Home

1. Introduction to Claimstronic PMS

1. ssssss 2 27 2 2 5 Claimstronic Practice Management System Component 2 28 2 2 0 Microsoft Data Engine Component ssss 2 30 2204 Database Setup LODIDODPDE GL eene bia EREN ER OU EELa a 2 31 8 iden second DUBBI seccina 2 36 Lay Nie a eeeseseiskbbieun d dieses earan 2 39 2 2 10 Creating Your User Account sisiccasccscascccsanscnsacaseracisanscasecaces 2 41 3 Navigating the Claimstronic PMS Software 3 1 3 1 NEOON A 3 1 cS R 3 2 LP ME li RR 3 3 Sd Pe OR O LL assdiaccnieisM eau ERE o br dU Mu oi MM MUR 3 3 dud The Patient Guarantor Information Window 3 4 3 3 Maintenance Windows NIIT TIT 3 6 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 3 4 3 5 3 6 4 4 1 4 2 4 3 4 4 4 1 6 4 2 4 2 1 4 3 4 3 1 4 3 2 4 3 3 4 4 4 4 1 4 4 2 4 4 3 4 4 4 4 4 5 4 5 4 6 4 7 4 8 4 0 5 1 92 5 3 5 4 5 5 5 6 TD Popo Gone Lo cesses 3 8 Tn Appoimimeni SCC UIC s0xssvecsrsseiesssnsanersentereiermsersssins 3 9 ClaimsTronic PMS Keyboard Shortcuts 3 10 System Setup and Customization 4 1 i acide mp Melun nM Rd WEEK Pol 4 wu cL IM ES RETRO T 4 ix indi i rc OP 4 3 M gnME T 4 4 PACIDEDE TN La einem HRURUMEEEHODEI PERPE EAE 4 5 i o M
2. M File Maintenance b gt I Close Figure 4 13 ICD 9 Table Screen To customize the Diagnosis Code table and make it more manageable you may do any of the following Identify the codes that are most relevant to your practice s Use Search to quickly locate a code Use Edit to create user codes D codes for often used items Use Change Index to sort the records in a way that is most useful Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last Claimstronic PMS Users Manual gt SS KH Version 5 1 4 May 19 2001 System Setup and Customization ctwinkdata amp D Code mkd Mie x Di Cade 070 1 ICOS Desc HEPATITIS INFECTIOUS ICD Code 070 1 vet en rn pee won eos Figure 4 14 Add Edit ICD 9 Record Window DIAGNOSIS CODE DATA ITEMS This is the code you will key to the patient s account to designate the diagnosis during Charge Entry This does DCODE l not print on the insurance claim form ICD9 DESC The code description that appears in the Charge Entry screen ICD CODE The code the practice uses for insurance filing After you have made your entries changes click on Update Claimstronic PMS Users Manual SS 12 Version 5 1 4 May 19 2001 System Setup and Customiza
3. E CLAIMSRONIC PATIENT FINAN ME EJ PATIENT PROCEDURE FINANCIAL HISTORY REPORT Day F eriad ee All Dates From 4 14 01 L Ta 4 14 01 L Patient History Procedure Finance View Print Close Figure 10 39 Patient Procedure Financial History Report Window 3 Click on View Print to view the report before printing 4 When the printing is done click on the Close button x to close the preview window 5 Click on the Close to exit the Patient Procedure Financial History Report window 10 32 Producing System Reports NIB a av II E Zoom 100 PATIENT PROCEDURE HISTORY BY DATE OF SERVICE ABC CLINIC Account 000003 Name ALICE YOUNG Sex F Address 123 OLIVELN DOB 12 12 54 city State Zip DUNN LORING V 22027 SSN 929 38 4884 Home Phone Driver Lic Tuesday April 17 2001 Page 1 DOS DR CODE CPT4 CODE DESCRIPTION ICDNo ICD9 CODE UNITS LINE CHARGE 4 2 01 01 99211 EST PATIENT BRIEF 1 034 0 1 45 00 4 4 01 01 99213 INTERMEDIATE OW EST PAT 1 034 0 1 65 00 TOTAL 2 110 00 END OF REPORT Paos OR LY Figure 10 40 Sample Patient Procedure Financial History Report Procedure Option 10 3 4 DDDD Claims with a Balance gt 0 CLAIMSTROAIC DEMOD DATA wn JU A File Appointment Patient Billing EndofDay Reports Maintenance Tools View Help New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End OF Month
4. Payment Continue with Payment Figure 7 7 Patient Billing Menu Pre Copay Option 2 When the PreCopay List window appears enter the patient s name type of payment amount of payment and the check or credit card ID number Choose Save Copay or Alt S and the entry will be added to the list 3 Once you have entered the copayment from the PreCopay List select the appropriate patient and choose Delete or Alt D to remove them from the list ClaimstronicPMS User s Manul STE Version 5 1 4 May 19 2001 Producing System Reports ll PRE COPAY LIST Mey cec B Pre Copay y Typ EM ox Save Copay Delete Refresh Print Receipt ENIT Name Amount Check Card ID Pay Type Pay Date 10 17 2001 JACE YOUNG Receipt Mate Thank you for letting us serve you Have a great day Figure 7 8 PreCopay List Window 7 3 2 Posting a CoPayment L Without closing the ICD9 amp CPT4 window and prior to saving the claim access the PreCopay List window as previously instructed S PreCopay List X i Name Payment Type CHECK Claim Entry ayment Type CHECK M Amount FE Code ICD 9 u VIRAL Y Delete Jack Young 10 00 4 11 01 wv Delete Proc Line Total 95 00 55 00 meint 5 00 Payment 42 7 h e Exp r Amount Tyne CASH v ID Date Auth Clem j ICD9s amp CPT4s Claim Note 11 26 21 4M v Save X
5. Click Cancel ta quit Setup and then close any programs you have running Click Next ta continue with the Setup program WARNING This program ig protected by copyright law and international treaties Unauthorized reproduction or distribution of this program or any portion of it may result in severe civil and criminal penalties and will be prosecuted ta the maximum extent possible under law Cancel Click Next to continue 3 Software License Agreement Claimstronic PMS User s Manual 2 22 Version 5 1 4 May 19 2001 Software Installation Software License Agreement E X Please read the following License Agreement Press the PAGE DOWN key to see the rest of the agreement Pervasive Software Inc Pervasive SUL License Agreement workstation workgroup Edition IMPORTANT DO NOT INSTALL THE ENCLOSED SOFTWARE UNTIL YOU HAVE HEAD THIS LICENSE AGREEMENT Br INSTALLING THE SOFTWARE OF AUTHORIZING ANY OTHER PERSON TO BO SO YOU AND SUCH OTHER PERSON IF APPLICABLE ACCEPT THE TERMS AND CONDITIONS OF THIS LICENSE AGREEMENT IF VOL DO NOT AGREE TO THE TERMS OF THIS LICENSE AGREEMENT RETOURN THE ENTIRE PACKAGE WITHIN TEM G 44 S OF PURCHASE FOR amp REFLND 1 DEFINITIONS 1 1 Pereasive means Pervasive Software Inc a Delaware corporation 12365 Riata Trace Parkway Building Il Austin Texas LI 5 5 872 Do you accept all the terms of the preceding License Agreement If you choose No S
