at one time in this mode the day will have a scroll bar that can be used to scroll through the visit Also to view more visits at once click the button Week One week of visits is displayed at one time Within each day visits are stacked and color coded for status This is very handy when multiple employees are visiting the same client at the same time e To switch the viewing mode you are in click on the drop down field to the right of the Legend button This will show you the possib
225. e Suspended option to list claims that have NOT satisfied their invoice requirements for instance a claim has not been created Select the Draft option to list claims that are in a draft state Select the Final option to list claims that have been printed in the final state or have been transmitted Select the Not Transmitted option to list claims that have not been transmitted e Inthe INVOICE DATES section enter the week ending date range of the service covered by the claims you want to print You can leave the To date empty to retrieve all claims later than the From date e To retrieve only claims for a particular payer s click the Select button next to the Payer field This will cause the Select Payer screen to be displayed On this screen you can either type in some or all of the payer s name and click the Generate button or you can leave the name blank and click the Generate button to get a list of all payers Or you may select by Payer Number if you know the payer number in the system Select a payer by double clicking on the payer in the list OR by clicking on the payer and clicking on the Select button To select multiple payers control click on each payer or shift click on the first and last payer e To retrieve only claims for a particular client click the Select button next to the Client field This will cause the Select Client screen to be displayed On this screen you can either type in some or all of the client s nam
226. e and click the Generate button or you can leave the name blank and click the Generate button to get a list of all clients Or you may select by Client Number if you know the client number in the system Select a client by double clicking on the client in the list OR by clicking on the client and clicking on the Select button e If you would like to select claims for a particular Electronic Claims Submission type select from ECS drop down the ECS style that applies Ifthe ECS style selected supports multiple payers in one transmission file the Transmit button will be enabled e Click the Generate button e To select one claim click on the claim in the list e To select multiple claims control click on each claim or shift click on the first and last claim e Click the Print button to print or the Preview button to see the claims on the screen e Fach time you print a claim the Print Options screen will appear 01 18 06 3 13 PM Page 265 of 448 Users Manual fal Print Options X PRINT OPTIONS Print C Do Not Print I Convert Draft copies to Final copies I Print Claim on RED form Cancel e Print vs Do Not Print This option is used in conjunction with the Convert Draft copies to Final copies You may choose to actually print the claim or not print the claim while converting it to a final copy or not converting it to a final copy e Convert Draft copies to Final copies This option if selected will con
227. e appropriate payer set from the combo box who is to pay for the supply Note that the list of available payer sets is dependent on the date the supply was used e Click the Save i button to save the supply item e Click the New BI button again to add another one e Click the Find al button to view existing supply items e Click the Exit T button to leave the screen Adding Service Items Service items are entries that record what services have been rendered how much they cost and how much is billed to payers Service items are always associated with clients Perform the following steps to get to the Edit Service Item screen e From the Scheduler screen click the Client button to get to the Client List screen 01 18 06 3 13 PM Page 132 of 448 SAM gt Melbourne GUEST Scheduler lei ce Ble Administration Schectie AD Gonfiauraton Mentenence Login Seniioto Reports Hep ey Client List x ATTRIBUTES NAME 7 SCHEDULED SERVICE Type ALL Name Beginning With Status Active 7 I Has visits scheduled during selected week Payer 10 12 2002 1071872002 Class ALL z z l Has unassigned visits Refresh CSR ALL hd 06 16 2005 06 29 2005 Affiliation ALL x I Use Client Payer CSR _Reset List Client Admit Status Entry Date Phone Abbey Helen 05 16 2001 555 739 0474 West Springfield Aldrich Margaret 07 10 1999 555 781 5070 Springfield Alqawi Henry h 10 23 2001 555 525 0118 East Longmeadow An
228. e been signed your Care Plan Oversight system will allow you to create a XML file of these signed order that you can re import back into SAM to populate the Received Signed date on the orders Please see the Import Signed POC VO section in this manual Importing Signed Plans of Care and Verbal Orders Signed Plans of Care and Verbal orders may have their Received Signed date imported into SAM from an XML file created by a Care Plan Oversight and eSignature System CPOS There is a XML interface to the following CPOS systems Ancillary Care Management ACM EClickMD Alacare 01 18 06 3 13 PM Page 199 of 446 Users Manual To import a XML file of signed Plans of Care Verbal Orders it is very important to first install the RiverSoft XML reader on any workstation that you will be using to import the XML files To install 1 Double Click on n tools rs_xml rs_xml_stuff msi 2 Click on the Next button on each of the screen accepting all defaults 3 On the last installation screen click the Close button e After you have installed the RiverSoft XML reader to import the signed Plans of Care Verbal Orders you should first move any XML files to be imported into SAM into the n xml files importfiles folder e To access the Import Signed Poc VO screen select menu option File Import Signed POC VO e The XML Import Option screen will be displayed SAM gt Melbourne GUEST lei Ez Bie Administration Schedule AR
229. e check The information consists of two parts the top window shows each compliance rule broken into units of frequency like weeks with the total visits associated with the rule The number of visits under the minimum allowed for the rule Under and the number of visits that can still be schedule and be within the maximum are displayed Avail The bottom window shows visits that are out of compliance along with the reason Payer Set Dates Payer Authorization Dates Dr Order or Insurance Authorization 01 18 06 3 13 PM Page 124 of 448 SAM gt Melbourne GUEST Scheduler Bie Aeministaton schedule AE Gontiauraton Mantenance Loon semioto Hepots Help Wi Compliance Summary x Helen Abbey Frequency Period Rule Description Start End Under Avail 1 3 As Needed 1 3 V A Week 1 A Week 1 3 V As Needed 1 A Week 1 V A Week 1 A Week Print displayed lists How SAM Checks for Compliance l A Any visit associated with a client and payer that is outside of the client payers authorization date range will be marked in the schedule as out of compliance This means the visit will turn black on the schedule Beyond payer authorization date checking if insurance authorization rules or doctor order compliance rules exist for visit s client payer skill each visit not covered by a rule will be marked out of compliance on the schedule Ifa rule authorized more visits than are scheduled th
230. e compliance summary screen will show how many more visits are authorized under the rule The compliance summary screen will also list all out of compliance visits Visits for a client payer skill sub skill are only checked for compliance if there is a related rule Visits occurring before the start date of the first rule are not checked for compliance they are considered in compliance If you have created rules for a client that include a rule for the skill level and the sub skill level it is important to note that the rule at the sub skill level will be used first and then the rule at the skill level will be used For example If you have a rule for a LPN 3 visits a week and a rule for a LPN HighTech 3 visits a week If schedule 4 LPN HighTech visits in a week and only 2 LPN visits in the same week all visits are in compliance because the 4th LPN HighTech visit was compliant under the LPN rule We typically recommend that rules either be entered at the skill level OR at the sub skill level For more information on compliance checking see the Compliance Checking presentation in N user manuals 01 18 06 3 13 PM Page 125 of 448 Tip The compliance checking feature may slow down the verification process If this is a problem you may either turn off compliance checking while verifying or delete old compliance rules for patients where compliance checking is slow Setting Viewing and Clearing Model Week You may create model sched
231. e screen will be redisplayed Review the new cash application item now displayed in the list for the selected invoice for correctness The Cash Applied column will be filled in with the maximum amount that can be applied to the invoice that is available from the payment You may change the Cash Applied amount on the invoice at this time Click the Save i button to apply cash to the selected invoice The Unallocated Amount for the payment is automatically adjusted Repeat as necessary Click the Save fl button Click the Exit Tl button Payment and Cash Applications and Adjustments for Medicare PPS 1 When you get a remittance add that as a payment in SAM and record the EFT Check or Remit as the payment number 2 If there is a payment for a RAP apply the cash to the RAP invoice 3 Ifthere is a recoup for a RAP apply a negative cash application to the RAP invoice AND adjust the RAP service item to 0 4 If there is a payment for an EOE at this point it should be payment for the entire episode 1 apply the cash to the EOE invoice and then 2 adjust the EOE service item to match the amount paid for the EOE If you follow these steps for Medicare remittance you should be able to balance to each of your remittance 01 18 06 3 13 PM Page 284 of 448 Users Manual Payment Log and Bank Reconciliation e To access the Payment Log screen select menu option Reports e The Select Report screen will be displayed
232. e ssteteseec seid cist ated Bases Ss aI ade det ee hat ede ee aes ete 42 Insured s Information Sectio irra ann iss Sek E a gale as wae Leo Reese Sadek casa onl ek oto SEO Se oT 43 Policy Information Section siese sedese tend E ae eh eee Sad hace eS eee tdete Roe eee eed A 43 Invoicing Information Section nensi nann iea a e E A E Re E 43 Adding Client Payer Requirements seseessssooecsssssssooossssssoocesssssssooccssssssssocessssssoosesessssssoesessssssssee 44 Requirements List Sections cvcci ierti en nri ces E EE EEEE EE EESE AEE SE eea 44 Adding Client Payer Requirements Skills and Codes cssssssssssccssscessceeecessssccccssceessssssccesees 45 Defining Client Insurance Authorization Compliance Rules eseesessssssocesssssssesessssssssecssesssssssee 47 Defining Pay Rates and Bill Rates ccsssssssssccesssscsceecccssccccccceeessssscccccessssssssceceseseesssssssoseee 50 Addin Pay Rates ssicccssssessscistecesscsccstscesanstsascccasetnacacovevescuoxescoceceeseGadadeleveseensnoncnedecsenswassseecsoseassonsnesss 51 Deleting Pay Rates scississscesessavavssecsvesensssssesdescvevedadssesodesndsansdecsscnsncecsssasevecuseastasssessnacseasceasdesensooasnse 52 Printing Pay Rates cciccsscccscssenssscecssssesesessecesseeescenseseedesetavevedsaessensssdcasssccostenncsaanadedssesacssesedssessecssocses 53 Copying Pay Rates vcsccccrsesvssscocccccvvevevssccscsvoccsscosesevevsssdessssdesevernssscessssenevdaesssesvessduscs
233. each button 01 18 06 3 13 PM Page 219 of 448 Users Manual e Click the button for the information that you wish to enter e Click the New m button to create new assessment information e Enter the assessment information You may notice that some fields are not available for input The disabling enabling of fields is based on your answers to other fields This is defined by the OASIS Specification provided by Medicare e The screen may include multiple tabs multiple screens To access another tab click on the title of the tab e Once all of the assessment information has been entered press the Save a button to save the information If the screen is comprised of multiple tab multiple screens click on the title of the first tab to access the Save button Warning messages will be displayed if any required information has not been entered e Press the Exit Tl button to return to the initial OASIS Assessment screen e After you have entered ALL of the information for the OASIS Assessment change the status on the assessment to Completed by selecting Completed from the Status drop down Warning messages will be displayed if any required information has not been entered At any time you may click the Summary button to see display warning messages or errors if any required information has not been entered If the Plan of Care associated with the OASIS Assessment is for a Medicare payer the Summary button will also give yo
234. eate Date 2 7 AM Unallocated Cash 1 500 00 Service Dates Billing Dates Invoice Client Payer or Description Amount 12 02 01 12 05 01 12 01 01 12 07 01 0002019478 Cox Andrew A M Mutual Ins Total Cash Applied to Invoice Adjustment to Invoice 12 09 01 12 09 01 12 08 01 12 14 01 0002019592 Cox Andrew A 1 M Mutual Ins Total Cash Applied to Invoice Adjustment to Invoice V Show Open Invoices Only 9 30AM 01 18 06 3 13 PM Page 299 of 448 Users Manual Add a Account Log e To add a new account log click the New m button You can right click on the white space to enlarge the memo entry area as shown above Click inside the large white text window and type in the comment This window works like any standard word processor e Click the Save fl button e Each account log is saved as a unique log entry along with the creation date and time These logs may optionally be printed on the Invoice Aging report Modify a Account Log e To modify an account log click the Find A button A screen will be displayed of all of the account logs for the current account Click on the account log you wish to modify and click the Select button e You can right click on the white space to enlarge the memo entry area as shown above Click inside the large white text window and type in the comment This window works like any standard word processor e Click the Save i button e Each account log is saved as a unique
235. ecacsssccssscccuauasseeseecseueasdscesesocebscasscsessssennssasocesvsenesaaosodssssesuseaasesees 99 The Verification Process Weekly Payroll ssssosseessssssoossssssoocoesesssssoceseesssssooesssssoocsssssssssooese 100 Verifying Visits by Employee ccssccccssssscssscsccssseccsssscccssccesscsssccsscceesesscsccccceeessssssscceseeeeees 101 Verifying VISITS Dy CHENE sisccsssccscccsccctceessssdsssensedunsesocosensvesscsdsssdedevasacesdtesevesenansseesececnbbcas sscoueboues 102 Deleting AVIS ics ssisccesssccscsesesssusedscecstesecssecesseccsssansdssssevceasssssessvenstbecessssesssaeasedecedecvedsessssesssoscvons 105 MOVING 2A AAT E cccsscosscccsssonsecacassssssscusvasscesssostannonesosecesseoass cocsesosesensnsededeteUelacasescscesnoveuceasevesesesesausscs 105 VIEW OLED scsesccticeciccicecesssicesecdsedenssavessuasavedesassbsnsesandsisceosasesssudceuecssedeisesacecdeeasehieesacessdeesesscescacceaes 107 01 18 06 3 13 PM Page 4 of 448 Specify Employee vsssisscsccssessiscsisccccnvensssecssdectendsasccsssocteisesdcesevebecesosessesennssasesscsseseonasasdcsssssnsssacsssesesse 107 Employee Matchinng ccccssscccssscscssscccccssccecssssscccsscceeccssccecsccesssssssccccccsescsssscssscesesssssscosscsooees 108 Visit Phone Log Canceling a Visit sssccccccssssccssseccssssccccssccesssssssccccscessssscccsseeeessssscccccssoeee 111 COPYING a VASICSsccscecsccccsnedacacesssessncesshessesennesacesecssesesusaueseossnsanans
236. eccsssssescssssescssssescssssseesssssssssssssescssseseesoosseees 336 Command Window sccsssscccsssssssscssssccsssssesessssseccsssssescnsssecssssssscssssssecssssssecsssssscossssssssssssseees 336 Defining Accounting Periods sccccssssssssseccsssscccssscsccsssscccssceesesssscsscseeeessssscessoesesesscocssoes 337 01 18 06 3 13 PM Page 9 of 448 Defining SKUMSicciccissstsssssccistctstedesshsccccsceancscedsdedebsasaacscccccssdsasssesedesenscenacssseosstnanasesevessonneadnsscessessesss 338 Defining Sub SKills sscccccccssssccsscrscssssscscssceessssssssccsscssessssccescesssssssscoccssessssssccsssseeesssssscoeees 339 Defining AteriDutess icss ccscsesevessuevevesssevnsisoceccvocenesesesdsessdevsecdsseosdsenvobcnssedsoessennsasesssonsvsesesesssdesesessaes 341 Defining Employee Tracking Items csscccsccsssccsscseccccssscccsscceecessssccccceesssssscccssseseessssscoeees 342 Defining Sup plies cccscacsssccecsserwassccssdscisevovasssecosocesseasdssesessbnonsssesessersencansdsesseesasenassssdsesscsacescocseseuvante 343 Defining Services ih cissadinscccsceccsessassssesscesaaessoeseseswvebessecesodsdsvagdcocescsnsedscnsdseocscensenandscscadeasssesdesseeesees 345 Defining AMliatiOns cicscscccsccsssesesssccesccovosesscesssscsseesssesesssseseaasssesssesonnsadesddsscdedseadssscesensaaaanasdsosesenseaes 346 Defining Referral Sources cccccssssscscccssccssscecccsssscccsscceeccssssccsscesessssscsssscseseessss
237. ecsssesunseaesesesoseees 53 Updating Visits acisssisisccissccussdscstescesansstesssecsssnsdiccedsssderccsedesdesevodeasseeevesenonsancssedenwsesasesesssesnsseasscscstese 54 Defining Bill R t S ssssssssssesssesscossssosessicosrsseveser osar osos sarosar rsr KoE Eo rE EEEo SEs ssas SESS SESS 56 Deleting Clients sccssscsscsiciscsissedacssccsevsscasssseccssusevennscessscssveesecedesoenenenssesesestesenaascsdsesenesdnscesssessevenadeses 56 Defining EMD OVCOS cisien nesas ooreen teas isise esaeas Ers aaasta Saens 57 Finding an EMployee ccccssccosssssssescssonsnsessccesssoseccssscsssvonsesesessssesoonsssssessscesosessscssscssossasencees 58 Adding an EMPlOvee vivcsccsscecssescsssccecscoessscoscesesesbaccsssssesssannbeacsssodesusooasodcdesssscdbedssscdessneanssssesosesenvenes 59 Profile PAG ci siiccsicdeccccissesnsscsssssscusnssdasasdcccdcecdecaivesedetesesactcecdesevesenenesedebebenssnsoseesssesdsccsssssecSeasseseosesse 60 Witals SOCtOn As ei checo cies A waded ot ti fale Bid adn E il EA E 60 Payroll Billing Sections 4 408 sccede cesses fockad T A E EEEE 62 Miscellaneous Sectioit asic E tied teeta eect eee A Aaa oleae Sa ate ite a dade 62 PAXCS PAGE E OEE EE E 63 Exempt from Withholding Section cccesccceesssceeesseeceeeneeeeeeeneeeeseaeeecseaeesenneeeesnaeeeeseneeeessnaeeeesseeeeseneeeenss 64 Federal Sections ena ede sah gs cde sia tate aes ak ance cieseas a E shee sae es 64 State Sect OM vase tearcadissesades vest e des ace
238. ection Viewing Client Visit History e Click the Pay Rates button to add custom pay rates for this client Generally custom pay rates per client are not needed however in special cases they are See section Defining Pay Rates and Bill Rates e Click the Bill Rates button to add custom bill rates for this client Generally custom bill rates per client are not needed however in special cases they are See section Defining Pay Rates and Bill Rates e Click the Auth button to add insurance authorizations compliance rules for the client for self pay only See section Insurance Authorization This button will only be enabled if skills have been added on the Client Skills amp Codes Self Pay screen Readmitting a Client A client with a status of Discharged may be readmitted into an organization using the Readmit button on the Edit Client screen To access the Client screen select menu option Administration Clients The Edit Client screen is displayed Use the Find button to display the Client List screen Select the discharged or non admitted client to be readmitted Once the details of the client are displayed on the Profile page of the Edit Client screen the Readmit button becomes enabled Click the Readmit button e The Edit Client screen will be refreshed as if the New button has been clicked and a copy of All of the client s information is displayed Notice The beginning of the Client will remain
239. ee ile Ee Bie Adminstatcn schedule AH Gontiguratcn Meintenance Loan Semiicto Hepots Help E Add Pay Rates Copy Update Visits Payer DEFAULT gt Default Select Employee Tanya Acevedo Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 Hours 11 17 2001 10 30 10 30 10 30 11 00 11 00 11 00 C Visits 70 9 70 9 10 40 10 40 10 40 VIEW 11 17 2001 10 00 10 00 10 00 10 70 10 70 10 70 G AN 07 22 2000 9 40 9 40 9 40 10 10 10 10 10 10 a Current ORDER BY C Date Skill BILL Invoice z Reimb Mon Tue Wed Thu Fri Sat Sun Update Rates 1 0 00 0 00 0 00 _ 0 00 _ sooo 0 00 0 00 2 __ 0 00 0 00 _ 0 00 _ 0 00 _ 0 00 _ 0 00 _ 0 00 Stop 3 0 00 0 00 0 00 0 00 0 00 0 00 0 00 JM 19162001 11 43 AM Select the skil sub skilthattheratels represent SCS S S S S Ss CSCSSSS ST e Select the pay UNIT for the rate Hours or Visits e Select a skill sub skill or Any from the Skill combo box Only those skills that have been identified as valid on the Skills and Codes screen will be listed as a skill that may have a rate associated with it This is the case for Client Client Payer Relationships and Payers e Enter the starting Effective Date of the new rate e Use the Shifts and Rates buttons to select the shifts to which the rate i
240. eeccccecesssceeesceecseneeeeeeeneeeceneeeeseneeesenseeeesseeeesenseeesssteeeenseeeenes 82 Viewing an Employee s Schedulle ccssssssssccsssscssssscccsssccccsssccsccsssscccccesecsssscccsscceessssssccccesoesees 85 Viewing the Scheduler in Different Modes ccsssssssssccsscccsssscccssscccssscceesccsssccsceseessssscocssees 87 The Visit MOD iccccecccsccceccccedenacscedecccsedsssssoscesssoseoenssooesesesseceacsacseuceocsceasessssesascediccecesessacenccsecseaesbececs 89 Changing the Text That Appears on a ViSit ccccccssssssssssssssssccccssecccsssssccsccceesessccscseseeesssseees 90 Creating a Phone Log Entry Not Based Upon a Visit sccccssssccesscsesssccccssceesessssscscsoeeesssoees 91 Schedule Summary Display Screen ccccssscsscssssscsssssccsssscescsssscccsssceesssscccsseeseesssssccccesseeeessees 93 Viewing the Rules Governing the Current Schedulle ssscccccssssscsssssccsssssccsssceeessssscsccceeeeess 94 Viewing the Visit Legend ccsssccccccssssscsseeesscssscccssscesscssssccscccsssssscccsssseescsssssccecsssessssscossseeeeees 95 Creating A Visit sccsscecceeccendcd scssscosescsassessesesesoansodescevsecauaucesssosensveasaleseUeGounubanscccseusatacessssedesevaseuescosseses 96 Daylight Savings Time vscsssiscscscscssscssccenessensscsvenvenssespssessssvsceccsssdcsensvadesscecssecsnnesaecscedeceeecsscssessssesseoses 99 Editing a ViSIt c s scscdaccdssisesssbenstesetens
241. een e From the Scheduler screen click the Employee button to get to the Employee List screen SAM gt Melbourne GUEST Scheduler Ble Achinistraton Schedule AR Gontiauration Mamntenance Login Semiicto Hepots Help GA Employee List ATTRIBUTES NAME 7 SCHEDULED SERVICE wr aLL M Name Beginning With ALL as Comm 8 Active z during selected week 1071272002 1071872002 Reset List Binsbacher Pamela Black Christine Blanchard Kathryn A Select Employee to process Employee 000136 3 36 PM e Click the employee to whom you want to associate a pay item and then click the Pay Items button to go to the Edit Pay Item screen 01 18 06 3 13 PM Page 135 of 448 SAM gt Melbourne GUEST Scheduler Of x Bile Administration Schedule AR Gonfiguraticn WMeintenance Login SamiicGoa Reports Help F Employee List _ z Tanya Acevedo PAY ITEM Closed 10 29 1999 REIMBURSEMENT INFORMATION Tope couse Tesining E c Dae EE ea Amount Le Paid Dollar Amount Bill 0 00 Amount Hours Total Rate x 7 87 Invoice Desc M RAK 11031999 04 26 PM Enter payitem comments appears on sales and payitem reports right click F2 to zoom 3 37 PM e Click the New m button to add a pay item Pay Item Section This section defines how much is paid to the employee Click on the pay item you want to add from the Pay Item combo box Note that some fields are enabled or disabled depe
242. een e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click the Find button on the Edit Plan of Care Verbal Order screen e The Plan of Care Verbal Order List screen will be displayed e Click on the Plan of Care Verbal Order you would like to print preview and click the Select button The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care Verbal Order 01 18 06 3 13 PM Page 191 of 446 Users Manual e Make sure that the Plan of Care Verbal Order displayed is the one you want to print preview e Click the Print l button above the toolbar to print the Plan of Care Verbal Order or Click the Preview I button above the toolbar to preview the Plan of Care Verbal Order on the screen e You will be prompted whether or not you would like to Print locator 26 and 28 verbiage You may choose Yes No or Cancel Print locator 26 and 28 verbiage HCFA4 485 e If Print was selected you will be prompted whether you would like to print the Final D
243. elationships and associated skills codes and rates e All employees that occur on any visits for the client in the source office The employee availability and tracking information is also copied e The copy feature will not allow the copy of the client in the following circumstances 01 18 06 3 13 PM Page 334 of 448 Users Manual You may not copy a client to the same office The client will not be copied if the payer number already exists in the target office with a different payer name e The client will not be copied if the client already exists in the target office with the same name and SSN social security number phone number or birth date Copy Employee This feature will allow you to copy an employee and associated information from one office to another Copy Employee gt Melbourne GUEST Ble Administration Schectie AED Lonfiguretcn Mentenance Login Senco Reports Hep g Copy Employee x From Office Melbourne 0002 x From Employee Aaltonen Omega The employee will be copied to the target office with a new employee number The following info will be copied for the employee demographic rates availability and tracking To Office g ext RiverSoft Select office 12 57 PM Select the From Office to copy the employee from Select the From Employee name that should be copied Select the To Office to copy the employee to The employee will be copied to the target offi
244. elds Select the employee s sex using the Sex option buttons Enter the employee s Birth Date After you have entered and saved the preliminary information for the employee the Edit Status button will become enabled When adding a new employee you must press the Edit Status button to add a status for the employee To make the employee active you will press this button when it becomes enabled The available statuses are Active Applicant Claim Pending Do Not Use Inactive Not Hired and Terminated As an employee s status changes within the agency you can add the status and status date to the employee status screen keeping a history of their status in the agency e Click the New BI button on the toolbar to add a new Employee status e The status will default to Active in the Status combo box You may change this status to any of the following Applicant Claim Pending Do Not Use Inactive Not Hired or Terminated e Once you have selected a status enter a date in the Status Date field e The Reason field is only enabled for a status of Terminated e Click the Save button on the toolbar to save the new status e The list on the Edit Employee Status screen now displays a row with the Date column containing the status and date that you entered e You will use this screen to enter any employee statuses in order to keep a history of all employee status SAM gt Melbourne QA Edit Employee
245. elect button on that screen The Edit Plan of Care Verbal Order screen will be redisplayed with the Prime Physician field filled in with your selection Refer to the section Defining Physicians on how to add edit or delete physicians from the Physician Database Assigning the Case Manager to the Plan of Care It is recommended when entering a new Plan of Care that the patient s Case Manager be assigned as soon as possible however this is not required to save the new Plan of Care e Click on the Select button next to the Case Manager field in the section titled Miscellaneous 01 18 06 3 13 PM Page 165 of 446 Users Manual SAM gt Melbourne GUEST dministation Sehequle AR lontiguretion Memtenence Loan samiiomo Reports Help x Orders Goals Medications Compliance Rules Recert Copy Digonoses Suro P pree lt E Ello We PLAN OF CARE VEF Patient Name osh Agency Start of Care 06 2 Type Plan Cert Begin 06 2 Payer a BMC Healthne Primary Physician C 5 KHALED ABDELKADE Poraa ati Secondary Physicia Gauthier Marie ee Verbal Start of Care P Stet ol Cae oe Payer Received Discharge Date 7 7 Edit Payer Status Signed 77 m GUE ONZU2005 04 57 PM Select the desired Case Manager 4 37 PM e Select the case manager s name by clicking on it in the list on the Select Case Manager screen and then click the Select button The E
246. en in the front office database physically in the front office you may only make modifications to a user s password e To access the Edit User screen select menu option Configuration Users e The Edit User screen is displayed SAM gt Melbourne GUEST lel E Bie Adninisteton Schedule AG bonhaureton Mamtenance Loon samico Repots Hep User Profile l Scheduling Clinical AR Config Maint Misc Reports gt alo lx gt Ws FullName GUEST OO I Select All I Clear All User Code lt lt Get Unique Code Office Name Selected User Name GUEST Back Office Melbourne Password I Do Not Use IV System Administrator Copy Permits from Another User RS 06252003 06 02 PM Enter the user s full name 2 42 PM Creating a New User e On the Edit User screen click the New E button on the toolbar to add a new user e Enter the Full Name of the new user This name is for reference only e Enter the User Code for the new user This code must be unique across all users defined in your system and may be up to 3 characters in length This code is used to mark all records created or modified by the user If you do not know a unique code press the Get Unique Code button and the system will generate a new unique code for you e Enter the User Name for the new user This will be the User Name that the user will use to login The User Name may be up to 10 characters in length e Enter the Pas
247. en will appear with the moved visit displayed If you moved the visit to another week you will have to navigate to that week to see it 3 Update visit wizard to move multiple visits at one time 01 18 06 3 13 PM Page 106 of 448 View Order To view an Order right click on any visit to display the visit menu and then choose the View Order option Orders are containers that hold all of the visits by Payer Skill combination SAM gt Melbourne GUEST Scheduler lel Ee BIE Administration Schedule AB Eoniguaton Memntenence ogm Seniicto Hepots Help n Employee Rules Prefs Phone Sum Legend Month gt 12 ia 4 d gt I l Tel Client Helen Abbey A 555 739 0474 29 50 1 00 0 00 0 00 Hrs 2002 ES a EAE 10719 10 20 10 21 10 22 10 23 10 24 10 25 a Edit Schedule Order Order A01293 I Do Not Use n gt gt a LX gt We Client Helen Abbey Payer Set 01 Tufts Associated HMO N 05 17 2001 11 07 2002 Skill ENN o Netist 8 Payer Dates 0571772001 p170772002 Pay Unit Bill Unit Per Visit Qual Unit EPAR 9 59 4M Move to first record This will cause the Edit Schedule Order screen to be displayed This is an informational display only screen Specify Employee This is a very quick way to assign an employee to a visit It is important to note that if you use this feature the system assumes you know that the employee is available an
248. enance Login samomo Reports Cert Period 09 09 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Type Plan of Care X Patient Hem Abbey p Client 002080 02 T Goals Rehabilitation Potential Discharge Plans Select Phrases a f PAI OWO4 2002 12 04 PM Save all changes to database e Verify that the information section at the top of the screen describes the Plan of Care Verbal Order you want to create the Goals paragraph for e The paragraph may be edited like any standard word processor window i e you may highlight sections to cut and paste etc To copy text highlight the text and press Ctrl C To paste text press Ctrl V e When you are entering text for Goals and Orders if you want the text to occur on a new line click Enter and it will force a line break The Select Phrases button works the same as on the Edit Orders Paragraph screen 01 18 06 3 13 PM Page 173 of 446 Users Manual Defining Plan of Care Verbal Order Medications e To access the Edit Plan of Care Verbal Order Goals screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the
249. enote the client as a regular client a patient or a facility By choosing patient you can admit the client into your agency as a patient and create a plan of care and OASIS Assessment Facility This is a particular type of client for which you may be supplying staffing type of services Multiple employees normally provide Facility type clients service Examples of facility clients are hospitals and nursing homes Staff Employee A staff employee is one who is paid a salary SAM has the ability to pay staff employees a specific pay rate for visits over and above a number of visits that are expected as a part of an employee s salary Field Employee A field employee is one who is paid on a weekly basis for the time slips and notes they turn in Contract Employee A contract employee is one who works for an agency that provides employees Contract employees are paid by their own organizations Those organizations invoice your agency and you pay those organizations through your accounts payable system 01 18 06 3 13 PM Page 14 of 448 How List and Data Screens Work Terms Click click the left mouse button while the mouse pointer is on the item Select click the item then click the select button Double Click click the item twice quickly Shift Click click the item while holding the Shift key Control Click click the item while holding the Ctrl key Right Click click the item using the right mouse button D
250. ent one client payer relationships and associated payer s including skills codes and rates In addition any servicing employees will also be copied including availability and tracking The client will not be copied if the payer number already exists in the target office with a different payer name or if the client already exists with the same name and SSN phone number or birth date Note The poc in the new office will not be considered for Medicare PPS billing To Office Melbourne 0002 hd Melbourne 0002 fd Select office 12 56 PM Select the From Office to copy the client environment from Select the From Client name that should be copied Select the To Office to copy the client environment to The copy feature will copy the client to the target office with a new client number with the same admission number that the source client had e The following client information is copied e Client demographic information excluding referral e Dr Orders and Insurance Authorizations for the client e Clinical Patient information for the client including patient status and hospital stay history e The most recent Plan of Care only the last Plan of Care is copied It is important to note that the Plan of Care in the target office will not be considered for Medicare PPS billing e All client payer relationship and associated skills codes and rates e All payers on the client payer r
251. entifies the EclickMD Provider ID for export Plans of Care to an XML file that may then be used to import to a Care Plan Oversight and eSignature System CPOS Ini_EclickMD_ProviderID RIVEROO1 Ini_SAMdb_Path For a Fox Pro database installation this will direct SAM where to store the SAMdbxx zip backup files Ini SAMdb_Path N DEX Ini SQL Server Name For a SQL database installation this will direct SAM where to find the Server Name for the SQL database Ini SQL Server_Name RS10 1 Ini SQL_Database_Name For a SQL database installation this will direct SAM where to find the Database Name for the SQL database Ini SQL_Database_Name SA MDatabase Ini_SQL Backup Check Enable d For a SQL database installation directs SAM whether or not to display the warning message The xxxx database has not been backed up Please notify your system administrator If it is determined that the SQL database has not be backed up If there is not a entry in the SAM INI file this option will default to Y es Ini SQL Backup Check Ena bled N Ini_oncall_file path Directs SAM to save the On Call report spreadsheets to this network path This should be set to the network path of the folder that is used for file synchronization with the PDA i e If it is not defined the spreadsheets will go to n excel files and must be moved manually to sync with the PDA Ini_oncall_file_path C Docu ments and
252. er Visits Are there client employee rates Are there client payer rates Are there client rates Are there payer rates Are there agency default rates Are there agency default rates If all answers are no rate is 0 00 If all answers are no rate is 0 00 Employee pay rates are created and edited from the Edit Pay Rates screen e To access the Edit Pay Rates screen select menu option Administration Employees The Edit Employee screen is displayed Display the details of the employee See section Finding an Employee Click the Pay Rates button The Edit Pay Rates screen is displayed 01 18 06 3 13 PM Page 76 of 448 QA Edit Employee Gi Bontiaureticn Menterence Loan Semiicto Reports Hep 11171772001 10 00 10 00 10 00 10 70 10 70 10 70 i 11 00 11 00 11 00 1121772001 10 00 10 00 10 00 10 70 10 70 10 70 e Invorce Remb Adding Pay Rates e Select the payer that is associated with the pay rates you are going to define by clicking the Select button next to the Payer field then select a payer from the Payer List form Or click the Default button next to the Payer field to default to all payers e Note that the Employee field displayed next to the Payer field contains the name of the employee the pay rates are being defined for e Click the Add Mode b button to add a new rate 01 18 06 3 13 PM Page 77 of 448 SAM gt Melbourne QA Edit Employee x
253. er reviewing the visits the back office closes the week to lock the data permanently Also when the back office performs a close week overtime is recalculated across all offices including shared employees across offices 01 18 06 3 13 PM Page 235 of 448 Users Manual SAM gt Melbourne GUEST lei Ee Ble Administration Schedule AE Configuration Memtenence Loan Saniicto Hepots Help inl Close Week Melbourne This office is closed Closed at Closed at Back Office Front Office 0001 Back Office 0002 Melbourne l Closed 0672172005 The Close Week screen displays all the offices in the database and whether they have been closed in the front and or back office for the current week If an office has been closed at the back office it will show Closed in the back office column If an office has been closed at the front office it will show the date that it was closed in the front office column If no date appears in the front office column for an office that office cannot be closed at the back office The only way to change a visit after it is closed is through an adjustment Visits must be closed to appear on the sales report to be invoiced to be interfaced to payroll or to be interfaced to the general ledger Perform the following steps to close the week e To access the Close Week screen select menu option AR Close Week e The Close Week screen will be displayed e Select the office s to close from the list
254. er the value e The Period Number will default to 01 press the tab key to accept this default or type over the value e Enter the period Start Date e The End Date will default to the end of the start date s month press the tab key to accept this default or type over the value e Click the Save El button e To add another period click the New m button e Notice that all fields will default to the next month based period e Complete the information for the new period and click the Save i button 01 18 06 3 13 PM Page 337 of 448 Users Manual You cannot modify a period you must delete it and add it using the Delete x and New m buttons This is done because it is assumed that the periods for fiscal years are entered for the next several years during the same editing session This screen is optimized to make this one session simple and quick The periods are used on the General Ledger reports screen to organize sales cost payments cash applications and adjustments into date ranges Before information for a period can be transferred to the general ledger the period must be closed Defining Skills SAM is delivered with a standard set of predefined skills but an organization may define additional skills Skills are associated with employees in order to determine the type of work they are capable of doing i e Registered Nurse Homemaker Skills can also be associated with a client in that the client
255. er the From and To cash application dates this is the Date entered when the cash application record was created or leave the fields blank for all cash application records regardless of date e Select the appropriate sort criteria e Note when the Payment Cash Application Report print option is selected the sort criteria Invoice No becomes enabled This sort is useful when trying to identify what cash has been applied to a specific invoice e Select the Office for the cash application records this is the office associated with the invoices the cash was applied to or select ALL for all offices e Make sure the Payment Cash Application Report print option is selected e Click the Generate button The Payment Cash Application Report may also be generated for a specific payer as described above for the Payment Log Payment Adjustments Report Option on Payment Log screen A Payment Adjustments Report may be generated using the Payment Log screen This option produces a report of payment adjustments and refunds for payments depending on the selection criteria 01 18 06 3 13 PM Page 286 of 448 Users Manual On the Payment Log screen Enter the From and To adjustment dates this is the Date entered when the adjustment record was created or leave the fields blank for all adjustment records regardless of date Select the appropriate sort criteria Select the Office for the adjustment records this is the office logged into
256. er the employee s professional Licenses s The first license number will appear on the invoice on each line item representing service performed for this employee e Select how the employee s paycheck is to be sent to the employee from the Check Handling combo box e Enter the maximum number of hours the employee wants to work into the Max Hours field Scheduling will use this information in the employee matching function e Ifthe employee should not receive premium rates for working overtime check the Exempt from Overtime check box e Ifthe Employee Type is a Staff Employee salaried and the employee has agreed to perform a certain number of visits for their salary but visits over that number should be paid over and above their salary enter the number of salaried visits into the Salaried Visits field Make sure that the pay rate for the visits performed by the employee are at the rate they should receive if they were being paid over and above their salary When the week is closed the verified visits are automatically counted and the visits falling within the salaried quota are marked as already paid and are not counted in the week s payroll All visits for the employee over the salaried quota are counted and paid in the week s payroll e If you want to pay the employee an amount more than the normal pay rates defined for your agency enter the additional amount per hour and per visit in the Merit Pay fields This is assuming
257. erforming the final close e To Close Week select menu option AR Close Week Selecting this option causes the Close Week screen to be displayed E SAM gt Melbourne GUEST lei Ee Bie Acministaton schedule AE Gonfiattatcn Memntenence Loan Semiicie Reports Help fal Close Week x Closed at Closed at Back Office Front Office Gose Week Exit the screen The Close Week screen displays a list of the offices in the front office s database This is normally one office but it is possible to separate a site into multiple offices The week is closed for an office by highlighting the office and clicking the Close Week button 01 18 06 3 13 PM Page 141 of 448 Overtime Report If the close week function detects that some employee have overtime an overtime screen will pop up and display the overtime cases It is a good practice to print this overtime list every time it is displayed then cancel the close week process to correct any overtime problems and or print a new verified visit report that shows the overtime information SAM now offers 2 ways to calculate overtime pay for your employees Algorithm A Overall Average Rate Algorithm A is the default overtime calculation This algorithm calculates an overtime rate based on the overall average pay rate of an employee per week The average rate is computed by dividing the total pay for the week by the total hours for the week of visits and or pay items that count towards overtime
258. es Self Pay Client Attributes Client Ancillary Info Client Race Beadmit Payers Visits Pay Rates Bill Rates Auth al 4 2 i Hl fal X lt gt p VITALS Client Client Type Patient 7 Entry Date 0671372005 Client Name H Zip Code Affiliation None jd sous ST Phones o M __ a Birth Date _ Sex Male Female SSN TaxTenitoy CSR GUEST x Comment z l Referral nny SELF PAY BILLING INFO Name _____ Same ZipCode zl Payer Class Private Pay 7 Payer Program Private Pay z Service Location Home z Billing Supervisory Frequency Visit Freq ee Weekly 1 50 Holiday C BiWeekly Days 1 50 07 C Monthly Weeks 200 Dbl C Months _ _ 0 00 Weekend z per hour Tax Exempt ID M Show Times Bill Notes _ Select the client type 2 55 PM 01 18 06 3 13 PM Page 18 of 448 After you have changed or added client information click the Save i button to save your work If you have mistyped information click the Restore Lo button to restore the currently displayed record to the data last saved To delete the record you are looking at click the Delete x button To exit the screen click the Exit T button 01 18 06 3 13 PM Page 19 of 448 Defining Payers To access the Payer screen select menu option Administration Payers The Edit Payer screen contains tabs for pages of related inform
259. essaeseotgusensdsaaeossilubandiencseses 358 CHIENE PAV EN LAS ivcsccsscsesesessssseseserevennsesdesesescnsseseseececsseseseseseuvveweedsesssseenetdsessdededubunenscdsesecusesensssedeses 358 Employee Tax Withholding Report sccccccssscccssssccsssscccssseescsessscccssscesssscccscssesesssssscocesooeee 358 Visit Compliance REPOMt viisccisscccccccevscccsssssseccsecssssessssesedecssedsocsesvassassdsececvavesssecessseannanassscssanseccesesss 358 Employee Tracking Report scccccsssscsssssscssssssccssscccsssscccssceesesscccsscccsescssssccccccsesssssssossseeseees 359 VISIE REPOT sc ssevsssscsccsvseacssoacesdceossncecasssccssoscsvavcucscecscebedssssscosocesbansdessessssudeedssdcedscasseeesessesscensesasneses 359 Billing Application Group Reports ssccccccssccssscssssccsscscssssscccccsscscsccssscecessscccsssesesesssesesees 360 Accounts Receivable Function Group Report ssssscccsssscsssseeccssssscscsscesessssscccseessesssccessees 360 401k and Paycheck Reporting 5 535 so so hh Sod co heeded tee E occ E A E S 360 Adjustment Reports osc sce oss Gnd chee learns ieee a See a ee eee 361 General Ledger Cash AR Summary icenen a E E A R N a 362 General Ledger Reports nern n E E E ee cee ee ee ee ee 363 IMVvoice Aging Reportaasi edie che ER R Sede eet eee eee 364 MNVOICE R sister en e a ites genes OS Saeed eee ee 365 Medicare Episode Report 2 502 cece tetas Ate cove eee eed etd AE eee et EES 366 Payroll Interfac
260. et on Edit Client Payer screen followed by the payer name e The Payer Start End Date fields contain the payer set Start End Date same as the Start End Date on the Edit Client Payer screen To modify the displayed Payer Start of Care date for the displayed payer e Enter the desired date in the Payer Start of Care field e Click the Save fl button to save the new status and date 01 18 06 3 13 PM Page 203 of 446 Users Manual e The Edit Plan of Care Verbal Order screen will be redisplayed with the Payer Start of Care field filled in with the saved start of care date The Payer Start of Care is now available to be used as the Start of Care on all HCFA 485s and Claims associated with all Plans of Care for this payer Discharging a Patient from a Payer To discharge a patient from a specific payer and not the agency i e Medicare e To access the Edit Plan of Care Verbal Order screen to modify the payer status dates select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to discharge from a payer e Click on the Define Plan of Care Verbal Order button e Use the Find button to select the latest Plan of Care associated with the payer the patient is to be discharged from NOTE Selecting the latest Plan of Care for the payer is especially important after the patient has already been discharged and then readmitted to the payer in
261. et for the payer for the patient Use the Edit Client Payer screen to create a new payer set for the payer the patient is to be readmitted to Refer to section Defining Client Payer Sets for screen pictures To access the Client Payer screen select menu option Administration Clients and click the Payers button SAM gt Melbourne GUEST Edit Client Payer Of x Bie Administration Schedule AR Eoniguaton Mamtenance Logam Seniictto Reports Hep Client Payer Profile l Client Payer Requirements Client Payer Skills amp Codes Ins Auth Pay Rates Bill Rates gt gt a D fal Be PAYER INFORMATION Set A4 POLICY INFORMATION I Do Not Use Client Helen Abbe insureds ID Payer Medicare N Select Authorization aay Bill Name DEE SS O OCG roupName ____ Contact ___ PayeaD efault Group Number C Address Policy Number Assoc Hosp Service of Maine Aud leonizend Dates e ovo1 2001 Sf 270172002 Zip Code 04106 6911 South Portland ME 04106 z T Use this payer for all Point of Care information Phones 1 207 822 8585 Extension _ mac INVOICING INFORMATION CSR GUEST 7 Invoice Method Percent 100 00 C CoPay EEG Pe visit INSURED S INFORMATION Supervisory Relation Patient is Insured z Visit Freq Days Weeks Name Helen Abbe C Months DOB 06 24 1999 Sex C Male Female Bill Notes o Employer
262. evel A patient has an Agency Current Status Incomplete Active Hold or Discharged The Agency Current Status is the patient s status in the agency no matter how may payers the patient has i e Self Pay Unisys and Medicare The patient is only discharged from the agency when the patient is no longer receiving any care by the agency A patient is admitted and discharged from the agency by first selecting the Clinical Information menu option to display the Edit Patient screen then pressing the Edit button on the Edit Patient screen which in turn brings up the Edit Patient Status screen Refer to the sections Admitting a Patient into the Agency Discharging a Patient from the Agency and Modifying a Patient s Agency Status for more information on setting the patient s Agency Current Status A patient is admitted to a payer simply by defining the client payer relationship via the Client feature SAM also gives the user the capability to discharge a patient from a payer without 01 18 06 3 13 PM Page 201 of 446 Users Manual discharging the patient from the agency and then to readmit the patient to the payer This feature is used in an invisible fashion and does not have to be used This capability allows offices that have patients receiving some care covered by one payer i e Medicare and also some other care covered by a private insurance company or Self Pay a way to discharge the patient from Medicare
263. f pay invoice You first rebill the visit so that it will be adjusted off of the original payer s invoice Rebilling an item causes the item to think that it has never been billed This means that to get the item on an invoice you must create invoices 01 18 06 3 13 PM Page 317 of 448 Users Manual Closing a Period and the General Ledger Interface All sales cost payment cash applications payment adjustments and invoice adjustments flow to the general ledger through an interface The date associated with each item is used to determine what period the item belongs to All visits supplies services and pay items belong to the period that their payroll date falls in Payments cash applications payment adjustments fixes recoups and refunds and invoice adjustments each have an associated item date Each item belongs to the period that this date falls into When closing a period first run the GL sales cash adjustment and Worker s Compensation reports for the period This causes data to be extracted from the live database into the GL database Each time the reports are run against an open period the data is re extracted and refreshed in the GL database Once the period is closed the GL database entries for the closed period are locked and all subsequent reports for the period are done from the locked data in the GL database You will notice that it takes much longer to run the GL reports for an open period than
264. f the office NNAM e To preview the claim click the Preview IL button e To print the claim click the Print BI button e To delete the claim click the Delete x button If you would like to change the claim type for instance you no longer want a HCFA 1500 for this invoice you would instead like a UB92 claim Simply delete the HCFA 1500 claim then return to the Invoice Details screen click the Edit Claim button and choose which claim you would like created HCFA 1500 or UB92 Even though this screen may be used to add change data on a claim it is NOT recommended that you do so unless it is your last resort or you are editing a Medicare PPS claim The information that appears on a claim is generally stored somewhere else in this system If you can find the source of the data that appears on your claim fix the data there instead of on the actual claim If you fix the data at its source you will not have to fix each subsequent claim It is recommended that you use the Claim Mapping tables at the end of this document to pinpoint where claim data can be found in this system After correcting the data at its source you should delete the erroneous claim and then recreate it using the steps described above 01 18 06 3 13 PM Page 274 of 448 Users Manual Medicare PPS Claims The Claim created for End of Episode EOE contains line items for visits and supplies closed at the time the episode is detected
265. f you wish to add a new status for the client or facility the available statuses are Active Hold and Inactive As a client or facility s status changes within the agency you can add the status and status date to the Edit Client Status screen keeping a history of their status in the agency e Click the New m button on the toolbar to add a new client or facility s status Select the appropriate status from the Status combo box Once you have selected a status enter a date in the Status Date field e Click the Save i button on the toolbar to save the new status e The list on the Edit Client Status screen now displays a row with the Date column containing the status and date that you entered e You will use this screen to enter any client or facility statuses in order to keep a history of all client or facility status 01 18 06 3 13 PM Page 30 of 448 Client Atwood Marjorie Client 000305 01 Date Status Reason 03 25 1999 Active 01 18 2006 Client Status not Patient Status Client Status not Patient Status Status Inactive v Status Date for718 2006 lt 4 Delete Comment a GUE 01182006 09 18 AM e Click the Exit button on the toolbar to exit the Edit Client Status screen e If you wish to remove a status from the Edit Client Status screen click on the status you wish to remove then click the Delete button Vitals Section continued Enter the client s telephone number s
266. fice is subject to daily overtime If checked overtime will be automatically calculated as a part of closing a week Enter the times for Shift 1 Start Shift 2 Start and Shift 3 Start as desired These values are used in scheduling for staffing assignments The Shift 1 End Shift 2 End and Shift 3 End times will be adjusted depending on the values of the start times entered e After all the office information has been modified correctly click on the Save i button Office OASIS Header Info OASIS Header information may be entered for each office on the Office OASIS Header Info page on the Offices screen OASIS header information is stored for each office This information is used for each OASIS Assessment export 01 18 06 3 13 PM Page 324 of 448 Users Manual Edit Office gt Melbourne GUEST lel x Ble Administration schedule AED Eoniauaton Mentenance Login SeniioGo Reports Help Office Profile 0002 Melbourne Office OASIS Header Info Agency Name Street Address 1 SueetAddess2 OO O o Ciy State Zip 201 Contact Phone Ext Unique HHA ID Code Office Logo Medicare Provider Number 227200 M0010 Medicaid Provider Number 060300 M0012 Branch ID Number _ M0016 11 46 AM e Itis important the information on this screen be completely filled in You may not have a Street Address 2 Ext Unique HHA ID Code or Branch ID Number e The Branch ID Number is valida
267. field Select a Status of either Onset Exacerbation or History that is associated with the Date For Verbal Orders select the Verbal Order Status of either New or Discontinued e Make sure that all the information is correct for the new diagnosis e Click the Save i button on the toolbar to save the new diagnosis e The new diagnosis will be displayed in the list on the screen The first diagnosis in the list is the patient s Primary Diagnosis for the Plan of Care e At this point you may enter other new diagnoses by repeating the steps above e Click the Exit T button on the toolbar to exit the Edit Diagnoses screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying a Diagnosis e Refer to section Defining Plan of Care Verbal Order Diagnosis to display the Edit Diagnosis screen e Verify that the information section at the top of the Edit Diagnoses screen describes the Plan of Care Verbal Order you want to modify diagnoses for 01 18 06 3 13 PM Page 168 of 446 Users Manual On the Edit Diagnoses screen select the diagnosis you would like to modify by clicking on it in the list on the screen The details of the selected diagnosis will be displayed in the fields on the lower section of the screen You may modify any of the fields displayed in this section Make sure all the modified information about the diagnosis is correct Click the Save a button on the toolbar to save t
268. fing Skilled Nursing If you add a valid skill of SN you may assign a RN a LPN or a LVN type of skill to a visit If you add a valid skill of SN Staffing you may assign a RN Staffing or LPN Staffing type skill to a visit The Skill Category SN is delivered with your software if you wish to have the Skill Category SN Staffing please contact your software representative Click the Attributes tab to go to the next page Client Attributes Page The Attributes page is used to help in the assignment of employees to a client that has specific needs These attributes are used in the employee matching function of Scheduling when assigning an employee to a visit Generally it is not necessary to define skills and attributes to clients but some cases do need them These attributes are also used to fill in the PHC and CBA formats of the Timesheet report Schedule Manager gt Melbourne GUEST Edit Client File Schedule Administration Payroll System Help Client Profile Client Skills amp Codes Self Pay Client Attributes Client Ancillary Info Client Race Marjorie Atwood ATTRIBUTES WANT EMPLOYEES THAT CAN ARE Master list of attributes double click or Add to add entry to client list 10 31 AM 01 18 06 3 13 PM Page 34 of 448 Attributes Section e Click any attribute in the list then click the bottom Add gt gt button next to the list to add it to the Want Employees That Can Are selecti
269. for e Click on the Define Plan of Care Verbal Order button e On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click the Find button on the Edit Plan of Care Verbal Order screen e The Plan of Care Verbal Order List screen will be displayed e Click on the Plan of Care Verbal Order you would like to delete and click the Select button The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care Verbal Order e Make sure that the Plan of Care Verbal Order displayed is the one you want to delete e Click the Delete x button on the toolbar to delete the Plan of Care Verbal Order e Click on the Yes button in the popup screen that asks Delete displayed Plan of Care Verbal Order e The detailed information about the deleted Plan of Care Verbal Order will be removed from the Edit Plan of Care Verbal Order screen and from the Plan of Care Verbal Order List screen e At this point you may delete other Plan of Care Verbal Orders by repeating the steps above e Click the Exit Tl button on the toolbar to exit the Edit Plan of Care Verbal Order screen Recertifying Copying a Plan of Care Recertifying or Copying a Plan of Care is the function of the Recert or Copy buttons on the Edit Plan of Care Verbal Order screen Verbal Orders cannot be recertif
270. for a closed period That is because reporting on open periods cause an extraction to occur from the live database While a period is open values on reports may change because they reflect the live database Once the period is closed the values on the reports for the period will of course never change Below is how to run the GL reports GL Sales Cash Adjustment and Worker s Compensation Reports e To access the General Ledger Reports screen select menu option Reports The Select Report screen will be displayed Click the Accounts Receivable option Click the General Ledger Reports report Select the office from the Office combo box or choose Al Select the period you may choose any closed or open period If you want to select by service dates click the Service option and enter the service date ranges for the report e For sorting and grouping the sales and cost report refer to the panel on the right side labeled Sort Sales Report By By dragging an item to a new position you can cause the report to be sorted in any order you wish e By default the report will generate for the period or date range you have selected However if you would like quarter to date figures select the Quarter To Date option If you would like year to date figures select the Year To Date option By default only the Sales Cost report will be generated If you want a Cash report click the Report Cash Entries option If you want an Adju
271. for the work item units The space for work units is very small and if the unit is greater than or equal to 10 only 1 decimal place will be printed e Signed Plan of Care and billable visit If this is turned on and if the payer is Medicare The system will not create a EOE if it finds that the Plan of Care or Verbal Orders during the certification period do not have a date in the received signed field In addition if a billable visit is not found during the certification period the RAP will not be created e Ifthe payer requires that Supplies be summarized to one line on the claim click on the Summarize Supplies option The right side of the screen displays what has been defined for the Payer Adding Client Payer Requirements Skills and Codes The Skills and Codes page is used to select from the Skills added to the Payer those that may have services scheduled for this particular client No visits may be scheduled for the client until valid skills have been identified A valid skill must be added on the Skills and Codes Page in order to add Pay Bill rates for the skill on the client payer relationship In addition if the Revenue Codes HCPC Codes or Modifiers are different for this client than what has been entered for the payer they may be entered on this screen 01 18 06 3 13 PM Page 45 of 448 SAM gt Melbourne QA Edit Client Payer lel Ea File Administration Schedule AR Configuration Maintenance
272. fying Diagnoses Priorities e On the Edit Diagnoses screen click the Reorder button under the toolbar on the screen SAM gt Melbourne GUEST ox Ble Administration schedule AR Lonfiguretion MWemntenance logn samiono Reports Help E Edit Diagnoses mr xj L _ Patient Helen dhhen Client nnonan no maS el pi fal Reorder Priority x PL Patient JHelen Abbey Client 002080 02 Cert Period 0370972002 11 07 2002 POC A0001486 Pi Payer Tufts Associated HMO Type Plan of Care A si ICD 9 CM Diagnosis Description Date 07E VO Status 0796 RESPRTRY SYNCYTIAL VIRUS 33510 _ SPINAL MUSCL ATROPHY NOS ESOPHAGEAL REFLUX 06 2471999 0 04 01 2001 O z PAI OWO42002 12 04 PM Position Diagnoses in desired Priority Order e Click on the 1 button and drag a payer in the list to reorder its position within the list e Click the Save Order button to save your changes e The Edit Diagnosis screen will now be displayed with the diagnoses reordered as you selected e Click the Exit button on the toolbar to exit the Edit Diagnoses screen The Edit Plan of Care Verbal Order screen will be redisplayed Defining Plan of Care Verbal Order Orders Paragraph The Orders button on the Edit Plan of Care Verbal Order screen is used to create the paragraph corresponding to the HCFA 485 Locator 21 paragraph Orders for Discipline and Treatments This paragraph typically contains Doctor Order
273. g the steps above Click the Exit T button on the toolbar to exit the Edit Medications screen The Edit Plan of Care Verbal Order screen will be redisplayed 01 18 06 3 13 PM Page 176 of 446 Users Manual Deleting a Medication e Refer to section Defining Plan of Care Verbal Order Medications to display the Edit Medications screen e Verify that the information section at the top of the Edit Medications screen describes the Plan of Care Verbal Order you want to delete medications from e On the Edit Medications screen select the medication you would like to delete by clicking on it in the list on the screen e The details of the selected medication will be displayed in the fields on the lower section of the screen e Make sure that the medication displayed is the one you want to delete e Click the Delete x button in the lower section of the screen e Click on the Yes button in the popup screen that asks Delete displayed Medication e The deleted medication will be removed from the list on the screen e At this point you may delete other medications by repeating the steps above e Click the Exit Tl button on the toolbar to exit the Edit Medications screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying Medication Priorities e On the Edit Medications screen click the Reorder button under the toolbar on the screen SAM gt Melbourne GUEST lel Ea Ble Administration schedule AR Lonfi
274. ge 372 of 448 Users Manual Sales Misc Report Use this report to report sales by Service Location The Sales Misc report that will create 2 Excel xls files 1 medicaresalesbyservloc xls this file reports the total sales for Medicare by Service Location 2 nonmedicaresalesbyservloc xls this file reports the total sales for all Non Medicare by Payer Class and Service Location Also included are total costs transportation sales and cost sales tax and invoice adjustment totals SAM gt Melbourne GUEST Me x File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help x REPO si Sales Miscellaneous Report Billing Week Ending Dates 4 774 Jv Adjusted Medicare PPS Sales by Service Location M Adjusted Non Medicare Sales by Service Location x Generate Revo Ontns est Enter the from Invoice date 12 55 PM 01 18 06 3 13 PM Page 373 of 448 Users Manual Sales Item Report This is an excellent report to run to report almost any information regarding closed visits Sales Item Report gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Sales Item Report Back Office 0001 Client ALL Exclude Items For Client Facility Patient Employee ALL Exclude Items For Contractor Staff Field Select Payer Info All Classes Payers Programs a f C Clas
275. ge Reindex To setup the Data Exchange Reindex options select menu option Configuration Data Exchange Reindex CE SAM gt Melbourne GUEST RIED Aaministiaton Schedule Ai lontgureaton Memntenence Login samiot Reports Hep Wi Data Exchange Reindex Configuration E B M M M M M To setup Data Exchange to process automatically in your back office l 2 3 4 Access the Data Exchange Reindex Configuration screen On this screen you may specify the times of day the days of the week and the office s for which data will be exchanged Click the Set Defaults button Exit the screen SAM s RiverSoft Process Monitor service which is automatically running continually on your server s will automatically process the requested data exchanges For your front offices there is no need for any setup in SAM the function that processes data exchange files will be done automatically by the RiverSoft Process Monitor service Exchange Now If for any reason you would like to exchange data with an office immediately for instance you would like their payroll information NOW select the target office and click the Exchange 01 18 06 3 13 PM Page 352 of 448 Users Manual Now button SAM will send a request to the RiverSoft Monitor Process service to begin a Data Exchange Data for the front office will be extracted a connection with the office will be established and the file will be sent to the office
276. guration Mentenance Login Senlicto Reports Help a E xj Patient Helen Abbev Client 002080 02 olmal g E Pi Patient Helen Abbey E Client 002080 02 M Cert Period 09 03 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Type Plan of Care T Medication Name Quantity Dosage Route Frequency Stat Start Date M 5 mg 7 10 ml GT QD 0 FERRAN Al 7 TYLENOL SUPP S 5 L mask PRN for resp distress Pl E ACETAMINOPHEN 1 tsp 160 mg GT PRN Q 4 HOURS IBUPROFEN 1 5 tsp 150 mg GT PRN q 6 hours _ J SINGULAIR GT QD PULMOCORT UPDRAFT inhaler QD lo PAI OWO42002 12 04 PM Position Diagnoses in desired Priority Order e Click on the 1 button and drag a payer in the list to reorder its position within the list e Click the Save Order button to save your changes 01 18 06 3 13 PM Page 177 of 446 Users Manual e The Edit Medications screen will now be displayed with the medications reordered as you selected e Click the Exit Tl button on the toolbar to exit the Edit Medications screen The Edit Plan of Care Verbal Order screen will be redisplayed Defining Plan of Care Verbal Order Surgical Procedures e To access the Edit Plan of Care Verbal Order Surgical Procedures screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan
277. he Comment field if desired this comment appears on the Payment Adjustments Report e Click the Update List button to see the new adjustment item displayed in the list e Click the Save i button to save the changes e Click the Exit T button 01 18 06 3 13 PM Page 295 of 448 Users Manual Determining Which Refunds Have Had AP Checks Written When a check is written to refund a payment to a payer from the accounts payable system you can track this by checking the AP Check Written checkbox on the Adjust Payment screen for the associated refund payment adjustment This information will be included on the Payment Adjustments Report In this way you can track what refunds entered during a period of time have been processed via accounts payable Recouping a Payment When a payer is over billed and sends a remittance advice with instructions of how to apply the overage to some other invoice on its account the process is called a recoup Recouping is done in two steps first cash is un applied from the invoice that was incorrectly billed to the payer Then the new unallocated cash is applied according to the directions on the remittance advice The side effect of a recoup is that there is now an invoice that does not have cash applied to it This invoice must be re billed to the appropriate payer Tracking Receivables There are many tools specifically designed to make tracking an agency s receivables a simple straightforward proce
278. he Edit OASIS screen is displayed make sure the correct Patient Name is displayed on the screen e Press the Find l button to locate the OASIS Assessment you want to Modify A screen will be displayed that lists the OASIS Assessments for the patient Highlight the assessment you want to modify and either double click or click on the Select button The Edit OASIS screen is then displayed with the OASIS Assessment that you selected e Make sure that the OASIS Assessment displayed is the one you want to print e Click the Print E button on the screen to print the OASIS Assessment e You will be prompted with the same message as if you had clicked the Summary button After answering the prompts your assessment will be displayed in a Report View Windows e From this Report View Window you may view print or save the pdf file e Click the XI button to exit the Report View Window e At this point you may print other OASIS Assessments by repeating the steps above e Click the Exit button on the toolbar to exit the Edit OASIS Assessment screen 01 18 06 3 13 PM Page 224 of 448 Users Manual Exporting OASIS Assessments You may export your OASIS Assessments to a file SAM does not submit the file to your state s OASIS website this will need to be done after exporting the file Note that OASIS Assessments will not be listed on the OASIS Export screen if the patient was less than 18 years of age at the time that the assessment
279. he Payer Start of Care field filled in with the saved start of care date The Payer Start of Care is now available to be used as the Start of Care on all HCFA 485s and Claims associated with all Plans of Care for this payer The patient is now readmitted to the payer and the shell for the initial Plan of Care has been created At this point the contents of the Plan of Care may be modified and completed correctly 01 18 06 3 13 PM Page 207 of 446 Users Manual Verbal Order Management Entering a New Verbal Order A Verbal Order should be created for a patient whenever the physician has decided to make a revision to the original Plan of Care for the patient The original Plan of Care should not be modified but instead the change is documented by creating a Verbal Order associated with the Plan of Care The Verbal Order form created is titled Revision to Plan of Care A Verbal Order documents change to any part of the Plan of Care including Medications Diagnoses Surgical Procedures Supplies Orders and Goals A new Verbal Order is created for a patient using the Edit Plan of Care Verbal Order screen You are required at a minimum to select the New Verbal Order button enter the Cert Begin and Cert End dates select a Payer select a Physician and enter the Verbal Order Date It is very important that the Verbal Order has the same Cert Begin and Cert End dates Payer and Physician as the original Plan of Care that this Verbal Order is d
280. he modified diagnosis The modified diagnosis will be redisplayed in the list on the screen At this point you may modify other diagnosis information by repeating the steps above Click the Exit button on the toolbar to exit the Edit Diagnoses screen The Edit Plan of Care Verbal Order screen will be redisplayed Deleting a Diagnosis Refer to section Defining Plan of Care Verbal Order Diagnosis to display the Edit Diagnosis screen Verify that the information section at the top of the Edit Diagnoses screen describes the Plan of Care Verbal Order you want to delete diagnoses from On the Edit Diagnoses screen select the diagnosis you would like to delete by clicking on it in the list on the screen The details of the selected diagnosis will be displayed in the fields on the lower section of the screen Make sure that the diagnosis displayed is the one you want to delete Click the Delete x button in the lower section of the screen Click on the Yes button in the popup screen that asks Delete displayed Diagnosis The deleted diagnosis will be removed from the list on the screen This may cause the priority of the remaining diagnoses to be automatically adjusted At this point you may delete other diagnoses by repeating the steps above Click the Exit button on the toolbar to exit the Edit Diagnoses screen The Edit Plan of Care Verbal Order screen will be redisplayed 01 18 06 3 13 PM Page 169 of 446 Users Manual Modi
281. he most recently updated shared employee record is reported Ifa particular office is selected the shared employee record for the selected office is reported lei E Employee List Report gt Melbourne GUEST Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Employee List Report x SELECT EMPLOYEE ATTRIBUTES DISPLAY OPTIONS ALL IV Include Vitals Info I Include SSN Fed ID Employee XT I Include Payroll Info Skill ALL IT Include Comment P Include Availability Type ALL I Include Referral Status ALL I One Employee per Page I Shared Employees Only T Run Summary Report Use Current Status Status Dates Attribute lany O E F Include Last Work Date Between Affiliation aT ro Hire Dates O OC y M Visits M Pay Items 01 18 06 3 13 PM Page 381 of 448 Users Manual Employee Tax Withholding Report This Employee type report details all the tax withholding information entered in the system for employees je Employee Tax Withholding Report gt Melbourne GUEST Me File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help x APPLICAT SALEEM ti Employees that have never received a payroll check via SBT 4 11 PM 01 18 06 3 13 PM Page 382 of 448 Users Manual Employee Tracking Report This Employee report shows detailed information about specified employee tracking item on employees This report can
282. he next level of rates is searched How SAM Computes a Visit s Pay Rate Self Pay Visit All Other Visits Are there client employee rates Are there client employee rates Are there employee rates Are there employee payer rates Are there client rates Are there employee rates Are there agency default rates Are there client payer rates If all answers are no rate is 0 00 Are there client rates Are there payer rates Are there agency default rates If all answers are no rate is 0 00 How SAM Computes a Visit s Bill Rate Self Pay Visit All Other Visits Are there client employee rates Are there client payer rates Are there client rates Are there payer rates Are there agency default rates Are there agency default rates If all answers are no rate is 0 00 If all answers are no rate is 0 00 Defining a pay rate is similar to defining a bill rate Therefore we will only describe how to define a pay rate in this section You may apply the same steps of defining a pay rate to defining a bill rate The differences are that pay rates apply to employee payer relationships and bill rates apply to client payer relationships 01 18 06 3 13 PM Page 50 of 448 SAM gt Melbourne QA Edit Employee le x Ble Administration Schectie AED Lonfiaureton Mentenance Login Senco Reports Help Print List Copy _ Update Visits DB al Payer kDEFAULT gt Default Select Employee Tanya Acevedo
283. he selected criteria Select a Type of client you want to see Any client covered by a plan of care is a Patient Clients who are staffed like hospitals or nursing homes are Facility type clients Everyone else is a Client type client Select the status payer class or affiliation of the client s you wish to see You may also receive a list of only those clients with a specific CSR assigned If Use Client Payer CSR is Off only those clients with the specific CSR assigned to the client will be listed If Use Client Payer CSR is On only those clients with a specific CSR assigned to the client payer relationship will be listed In this case the client payer relationship must be current and not set to Do Not Use If you wish to shorten the list you can type in the first few characters of a last name in the Name Beginning With field Also to shorten the list you can click on the option Has visits scheduled during selected week or Has unassigned visits Click the Generate button 01 18 06 3 13 PM Page 81 of 448 e Select a client from the generated list by double clicking on the client or highlighting the client and pressing the Select button e The Scheduler screen will be displayed with the client s schedule for the current month SAM gt Melbourne QA Scheduler lel Ee fe Aammistaton Schedule AE Eoniguaton Memnterence Loan Semniicto Hepo Client iae Rules Prefs Phone Sum E cz E el I
284. he value or by clicking the Select button The Select Medication screen is displayed 01 18 06 3 13 PM Page 174 of 446 Users Manual SAM gt Melbourne GUEST lel Es fdiinistation schedule AR Eoniauaton Meintenance Logn Senco Reports Help 5 AMINO SALICYLIC ACID 5 AMINO SALICYLIC ACID 5 DAY 5 AMINOSALICYLIC ACID 5 AMINOSALICYLIC ACID Antibiotics PNE nearly all Anti infectives ound Infection Antibiotics Select the desired Medication 4 53 PM Select a medication and then the Edit Medications screen is redisplayed Select a Status of Existing New Changed or Discontinued Enter a Start Date for the medication if desired this field is not required Enter a Discontinued Date for the medication if desired this field is required if the Status is Discontinued There are 2 different ways to enter detailed information about each medication 1 Free Type e Enter the text in this field in the exact format that you would like to see it printed on the Plan of Care output This is a quick data entry type 2 Tabular e Select a Quantity if desired this field is not required The choice of Other enables a text area where you may enter any quantity value e Select a Dosage if desired this field is not required The choice of Other enables a text area where you may enter any dosage value e Select a Route The choice of Other enables a text area where you may enter any
285. he whole reason behind closing a period is to ensure that reports run for the period any time in the future yield the same results 2 Close Period gt Melbourne GUEST BIE Adminstration Schecuie At Bontiquraticn Memnterance Loon Sambo reports Help Hose Renod 01 18 06 3 13 PM Page 320 of 448 Users Manual Creating the SBT General Ledger Interface File Once the sales cost cash adjustment licensed unlicensed and sales reports have been run and verified the period should be closed Closing the period causes transactions within the period to be locked so that they cannot be changed This should be done before creating the GL export file to ensure that the journal entries made automatically by the system agree with the database To create an ACCPAC GL export file you must select one office Click the Create SBT GL Import File option and click the generate button To create a standard Excel GL Import File click the Create Excel GL Import File Period Sales Cash Adjustment and Worker s Compensation Reports gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help si Period Sales Cash Adjustment and Worker s Compensation Reports Office z SORT SALES REPORT BY Payer Class Period 2005 06 06 01 2005 to 06 30 2005 7 Transaction Type Employee Type Week Ending Dates Within Period Bill Unit 06 01 2005 06 30 2004
286. heir contents The only fields available for modification are described below If the office address needs to be modified e Enter the office s new address in the Address fields The first address line is for street address or PO Box numbers The second line is for apartment or suite numbers etc Ifa street address is long and will not fit in line one its okay to overlap it on line two avoid splitting a word in half when you use two lines for the address if you can because it is printed with a space where the split occurs 01 18 06 3 13 PM Page 323 of 448 Users Manual Enter a Zip Code If you do not know the entire zip code you must enter at least the first three digits After you enter the zip code a list of cities with the given zip code appears in the combo box below the zip code Select the correct city from the combo box under the Zip Code field Use up or down arrows on the keyboard to find the city or click the down arrow on the combo box to display the list of cities and then click the city If the office telephone number s needs to be modified Enter the office s telephone number in the Office Phone field or the fax number in the FAX field If the compensation taxes information for an office needs to be modified Enter the day the office has set for the end of a payroll week in the Week Ends On field Enter the Rate Differentials for Overtime and Holiday as desired Check the Daily Overtime box if the of
287. here is some initial setup required before you may export of a Plan of Care to an XML file 1 First you will need to edit the file SAM INI on the N folder This file must contain your ACM EClickMD and or Alacare Provider ID in the following format you may have a line per care plan oversight system Ini ACM _ProviderID RIVERO01 01 18 06 3 13 PM Page 197 of 446 Users Manual And or Ini_Alacare_ProviderID RIVERO01 And or Ini_EclickMD_ProviderID RIVEROO1 2 Those physicians who are registered with a Care Plan Oversight system will need to have their records modified in the physician s database in SAM The name of the CPOS acm alacare and or eclickmd must be placed in the POC VO Email Addr field of the physician s record SAM gt Melbourne GUEST Bie Administration schedule AR Eoniguaton Mamntenance Loon Samica Reports Help FI x n pil all Exi We UPIN joro Select Physician Name a I Do Not Use ABDELKADER Title JMD p Address pam Zip Code 01069 Palmer MA 01069 Phone 1413 267 9101 FAX J License Number 78893 License Date 04 20 2003 al Date Verified 05 01 2001 ja General EMail Addr POC VO EMail Addr eclickmd POC VO Submission C Mail EMail Claim ID Enter Email Address for Plan of Care Verbal Order Submission PAI OW182002 09 41 AM 3 For physicians that you will be sending a Plan of Care for you will need to verify that
288. hese visits cause the employees to surpass the number of hours they are normally expected to work as a part of their salary the following screen is displayed Visits within the limit are not exported to payroll Visits beyond the limit are exported to payroll with the pay rate associated with the visits Pressing the Continue button on this screen will cause the close week processing to complete The week will be marked as closed and the status of all verified visits with a care date on or before last Friday will be changed to at status of closed Closed visits cannot be edited They can only be adjusted 01 18 06 3 13 PM Page 238 of 448 Users Manual Exporting Payroll Interface In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates There is a payroll interface to the following payroll systems ACCPAC SBT Paychex Automatic Data Processing ADP Millennium Ultipro MAS 200 Advanced Payroll Systems PrimePay Simple Payroll Time Clock After closing the week at the back office employee payroll information should be exported to the payroll system so that payroll checks can be printed Payroll inform
289. hould be REDUCED by Medicare will pay the episode at the LUPA rate Adjust the RAP as usual to reflect the take back Adjust the EOE making the episode equal to the payment In addition the billing log will include information about the service items created and any adjustment advice The billing log is saved as N pps log and is appended to each time the Create Invoices option is processed An additional billing log in Microsoft Excel format n ppslog xls is also created which will contain all of the information last appended to the billing log n pps log only current information This will allow you to easily sort the file by name messages etc Long messages such as OUTLIERS or SCICS are truncated to 254 characters in the xls file If the Plan of Care does not already have a PPS RAP service item a PPS RAP service item will be created also created are an invoice and a UB92 claim 01 18 06 3 13 PM Page 256 of 448 Users Manual If the Plan of Care does already have a PPS RAP service item and the episode for that patient is over and the End of Episode EOE date is on or before the last week ending date a PPS EOE service item is created also an invoice and UB92 claim The PPS billing that the episode for the patient is over if the billing date is after the Plan of Care cert end date or patient discharge date If Partial Episode Payment PEP a Low Utilization Payment Adjustment a Significant Change in Cond
290. ical information closed visits closed supply items closed service items and or closed pay items The system will warn you before deleting a client if the client is associated with verified visits verified supply items verified service items and or verified pay items When you request to delete a client the system will delete the schedule order if there are no visits on the order 01 18 06 3 13 PM Page 56 of 448 Defining Employees e To access the Employee screen select menu option Administration Employees e The Edit Employee screen is displayed SAM gt Melbourne GUEST Edit Employee Of x Bie Administration Sch fedule AG Gonfiauraton Memtenance logn Semiono Reports Help Emp Profile l Emp Taxes Emp Skills Attributes l Emp Preferences Bonuses Emp Photo Tracking Availability Visits _ Pay Rates lt gt aD Tel ITALS Emp 000136 PAYROLL 7 BILLING Names EDE Jacevedo Employee Type Fictd Employee SSN 124 53 6551 Federal 1D ME Address 19 Foch Avenue Primary SKA EI HHA Ss licenses D _ _ JD Zip Code 01075 __ Check Bank z E th Hadley MA Z H npg 01075 x vanna a aa ampt Max Hours Exempt from Overtime Affiliation Hampshire County z Salaried Visits J Phones 1 555 538 8792 2 Merit Pay 0 00 per hour 0 00 per visit oo U talon el 0 00 per hour 0 00 per visit Sex C Male Female T HM Birth Date 11 4 MISCELLANEOUS
291. ician has a specific ID for a program i e Medicare enter the ID in the Claim ID field e Click the Save fl button 01 18 06 3 13 PM Page 349 of 448 Users Manual e Click the Exit T button to exit the Edit Physician screen 01 18 06 3 13 PM Page 350 of 448 Users Manual Managing Standard Plan of Care Phrases Standard Plan of Care phrases are configurable for each organization and can be uses as standard building blocks with verbiage is added to different parts of the plan of care In this way descriptions of similar or exact situations can be standardized Phrases are stored and accessed by category code ICD9 type and by skill code The ICD9 Code for phrases is limited to the first three characters of the ICD9 Code This in effect means that the phrase is for that ICD9 Code and all levels beneath it e To access the Phrases screen select menu option Administration 485 Phrases Phrase gt Melbourne GUEST Ble Administration schedule AR Lonfiguration Mantenance logn samioco Reports Hep E Phrase x uff oi aa T Category HESIEN EAEN X Code DSM DP Phrase DISCHARGE PATIENT AFTER 4TH VISIT TO CLIENT a mz EVERY 4 WEEKS X 36 WEEKS x ICD9 Type aLL 7 ICD9 Code Select asst Skill Code ALL Ai WFS 02112002 10 46 AM fel Ea Select the Phrase Category 2 40 PM 01 18 06 3 13 PM Page 351 of 448 Users Manual Data Exchan
292. ide you with an E mail address to which you can mail the file 01 18 06 3 13 PM Page 377 of 448 Users Manual Statements This Accounts Receivable report gives account statements for payers and or clients Statements gt Melbourne GUEST F Statements d r h Shon Un Allocated Cash 01 18 06 3 13 PM Page 378 of 448 Users Manual Client Payer Function Group Reports Client Payer List Report This Client Payer type report shows the relationships of an agency s clients with the agency s payers m Client Payer List Report gt Melbourne GUEST E Client Payer List Report q M M al al al al al al 01 18 06 3 13 PM Page 379 of 448 Users Manual Scheduling Application Group Reports Employee Function Group Reports Employee Dispatch Report This Employee report consists of a list of visits in the specified date range that is assigned to the specified employee s The visit information on the report includes the employee s name the client s name and phone number and the visit date start time and end time You may optionally generate the report in Report and or Calendar format If you select the Report format the visit information on the report includes the employee s name the client s name and phone number and the visit date start time and end time You may also include the client comment on the Report format If you select
293. ie aar a aeea ne n en a ENE r Eo aaeei eis 32 Client Skills and Codes ssssccssssssssssssscssssscecssssseecssssssesssssssessssssscssssssesssssssscsssssssncssssscssssssoes 33 Client Attributes Page saicccnccscccscccccocenssscccosssseasssssosseospassssdedssedseonsessdedesncsdeccscssdecbesadssesesasesdsasssoeseses 34 01 18 06 3 13 PM Page 2 of 448 A TiribiiteS SeCtl Oris 80055 bees eee ho sen Rie oN as Lael AEE Sods oe Mires ae ot eae tek Shs See 35 Want Employees That Can Are Section ccccessccceeessceeeeceeceeeeeeeseneeecssaeeeeseaeeeenseeeeseaeeessenseeeeeseeeenentesees 35 ChEent Ancillary MiO sicieieiccdscssccsdsccssssccecsensecessscsssssnssanascevsessdvonssacecssesvenanssesdsesscvsdsavessssescoucssscesesese 35 Client RA CC sireicssieccisiescssdsscidsscbessensadusccdvessesusecasscescededeasedescesesguvocevssesesssmvasaveeesessesbenssdaceioseduedacsscesdense 36 R adimitting A CHENG lt s csccccavssscessvernssnnacsscocevevasedscssecernvedesoesdedesebenssesedeenenesssossssssssnessecesoseasbesnansosed 37 Viewing Client Visit HIStOry c eecciessscsescesovsscsssssesnsasadsssessscsensecassecccesebesacsscescsescdsbsssesesesceseseseces 38 Defining Client Payer Sets Client Payer Relationships scccccsssssssssssssssccccssoeeecsssssccceooeee 41 Adding a New Payer SetisiisssssscccdcediccsWesieisiscedessdenssdecosecssecaaedsdesossaannssscesssevsbensdesesseseavtscedecsesusveeuns 41 Payer Information S ctionis sis