6. Us 4 6 Adding or Deleting a User Account ssssss 4 7 Changing Your User Infomration sss 4 8 Customizing Data Tables RTT 4 10 D Eo e A EI A E TUR 4 11 Procedure TDi siii HEPRIS ANIME REDE EUR END ERES UN DUM HERR 4 13 itus Wr jeer 4 16 Customizing Practice Specific Data Tables 4 17 lunonis bci EET 4 18 Facility TOA ho crsaiaicanaveincrnraeriiaraiaebniatnaenarnieieets 4 21 Prcice TI MT 4 23 Prob OHA tia ceperit RR HERO CHOR GUERRE 4 26 Referral Doctor ItottnabfOllsseere sept prr bi pEPHR E REIR Ero 4 29 Configuring the Appointment Scheduler 4 32 Managing the Routing Sheet eeeeeeesssssss 4 37 Customizing the Claim Appeal Letter 4 40 Patient Statement Setup cccccccccsssssseeeececeeeeaaeeeeeeeeees 4 42 Statement Dunning Message Setup eeuusss 4 43 Using the Appointment Scheduler 5 1 Components of the Appointment Scheduler 5 1 Creating a New Appointment c cc ceeeesseeeceeceeceeeseeeeeeeees 5 3 Viewing or Editing an Appointment cccccceessseeeeeeeeeees 5 9 Moving and Appointment cccccccsssessseeeeeeeceeeeeeseseeeeees 5 9 Deleting an Appointment cccccccssssesseeeeececeeeeeeeseeeeeees
7. El https secure freeclaims com frcl FRCLmember FreeClaims com Payor List Logout Upload Claim File re ee Correct Claims with Missing Network ID Figure 9 10 FreeClaims com Upload Claim File Option 17 Click the Browse option to view a list of files to select 24 FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSpr zx t GT EITGU httos secure freeclaims com frcl FRCLmember FreeClaims com Payor List Logout Upload Claim File Step 1 Click the Browse button to select your file Tip for PC users select All Files for Files of Type Step 2 Click Upload File _Uptoad File Submitted files for this session Size Server assigned name No filas submitted Ask customer service a question Figure 9 11 FreeClaims com Upload Claim File Option Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 18 Double click on the My Computer icon to access the Claimstronic PMS Then choose the appropriate drive as designated during installation Ji FreeClaims com Completely Free Online Medical Eile Edit View Favorites Tools Help v M gt 9 a Back omad Stop Refresh Home Sear Address e https secure freeclaims com frcl FRCLmember Frec Choose file 21x Look in amp My Computer z amp Al gi HERES 23 3 Floppy A Compaq C Zip 100 D 2 E Files of type fan Files C
8. PHS5HEPUHBHT rprikckkes plararbepmt LJ pi Tickler Report ing ru ieee Total Furrber of Page Tock len Flee Pagar Hatin Pons Account Claim Hemp Date Alarm Date Charmed Paa Adjuzted Halan HJAHA ALLIE pm 54 545 D l NAA 2000 42 2 10 DO n un 100 3210 MOAWA ALLIE r 254 0545 QD 5 OG 5 2000 32 210 00 t Hiii 210 y FU XE TANDEM ee End of Report Pee Mai MM a Figure 10 10 Sample of Generated Tickler Report 10 7 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports 10 1 4 Appeal Claim Report If you set your parameters for appealing a claim refer to Section 4 1 3 Claim Tab this report will let you customize and send individual or batch appeal letters for any claims in the system that have been returned unpaid or underpaid l From the Claimstronic PMS menu bar click on Reports and select Claim Appeal Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View H molala New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 11 Reports Menu Appeal Claim Report 2 The Appeal Claim List appears and contains all accounts that have been flagged as a claim
9. 100 00 0 00 Paid Adjusted Balanced In 0 100 00 000003 4 12 01 4 12 01 100 00 55 00 40 00 000003 000003 4 12 01 4 3 01 4 12 01 4 3 01 D D D 100 00 35 00 110 00 5 00 20 00 50 00 Bt 000003 4 3 01 4 3 01 145 00 000003 473 01 4 3 01 E E T ID IDA jT t P P D 35 00 000003 4 3 01 4 3 01 35 00 Patient Info Additional Pat Info Primary Insured Secondary Insured Tertiary Insured Routing Sheet al Chart Label RINT VIEW PRINT w o x Cancel 288 Close Figure 7 15 Printing A Superbill 7 17 Producing System Reports 7 6 Editing Correcting and Resubmitting Claims 7 6 1 Changing the Billing Status You may from time to time need to resubmit an insurance claim If the insurance carrier has not changed Claimstronic PMS offers the ability to reassign the claim for submitting 6 From the Claimstronic PMS menu bar click on Patient Billing and select Patient or click on the Patient icon Hi from the toolbar From the Patient Guarantor Information window select the account that you want to check refer to Section 6 2 Finding an Existing Patient for instructions and then click on the Claim tab to view the Claim page From the Claim page click on Edit The Claim window appears on your screen with the
10. 4 9 Statement Dunning Message Setup Claimstronic PMS allows for customization of statement notices You are able to create individual notices per insurance type or create global messages for all patients l From the Claimstronic PMS menu bar click on Maintenance and select Statement Message CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View e Gol HG P 3 se Diagnosis Code Procedure Code Insurance Code Address Code Referrall Dr Code Facility Info Practice Info Provider Info Liser Info Category Info Anesthesia Options Figure 4 46 Maintenance Menu Statement Message Option 2 From the Statement Message Set window select Add or Alt A to create a new set of messages E WNPMS Statement Message Set Window X STATEMENT MESSAGE SET SetID 0 Description Default Dunning Messages Message for 0 30 Your insurance has been filed Information Only Message for 31 60 Please contact your insurance company regarding this outstanding claim Message for 61 90 Your account is past due Please contact the office Message for 91 120 Your account is seriously Past Due Contact the office immediately Message for 121 Colllection Actions are now in process Your immediate attention to this matter is requested Add Edit Delete Update Cancel Refresh Close m Were Hr 4 47 Statement Message Set Window Note Utilize the
11. Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Account v Search Account Guarantor LastName FirstName Address City 000002 000001 WU CUONG 1200 MAIN DUNN 000001 000001 DANG 1200 MAIN DUNN 000003 000001 AMANDA 1200 MAIN DUNN 000004 000004 WALLACE GEORGE 1920 MAIN FAIRFA 922 LARADO DR VIENN DUNN ooooog o0009 f jf 31 00 2 44 52 PM Figure 10 36 Data Source List Patient List Window 10 29 Producing System Reports 3 In the Ledger Report window locate the Transaction Date box and specify the start and end date in the Begin and End fields respectively 4 Click on View Transactions The fields in the Account Information box are automatically filled with data and the box that follows the View Transaction Type displays all information about the account 3i By default the View Transaction Type is set to All which means that the report includes all information about the specified account If you want to include only specific information about the account click on the information that you want from the available options in the box 6 If you want to search for a specific claim enter the claim information that you want to search in the Find Claim field and click on Search de From the displayed list of information select a transaction 8 The Detail of Selected Transaction box provides a quick view of the selected item within the claim e Diagnosis Shows the
12. DK Cancel Apply Figure 4 3 Options Menu Patient Tab 4 1 2 Patient Tab a Number of copies to print for Chart Label If you have chosen to utilize the label print option indicate the number of labels you wish to print for each patient account b Default Zip Code This allows you to enter the most common zip code for your area c Auto Account Check this box if you want Claimstronic PMS to automatically assign patient account numbers If you have a customized numbering system Claimstronic PMS will allow you to enter the customized number manually d When To Create New Account from Appointment This option allows you to determine at what point a New Patient Account can be created 1 Never Choosing this option indicates to the system that all new patient accounts will be entered manually 2 When an appointment is created Choosing this option indicates to the system to create a temporary new patient account when an appointment is created in the Appointment Scheduler You will have an option to complete all the data at that time or return to the account later 3 At check in time Choosing this option indicates to the system to create a temporary new patient account when the patient has been checked as arrived for appointment in the Appointment Scheduler You will have an option to complete all the data at that time or return to the account later Claimstronic PMS Users Manual 43 Version 5 1 4 May 19
13. No Core I No V Pint rarse pending clam b do nol tol al Global Statement Message Pint reuence pending clive and anak toll i Puntireursnce pending clara aod tall Figure 9 24 Statement Report Window Statement Data Description Account Name Zig Driver Lic Prints statements by driver license Sent Date Date transaction was filed with insurance Aging Period Leave blank to print all balances due or select any variation of the options to print statements based on their account age Messages Attached a dunning message to accounts as they are aged in the system Cycle Billing Leave blank for all patient accounts To produce statements for patient s with the last name Claimstronic PMS User s Manual 9 15 Version 5 1 4 May 19 2001 Insurance and Billing To produce statements for patient s with the last name To produce statements for patient s with the last name Three To produce statements for patient s with the last name Minimum Balance to Indicate a minimum dollar amount you want to Print produce a statement for Print Options for Pending Claims Skip insurance Does not print information regarding pending pending claims claims that are not pass the number of days limit indicated Print insurance Prints pending claims but does not add the totals pending claims but to the amount due on the statement do not total Print insurance Prints pending claims and bills the amount for any pe
14. Customize the letter by e Typing your changes directly into body of the letter e Save your changes by clicking on the save icon l e Inthe Save As window type in the name of the letter and click on save Note The name of the file must include the word Letter Ex Aetna Letter The patient and claim information automatically populates into the appropriate fields Select on the Print Claims button to choose all letters or just the current one The directional keys 1 lt lt gt gt 1 to move from one letter to another Click on the printer icon iB to begin printing the appeal letters When printing is done click on the Close button x to close the letter window Choose Close on both the Appeal Letter Customization and Appeal List windows 10 9 Producing System Reports 10 1 5 Print Patient Demographic Labels When preparing for the next day s appointments or to catch up from the existing days added appointments this report is an efficient way to verify and receive an updated signature on each patient s personal information This report also provides an option for printing patient labels l From the Claimstronic PMS menu bar click on Reports and select Print Patient Demographic Labels CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View tE Go He 2 3 32 New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report