294. ied or copied To Recertify a Plan of Care simply press the Recert button the certification dates for the next episode will default for you You may keep the same Payer and Prime Physician as the original Plan of Care To Copy a Plan of Care simply press the Copy button You may then enter new episode dates and optionally change the Payer and Prime Physician e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Plan of Care for e Click on the Define Plan of Care Verbal Order button 01 18 06 3 13 PM Page 188 of 446 Users Manual e On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click the Find button on the Edit Plan of Care Verbal Order screen e The Plan of Care Verbal Order List screen will be displayed e Click on the Plan of Care you would like to recertify or copy and click the Select button The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care e Make sure that the Plan of Care displayed is the one you want to recertify or copy e Click the Recertify or Copy button above the toolbar The Recertify or Copy Plan of Care screen will be displayed
295. iew details or summary about each visit edit a visit or assign one several or all of the visits to the current employee In this way employees calling the agency looking for assignments can be offered assignments and scheduled while the calling employee is still on the phone Compliance Checking By choosing the compliance option on the visit menu the system will check all visits in the current schedule for compliance with all doctor order and insurance authorization compliance rules entered for this client The system will run a compliance check anytime the schedule is changed A compliance check may optionally be run manually by right clicking on one of the visits belonging to a schedule order and choosing the Compliance option 01 18 06 3 13 PM Page 123 of 448 SAM gt Melbourne GUEST Scheduler le Ee Ble Administration schedule AED Lonfiguretcn Mentenance Login Senco Reports Help Client Employee Rules Prefs Phone Sum Legend Month z E gt Be EJ Employee Vickie Dillon RN 555 566 5078 19 50 29 50 8 00 0 00 Hrs 2002 3 Create Visit Edit Visit Delete Visit Move Visit View Order Assignment Match Visit Phone Log Copy Single Visit Copy Visit Wizard Update Visit Wizard Client View Status Confirmed Skil RN Pedi High Tech Payer Medicaid P D Reg Rates 22 50H 37 50H 09 00a 05 00p 2 29PM The Compliance Summary screen will be displayed with the results of th
296. ified supply e The modified supply will be redisplayed in the list on the screen e Atthis point you may modify other supply information by repeating the steps above e Click the Exit T button on the toolbar to exit the Edit Supplies screen The Edit Plan of Care Verbal Order screen will be redisplayed Deleting a Supply e Verify that the information section at the top of the Edit Supplies screen describes the Plan of Care Verbal Order you want to delete supplies from e On the Edit Supplies screen select the supply you would like to delete by clicking on it in the list on the screen e The details of the selected supply will be displayed in the fields on the lower section of the screen e Make sure that the supply displayed is the one you want to delete Click the Delete x button in the lower section of the screen Click on the Yes button in the popup screen that asks Delete displayed Supply The deleted supply will be removed from the list on the screen At this point you may delete other supplies by repeating the steps above e Click the Exit Ae button on the toolbar to exit the Edit Supplies screen The Edit Plan of Care Verbal Order screen will be redisplayed 01 18 06 3 13 PM Page 183 of 446 Users Manual Defining Plan of Care Safety Measures Nutritional Requirements Allergies Functional Limitations Activities Permitted Mental Status Prognosis e To access the Edit Plan of Care Verbal Order Saftey Etc
297. imilar to the format below first_name mid init last_ name address 1 address2 city state zip The last name field might go down to the second line depending on how big the label you chose is so don t worry about that Once you create the labels it will create correctly 01 18 06 3 13 PM Page 445 of 448 Users Manual 16 Once your label is in the format you want you need to populate the same label format throughout all the labels To do this you find the button Propagate Labels and click on it Once you do this the same format you have in the top left label will copy into all the labels 17 Next you want to find the button Merge to New Document and click on it Once you have clicked on it the window below will pop up Once this window pops up hit OK Merge to New Document x Merge records Oki Current record Otwm e 18 Once you hit OK a new document will be created and this will have all your labels on it and can be printed The final document might look like the one below E Labels Microsoft Word ek Type a question for help X i Aq Normal Left v Times NewRoman 12 x B Z A K im Suite D Rockledge FL 32955 Leon Cohen L Chapman Bean 1344 8 Apollo Blvd Suite B Melbourne FL 32901 Melbourne FL 32905 Sara Switzer s Fredy Delacruz Susan Fair 105 5 Banana Ri
298. ims for multiple invoices that require claims Selecting invoices and clicking the Create Claim button will create claims for each selected invoice that does not already have a claim and requires one ESAM gt Meboune Guest File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help i Print Transmit FORMS STATES DATES ORDER BY Invoices All Creation Dates From 01 17 2003 Invoice I Self Pa C Ready C Invoice Dates To 77 C Client CLIENT PAYER uB 92 Generate C HCFA 1500 Draft Final Client a Reset List claim will be created for each selected invoice that requires a claim but does not currently have one REGAL ULZTEA0te lt 0002A04069 Te Kent Medicare 0002A04070 01 Boberek Patricia Medicare 0002404071 01 Coons Frances Medicare 769 28 01 27 2003 783 31 01 27 2003 7 Create Contractual Preview Print ronswi Exit Perform the following steps to manually create claims for invoices e To access the Print Transmit screen select menu option AR Print Transmit e The Print Transmit screen will be displayed Follow the instructions in the Printing Invoices for Payers section except e Click the Create Claim button to create a claim for the selected invoices This function allows you to create claims for multiple invoices at once Note however that claims will only be created for invoices that require a claim but do
299. indexes by default If you wish to modify this default time frame add the following line to your n sam ini file where is the number of months back to keep compliance rules Ini Comp Rules Purge Month SAM gt Melbourne GUEST a x Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help E Select Report g Expired Compliance Rules Report X Expiration Date Range From OMAE To 0171372006 4 Client Status MV Active admitted Non Admitted I Discharged I Transferred lV Incomplete T Hold ALL z M Show Doctor Orders V Show Insurance Authorizations V Show Payer Authorization Dates M Show Comments Generate ff Report Options J Ext Select start date of visit care date range 11 25 AM 01 18 06 3 13 PM Page 395 of 448 Users Manual Filled Visit Report This report is useful in Staffing situations to get a clear picture of where visits or shifts are not being filled The report includes the number of hours and shifts by each visit type e g Unassigned Confirmed Verified Client Cancelled Employee Cancelled Office Cancelled Closed Other and includes a Filled column i Filled Visit Report gt Melbourne GUEST Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help ERME x E Filled Visit Report x SELECTION CRITERIA Office Sa a Date Range El EZ F Client ALL Employee Affiliation ALL SORT
300. information and interventions associated with the Doctor Order skills e To access the Edit Plan of Care Verbal Order Orders screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Plan of Care for 01 18 06 3 13 PM Page 170 of 446 Users Manual e Click on the Define Plan of Care Verbal Order button e On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click on the Orders button The Edit Orders Paragraph will be displayed SAM gt Melbourne GUEST lei Ea Bile Administration schedule AR Lonfiguration Mantenance logn SenlioGo Reports Hep E Orders Paragraph x Patient Helen Abbey Client 002080 02 Tel Cert Period 0370972002 1120772002 POC A0001486 Payer Tufts Associated HMO Type Plan of Care Orders for Discipline and Treatments Select Phrases a B PAI OWO42002 12 04 PM Save all changes to database e Verify that the information section at the top of the screen describes the Plan of Care Verbal Order you want to create the Orders paragraph for e The paragraph may be edited like any standard word processor window i e you may highlight sections to copy and paste etc To copy text highlight the text and press Ctrl C To paste text
301. invoke the copy wizard s finish screen SAM gt Melbourne GUEST Scheduler lel Ee Bie Acministaton schedule AEG Gonfiatratcn Memntenence Loon Semiicho Hepots Help Copy Visit Wizard Ee Step 3 Specify Copy Options How Should the Visits Be Copied amp What Checking Should Be Done Visit Information I Change Status of Visits to Unassigned copied visits will not have employees assigned to them T Include Cancelled Visits cancelled visits will be copied with status changed to Not Assigned or Confirmed Additonal Info I Include Comments and Invoice Description comments and invoice description in selected visit on schedule will be copied I Copy Travel Pay amp Bill travel pay and bill in selected visit on schedule will be copied Checking to Perform N Use Shift Availability use both shift amp day availability to determine whether employee is assigned lV Use Payer Set Dates use Payer Set start amp end dates to determined validity of visit dates V Check for Scheduling Conflicts change status of visit to Not Assigned if the id aa is scheduled elsewhere IEND WITH GENTIVA 731 3050 Mom s work 7 Advance to the next page 01 18 06 3 13 PM Page 115 of 448 The second way to use the copy visit wizard is to use the current week or month as the copy template When this method is chosen the following screen allows you to define what is to be copied the week or the month specific or
302. ion Auth BEE o Payer ConnectiCare N Skill Subskill SN E Payer Set Dates 08 2972002 10 27 2002 Min Max o Hours Frequency 1 00 to 1 00 na Visits A Day fa Days Duration for 43 C Weeks Months Days Interval every 0 Weeks Months COMPLIANCE RULE COMMENT Start Date 08 30 2002 z End Date hani 2002 34 MAC 1002 2002 04 23 PM e Click the m button to add a new insurance authorization e Notice that the Rule Type defaults to Insurance Authorization e Enter an Authorization Number if applicable This Authorization Number will be printed on the UB92 claim and may be optionally printed on the visit report e Select the Skill Subskill for the Insurance Authorization from the list This list of Skill Subskills is derived from the valid skills you have entered either on the Client Skills and Codes Self Pay or the Client Payer Skills and Codes screens Compliance rules may only be entered for valid skills e Enter the minimum and maximum number of hours or visits defined in the insurance authorization e Click the visit type option Hours or Visits Specify a frequency for the number of hours or visits from the combo box A Day A Week A Month or As Needed Enter the duration as a number of days weeks or months Click the duration type Days Weeks or Months If appropriate enter the Interval as a number of days
303. ions 01 18 06 3 13 PM Page 150 of 446 Users Manual 1 You may now define a Plan of Care for the patient by clicking the Define Plan of Care Verbal Order button See section Entering a New Plan of Care 2 You many now define an OASIS for the patient by clicking the Define OASIS Information button See section Entering OASIS Information You may continue admitting other patients using the Edit Patient screen 4 You may exit the Edit Patient screen by clicking the Exit Tl button Modifying a Patient s Agency Status After a patient has been admitted into the agency see section Admitting a Patient into the Agency a patient s Agency Current Status may be modified using the Edit Patient screen A patient s status may be Incomplete Non Admitted Active Hold Discharged or Transferred A date is associated with each status You may add a Discharge status on the same day as the Active status but no other statuses may be added for the patient on the same day as the Active status You cannot add another status after a status of Discharged The status of Transferred would be used for clients that have not been discharged by the agency but the file may have been transferred to another office within the agency It is important to not modify the existing status of the patient by overwriting the patient s current status record Instead a new patient status record shoul
304. is date range The following is the calculation for both values Days Sales Outstanding DSO Total AR period sales period days Best Possible Day Outstanding BPDSO Period AR period sales period days DSO Ignore if an invoice has this option marked the invoice will be ignored in the calculations for DSO days sales outstanding and BPSO best possible days sales outstanding on the Invoice Aging report e You may also optionally filter to only those clients or payers based on their balance e Click the Generate button In order to choose a client one office must be selected If a payer class is selected you may not select a payer or client If you choose all offices only the national payers are selectable SORT BY Office Class Payer and Client will give you a payer based aging SORT BY Office Client and Payer will give you a client based aging Generating Statements Statement can be generated for a client showing all invoices adjustments and payments for the client regardless of payer Statements can be generated for a payer showing all invoices adjustments and payments for the payer 01 18 06 3 13 PM Page 297 of 448 Users Manual STATEMENT OPTIONS Client J i Payer jae Invoice Dates O O Return Address Lock Box Address Office Address Mailing Address Payer Address Client Address Statement Memo a V Only show invoices with non zero balances I Consolidate statements
305. is date to default to the patient s start of care date Ini_Inherit_Oasis SOC F Ini_Ext_Payerdt_On_485Copy Directs SAM to not automatically extend the Payer Authorization End Date on the Client Payer Relationship when you Recert a Plan of Care Ini_Ext_Payerdt_On_485Cop yF Ini UQ Visit Directs SAM to default the Qual field on ALL new visits to U nqualified or Q ualified Ini UQ Visit x where x is either U for unqualified or Q for qualified ini_use_skills_visit_hrs Directs SAM to use the Visit Hours defined for a Skill or Sub Skill as the default for hours for a new visit The default hours only work for the initial skill of the visit If anything is changed after that including changes to the sub skill the hours must be changed manually ini_use_skills_visit_hrs T 01 18 06 3 13 PM Page 448 of 448
306. isisiscnsscecanecenssssnsdsesasecatesesincscsdccssonssebacabeasssonesecescessnacesoacedenssesbscessasdoanastsoncs 71 Day Availability ccccccccacscsesccssenssaascscecsnscsanssesesosesoscaassesvsdsessasosoessdsenssusnsesusccensashontesecsucceescceasssesensedecses 71 Viewing Employee Visit History ccccsssssssccssssssssscccccssccccssececcsssscccccesecssssccccscseessssssccscesorsss 73 Defining Employee Pay Rates scccssssssscsssccssscsssssscecccsssscccssscesssssccccceeesssssscccesscessssssccessoes 75 Adding Pay RAtES ncscscscccssccsssassssssd sccasevesssovesesovenaseeseossureensacssvevavonesesasdsssenssdeesesesssencdanaseasecseteasasssse 77 Deleting Pay Rates ssscsicscccisscissenssssecescoenascscedecesvsscnsssessscsctetstceoseenvenensssesesecenosaasccesesuasduaccedssccesanasesse 78 Printing PAY RAteSs iisssisisscsssasedsisissdevessecscccocecsoveasssssssanspepapsadsddevsesceessdessesaedcdvssdesendecsecesssssesansensasese 78 Copying Pay Rates to Employee within Current Office ccccccssssssssccssccsssseeecssssccccssoeeessseees 79 Schedulin Dos sisa o eaoaai erae re EEEE iaso aao oaa Eae 80 Getting to the Scheduler Screen eessssseseeesessssssocsssssosoccessssssoocessesssssoecessssoocesesesssoooessssssssssesssssose 80 Viewing a Client s Schedule cssvesssccctesivsssssssscssccccsansccscsssccadesesscscesoonassoascedesesenscsasssdeescsensveasssosesesseess 81 Moving to a Different Week s Schedulle c
307. isit Summary Client Helen Abbey Employee Kathryn A Blanchard Address 787 Prospect Avenue Address 25 Wentworth Manor Drive West Springfield Amherst MA 01089 MA 01002 Phone 1 555 739 0474 2 IE Phone 1 J655 256 4256 2f mE 3 DE aly CURRENT VISIT INFO 310 al Current Reg Visit Date 10 27 2002 Sun Pay Rate 26 00 per visit Start Time 03 00AM 1 00 hours Bill Rate 80 00 per visit Specific Hours Skill ENAN Message Rate default regul Type Accepted a Offered Kaam ester conteyes Duration Accepted Call Date amp T Cancelled Em Cancelled Office GUE 0616 2005 10 08 AM Indicate the basic content No Show 10 10 AM e Select the appropriate Message Type 1 Accepted if the employee has accepted assignment of the visit Also used while performing Employee Matching Cancelled Client if the Client is canceling the visit Cancelled Employee if the employee is canceling the visit Cancelled Office if the office is canceling the visit Left Message if you have left a message for the employee regarding the visit also used while performing Employee Matching 6 No Answer if you attempted to reach the employee regarding the visit but there was no answer also used while performing Employee Matching 7 No Show if the employee did not show up for the visit 8 Other if none of the other message types a
308. isits and supplies as well as the service items and adjustments that represent the RAP and EOE sales Your Glaccount table should be updated to place the RAP and EOE service items into NEW accounts in your general ledger We recommend when adding new Medicare Payers that you set their Billing Frequency equal to Calendar and enter only one billing period on the Calendar screen You may then perform PPS billing at any time PPS billing will automatically calculate the episode payment based on the OASIS Assessment If the Medicare client is Medicare Secondary Payer placing MSP in the client s Bill Notes field will cause all RAP and EOE claims to be created with occurrence code 1 05 occurrence date 1 RAP date and the remark will read Services provided by our agency are not associated with previous MSP 01 18 06 3 13 PM Page 259 of 448 Users Manual Print Transmit Screen The Print Transmit screen is used for printing multiple invoices or claims creating multiple claims for invoices requiring claims and transmitting multiple claims electronically To access the Print Transmit screen select menu option AR Print Transmit SAM gt Melbourne GUEST lel Es Ble Administration schedule AED Eoniauaton Meintenance Loch Seniioto Reports Hep oF Print Transmit FORMS STATES r ORDER BY DATES Invoices all Creation Dates From 01 17 2003 Invoice I
309. ities with the given zip code appears in the combo box below the zip code e Select the correct city from the combo box under the Zip Code field Use up or down arrows on the keyboard to find the city or click the down arrow on the combo box to display the list of cities and then click the city e If needed select an affiliation from the Affiliation combo box The affiliation attribute is used as an aid to employee client matching Clients and employees may be assigned to locations It is beneficial to assign employees to clients that are within the same location to reduce travel time and cost Locations are defined per office and are usually geographically based Client and employee list and dispatch reports as well as sales reports are available by affiliation This lets you sub divide your office into different sections e The Status combo box works as follows for each client type 1 Patient the Status combo box shows Incomplete when adding a client with a Client Type of Patient and is disabled The status for a Patient can only be changed using the Edit Patient Status screen via the Administration Clinical Information menu option 2 Client or Facility after you have entered and saved the preliminary information for the client or facility the Edit Status button will become enabled When adding a new client or facility SAM will automatically add an Active status on the Edit Client Status screen I
310. ition or a Outlier is detected PPS billing will issue adjustment advice on how to adjust the PPS service items so that the total amount billed for the episode equals the amount to be paid The billing log will not report a possible PEP Partial Episode Payment where the patient was discharged with a reason of Normal Discharge Goals Achieved All adjustment advice is placed onto the PPS billing log and in the client s account log This is an example of the type of advice that will be added to the client s account log Note that the account log information will optionally print on the aging report Please refer to section The Account Log for more information regarding this screen SAM gt Melbourne GUEST ME Bie Administration schedule AR Eoniauaton Mentenance Login samiot Reports Hep Office 0002 Melbourne T 4 gt gt I 1 ie Account No 002209 02 7099 8 alol mlx Tl Account Name Medicare Total Charges 0 00 Sub Account Abdow Stephen 02 Total Adjustments 0 00 Contact Total Applied Cash 0 00 Phone 207 822 8585 EXT Account Balance 0 00 Create Date 06 27 2001 05 10 PM Unallocated Cash 0 00 RAP created for 6 of 2264 07 with the following attributes 6 hhrg C2F250 hipps HCOGJ1 wi 1 0678 cmw 0 9949 on 06 20 01 for Kaiser Mary Plan of Care beginning 05 08 01 above added 06 20 01 03 29 PM Final claim created for 905 63 on 06 27 01 for Kaiser Mary Plan of Care beginning 05 08 01
311. its per day can be displayed on the timesheet If more than 2 visits per day are entered an additional timesheet will automatically be generated for that date range e When using the 1 15 or 16 EOM date format options you must enter a full week date range e When using the entered date format option to generate a partial week your date selection must either begin on the week begin date or end on the week ending date e This timesheet only has the ability to display up to 14 assigned attributes Any attributes after the 14 will not show on the timesheet PHC CBA and CLASS Timesheets e Can be generated with all three date format options entered 1 15 or 16 EOM 01 18 06 3 13 PM Page 386 of 448 Users Manual e All date ranges entered must fall within the same month e Up to two visits per day can be displayed on the timesheet If more than 2 visits per day are entered an additional timesheet will automatically be generated for that date range e When using the 1 15 or 16 EOM date format options you must enter a full work week date range ending with a valid work week ending date e When using the date format option Entered to generate a partial week your date selection must either begin on the week begin date or end on the week ending date e The CBA and PHC formats of the Timesheet Report will include a client signature line above the employee signature line
312. iven before the choice is made to commit the changes to the schedule There is also the option of choosing the delete visits instead of updating them CE SAM gt Melbourne GUEST Scheduler Bie Edmmstraton Sci a BoniGureiGn Mentenarce Login Sencha Hepots Hep N Update Visit Wizard The preview screen gives information about the update of each visit The visit updates are committed to the schedule by clicking the Continue button 01 18 06 3 13 PM Page 119 of 448 Employee Client View From the client view of the schedule normally the visits display the name of the employee servicing the client To see a visit employee s view of the schedule right click on the visit and choose the Employee View option SAM gt Melbourne GUEST Scheduler le x Bie Administration schedule AED Gonfiauretcn Mentenance Login samiomo Reports Help Client Employee Rules Prefs Phone Sum Legend Month z ml T 4 d alle EJ Client Helen Abbey A 555 739 0474 29 50 29 50 8 00 0 00 Hrs 2002 Create Visit Edit Visit Delete Visit Move Visit View Order Specify Employee Employee Match Visit Phone Log Copy Single Visit Copy Visit Wizard Update Visit Wizard rte Set Model Week View Model Week Clear Model Week Status Confirmed Skil RN Pedi High Tech Payer Medicaid P D Reg Rates 22 50H 37 50H 09 00a 05 00p 2 25PM This will cause the schedule screen to refresh with in the emplo
313. justments items within the date range and all unposted adjustments Show all items within date range items and adjustments within the date range I Print One Employee per Page Employee ALL Emp Type V Field I Staff V Contractor Repo Options a Report items payrolled for this week ending date 3 28 PM 01 18 06 3 13 PM Page 370 of 448 Users Manual Sales Invoice Report The Sales Invoice Report is invoice based and will report all activity on invoices during a selected date range Because this report is invoice based it can be used to balance an earlier Invoice Aging Report to a later Invoice Aging Report First Aging Total AR Total Change in Sales on the sales invoice report Cash Applied to Aging During Date Range Later Aging Total AR To balance the Invoice Aging report and the Sales Invoice report it is necessary to run the Invoice Aging report using the Invoice Creation Date option and run the Sales Invoice Aging report using a date range equal to the period between the first and later Aging reports For example if you are balancing an Aging for 12 31 02 and an Aging for 1 31 03 the date range for the Sales Invoice Aging report should be 1 01 03 through 1 31 03 To balance the Sales Item report and Sales Invoice report for Medicare Only l on Run a Sales Item report for Medicare for a date range for service items only by payroll dates all transactions This wil
314. k next to the Always Maybe or Never option This information will be used when the scheduling features are used to fill an unassigned visit e Ifan employee s availability is the same for every day of the week you should edit the first day and then click the Duplicate 1 Day button to copy your selection to the rest of the days of the week e Click the Save i button and the Employee Availability Calendar screen will be redisplayed Day Availability e To define certain days or portions of days that an employee may not be available click the Day Availability button e The Edit Day Availability screen will be displayed 01 18 06 3 13 PM Page 71 of 448 SAM gt Melbourne eal aad Aveta Calendar ojeli Times Availability Comment 0672671999 0770371999 0000 0000 Never VACATION RTW 774799 YESII774 08 01 1999 08 07 1999 0000 0000 Never ACATION RTW 8 8 0970471999 0970671999 0000 0000 Never A E OFF RTW 977799 05 20 2000 05 20 2000 0000 0000 Never 05 27 2000 05 30 2000 0000 0000 Never rtw 5 31 06 24 2000 06 26 2000 0000 0000 Never vacation rtw 6 27 07 20 2001 07 27 2001 0000 0000 Never VAC RTW 7 30 01 A k C EH 1o aj To enter availability single days quickly Mise All Day i Eick the Nen button ailability C C oO nter availability information ay lity LMazbe CETE Right click on the Date Field Comment VACATION RTW 774 99 YESI7 4 4 Using the Calendar double click on the date
315. k on this option to list standard and local supplies e Click on the supply in the list and click the Select button e The Edit Supplies screen will be displayed and the Description field is filled with the selected supply e For Verbal Orders select the Verbal Order Status of either New or Discontinued e Make sure that all the information is correct for the new supply e Click the Save i button on the toolbar to save the new supply 01 18 06 3 13 PM Page 182 of 446 Users Manual The new supply will be displayed in the list on the screen At this point you may enter other new supplies by repeating the steps above e Click the Exit T button on the toolbar to exit the Edit Supplies screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying a Supply Refer to section Defining Plan of Care Verbal Order Supplies to display the Edit Supplies screen e Verify that the information section at the top of the Edit Supplies screen describes the Plan of Care Verbal Order you want to modify supplies for e On the Edit Supplies screen select the supply you would like to modify by clicking on it in the list on the screen e The details of the selected supply will be displayed in the fields on the lower section of the screen e You may modify any of the fields displayed in this section e Make sure all the modified information about the supply is correct e Click the Save a button on the toolbar to save the mod
316. k the Generate button Select the invoice you want to apply cash to To select multiple invoices control click on each invoice or shift click on the first and last invoice Click the Select button The Apply Cash to Invoice screen will be redisplayed Review all of the cash application items now displayed in the list for the selected invoices for correctness The Cash Applied column will be filled in with the maximum amount that can be applied to each invoice that is available from the payment You may change the Cash Applied amount on any of these invoices at this time Click the Save a button to save the information in the list once it is correct The Unallocated Amount for the payment is automatically adjusted 01 18 06 3 13 PM Page 283 of 448 Users Manual Click the Exit T button If the remittance advice contains very little information and you need very detailed information to determine which invoice the remittance applies to click on the Identify Invoices button On the Invoice Details screen click the Find al button Enter Start and End dates If the remittance is for just one client select the client Click the Generate button Select the invoice you want may want to apply cash to Click the Select button On the Invoice Details screen look at the invoice line items to determine if this is the correct invoice to apply cash to If this is the correct invoice click the Apply Cash button The Apply Cash to Invoic
317. k the X in the upper right corner of the screen to exit e The visits will be redisplayed according to the preference you have selected 01 18 06 3 13 PM Page 90 of 448 Creating a Phone Log Entry Not Based Upon a Visit e On the Scheduler screen click the Phone button This will display the Edit General Phone Log Entry screen e If you are on a client s schedule any phone log entry of Call Type Business will be tied to the client e Ifyou are on an employee s schedule any phone log entry of Call Type Business will be tied to the employee e If you click the Call Type Personal option the phone log entry will be tied to the person who is logged in SAM gt Melbourne GUEST Scheduler ile ez Bile Administration Schedule AR Donfiguraticn Mamntenance ogm Seamlioco Reports Help Client Employee Rules Prefs Phane Sum Leaend Month mj E Edit General Photo Log Entry _ Client Beverly CALL SOURCE Call Type Ci Business Client Beverly Case CALL DETAILS Type Other 7 Details Spoke to pt at 1pm to let her know we have tried several different hha and are unable to Call Date amp Time 08 20 2002 at 01 42 PM Modification Date RM 08202002 01 43 PM Indicate whether the call was personal or business 4 52 PM e Click the New E button 01 18 06 3 13 PM Page 91 of 448 e Select the Message Type and type in the Details you wish to record abo
318. kill and click the Remove button To mark a skill as Do Not Use select the skill and click the Do Not Use check box e The system offers two special types of Skill Categories SN and SN Staffing Skilled Nursing If you add a valid skill of SN you may assign a RN a LPN or a LVN type of skill to a visit If you add a valid skill of SN Staffing you may assign a RN Staffing or LPN Staffing type skill to a visit The Skill Category SN is delivered with your software if you wish to have the Skill Category SN Staffing please contact your software representative 01 18 06 3 13 PM Page 46 of 448 e When creating invoice if you have a SN skill identified on the client payer Skills amp Codes screen but the codes are blank the system will search for the skill on the visit RN LPN etc for the appropriate codes Defining Client Insurance Authorization Compliance Rules An insurance authorization type of compliance rule can be entered when an insurance company wants to define what care and services are covered in the insurance policy of the client such as dictating the skill and frequency of visits and you want to perform compliance checking against the insurance authorization To access the Insurance Authorization Compliance Rule screen select menu option Administration Clients click the Payer button and click the Ins Auth button Note Any compliance rule that is older than 1 ye
319. l Insert Merge Field Insert Address Fields Database Fields Fields client_no_ admit_no_a client a 3 mid_init last_name address1 address2 city state zip county phone bill_name bill_addr1 si 12 Once this window appears you want to highlight the first field you want shown and click Insert Once you have click Insert you want to hit the Close button the Cancel button will turn into the Close button once you have inserted at least one field 13 Now you will be back in the top left label and you want to do one of the following If you want a space in between fields such as FirstName MiddlelInitial LastName click the space bar once If you want a comma and then a space in between fields such as City State hit comma and then the space bar once If you want to go to the next line such as go from the name line to the address line hit the enter key once 14 Once you have done the one of the above three choices click the Insert Merge Fields button again to bring up the same window as above Once you bring up that window choose the next field you want displayed and click insert Now click the Close button again and edit the label by doing one of the three steps I listed above and then clicking the Insert Merge Fields button again and inserting the next field you want 15 Continue to do this until the label is in the format you want It should look s
320. l UB92 Locator Mapping UB92 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field l Provider Name Configuration UB92 Under Office Address Telephone Offices Address Lock Box 2 Untitled N A N A N A 3 Patient Control Invoice Number N A Invoice Number Number 4 Type of Bill Administration UB92 Bill Type Payers Bill Mask 5 Federal Tax Number Configuration UB92 Fed ID Offices Federal ID 6 Statement Covers Billing Period UB92 Dates Period Either weekly or by billing calendar 7 Covered Days N A UB92 Days Covered 8 Noncovered Days N A UB92 Not Covered 9 Coinsurance Days N A UB92 Coins Days 10 Lifetime Reserve N A UB92 Life Res Days Days 11 Untitled Administration Clinical Locator 11 NC Medicaid Physicians Codes Carolina Access Claim ID Number 12 Patient s Name Administration UB92 Patient Name Clients Profile Client Name 13 Patient s Address Administration UB92 Under Patient Clients Name Profile Under Client Name 14 Patient s Birth Date Administration UB92 DOB Clients Profile Birth Date 15 Patient s Sex Administration UB92 Sex 01 18 06 3 13 PM Page 432 of 448 Users Manual UB92 Locator Initial SAM Data Location Edit Claim Screen Data Mapping Description Name Tab Title Field Clients Profile Sex 16 Patient s Marital Status Administ
321. l be recreated overwriting any existing xls files of the same name 01 18 06 3 13 PM Page 398 of 448 Users Manual Pay Item Report This report shows all pay items that have not yet been closed within a specified date range A specific employee and or pay item may also be specified If you wish to report closed pay items we recommend you use the Sales Item Report e Pay Item Report gt Melbourne a GUEST E Pay Item Report 01 18 06 3 13 PM Page 399 of 448 Users Manual Payroll Interface Report This report will list postings created when a Payroll Export was processed to a payroll system e Payroll Posting Log gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help E Select Tx APPLICA g Payroll Posting Log The Date Range selection refers to the date that the interface postings were created Select the office to run the report for 4 54 PM 01 18 06 3 13 PM Page 400 of 448 Users Manual Payroll Report This report can be used to send to an outside payroll vender to perform your agency s payroll When run for just an agency s contractor employees this report can be used to check against invoices received by the accounts receivable department If a comment exists for a pay item it will be included on this report Selecting the Summary Spreadsheet will generate a Microsoft Excel xls file that will have a
322. l give you a total items sales figure Run a Sales Invoice report for the Medicare payer for the same date range This report now gives you three figures a Total change in sales the total change in invoice activity during the date range b Total change in sales due to invoice line items with trans dates outside date range the portion of the figure in a that are due to RAP or EOE service items that have Trans dates payroll dates outside the date range This means these sales do not show on the Sales Item report c Ifthere are any invoices that have RAP or EOE service items with Trans dates within the reporting date range yet their invoice creation dates are before the date range a second Sales Invoice report will appear proving the Total change in sales for invoices before the date range Medicare Sales Item Report Sales Medicare Sales Invoice Report Total change in sales Total change in sales due to invoice line items with trans dates outside date range Total change in sales for invoices before the date range for services that appear on the sales item report 01 18 06 3 13 PM Page 371 of 448 Users Manual Sales Invoice Report gt Melbourne GUEST Sle x File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help Fy Select Report x g Sales Invoice Report x DATE RANGE PERE AAE e To 06 22 2005 2 Enter the from Invoice date 3 29 PM 01 18 06 3 13 PM Pa
323. lan of Care associated with the payer whose Payer Start of Care is to be modified Click on the Plan of Care you would like to modify and click the Select button e Once the Plan of Care is displayed make sure the Payer field contains the correct payer name e Click the Edit Payer Status button near the bottom of the screen The Edit Payer Status screen will be displayed filled in with information about the payer selected SAM gt Melbourne GUEST el x Bie Adminstration Schedule AR Eoniguaton Meamntenance Login Seaniicto Reports Hels Orders Goals cae compans Tues Recert Copy 5 tleleiri 1 pe Diagnoses Sur raramen wlx amp PLAN OF CARE Patient Helen Abbey Client 002080 02 Patient Name Agency Agency Start of Care 05 17 2001 Discharge Date ee Agency Start of Care ji Type J Payer JOT Tufts Associated HMO Cert Begin i Payer Payer Start End Date 05 17 2001 11 07 2002 fo Tufts Asso Payer PAR Status SEE g Michael K Posner on Plan of Care Payer Start of Care 05 17 2001 Secondary Physi Payer x Verbal Discharge Date a t Printed N0 Start of Care m Save Cancel Payer Start of Care aus ACE mmes Payer Received Discharge Date 77 Edit Pdver Status Signed 77 4 EA Select the Status for the Payer 10 17 AM e The Payer field contains the payer Set same as the S
324. le Manager gt Melbourne GUEST File Schedule Administration Payroll System Help wi Information The following visits pay items contain overtime hours They are displayed as overtime double time Pressing Continue causes close week to continue Cancel allows rates and or hours to be modified before closing the week 01 18 06 3 13 PM Page 143 of 448 Salaried Visits Information SAM gt Melbourne GUEST BIE Achinistaton Schedule AR Configurator Maintenance Loan Semiisto Reports Help fal Information The following visits are beyond their respective employees salaried visits Pressing Continue causes close week to continue Cancel allows rates and or hours to be modified before closing the week Print the contents of the list If verified visits exist for salaried employee and these visits cause the employees to surpass the number of hours they are normally expected to work as a part of their salary the following screen is displayed Visits within the limit are not exported to payroll Visits beyond the limit are exported to payroll with the pay rate associated with the visits Pressing the Continue button on this screen will cause the close week processing to complete The week will be marked as closed and the status of all verified visits will be changed to a status of closed Closed visits cannot be edited They can only be adjusted using the Make Adjustments function Verified Visit Repo
325. le viewing modes Select the mode you want e The Scheduler screen will be re displayed in the selected mode e All of the previous screen shots are in the Month viewing mode 01 18 06 3 13 PM Page 87 of 448 This is the scheduler screen in the List viewing mode SAM gt Melbourne QA Scheduler Adninistaton schedule AR Lonfiguration MMemtenance loan Sa Go Heports Client aiana Rules Prefs Phone Sum Legend TETUN ist J ar gt 1 lt gt Ble lt Employee Tanya Acevedo HHA 800 538 8792 0 0070 0071 0075 00 Hrs 2002 gt 09 07 10 04 Order By 9 Date Time Label Display X 1 Week 4 Weeks C Rest 4 27 PM Select the desired viewing style for the scheduler This is the scheduler screen in the Week viewing mode SAM gt Melbourne GUEST Scheduler lel Ee ie Acmmistaton Schedule AE Gontigureton Memntenanc Loan SenieGe Reports Hep Client eae Rules Prefs Phone Sum econ EES Week Week i aj n 4 b gt I Tel Employee Pamela Binsbacher PT 555 596 9366 4 30 PM Select the desired viewing style for the scheduler In all modes right clicking a visit will cause the Visit Menu to appear This means that you can perform all scheduling functions from any mode 01 18 06 3 13 PM Page 88 of 448 The Visit Menu Right clicking on a visit in any view will cause the visit menu to be displa
326. leave the payer field blank See the section Printing Invoices for Payers for instruction for selecting a payer e Either select a client or leave the client field blank See the section Printing Invoices for Payers for instruction for selecting a client e Select an invoice by double clicking on the invoice in the list OR by clicking on the invoice and then clicking on the Select button Generate Reset List Service Adjust Dates Status a The Adjustment Status column will display DC for the invoice if it has had detail item adjustments completed to it or IC if it has had invoice adjustments completed This means that it is not the current invoice there is a newer invoice that is a clean correct version This column will display DP for the invoice if it has detail item adjustment pending or IP if it has an invoice adjustment pending This means that adjustments have been made for this invoice but they have not been accepted 01 18 06 3 13 PM Page 271 of 448 Users Manual e The Invoice Details screen will be displayed for the selected invoice SAM gt Melbourne GUEST lel Es Help Hle Administration schedule Ea Eoniauaton Memntenence logn Seniioko Reports x Edit Claim Collection Log alll gt gt aa T Invoice 0002402135 View Cash Applied Invoice Date 06 07 2002 Version 01 M DSO Ignore Service Peri
327. lect the Doctor Order skill and sub skill in the Skill Sub skill combo box This list of Skill Subskills is derived from the valid skills you have entered either on the Client Skills and Codes Self Pay or the Client Payer Skills and Codes screens Compliance rules may only be entered for valid skills e Enter the minimum number of times frequency that a visit should occur within the specified time unit in the field before the word to e Enter the maximum number of times frequency that a visit should occur within the specified time unit in the field after the word to e Indicate whether the frequency for the Doctor Order applies to a number of Hours or Visits by clicking on the option e Specify the frequency unit A Day A Week A Month As Needed in the frequency combo box that corresponds to the number of Hours Visits entered e Enter the duration of the Doctor Order in the field after the word for e Specify the time unit corresponding to the entered duration by selecting the Days Weeks or Months option e Enter the interval of the Doctor Order in the field after the word every e Specify the time unit corresponding to the entered interval by selecting the Days Weeks or Months option e Enter the first day that a visit can be scheduled for this order in the Start Date field e Enter the date that visits can no longer be scheduled for this order in the End Date field e Make sure all the information about the Doctor Order is correct
328. lel Ee Ble Administration schedule AED Eoniauaton Mantenance ogm samiomo Reports Help Peer Repay x le a arm tae oe le n m E Edit Employee Status Date Status Reason 06 15 2005 Active Affiliz Phon ha Sex Status Active z Status Date 06 15 2005 i Delete Bith Reason Comment a z E F Eligible for Rehine E J Assignment Gomplete QA 06182005 03 04 PM Select Patient Status to edit or delete 3 04 PM e Click the Exit T button on the toolbar to exit the Edit Employee Status screen 01 18 06 3 13 PM Page 61 of 448 e Ifyou wish to remove a status from the Edit Employee Status screen click on the status you wish to remove then click the Delete button e Enter the employee s Email address Payroll Billing Section e Select one of the employee types from the Employee Type combo box 1 Contractor ifthe worker is contracting with your home care agency to provide care choose contractor 2 Field Employee if the worker is paid for the service they provide and does not receive a base salary choose field employee 3 Staff Employee if the worker receives a salary choose staff employee Staff employees can also be paid by the visit see the Salaried Visits field for an explanation e Ifthe Employee Type is a Contractor enter the federal ID of the worker s company in the Federal ID field e Select the appropriate skill from the Primary Skill combo box e Ent
329. lf Pay Client Attributes Client Ancillary Info Client Race Readmit Payers Visits Pay Rates Bin Rates aun gt ajo Nxs Re VITALS Client 000305 01 SELF PAY BILLING INFO Client Type mrw Client JRA Entry Date 0372571999 Name VOC Adult Day Care Same Client Name fees TL Address 591 Memorial Drive two ae Address pl Memoval Dive __ Memorial Drive Office Zip Code 32905 Zip Code e mme Melbourne FL Z 32905 x Melbourne FL Brevard 32905 7 Payer Class Private Pay x ree P Affiliation Staffing z Fragen None m Status Active X Service Home z Location Home gt s Phones 1 800 593 8805 2 1 h 4 Billing Supervisory 3 a a i Frequency Visit Freq Differentials Birth Date fi Sex Male Female Weekly Co SSN C TaxTenitoy __ Biweekly C Days CSR BILL x C Monthly C Weeks Comment F C Months 0 00 Weekend per hour Tax El Exempt ID M M Show Times Referral Bill Notes GUE 06182005 02 54 PM Select the client type 2 54 PM Use the navigation buttons to quickly move to other clients in the list To create a new client record click the New m button The client screen will clear and will be ready for you to add a new client SAM gt Melbourne GUEST Add Client Ble Administration i Wonfgureton Mam Schedule tenance lei E Loan Samioco Reports Help Client Profile Client Skills amp Cod