15. Follow the same procedures for preparing the patient statements from Section 9 3 Preparing Patient Statements Follow the same procedures for preparing for electronic transmitting from Section 9 2 Preparing Electronic Claims You will be assigned a separate User Name and Password for patient statement transmission 9 17 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 9 5 Quick View of Claims L From the Claimstronic PMS menu bar click on Patient Billing select Claims and the View Claims CLAIMSTRONIC Practice01 Eile Appointment Patient Biling EndOfDay Reports Maintenance J e maola Patient View Claims Pre Copay Payment Resume Posting Payment Find Check Information Figure 9 25 Patient Billing Menu Claim View Claims Option 2 Define your sort options to view a list of claims L Claims Information im x Claims Information Claim Options Balance gt 0 Insurance not pay yet Age between days af O00008 000003 2001 04 03 DDDA 0403 DDDD DDDD 000002 000003 2001 04 12 EDDD BCBSO1 45 00 000 00002 000003 2001 04 12 EDDA BCBSO1 100 00 65 00 3500 oon oo0008 000003 2001 04 12 EDDD BCBS01 100 00 110 00 10 00 20 00 01 n 5 nn nnn 71 26 PM 4 26 01 25 Chains SC Sr EL Figure 9 26 Claims Information Window 9 18 Insurance and Billing CLAIMS INFORMATION DATA ITEMS SELE
16. LAIMS TIRRONIC Practice Management System User s Manual Version 5 3 5 October 09 2002 Anva ce Claimstronic Support Software If you have questions or difficulties during the installation or operation of the Claimstronic software contact AnviCare Customer Service Toll Free 877 268 4676 Custom data conversions and consulting services are available Documentation If you have any comments regarding this User s Manual or find any problems we will appreciate it if you will letus know Please fax or mail your comments and the page s that contain the error s to Customer Service at AnviCare Inc Claimstronic PMS User s Manual Copyright Copyright AnviCare Inc 2000 Licensed users of Claimstronic may copy this manual in whole or in part for use in their own private practice Trademark Acknowledgements Claimstronic and FreeClaims are trademarks of AnviCare Inc DCOM for 98 for Windows Windows 95 95 2000 and NT MS DOS Microsoft Data Access Components and Microsoft HTML Help are trademarks of the Microsoft Corporation Pervasive WorkGroup Database and Pervasive Service Pack are trademarks of Pervasive Software Inc Disclaimer Changes may be made periodically to the information in this documentation without obligation to notify any person of such revision or changes Such changes will be incorporated in new editions of this manual or supplementary documents and publications AnviCare Inc makes no
17. VGA 800 x 600 resolution 1 gigabyte free disk space 56 K modem The modem as well as internet connectivity is needed to connect to www Freeclaims com CD ROM Drive Microsoft DCOM for Windows 95 98 Insert the Claimstronic Installation CD into CD ROM drive Program should launch automatically if not go to Start Run and 2 19 Software Installation type d setup If your CD ROM is not drive D substitute the appropriate letter for D 2 Install needed components by left clicking once on the component s Start from the top of the menu select Microsoft DCOM for Windows 95 98 first left click on component proceed in top down order You should install components that are not grayed out CLAIMSTRONIC For proper installation please click on each component in the top down order 4 Support Information 3 Click Yes to install DCOM Support Information 4 Click Yes for license agreement Claimstronic PMS User s Manual 2 20 Version 5 1 4 May 19 2001 Software Installation TI DCOM9S for Windows 95 and Windows 98 CUI x Please read the following license agreement Press the PAGE DOWN key to see the rest of the agreement Microsoft DCOMSS 1 0 END USER LICENSE AGREEMENT FOR MICROSOFT SOFTWARE IMPORTANT READ CAREFULLY This Microsoft End User oe eement EULA i isa fae agreement between you either entity and Microsoft Corporation C Mierosat for computer softwa
18. update the appointment grid with all newly made appointments To configure the Appointment Scheduler l Select Appointment from the Claimstronic PMS main window menu bar or click on the Appointment icon from the toolbar WIHPHS File Appointment Patent Billing End fDay Reports Maintenance View Help Daily Sppointment Figure 4 28 Appointment Location on the Menu Bar 2 From the Appointment Scheduler window select Settings then Scheduler Configuration to open the Scheduler Configuration Settings window Claimstronic PMS Users Manual SSS 432 Version 5 1 4 May 19 2001 System Setup and Customization Appointment Scheduler Scheduler Configuration Figure 4 29 Settings and Scheduler Configuration Location Scheduler Configuration Settings David Jones C Susan Smith Alan Ingle C John Smith Code Physician Max Bookings Location WD DavidJones 1 Office 95 Susan Smith 1 JjMalne o 1 PIS John Smith Figure 4 30 Scheduler Configuration Settings Window 3 Add the Resources to be scheduled Code Physician MasBookinas Code Location Max Bookings DE Davidsons i kj ee SS ss Susan Smith 1 X KReRm 2 Alani 1 Ej e 23 s Joson 1 1j oe Figure 4 31 Resource Settings Area Physicians CODE The code utilized to identify the provider of service This code shou
19. 3 1 3 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Open icon lets you select from among multiple practices if the system is so configured Appointment icon gets you into the Appointment Scheduler Patient icon Provides access to the Patient Guarantor Information window Claim icon Provides access the Patient Guarantor Window for bar code entries Payment icon Provides access to the Payment window File maintenance icon Lets you perform system configuration establish printer preferences and other system administration tasks Additional Buttons Close button The function is similar to the Close box located in the upper left corner of the active window Clicking on this button will take you out of the active window Maximize button Maximizes the active window into full window If you have multiple windows open at the same time clicking on this button will shrink your active window so you can view other windows at the same time Minimize button Puts your window out of view and shrinks it into an icon on your status bar 1 e the bar located at the bottom of your window while it remains open Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Navigating the Claimstronic PMS Software 3 2 The Patient Guarantor Information Window The Patient Guarantor Information window is actually a set of up to seven windows that record patient insurance and claim in
20. 5 00 PM v Print Bar Codes Figure 5 25 Routing Sheets Window 2 Enter the desired date that you want to check in the Date field Claimstronic PMS User s Manual 5 20 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 3 Select a physician from the Physicians list 4 Specify the desired time period from the Time Frame box Click on Print Bar Codes if you want a bar code to appear on your printout This option is necessary if you have chosen to utilize the scanner option for the Claimstronic PMS 6 Click on the Print icon 5 14 Printing a Chart Label There are three ways to print a patient chart label Q Via the Appointment Scheduler window allows you to print individual labels for patients Q Via the Patient Guarantor window allows you to print individual chart labels refer to Section 6 5 Printing Patient Routing Sheet and Chart Label Q Via the Report Generator allows you to chart labels for patients for a specific date and provider refer to Section 10 1 5 Print Patient Demographic Labels To print a chart label via the Appointment Scheduler window 1 From the Appointment Scheduler double click on the desired appointment from the displayed list The Appointment window will appear on your window Appointment Account me Guarantor jooooos First Mame payo MW Last Name PLOTKOWSKI Suffix E
21. Address je np Nee cure Peace conincur ACL member DEREN Freeclaims eom FEMALES LAA Auto Update Payor Id To Claims TDL wer Parade ii darc ranig and al Clans Chat matcr rhe selacred pexor information will be up rapa Click Fae 1d i Dgour Ex well aioa rraresl ar pir ici from parcs ee a Eee CUE Pair EJ imul Dx ee lr u Mur Fagur Infe aion Payor ld uper Bon pect EPEUAEL wi CRIT PATI GAT CL E 25007 VETERE MET r MIERS FL 32542 TARTS CITE 2 PO EOIS a NE r T ilL H aise FL ee CLUB CEHTEE FR PO BON OB c LAP ELH FL 325056 CIRR IM CHARA DMO EY E DONE x S i r E s M Figure 9 19 FreeClaims com Home Page Auto Update Payor ID to Claims Window 4 After you have made your corrections click on the Submit button found at the bottom of the page s The next step is to select Correct claims with Missing Network ID from the Upload Claim File menu Ji FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSpring Internet Expl MEEI Eile Edit View Favorites Tools Help me f fa gv Back Forward Stop Refresh Home Search Favorites History Mail Print Edit RealGui Address e https secure freeclaims com frc FRCLmember Go Links FreeClaims com Payor List Logout Auto Update Network Id and Group Network Id To Claims e If submitted your Network Id and Group Network Id Match table and all claims th
22. D4 Version 5 1 4 May 19 2001 Payment and Adjustment Entry 8 Payment and Adjustment Entry Claimstronic PMS offers a variety of options for posting and tracking your financial data Each payment entry option functions differently in processing payment information Q Payment and adjustment entry via the Patient Guarantor Information Window allows individual claim posting options Refer to Section 7 3 3 Posting a Claim Payment and Adjustment Q Payment and adjustment entry via the Payment window through Patient Billing allows for multiple claim posting options without having to retype the check information for every account This option is very useful when posting bulk payments Q If during payment entry you are unable to complete posting of a check Claimstronic PMS will keep track of all pending information via the Resume Payment Posting window found in the Patient Billing menu 8 1 Entering Payment Information This section pertains mainly to posting payments received in bulk through the mail or insurance payments from explanation of benefits To enter the Payment information From the Claimstronic PMS menu bar click on Patient Billing then on Payment or click on the Payment icon 3 from the toolbar 2 When the Payment window appears select the account that you want to post a payment or adjustment refer to Section 6 2 Finding an Existing Patient for instructions Fields that are underlined are required data Clai
23. EN email Work Fax 703 929 3929 Employer ANY ICON Effective Date 12 12 1999 Emp Id 25 Termination Date Policy Id 582 92 9292 Copay Amt 10 00 Gould _ Deductible Amt 0 00 Group Name 1 Percent Coverage NM 7 28 00 3 10 35 PM Y OK AJ cose Figure 6 6 Insured Insurance Information Window Note The insured s personal demographics will automatically populate into the top section of the Insured Insurance Information Screen from the guarantor account If the insured is different than the guarantor update the fields accordingly Table Insurance Information Data Items a a oon Pat Insurer Indicates the relationship of the patient to the insured Rel individual Click on the button to display a list of acceptable values Payor Code The code and the name of the payor organization from which the provider expects to receive reimbursement for a claim Click on the button or press F2 to display a user definable list of payor codes Employer Name of the patient s employer Empld The patient s employee identification number Policy Id The patient s insurance policy number By choosing the z sign and hitting enter the social security number of the insured will automatically populate into this field The code assigned by the payor or administrator used to identify the group under which the insured is covered Group Name The name of the group or plan through which the insurance is
24. Payment and Adjustment Entry PAYMENT DATA ITEMS CONT Prompts the system to pay the selected claim Print HCFA Prompts the system to produce an insurance claim form Choose from primary secondary or tertiary Print Superbill Prompts the system to produce a patient superbill Print Statement Prompts the system to produce a patient bill Choose from current or all claims Edit Notes Allows you to add or edit claims notations Refer to Section 7 4 Creating Claim Notes Claims Tab Initial payment screen for accessing claims for payment Claim s Procedure Active payment screen for line item posting Tab Claim s Notes Tab Screen for storing claim notations Refer to Section 7 4 Creating Claim Notes 3 Utilizing the tab key to advance through the fields enter the payment type and payment amount Claimstronic PMS will automatically fill in the payor information 4 Verify the claim that the cursor is on is the claim that you are applying the payment and hit enter If not with the arrow keys scroll to the correct chim and hit enter 5 Choose the correct payor making the payment on the account from the Claims Payor List WINPMS Claim s Payor List Fo INS2 F INS3 FB GUA ALICE YOUNG Figure 8 2 Claims Payor List Claimstronic PMS User s Manual 8 3 Version 5 1 4 May 19 2001 Payment and Adjustment Entry 6 Enter the payment amount into the C Pay column If you are not posting an ad