330. liance rule will be checked each time a change is made to the client s schedule Ifa visit of the same client payer skill sub skill combination breaks any part of the rule the visit will be given a status of out of compliance displayed as black due to Dr Orders If Out of compliant visits are verified and closed they are still paid and billed For more on compliance checking see the section on compliance checking in this manual 01 18 06 3 13 PM Page 216 of 446 Users Manual HCFA 485 Locator Mapping HCFA 485 Locator Field or Edit Plan of Care Verbal Order screen Button 4 5 7 10 Medications Medications button o O 11 Principal Diagnosis Diagnoses button S 12 Surgical Procedure Surg Proces button S 13 14 DME and Supplies Supplies button S 15 16 Nutritional Requirements Safety Ete button S 17 Allergies Safety Ete button S 18 Functional Limitations Safety Ete button S O 18 Activities Permitted Safety Ete button S 19 Mental Status Safety Ete button S 20 Prognosis Safety Ete button O O 21 Orders and Discipline and Treatments Orders button Z o Z o Z o 22 Goals Rehab Potential Discharge Plan Goals button o o Z o o O 23 01 18 06 3 13 PM Page 217 of 446 OASIS Assessment Management SAM provides the ability to maintain OASIS Assessments for patients Using SAM you are able to input modify delete or export the OASIS Assessment Export of an OASIS Assessment will
331. lient s visits that meet the selected criteria You can order the list by date client or employee by clicking on those corresponding sort options z SAM gt Melbourne GUEST Edit Client BIE Aaninistetion SG onfiGureuch Memnterance Logi Sennlicko Reports Hi Beadmet fall Visit History List Kennedy Aldrich 107 12 1999 SN RN Cancelled Office W r e For each visit the employee client date skill and status of the visit are shown e Click the Print List button to send a copy of the Visit History List to the printer e To view more information about a particular visit double click the visit or select the visit and then click the View button e The Visit Summary screen is displayed containing details of the visit 01 18 06 3 13 PM Page 39 of 448 SAM gt Melbourne GUEST Edit Client BIE Aaministaton Screcuie At oriiguraticn Memnterence Login Senlicto Geports Hep fal Visit Summary Margaret Aldrich Readmit Kennedy Mi 911 J d Office e Click the X in the upper right corner of the screen to exit e Click the Exit button to exit the Visit History List screen e Click the Exit button to exit the Visit History Criteria screen to return to the Profile page of the Edit Client screen 01 18 06 3 13 PM Page 40 of 448 Defining Client Payer Sets Client Payer Relationships Defining payer sets for a client sets up the association of a client to payers for visits plans of care inv
332. lient for the invoice you want to rebill and click the Generate button Select the invoice you want to rebill On the Invoice Details screen click the Rebill Invoice button Rebill Invoice gt Melbourne GUEST lel x Bile Administration schedule AED Eoniauaton Mentenance Logi Seniioto Reports Hep xj Adjust Invoice _ Collection Log alal gt aa T Invoice 0002403577 View Cash Applied Invoice Date 0970672002 Version joi T DSO Ignore Service Period 0873172002 to 09 06 2002 Client Squire Arlene Invoice Amount 1 190 00 Pe Client Squire Arlene Bl Tel Payer Set Before Rebill 02 Medicaid N 11 19 01 11 14 02 After Rebill 02 Medicaid N 11 19 01 11 14702 Select the desired payer set for the selected client 10 24 AM Note that if the invoice has cash applied to it you will get a warning message The Rebill Invoice screen is displayed Select the new payer to bill the item to from the After Rebill payer list Make sure you have the correct payer with the correct dates Click the Save al button Click the Yes button when asked Re bill this invoice to the selected Payer Set When you rebill an ivnoice to a new payer the work items will be refreshed with the new payer s bill rates Invoice rebills are processed when you click the Save button They do not need to be reviewed or accepted However you will need to create invoices for the payer
333. lients xls This contains a list of active clients The following are the columns in the xls file a Client name b Phone c Address 1 d Address 2 e City f Comment 2 Client_schedules xls This contains visits for active clients within the date range selected The following are the columns in the xls file a Client name b Visit date c Visit time in 24 hour format d Employee name e Skill of the visit f Hourly pay rate g Hourly bill rate 3 Emplo Employee name Skill of the employee Phone Alt Phone Address 1 Address 2 City Comment Be me nose yees xls This contains a list of active employees The following are the columns in the xls file 4 Employee_schedules xls This contains visits for active clients within the date range selected The following are the columns in the xls file Employee name Visit date Visit time in 24 hour format Client Name Skill of the visit Hourly pay rate Hourly bill rate mpra 5 Emp_sch_extended xls This contains visits for active clients within the date range selected The following are the columns in the xls file Employee name Visit date Visit time in 24 hour format Client Name Skill of the visit Hourly pay rate Hourly bill rate Client Address 1 Client Address 2 Client City Client Zip Visit Status crip moe ae op Each time you process the report with the option On Call Spreadsheets chosen these xls files wil
334. llable visit s date The first billable visit for an initial RAP 60 is a skilled visit with a status of confirmed verified or closed e The first billable visit for a subsequent RAP 50 is a skilled or unskilled visit with a status of confirmed verified or closed If no billable visit is found the date will be set to the certification begin date On the UB92 claim locator 6 dates will be set equal to the RAP service item date On subsequent RAP claims locator 6 dates will reflect the certification begin date On EOE claims locator 6 dates will reflect the certification period The date in locator 6 on the EOE UB92 must match the date in locator 6 of the RAP UB92 For this reason it is important that the date of the first billable visit be known at the time the RAP is created If this is not the case BOTH the RAP and EOE claims must be edited and resubmitted If you need to edit the claims check with your clinical staff to make sure that the OASIS Assessment and scheduled visit information are correct If not they may need to make adjustment to the assessment s or schedule before you recreate the RAP EOE claims Note You can set Creating Medicare PPS Invoices to only look for visits with a status of closed or verified not include confirmed visits To enable this feature add the following line to your N sam ini file Ini_FBV_visit_status_list T V Also on the
335. losed week 2 Must have OASIS 4 View possible adjustment associated with Plan 2 Ifa patient is information for invoices that of Care discharged from the may need PEP LUPA or agency in Care SCIC adjustments Manager or if the Payer is discharged from the Plan of Care 01 18 06 3 13 PM Page 249 of 448 Users Manual Medicare PPS Invoices amp Claims Diagram Collection Log Optional View an Invoice or Claim View Invoices amp Claims Print an Invoice or Claim Create a Claim Delete a Claim Edit a Claim Convert a HCFA 1500 to a UB92 Print Transmit View all versions of Invoices View Multiple Invoices or Claims Print Multiple Invoices or Claims Create Multiple Claims Transmit Multiple Claims Create Automatic Contractual Allowances Note The initial RAP invoice and UB92 claim will only contain the amount for the initial RAP service item When the EOE service item gets created all the related visits and supplies will appear on both the EOE invoice and UB92 claim At this time you can then adjust the EOE if required by the patient s status etc You cannot do Contractual Allowances Shift Payment Responsibilities and Write Offs to Medicare invoices You must instead do an item adjustment to the RAP or EOE ser
336. lowed by the payer name e The Payer Start End Date fields contain the payer set Start End Date same as the Start End Date on the Edit Client Payer screen To discharge the displayed patient from the displayed payer e Select the status of Discharged in the Payer Status combo box e The Payer Discharge Date field will become enabled e Enter the Payer Discharge Date e Click the Save button to save the new status and discharge date The client payer authorization end date will be set equal to the discharge date plus one day The Edit Plan of Care Verbal Order screen will be redisplayed with the Payer Status field filled in with Discharged and the Payer Discharge Date filled in with the saved discharge date The patient is now discharged from the payer The Payer Discharge Date is now available to be used as the Discharge Date on all Claims associated with all Plans of Care for this payer 01 18 06 3 13 PM Page 205 of 446 Users Manual Readmitting a Patient to a Payer A patient may be readmitted to a payer that the patient has been previously discharged from Refer to the previous section Discharging a Patient from a Payer First a new payer another payer set with the same payer as the payer the patient was discharged from must be defined for the patient before a new Plan of Care may be defined using the payer To readmit a patient to a specific payer and not the agency i e Medicare first create a new payer s
337. ment Depending on the Assessment type selected the system will default the Reason M0100 to the first acceptable reason for the assessment type e Enter the information all of the fields that you have the information for e Click the Save i button to save the initial OASIS Assessment screen Warning messages will be displayed if any required information has not been entered After you have saved the initial OASIS Assessment screen the buttons along the top of the screen to allow access to input more assessment information become available Note it will depend on the Assessment Reason M0100 selected as to whether or not each button is made available The Agency Info button will display a screen that shows your agency information This information may be entered using the Offices feature It is important that this information be entered for each office before any OASIS Assessments are exported In addition the Assign POC button will become available If for any reason you need to reassign an OASIS Assessment to a different Plan of Care click this button A screen listing the existing Plans of Care will be displayed Select the Plan of Care that you want to associate the OASIS Assessment with You may now continue to enter the information for the remainder of the OASIS Assessment If you place your cursor to hover over each of the button a yellow tool tip will show you the MOxxx numbers that may be defined by pressing
338. ministration schedule AR Lonfiguration Mantenance Loon Senlicto Reports Hep X Print List Copy Update Visits BO Bl Payer Aetna US Healthcare N Client kDEFAULT gt Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 08 01 2002 17 43 17 43 17 43 17 43 17 43 17 43 Hours HHA Homemaker 08 01 2002 15 66 15 66 15 66 15 66 15 66 15 66 C Visits LPN 08 01 2002 31 36 31 36 31 36 31 36 31 36 31 36 VIEW RN 08 01 42002 37 91 37 91 37 91 37 91 37 91 37 91 C AM Current ORDER BY Date Skill BILL Invoice a C Reimb Skill HHA 7 Effective Date 08 01 2002 2 Mon Tue Wed Thu Fri Sat Sun Update Rates 1 517 4300 17 4300 17 4300 17 4300 17 4300 17 4300 17 4300 2 17 4300 _ 17 4300 17 4200 s17 4300 17 lt a00 17 4200 17 4300 Remove 3 17 4300 17 300 17 4300 17 4200 17 lt 200 17 4300 17 4300 JM 0812 2002 09 24 AM Bill Rates for specified Client Payer Z Bill Unit 10 27 AM And this screen shows a HHA Reimbursement rate 01 18 06 3 13 PM Page 313 of 448 Users Manual Edit Bill Rates gt Melbourne GUEST lel Ee Fi Edministeton Schedule AE Eonnauraton Mamtenance logn samico Hepots Hep x Print List a Copy Update Visits ol fl Payer Aetna US Healthcare N Client KDEFAULT gt Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 0870172002 14 00 14 00 14 00 14 00 1
339. mp Photo Photo Aspect Ratio h x w 4 x 3 No Photo Delete Photo e To add photo click the Add Photo button and the Open Picture screen will be displayed 01 18 06 3 13 PM Page 67 of 448 Open Picture 21x Look in E Sam20 z 3 E ak emphoto1 jpg al emphoto2 JPG Sam ico CETHS File name X Places Files of type All Graphics Files bmp dib cur ani ico j Cancel Li e Enter the path and filename where the photo file resides on your workstation or network You may add a picture jpg bmp etc lt 100 KB in size SAM gt Springfield QA Edit Employee BIE Administration Sehedvie AEN Eoniauaton Menmterance loon Seniictoa Reports Help Emp Profile Emp Taxes Emp Skills Attributes Emp Preferences Bonuses Emp Photo Shirley Amaker Photo Aspect Ratio h x w 4 x 3 Delete Photo LUOU M 10 39 AM e To remove an employee photo click the Delete Photo button 01 18 06 3 13 PM Page 68 of 448 Employee Tracking Tracking information may be defined for an employee using the Tracking Information screen This information can be used in scheduling when assigning an employee to a visit All tracking information entered into this screen is available from the Employee Tracking Report This report allows you to build a list of employees whose items like license dates are coming up for renewal e To access the Tracking Information screen select menu
340. mployee matching is used to fill unassigned visits for this client If you want to comment why the relationship exists enter this information into the Comment field Click the Update List button to complete the addition of the employee client relationship Click the Cancel button to cancel the addition of the employee client relationship 01 18 06 3 13 PM Page 66 of 448 Bonuses Section To give the employee a bonus over and above the normal pay rate scheme when performing service for a particular client e Click the Add button e Click the Select button next to the Client field This will display the Client List screen e Use the attributes to shorten the list of clients e Click the Generate button e Select a client from the generated list Enter the additional amount per hour and per visit into the Amount fields If you want to comment why the bonus exists enter this information into the Comment field Click the Update List button to complete the addition of the employee client bonus information Click the Cancel button to cancel the addition of the employee client bonus information Click the Emp Photo tab to go to the next page Employee Photo The Employee Photo page is used to optionally store a picture of the employee SAM gt Melbourne GUEST Add Employee Bie Administration schedule AE Lontiguration Memntenance Login samnmioto Reports Help Emp Profile Emp Taxes Emp Skills Attributes Emp Preferences Bonuses E
341. n Physician UPIN Number Physicians Diagnosis UPIN 18 Hospitalization Clinical Information HCFA1500 Hospital Dates Dates Edit Patient Edit Hospital Stays Start Date End Date 19 Reserved for Local N A Physician Local Use 2 Use Diagnosis 20 Outside Lab Default to NO Physician Outside Lab Charges Diagnosis Charges 21 Diagnosis Codes Clinical Information Physician Diagnosis Code 1 Edit Patient Diagnosis Diagnosis Code 2 Define Plan of Care Diagnosis Code 3 Verbal Order Diagnosis Code 4 Diagnoses ICD 9 CM 22 Medicaid N A Physician D Resubmit Code Resubmission Code iagnosis Original Ref Reference Number 23 Prior Authorization Administration Insurance Auth Number Clients Define Payer Sets Authorization 24a Dates of Service Schedule Detail Lines Sve Dates Display Schedule Visit Right Click Edit Visit Date 24b Place of Service Default to 012 Detail Lines Location 24c Type of Service Default to 01 Detail Lines Sve Type 24d Procedures Visits Detail Lines HCPCS Services or Administration Modifier CPT HCPCS Client Payer Skills amp Modifier Codes or Payer Skills amp Codes 01 18 06 3 13 PM Page 429 of 448 Users Manual HCFA 1500 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field Supplies Schedule Display Schedule Supply Item
342. n be used to show an employee s current and historic payroll and the payroll interface report can be used to show what has been exported 01 18 06 3 13 PM Page 240 of 448 Users Manual This is an example of a reimbursement pay item being adjusted from 30 75 to 10 Because it is the only payroll for the employee for the week the employee will not be paid this week they owe 20 75 As soon as they accumulate another 20 75 in payroll the employee s payroll can be exported mI Posting groups that would cause a negative paycheckc sam held txt x Posting groups that wou This is caused hy payroll e enough payroll to adjustment export iin When the f the t a tal Pay 1 0 0000 3 10 00 11 Of 30 7508 0 0000 03 29 03 10 00 11 00 10 0008 When the employee earns more in this case 20 75 during the payroll export the export adjusts the current postings to recuperate the money owed The posting before the recuperation and after are shown on the screen with the option to print The posting s shown after the adjustment is applied is what is exported to the payroll system I Adjusted Postingsc sam djPost txt x in order to cover a m Posting groups that were adj gt postings are shows own after the negative postings have been applied mp Ho Name Payt ype Unite Date Times Skill Total Pay A 06020 0 00 11 00 30 7500 06020 9 12 00 33 0000 0002000284 oc cole ERS 8 0000 03 29 03
343. n invoice the Print Options screen will appear 01 18 06 3 13 PM Page 263 of 448 Users Manual fal Print Options x PRINT OPTIONS Print C Do Not Print I Convert Draft copies to Final copies I Print Clean Invoices no adjustment lines I Print Client Copy Invoices excluding self pays I Print Invoices without Employee Names Cancel e Print vs Do Not Print This option is used in conjunction with the Convert Draft copies to Final copies You may choose to actually print the invoice or not print the invoice while converting it to a final copy or not converting it to a final copy e Convert Draft copies to Final copies This option if selected will convert all Draft copies of invoices to Final copies of invoices Invoices are created in the draft state and are printed with the word DRAFT on them Final copies do not print with the word DRAFT Final copies may be mailed to the payers If you convert the invoice from Draft to Final the claim is also converted to Final e Print Clean Invoices no adjustment lines When invoices have items with adjustments the adjusted items appear on the invoice as gray lines If this option is selected any invoice with adjustments will print only the final adjusted values with no gray items e Print Client Copy Invoices excluding self pays Sometimes a client wants a copy of an invoice that was mailed to their insurance
344. n is off the Reports menu option Pay Rate Report will be disabled 6 Pay Item Report if this option is off the Reports menu option Pay Item Report will be disabled 7 Sales Item Report if this option is off the Reports menu option Sales Item Report will be disabled 8 Adjustment Report if this option is off the Reports menu option Adjustment Report will be disabled 9 Plan of Care Verbal Order if this option is off the report menu option Plan of Care Verbal Order will be disabled e After all the user information has been entered correctly click on the Save i button on the first User Profile screen Modifying User Information Any portion of the user s information may be modified except the User Code including the user s password e On the Edit User screen display the details of the user to be modified using the Navigation Hl a gt n buttons or the Find Al button e Modify any of the fields on the screen e After all the user information has been modified correctly click on the Save a button Deleting a User e On the Edit User screen display the details of the user to be modified using the Navigation Hla gt mt buttons or the Find A button e Click the Delete x button e Click the Yes button when prompted Delete Displayed User e The deleted user s information will be removed from the Edit User screen Change Password
345. n screen shows how the current models are displayed SAM gt Melbourne GUEST Ble Achimistaton Schedule AR Donfauretion Menmtenence logn Seniioto Hepots Help fal Information This list of clients and their model weeks is based on payer source ALL and CSR ALL Mon Medicaid P D Dillon Vickie RN Pedi High Tue Medicaid P D Wed Medicaid P D Davis McMullen J Mitchell Jennifer Busiere Sharman Busiere Sharman Busiere Sharman Busiere Sharman Busiere Sharman Brooks Patricia Mon Dept of Veterans Affairs Steinberg Eunice Brooks Patricia Fri Dept of Veterans Affairs Steinberg Eunice MOE Print the contents of the list 3 27 PM 01 18 06 3 13 PM Page 128 of 448 When creating client models it may be useful to know which clients have not had models set Clicking the Missing Model Weeks button on the Copy Model Weeks screen can show this SAM gt Melbourne GUEST Ble Achinistation Schedule AE Wontiguraton Memntenence Loan Semiicko Reports Help fal Information The following clients and their payer sources do not have any model weeks defined This list of clients is based on payer source ALL and CSR ALL Abair Meiko Self Pay Print the contents of the list 3 27 PM Adding Supply Items Supply items are entries that record what supplies have been used how much they cost and how much is billed to payers Supply items may be recorded two ways 1 they may be associated with the
346. nd button 13 A transmission status window now appears during the transmission until it completes 14 After the file is transmitted type the G command Goodbye to log off the bulletin board 15 Type Y to confirm that you want to disconnect 16 Exit out of HyperTerm 17 If you selected Capture to Printer in step 4 above a printout of the session is sent to your printer Oy i pa 01 18 06 3 13 PM Page 269 of 448 Users Manual Invoice Register Report Tracking Which Bills Were Sent Finalized When an invoice is printed or transmitted billing marks it as finalized This is an agency s way of knowing which invoices have been actually billed The invoice register report is not only for generating lists of invoices but can be used to generate lists of invoice that have not been billed This is a powerful report for selecting sorting and reporting your invoices You may also report invoices that should have claims created but for some reason the claim is missing If you select to Include Skill Totals Report then the detail of the invoices will be sorted by skill CE SAM gt Melbourne GUEST File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Invoice Register x DATE RANGE DISPLAY OPTIONS IV Include Addresses Al po r ee From 96 21 72005 M Include Header Info Creation Dates To 06 21 2005 2 z PEE iais ae nclude Invoice De SORT BY STATES IV Include
347. nd or eclickmd must be placed in the POC VO Email Addr field of the physician s record SAM gt Melbourne GUEST Bie Administration Schedule AEN Eonigauaton Metntenance Loon Semioto Reports Help x nle pil alol Exi Be UPIN JOTHO jee Select Physician Name fap I Do Not Use ABDELKADER Title MD v Address m WRIGHT Zip Code 01069 Palmer MA 01069 Phone 413 267 9101 FAX Il is License Number 78893 License Date 04 20 2003 2j Date Verified 05 01 2001 al General EMail Addr POC VO EMail Addr Jeclickmd POC VO Submission C Mail EMail Claim ID Enter Email Address for Plan of Care Verbal Order Submission PAI 09182002 09 41 AM 3 For physicians that you will be sending a Plan of Care for you will need to verify that you have the correct UPIN the system will not export Plans of Care for physicians without valid UPINs UPIN beginning with OTH VAD INT PHS RES and RET are not considered valid e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information 01 18 06 3 13 PM Page 193 of 446 Users Manual The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Ca
348. nding on which pay item you select For example If you select the Bonus affect Overtime you will have the option to select a start end date This reflects the payroll week that the OT should be calculated for If you enter a date that does represent the start of end of a week the system will snap to the start or end of the week Enter the date the pay item occurred If an end date is required for the pay item enter it too If the pay item is paid as a flat dollar amount enter the amount in the Dollar Amount field If the pay item is paid hourly enter the hourly rate and the number of hours in the Rate X Hours fields Reimbursement Information Section If the client s payer may reimburse the pay item this section defines how much is billed Click the Select button to identify the client involved in the service Select the appropriate payer set from the Payer combo box Note that the list of available payers is dependent on the date the pay item occurred Enter the proper bill amount in the Bill Amount field Enter an invoice description Optional 01 18 06 3 13 PM Page 136 of 448 e Click the Save a button to save the pay item e Click the Find a button to view existing pay items e Click the Exit Ae button to leave the screen The following are the type of Pay Items Pay Item Description Rate Dollar Affects Taxable and Amount OT Hours Bonus affects over
349. nformation on the report includes the client s name the employee s name and the visit date start time and end time You may also include the visit comment on the Report format If you select the Calendar format the visit information will include the client s name the employee s name in calendar format including the start and end times of the visit The End of Week will default to the end of week defined for the office however you may change this for the calendar format In addition you can control the vertical size of each calendar week The size will be the minimum of either the value you enter or the number of visits that occur on each day You may optionally select to Show Time or Show Only AM PM or to not show times This will affect the report and calendar output You may optionally select to Show Name or Show Skill This will affect the calendar output only Client Dispatch Report gt Melbourne GUEST le File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help g Client Dispatch Report i Greate tit V Report Format C Name Beginning With a V isit Comment Visit Date Range wz e A MV Calendar Format End of Week Client Friday z Facility Client Admit S Client Name Patient No No Min Week Size a V Unassigned Visits Show Times C Show Only AM PM C Don t Show Times Show Name C Show Skill Indicate whether to use all clients
350. ng Adjustments 01 18 06 3 13 PM Page 306 of 448 Users Manual Pay Item Adjustment Adjust Pay Item gt Melbourne GUEST BIE Baministaton scenedule Ar Lontiguraticn Memtenence Loar Semniioto Reports Hep e Change any of the following fields pay item type regular hours overtime hours double time hours regular pay rate overtime pay rate double time pay rate employee and bill amount e If you click on Sent to Payroll this will flag the payroll export to ignore this adjustment when exporting gi e Click the Save button e Click the Exit button Remember that adjustments are not actually applied until they are accepted Refer to section Accepting and Rejecting Adjustments 01 18 06 3 13 PM Page 307 of 448 Users Manual Item Rebills Rebill Visit gt Melbourne GUEST Bie Achinistaton Schedule AR onfiguraton Meintenence logn Semiicio Reports Help fal Item List CARE DATE EMPLOYEE OR CLIENT PAYER Start 0170172002 2 _Employee_ Ende ee Client Payer Godaire Shari __ Generate _ 01 Medicare N 01 14702 07 12 02 Reset List WI Rebill Visit x Order No 004791 Visit No 00001 Date 01 14 2002 Payer Set 01 Medicare N 01 14 2002 07 12 2002 Before Rebill 01 Medicare N 01 14 2002 07 12 2002 N After Rebill 01 Medicare N 01 14 2002 07 12 2002 1 7UUZ Goodale la ToUy lt 1 56Z UU 01 18 2002 Godaire Shari i 80 00 42 00 01 18
351. ng how a specific skill of service should be administered to the patient A Doctor Order consists of a skill frequency duration optional interval start date and an end date Note Any compliance rule that is older than 1 year based on the end date of the rule will be purged nightly when the system reindexes You can change the timeframe for deleting these rules by adding the following line to your n sam ini file Ini_Comp_Rules_Purge Months Where is the number of months back from today to keep compliance rules Scheduling interprets the rules as set up in the associated Doctor Orders to do Compliance Checking on the scheduled visits In this way it can then be determined whether visits are in or out of compliance with the physician s prescribed care e To access the Compliance Rule screen for Doctor Orders select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter Doctor Orders for Click on the Define Plan of Care Verbal Order button The Edit Plan of Care Verbal Order screen will be displayed On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to add Doctor Orders to is displayed 01 18 06 3 13 PM Page 213 of 446 Users Manual SAM gt Melbourne GUEST lel Es Bie Administration Schedule AG figuration M
352. nits checkbox if the payer wants hourly work broken into 15 minute units If you want the individual start and end times of visits to appear on invoices click the Show Times check box Choose the Bill Site for this payer Front Office if a payer is billed at the front office claims may only be edited at the front office Back Office if a payer is billed at the back office claims may only be edited at the back office Note that national payers may only be billed at the back office 01 18 06 3 13 PM Page 22 of 448 e Choose the Billing Frequency options Weekly Invoicing for this payer will occur for this payer at the end of each week Bi Weekly Invoicing for this payer will occur for this payer at the end of each two weeks Monthly Invoicing for this payer will occur for this payer at the end of each month Calendar If a payer is not billed weekly billing periods must be defined for the payer which determine when invoicing should occur Note that when Weekly Bi Weekly or Monthly is selected the Calendar tab is disabled and when Calendar is selected the Calendar tab is enabled to allow you to enter billing periods We recommend when adding new Medicare Payers that you set their Billing Frequency equal to Calendar and enter only one billing period on the Calendar screen SAM will then allow billing of Medicare PPS at any time We also recommend that the Bill Rates for ANY skill is input a
353. nly No Include Client Type Client No Payer Do Not Resuscitate Only No Office Clem CP Last Sup Freq Next Sup SOC Misch SOC Disch Cert Case Affiliaion Status TT Client Name Visit Unit Visit County Date Date Payer Begin End Manager Physician DC Melboume A005130 P Wiener Ashanti Hampden No Active POC Melboume 002512 A3 A P H Wilse Jerniter Hampden 05 2302 05 2302 No Active POC Ietaw Rist Melboume A00145 42 4 P H Wison Michael Hampden 06 0802 060802 No Active POC Dareage Rit Meboume 00479014 P Yarmac Pad Hampden No Active POC Melboune 000062 01 A P C Zducki Gerbera Hampden 03 11 93 03 11 93 No Active POC Daage Rit Meboume O00018 01 4 P C Zansiski Rosario Hampden 10 22 90 10 22 90 No Active POC 2arerage Bint Patient Status as of 06 24 03 Unduplicated counts use on Census Totals Duplicated Unduplicated pne admission per client y Number of duplicated client Number of episodes episodes due to recerts and Active patients includes holds as of 06 24 03 multiple payer sources Patients admitted during date range 0 Patients non admitted during date range Patients discharged during date range Active patients does not include holds as of 06 24 03 Incomplete patients as of 06 24 03 Number of patients on hold as of 06 24 03 Patients active at any time during dae range These values are calculated as follows Duplicated Census Summary 1 Number of
354. not found during the certification period the RAP will not be created Also when creating initial RAPs 60 the RAP will not be created if the first billable visit does not occur on the certification begin date e Ifthe payer requires that Supplies be summarized to one line on the claim click on the Summarize Supplies option 01 18 06 3 13 PM Page 24 of 448 Note that when creating claims for a client the requirements set on a Client Payer relationship will take precedence over the requirements set on the payer Click the Skills and Codes tab to go to the next page Skills and Codes Page The Skills and Codes page is used to define 1 Valid skills sub skill that the payer will pay for services A valid skill must be added on the Skills and Codes Page in order to add Pay Bill rates for the skill on the payer 2 For each of those skills a The Pay and Bill Unit Hours or Visits b The Revenue Codes and HCPC Codes to be printed on a UB92 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc c The HCPC Codes and Modifiers to be printed on a HCFA 1500 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc SAM gt Melbourne GUEST Edit Payer lel x Bie Administration Schedule AR Lontaureton Mentenance Logn Seniicio Reports Help Payer Profile Payer Requirements Payer Skills amp Codes Payer Calendar Blue
355. nsedeseUousGancoecssnsancesscsesetesenesesesessess 112 COPY Visit WIZALO s ccsccsssscastecssssctssdeces ceceveunsasesoees susr SSENT oeeo SeS a aP OTEO E SS SSNST SaS SETS 114 Update Visit WAZANd scscscscssscccssseresesassstsvsenssndstesssscnssnsasdsssssssacsssedsedennnaaanssdesesecenousbessseseacasccosesteses 116 Assignment Matching vicsc c ccsciescsssesscceesssenscsosesvedeassosssvssnsobaiessddoesaadesededsscsenscacsssccssctaaenasdsosssensases 121 Compliance Checking cccssscssccsssccsccceccsssccccsscecesssssscccccesessssccccssessssssssccsssssesssssccsssseeseessees 123 Setting Viewing and Clearing Model Week ccssscscsssssscssscccsssseccssssscccccccesessssccscceseessooees 126 Adding Supply MEMS vsss ccscsccevevvrsscccccenesevcsecccccedecessdsssdsdnsesesesesbssunsssessecesesedvanssecssessensoadosssodesesnneons 129 Adding Supply Items Associated with Visits ccccssccecesseceeeneeeceeneeeessnseeeeseeeeesseeeseeaeeecseneeeessateeensenees 129 Adding Supply Items Associated with Clients ccccccccsssceessneeeeeneececsseeeeeseaeeeeseaeeeensaeeessneeeessneesensnees 130 Using the Edit Supply Item Screen c ce ecececccsesceceeeeeeeesseeeeseeeeeseaeeecseneeesenaeeeseeseeecseeeeessnseeecsseeeeseaaees 131 Master Supplies Section ccccccessccecssneceeeneeeeeeneeeecseaeecessaeeesseaeccsseeeeesceeessseesesseesenaeeesseteeeessaesensenees 132 SUpply Item SeCtoms sack cheb ooet 9248 et es a e aa cee dideseedo
356. nsurance payer First skilled billable visit on the cert begin date for 60 RAPs Plan of Care for the Medicare or Episodic Insurance payer no overlapping plans of care for same payer 6 A Start of Care Resumption of Care Recert or follow up OASIS Assessment for the patient 7 The OASIS Assessment is associated with the appropriate Plan of Care The OASIS Assessment has a status of locked or exported 9 You can click the summary button on the OASIS Assessment and get the PPS Episode amount with no assessment errors reported 10 If the Medicare client is Medicare Secondary Payer placing MSP in the client s Bill Notes field will cause all RAP and EOE claims to be created with occurrence code 1 05 occurrence date 1 RAP date and the remark will read Services provided by our agency are not associated with previous MSP Aes al see 9 Perform the following steps to creating invoices and claims for Medicare PPS To access the Create Invoices screen select menu option AR Create Invoices The Create Invoices screen will be displayed Select the PPS option The payer list box will not list any payers Optionally select a specific Client to create the invoices for Click on the Create Invoices button Invoices and claims for the payers that require claims are created at the same time The PPS billing will step through each Patient type Client that has a Plan of Care defined
357. nt Reporting and Electronic File Creation Some states require that quarterly unemployment reporting be made electronically if you have over a certain number of employees SAM gives you both a report for quarterly unemployment and the ability to create an electronic file for your state in the state s accepted format You will need to know the password to run this report Unemployment Reporting gt Melbourne GUEST ix Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help j Unemployment Reporting Create Unemployement Report and Data File for the seleced office s OR company s C 2nd gtr C 3rd qtr C Ath qtr Wage Base z The data file will be created after the report is generated St Fed Tax ID I NetProfit File To create the electronic file you must enter some state specific information 2 lunda Waye lile Inlornmnalor Florida Specific Infomation Required to Create Electronic Wage File 01 18 06 3 13 PM Page 376 of 448 Users Manual Before creating the file you are given a chance to name the file and tell the system where to create it Each state has filename that they require these are the default names the system uses C SAMSource C windows ServerSAM Bootlog txt Skip Detlog txt C SoloSoftware Frunlog txt a Temp Junk Resetlog txt The file may then be copied to a floppy and sent to the state In some instances the state may prov
358. nt is displayed Confirm that the correct skill is displayed Confirm that the correct payer skill pay unit bill unit combination is displayed Confirm that the correct date is displayed 01 18 06 3 13 PM Page 101 of 448 Confirm that the correct start and end times are displayed and that the visit has the correct total hours Confirm that the correct pay type is displayed Regular or Holiday Confirm that the correct pay rate and pay unit is displayed Confirm that the correct bill rate and bill unit is displayed If you know that start and end times are specific and not estimates check the Specific Times check box Note that this is just for informational purposes If any part of the visit was supervisory check the Supervisory Visit check box Supervisory visits are counted on several reports Note that if the sub skill is Supervisory this box is checked for you If any part of the visit was an assessment check the Assessment Visit check box Note that if the sub skill is Assess this box is checked for you Ignore the Status combo box Status will change to Verified later Enter any comments about the visit Enter any description about the visit to appear on the invoice If all documents are present and in order click the Timeslip Verified check box Note that checking this box changes the status of the visit to Verified If the employee has already been paid for this visit or the empl
359. ntenence Logi Semlicto Gepots Hep es Copy Visit Wizard GE lt K Emish Select the desired method for copying visits CAM The copy visit wizard offers two ways to copy visits specifying each visit individually and copying the current week or month forward The first way to use the copy visit wizard is by choosing each individual day to which the current visit should be copied Clicking on the day on the calendar to which you want the current visit to be copied does this As you click the days they are added to the scrolling list of Selected Dates To remove any selected dates click on the select date and then click the Remove button The number of visits per day to be copied may be entered 01 18 06 3 13 PM Page 114 of 448 SAM gt Melbourne GUEST Scheduler le ee Ble Administration schedule AD Eoniauaton Mentenance Login samiomo Reports Help Copy Visit Wizard Ee Step 2 Select Days to Copy Visits To Which Days Should the Selected Visit be Copied To Date of Selected Visit 10 27 2002 Selected Dates October 2002 10 29 2002 Tue Sat Sun Mon Tue Wed Thu Fri 10 31 2002 Thu Additional Info of Visits Per Day Mom s work Advance to the next page 10 30 AM The next screen allows you to define what information on the selected visit should be copied and what type of checking should be done when the new visits are created Clicking the Next button will
360. ocument You may choose Yes No or Cancel If you choose the print the Final Document the document will be sent to the printer and the Final Document Printed field will display YES on the Edit Plan of Care Verbal Order screen Print Final Document HCFA 485 a Cancel e If you answered Yes to Print Final Document you will prompted whether or not you would like today s date to automatically be filled in the mailed date You may choose Yes No or Cancel e If Preview was selected once the screen preview is displayed you may click the Print E button on that screen to print the Plan of Care Verbal Order or click the Exit Tl button to redisplay the Edit Plan of Care Verbal Order screen Exporting from the Edit Plan of Care Verbal Order screen There is some initial setup required before you may export of a Plan of Care to an XML file 01 18 06 3 13 PM Page 192 of 446 Users Manual 1 First you will need to edit the file SAM INI on the N folder This file must contain your ACM EClickMD and or Alacare Provider ID in the following format you may have a line per care plan oversight system Ini_ACM_ProviderID RIVEROO1 And or Ini_Alacare_ProviderID RIVERO01 And or Ini_EclickMD_ProviderID RIVEROO1 2 Those physicians who are registered with a Care Plan Oversight system will need to have their records modified in the physician s database in SAM The name of the CPOS acm alacare a
361. ocumenting a change to e To access the Verbal Order screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Verbal Order for e Click on the Define Plan of Care Verbal Order button e The Edit Plan of Care Verbal Order screen will be displayed with the Patient Name field filled in with the name of the patient selected e Once the Edit Plan of Care Verbal Order screen is displayed make sure the correct Patient Name is displayed on the screen 01 18 06 3 13 PM Page 208 of 446 Users Manual SAM gt Melbourne GUEST lel Es Ble Administration Schecuie AED Eoniauaton Mantenance ogm Seniioto Reports Help E Edit Plan of Care Verbal Order x Orders Goals Medication Compliance Rules Recert Copy Diagnos es Surg Procs Supplies Safety Etc gjall ri 4 4 mixio l PLAN OF CARE VERBAL ORDER Client A00145 A2 VERBAL ORDER INFORMATION POC A0001676 Verbal Order Date or Patient Name Michael Wilson MISCELLANEOUS Medical Rec No Jeon 45 42 HI Claim No 0321249068 Provider No 227213 Agenc nc Start of Care 06 08 2002 cad Active Type Plan of Care 60 Days Cert Begin KIMNPIIE S Cert End 12704 2002 Payer fal Medicare N 06 08 2002 12 04 2002 z Comment A f Primary Physician c KRISHNAN ABABU s ase KRISHNAN A BABU
362. od 06 01 2002 to 06 07 2002 Client Perrault Brian Invoice Amount 515 17 Payer Blue Cross Blue Shield of Mass Bill mount 515 17 JM 06 12 2002 01 35 PM Date Service Description Quantity Rate Amount RN RN RN RN RN Conform Bandage 3 x4 1Yd St Sales Tax Gauze 2x2 4Ply St 2s Sales Tax Sodium Chloride 250ml Sales Tax Move to first record 4 46 PM e To preview the actual invoice click the Preview e button e To print the actual invoice click the Print Ej button e To see what cash had been applied to this invoice press View Cash Applied button e DSO Ignore ifan invoice has this option marked the invoice will be ignored in the calculations for DSO days sales outstanding and BPSO best possible days sales outstanding on the Invoice Aging report The User logged into SAM must have System Administrator Privileges to set this option Viewing Editing Creating or Deleting a Claim for an Invoice e While viewing an invoice on the Invoice Details screen click the Edit Claim button In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates 01 18 06 3 13 PM Page 272 of 4
363. of 448 SAM gt Melbourne QA Edit Employee x Bie Administration Schedule AR Eoniguaton Mamtenance Logn Seniicito Reports Help El Edit Pay Rates Print List Copy E Payer KDEFAULT gt Default Select Employee Tanya Acevedo Skill 7 Sub Skill Date Daily Rates Weekend Rates UNIT 11 17 2001 20 00 10 00 10 00 10 70 10 70 10 70 Hours C Visits HHA 07 2272nnn lea 7N a 7N 9 7N ein an ein an 10 40 NA TEE Update Visit Rates 10 70 AN NA 07 RER 10 10 gt p Update pay bill rates for visits in office Current J 0002 Melbourne affected by this change ORDER BY Note that changes to rates for the ANY skill C Date or deleted rates will not cause updates to visits Skill BILL Invoice ha Reimb Update Remove JM 11162001 11 45 AM Update pay bill rates on visits 11 06 AM e Click the Yes button if you would like to update the rates or No if you would like to cancel e Ifyou answer Yes the system will scan all visits with the same skill and on or after the earliest effective date of any rate change made today If the rate should be updated by the change that you have made it will be updated This process could take several minutes if there are a lot of visits to scan e A message will be displayed showing how many visits were scanned this does not necessarily mean that they were all changed Only those visits that should
364. of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed e Click on the Surg Procs button The Edit Surgical Procedures screen will be displayed E SAM gt Melbourne GUEST lel Ea Bie Administration Schectie AED Eoniauaton Meintenance ogm samiomo Reports Help E Edit Surgical Procedures Patient Helen Abbey Client 002080 02 oE oe Cert Period 03 03 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Type Plan of Care ICD 9 CM Surgical Procedure Description Date VO Status ENTRAL INFUS NUTRIT SUB 10570872001 9607 INSERT GASTRIC TUBE NEC 0773172001 4466 CREAT ESOPHAGASTR SPHINC 0773172001 ICD 9 CM 966 Select Delete Description ENTRAL INFUS NUTRIT SUB Date 0570872001 2 Verbal Order Status C New C Discontinued PAI ONON2002 12 04 PM Select surgical procedure to edit or delete 11 15 AM Entering a New Surgical Procedure e Verify that the information section at the top of the Edit Surgical Procedures screen describes the Plan of Care Verbal Order you want to enter new surgical procedures for 01 18 06 3 13 PM Page 178 of 446 Users Manual e Click the New m button on the toolbar on the Edit Surgical Procedures screen to add a new surgical procedure to the Plan of Care Verbal Order e Fill in
365. of attribute The Edit Attribute screen is displayed Click the New E button to add a new attribute Enter a Description for the new attribute e Be very careful to review the attribute information on the screen before saving because new attributes cannot be deleted after they are saved e Click the Save a button Click the Exit Tl button to exit the Edit Attribute screen 01 18 06 3 13 PM Page 341 of 448 Users Manual Defining Employee Tracking Items Employee tracking items are a set of items that can be associated with an employee such as license expirations inoculation dates and training credits All employee tracking items are defined by an organization These items can be used by the Employee Matching function and can be reported using the Employee Tracking Report Refer to the Defining Employees for information on associating tracking items with employees If you are logged into your admin office you may add edit or delete tracking items Adding a tracking item will add the tracking item for all offices Modifying a tracking item will not modify the tracking item in other offices Deleting a tracking item will delete the tracking item for all offices If you are logged into a non admin office on the back office database you may modify the tracking items for the office but you may not add or delete tracking items If you are logged into a non admin office and are not on the back office database are