25. Printed S Sent The file has been sent to the appropriate clearinghouse The file has been successfully printed and ready T Printed for delivery to the payor The claim has been paid Claimstronic PMS User s Manul DS Version 5 1 4 May 19 2001 Producing System Reports CLAIMS DATA ITEMS CONT barie rr ddl icd d rdi aa cab H Hold Temporarily holds the processing of the claim G Statement to Refers to Guarantor specific claims Guarantor C Statement to PAT Refers to Patient specific claims A Active This code is valid only for Guarantor s Balance It signifies that the guarantor still has a balance Carrier Name Name of the insurance organization associated with this claim Insured s Name The name of the insured individual Guarantor s The code for the status of the guarantor s Balance remaining balance Press F2 to display a list of acceptable codes Sent Date The date the bill was sent to the insurance organization Must be entered as MM DD YYYY i e 12 10 1962 The code used to indicate whether there is a signature from the patient on file Press F2 to display a list of acceptable codes Enter Y or N to indicate whether the provider has a signed form authorizing the payor to pay the provider and whether the provider accepts such a payment arrangement Press F2 to display a list of acceptable values Empl Related Enter Y or N to indicate whether this claim is employment related
26. click on the Upload Claim button E FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSprinc Eile Edit View Favorites Tools Help S a 3 By 8 Back ESTATE Stop Refresh Home Search Favorites History Mail Print Address e https secure freeclaims com frcl FRCLmember FreeClaims com Payor List Logout Home Upload Claim File view Reports View Batches Manage Claims Customer Service Reports Manage User s Profle Upload Claim File Step 1 Click the Browse button to select your file EEUU Browse Tip for PC users select All Files for Files of Type Step 2 Click Upload File Upload File Submitted files for this session Size Server assigned name No filas submitted Figure 9 16 FreeClaims com Home Page Upload File Option 23 Once the file has successfully transmitted the batch file will appear in the Submitted Files for This Session window located directly underneath the Upload File button Claimstronic PMS User s Manual 9 0 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 9 2 1 Viewing and Correcting Electronic Claims Through FreeClaims you have the ability to edit correct and resubmit any electronic claim 1 From the FreeClaims com Home Page select View Reports This will activate the batch confirmation report from FreeClaims com as well as from the payors F Freeclaims com Co
27. cut and paste an appointment delete an appointment find an open time slot find a patient s appointment and print appointment reports Daily Data Entry Processes Discusses how Claimstronic PMS automates the day to day business operations of the practice by entering information about patients billing insurance claims payments and ledger information End of the Day Processes Gives guidelines on how to prepare insurance claims both in electronic and paper forms Producing System Reports Guides you on how to select the parameters for generating and printing patient reports aging reports end of the month statistics ledger reports statements and detail procedure reports 1 2 Software Installation 2 Installation of Claimstronic Practice Management System 2 1 Installation Process For Windows NT 2000 Professional 2 1 1 System Requirements To run Claimstronic PMS software your computer system should meet following minimum requirements l 2 2 1 2 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 A Pentium class processor running at 500 MHz or faster Windows 98 second edition ME NT or 2000 operating system At least 64 MB RAM optimally 128 MB RAM VGA 800 x 600 resolution 5 gigabyte diskspace 56 K Modem The modem as well as internet connectivity is needed to connect to www Freeclaims com CD ROM Drive Pervasive Data Engine Component Insert CD ROM in CD drive Prog
28. from the toolbar Q From the Patient Guarantor Information window select the account that you want to check refer to Section 6 2 Finding an Existing Patient for instructions and then click on the Claim tab to view the Claim page Patient Guarantor Information Window Account LastFirstName MIT sur Guarantor Address Te NickName 7 Address2 7000000000 show Quick Note OiState Zip To papa Con on Account Guarantor ClaimNumber StpDate Paid Adjusted Balanced In view Claims of Guarantor Patient dF New X Delete Payment Patient Info Additional Pat Info Primary Insured Secondary Insured Tertiary Insured w ok gt cocos ay Close Figure 7 2 Patient Guarantor Information Window Claim Page QO From the Claim page click on New or Alt N The Claim window appears on your screen with the Claim page as the default view O Select a Case refer to Section 6 7 2 Case Management Information or hit esc if there is not a case related to this claim Or Q From the Claimstronic PMS menu bar click on Patient Billing select Claims and click on Add Edit Claims CLAIMSTRONIC Practice 1 Eile amp ppointment Patient Biling EndOfDay Reports Maintenance 1 mlll Patient Claim Edit amp dd Claim Views Claims Pre Copay Payment Resume Fasting Payment Find Check Information Figure 7 3 Patient Billing Menu Claim Edit Add Claim Option Claims
29. the to p d own order Support Information Claimstronic PMS User s Manual 2 17 Version 5 1 4 May 19 2001 Software Installation 2 1 7 Creating Your User Account After the installation the Claimstronic PMS System icon will be added to your Windows desktop To create your user account 1 Click on the Claimstronic PMS System icon this is your first time to click the icon Claimetranic Figure 0 1 Claimstronic PMS System Icon 2 When the Welcome New User screen appears enter all requested information Underlined items are minimum required fields 3 After confirming your entries click on the Create User Account button Note Remember your User Code This will be your LOGIN ID Claimstronic PMS User s Manual 2 18 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Software Installation 4 After you create your user account the Login screen will now 5 2 2 2 2 1 appear every time you start up Claimstronic PMS Loinid Password Cancel Enter your LOGIN ID and password then click OK to login to the system Installation Process For Windows 98 System Requirements To run Claimstronic PMS software your computer system should meet following minimum requirements l 2 2 2 2 A Pentium class processor running at 500 MHz or faster Windows 98 second edition NT or 2000 operating system At least 64 MB RAM recommended 128 MB RAM
30. 4 May 19 2001 Producing System Reports 7 Claim Entry Whether you choose to enter your claims manually or by taking advantage of Claimstronic PMS state of the art scanning system you will find all data screens user friendly and easy to manage 7 1 Entering a New Claim via Scanning L You will need to print all the routing sheets with their bar codes Refer to Section 4 1 1 System Tab 2 Using the infrared line as a guide simply scan over the patient name diagnosis codes and transaction codes If a copayment is due you are able to scan that in as well Review the Claim tab to manually add any additional information Scan the Save option and you re done ob OY dee A Refer to sections 7 2 Entering a New Claim Manually 7 3 Entering a Payment and 7 4 Creating Claim Notes for instructions on posting items manually 7 1 Producing System Reports 4 12 01 Routing Sheet Number 13 Your Practice Name Goes Here 2301 Gallows Rd Dunn Loring V 22027 703 876 6170 TaxID 00 000000 HU LLL LLL MOL ALI IULII DEBBIE GIORGIO 3220 RIVER VILLA WAY 3MIEEBOLURNE BEACH FL 32951 Account 000008 SSN 123456789 DOB 3 10 65 Insurance HFHP Policy 456 ALICE YOUNG Home Work Grp HEALTH FIRST Emp Emp Tel Account 000003 ALICE YOUNG Balance 882 Co Pay 10 ICD9 LAU POUR MONON DELETE E EETHE ET DL ETT FULL LAE UU OIIO CULA LT LI FULL OIOI LII LR LUI UNII IONI EULLE DAE EI HE THU LT IONI 706 1 Acne Vulgaris 414 9 Cad 706 2 Cyst
31. 5 E Today 4 9 01 1 00 AM 1 30 AM Appointment Detail 200 PM Lunch Patient DAVID SMITH Sex Male 2 30 PM Birth Date 03 11 1942 1 00 PM Home Phone 956 8421 1 30 PM Work Phone 857 4158 nme m Physician Dir John Smith Diagnosis Default Last Cut Appt To Do List Template tp eT EM Figure 5 1 Appointment Scheduler Window E 2 E 3 ih a The Menu Bar is located at the top of the window and includes functions to produce reports search for appointments get help and change configuration settings O The Schedule Date located at the upper left corresponds with the current displayed schedule OQ The Appointment Grid shows all appointments for the schedule date and the Profile specified Each column in the grid corresponds with a doctor or room being scheduled When an appointment is scheduled the patient s name an optional additional information appears and the corresponding grid cells are shaded Refer to Section 4 5 Configuring the Appointment Scheduler 5 1 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler The Calendar is used to select the active Schedule Date You can click on the Today button to go to the current calendar day You can also use the arrows at the top of the calendar as well as the month and year to advance or back up through time The Profile Buttons let you select from among various pre defined combinations of doctors and
32. 5 5 Appointment Scheduler Appointment Info Window 8 Use the pull down menus or type the information necessary to complete the Appointment Info window and press OK The appointment is now booked Claimstronic PMS User s Manual 5 6 Version 5 1 4 May 19 2001 Using the Appointment Scheduler 9 Claimstronic PMS keeps track of appointment information for various statistical reports From the At Time of App t tab identify the patient as arrived cancelled or no show Indicating the Check In and Check Out time provides a valuable tool to evaluate time efficiency First Hame LINDA Date 06 05 00 Last Name WILSON Time 08 00 AM Check In Time Ja 05 Wj ex 2 15 PM Patient Room In Time e 15 mv Check Qut Time 8 40 e C Concallation C No Show OK Cancel Figure 5 6 Appointment Scheduler At Time of App t Window Appointment Scheduler Data Items Data Description Patient Tab Displays a patient s account number Accounts can also be accessed directly by entering an account number here Press the l button to perform a search for a specific account Patient Eligibility Use the radio buttons to indicate whether the Verified patient has an insurance policy eligible for services rendered Print File Label Use this button to print the patient s chart label Appointment Info Tab The date of the patient s appointment Click on the button to display a list of available dates Must b