366. of interest so that this manual can be used as both a teaching tool and a reference guide Back vs Front Office At the back office users have full access to all of the data and functions of the front office All information that is changed at the back office location is automatically transmitted to the front offices This means the back office can audit track and manage all of their front offices information if the back office chooses to Logging In This is the screen that allows a user to gain access to system components A system representative or your system administrator will assign your user ID and password Users marked as System Administrator are the only users with the authority to create and maintain user information Enter User Name Enter Password Select Office iy When you log into SAM you will notice an option XP Themes on the login pop up This option will only be displayed if you are running Windows XP and have XP Themes enabled This option will display the windows using the XP format To log into SAM type in the User Name that has been assigned to you along with your assigned password As you type each character of your password the system will echo the character with a Tt does this so that someone looking over your shoulder cannot learn your password by reading from the screen You get three tries to enter a correct User Name and password After three unsuccessful attempts the
367. oice screen does not exist you will be given a message that the invoice number is invalid Entering a Payment for Multiple Invoices and Applying Cash e Make sure you are logged into the office to which the payment is to be credited on the bank reconciliation When payments are reported on by office the office you are logged into at the time the payment is entered is associated with the payment If you enter a payment from a national payer that pays for invoices in several offices it is a good idea to be logged into the headquarters office so you can find the payment later e To access the Edit Payment screen select menu option AR Enter Apply Payments e The Edit Payment screen will be displayed 01 18 06 3 13 PM Page 282 of 448 Users Manual Click the New BI button to create a new payment Select the payer who sent the payment this may be either a payer or a client by clicking the Identify Payer button The Identify Payer screen will be displayed On the Identify Payer screen You can either type in some or all of the payer s name in the Name Starts With field or you can leave the field blank In the case of a client this is the client s last name Check the Self Pay check box if you would like to generate a list of clients to choose from You may also specify other information about the payers that you would like in the list Click the Generate button to generate the list of payers
368. oices and claims Payer sets are defined for a client using the Edit Client Payer screen To access the Client Payer screen select menu option Administration Clients e Click the Al button to find the client e Click the Payers button e The Edit Client Payer screen is displayed SE SAM gt Melbourne GUEST Edit Client Payer Bie Administration Client Payer Profile l Ins uth Pay Rates Bill Rates PAYER INFORMATION Set Al Client Donald Bans Payer Medicae N Select Bill Name Contact ______ Paye Default gt Assoc Hosp Service of Maine Zip Code South Portland ME 04106 7 Schedule ER Phones 1 207 822 8585 Extension __ U CSR AMY x Cif ed Visits INSURED S INFORMATION Relation PatientisInsued Name DOB 05 07 1924 Sex Male Female Employer Configuration Mamntenance Login Santee Client Payer Requirements Sei Reports Hep Client Payer Skills amp Codes gt gt 4 DB alx Ws POLICY INFORMATION I Do Not Use Insued sID sd Authorization Cd Group Name Group Number L __ Policy Number E Authorized Dates 08 16 2002 10 14 2002 S T Use this payer for all Point of Care information INVOICING INFORMATION Invoice Method Percent _ 100 00 C Co Pay BREW Pe visit Vie rea Days C Weeks Months Bill Notes ABQ 08 16 2002 04 03 PM Enter the billing
369. ompliance visits SEAE Fon em S To 06 17 2005 4 Client Status M Active admitted Non Admitted I Discharged I Transferred M Incomplete T Hold Payer ALL zl Selecting status and payer will select clients However the reports include compliance information for all payers associated with the selected clients V Show compliance rules with service deficits I Ignore visits with 0 bill rates during compliance checking I Ignore supervisory visits during compliance checking V Show visits out of compliance with doctor orders V Show visits out of compliance with insurance authorizations lV Show visits out of compliance with payer dates This report will run compliance checking however the results will only be saved to the visits if you are running the report in the front office If you are running the report for the front office from the back office the results will not be saved we do not want to overwrite visits in the front office Report Options JN Ext Select start date of visit care date range 01 18 06 3 13 PM Page 394 of 448 Users Manual Expiring Compliance Rules Report This report may be used select a specific time frame and report compliance rules Dr Orders Insurance Authorization and or Payer Authorization Dates that are going to expire in that time frame Note Any compliance rule that is older than 1 year based on the end date of the rule will be purged nightly when the system re
370. on Answering No to this question will not copy the verbal order information to the new Plan of Care e Once the Plan of Care is recertified or copied a message will appear containing the unique POC that the system has assigned to the new Plan of Care e Ifthe end date for the new Plan of Care is after the payer set end date for the client payer relationship reflected on the Plan of Care SAM will automatically extend the payer set end date to reflect the end date on the new Plan of Care Recertifying or Copying Plan of Care Notes The new Plan of Care cannot have the same Cert Begin Cert End Payer and Prime Physician as another Plan of Care This would make the Plan of Care not unique and you will not be able to save it The following Plan of Care information is copied from the original Plan of Care to the new Plan of Care when the Recert or Copy button is clicked Medications Diagnoses Surgical Procedures Supplies Safety Measures Nutritional Requirements Allergies Functional Limitations Activities Permitted Mental Status Prognosis and Case Manager Printing Previewing and Exporting Plans of Care and Verbal Orders Plans of Care and Verbal Orders may be printed or previewed on the screen at any time after they are created Plans of Care may also be exported to an XML file that may then be used to import to a Care Plan Oversight and eSignature System CPOS There is a XML interface to the following CPOS
371. on C Types escription _ Generate Report Options J Ext Select all or a particular supply type 3 56 AM 01 18 06 3 13 PM Page 406 of 448 Users Manual Transportation Report This report shows all travel expenses in the system within a specified date range A specific client and or employee may also be specified This report will only report transportation on Verified visits If you wish to report transportation on closed visits please use the Sales Item Report If you wish to report transportation on confirmed visits please use the Visit Report Transportation Report gt Melbourne GUEST lel Ee Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help Si Select Reppites j xj SORT GROUP REPORT DATES Client From 06 23 2005 iar ES To E 4 SELECT CLIENT EMPLOYEE Client ALL z Employee ALL 7 R f Generate MAM Ror option M Ee Indicate whether to sort the report by client or employee 9 57 AM 01 18 06 3 13 PM Page 407 of 448 Users Manual Visit Report This Work Sales type report shows detailed information about visits in the system Selecting the Verified Visit Report option will report only verified visits in the week ending specified Selecting the General Visit Report give you the option of defining the report time frame and the type of visits to include You may optionally have the authorization number defined on the Insurance Auth
372. on list Want Employees That Can Are Section e When an attribute is selected in this section you may click the Reverse button to alternately add remove a NOT qualifier to the attribute Such as Spanish Speaking or NOT Spanish Speaking e When a skill or attribute is selected in this section you may click the Remove button to delete it from the list e You may click the Remove All button to remove all skills and attributes from the list Click the Ancillary Info tab to go to the next page Client Ancillary Info The Ancillary Info page is used to define miscellaneous information about the client SAM gt Melbourne GUEST Edit Client Bie Administration Scheckie AR Eoniauaton Memterance lei Ea logn Senco Reports Hep Client Profile Client Skills amp Codes Self Pay Client Attributes Client Ancillary Info Client Race Marjorie Atwood ANCILLARY INFORMATION Nickname e ContactName OOOO EC Contact Phone Next of Kin No C O _ ZipCode xl Marital Status None w Employment Status None Accident None E Injury Date o Auto Insurance State ay Disaster Code Non Scheduling Comments Back OfficeCaseMor _ Biling Case Mor i z Enter name client prefers 3 48 PM All fields on this page are optional e Select a marital status from the Marital Status combo box e Select an employment status from the
373. on the care date of the work item adjusted Items with Adjustments by Date Adjusted Will report both the work items and the adjustments Adjustments reported are based on the date of the adjustment Below is an example of how the different Adjustment options will affect your report This example is for Care Dates 9 1 02 9 10 02 This report will find any work items selected hours visits pay items etc that fall within that date range In addition this report will find any adjustments for those work items regardless of when the adjustment was made Just Items Date 9 1 02 Desc Bill Unit Visit 5h Total 5h Adjusted Items Sales 35 Date 9 1 02 Desc Bill Unit Visit 7h Total 7h 35 01 18 06 3 13 PM Just Adjustments Sales 35 25 10 Date Desc Bill Unit 9 1 02 Adj 9 15 02 7h 9 1 02 Adj 9 15 02 5h Total 2h All Transactions Sales 35 25 25 35 Date 9 1 02 Desc Bill Unit Adj 9 15 02 7h 9 1 02 Adj 9 15 02 5h 9 1 02 Visit 5h Total 7h Page 374 of 448 Users Manual Output Options Output Options if selected will generate Microsoft Excel xls spreadsheets for the data selected providing the following information By County and Age Client Visits Hours OT by Payerclass Client Employees Visits Hours by Skill Payer Client AR Payroll Dates Only Hours by County and Skill Patient Summary 01 18 06 3 13 PM Page 375 of 448 Users Manual State Unemployme
374. onetdevetlsapetheahtgerster a wapcts uteeese 20 Billing Clinical Requirements Section ccceescccceseseeeeeeceecseneeeeeeeeeeecsseeeeessaeeeenaeeeeseeeeesenseeeesieeeeseeeeeees 22 REQUIFEMCNUS PAGO y i5 cs iccdccesesscscsvsccusvsesesssosesetetescocdoossensdenssacseunsscdensdscecscnabeachsodessodsaassecssossestessases es 24 Skills And Codes Pages cncascvcsscecccevevnnnsscescecsecasocsesdecevecccasesssoessasensseescevetevedessssssedsonebavsosessonbesasesesoseses 25 Changing Revenue Code HCPC Codes or Modifiers for a Payer sssssssssssscsssccssseeeeessseees 27 Calendar Page cisiccscccscccsoncactsscistctuscssssassdedovecevesscesooesensassessdsenvsasdeseedsesenosecesscessdesddasddecsesecneacanscscsssees 28 Billing Period Section sniene ces sceiic cus n pouse slay ceevess cas A E E N a p a ae 28 Payer Billing Periods Section 2 c e ccseesveteiccsvessecgeedugcdivesascdeveueacevecdalesvelaseasscdiedesaceacaeccusidvdestendiuersedeieesses 28 Defining Clients cicriacccswndtesacssiadispahossisteasusantssinosepodbanndadaseuteomhusdde und a EEEE e oao Eosi 29 Chient Profile sccccccccscescsscececestcteisccssedecnsecedecaiscesasescoosoonsevaueasseasecasccecescenedacassaseckeseodsesedseescoesseeseacseses 29 Vitals Sectio ne a asl wheelie a eae Mantle ES an EEEa t a ae aaee EEE Ei A EESAN 29 Vitals Section continued serier e earainn sir e vane EE cavengecdavelasecpuelasevsacisdeeseddsctansesnesiiersesedievees 31 Self Pay Billing Info Section ir
375. onitoring SAM is delivered with a standard set of predefined services but an organization may define additional services e To access the Services screen select menu option Configuration Services Edit Service gt Back Office GUEST Bie Acministraton Schedule AG Gontiauraton Memntenence Loan Semniicke Reports Hel id Bi 2 ini p j CARE E a Edit Service gt sD PIER Unit Cost EWI p Unit Bill 3 00 M Standard Service Description Mileage Charge JM 07182001 10 05 AM aA RiverSoft Enter the cost of the service e The Edit Service screen is displayed Click the New m button to add a new service Enter a Description for the new service Enter the cost of the service in the Unit Cost field Enter the amount to bill for the service in the Unit Bill field Only the back office can specify that a service is standard by checking the Standard Service check box Extra care should be taken in defining standard services because they cannot be deleted after they are saved Once entered at the back office standard services are copied to all front offices e Click the Save fl button e Click the Exit l button to exit the Edit Service screen 01 18 06 3 13 PM Page 345 of 448 Users Manual Defining Affiliations Affiliations can be a geographical affiliation used to describe an area where a client is to be serviced or an area where an employee provides servi
376. only not the agency since the patient is still receiving care covered by another payer and to specify a Discharge Date specific to the Medicare payer to be printed on the Medicare Claim At a later date the offices may readmit the patient to Medicare and specify a new Start of Care Date specific to the Medicare payer to be printed on the HCFA 485 and the Medicare Claim The capability to change a Start of Care date and to discharge and readmit a patient from to a payer is accomplished using the Edit Plan of Care Verbal Order screen e The date that is displayed in the Payer Start of Care field is the date used to fill in Locator 2 Start of Care Date on the HCFA 485 and on the Claim associated with the Plan of Care displayed on the screen e The date that is displayed in the Payer Discharge Date field the date used on the Claim associated with the Plan of Care displayed on the screen The default dates supplied are usually the dates most users will want to use without change However if the default Payer Start of Care date or the default Payer Discharge Date are not the dates the user wants used on the HCFA 485 or Claims the dates may be changed using the Edit Payer Status screen This screen is displayed by pressing the Edit Payer Status button on the Edit Plan of Care Verbal Order screen The only times a user would want to use the Edit Payer Status button to edit the Payer Status Payer Start of Care or Payer Discharge Date are
377. or Medicare Cost Reporting You can input an average cost per visit per skill so that an episode cost and gross margin can be calculated Visits with a skill of ST ST Eval and ST Assistant will be shown in the ST column Visits with a skill of PT PT Eval and PT Assistant will be shown in the PT column Visits with the skill of OT OT Eval and OT Assistant will be shown in the OT column If you select to send the report to Excel all of the OASIS questions that determined the PPS payment are available in the Excel file If you select multiple offices the average visit copy per skill entered for each office will be used However the fields will be disabled for entry To enter average visit cost per skill per office select one office Medicare Episode Report gt Melbourne GUEST Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help Medicare Episode Report x 2j SELECTION ATTRIBUTES M Count Billable Visits Only I Exclude visits outside date range FUNCTI C Begin Date Episode Dates on octo em 77 C Client 7 AVERAGE VISIT COST PER SKILL for highlighted office ST MSW HHA Other SN PT 0 60 71 76 01 75 09 79 44 98 19 40 40 0 00 To activate cost report spreadsheets choose Exclude visits outside date range and Begin Date options 01 18 06 3 13 PM Page 366 of 448 Users Manual An example of the Medicare Episode Report Report Designer episode frx Page
378. or detailed supplies 47 Total Charges Bill Rate Units Detail Lines Total Charges 48 Non Covered N A Detail Lines Non Covered Charges Charges 49 Untitled N A N A N A 50 Payer Identification Administration Insurance Payer Name Payers Profile Payer Name 51 Provider Number Administration Insurance Prov Payers Provider IDs 52 Release of Default to Y Insurance Release Info Information 53 Assignment of Default to Y Insurance Assigned Benefit Benefits Indicator 54 Prior Payments N A Insurance Prior Payments 55 Estimated Amount N A Insurance Estimated Amt Due Due 56 Untitled N A N A N A 57 Untitled N A N A N A 58 Insured s Name Administration Insurance Insured s Name Clients Define Payer Sets Name 59 Patient s Administration Insurance Relation Relationship to Clients Insured Define Payer Sets Relation 60 Insurance ID Administration Insurance Cert SSN HIC ID no Clients Define Payer Sets Insured s ID 61 Group Name Administration Insurance Group Name 01 18 06 3 13 PM Page 435 of 448 Users Manual UB92 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field Clients Define Payer Sets Group Name 62 Insurance Group Administration Insurance Group Number Number Clients Define Payer Sets Group Number 63 Treatment Administration UB92 Auth Code
379. or generate a list 4 44PM 01 18 06 3 13 PM Page 389 of 448 Users Manual Client List Report This Client Payer type report is a list of clients defined in the system It can be run for all office or one office in particular office Choosing a status and then entering in a date range will show only the client s that were given the selected status within the selected date range In this way you can show all patients admitted or discharged between two date ranges Client List Report gt Melbourne GUEST lei E File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help g Client List Report x REPORT TYPE EEE E REPORT ATTRIBUTE ALL 7 Type ALL Payer Class ALL Payer ALL CSR Aliiation es Referal Source I Multi Pick Client Generate f Report Options By Status Date Status REPORT FORMAT Client List Format C Client Profile Format Discharge Transfer Summary C Case Information Form DISPLAY OPTIONS T Include SSN IV Include Vitals IV Include Address Tl Include Referral I Include Status Reason Tl Include Self Pay Billing Info I Include Differentials I Include Ancillary Info I Include Skills amp Codes F Include Client Comment P Include Ancillary Comment There are four report formats available 1 The Client List format reports brief information about each client you may select what information is included This reports multiple clients pe
380. orders the report by the ending date for the cert period based on the dates chosen for the certs active 01 18 06 3 13 PM Page 416 of 448 Users Manual 4 Client name Orders the report alphabetically by client name 5 Disaster code risk code This will sort the report by the risk code of the client The disaster code has to be filled out in the client ancillary information on the Client screen or the Edit Patient screen for the report to populate this field Next supervisory visit Orders the patients by next supervisory visit Physician Orders the report by physician from the patients POC 8 Affiliation Client If you chose an office and that office has defined affiliations you may order your report by checking this box 9 Status Client This option lists the report by the clients status which is listed after the client number by a letter i e A active D discharged H hold N not admitted T transferred and I incomplete 10 Race Client Sorts by the patients race as entered on the client TA If you condition the report by Payer Payer Class or Medicare Medicaid only only patients with active Plan of Cares based on the Cert Period Date will be reported To track supervisory visits with this report simply schedule a visit with a supervisory sub skill for client The visit must be closed and the patient has to have an active Plan of Care in order to show on report Ensure the supervisory visit frequency is not set to zero for
381. orizations reported providing a report to verify that you can use to check if you have insurance authorizations for all visits You may also optionally report only those visits that were imported into the office using the DLL interface with another vendor s system telephony point of care etc Visit Report gt Melbourne GUEST ma x File Administration Schedule AR Configuration Maintenance Login SamToGo Reports Help REPORT TYPE We Week Ending Date 06 17 2005 4 C General Visit Report Care Date Range EZENN SELECTION OPTIONS SORT ORDER Visit Status Client Employee D ate C Client Date Employee __ shite FAC C Employee Client D ate Day of week p C Employee Date Client Payer Client Employee D ate Client JaLL C Payer Employee Client D ate Employee C Payer Class Client Employee Date C Payer Class Employee Client D ate Payer J Split Medicare Non Medicare DISPLAY OPTIONS I Include Visit Comment I One Employee or Client per Page I Include Visit Phone Log I Show only imported visits I Include Invoice Description Show auth instead of visit no or status 01 18 06 3 13 PM Page 408 of 448 Users Manual Clinical Application Group Reports Patient Function Group Reports Blank 485 487 This report will allow you to print blank 485 and a blank 487 Blank Verbal Order This report will allow you to print blank Verbal Order OASIS Potential Problem Log This report can be used
382. otice that the Patient Vitals section is filled in with the selected patient s information that was entered on the Client s profile The Clinical Information will be blank except the Agency Current status field will display Incomplete 01 18 06 3 13 PM Page 147 of 446 Users Manual Admitting a Patient into the Agency In order to admit a patient into the agency the patient s Agency Start of Care date must be entered and the patient s Agency Current Status must be changed from Incomplete to Active which will in turn set the patient s Agency Admit Date This is accomplished using the Edit Patient screen associated with the Define Patient function e To access the Define Patient screen select menu option Administration Clinical Information e The Edit Patient screen is displayed e Display the details of the patient you want to admit See section Finding a Patient SAM gt Melbourne GUEST le ee Bile Administration schedule AR Lonfiguration Mamntenance logn Senlicto Reports Hep E Add Patient x Define Plan of Care Verbal oae Define GASIS Assessment ia 4 gt gt I gj x e CLINICAL INFORMATION Agency a Start of Care WE m Required for PATIENT VITALS Client A00571 01 Patient Name Joshua i A Plan of Care DASIS gency Adkins Current Status Incomplete Edit Agency Required for Address fizo Canon Circle Admit Date ee Plan of Care OASIS
383. ouble click the client All visits assigned to the selected client are now displayed on the Scheduler screen Right click the first visit of the week A popup menu appears Click the Edit Visit menu option to display the Edit Visit screen Confirm that the correct employee is displayed Confirm that the correct skill is displayed Confirm that the correct payer skill pay unit bill unit combination is displayed Confirm that the correct date is displayed Confirm that the correct start and end times are displayed and that the visit has the correct total hours Confirm that the correct pay type is displayed Regular or Holiday Confirm that the correct pay rate and pay unit is displayed Confirm that the correct bill rate and bill unit is displayed If you know that start and end times are specific and not estimates check the Specific Times check box Note that this is just for informational purposes If any part of the visit was supervisory check the Supervisory Visit check box Supervisory visits are counted on several reports Note that if the sub skill is Supervisory this box is checked for you If any part of the visit was an assessment check the Assessment Visit check box Assessment visits are counted on several reports Note that if the sub skill is Assess this box is checked for you Ignore the Status combo box Status will change to Verified later Enter any comments about the visit En
384. our visits on your EOE claim and adjusts your payment accordingly if you have reached the threshold amount for an outlier After you receive your payment for the episode you will need to adjust your EOE service item to match the remittance e Patient s original condition has changed SCIC The original HIPPS code is FIRST_HIPPS As of SCIC_DATE the new HIPPS code is HIPPS with a Case Mix Weight of CMW A SCIC adjustment may be appropriate Only adjust the claim if the SCIC will cause the episode amount to increase Adjust the EOE claim before transmitting Adjust the current EOE detail line 0023 line to reflect the number of days in the days units field appropriate from the pps log for the original HIPPS code Add a new line as follows description PPS EOE code 0023 HCPCS rate new HIPPS code from pps log date of service date of SCIC from pps log days units days for new HIPPS code from pps log e Skilled billable visit for patient not found on or after date RAP PPS bill was created BUT be sure a billable visit was done Adjust the claim to reflect the date of the skilled billable visit in locator 46 serv date to be equal to locator 6 statement period covers dates from date before you transmit the RAP claim e The episode patient for the date plan of care has only x visits and qualifies as a LUPA The RAP payment for this episode was The EOE payment for this episode is The total episode payment s
385. ove the skill To remove a skill select the skill and click the Remove button To mark a skill as Do Not Use select the skill and click the Do Not Use check box e If you modify Revenue Code s HCPC Code s or Modifier s on a payer SAM will automatically update any client payer relationships for that payer with the updated codes However only those codes on the client payer relationship that match the payer s codes before the update are changed This information will be used as the default when you add Client Payer relationships skill and codes but it may be overwritten for each Client Payer relationship After you have added the Payer and input all of the valid skills and the appropriate information for each skill you will be ready to associate Clients with Payers 01 18 06 3 13 PM Page 26 of 448 SAM offers two special types of Skill Categories SN and SN Staffing Skilled Nursing If you add a valid skill of SN you may assign a RN a LPN or a LVN type of skill to a visit If you add a valid skill of SN Staffing you may assign a RN Staffing or LPN Staffing type skill to a visit The Skill Category SN is delivered with your software if you wish to have the Skill Category SN Staffing please contact your software representative When creating invoice if you have a SN skill identified on the client payer Skills amp Codes screen but the codes are blank the system will search for
386. oyee has a salary check the Already Paid check box This prevents the payroll entry for this visit from being exported to the payroll system Enter any travel money to be paid to the employee Enter any travel money to be billed to the payer Enter any sales tax Click the Save next g button which is located to the left of the Timeslip verified check box field This button will save the visit and jump to the next visit speeding up the verification process Click the Find H button to locate the next confirmed visit you would like to verify Repeat the steps above for each visit until they are all verified Click the Exit T button to return to the schedule Click the Ho button to select the next employee or Click the Right Arrow 141 41 P button to advance the schedule to the next employee in the current list Repeat until all visits for all employees have been verified Verifying Visits by Client This is the same process as verifying by employee except for one key difference The schedule is viewed in from the client perspective Click the Client button to display the Client List screen Click the checkbox labeled Has visits scheduled during the selected week 01 18 06 3 13 PM Page 102 of 448 Click on the Generate Refresh button to generate a list of all clients that have scheduled visits during the week displayed on the schedule Click the client listed on the timesheet then click the Select button Or simply d
387. patient is displayed e Click on the Medications button The Edit Medications screen will be displayed E SAM gt Melbourne GUEST lel Es Ble Administration schedule AED Eoniauaton Metntenance ogm SeniicGo Reports Help E Edit Medications x Patient Helen Abbey Client 002080 02 DB BS lt Cert Period 09 09 2002 11 POC A0001486 Payer Tufts Associated HMO Type Plan of Care Reorder Medication Name Quantity D osage Route Frequency Stat Start Date Disc d Date POLY I SOL IRON 5 mg 10 ml GT QD TYLENOL SUPP 1 suppository pr PRN q 6 hours 5 L mask PRN for resp distress ACETAMINOPHEN 1 tsp 160 mg GT PRN Q 4 HOURS IBUPROFEN 1 5 tsp 150 mg GT PRN q 6 hours SINGULAIR GT QD PULMOCORT UPDRAFT inhaler QD ha Select JPOLY VI SOL Delete C Free Type DEER Status Existing Tabular C New Quantity 0750 ce v Che C Changed Discontinued Dosage 0000 the i Route oT Othe my StortDato 77 Discontinued f EA Frequency QD PRN Cther A Date L Select medication to edit or delete Entering a New Medication e Verify that the information section at the top of the Edit Medications screen describes the Plan of Care Verbal Order you want to enter new medications for e Click the New By button on the toolbar on the Edit Medications screen to add a new medication to the Plan of Care Verbal Order e Fill in the Medication Name field by entering t
388. pay items using the Scheduling function Make sure you enter the items with dates that are covered on the current invoice You may either view them in scheduling or print off reports of the specific items to confirm the dates Close the week to make the items available for invoicing Rebill the current invoice to the SAME payer set Make sure the dates are the same Create Invoices for the office payer and client associated with the old invoice A new invoice is created that contains the missing items Note that the old invoice was zeroed out and the new invoice has a new invoice version number Handling Payer Denials when Item Must Be Rebilled to Self Pay at Street Rate To access the Item List screen select menu option AR Make Adjustments Items The Item List screen will be displayed Generate the list and then select the item you want to rebill from the list Click the Rebill button The Rebill Item screen is displayed Select the Self Pay payer to bill the item to from the After Rebill payer list Click the Save a button Click the Yes button when asked Re bill this item to the selected Payer Set Review the new version of the original payer s bill Use the Print Transmit screen with the All Versions option selected When you rebill an invoice to a new payer the work items will be refreshed with the new payer s bill rates Create the self pay invoice using the Create Invoices function Print the sel
389. pay rate is then ADDED to each overtime hour Algorithm B Item Average Rate Algorithm B calculates n individual overtime rate per visit and or pay item The overtime rate is computed by determining the average rate of the individual visit pay item considering regular pay holiday pay etc then REPLACING the pay rate of the visit pay item with 1 5 times the average This algorithm is consistent with existing overtime laws Note All employees must agree to the use of this algorithm before its use To activate this overtime option add the following line to your n sam ini file Ini_ot_algorithm B If you choose to use overtime option B it will be important to update the n sam ini file for your back office and all of your front offices so that all of your offices are calculating overtime using the same option By default 40 hours of work by an employee in one week is what will trigger any additional hours in the week to go into overtime You can control the number of hours that will trigger overtime for an employee If you do not have this variable set SAM will use the default of 40 hours To use this feature enter the following line in your n sam ini file where is the number of hours that should trigger overtime example 48 Ini_weekly ot 48 e To Cale Overtime select menu option AR Calc Overtime e If Overtime is found the following information screen will be displayed 01 18 06 3 13 PM Page 139 of 448 e Click on the Prin
390. payer name to appear on invoices and claims 9 23 AM Adding a New Payer Set e Click the BI button e Click the Select button next to the Payer field e The Payer List screen is displayed 01 18 06 3 13 PM Page 41 of 448 SAM gt Melbourne QA Add Client Payer lel Ez Ble Administration Schectie AED Lonfiaureton Metntenance Login SeniicGo Reports Help noe 1 as a i ERE Sie LT x Insi T National PAYE Payor Nase I Include Do Not Use Payers Payer DNU Clie A M Mutual Insurance Pay AARP Health Care Options Bill AccessOne Health Care Systems incl Ace Property and Casualty Conii ADIMA Addi Aetna US Healthcare American Disease Management Zip American Travelers Life Insurance Co APWU Health Plan Care Programs _ Arbella Life amp Health Insurance Pho Arbella Mutual Insurance Arrow Mutual Insurance Co Baystate Health System CSR Berkley Administrators Berkshire YNA INSU Blue Cross Blue Shield of Connecticut Blue Cross Blue Shield of Illinois Blue Cross Blue Shield of Mass Select the desired payer 2 24 PM e Click the name of the payer you want to add e Click the Select button e The Add Client Payer screen is displayed Payer Information Section e You may enter a Bill Name for each client payer relationship The Bill Name field may be used to change the name of the payer which appears on invoices and claims for that specific client e Confirm that the payer s Contact field is
391. plies Venty Week Us Client Helen Abbey Payer No Employee NOT ASSIGNED Payer Set Skill Sub SKill Visit NEW Payer Skill X al M Specific Times Date 10 27 2002 al Sunday 1 0000 total hours I Supervisory Visit Break Start Break End P Assessment Included Times EH EH Staus PES El Far y Computed Iin Compliance Type z Raes lea i l phi AN Oo il MM Override 0 00 Bill Per Hour tan Invoice Qual PILOTAGE na Verification w I Timeslip Venfied Travel Pay Total Sales Tax Pl Already Paid Travel Bill Payroll Date 77 Save all changes to database 8 50 AM 01 18 06 3 13 PM Page 96 of 448 Select the appropriate Payer Skill Pay Unit Bill Unit combination for the visit This information was previously entered when the Client was associated with a Payer and the valid skill combinations were entered or when the valid skill combinations were entered for the Client for a Facility type client or a Self Pay situation Refer to section Defining Client Payer Sets Client Payer Relationships Once you have selected the appropriate Payer Skill the remaining fields for the visit will become enabled SAM gt Melbourne GUEST Scheduler lel x Bie Administration Schedule AR Eoniguaton Meintenance Loon Seniicito Reports Hep a Create Visit x Split Hours Employee Emp Match Supplies Wenty week T l
392. port 4 51 PM 01 18 06 3 13 PM Page 393 of 448 Users Manual Work Sales Function Group Reports Compliance Summary Report This Work Sales report will run compliance checking selection on client status and payer are provided Additional selection options allow you to ignore visits with 0 bill rates and or supervisory visits You may optionally report compliance rules with service deficits and or visits that are out of compliance It is important to note that visits will only be updated with compliance information if you are running the report in a front office or in a back office that has no front offices If you run the report from a back office for a front office the compliance information is not saved on the visits They are not updated because this would cause the updated visit to data exchange to the front office possibly overwriting work done on the visit by the front office Note Any compliance rule that is older than 1 year based on the end date of the rule will be purged nightly when the system reindexes by default If you wish to modify this default time frame add the following line to your n sam ini file where is the number of months back to keep compliance rules Ini Comp Rules Purge Month Compliance Report gt Melbourne GUEST lel Ee File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Compliance Report Select date range for rule deficits and out of c
393. port an OASIS file only one time with the Production Import option This option will process the file report any error assessments not importing any assessments in error assessments with warnings reported will be imported and import all valid assessments All assessments will be imported with a status of Locked 01 18 06 3 13 PM Page 231 of 448 Users Manual e A processing log report of the import is created in your n oasisimport folder e The office to import the assessment into is located based on the client name and a few other demographic fields If you have the same client in multiple offices with duplicate demographic information then the import will not be able to determine which office to import the assessment into and will report an error for that assessment If you have the same client in the same office with duplicate demographic information then the assessment will be imported for the last occurrence of the client that it finds e You may not import OASIS assessments for Client or Facility type clients e Duplicate assessments will be determined based on M0090 INFO COMPLETED DT M0100 ASSMT_REASON CORRECTION NUM and the appropriate dates associated with the assessment reason M0030 SOC_DT M0032 ROC DT M0906 _DC_TRAIN DTH_DT and M0903 LAST HOME VISIT e You may currently only import OASIS version 1 40 data 01 18 06 3 13 PM Page 232 of 448 Users Manual Calculating Overtime at the Back Office
394. pply be sure to input a comment Ou le 01 18 06 3 13 PM Page 111 of 448 9 Refused if the employee has refused assignment of the visit Also used while performing Employee Matching e Input an appropriate comment in the Message field for later reference e Press the Visit Summary button to see more information regarding the visit SAM gt Melbourne GUEST Scheduler mik Fle Kdminisiation Schedule AH Wortauraton Mamntenance ogm Sanita Reports Hep 2 ni LGTHTG l Log i p nap fal Visit Summary Helen Abbey xi Employee Kathryn A Blanchard Client Address amp 25 Wentworth Manor Drive 1 555 256 4256 Address Phone H s 2i Amherst a i Ip o MA 01002 4 ma Skill J5N RN Rates 26 00V 80 00 Times 0S004M TO fit 00AM CURRENT ies Visit Date Status Confirmed Out of Compliance Ins Authorization Start Time Comment aS a xi M Invoice essage Description o jefault regular Type ate for employee Duration Message Offered Call Date amp Time 06 16 2005 at 10 08 AM Modification Date GUE 06162005 10 08 AM 10 11 AM Comment entered for the selected visit right click F2 to zoom Visit Phone logs can be searched and printed by choosing the Schedule menu option and selecting Search Phone Log Copying a Visit Copying a visit can be done three ways 1 If you want to copy one visit to another time or day on the same sched
395. press Ctrl V e When you are entering text for Goals and Orders if you want the text to occur on a new line click Enter and it will force a line break 01 18 06 3 13 PM Page 171 of 446 Users Manual e Click the Select Phrases button to select Intervention phrases from the Phrases Database to be place into the paragraph The Select Phrases for Orders screen is displayed SAM gt Melbourne GUEST le Ee Bie Administration schedule AR ontguratcn Mamtenance Woon Seniicho Reports Hel E TH H fal Select Phrases for Orders x Patient Helen Abbey POC A0001486 View All Phrases Category ALL x ICDS Type ALL Skill Code ALL nd ICD9 ICDS Code Category AVAILABLE PHRASES Type Code Skill EVALUATION ESTABLISH UPDATE HOME EXERCISE PROGRAM GAIT TRAINING PULMONARY PHYSICAL THERAPY PROSTHETIC TRAINING FABRICATION TEMPORARY DEVICES SELECTED PHRASES Keep Cancel Available Phrases List double click or Add to add phrase to Selected Phrases List e Highlight the phrase you would like to insert and either double click or press the Add button The phrase will be displayed in the Selected Phrases area of the screen e Click on the 1 button and drag a phrase in the list to reorder its position within the list e Click the Keep button to save your changes After phrases have been selected a dashed line will appear in the paragraph and the new phrases will be displayed below the lin
396. r any time that you do not wish to be counted for billing or payroll in the Break times You may input in 12 hour or 24 hour military format for all visit times The Pay Type may either be Regular or Holiday Selecting Regular will pick up the regular pay rate without applying holiday differential and selecting Holiday will apply the holiday pay differential to the pay rate The pay and bill rates will be defaulted from the pay and bill rate tables These values are defaulted any time this screen is invoked If you choose to override the pay bill units or rates and do not want them to recalculate the next time the screen is invoked for this visit only click the Override option next to the pay or bill rate The computed pay and bill rates to the right will always be displayed to the right The Qual field may either be Qualified or Unqualified This information must be entered the for the FIRST visit using the Payer Skill Pay Unit Bill Unit combination then any subsequent visits created will use your input as their default Specify Qualified for any visits that you wish to be included in your Medicare Cost reporting By default the Specific Times option is checked signifying that the times assigned to this visit correspond to when the visit should be done In some cases employees set there own schedule and the time of the visits are not known at the time they are assigned to an employee In this case the
397. r first letters of payer name 01 18 06 3 13 PM Page 277 of 448 Users Manual e On the Identify Payer screen You can either type in some or all of the payer s name in the Name Starts With field or you can leave the field blank In the case of a client this is the client s last name Check the Self Pay check box if you would like to generate a list of clients to choose from You may also specify other information about the payers that you would like in the list Click the Generate button to generate the list of payers Select a payer by double clicking on the payer in the list OR by clicking on the payer and then clicking on the Select button e The Edit Payment screen will be redisplayed with the Payer and Payer Office fields filled in with your selection e Enter the date of the payment in the Payment Date field the default is today s date e Enter the check or remittance advice number in the Check RA No field e Enter the amount of the check or remittance advice in the Check Amount field e The Adjusted Check Amount Unallocated Amount and Payment Balance fields will be filled in for you with the Check Amount value entered e Enter an optional Comment e Click the Save button e The Payment ID Payment Office and Status fields will be filled in for the payment e Enter the next payment by clicking the New E button and repeating the steps above e When you have entered the last payment click Exit button
398. r general information about a client e On the Edit Client screen click the New button on the toolbar to add a new client Vitals Section e Select one of the client types from the Client Type combo box 1 Client an individual for which clinical information is NOT required For example someone who will receive flu shots specimen analysis etc 2 Patient an individual for which clinical information is required To define clinical information on a client they must be defined as a Patient 3 Facility an organization to which employees are sent to work on a temporary basis such as hospitals or other health care providers 01 18 06 3 13 PM Page 29 of 448 e Enter the client s name in the Client Name fields For a Client Type of Client and Patient enter their first name middle initial and last name For Facility Client Type enter the name of the facility e Enter the client s address in the Address fields The first address line is for street address or PO Box numbers The second line is for apartment or suite numbers etc If a street address is long and will not fit in line one its okay to overlap it on line two avoid splitting a word in half when you use two lines for the address if you can because it is printed with a space where the split occurs e Enter a Zip Code If you do not know the entire zip code you must enter at least the first three digits After you enter the zip code a list of c
399. r page 2 The Client Profile format report more information regarding a client This report includes information defined on the Edit Client screen Payers and Compliance Rules 3 The Discharge Transfer Summary format reports the patient s status and reason defined for that status on a Discharge Transfer Summary form 4 The Case Information form reports client information on a Case Information form If you would like to select one or multiple clients click on the Multi Pick Client button After you have filled in this screen with the conditioning you would like for the report and then click the Generate button the report will display a list of all clients that meet your conditioning criteria To select one client click on the client then click the OK button To select multiple contiguous clients click on the first client and then while holding down the Shift key click on the last client then click the OK button To select multiple non contiguous clients hold down the Ctrl key and click on each client then click the OK button The Client List report uses the following logic when selecting by payer class or by payer 01 18 06 3 13 PM Page 390 of 448 Users Manual 1 When selecting a specific payer class all clients with payer sets that are not do not use that have the associated payer class combined with all self pay clients with the associated payer class that have self pay allowed skills skills that are not do not use a
400. r the new 1 sa Responsibility payer Write Off Invoice Page 247 of 448 Users Manual Entering Payments amp Cash Applications Diagram Enter Apply Payments Account Log Note Payment Report Invoice Aging Report Manual account log entries and Statements PPS Billing Information Invoice Register General Ledger Cash Report Add Payment into SAM Find Invoices with balance due that belong to payment Apply cash to invoices 01 18 06 3 13 PM View or Find Payment in SAM Find Invoices with balance due that belong to payment Apply cash to invoices Page 248 of 448 Users Manual Billing Medicare PPS Diagram Patient s Oasis information must be entered and OASIS assessment must be associated with the patient s Plan of Care Patient s Plan of Care shell must be entered into SAM SOC Date Cert Dates Payer Medicare Primary Diagnosis and Physician Note Select PPS option oe S Create Invoices PPS Log PPS RAP service PPS EOE service Automatically generated item created on item created on invoice and UB92 invoice and UB92 1 View PPS log claim claim 2 Print PPS Log 1 Must have Plan of 1 Ifthe Medicare Plan Care with payer of of Care cert end date 3 View errors and missing Medicare is included in the information last c
401. rag click and hold down the left mouse button and then move the mouse pointer to a new position on the screen and release the left mouse button Buttons Navigation Buttons Find Button New Button Save Button Delete Button Restore Button 4 oH moves displayed data through a collection of records i displays a screen used to create a collection of records from which a record to display edit may be selected L ny fal x E T presents a blank data entry screen for creating a new record saves all changes made to the currently displayed record x deletes the currently displayed record restores the currently displayed record to the data last saved Exit Button closes the current screen and redisplays the previous screen Date Fields Date Fields Date 03 24 2002 RE Calendar T or t Move to today s date in the calendar Enter Accept current date and exit calendar June 2004 maj Esc Return to original date and exit calendar Click on left arrow to move back one month 3930311 2 3 4 Click on right arrow to move ahead one month 6 7 8 9 10 11 Click on month to select a month 13 14 15 16 17 18 Click on year then click on down arrow to go back one year Click on year then click on up arrow to forward one year Click on today to go to today s date Keyboard Hot Keys include Up Arrow Move back one week 20 21 622 29 24 25 27 28 29 1 2 4 f 7 5 4 D Today 06 30
402. ration Clients Insurance Info Marital UB92 Marital Status 17 Admission Date Clinical Information Edit Patient Admit Date UB92 Admit Date 18 Admission Hour N A UB92 Admit Hour 19 Type of Admission N A UB92 Admit Type 20 Source of Admission N A UB92 Src 21 Discharge Hour N A UB92 Dischrg Hr 22 Patient Status Medicare 01 discharged to home or self care 30 still patient or expected to return for outpatient services if the cert end date is the end of episode All Others The Payer s Bill Mask s 3 character will determine what is placed in the UB92 claim status field locator 22 If it is not numeric the patient s status will be used If it is numeric the numeric value is what will be placed in the status field on the UB92 claim UB92 Patient StatusAM wound care BID wound care New Wound Care Orders for Toe red 5 16mask 23 Medical Record Number Client Not Admit_ No UB92 Medical Record 24 30 Condition Codes N A Payer Codes Condition Codes 1 7 31 Untitled N A N A N A 01 18 06 3 13 PM Page 433 of 448 Users Manual UB92 Locator Initial SAM Data Location Edit Claim Screen Data Mapping No Description Name Tab Title Field 32 35 Occurrence Codes and Dates N A Medicare If there is a ICD9 that is a trauma code
403. rbal Order you want to modify for the patient is displayed e Click the Find button on the Edit Plan of Care Verbal Order screen The Plan of Care Verbal Order List screen will be displayed SAM gt Melbourne GUEST lel Ee Ble Administration schedule AED Eoniauaton Meintenance Login Senioto Reports Hep F Plan of Care Verbal Order List PATIENT LIST ORDER LIST DIRECTION Cert Dates Patient Helen Abbey m C Ascending Client 00206002 Physici Descending Cert Begin Cert End aod Michael K Posner Michael K Posner Michael K Posner Plan _ 09 14 2001 11712 2001 01 Tufts Associated HM ALBERT J CENNER Select the desired Plan of Care or Verbal Order e Click on the Plan of Care Verbal Order you would like to modify and click the Select button 01 18 06 3 13 PM Page 186 of 446 Users Manual The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care Verbal Order e You may modify any of the Plan of Care Verbal Order fields displayed on the screen e Make sure all the information on the screen is correct e Click the Save i button on the toolbar to save the changes made to the Plan of Care Verbal Order e Click on any of the following buttons to modify the Plan of Care Verbal Order associated information Refer to the sections associated with defining each of these parts Orders Goals Medications Diagnosis Surg Procs Supplies Safety Et
404. rder screen not the contents of the Agency Start of Care field e Ifthe date in the Payer Start of Care field is not the correct Start of Care date for this Plan of Care use the Edit Payer Status button to change the Payer Start of Care date Refer to section Modifying the Payer Start of Care for a Payer e Doa final review of the contents of the Edit Plan of Care Verbal Order screen to verify that all the information is now correct for the new Plan of Care e You may preview the Plan of Care contents at any time by clicking the Preview button contains paper magnifying glass icon above the toolbar on the Edit Plan of Care Verbal Order screen e You may also print the Plan of Care by clicking the Print button contains printer icon above the toolbar on the Edit Plan of Care Verbal Order screen It is highly recommended that you complete the following at this time e Select the Primary Physician for the Plan of Care Refer to section Assigning the Primary Physician to the Plan of Care e Select the Case Manager for the Plan of Care Refer to section Assigning the Case Manager to the Plan of Care e Select the Primary Diagnosis for the Plan of Care Refer to section Assigning the Primary Diagnosis to the Plan of Care All of the essential initial pieces of a new Plan of Care shell have now been entered Now that a new Plan of Care shell has been entered you have several options 1 You may continue defining other parts of the Plan of
405. re Verify that the information section at the top of the Edit Surgical Procedures screen describes the Plan of Care Verbal Order you want to modify surgical procedures for On the Edit Surgical Procedures screen select the surgical procedure you would like to modify by clicking on it in the list on the screen The details of the selected surgical procedure will be displayed in the fields on the lower section of the screen You may modify any of the fields displayed in this section Make sure all the modified information about the surgical procedure is correct Click the Save a button on the toolbar to save the modified surgical procedure The modified surgical procedure will be redisplayed in the list on the screen At this point you may modify other surgical procedure information by repeating the steps above Click the Exit Ae button on the toolbar to exit the Edit Surgical Procedures screen The Edit Plan of Care Verbal Order screen will be redisplayed Deleting a Surgical Procedure Verify that the information section at the top of the Edit Surgical Procedures screen describes the Plan of Care Verbal Order you want to delete surgical procedures from On the Edit Surgical Procedures screen select the surgical procedure you would like to delete by clicking on it in the list on the screen The details of the selected surgical procedure will be displayed in the fields on the lower section of the screen Make sure that the surgical p
406. re s cert begin and cert end dates 9 MO825 answered No yet 10 or more therapy visits scheduled reports patients that have the Therapy Need question on the OASIS Equip Therapy screen answered as No on a assessment completed on or after the date you specify yet 10 or more scheduled confirmed verified or closed therapy visits skills PT OT ST PN PT Assistant PE PT Eval OA OT Assistant OE OT Eval SA ST Assistant and SE ST Eval were found between the Plan of Care s cert begin and cert end dates 10 MO825 answered Yes yet less than 10 therapy visits scheduled reports patients that have the Therapy Need question on the OASIS Equip Therapy screen answered as Yes on a assessment completed on or after the date you specify yet less than 10 scheduled confirmed verified or closed therapy visits skills PT OT ST PN PT Assistant PE PT Eval OA OT Assistant OE OT Eval SA ST Assistant and SE ST Eval were found between the Plan of Care s cert begin and cert end dates 11 LUPA predicted 4 or fewer visits scheduled for RAP report patients that currently have 4 or fewer visits scheduled for the episode reported 12 Plan of Care ends within 5 days of report date with no recert plan of care reports patients that have their plan of care ending within 5 days of From date and do not currently have a recert plan of care entered 13 New admission falls within patient s last episode
407. re Plan Oversight s documentation for the download process e After the Plans of Care Verbal Orders have been signed your Care Plan Oversight system will allow you to create a XML file of these signed order that you can re import back into SAM to populate the Received Signed date on the orders Please see the Import Signed POC VO section in this manual Printing Previewing or Exporting from the Plan of Care Verbal Order Report screen e To access the Select Report screen select menu option Reports e The Select Report screen will be displayed SAM gt Melbourne GUEST Me x Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Select Report x REPORT GROUP Clinical C Scheduling FUNCTION GROUP State Unemployment Reporting Accounts Receivable Statements C Client Payer Display the list of available Employee reports e Click the Clinical Information and Patient options e Select the Plan of Care Verbal Order report e Click the Proceed button 01 18 06 3 13 PM Page 195 of 446 Users Manual The Plan of Care Verbal Order Report screen will be displayed SAM gt Melbourne GUEST E Plan of Care Verbal Order Report e Generate a list containing the Plan of Care Verbal Order you would like to print preview or export by filling in the Name Beginning With field or the Cert Begin Range fields as desired and then clicking the Create List button
408. re Verbal Order you want to modify for the patient is displayed e Click the Find button on the Edit Plan of Care Verbal Order screen e The Plan of Care Verbal Order List screen will be displayed e Click on the Plan of Care Verbal Order you would like to export and click the Select button The Edit Plan of Care Verbal Order screen will be redisplayed containing the details of the selected Plan of Care Verbal Order e Make sure that the Plan of Care displayed is the one you want to export e Click the Generate Internet File 2 button above the toolbar to export the Plan of Care e You will be prompted for a path and filename for the file to be created The system will default to storing the files on the folder N XML Files ExportFiles and naming the file with a unique name based on your Care Plan Oversight system and Provider ID in the SAM ini file and the current date and time This may be overwritten Save in Sq ExportFiles l Tl c XML file acm_river 01_200304291 43346 xml Save as type rmi Cancel Help Bode Rage e After the file has been created and Plans of Care Verbal Orders exported to the file are updated in SAM as having been mailed on that date They are also marked as having their final document printed 01 18 06 3 13 PM Page 194 of 446 Users Manual e Once you have saved the XML file this file may be uploaded to the Care Plan Oversight website for signature Please refer to the Ca
409. re included in the report 2 When selecting the payer Private Pay all clients with payer sets that are not do not use that have the payer class Private Pay combined with all self pay clients with payer class Private Pay that have self pay allowed skills skills that are not do not use are included in the report 01 18 06 3 13 PM Page 391 of 448 Users Manual Client Payer List Report This Client Payer type report shows the relationships of an agency s clients with the agency s payers Client Payer List Report gt Melbourne GUEST ET Client Payer List Report M M E al al al E al 01 18 06 3 13 PM Page 392 of 448 Users Manual Payer List Report This report shows payer information The report may be filtered on various fields and optionally includes different information defined for the payer Payer List Report gt Melbourne GUEST lel Ez File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help vl Ey Payer List Report X DISPLAY OPTIONS Payer ALL M M Include Address I Include Billing Profile Payer Class ALL z I Include Differentials I Include Requirements Payer Program ALL v I Include Comment SELECT PAYER ATTRIBUTES I Include Skills amp Codes Payer Type ALL I Include Calendar C Local Payers C National P I Include Do Not Use Generate Report Options I Exit Select a payer for the re
410. regarding an employee going into an overtime situation you can add the following line to your n sam ini file Ini_Show_Overtime_ Warning F Printing Post Verification Reports Before closing the week the following reports should be generated and reviewed 1 Verified Visit 2 Pay Item 3 Service Item 4 Supply Item 5 Transportation For instructions see the section on Reports 01 18 06 3 13 PM Page 138 of 448 Calculating Overtime at the Front Office In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates You may choose to calculate overtime at anytime An overtime screen will pop up and display the overtime cases Overtime is calculated across all offices for the previous week SAM now offers 2 ways to calculate overtime pay for your employees Algorithm A Overall Average Rate Algorithm A is the default overtime calculation This algorithm calculates an overtime rate based on the overall average pay rate of an employee per week The average rate is computed by dividing the total pay for the week by the total hours for the week of visits and or pay items that count towards overtime One half the average
411. riod 03 09 2002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Mental Status liv j 31 Forgetful 5 Disoriented 71 Agitated 21 Comatose 4 Depressed 6f Lethargic 81 Other specify Prognosis 1 Poor 2 Guarded 3 Fair 4 Good 5C Excellent e Make sure all the information on all of the pages is correct e Click on the Safety Measures Nutritional Allergies tab to redisplay the first page 01 18 06 3 13 PM Page 185 of 446 Users Manual e Click the Save i button on the toolbar to save the Safety Etc information on all pages e Click the Exit button on the toolbar to exit the Plan of Care Safety Etc screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying a Plan of Care Verbal Order Modifying a Plan of Care or a Verbal Order is done in essentially the same way They are both modified using the Edit Plan of Care Verbal Order screen The main difference between the two is that the Type field will contain Plan of Care for Plans of Care and Verbal Order for Verbal Orders e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Ve
412. rmation Insurance Physician Name Edit Patient Define Plan of Care Verbal Order Prime Physician 83a Other Physician ID Administration Insurance ID No Under Physicians Physician Other UPIN 83b Other Physician Clinical Information Insurance Physician Other Name Edit Patient Define Plan of Care Verbal Order Sec Physician 84 Remarks Medicare Insurance Remarks Trauma Code Descriptions 85 Provider Administration N A N A Representative Payer Signature Provider Rep 86 Date Invoice Date N A N A 01 18 06 3 13 PM Page 437 of 448 Users Manual Massachusetts Medicaid Form 9 Form 9 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field 1 Provider s Name Configuration HCFA 1500 Office Fields Address amp Offices Telephone Number _ Lock Box Address 2 Pay To Provider Administration Insurance Provider I D Number Payers Provider ID 3 Billing Agent N A N A N A Number 4 Prior Authorization Administration Insurance Auth Number Clients Payers Authorization 5 Servicing Provider N A N A N A Name 6 Servicing Provider N A N A N A Number 7 Referring Provider s Administration Insurance Group Name Name Clients Payers Group Name 8 Referring Provider Administration Insurance Group Number Clients Payers Group Number OR Administration Physicians Claim ID 9 Recipients Name Administration HCFA 150
413. rmation Physician Diagnosis Code 2 Edit Patient Diagnosis Define Plan Of Care Verbal Order Diagnoses 01 18 06 3 13 PM Page 439 of 448 Users Manual Form 9 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field ICD 9 CM Secondary 24 Diagnosis Name Clinical Information Physician Diagnosis Code 2 Edit Patient Diagnosis Define Plan Of Care Verbal Order Diagnoses Diagnoses Description 25 Line N A N A N A 26 Dates Of Service Schedule Detail Lines Sve Dates Display Schedule Visit Right Click Edit Visit Date 27 Description Of N A N A N A Service 28 Procedure Code Administration Detail Lines CPT HCPCS Modifier Clients amp Client Payer Skills amp Modifier Codes or Payer Skills amp Codes 29 Treat Rel To Diag N A N A N A 30 Treat Rel To Fam N A N A N A Pl 31 Units Of Service Number of Units Detail Lines Days Units 32 Usual Fee Bill Rate Detail Lines Charges 33 Other Paid Amount N A N A N A 34 Emerg Serv N A N A N A 35 Remarks N A N A N A 36 Total Usual Fee Sum Of Usual Fees Detail Lines HCFA Total 37 Total Other Paid N A N A N A Amount 38 Authorized Administration N A N A Signature Payers Provider Rep 39 Billing Date Invoice Date N A N A 40 Adjustment Local Use 2 N A N A Resubmittal Where the Local Use 2 has an A in the left most charac
414. rocedure displayed is the one you want to delete Click the Delete x button in the lower section of the screen Click on the Yes button in the popup screen that asks Delete displayed Surgical Procedure The deleted surgical procedure will be removed from the list on the screen At this point you may delete other surgical procedures by repeating the steps above Click the Exit T button on the toolbar to exit the Edit Surgical Procedures screen The Edit Plan of Care Verbal Order screen will be redisplayed 01 18 06 3 13 PM Page 180 of 446 Users Manual Defining Plan of Care Verbal Order Supplies To access the Edit Plan of Care Verbal Order Supplies screen select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to enter a new Plan of Care for Click on the Define Plan of Care Verbal Order button On the Edit Plan of Care Verbal Order screen make sure the correct Patient Name is displayed and the correct Plan of Care Verbal Order you want to modify for the patient is displayed Click on the Supplies button The Edit Supplies screen will be displayed SAM gt Melbourne GUEST le Ee Bie Administration Schedule AR Wonfiguratcn Mentenance Login semioto Reports Help E Edit Supplies _ Patient Helen Abbey Client 002080 02 E R Di Cert Period 09 09 2002 11 07 2002 POC A0001486 pL _
415. rocessec GUE 06 22 2005 09 00 AM log of the account activity for this invoice right click F2 to zoom 3 00 AM The last collection log that was entered for the invoice will be displayed Add a Collection Log To add a new collection log click the New m button You can right click on the white space to enlarge the memo entry area as shown above Click inside the large white text window and type in the comment This window works like any standard word processor Click the Save i button Each collection log is saved as a unique log entry along with the creation date and time These logs may optionally be printed on the Invoice Aging report Modify a Collection Log To modify a collection log click the Find al button A Log List screen will be displayed of all of the collection logs for the current invoice Click on the collection log you wish to modify and click the Select button You can right click on the white space to enlarge the memo entry area as shown above Click inside the large white text window and type in the comment This window works like any standard word processor Click the Save i button Each collection log is saved as a unique log entry along with the creation date and time These logs may optionally be printed on the Invoice Aging report 01 18 06 3 13 PM Page 288 of 448 Users Manual Delete a Collection Log e To delete a collection log click the Find A button A Log Lis
416. route value e Select a Frequency The choice of Other enables a text area where you may enter any frequency value e Make sure that all the information is correct for the new medication e Click the Save fl button on the toolbar to save the new medication 01 18 06 3 13 PM Page 175 of 446 Users Manual The new medication will be displayed in the list on the screen At this point you may enter other new supplies by repeating the steps above e Click the Exit Tl button on the toolbar to exit the Edit Medications screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying a Medication Refer to section Defining Plan of Care Verbal Order Medications to display the Edit Medications screen Verify that the information section at the top of the Edit Medications screen describes the Plan of Care Verbal Order you want to modify medications for On the Edit Medications screen select the medication you would like to modify by clicking on it in the list on the screen The details of the selected medication will be displayed in the fields on the lower section of the screen You may modify any of the fields displayed in this section Make sure all the modified information about the medication is correct Click the Save El button on the toolbar to save the modified medication The modified medication will be redisplayed in the list on the screen At this point you may modify other medication information by repeatin
417. rrent date Assessments that have a status of Locked are ready for export Modifying a OASIS Assessment You may need to make modification to an existing OASIS Assessment due to a rejection etc e To access the OASIS Assessment screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like modify an OASIS Assessment for e Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical Information section of the screen Refer to section Admitting a Patient into the Agency in this manual e Click on the Define OASIS Assessment button e The Edit OASIS screen will be displayed with the Patient Name field filled in with the name of the patient selected Once the Edit OASIS screen is displayed make sure the correct Patient Name is displayed on the screen e Press the Find A button to locate the OASIS Assessment you want to Modify A screen will be displayed that lists the OASIS Assessments for the patient Highlight the assessment you want to modify and either double click or click on the Select button 01 18 06 3 13 PM Page 221 of 448 Users Manual SAM gt Melbourne GUEST Bie Achinistaton Schedule AR Eonnauaton Meintenence Loci Seniioto Heports Help F OASIS Assessment List Patient Rosario Zawalski Client 000
418. rt with Overtime After overtime calculations have been encountered during the close week function a Verified Visit Report should be reprinted to show the overtime calculations Please refer to the Visit Report section in the manual 01 18 06 3 13 PM Page 144 of 448 Users Manual Patient Management Defining a Patient Once it is determined that a patient is to receive services from the agency a patient must be admitted into the agency A patient is admitted into the agency using the Clinical Information function to specify patient clinical information After a patient is admitted Plans of Care and or OASIS Assessments may be entered for the patient using the Clinical Information function All patients that you will track clinical information for are originally defined as clients with a client type of Patient using the Client function The list of patients presented on the Patient List screen associated with the Edit Patient screen contains all of the clients currently defined in your system with a client type of Patient Finding a Patient e To access the Patient screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed SAM gt Melbourne GUEST lel x Bie Administration senedle AR Eoniauaton Memntenance Login Seniioto Hepots Hels E Edit Patient Define OASIS Assessment x n gt gt gl fal X gt m CLINICAL INFORMATION Agenc
419. rted Any payroll information for Employee s with a type of Contractor will not be exported All Contractor payroll information will however be marked as payrolled so that if at any time they are change to a Staff or Field employee their old payroll information will not be exported Employee s receiving adjustments for additional pay will receive additional pay Employee s receiving adjustments causing a deduction in pay will have deductions taken from their normal pay If deductions are to be taken and there is not enough pay in the current week all postings for the employee will be held until the next payroll that has sufficient pay to cover the deductions A visit or pay item adjustment may be performed that will cause one of two situations 1 Anemployee s payroll amount for a specific pay type like regular or overtime for the week is negative or 2 Anemployee s payroll amount for the week is negative In the first case the adjusted dollars will be subtracted from other postings in the employee s payroll for the week The largest postings are subtracted from first so that the fewest number of postings will be affected The export will show a screen report of the original postings and the adjusted postings during the payroll export In the second case a screen report will show all of the employee s postings for the week None of the postings will be exported In both cases the payroll report ca
420. s Client Related or Visit Related HCPC Codes and Modifier 24e Diagnosis Code N A Detail Lines Diagnosis Code Ref Reference Number 24f Charges Bill Rate Units Detail Lines Charges 24g Days or Units Number of Visits Detail Lines Days Units 24h EPSDT N A Detail Lines EPSDT 24i EMG N A Detail Lines EMG 24 COB N A Detail Lines COB 24k Reserved for Local N A Detail Lines Local Use Use 25 Federal Tax ID Configuration HCFA1500 Fed ID Number Offices Federal ID EIN Always 26 Patient s Account Invoice Number N A Invoice Number Number 2T Accept Assignment Default to NO Insurance Accept Assignment 28 Total Charge Sum of Charges Detail Lines HCFA Total 29 Amount Paid Default to 0 00 Detail Lines Amount Paid 30 Balance Due Default to 0 00 Detail Lines Balance Due 31 Signature of Administration N A N A Physician or Payer Supplier Provider Rep Date of Bill Invoice Date 32 Outside Facility N A Physician Outside Facility Diagnosis Fields 33a Billing Name Configuration HCFA1500 Office Fields 01 18 06 3 13 PM Page 430 of 448 Users Manual HCFA 1500 Locator Initial SAM Data Edit Claim Screen Data Mapping Location No Description Name Tab Title Field Address Offices Address Lock Box 33b PIN N A HCFA1500 PIN 33c GRP Administration Insurance Prov ID Payers Provider IDs 01 18 06 3 13 PM Page 431 of 448 Users Manua
421. s Skill Payer C Skill Class Payer Sort By Class Payer Program C Class Payer Skill C ICD9 Skill Class MSA C Employee C Emp Skill Class Payer C Skill Emp Skill MV Show Client Totals on Summary Medicare Cost Reporting Show Only PPS Sales Bill Unit ALL Work M Hours Unit V Supplies V Services V Pay Items V Transportation IM Include Non Billable Pay Items I Include Balance Forward Service Items Skills ALL Affiliation ALL fad By Client IV Visits C By Employee Y v E Cc i io APET Service Dates Payroll Dates C Just Items C Just Adjustments C Adjusted Items All Transactions C Items with Adjustments by Date Adjusted Include All Billed Items Unbilled Items To select skills click the Select Skills button and click the Generate button To select multiple contiguous skills click on the first payer and then while holding down the Shift key click on the last payer then click the OK button To select multiple non contiguous payers hold down the Ctrl key and click on each payer then click the OK button Adjustments Just Items Will report only the work items no adjustments Just Adjustments Will report only the adjustments no original work items Adjusted Items Will report the work items only after the adjustments are applied All Transactions Will report both the work items and the adjustments Adjustments reported are based
422. s Date field e Select the reason the patient is being discharged in the Reason combo box e Click the Save button on the toolbar to save the new status 01 18 06 3 13 PM Page 158 of 446 Users Manual SAM gt Melbourne GUEST stration Schedule Att Wontiquraton Mantenance Login Seniliclo Geports it dit Patient Agency Status 5i 5 Horst Sta 5 mol pie 11 12 2001 A 06 20 2005 Discharged Normal Discharge Goals Achieved z 06720720054 Normal Discharge Goals Achieved y e Click the Exit button on the toolbar to exit the Edit Patient Agency Status screen The Edit Patient screen will be redisplayed You will notice that the patient s Agency Current Status is now Discharged and the Agency Discharge Date is filled in Note A new Plan of Care or Verbal Order cannot be created for a patient with a status of Discharged Also you may not add any new statuses for the patient after a Discharged status A patient is readmitted using the Client function Use the Readmit button on the Edit Client screen See section Client 01 18 06 3 13 PM Page 159 of 446 Users Manual Plan of Care Management A patient s Plan of Care includes all the information necessary to produce a HCFA 485 form Home Health Certification and Plan of Care This information includes Certification Period Payer Physician Orders Goals Diagnoses Surgical Procedures Medications Supplies Safety
423. s Manual E SAM gt Melbourne GUEST lei E3 Ble Administration Schectie AED Eoniauaton Mentenance Login SeniioGo Reports Help E Edit Patient x Define Plan of Care erbal Order Define OASIS Assessment K 4 gt I l x Tel PATIENT VITALS Client 002080 02 CLINICAL INFORMATION Agency Start of Care 05 17 2001 3 Required for Patient Name JHelen El A Plan of Care OASIS gency Abbey Current Status Active Edit Agency i Address 787 Prospect Avenue Admit Date ISAT 207 eh Oasis Agency Discharge Date ie City West Springfield p HEE MA Zip Code 0108F Patient Type Home Health x Disaster Code 1 Low Risk x Phone 555 739 0474 Birth Date 06 24 1999 Sex Female Entry Date 05 16 2001 Source of z Admission I Do Not Resuscitate MISCELLANEOUS Comment CO VEND WITH GENTIVA 731 3050 Mom s work 786 8000 EXT 444 PAI 07092001 01 55 PM Enter the patient s Start of Care date 12 42 PM e Click the Edit button next to the Agency Current Status field in order to change the patient s status to Hold The Edit Patient Agency Status screen is displayed SAM gt Melbourne GUEST lel x Bie Ad Be E Edit Patient Agency Status _Define Hospital Stays D Bly Ae PATIE station schedtle AG Eoniauaton Mamtenance Loan Semiicte Hepots Help Agency Patient Helen Abbey Client
424. s a 0 zero bill rate SAM will automatically calculate the episode payment based on the OASIS Assessment e Enter the required frequency of supervisory visits in the Supervisory Visit Freq field This is entered as one visit every required number of days weeks or months e The Differentials fields define the custom bill rate differentials for this payer Typically the default values are used but for special payers you may want to pay your employees more or less based on the differential The Weekend differential is a dollar amount not a multiplier e The Invoice Terms field shows up on invoices for this payer Generally this reads simply Net Due Upon Receipt e The Bill Notes field is used to customize how a bill is created for this payer You only need to populate this field if directed by RiverSoft e You can direct SAM to place D9 in occurrence code 1 of a UB92 claim for those patients who are 65 years of age or older by putting the following in the Payer s bill notes field 65D9 e By default SAM populates the Remit To address on UB92 and HCFA 1500 claims to the SAM office s lock box address You can now direct SAM to populate these fields using the SAM offices office address by typing in the following in the payer s bill notes field REMITTOOFFICE Click the Requirements tab to go to the next page 01 18 06 3 13 PM Page 23 of 448 Requirements Page SAM gt
425. s applied Then enter the rates per shift including weekends e Click the Update button to add the new rate to the list e Continue to add rates until finished When finished click the Stop button to get out of add mode e Click the Save El button Deleting Pay Rates e Select the payer that is associated with the pay rates you are going to delete by clicking the Select button next to the Payer field then select a payer from the Payer List form Or click the Default button next to the Payer field to default to all payers e Note that either an Employee field or a Client field is displayed next to the Payer field depending on where you are in the system and the name in the field may be Default e Click the rate that you want to delete from the list 01 18 06 3 13 PM Page 52 of 448 FE SAM gt Melbourne QA Edit Employee dule AG Loriiauretion Meintenence Login samico Reports Hep 11 17 2001 10 00 10 00 10 00 _ 10 70 10 70 10 70 11 00 11 00 11 00 10 40 10 40 10 40 10 70 10 70 10 70 10 10 10 10 10 10 e Click the Remove button Note that every rate for the selected skill and effective date is removed regardless of shift e Click the Save button Printing Pay Rates e Click the Print List button to print a list of the pay rates Copying Pay Rates e Click the Copy button to copy rates to other offices employees etc e The Copy Pay Rates screen is displayed 01 18 06 3 13 PM
426. s for information on associating a referral source with an employee To access the Referral Sources screen select menu option Administration Referral Sources Edit Referral gt Back Office GUEST Bie Bile Administration Schedule AR DBonfigureticn Memtenance Logn Seamioco Reports Help E Edit Referral xo a Id 4 gt lol Company First Name Rebecca Smith Last Name Address 123 Wilson St Zip Code 32901 Melbourne FL 7 Brevard 32901 x Phone s 333 444 5555 M Extension Te GUE 06 22 2005 02 33 PM oft Enter the referral s Company 2 33PM The Edit Referral screen is displayed Click the New m button to add a referral source Enter the referral source s name in the Name field Enter the referral source s address in the Address fields Enter a Zip Code If the entire zip code is not known enter at least the first three digits After the zip code is entered a list of cities with the given zip code appears in the combo box below the zip code Select the correct city from the combo box under the Zip Code field Enter the Phone s for the referral source Enter the phone Extension is appropriate 01 18 06 3 13 PM Page 347 of 448 Users Manual e Click the Save El button e Click the Exit T button to exit the Edit Referral screen Defining Physicians Physicians are associated with the patients Plan of Care and Verbal Orders e To
427. s on the Payer screen are disabled 13 Add Delete National Payer if this option is off when adding a new payer in the Admin office it will default to a non national payer and the national payer check ae A 01 18 06 3 13 PM Page 329 of 448 Users Manual box is disabled Also if this option is off the user will not be permitted to delete a national payer in the Admin office 14 Verify Visits if this option is off the timeslip verified check box and verify week button on editing a visit is disabled It is recommended for those users that you wish to not see pay rates that you also turn off access to the Pay Rate Pay Item Sales and Adjustment reports 0 Clinical if this option is off access to clinical features will be disabled Clinical features include Import Signed POC VO Import OASIS Assessments Export OASIS Assessments Patients POC VO OASIS Assessments 485 Phrases and Physicians 1 View and Print Plan of Care Verbal Order if this option is off on the Define Patient screen the Define Plan of Care Verbal Order button will be disabled 2 View and Print OASIS if this option is off on the Define Patient screen the Define OASIS Assessment button will be disabled 3 Change OASIS Lock Date if this option is off the user will not be able to edit the Lock Date field on OASIS Assessments 4 Edit Phrases if this option is off
428. screen is displayed SAM gt Melbourne QA Edit Client Payer Hie Administration Schectie AE Eoniauaton Memntenence Loon Seniioio Hepots Hels Client Payer Profile Client Payer Requirements Client Payer Skills amp Codes Donald Barns Medicare N N CLIENT PAYER REQUIREMENTS PAYER REQUIREMENTS display only CI Claim Type No Gaim UB92 Claim B92 Claim Locator 6 Locator 6 Billing Period G Billing Period C Service Dates Service Dates HCFA 1500 Claim HCFA 1500 Gam Locator 24G Locator 24G 0 Decimals 0 Decimals 2 Decimals 2 Decimals IV Signed Plan of Care and billable visit M Signed Plan of Gare and billable visit I Summarize Supplies Summarize Supplies 2 28PM Requirements List Section This section lists the available billing requirements that may be assigned to an invoice The Requirements page is used to define the client payer s billing requirements e For Claim requirements select one of the following e UB92 required Used for payers that require UB92 claims e Selecting Billing Period will show billing period dates in locator 6 e Selecting Service Dates will show the span of service dates fir the work items on the claim locator 6 e HCFA 1500 required Used for payers that require HCFA 1500 claims 01 18 06 3 13 PM Page 44 of 448 e Selecting 0 Decimals will report 0 decimal places for the work item units e Selecting 2 Decimals will attempt to report 2 decimals
429. scssscesecssssccsccseessessssssseesessssoes 306 Pay Item Adjustment ccccccceccssseissesescocessscesnestecsssecsssdsenbeasssassssdsccasececsescsuaeacesesedesedsesssocesesasnbaaasostes 307 Wtem Rebills a A E E 308 INVOICE AGUSCMENES ss scccsciscdsssceccsctecsvesscsseccensadsedsssdscnsondssacssdonssdensdsesoncenseacssadedesesnodsssassesetcasacssses 309 Invoice Rebills ssscsssssscsscsssccsssssecsscsssecsssssseesssssscsssseescsnssescensssescesessssnsssescsnssssscesssescsoceses 312 Creating Contractual Allowance Invoice Adjustment In Batch sscccsssssssssseesssssseesssseeees 313 Accepting and Rejecting Adjustments scccccsssscccsssessssscccssscessssssscscssseesessscscssssseesssscsseees 315 Adding Missing items to InvOices cccsccccssccssrccscccccscceesssssccccscceesessssscscecesesssscccecsosssssssssoocese 317 Handling Payer Denials when Item Must Be Rebilled to Self Pay at Street Rate s000 317 Closing a Period and the General Ledger Inter face ssssssssscccssssssssssccccssscsscsssccecesssscesees 318 GL Sales Cash Adjustment and Worker s Compensation Reports scccccsssssscssoreessseees 318 CLOSING a Period vasssicsssisssssisisictsdsevnvenscedscedscesassasecssecsseadesscesessbecesscecdeseunnseesssdesessesasasoassesanssoassesesdses 320 Creating the SBT General Ledger Interface File sssccccssssscssssccssssccccsseesesssscccesseesssseees 321 OREMPLOVINCNE
430. sctesedacesscsccsssanssosesssensoasdnosssososesnsdsvessseuscacsseccdseedeceedessssecsnnasasssecssess 243 Combined Sales REPOrts cssscccccccocresoccsesessssccdesssedevesessscessscsvsesasssesedensocsseecssoeseveveseseseonsoaaasosesosenes 243 Balancing the Sales Item Report with the Combined Sales Report cssssssssccssscsseeeeees 243 Balancing Sales Item Report Royalty Report GL Sales Report Worker s Compensation REPOLU seccsccecieceseceseesececssecscsseceseseseunsesodseusdesdsctcescocsssesstatoseescondsesediacsedestsesesosscsssdececedescecdeececsteseseneies 243 Balancing Receivables Against Salles cssssscssssssscsssssscsssssescsssssescssssssscsssssscsssssesossssssscosssees 244 Royalty Report sscccssssscsssssscsssssecsscsssecsssssssesssssssssseescsnssesesnsssssensesescnssesconsssscssssssecoseses 244 PRU I EOE EE NAE E L TE ORAE E O E E ION ETS E E 245 Billing Diagram and Payroll Work Flow Diagram sscccssssssccssssecsscsssesssssssesesssssesosseeees 245 Invoices amp Claims Diagram eesesssseseeeessssssoccesssssocecesesssssoccsssssssoocessssssocessssssssoocssssssssoooeessssscoese 246 Invoice amp Item Adjustments Diagram ssssssssssssooocesssssocccssssssooccesesssssoceccsssssocesesssssosceessssssoooee 246 Invoice amp Item Adjustments Diagram sccssssssssoseccsssssocccssssssooocessssssssceesessssocesesssssooeeesssssssosee 247 Entering Payments amp Cash Applications Di
431. se to view visits for all orders associated with the client or you can select one specific order from the Orders combo box e Optionally you can enter in the range of service dates for the visit history you wish to see in the Date Range fields e You can choose to look at a visit of only a certain status by selecting it in the Status combo box e Click the Generate button to view the list of visits 01 18 06 3 13 PM Page 73 of 448 e The Visit History List screen will be displayed containing all the employee s visits that meet the selected criteria You can order the list by date client or employee by clicking on those corresponding sort options SAM gt Melbourne QA Edit Employee fall Visit History List Acevedo Flores CEIHVAR EE Closed e For each visit the employee client date skill and status of the visit are shown e Click the Print List button to send a copy of the Visit History List to the printer e To view more information about a particular visit double click the visit or select the visit and then click the View button 01 18 06 3 13 PM Page 74 of 448 e The Visit Summary screen is displayed containing details of the visit SAM gt Melbourne QA Edit Employee BIE Edmiston Scnedule Ata eoriiauratcn Memnterence Log Semlicto Geports Hep ee ee ee ee i iat Visit Summary Nancy Flores Acevedo e Click the X in the upper right corner of the screen to exit e Click th
432. selected to recertify the New Cert Begin date will default to the start of the next episode and the End date is automatically filled in with the date x x being the number of days in the original cert period days after the New Cert Begin Once the certification period is changed the New Payer combo box may be positioned to a new 01 18 06 3 13 PM Page 189 of 446 Users Manual payer if the original Payer for this patient is no longer valid for the new certification period entered e Make sure that all of the information displayed on the Recertify or Copy Plan of Care screen is correct e Click the Recert or Copy button to create the new Plan of Care or click the Cancel button to cancel the recert or copy e Click on the Yes or No button in the popup screen that asks Do you want to copy the Orders and Goals paragraphs Answering Yes to this question will copy the orders and goals information from the Plan of Care that you selected to the new Plan of Care Answering No to this question will not copy the orders and goals information e Click on the Yes or No button in the popup screen that asks Do you want to append verbal order information to the new recert POC Answering Yes to this question will ALL verbal order information except for comments to the new Plan of Care in addition to the previous Plan of Care s information It is then up to you the user to edit the resulting recert Plan of Care to reflect the correct informati
433. sers Manual Click the Application Group Billing Click the Accounts Receivable option Click the Invoice Aging Report Click the Proceed button Select all or one office all or one payer class all or one payer all or one client Select whether you want invoices with balances only to be the only invoices printed If more than the opened invoices are to be reported you must specify the oldest invoice you want on the report Select whether you want the invoices to be aged based on the date that the invoice was created Age Creation Date or the end of the billing period s week for the invoice Age Invoice Date Select the appropriate PRINT option collection logs are kept at the invoice level and account logs on maintained on client payer or client payer basis Input a date that you want to Show Logs From You may also optionally include adjustments the original amount amp service creation and last transmitted dates Select the appropriate SORT BY option Select the day you want to age by this default to today Enter the number of days in each aging bucket if the default values are not appropriate e The Invoice Aging report by payer will report a Best Possible Days Sales Outstanding value in addition to the Days Sales Outstanding DSO value Enter a date range used to calculate the period days This date range will default to the last 13 weeks ending with the last week ending date You may optionally change th
434. setting the Net Due on the Term portion of self pay invoices Ini_Self Pay Invoice Net_D ays 10 Ini_Ignore_New_Software_Alert Directs SAM to allow users to continue running in SAM after the New Software Exists alert has been displayed This should only be used when C drives are shared by multiple users Ini_Ignore New_Software_Al ert T Ini_poc_master Directs SAM to not allow the entry of a new Plan of Care or Verbal Order in SAM Assumes using Golden Rule PDA point of care software to send the Plan of Care Verbal Order to SAM via the SAMDLL Ini_poc_mst golden rule Ini CBA PHC Client Signature Directs the he CBA and PHC formats of the Timesheet Report to include a client signature line above the employee signature line Ini CBA_PHC Client _Signat ure T Ini_Show_Overtime_Warning Directs Scheduling to suppress any of the warnings regarding a employee going into an overtime situation Ini_Show_Overtime_Warning F Ini_POC_Xmit_Blocker F Directs SAM to not report message Plan of Care for patient on xx xx xx was not signed Claim cannot be transmitted until POC VOs are signed when transmitting claims for Connecticut Medicaid ECS 50 Ini_POC_Xmit_Blocker F Ini_Inherit_Oasis SOC Directs SAM to not populate OASIS M0032 Start of Care Date with the patient s start of care date In some cases when you have multiple payers for the patient you may not want th
435. sit History Criteria screen select menu option Administration Employee use the a button to find the employee click the Visits button e The Visit History Criteria screen is displayed SAM gt Melbourne QA Edit Employee Of x Bie Administraton Schectie AR Eoniauaton Memntenance Loon Seaniioto Hepots Hels Employee Profile l Employee Taxes Employee Skills Attributes Employee Preferences Bonuses Tracking Availability vpits Pay Rates gt dh Ba xo Be VITALS Fmn NNNI3R PAYROLL 7 BILLING Employee fal Visit History Criteria x Name Tat SSN 124 C All Employees Select Employes 1 addet Select Tanya Acevedo el Zip Code 32 ts C Select Client Melbourne FL Select from Overtime Orders Affiliation Sn Ph 1 E 0 00 per visit jones 2 3 Date Range 77 aO 4 0 00 pe vist Sex s Status ANY X Birth Date 117 Status Hired Joe Inactivated E Indicate whether visits should be searched for all clients or a specific one Generate Exit e By default visits for the current employee and all clients will be displayed e You can choose one specific client by clicking the Select Client option and clicking the Select button This will cause the Client List screen to be displayed Selecting a client from this list will cause the Visit History Criteria screen to be redisplayed with the selected client displayed e You can choo
436. sits for this employee Use this field to show information about the employee that effects how you schedule work for them For instance if an employee routinely misses morning appointments you could enter assign to visits later in the day or prefers live in assignments e Click the Taxes tab to go to the next page Taxes Page SAM gt Melbourne QA Edit Employee ile Bie Administration Schedule AR Dontauration Memtenance Logam Seniicio Reports Help Employee Profile Emplovee Tanes Employee Skills Attributes Employee Preferences Bonuses Tanya Acevedo EXEMPT FROM WITHHOLDING STATE F I State Tax Filing Status No Withholding Status Require z T FICA I City Tax of Exemptions _ 0 resident _0 non resident Exempt Amount 0 00 I Head Tax 2 no longer exempt Additional Amt 0 00 Additional ___0 00 Will not go to SBT will not go to SBT FEDERAL CITY Filing Status Maried z Additional Amt 0 00 Additional _ 0 00 will not go to SBT will not go to SBT EIC Status Married z Will not go to SBT i ll not go to SBT t of E ene ADDITIONAL TAX INFO will not go to Additional Amt 0 00 Will not go to SBT Additional L oox will not go to SBT MISCELLANEOUS Used to send payroll posting to external payroll system like ADP and Paychex Payroll Dept Payroll 1D S l Indicate whether the employee is exempt from federal tax wi
437. soeeee 285 Payment Adjustments Report Option on Payment Log SCreen sssccsssssscsssssecssssseessesseees 286 Logging Collection Comments at the Invoice Level ssccccsssscccsssccsssssccsssceessssssscscsseeees 287 Adda Colect Woe a ito icne dee tietect sy chbe cee i Sagstaathatecbld gh choles fecestebth Sosdeaiah lee tats dec E 288 Modify a Collection Log rerit i ann een ian eaaa e iei E a aa e 288 Deleted Collection E o EE E E EEE ETTA E E E EE 289 Logging Collection Comments at the Account Level sccccssssssccsssrssssscccssscceeessssscccssooeees 289 Apply Cash Via 83S vissssscssssccssssassssecoteerencsosssocesedercdssedevessesecadecssssenvocsavsesdssedunseadesesecensdocssscsesosessions 289 Payment Adjustments ica cdicaiesustisvsboris cilia tadbostividecdesnaueselasesepclapseles auscdebundsusandsebatabensctessosnaeees 293 Entering a Fix to a Payment Check AmMount sccccccsscsssssrccsssscscsssessecssssccsccsesssscccssseeseees 294 Entering a Refund of a Payment ccssssssccsssscssssecccssscccsscceesssssccccecescsssssccesseesssssssccccessoeees 295 Determining Which Refunds Have Had AP Checks Written scccsssscsssssscsssssescssseseessnees 296 Recouping a PayMent ccsscccssccssccccccccssceccsssscccsssceescsssssssceesssssscccccsssssessssscccsesssssscccssssoeeees 296 Tracking Receivables soi chccisecipissios ss Cotssces cuss Capaueseudsoeas bens yuusiuws aces tuasseasisu
438. ss The invoice aging report the account log screen and the statement report all work together to provide an agency with a clear picture both at the detail and summary level of what is owed and what has been paid to an agency Invoice Aging Report SELECTION Office ALL PRINT OPTIONS ATTRIBUTES Baeacida Vv Payment Information V Collection Logs V Account Logs MV Adjustments Orig Amt amp Service Creation and Last Xmit dates Client Z Show Logs From Client Status ALL ie SORT BY V Invoices with balances ONLY Q Office Class Payer Client C Office Client Payer Age Invoice Date Age Creation Date C Office Class Payer Summary AGING BUCKETS DAYS SALES ONLY SHOW CLIENT S 7 PAYER S WHO Age as of 0672272005 2 OUTSTANDING DSO A Have any balance Ped End Period Credit Sales Have balance older than period 1 i E includes invoices Have balance older than period 2 Period 2 End Gb between Have balance older than period 3 Period 3 End mA C Have balance older than period 4 Period 4 End 03 18 2005 Have balance older than period 5 Period 5 End Have balance older than period 6 0671772005 2 P Period 6 End AND BALANCE IS OVER 0 00 Generate Report Options Exit O All Classes Payers Programs Invoice Aging e To access the Invoice Aging Report screen select menu option Reports e The Select Report screen will be displayed 01 18 06 3 13 PM Page 296 of 448 U
439. staton Schedule A loriigureaticn Memnterence Login Seniicto Geports Hep fal View Model Week for Client Helen Abbey Mon Medicaid P D Dillon Yickie 09 00AM 05 00PM RN Pedi High Tech The View Model Week per Client screen allows visits from the model to be removed The model week for a client can be cleared from the Visit menu Once models have been created for each appropriate client the Copy Model Week function may be used to create future schedules The Copy Model Weeks screen will allow the models for all or a specific payer and scheduler to be viewed and copied into the future To access the Copy Model Weeks screen select menu option Schedule Copy Model Week Once the desired copy option has been selected click the Copy button will cause all models to be copied as directed To view the current client models click the Client Model Weeks button 01 18 06 3 13 PM Page 127 of 448 SE SAM gt Melbourne GUEST jo iaix Ble Achimnistaton Schedule AR Eonnauaton Meintenence Loci Semniioto Hepots Help ial Copy Model Weeks x COPY MODEL WEEKS FOR Payer ALL ba CSR ALL z Start Week 06716 2001 2 i of coke OPTIONS IV Preview Clients To Be Copied M Use Tracking Info W Check for Scheduling Conflicts Copy Travel Pay amp Bill I Copy Visits as Self Pay if Payer Expired iChent Model Missing 2 Copy i Model Weeks Exit Press to view clients model weeks 3 24PM This informatio
440. stion a screen listing the existing Plans of Care will be displayed Select the Plan of Care that you want to associate the OASIS Assessment with Users Manual SAM gt Melbourne GUEST lel Ee Ble Admin enance Loan Semiicto Reports Help Add OASIS Demo Pat Hist Liv Supp Sens Integumentary Ly 7i 4 7 Eal REE ADLSAADIs Medications Equip Therapy Emergent Gare Inpat Ramae liont r z 002512 A3 Patient flenniferWilke Status Active Correction 0 Summary Assessment e Status in Use v Lock Date ore Discharge from Agency tate Provided a M0020 Follow Up j Baeney into its of Care Start Resumption of Care Transfer to an Inpatient Facility M0040 S n oe ra I NA Not Applicable Wilse Ea Patient State of Residence MA Patient Zip Code Jo 01106 M0050 ee lng Number T NA No Medicare Gant Security Number 339 69 8143 I UK Unknown or Not Available z pe DA MODES za I NA No Medicaid z P X Ermar a 05 17 1942 MO05S E Male imary Referrin Physicia sician mine i 664652 Select T UK Unknown or Not Available Discipline of Person Completing Assessment 7 Assign PUG Jaco 548 pat ee Completed al Effective Date 7 vv Rear oo Select the Assessment Version 1 34 PM e Enter the Assessment type for the OASIS Assessment The status field will default to In Use for a new OASIS Assess
441. stments report click the Report Adjustment Entries option If you want a Worker s Compensation report click the Report Worker s Compensation option e Ifyou want only the totals for each Worker s Compensation code click the Summary Only option 01 18 06 3 13 PM Page 318 of 448 Users Manual e If you would like Excel spreadsheets created instead of reports click the Create Excel Files Instead Of Reports option e Click the Generate button This Sales Cost Report will balance to the Sales Item Report if run for the same payroll dates Only the Sales Cost Report is available for service dates All other reports must be run by period 01 18 06 3 13 PM Page 319 of 448 Users Manual Closing a Period Once you have run the GL Reports and Sales Item Report for the period and are satisfied that all the sales cost cash and invoice adjustments have been done for the period you should close the period e To access the Close Period screen select menu option AR Close Period e The Close Period screen will be displayed e Select the office s to be closed and then click the Close Period button Although visits service items supply items pay items are not changeable once closed during the normal weekly close operation other items could be changed payments cash applications etc That is why the period should be closed When a period is closed payment and cash application information is locked down T
442. sword the new user will use when logging in The Password may be up to 10 characters in length As the Password is entered it is echoed back as asterisks 01 18 06 3 13 PM Page 327 of 448 Users Manual Note SAM has an option for valid users to change their own password To access the Change Password screen select menu option Login Change Password e Grant the new user access to one or more offices in the organization by double clicking on the office name in the office list at the bottom of the screen An X will appear in the Selected column in the list A user may not log into an office without this association e Click the Select All check box to select all of the offices in the list e Click the Clear All check box to unselect all of the offices in the list e A user may be marked as Do Not Use Any users marked as such will no longer be able to log in e A user may be marked as a System Administrator A System Administrator will have access to ALL functions within this system The following are features that a System Administrator will have access to Offices Users Accounting Periods Worker s Comp Rate Run Maintenance Program Copy Client Environment Copy Employee Environment Check Login Count 9 Clear Function Locks 10 Command Window 11 Split Office e You may Copy Permits from Another User This screen will prompt you for what user you would like to copy from and then will make the current user s
443. system gives up on you and denies you access to the system If this happens take a deep calming breath and call the person in your organization responsible for the care and feeding of this system If that person cannot help you give the nice people at RiverSoft a call Press the Esc key to exit without having to log in 01 18 06 3 13 PM Page 13 of 448 At the back office it is important which office you log into when using SAM You will only be able to see the information for the office to which you are logged in If you want to change the logged in office use the Select Office and User function from the Login menu Definitions Back Office The site that performs the payroll the bulk of the billing and handles accounts payable and general ledger for the provider offices front offices The office representing this site is called the Headquarters or Admin office Front Office Site at which client charts and SAM is used to coordinate and document the care and service provided to clients Payer Payer of services provided The payer may be Medicare Medicaid an insurance company or a third party who is not the client Client The Client is the person receiving the service When a client pays for his or her own service we call the client a self pay client Patient This is a particular type of client for which a plan of care must be created and maintained When you add a client record you can choose to d
444. systems 01 18 06 3 13 PM Page 190 of 446 Users Manual Ancillary Care Management ACM EClickMD Alacare There are two screens that may be used to print or export the Edit Plan of Care Verbal Order screen and the Plan of Care Verbal Order Report screen The Edit Plan of Care Verbal Order screen allows you to create an XML file with only one Plans of Care Verbal Order in it the one currently displayed on the screen The Plan of Care Verbal Order report allows multiple Plans of Care Verbal Orders to be sent to one XML file When printing a Plan of Care or Verbal Order you must decide if you want to print the Final Document otherwise you will be printing a draft copy of the document and it will be printed with the word DRAFT across each page A Final Document will be printed clean without the word DRAFT so it may be mailed to the physician You will be given a warning that the Final Document has been printed any time you try to modify or delete an existing Plan of Care or Verbal Order Once a Final Document has been printed the Final Document Printed field on the Edit Plan of Care Verbal Order screen will contain the value YES and all other screens associated with the Plan of Care Verbal Order will contain the text Final Document Printed In order to print a Final Document the Plan of Care or Verbal Order must have an assigned Primary Physician Printing Previewing from the Edit Plan of Care Verbal Order scr
445. t button to print an overtime report e Click on the Cancel button to exit from this screen Schedule Manager gt Melbourne G File Schedule Administration Payroll System Help mal Information x The following visits pay items contain overtime hours They are displayed as overtime double time 01 18 06 3 13 PM Page 140 of 448 Closing the Week after Verification at the Front Office In order to assure that critical processes are working with static data the system will not allow this process if anyone is doing any of the following in the database Close Week Calculate Overtime Create Invoices Create Automatic Contractuals Transmit Claims Make Adjustments Items Invoices Rebills Reviewing and accepting etc Payroll Export and Updating Visit Rates After all verification is finished and all work items are ready for payroll the next step is to close the week This locks down the work items so that they cannot be edited and prepares them for payroll and invoicing The week may be closed many times so that one segment of the business within an office can be verified closed patrolled and billed before another segment of the business The week is closed first at the front office Once the Data Exchange has occurred either automatically or on demand the office must be closed at the back office before payroll or billing can occur This gives the back office the opportunity to re verify the week s information before p
446. t creates one line of the report for each client payer relationship and shows plan of care information on each line if the plan is in effect during the entered Cert Period Date Every active Plan of Care for the Cert Period Date selected will be reported including Self Pay If there is not an active Plan of Care for the Cert Period Date selected No Active POC will be noted The information on the report includes supervisory visit details patient s county agency and payer start of care dates payer and certification begin amp end date case manager physician and disaster code Optionally you may include diagnosis Dr Orders patient address and phone number allowed skills and discharge dates You may also filter the report to show clients with one or more of the following conditions continuous care home health continuous care home health both Medicare Medicaid DNR s or patients with active Plans of Care only You may sort the report by 1 Case Manager Client Orders the report by the case manager whom has to be specified by checking the case manager box in under the employee demographics and the same employee case manager has to be associated with an active Plan of Care of the patient The report lists the clients alphabetically per case manager 2 Case Manager Next Supervisory Visit Orders the report the same as above but lists the next supervisory visit per case manager 3 Certification end date This option
447. t name in the Employee Name fields e Enter the employee s Social Security Number in the SSN field e Enter the employee s address in the Address fields The first address line is for street address or PO Box numbers The second line is for apartment or suite numbers etc If a street address is long and will not fit in line one its okay to overlap it on line two avoid splitting a word in half when you use two lines for the address if you can because it is printed with a space where the split occurs e Enter a Zip Code If you do not know the entire zip code you must enter at least the first three digits After you enter the zip code a list of cities with the given zip code appears in the combo box below the zip code e Select the correct city from the combo box under the Zip Code field Use up or down arrows on the keyboard to find the city or click the down arrow on the combo box to display the list of cities and then click the city e Ifneeded select a location from the Affiliation combo box The affiliation attribute is used as an aid to employee client matching and selecting on some reports Clients and employees may be assigned to affiliations It is beneficial to assign employees to clients that are within the same affiliation to reduce travel time and cost Affiliations are defined per office and are usually geographically based 01 18 06 3 13 PM Page 60 of 448 Enter the employee s telephone number s in the Phone s fi
448. t of payers Select a payer by double clicking on the payer in the list OR by clicking on the payer and then clicking on the Select button The Edit Payment screen will be redisplayed with the Payer and Payer Office fields filled in with your selection Enter the date of the payment in the Payment Date field the default is today s date Enter the check or remittance advice number in the Check RA No field Enter the amount of the check or remittance advice in the Check Amount field Enter the Deposit No of the check if applicable e The Adjusted Check Amount Unallocated Amount and Payment Balance fields will be filled in for you with the Check Amount value entered Click the Save i button The Payment ID Payment Office and Status fields will be filled in for the payment Click the Apply Cash button to display the Apply Cash to Invoice screen Click the Add button on the Apply Cash to Invoice screen Apply Cash to Invoice gt Melbourne GUEST lel Ee Bie Administration genede AR Eoniauaton Memntenance Logam Seniiolo Hepots Help E Apply Cash to Invoice Adjusted Payer ATM Mutual Insurance Check Amount 3 2 000 00 Check RA No 1022 Unallocated Amount 2 000 00 Check Amount 2 000 00 2 000 00 Invoice Invoice Net Due Cash Date Amount Amount Applied Date C x KER Payment ID jao 273 Payment Office Melbou Payment Balance Invoice No Client Name zl Invoice No Invoic
449. t reneo e ae a EE Ea PEE EO ANTEE EEA EEES TA OAR E EE EE oiis 421 Physician List Report 2 lt iccasecces case casveszteceideu a E R E EE E E E E EEEE a a TEs 422 Strategic Planning Report ieee anr EE a EE A ETEA ENE EEAS EEEE SEEEN E EES SEE 423 DLL TROD OVS viviscuzscevasceveoth eselessudatuiso ies tavansaneadgetencuesebs ten iesise aee O S aa oa soian si 425 DLE Eto REPOL ooet a a A A Ra aE R waves AA T 425 01 18 06 3 13 PM Page 11 of 448 This report will include any error message generated by attempt to import into this systems database 425 DEL TransactlonRegister 3 5 24 sits vex calet eyeperads Pesastast oGteath E O 426 UBIZ Locator MAP pine ssccusecaessiascscavavassvacocesecnssuvdesrsssseuses susessssasssevindsshsadcoususaabadasno S E Eois 432 Massachusetts Medicaid Form 9 icscsscsicssciscovssctaiuidectetsdiniestidtcatsaasseandendpeasteceadenaoudesteigudesiess 438 Summary Of System SPCCIICULIONIS 6 ssccivsesdsassasesicssuvupsodesivitavepiedeunhedsuunuevadasdedcdetentaoceverdctesusds 442 Creating Labels Using Reports Microsoft Excel and Wor d cccscccsssssssscccssssssssecesssssscssoees 442 SAMLINI Variables sscssssssssssssscsssscccsssssescsssssescsssssessssssssssssssecessssseccsssssscsssssscsssssscossssseees 447 01 18 06 3 13 PM Page 12 of 448 Getting Started Overview This manual shows how to use this system in your day to day operations The table of contents will point you to specific sections
450. t screen will be displayed of all of the collection logs for the current invoice Click on the collection log you wish to delete and click the Select button e Once the collection log you wish to delete is displayed click the Delete x button and answer Yes to the prompt Are you sure you want to delete this log Logging Collection Comments at the Account Level See the Account Log screen Apply Cash via 835 This option will read from electronic R amp S reports and EOB s from the Texas Department of Human Service to automatically create the payment cash application records in this system e To access the 835 Automatic Cash Application screen select menu option AR Apply Cash via 835 e The Open screen will be displayed Look in Claims Transmission 013278TB 835 04134KZN 835 09731JX3 935 1183NKVE a o20zz04y 835 a 04836EAT 835 097 311 835 a 1183NKVF a 02731F64 835 2 04836EB8 835 1043K1L0 835 03433366 835 055381ZK 835 1043K1M7 835 a 03433361835 a 055381Z2 835 9 111 3LVC1 835 a 04134Kz8 835 a 0903GKVR 835 4 111 3LVCY 835 gt Choosea 835 Files of type e835 O Cancel Help Code Page e This screen will default to look for the 835 files in the N Claims Transmission folder If the files exist in a different folder use the Look In drop down to select the correct folder Then click on the filename of the 835 that you
451. t this point you may click the Define Doctor Orders button to define Doctor Orders for the Plan of Care if you wish to do compliance checking on the patient s visits After the Doctor Orders have been defined the CSR responsible for scheduling the visits for the patient may proceed with creating the visits Then the rest of the contents of the Plan of Care Medications Orders Goals etc may be completed at a more leisurely pace To enter a new Plan of Care e To access the Edit Plan of Care Verbal Order screen select menu option Administration Clinical Information e The Edit Patient screen will be displayed e Select the correct patient that you would like to enter a new Plan of Care for e Confirm that the patient has been admitted into the agency by noting that the Agency Start of Care field and the Agency Admit Date field contain values in the Clinical Information section of the screen Refer to section Admitting a Patient into the Agency in this manual e Click on the Define Plan of Care Verbal Order button 01 18 06 3 13 PM Page 160 of 446 Users Manual e The Edit Plan of Care Verbal Order screen will be displayed with the Patient Name field filled in with the name of the patient selected e Notice that the patient s Agency Start of Care and Agency Current Status are displayed on this screen for reference SAM gt Melbourne GUEST en AGiinstacn Sc A Boriguratcn Mamntenance Loon samoto Gepots help pixle e r
452. ted against the OASIS 1 40 specifications e This information is used to create the header record for each of your OASIS Assessments that you submit to the state If the information does not match EXACTLY with the state records your OASIS Assessment will be rejected e Once you have entered all of the information click on the Office Profile screen to save your information the click the Save button Office Logo The Office logo may be entered for each office on the Office Logo page on the Offices screen The logo should be entered for each office Any bmp file may be used Optimally the bmp file should have an aspect ration of 2h x 3w The bmp file should be placed in your n logos folder and then added to the office This logo will be used for invoices and statements 01 18 06 3 13 PM Page 325 of 448 Users Manual Edit Office gt Melbourne GUEST Bie Aamnistetch Senede Ais Bontiqutaton Mantenance Logi Senlicho Reports He E Edit Office 01 18 06 3 13 PM Page 326 of 448 Users Manual Maintaining Users In order for someone to use this system they must be able to log in and in order to log in they must be registered as a user in SAM This user registration process is accomplished by defining users using the Edit User screen Only users with the access level of System Administrator are able to create and maintain users This is accomplished using the Edit User screen If you access the Edit User scre
453. tem will build a list of employees whose primary skill matches the skill of the visit Each employee in the list is available or may be available during the time of the visit is not in an overtime situation is not scheduled elsewhere and matches the Type Status Affiliation and Sex on the Miscellaneous panel of the Employee Match screen 01 18 06 3 13 PM Page 108 of 448 Upon clicking the Search button the Employee Candidate List screen will be displayed E SAM gt Melbourne GUEST Scheduler BIE Adminstration Screcuie At Lontiguraticn Memnterance Loon Sambo reports Help EL Wi Employee Candidate List Blanchard KathynA RN A 4070 00 26 00 You may double click on any employee or choose the View Visits button to see the visits that the employee is already confirmed on You may quickly assign an employee to the visit by pressing the Assign button The purpose of this screen is to help you call employees in sequence and offer the visit to them To do this highlight the employee you want to call and click the Phone Log button The Add Visit Phone Log Entry screen will be displayed 01 18 06 3 13 PM Page 109 of 448 SAM gt Melbourne GUEST Scheduler FANE Inistiation schedule Ar ontiquretcn Meamntenance Loon Semniicto Gepots Help dd Visit Phone Log Entry x e Call the employee the employee phone number s are displayed in the upper right panel e Based on the outcome of the phone call
454. ter the Locator 40 s 01 18 06 3 13 PM Page 440 of 448 Users Manual Form 9 Locator Initial SAM Data Location Edit Claim Screen Data Mapping Description Name Tab Title Field adjustment box is marked with an X If the left most character is an R the Locator 40 s resubmission box is marked with an X 41 Former Transaction Control No Local Use 2 Locator 41 takes the 3 12 characters from Local Use 2 to complete the ICN boxes N A N A 42 For Office Use Only N A N A N A 01 18 06 3 13 PM Page 441 of 448 Users Manual Summary of System Specifications Invoice Aging Report There is a limitation for multi selecting payers of 30 if you select a specific office a specific client and a specific client status If you would like to report all Payers use the default selection of ALL If you would like to select a large group of payers use the Payer Class option Creating Labels Using Reports Microsoft Excel and Word 1 In order to create labels choose the report that contains the information you need on your label For instance if you want physician labels use the physician report If you want patient labels use the client list report If you want employee labels use the employee list report 2 Select the criteria for the report so all the labels you want will be represented on the report
455. ter any description about the visit to appear on the invoice If all documents are present and in order click the Timeslip Verified check box Note that checking this box changes the status of the visit to Verified If the employee has already been paid for this visit or the employee has a salary check the Already Paid check box This prevents the payroll entry for this visit from being exported to the payroll system Enter any travel money to be paid to the employee Enter any travel money to be billed to the payer Enter any sales tax Click the Save next fe button which is located to the left of the Timeslip verified check box field This button will save the visit and jump to the next visit speeding up the verification process Click the Find al button to locate the next confirmed visit you would like to verify Repeat the steps above for each visit until they are all verified Click the Exit button to return to the schedule 01 18 06 3 13 PM Page 103 of 448 e You may distribute the hours of a visit to holiday hours and see where the system is deriving the pay and bill rates by clicking the Split Hours button SAM gt Melbourne GUEST Scheduler Of x Bie Administration Schedule AR Lontauretion Mamtenance Logn Seniicio Reports Help Fim Spit Visit Rates 10721720020 Times 09 00AM 05 00PM Total Hours 8 00 Pay Unit Hour Bill Unit Hour Pay Rate Based On Hours Rates Defa
456. ter general information about a payer e On the Edit Payer screen click the New button on the toolbar to add a new payer Vitals Section e Enter the name of the payer in the Payer Name field e Ifyou no longer want to see the payer in payer pull downs or list select Do Not Use This will remove the payer from all lists effectively hiding it from you in the future This is handy if you have incorrectly entered a payer but have closed visits belonging to it Marking a payer as Do Not Use will also mark the following records as related to this payer as Do Not Use All Payer Skills and Code All Client Payer relationships All Client Payer Skills and Codes 01 18 06 3 13 PM Page 20 of 448 All Schedule Orders e When this system was first installed in your office an office was designated as the Administrative office When you add a new payer in the Administrative office by default it will be saved as a National Payer If it has been saved as a National Payer the payer will be added to all offices including the pay and bill rates Skills amp Codes are copied to the front office only if the skill pay unit bill unit combination does not already exist in the front office s Subsequently if you modify any data on the National Payer in the Administrative office only the data that matched before the modification are modified in the other offices The exception to this is Pay and Bill Rates and Skills
457. the patient was discharged from e Once the Plan of Care is displayed make sure the Payer field contains the correct payer name e Click the Copy button to copy the old Plan of Care to the new Plan of Care e Enter the New Cert Begin date e Enter the New Cert End date e Select the payer the patient is to be readmitted to in the New Payer combo box If the Start End Dates on the Edit Client Payer screen were entered correctly for both the old and new versions of the payer only the newer version of the payer should be showing up in the New Payer list e Click the Copy button to save the new Plan of Care The Edit Plan of Care Verbal Order screen will be redisplayed positioned to the new Plan of Care Verify that the Cert Begin Cert End and Payer are correct The Payer Start of Care Payer Discharge Date and Payer Status are set to their default values To change the Payer Start of Care which will fill in Locator 2 Start of Care on the HCFA 485 to be different than the default value of the Agency Start of Care e Click the Edit Payer Status button near the bottom of the screen The Edit Payer Status screen will be displayed filled in with information about the payer selected To modify the displayed Payer Start of Care date for the displayed payer e Enter the desired date in the Payer Start of Care field e Click the Save fl button to save the new status and date The Edit Plan of Care Verbal Order screen will be redisplayed with t
458. the ICD 9 CM field by entering the value or by clicking the Select button e The Select ICD9 Code Surgical Procedure screen is displayed E SAM gt Melbourne GUEST Ble Administration Schedule AR Eonnauiaton Mantenance Loch Seniioto Hepots Help El BA Select ICD9 Code Surgical Procedure ICD9 CODE LIST CRITERIA Code From To Renae C Description Containing e 2lo lovew we Ge mimon a Prt e Either choose the Code option and enter a code range or choose the Description option and enter a verbal description of the surgical procedure and click the Generate button e Click a procedure in the list and then click the Select button e The Description field will be filled in once a valid ICD 9 CM field value is entered e Enter the date of the surgical procedure in the Date field e For Verbal Orders select the Verbal Order Status of either New or Discontinued e Make sure that all the information is correct for the new surgical procedure e Click the Save JE button on the toolbar to save the new surgical procedure 01 18 06 3 13 PM Page 179 of 446 Users Manual The new surgical procedure will be displayed in the list on the screen At this point you may enter other new surgical procedures by repeating the steps above Click the Exit Ae button on the toolbar to exit the Edit Surgical Procedures screen The Edit Plan of Care Verbal Order screen will be redisplayed Modifying a Surgical Procedu
459. the Office Client Payer sort option a client based aging may be produced This report will show all invoices for a given client sorted by each payer associated with the client This is especially useful as a reference tool when talking with the client about their account 01 18 06 3 13 PM Page 364 of 448 Users Manual Invoice Register This report lists invoices by Invoice Number Client or Payer If you select to Include Skill Totals Report a report will be generated after the Invoice Register report that will give you a summary by skill If you choose this option the Invoice Register report will sort the invoice details by skill lei ks SAM gt Melbourne QA Eile Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Invoice Register X DATE RANGE DISPLAY OPTIONS M Include Addresses C Service Dates From 03 23 2005 S F Include Header Info C Creation Dates r Include Payer List Fs LE 0972972005 S FF lincchuiis intioe Walaa 7 Include Times Invoice No z All 7 Include Employes Names Client Payer Invoice Hon I Include Skill Totals Report Draft I Include Only Invoices Missing Claims s r Client Invoice Eye C Transmitted C Not Transmitted SELECT CLIENT PAYER Client ALL 7 Payer aLL z I Show only DSO Ignore Invoices LL ct ct tt S 0aM 01 18 06 3 13 PM Page 365 of 448 Users Manual Medicare Episode Report This report is especially useful f
460. the dates on the current insurance authorization to end as the new rule begins For a complete discussion of compliance rules and compliance checking see the Compliance Checking presentation located in the n users manuals folder of your server The compliance rule will be checked each time a change is made to the client s schedule Ifa visit of the same client payer skill sub skill combination breaks any part of the rule the visit will be given a status of out of compliance displayed as black due to insurance authorizations If Out of compliant visits are verified and closed they are still paid and billed For more on compliance checking see the section on compliance checking in this manual 01 18 06 3 13 PM Page 49 of 448 Defining Pay Rates and Bill Rates A hierarchy of pay and bill rates for visits are support When determining a pay rate for a visit the system walks the hierarchy of pay rates beginning with Client Employee rates per skill sub skill shift down to default rates per skill sub skill shift When determining a bill rate for a visit the system walks the hierarchy of bill rates beginning with Client Payer rates per skill sub skill shift down to default rates per skill sub skill shift 2j How SAM Computes Pay and Bill Rates X At each level a rate for the skill sub skill is searched for If not found rates for just the skill are searched for If not found the any rate is used If there is no any rate t
461. the past e Click on the Plan of Care you would like to modify and click the Select button e Once the Plan of Care is displayed make sure the Payer field contains the correct payer name e Click the Edit Payer Status button near the bottom of the screen 01 18 06 3 13 PM Page 204 of 446 Users Manual The Edit Payer Status screen will be displayed filled in with information about the payer selected SAM gt Melbourne GUEST lel Es Ble Administration schedule AED Gonfiguratcn Meintenance Login Senioto Reports Hep E Edit Plan of Care Verbal Order Orders Goals ee compiance nues al Recert Copy ier A BEET 1 My Diagnoses Sun oyar ee Hix PLAN OF CARE Patient Helen Abbey Client 002080 02 Patient Name r Agency Agency Start of Care 05 17 2001 Discharge Date toe Agency Start of Care ji Type g Payer JOT Tufts Associated HMO Cert Begin i Payer Payer Start End Date 05 17 2001 11 07 2002 o Tufts Asso Payer ais passe Status SEEN id Michael K Posner Payer a IRA Start of Care 05 17 2001 E on Plan of Care Payer Discharge Date Verba Start of Care es Save Cancel Payer Start of Care mmen Racaived qe Signed 7 m P l 0N042002 12 04 PM Select the Status for the Payer 10 17 AM e The Payer field contains the payer set Set same as the Set on the Edit Client Payer screen fol
462. the same but the last two characters after the dash will increment These last two digits are the client s Admit which is also displayed on the Client List screen The Admit will begin with an A if the patient is readmitted in the back office Also note that the Status combo box now contains Active if the Client Type is Client or Incomplete if the Client Type is Patient e Change any information on the Edit Client screen as necessary and then click the Save button e The client has now been readmitted This new client record should be selected from this time on when dealing with this client 01 18 06 3 13 PM Page 37 of 448 Viewing Client Visit History A client Visit History List may be generated using the Visit History Criteria screen This list is very useful to view all or a subset of visits scheduled for a client To access the Client screen select menu option Administration Clients e The Edit Client screen is displayed e Click the Visits button e The Visit History Criteria screen is displayed SAM gt Melbourne GUEST Edit Client lel x Bie Administration Schedule AR Eoniguaton Memntenance Logn Seniicio Reports Help Client Profile Client Skills amp Codes Self Pay Client Attributes Client Ancillary Info Client Race Beadmit Payers IL viges_ Pay Rates Bill Rates Auth gt gt 1 aln Elx S ITALS Client 000701 01 SELF PAY BILLING INFO
463. the skill on the visit RN LPN etc for the appropriate codes If you have selected the Billing Frequency to be Calendar on the Payer Profile click the Calendar tab to go to the next page Changing Revenue Code HCPC Codes or Modifiers for a Payer e Ifthe payer is a national payer make the modifications to the Revenue Code s HCPC Code s or Modifier s on the payer in each office Do not remove the skill and re add it this will cause the skill to be marked as Do Not Use for all of the client payer relationships which in turn can delete all compliance rules for that skill e If you modify Revenue Code s HCPC Code s or Modifier s on a payer SAM will automatically update any client payer relationships for that payer with the updated codes However only those codes on the client payer relationship that match the payer s codes before the update are changed 01 18 06 3 13 PM Page 27 of 448 Calendar Page The Calendar page is used to define billing periods for payers that are not billed on a weekly bi weekly or monthly basis The Calendar page is enabled only if the Bill Calendar option on the Billing Clinical Requirements Section on the Payer Profile Page is selected SAM gt Melbourne GUEST Edit Payer lel Ee Bie Administration Schedule AR Eoniguaton Meintenance Login Seniicito Reports Hep Payer Profile Payer Requirements Payer Skills amp Codes Payer Calendar Blue Cross Blue Shield of
464. thholding 2 57 PM The Taxes page is used to record the information required to pay the employee This information is available on the Employee Tax Withholding Report If you are using the ACCPAC SBT payroll accounting package basic employee and tax withholding information such as name address SSN federal and state filing statuses and 01 18 06 3 13 PM Page 63 of 448 number of exemptions will automatically be exported into the SBT payroll system Other withholding information must be entered directly into the SBT payroll system The Employee Tax Withholding Report should be run on a weekly basis so that changes may be entered into the payroll system Exempt from Withholding Section e Ifthe employee is exempt from tax withholding you can record this information in this system so that it can be entered into the payroll system Choose the type of tax from which the employee has been exempted When you choose a type of tax the information panel for that tax will become disabled e If your agency is in an area subject to head taxes the no longer exempt date field will not be enabled If your area has a head tax use this field to record when an employee is no longer exempt Federal Section e Select the employee s Filing Status e Select the employee s EIC Status Earned Income Credit e Enter the number of federal exemptions the employee is claiming into the of Exemptions field e Ifan additional amount is to be
465. tically process the requested reindexes Each night at midnight 3 am or 5 am this screen will perform database maintenance including reindexing the database and save a zipped version of the database If the database maintenance does not occur users logging in will be notified by the message The indexing program did not run last night Also Data Exchange imports will be blocked until the database maintenance process has successfully occurred This database maintenance process can be manually run by clicking the Reindex Now button When you request reindex now SAM sends the request to the new RiverSoft Process Monitor service which is automatically running at all times on your server 01 18 06 3 13 PM Page 354 of 448 Users Manual If you request reindex now then exit the reindex log screen SAM will automatically close SAM and restart SAM Therefore we recommend you leave the reindex log screen open until the reindex has completed so you can see when it is finished You may redirect where the SAMDB ZIP file a backup of your database is created by entering a new record in your N SAM INI file for INI SAMDB_PATH For example INI SAMDB_PATH c backup View Reindex Log This function allows you to see what Reindex has been doing In it you will see when the database was indexed and when a backup copy of your database was made This log keeps the last seven days of entries 01 18 06 3 13 PM Page 355 of
466. time No Yes Yes Yes Note The bonus is added to the total amount before average is calculated Bonus doesn t affect No Yes No Yes overtime Holiday Yes No Yes Yes In House Training Yes No Yes Yes In Office Temp Yes No Yes Yes On Call No Yes No Yes Other No Tax No Yes No No Other Tax No Yes No Yes Reimbursement No Yes No No Show Up No Yes No Yes Sick Yes No Yes Yes Uniform Allowance No Yes No No Vacation Yes No Yes Yes 01 18 06 3 13 PM Page 137 of 448 Show Compliance Selecting this menu option will toggle the Show Compliance on off If Show Compliance is on all visits that are out of compliance will be display as black and compliance checking will be processed when adding modifying or deleting visits If Show Compliance is off out of compliance visits will not be displayed as blank and compliance checking will not be processed when adding modifying or deleting visits Turning off this option will speed up the process of scheduling your visits Show Employee OT Selecting this menu option will toggle the Show Employee OT on off If Show Employee OT is on visits that occur in a week where the employee is in an overtime situation have a displayed If Show Employee OT is off visits that occur in a week where the employee is in an overtime situation will not have a displayed If you would like to suppress any of the warnings
467. ting etc Payroll Export and Updating Visit Rates e To Make Invoice Adjustments select menu option AR Make Adjustments Invoices e The Invoice Details screen will be displayed e On the Invoice Details screen click the Find al button e The Invoice List screen will be displayed Invoice List gt Melbourne GUEST lel Ee Bie Administration schedule AED Lonfiguraticn Meintenance ogm Senco Reports Help ey Invoice List SELECTION CRITERIA INVOICE STATES ORDER BY From 09 01 2002 Invoice Date G AM Invoice Ooo 7 Service Date C Ready C Client Office Suspended C Draft Final ioe Not Transmitted Invoice Invoice Service Adjust Date Dates Status 09 06 02 08 31 09 06 PJ 71 00 443 90 2581 80 67 00 1996 88 9 00 334 00 6 00 85 00 Select the desired item 10 00 AM e Enter the date range payer and client for the invoice you want to adjust and click the Generate button e Select the invoice you want to adjust 01 18 06 3 13 PM Page 309 of 448 Users Manual Invoice Details gt Melbourne GUEST Bie Aciimistaton schedule A Eonigauaton Memntereance Loon Seniioto Hepots Hep Invoice Details x Adjust Invoice Collection Log Rebill Invoice alal gt 1 aa T Invoice J0002A03577 View Cash Applied Invoice Date 0970672002 Version Jor T DSO Ignore Service Period Jos731 2002 to 0970672002 Client
468. ting right to a line will take you to the last client in the list you generated when you entered the scheduling screen The other right pointer button will take you to the next client in the list you generated when you entered the scheduling screen e To go directly to a particular client s schedule follow the instructions in the section in this manual Viewing a Client s Schedule 01 18 06 3 13 PM Page 84 of 448 Viewing an Employee s Schedule To access the Employee s Schedule screen select menu option Schedule Display Schedule e Click the Employee button F Schedule Manager gt Melbourne GUEST Scheduler E Client Berei Case Put schedule in client view and specify client 01 18 06 3 13 PM Page 85 of 448 e The Employee List screen will be displayed E SAM gt Melbourne QA Scheduler RIE Baministaton Screcvie At eoriiguraticn Memnterance Log Semlicto Geports Hep Es ra Employee List Select a Skill of the employee you want to see Select a Type of the employee you want to see Select a Status of the employee you want to see Select the Affiliation of the employees you want to see If you wish to shorten the list you can type in the first few characters of a last name in the Name Beginning With field e Also to shorten the list you can click on the option Has visits scheduled during selected week e Click the Generate button 01 18 06 3 13 PM Page 86 of 448
469. tion Memtenance loan Senlicto Reports Help Client Profile Client Skills amp Codes Self Pay Client Attributes ir Client Ancillary Info Client Race Readmit Payers Visits Pay Rates Bin Rates aun M gt gt alol mlx Be VITALS Client 000305 01 SELF PAY BILLING INFO Client Type Gent PERM Enty Date 03 25 1993 Mame aay Cae Same Client Name Address 591 Memorial Drive Fei eee Address 591 Memorial Drive Office Zip Code 01020 Zip Code o TF Chicopee MA 7 01020 z Chicopee MA 7 Hampden 01020 7 Payer Class Private Pay 7 Affiliation stating Pam None 7 Status Active _Edit Status in Phones 1 555 593 8805 2 cease A 3 Billing Supervisory 3 DE UE Frequaacy Visit Freq Differentials Birth Date Sex Male Female Weekly Lo Holiday SSN C TaxTenitoy __ Biweekly C Days 07 CSR BILL x Monthly Weeks Dbl Comment x s Months 0 00 0 Weekend per hour Tax ha Espi D M M Show Times Referral Bill Notes WFS 08082002 08 08 AM Select the client type 2 45 PM The Edit Client screen contains tabs for pages of related information The pages on the Edit Client screen are Client Profile Client Skills amp Codes Self Pay Client Attributes Client Ancillary Info and Client Race The Client Profile page is the first page displayed upon entry to the Edit Client screen Client Profile The Client Profile page is used to ente
470. tion about the selected visits should be changed The Step 2 screen allows the user to select what should be updated 01 18 06 3 13 PM Page 117 of 448 SAM gt Melbourne GUEST Scheduler Bie Acministaton Schedule AD eonnauaton Memntenance Login Semniioto Reports Help BN Update Visit Wizard Step 2 Select Information to Update What Information Would You Like to Update I Employee Select Vickie Dilon C Staus RSS CDer Speci Day Cevo ET I Comment of Days esc Pay Rates Specific Amount BEEMAN hr Default P Bill Rates Specific Amount RGR unit Default Advance to the next page The Step 3 screen allows the user to define whether or not shift availability and scheduling conflicts should be checked for By default this checking is done SAM gt Melbourne GUEST Scheduler lel Es Bie Achinistaton schedule AR Gonfiatratcn Mamntenance Loon SamloGo Hepots Help BX Update Visit Wizard Step 3 Specify Update Options What Checking Should be Done M Use Shift Availability use both shift amp day availability to determine whether employee is assigned IV Check for Scheduling Conflicts change status of visit to Not Assigned if the employee is scheduled elsewhere 01 18 06 3 13 PM Page 118 of 448 The finish screen summarizes the information that will be changed On this screen it can be specified that a preview of update visits be g
471. tion that should be reported for Medicare 01 18 06 3 13 PM Page 244 of 448 Users Manual Billing Billing may be done in parallel with payroll The only requirement is that the week is closed The first step in billing is creating the invoices Billing Diagram and Payroll Work Flow Diagram Visits Required Client Payer Skill Date Unassigned Time Required Client Payer Skill Date Confirmed Time and Employee Required Client Payer Skill Date Verified Time Employee Pay Rate Bill Rate Pay Unit Bill Unit Pay Type and Employee Time slip Service Items Pay Items and Optional Travel Pay Bill and visit related Non visit related Supplies Supplies Closed Required Client Payer Skill Date Time Employee Pay Rate Bill Rate Pay Unit Bill Unit Pay Type Employee Time slip and Week ending date must be completed Payroll Billing Payroll Report Sales Report 01 18 06 3 13 PM Page 245 of 448 Users Manual Invoices amp Claims Diagram Calculate Overtime Optional Close week Calculate Overtime Automatic y Create Invoices And Claims View Invoices Print Transmit 7 amp Claims View an Invoice or View all versions of Claim Invoices Print an In
472. tional Allergies page is currently displayed e Click on the tab of any page to display the page e Enter information on each page as desired 01 18 06 3 13 PM Page 184 of 446 Users Manual e This is the Functional Limitations Activities page SAM gt Melbourne GUEST lei Ez Bie Administration Schedule AR Lontauretion Memntenance Loam Senlicio Reports Help Safety Measures Nutritional Allergies ional Limitati ctiviti l Mental Status Prognosis Patient Helen Abbey Client 002080 02 Cert Period 0370972002 11 07 2002 POC A0001486 Payer Tufts Associated HMO Functional Limitations 5 Paralysis ST Legally Blind 21 Bowel Bladder Incontinence 6 V Endurance AT Dyspnea With 31 Contracture 7M Ambulation Minimal Exertion 4 Hearing Sl Speech BIV Other specify decreased muscle tone Activities Permitted 1 Complete Bedrest 6 Partial Weight Bearing AV Wheelchair 21 Bedrest BRP 7 Independent AtHome Bl Walker 31 Up As Tolerated 8 Crutches CI No Restrictions 41 Transfer Bed Chair ST Cane DWV Other specify 5 Exercises Prescribed adaptive equipment e This is the Mental Status Prognosis Page SAM gt Melbourne GUEST le ce Ble Administration Schedule AED Lonfiguration Wemntenance logn Senco Reports Hep Safety Measures Nutritional Allergies Functional Limitations Activities Me St fi osi Patient Helen Abbey Client 002080 02 Cert Pe
473. to be over e PPS billing will default to code 270 for Medicare Supplies If those supplies are wound care the claim must be edited and the code for the wound care supplies changed to 623 01 18 06 3 13 PM Page 275 of 448 Users Manual Payments and Cash Application Payments are entries made to represent checks or remittance advices received from payers Cash application is the term used to describe when cash from a payment is applied to an invoice The Payment List screen and Edit Payment screen are displayed below Payment List gt Melbourne GUEST Bie Acministaton schedule AE Gonfiattatcn Mamntenance Loon Semiicho Hepots Help a Payment List PAYMENT DATE PAYMENT OFFICE 7 PAYER Start 01701720022 Office Melbourne 0002 z Ger ate Select Self Pay Select Self Pay End 7 E Payer Ee Reset List p T Only Non Zero SORT BY Payer Payment Date Check RA No Unallocated Amounts A I M Mutual Insurance Melbou 02 14 02 1126221 Select the desired payment e You may select a payment to work with from this screen or click on the Apply Cash button to apply cash from the payment to the invoice e The column labeled C will have display a if the payment occurs in a Closed Period Entering Multiple Payments e Make sure you are logged into the office to which the payments are to be credited on the bank reconciliation When payments are reported by office the offi
474. to pay your employees more or less The Tax Exempt ID field is only enabled when adding a client with a Client Type of Facility If you want the individual start and end times of visits to appear on invoices click the Show Times check box The Bill Notes field is used to customize how a bill is created for this client You only need to populate this field if directed by RiverSoft Click the Skills amp Codes tab to go to the next page 01 18 06 3 13 PM Page 32 of 448 Client Skills and Codes The Skills and Codes page is used for Self Pay private pay facilities etc to define 1 Valid skills sub skills that the self pay client will pay for services A valid skill must be added on the Skills and Codes Page in order to add Pay Bill rates for the skill on the client 2 For each of those skills a The Pay and Bill Unit Hours or Visits b The Revenue Codes and HCPC Codes to be printed on a UB92 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc c The HCPC Codes and Modifiers to be printed on a HCFA 1500 billing claim if applicable These can be different by shift 1 2 and 3 or by day Mon Tues etc SAM gt Melbourne GUEST Edit Client J SamlioGo B Hie Edm m g ul H Wonfigureaton Mamtenan lig ports He Client Profile Client Skills amp Codes Self Qa Client Attributes Client Ancillary Info Client Race Marjorie Atwood Units
475. to use for the file e After generating the list of claims click the Transmit button e A Save As screen appears which shows you the name of the transmission file and its default directory that is to be created The default directory is N Claims Transmission Click the Save button to create the transmission file This is the file you will actually transmit to the electronic claims bulletin board therefore it is important to note its name Up to two files may actually be created The first file is the actual claim transmission file that has a filename extension of ECS The second file is a log file that summarizes the transmission and has a filename extension of LOG e After the claim file is created HyperTerm may be invoked to allow you to connect to the electronic claims bulletin board See section on Sending an ECS File via HyperTerm If it is not invoked you will be responsible to submit the file to the BBS If there are missing or invalid items on any claim you will be given a message and the claim will not be included in the transmission file Sending an ECS File via HyperTerm A HyperTerm session is started from either the Print Transmit screen refer to Transmitting Claims to Payers section or possibly an icon available to you at your site The following steps describe an example HyperTerm session to North Carolina Medicaid Bulletin Board 01 18 06 3 13 PM Page 268 of 448 Users Manual 1
476. tus to exported 01 18 06 3 13 PM Page 227 of 448 Users Manual Click on the Continue button the Save As screen will be displayed DASISExpott G INACT_04_24_01 TXT E INACT_04_24_01_LOG TXT OASISV104 TXT E OASISV104_LOG TXT E OASISV110 TXT E OASISV110_LOG TXT we QASISV120 TXT a E OASISV120_LOG TXT Pr My Computer The system will default to saving your OASIS export file to the NAOASISExport directory The filename will default to the current date with a txt file extension You may overwrite this filename Click the Save button to save the OASIS export The OASIS export log file will be displayed 01 18 06 3 13 PM Page 228 of 448 Users Manual z SAM gt Melbourne GUEST lel Es Bie Admmistatcn schedule AH Gontiguratcn Memtenance Loan Seniicto Heports Help fal OASIS Export Log File N OASISEXPORT 06_21_05_LOG TXT Office Melbourne Production Submission OASIS Export Log 06 21 05 02 15 PM HN OASISEXPORT 06 21 05 LOG TXT Patient Assessment Reason Effective Completed A0000429 Berta Neung 4 Recertification follow up as 08 21 02 08 21 02 WARNING Lock Date 10 01 02 must HOT be greater than M0090 Date Assessment Completed 08 21 02 by more than 7 days 20000493 Hall April 1 Start of Are further visits 09 28 02 09728702 A0000492 Salois Barbara 4 Recertification follow up as 09 28 02 09728702 r of Assessments Exported 3 _ N
477. ty cies sss scstsssSacscusscccscsseseaseeesdsvecsaveasssedssscecsanssacesocevsgassees tecddeseanassosessdecsnssescesssscussssaceesscubtaasessoers 14 Staff EMpPlOVeC csssssesstectescsssissssssssvecssscasscesscesesssscssssesossussessedevedecedecesesecusoseessd ESSEE e Essos ostas sosoo 14 TDR DaN ol CLE A EEEE ETIT 14 Contract EMpPlOyee lt isccsccaccsscciiesscvsc ssccsesvvevanssocessovsesesssesssedsaccssecsssesenasassoosesodensecaccesccescnsacesesdcoesede 14 How List and Data Screens Work cccsicitssssssovsccotatesbiobapniaverusepiesessteeseatsckiosevs scusstensvoescatoeetadpeesivn 15 AKA a i occecesiveaceeescendecdtecsteccssstacecdecusocoscsabessoasescsoacesssdsaccsscesdenacseestedecoandadesseecascesseedeacenaeiedeasadesetesceses 15 BuUtt NS sse sssssssrssssssrsosorosesosssosoasesrooensorvedstss soost sisene oo er Eos snose s SES S S S nS eee 15 Date Biel s tcciccsicscacesccssccenccsossskcooacescessaccaccoccsnascossonesessaiscassacsscevseanecsoacocdcosseesdeadectsdseaceascoedesscsrecesense 15 EXpPlanatiOMinnsiceiesescsisissssssiccsscccccecesacasscedssteccveanacsecdsesccccsscsedsssavsoesasssesesesnniesosdcososwaasasesesessuswseedseesss 16 Defining Payer Sannn eases sacuangndastpusdusnuiasa wees E o niuenspiek eset vain sabe tantiuausnavesigeaoeruenien 20 PHOT Page sescscssasiiesssicisdstntusaccbescecesennnscdsssdevcveasavsostececaccssccsessonsboaeaedscgssesnecssscececsendaansesedessusnseausorses 20 MiadtalS SCCtl Oi exec 25 sccsas A seareahcat A rae iors ent
478. u PPS billing information You will either see a display warning messages for why PPS information cannot be displayed or PPS billing information will be displayed that will include e PPS Payment for the Episode HHRG Code HIPPS Code Version Key Wage Index Case Mix Weight HIPPS Code Note On a Medicare OASIS when you press the Summary button the pertinent information will be displayed from the Grouper DLL from HCFA Included in this information is the HIPPS code If this code s last value is a value other than 1 there is an error in the OASIS When you press the OK button on the screen that displays the HIPPS code another screen will be displayed titled HIPPS Check Error This screen will document what M00 fields that are in error and should be corrected Some of the warning messages for why PPS information cannot be displayed includes e M0100 must be equal 1 Medicare traditional fee for service e M0825 must be equal to Yes or No 01 18 06 3 13 PM Page 220 of 448 Users Manual e The effective date for the assessment must be equal to or later than 9 1 2000 to be considered a version 1 10 OASIS After you have changed the status for the assessment to completed and there are no longer any errors being reported change the status to Locked by selecting Locked from the Status drop down Warning messages will be displayed if any required information has not been entered The Lock Date will default to the cu
479. u have made click the Cancel button 01 18 06 3 13 PM Page 69 of 448 e The Profile page of the Edit Employee screen will be redisplayed e Click the Save button to save the employee tracking information Note Ifthe tracking item has been check as Always Required for this Office the tracking item cannot be deleted and will always report on the Employee Tracking report Specifying Employee Availability Employee availability is defined using the Employee Availability Calendar screen e To access the Employee Availability Calendar screen select menu option Administration Employees use the Find id button to find your employee click the Availability button e The Employee Availability Calendar screen is displayed SAM gt Melbourne QA Employee Availability Calendar F n Schedule AR Eoniguaton Mamtenance Il Day Availability I T A Employee Tanya Acevedo 800 538 8792 Sat 06711705 Sun 06712705 Mon 06713 05 Tue 06714705 Wed 06715705 Thu 06716705 Fri 06 17 05 Sat 06 18 05 Sun 06719705 Mon 06720 05 Tue 06 21 05 Wed 06 22 05 Thu 06 23 05 Fri 06724705 Sat 06 25 05 Sun 06 26 05 Mon 06 27 05 Tue 06 28 05 Wed 06729 05 Thu 06 30 05 Fri 07 01 05 Sat 07 02 05 Sun 07 03 05 Mon 07 04 05 Tue 07 05 05 Wed 07 06 05 Thu 07 07 05 Fri 07708705 Shift Availability E Always C Maybe HE Never Day Availability BB Always E Maybe HB Never Specify the employee s shift availability 3 1
480. u may preview the Verbal Order contents by clicking the Preview Ql button above the toolbar New Verbal Order Notes A new Verbal Order can only be created for patients that have a Plan of Care The Verbal Order is associated with the Plan of Care by having the same Cert Begin and Cert End dates Payer and Physician as the Plan of Care A new Verbal Order cannot be created for a patient with an Agency Current Status of Discharged Defining Verbal Order Contents Once the essential parts of a new Verbal Order are entered refer to Entering a New Verbal Order you must then decide what part of the original Plan of Care this new Verbal Order is documenting a change to This will determine what button on the Edit Plan of Care Verbal Order screen you will use to fill out the rest of the Verbal Order For example if the physician changed the Medications click the Medications button on the Edit Plan of Care Verbal Order screen and enter the medication information associated with the change If the physician ordered a change to the patient s scheduled care i e more SN visits are now required than previously ordered and you wish to do compliance checking on the patient s visits then you will click the Compliance Rules button to enter the new Doctor Order It is only necessary to define Doctor Orders if the physician has ordered a change to the patient s care that changes the services to be rendered Refer to the section
481. ual Perform the following steps to print payer invoices e To access the Print Transmit screen select menu option AR Print Transmit The Print Transmit screen will be displayed In the FORMS section select the Invoices option Make sure that the Self Pay check box is NOT checked In the STATE section Select the All option to list all invoices regardless of the progress within the billing cycle Select the Ready option to list invoices that have satisfied their invoice requirements Select the Suspended option to list invoices that have NOT satisfied their invoice requirements for instance a claim has not been created Select the Draft option to list invoices that are in a draft state Select the Final option to list invoices that have been printed in the final state or have been transmitted Select the Not Transmitted option to list invoices associated with claims that have not been transmitted e Inthe INVOICE DATES section enter the week ending date range of the service covered by the invoices you want to print You can leave the To date empty to retrieve all invoices later than the From date e To retrieve only invoices for a particular payer s click the Select button next to the Payer field This will cause the Select Payer screen to be displayed On this screen you can either type in some or all of the payer s name and click the Generate button or you can leave the name blank and click the
482. ule weeks per client and then copy these models all at once using the copy model week function This allows agencies that perform the same services week after week for certain types of clients to have the system automatically create the future schedules First the model week for a client is set z SAM gt Melbourne GUEST Scheduler Bile Administration schedule AR Lonfiguretion Mantenance Loon SenlicGo Reports Hep Client Employee Rules Prefs Phone Sum Legend Month z ml HE gt Hale Tel FES Client Helen Abbey IA 555 739 0474 29 50 29 50 8 00 0 00 Hrs Sat Sun Mon Tue Wed Ihu 10 12 10 13 10714 10 5 10 16 10 17 10 18 a E 3 Edit Visit 10719 10 20 Delete Visit Move Visit View Order Specify Employee 10 27 10727 Employee Match 10 31 Visit Phone Log Copy Single Visit Copy Visit Wizard Update Visit Wizard 11 02 5 mployee View 11 07 View Model Week Clear Model Week Status Confirmed Skil RN Pedi High Tech Status Confirmed Skil RN Pedi High Tech Payer M dP D Reg Rates 22 50H 37 50H 09 00a 05 00p 2 45 PM Do this by right clicking on a visit from the client view within the week to be made the model and selecting the Set Model Week option To view the current model week right click on a visit within the week and select the View Model Week option 01 18 06 3 13 PM Page 126 of 448 SAM gt Melbourne GUEST Scheduler BIE Aomini
483. uled visits during the week displayed on the schedule e Click the employee listed on the timesheet and then click the Select button Or simply double click the employee All visits assigned to the selected employee are now displayed on the Scheduler screen To verify the visits right click on the first visit of the week A popup menu appears e Click the Edit Visit menu option to display the Edit Visit screen SAM gt Melbourne GUEST Scheduler p xi Bie Administaton schedule AED sontiauratcn Memntenance Login Seniicio Hepots Hep a Edit Visit x Split Hours Employee Emp Match Supplies Verity Week n 4 gt Al x Tel Client Helen Abbey Payer No 7148 Employee Vickie Dillon Payer Set 43 Skill RN Pedi High Tech Sub Skill Visit 01188 40088 E Medicaid P D RN Pedi High Tech x a V Specific Times Date 10 21 2002 2 4 Monday 8 0000 total hours me visor Visit Break Start Break End End I Assessment Included Times 00 aig ety E Seats confirmed Te Regular x a Compliance 3 gt Per Hour zj 20 50 Gvernide Bill Per Hour zli 37 50 Gyenide H Invoice Qual Unqualified 7 Desc MB 0292002 03 15 PM Verification l Timeslip Verified Travel Pay 0 00 Total Sales Tax 0 00 J Already Paid Travel Bill Payroll Date 77 Enter the start time of the visit 3 06 AM e Confirm that the correct clie
484. uling screen control drag the visit to the desired location This method is not available in list mode 2 If you want to copy one visit to another time frame right click on the visit The Visit Menu will appear e Select the Copy Single Visit option e The Copy Visit screen will appear 01 18 06 3 13 PM Page 112 of 448 SAM gt Melbourne GUEST Scheduler lel Ee Bie Administration Schedule AR onfiguratcn Memntenance Login semota Reports Hep Client Employee Rules l Prefs Phone Sum Legend Month z ml T 4 b aleja Tel EJ Client Helen Abbey A 555 739 0474 29 5071 0070 0070 00 Hrs 2002 e e R Ld gt 10 19 10 20 10 21 10 22 107233 10 24 10 25 10 31 New Visit Start Date 0 27 2002 41z07 e New Visit 11 07 Start Time 11 14 penal 11703 T710 TA T72 TA3 TAs Enter new date for visit 10 26 AM e Enter the New Visit Start Date and New Visit Start Time You may input in 12 hour or 24 hour military format e Click the X button in the upper right of the Copy Visit screen e The Scheduler screen will appear with the copied visit displayed If you copied the visit to another week you will have to navigate to that week to see it 3 Copy Visit Wizard to copy multiple visits at one time 01 18 06 3 13 PM Page 113 of 448 Copy Visit Wizard SAM gt Melbourne GUEST Scheduler BIE Aanmnistaton scnedule At Lontiauretion Me
485. ults Payer Medicaid P D Regular Employee Pay 7 Bill MEME 20 50 tr 20 50 Client Holiday or 37 50 37 50 Skill RN Pedi High Tech 2nd Rate Holiday Shift Mon l based on predominant Pay 7 Bill 0 0000 30 75 Ahr 30 75 shift of visit EEE 37 50 Merit Client p Pay 0 00 Bonus 0 00 HEHE 1 50 x holiday j Overtime Moo M 38 50 Bill Rate Based On Pay 7 Bill 0 0000 i Payer Medicaid P D Natl ete 3750 anai Employee Pay Bill 0 0000 0 00 Client I 75 00 75 00 Skill RN Pedi High Tech ther 000 Shit Mont based on predominant Pa gt j shift of visit Entered Total Cost Total Bill 1 00 x holiday Hours 8 0000 164 00 300 00 1 Rate Help Move OT Keep Cancel Enter the number of regular hours in this visit e Ifthe week consists of many visits done by the same employee with the same skill the whole week of visits may be verified together using the Verify Week button on the Verify Week screen SAM gt Melbourne GUEST Scheduler Sle x Administration schedule AE onfiguretion Mamntenance loan Semiono Reports Hep SI c Copy Travel Verify All Verify Unverify GE Tel E S Visits for Client Helen Abbey Employee Vickie Dillon Travel Travel P Date amp Times Day Visit Unit Pay Bill Verified Is 10 21 2002 09 00 AM 05 00 PM Mon A01188 A0088 H D 1072272002 09 00 AM 02 00 PM Tue A01188 A0099 H 10 2
486. umber of Errors 0 umber of Warnings 1 K Exit the screen 2 16 PM The log file will report each OASIS assessment you have selected to export and any Errors or Warnings in each of the assessments If an error is reported you should edit the OASIS assessment to correct the errors and then export the assessments again This log file is also created on the NAOASISExport directory Once your have created your XX XX XX txt OASIS export file this file may be submitted to your state s OASIS website Remember the LOG file is name xx_xx_xx_log txt do not submit this file submit the Xx_Xx_xx txt file How to Submit an Inactivation Record Once it has been determined that an inactivation record must be submitted for an assessment a key field such as the Social Security Number needs to be changed you may create an inactivation export While on the Export OASIS Assessments Screen 1 Generate a list of assessments narrow the search by utilizing the Attribute fields 2 Select those assessments that require an inactivation record 3 Press the Export Inactivation Button to create an inactivation file The inactivation file is found in the N OASISExport directory just like the normal OASIS export files The inactivation file is prefixed with INACT_ to distinguish it from the normal export files followed by the date that the file is created 01 18 06 3 13 PM Page 229 of 448 Ts 8 Users Manual The system
487. unts 23 03 days Total LUPA Adjustments 7 116 24 Total PEP 0 00 3 aoo Total SCIC within PEP ow 3 oo Total SCIC only 5s gn 5 43337 Total Outlier 1266 E 472175 Total M0825 0 00 3 oo Total Other B os B 4998 12 Total Episodes 4 007 57 14 924 76 Total Recens For Melboume for episodes ending between 01 01 2002 02 012002 Gross Margin 18 50 Sup ply Cost Visit Cost 2 Final Amt Roport generated on OV17 06 at 14 02 OV1Ti06 14 02 01 18 06 3 13 PM Page 367 of 448 Users Manual Payment Log Cash Application Report This report shows details about payments received and is used to perform bank reconciliation The Cash Application Report is also available from this screen and shows the amount of cash that has been applied to invoices from payments To select payers click the Select Payer button and click the Generate button To select multiple payers click on the first payer and then while holding down the Shift key click on the last payer then click the OK button To select multiple non contiguous payers hold down the Ctrl key and click on each payer then click the OK button File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help g Payment Log x REPORT DATES SORT BY Week Ending Date C Date C Payer Name C Payer Class C Check RA No Invoice No C Deposit No SELECT OFFICE PAYER 7 Select Self Pay le Select Payer PRINT OPTIO
488. ut the conversation e The Call Date and Time will be saved and displayed Any Modification date will also be saved and displayed e Click the Save fl button e Click the Exit Tl button 01 18 06 3 13 PM Page 92 of 448 Schedule Summary Display Screen e Based on the week or month of schedules being viewed via the Display Schedule function the Sum button will show a summary of hour and visit counts across clients grouped by visit status SAM gt Melbourne GUEST Scheduler Of x login Semiono Hepots Hep Month efaj Be Hle Schedule AG eonnauaton Memterance Client Employee Bules Prefs Phone Adrimistration Visit Hour Total Units Units Cost Sales Visits I All Offices For Printout Use Visit Report Exit the screen 8 36 AM 01 18 06 3 13 PM Page 93 of 448 Viewing the Rules Governing the Current Schedule e By clicking the Rules button you can see the insurance authorizations and doctor s order that are in effect at the time of the current schedule These are the rules used by the compliance checking to mark visits as compliant or not SAM gt Melbourne GUEST Scheduler OE Xx Bie Adminstration schedule AE Eoniaueton Memtenance logn Seniicko Reports Help fal Compliance Rules Helen Abbey All Doctor Orders 1 2 A Week 1 Weeks 1 3 As Needed 9 Weeks 1 3V As Needed S3 Weeks 1 A Day 7 Days 3 7 A Week 1 Weeks 1 5V
489. ver Blvd 6100 Minton Road Health First Walk In Clinic 105 South Banana River Blvd Cocoa Beach FL 32931 Cocoa Beach FL 32931 Stanley Golovac Mark Hanley Space Coast Pain Institute 593 N Courtenay Pkwy 2 Merritt Island FL 32953 Melbourne FL 32935 Melbourne FL 32940 Oscar Jerkins Dennis King Bruce Hill Melbourne FL 32901 Melbourne FL 32901 Rockledge FL 32955 Alex Komar Da 7 Page 1 Sec 1 w atio 7 na cold REC TRK EXT ove Gm 01 18 06 3 13 PM Page 446 of 448 SAM INI Variables Users Manual In order to make SAM more flexible and powerful for our diverse user community we have developed a way to set a variable to a specific value that will then affect the way SAM processes By using this method SAM can be customized Below is a list of the variables that can be added to the N sam ini file the valid settings and how each will affect SAM N sam ini variable How it affects SAM Example Ini_Path_Model Directs SAM to compare the workstation s software with the software in this path to determine if the user should run Update Software from Server to update the workstation s software to newer software in this path In addition Update Software from Server will run the updwkst bat from this path This could be used in a case where you have setup multiple database areas with
490. vert all Draft copies of claims to Final copies of claims Claims are created in the draft state and are printed with the word DRAFT on them Final copies do not print with the word DRAFT Final copies may be mailed to the payers If you convert a claim from Draft to Final the invoice is also converted to Final e Print Claim on Red form You may print the claims on the standard Red form This requires placing the Red form in your printer and then selecting the claim to print and then selecting this option e If you have selected a HCFA two additional options will be displayed 1 Place ICD9 codes in locator 24e If you select this option then the ICD9 codes will be printed in locator 24e 2 Print Claim on 2003 Red Form If your HCFA 1500 Red Form claim has a Revision at the bottom of the page for 10 2003 please use this option If you do not choose any of these options claims will print according to their current state e Click on the Continue button e The claim will be printed You may print a UB92 claim to a printer using a non postscript printer driver This version of the UB92 claim will print units showing 2 decimal places To enable this feature add the following line to your n sam ini file INI PCL_UB92_ RED yes 01 18 06 3 13 PM Page 266 of 448 Users Manual Creating Claims Manually for Multiple Invoices The Print Transmit screen may be used to create cla
491. vice items 01 18 06 3 13 PM Page 250 of 448 Users Manual Medicare PPS Invoice amp Item Adjustments Diagram Make Adjustments Note Adjustment Report or Sales Report Item Adj nvoice Adjustment pene The Whole Thing l Visit Collection Note You cannot do 2 Pay Item Log C ontractuals Shift Payments 3 Service Item RAP EOE etc Optional and Write Offs for rps Invoices 4 Supply Item You must do an item adjustment on the RAP and EOE invoices Adjust Invoice Re bill Invoice Re bill Whole Invoice Detail Line Detail Line Note A new version Note A new version will be created of the old invoice will be created of the Note All invoice old invoice detail line adjustments except re bills must be Change Pay Rate reviewed and accepted before they will take Change Bill Rate effect If item is re billed you Change Hours must create invoices for the new payer Change Travel Pay Change Employee 01 18 06 3 13 PM Page 251 of 448 Users Manual Entering Medicare PPS Payments amp Cash Applications Diagram Enter Apply Payments Account Log Note Payment Report Invoice Aging Report Manual account log entries and Statements PPS Billing Information Invoice Register General Ledger Cash Report Add Payment View or Find Payment Find
492. visit or 2 they may be associated with clients Adding Supply Items Associated with Visits If your company wants to associate supply items to visits perform the following steps to get to the Edit Supply Item screen e Click the Edit Visit menu option to go to the Edit Visit screen From here you can click the Supplies button to get to the Edit Supply Item screen 01 18 06 3 13 PM Page 129 of 448 SAM gt Melbourne GUEST Scheduler iof x oministaton Sceyedule AR ontiguratcn Memntenance Loon Seniieto Report z lle ER MASTER SUPPLIES Select SUPPLY ITEM Sk Suply aa E Revenue Code x Dz HCPCS i Modifier ji 95 Ti Unit Cost Te Unit Bill Pa Quantity ooo Bil Total Sales Tax au Date ALL v Invoice Description Standard C Local All Supply Database Select the type of the supplies to view 3 28 PM e Note that the title of the screen includes Visit Related and that the visit ID is displayed on the top of the screen Adding Supply Items Associated with Clients If your company wants to associate supply items to clients perform the following steps to get to the Edit Supply Item screen e From the Scheduler screen click the Client button to get to the Client List screen e Click the client to whom you want to associate a supply item and then click the Supply Items button to go to the Edit Supply Item screen
493. voice or View Multiple Invoices or Claim Claims Create a Claim Print Multiple Invoices or Claims Delete a Claim Create Multiple Claims Edit a Claim Transmit Multiple Claims Convert a HCFA Create Automatic 1500 to a UB92 Contractual Allowances 01 18 06 3 13 PM Page 246 of 448 Users Manual Invoice amp Item Adjustments Diagram Make Adjustments Note Adjustment Report or Sales Report i Invoice Adjustment The Whole Thing the entire invoice Item Adjustment l Visit Collection 2 Pay Item Log 3 Service Item Optional 4 Supply Item Adjust Invoice Detail Line Note All invoice detail line Re bill Invoice Detail Line Note A new version will be created of the old invoice adjustments except re bills must be reviewed and Change Pay Rate accepted before they will take Change Bill Rate effect If item is re billed you must create invoices for the new payer Change Travel Pay Change Hours Change Employee 01 18 06 3 13 PM Adjust Whole Re bill Whole Invoice Invoice Note A new version will be created of the old Note All invoice invoice adjustments except re bills must be reviewed and accepted before they will take effect If an Manual Contractual invoice is re Allowances billed you must eae create invoices Shift Payment fo
494. was completed per HCFA Version 1 40 OASIS specifications To access the Export OASIS Assessments screen select menu option File Export OASIS Assessments The Export OASIS Assessments screen will be displayed SAM gt Melbourne GUEST lei File Administration Schedule AB Configuration Maintenance Login SamloGo Reports Help F Export OASIS Assessments ASSESSMENT LIST ATTRIBUTES MV Only Medicare Medicaid SORT ORDER Assessments G E Name Beginning With J Include Assessments 2 Patient Previously Exported Assessment Reason Lock Date Range 77 p7 4 aus s ied Assessment ALL z Reset List C Doc Admit Assessment Reason Effective Locked Exported Doc Select All Select None Export Normal Export Inachyation exit Enter the beginning letter s of the name for the patients to appear in the list 207 PM To see a list of OASIS Assessments to be exported click the Generate button OASIS Assessments with a status of Locked will be displayed To reduce or sort this list to specific Assessments you may use any of the following options Enter the beginning letter s of the name for the patient s in the Name Beginning With field Enter dates in the Lock Date Range fields Select the type of Assessment Select whether or not to include Only Medicare Medicaid Assessments Select whether or not to include Assessments Previously Exported 01 18 06 3 13 PM Page 225 of 448
495. what visits are out of compliance and why It is a good idea to use this report on an audit bases to see how the front offices are using the compliance checking features This report is available in the Scheduling application group under the Work Sales function group Note Any compliance rule that is older than 1 year based on the end date of the rule will be purged nightly when the system reindexes by default If you wish to modify this default time frame add the following line to your n sam ini file where is the number of months back to keep compliance rules Ini Comp Rules Purge Month 01 18 06 3 13 PM Page 358 of 448 Users Manual Employee Tracking Report This report will help you determine when employee s professional requirements are expiring It is a good idea to run this weekly at the front office and notify employees when they must complete course work or renew a license It is also a good idea to run this at the back office to audit how well employee s professional requirements are being tracked This report is available in the Scheduling application group under the Employee function group Visit Report This report may be run to check for any late time slips You may condition the report to those visits that have been confirmed but never verified This report is available in the Scheduling application group under the Work Sales function group 01 18 06 3 13 PM Page 359 of 448 Users Manual Billing Applic
496. when e The patient has received care by the agency which was paid for by one payer and now care is to be paid for by a new payer In this case the Agency Start of Care will be earlier than the new Payer Start of Care so the Payer Start of Care should be modified e The patient is to be discharged from a payer and not the agency e The patient is to be readmitted to a payer after being discharged from the payer and a new Start of Care date is required Modifying the Payer Start of Care for a Payer The Payer Start of Care date may be modified to be different from the Agency Start of Care date the default date The date that is displayed in the Payer Start of Care field on the Edit Plan of Care Verbal Order screen is the date used to fill in Locator 2 Start of Care Date on HCFA 485s and the Start of Care on Claims associated with Plans of Care for this payer 01 18 06 3 13 PM Page 202 of 446 Users Manual Whenever the HCFA 485 and Claim Start of Care for a payer are different than the Agency Start of Care the user should modify the Payer Start of Care for the payer e To access the Edit Plan of Care Verbal Order screen to modify the payer status dates select menu option Administration Clinical Information The Edit Patient screen will be displayed Select the correct patient that you would like to modify the payer start of care date for Click on the Define Plan of Care Verbal Order button Use the Find button to select a P
497. will change the status on the OASIS Assessment s to Inactivated You can use the OASIS Tracking Report to generate a list of any OASIS Assessments with a status of Inactivated Submit the inactivation file to the state system in the same manner as you would the OASIS export file Once the inactivation record has been accepted by the state use your OASIS Final Validation Report you may make changes to the assessments that require key field changes Do this by changing the status on the OASIS Assessment to In Use and click the Save i button Then make the changes necessary to the key fields make sure that the Correction field is 0 change the status to Locked and click the Save i button Then using the Export OASIS Assessments option select the assessment that is to be resubmitted and create a normal export file Submit the normal export file to the state system in the usual way Note The Correction Field should be set to 0 for a newly submitted OASIS this includes an OASIS that has been Inactivated due to changes in key fields If an assessment has been submitted and accepted by the state and the home health agency staff determines that corrections must be made to non key fields only you should do the following l 2 3 Revise any non key fields necessary in the new assessment record Increment the Correction Field by one digit in the new assessment record change the status
498. wing standard UPINs 01 18 06 3 13 PM Page 348 of 448 Users Manual e INT Prefix is used for INTERNS without standard UPINs Input the UPIN as INT000 followed by a unique 3 characters for the physician The UPIN will print as INT000 on the claim e PHS Prefix is used for Public Health Service physicians Input the UPIN as PHS000 followed by a unique 3 characters for the physician The UPIN will print as PHS000 on the claim e RET Prefix is used for RETIRED physicians Input the UPIN as RET000 followed by a unique 3 characters for the physician The UPIN will print as PHS000 on the claim e RES Prefix is used for RESIDENT physicians Input the UPIN as RESO00 followed by a unique 3 characters for the physician The UPIN will print as RES000 on the claim e VAD Prefix is sued for Veteran s Administration physicians Input the UPIN as VAD000 followed by a unique 3 characters for the physician The UPIN will print as VADO00 on the claim e OTH Prefix is used for other physicians without a standard UPIN Input the UPIN as OTH000 followed by a unique 3 characters for the physician The UPIN will print as OTH000 on the claim e Enter the physician s first name middle initial and last name in the Physician Name fields e Ifthe physician is not to be used anymore click on the Do Not Use check box e Enter a title for the physician in the Physician Title field This may be MD or Dr etc Enter the physician s address in the Address
499. would like to import and press the OK button e The Save As screen will be displayed 01 18 06 3 13 PM Page 289 of 448 Users Manual Save As amp Claims Transmission vile e This screen will default to save the results file in the N Claims Transmission folder If you would like to save the file in a different folder use the Look In drop down to select the correct folder Then enter the filename you would like for the result file or leave the default name and press the OK button e The import will process the 835 file and display the results of the process 01 18 06 3 13 PM Page 290 of 448 Users Manual Billing Manager gt Melbourne GUEST x File Biling AR System Help Sones 1023 cash applications totalng 131043 66 Results can be seen on the payment log and cash application reports Press return to continue Select operation to perform S14AM e Inthe example above the import has created 4 new payments and 1029 cash applications totaling 131 043 66 The payment and cash application dates will be set to the date this process was run e The results file will contain detailed information on what payments and cash application were created in this system Both the payment and cash applications will have the comment Auto Added 01 18 06 3 13 PM Page 291 of 448 Users Manual File Edit View Insert Format Help pele Sila al e O E a ASC X12 835 Claims R amp S File Submitter ID 94534
500. y Start of Care MIS pe cuired for Plan of Care 0ASIS Agency Current Status Edit Define Plan of Gare Verbal Order PATIENT VITALS Client Patient Name f Agency i Address ae Date 77 aaf Care DASIS gency k Discharge Date Ais ity Patient Type Disaster Code lt lt Admission J Do Not Resuscitate State ZipCode Phone Ore Birth Date nr Sex MISCELLANEOUS Comment Move to first Patient 4 40 PM 01 18 06 3 13 PM Page 145 of 446 Users Manual e On the Edit Patient screen click the Find Fl button on the toolbar The Patient List screen will be displayed SAM gt Melbourne GUEST BIE Aaministaton Screcvie At eoriiguraticn Memnterence Loon Senlicto Geports Hep Patient List Select the Status of the patient you would like to see Select the Type of the patient you would like to see You may also enter part or the patient s entire last name in the Name Beginning With field Click the Generate button to generate a list of patients who meet the criteria you have specified 01 18 06 3 13 PM Page 146 of 446 Users Manual e Select a patient in the list and click the Select button fe SAM gt Melbourne GUEST BIE Aoministaton senedle AG eonigueton Mentenance Logn semiicto Reports Hep a Patient List Adkins Joshua Ao0571 01 110702 2002 e The Edit Patient screen will be displayed You will n
501. yed From the visit menu you can 1 Create a visit from either the Client or Employee Schedule 2 Edit the current visit 3 Delete the visit not available if the visit is Verified or Closed 4 Move the visit not available if the visit is Verified or Closed 5 View Order 6 Specify Employee not available if the visit is Verified or Closed 7 Employee Match not available if the visit is Verified or Closed 8 Visit Phone Log not available if the visit is Closed 9 Copy Single Visit not available if the order is full has 99999 visits 10 Copy Visit Wizard not available if the order is full has 99999 visits 11 Update Visit Wizard 12 Employee Client View Switch to the employee or client view of the schedule based on the view you are currently in and the current visit 13 Compliance Run a compliance check 14 Set view or clear the model schedule week for the current client s schedule not available from the employee schedule Each of these items operations will be explained in later sections This is the scheduling screen when a visit has been right clicked SAM gt Melbourne GUEST Scheduler Ble Administration Sct AG DBonfiguration Memtenance le aGo elp eS Rules 1s Prefs Phone Sum eee B Client lt EEE Case Ei 555 747 2191 25 50 26 50 25 00 25 00 Hrs 2002 EJ Tue Wed Iw Fa A AH He
502. yee s view of the current month s schedule 01 18 06 3 13 PM Page 120 of 448 SAM gt Melbourne GUEST Scheduler Co Ble Administration schedule AR Donfiguretcn Mentenance Login Senco Reports Help Client Employee Rules l Prefs Phone Sum r ml T 4 l b ls E Employee Vickie Dillon RN 555 566 5078 19 50 29 50 8 00 0 00 Hrs 2002 10713 10 20 10 15 10 17 Smm 10 22 10 24 EE 10 23 Pierce 10 27 10 29 10 30 10 31 i a Status Confirmed Skil RN Pedi High Tech Payer Medicaid P D Reg Rates 22 50H 37 50H 09 00a 05 00p 2 26 PM MAH nat You may switch back to the client view by right clicking on one of the client s visit and choosing the Client View option Assignment Matching SAM gt Melbourne GUEST Scheduler OI Bie Administration schedule AED Gonfiauretcn Meintenance Login samiomo Reports Hep Client Employee Rules Prefs Phone Sum Legend Month ml T 4 l l i E Employee Vickie Dillon RN 555 566 5078 19 50 29 50 8 00 0 00 Hrs 2002 a A 10 713 10715 1076 10717 1078 10720 a Create Visit mogo 10 20 10 22 Delete Visit Move Visit View Order N Visit Phone Log 10712 10719 eel 10726 10 27 10 29 Copy Single Visit Copy Visit Wizard Update Visit Wizard T70 Client View ai Status Confirmed Skill RN Pedi High Tech Payer Medicaid P D Reg Rates 2
503. you are changing the Payer s address and would like ALL client payer associations for this payer to be changed also for ALL Offices press the Update Client Payer Addresses button e Enter the payer s telephone number s in the Phone 1 amp or Phone 2 field e Enter a telephone extension number in the Extension field if needed e Enter a FAX number in the FAX field if you have this information This FAX number will also print on the Invoice Aging report e Enter the name of a contact person at the payer s office in the Contact field e Enter the initials of the person at your office responsible for acquiring a contract with this payer in the Sales Rep field e Choose the Pay Rate Source for this payer Service Skill if service skill is selected pay rates for the employee is calculated based on the skill assigned to the visit Employee Skill if employee skill is selected pay rates for the employee is calculated based on the skill of the employee 01 18 06 3 13 PM Page 21 of 448 Enter any comments about this payer in the Comment field Billing Clinical Requirements Section Select a payer class from the Payer Class combo box Select a payer program from the Payer Program combo box Enter the unique id to a claim submitter that the payer provides in the Submitter ID field Select the ECS Style Electronic Claims Submission Style if you will be sending electronic transmissions of your claims to your payer This fiel
504. you have created default pay rates at the skill level for you organization e If you want to pay the employee an amount more than the normal pay rates defined for your agency for the work they perform on the weekends enter the additional amount per hour and per visit in the Weekend Differentials fields This is assuming you have created default pay rates at the skill level for you organization Miscellaneous Section e Ifthe employee is a case manager click the Case Manager check box This will allow you to build a list of case managers from which you can choose when creating plans of care 01 18 06 3 13 PM Page 62 of 448 e Ifthe employee was referred select the desired referral source by clicking the Referral button When the Referral List screen appears click one of the list items and then click the Select button or simply double click one of the list items If the referral source does not appear in your list click the Cancel button The selected referral source will be displayed in the Referral field If you would like to clear the current referral selection click the Clear Selection button You may enter new referral sources to be displayed in the Referral List using the Referral Sources option on the Administration menu to display the Edit Referral Sources screen e The Comments field is used to describe scheduling and work habits associated with an employee These comments will appear on the bottom of the schedule when viewing vi
505. ysician s database E Physician List gt Melbourne GUEST iol File Administration Schedule AR Configuration Maintenance Login SamIoGo Reports Help E Select Repon x APPLICATION RRANP E Physician List Office Melbourne 0002 nee T a Before 11 a Licenses Verified Before C 4 Select an Office 10 09 AM 01 18 06 3 13 PM Page 422 of 448 Users Manual Strategic Planning Report This report shows patient referral source payer cert begin date diagnosis primary and physician If the patient does not have current plan of care then the first active client payer relationship will be reported as the payer 1 Strategic Planning Report gt Melbourne GUEST f Strategic Planning Report 01 18 06 3 13 PM Page 423 of 448 Users Manual North Carolina DMA 3000 This Patient report prints a North Carolina DMA 3000 Plan of Care for the selected patient s This is a North Carolina state specific Plan of Care form and is available only in those offices that are located in North Carolina There is also the ability to print a blank version of this report SAM gt Melbourne QA North Carolina DMA 3000 Report 9 Verbal Order Only Both 01 18 06 3 13 PM Page 424 of 448 Users Manual DLL Reports These report s are used at offices that are using the SAMDLL technology to interface to another vendor software system To access the DLL Reports select menu option Fil

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