33. 5 Begign Neoplasn 428 0 Congestive Hear 25 0 Family Planning 401 0 Hypertension Un 15 00 15 00 Co pay DELL EU HERE LEO ENN 100I IANI DELEULTETTTE ETHER DET IONI DELETE EET TREO DEBET MANIA WIEN EH THU TOQUE FULL LLL UL ALI ANII IONI 611 7 Breast Mass 564 0 Constipation 780 7 Fatigue nd Male 242 9 Hyperthyroidism 20 00 20 00 Co pay LETT ED DUIO OOII DL FALL PARU LLL AL UI ABRE UT UT TULLE UNT UR 466 0 Bronchitis acute 496 Copd 780 6 Fever pyrexia 244 9 Hypothyroidism Vig hrs rra aa erac goes ALL OODUA EI LAU 90 Bronchitits Nos Cough Fungus Infection 463 Tonsillitis FULL LUI UIDI LU THE LOT IONI EULLI EU LLL UL LE HN IU HEUTE T RM DUUUEU UE LUEUT DODII PE IANI 727 3 Bursitis 436 Cva 558 9 Gastroenteritis 474 0 Tonsillitis Hypertrophic CPT4 EW PATIE EUBLLE HELLE TUI LIA IANI FUEL LUE LE IIIA ORINA LT LOT DULULURLUEULULEUETEU DT LITT I DULULTDLURETL 100I OII ULT I 99215 Level Five 29392 Well 1 4 Yr 44617 Nebulizer Mouth 17250 Umbil Cauteriz ALLE ORIOA ULL LU IURI LUE UONI ALLE VD UL DUE LUI LUI DLE HEALTH ETE ULT 99201 Level One REVENTIVE NEW 99393 Well 5 11 Yr PECIAL SERVICE 17000 Wart Rem sngl U im Perna rrr sett Soper Ph Lerner enirn Wan pes rne Level Two Well 0 1 Y 394 Well 12 17yr 99050 After Hours 17003 Wart Rem 2nd 14 DE ELLE EH BRETT NIINI DE ELLE ELLE ERIT E BOUT DELETE ELE ERI E EE BU LE DELL LETTER ET LT I DELETE HET ELTE RETI 29203 Level Three 99382 Well 1 4 Yr 99395 Well 18yr 99058 Office Emergenc 17004 Wart Rem 15 Up ALIE VEO VE
34. 59 11 34 59 EDT 137 44 D 3430 Batch 4472 Confi view Claims by Patient Name eae 2001 Kb 4 View Edit Claim by Trace No TE C RN fees 10 18 35 EDT Figure 9 21 Manage Claims Menu View Errored Claims Option 8 This will access all claims that did not pass the editing process at FreeClaims com Click on the claim line A HCFA form will appear and will list the error within the claim 4 FreeClaims com Completely Free Online Medical Claims Clearinghouse MII EG Eile Edit View Favorites Tools Help Errors from this claim Facility needed for this PlaceOfService Data 21 HEALTH INSURANCE CLAIM FORM Reset Cancel Ignore and Clear from Error List SUBMITTERID 3430 PAYOR S NAME MEDICARE PAYOR S ADDRESS 4474 nnn nnn nnnn P o Box 44117 Zip Code format nnnnn or nnnnn nnnn CITY STATE ZIP Charge Amount format DACKSONVILLE FL 3223 al m gt 4 122145579 ne 1214565792 12 e Done eS Internet 4 Figure 9 22 Health Insurance Claim Form Window PAYOR S I D FLMCR ADDRESS line2 Date format mm dd yyyy BATCH HO Phone format TRACE NO 9 Make the appropriate corrections and choose the Submit button to send the claim to the payor 10 If this claim is not to be sent to the payor click on the Ignore and Clear from Error List to remove the claim as pending 9 12 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 11 I2 13 Insurance and Billin
35. 89203 LEVEL FOUR 99204 ARTHRITIS LOWER LEG AND KNEE 7 1965 8 LEVEL FIVE 99205 ASTHMA ACUTE 493 9 Established Patient Number Of Column Number Of Column E T Font Size Jos v Font Size Show Values T RUE Show Values Print Seperate Page for ICDS and CPT4 TRUE Figure 4 39 Mange Routing Sheet Template 5 Replace the existing text in the Heading field with your practice or provider demographic information as well as the tax identification number 6 To delete an item from the ICD9 or CPT4 column simply highlight the item and hit the Delete key on your keyboard Claimstronic PMS Users Manual SSS 438 Version 5 1 4 May 19 2001 System Setup and Customization ils To add an item to the ICD9 or CPT4 column place your cursor at the end of the item preceding where the new entry will be added 8 Hit you enter key this will create a blank line item field 9 At the blinking cursor type in a brief description of the diagnosis or the procedure you are adding 10 Without using the spacebar follow the entry immediately with the tilde symbol and then the appropriate code for the entry 11 Determine the remaining values for the Routing Sheet e Choose between the numbers one through five on the Number of Column field to define the number of rows for the ICD9 and CPT4 information on the Routing Sheet e You may vary the size of the font by selecting one of the three options from the drop down box in the Fon
36. C Mo will restart my computer later Remove any disks from their drives and then click Finish ta complete setup lt Beck Click Finish to restart your computer Note After restarting your computer previously installed components will no longer be grayed out Do not reinstall these components Claimstronic PMS User s Manual 2 26 Version 5 1 4 May 19 2001 Software Installation 2 2 4 Microsoft Data Access Component l Accept the license agreement by clicking a check mark in the box click Next to continue with setup Microsoft Data Access Components 2 5 Setup 2 Click next to begin installation Microsoft Data Access Components 2 5 Setup Claimstronic PMS User s Manual 2 27 Version 5 1 4 May 19 2001 Software Installation 3 If this window is displayed click Finish to restart your computer Microsoft Data Access Components 27 5 Setup Ea Restarting the System The system will need to be restarted before Microsoft Data Access Components 2 5 will operate correctly Setup can restart the system for you or you can manually restart il Click Finish to continue C Let me restart the system later 4 Hack Cancel 2 2 5 Claimstronic Practice Management System Component L Select Claimstronic Practice Management System from menu by left clicking on the component For proper installation please click on each component in the to p d own order Support Information C
37. Cin D Tum Ammuxlm Bere j BE EDITUM TAT 0 00 Agung Shasi Ere wee Figure 6 9 Patient Guarantor Window Transaction Window 4 After you select an account the Roll Back button becomes activated Click on this button or Alt R This will lead you to the Check Payment Detail window a nage Det aii SP ETETE EROH Ledges e WPEILL I LR saint Dale Urta Bj Pug IE Leda PIE LM m HAMILTON TESTO 007756 15 00 Pasmant Allocations For Foi Selected 1 Transaction Metal Dela Cine odd 5 ale Emari Type ICP JC Descipliern E Jiao m Dac 137710 122533 Para HSPA quus i OFF CE VISIT Lin LEIN discat mare cries Ep Rolling Back detale ragasa you bo mmadiately re ellocte Medora elei Fondi Sarde Detal Hol becky He undis oH care dem Figure 8 10 Check Payment Detail Window 5 The Check Payment Detail window shows three levels of information regarding the selected account e Level One Check Information Ledger Displays detailed Claimstronic PMS User s Manual 8 9 Version 5 1 4 May 19 2001 Payment and Adjustment Entry information regarding the check Choosing the Check Roll Back function at this level will permanently remove the check information as well as any claim transactions associated with the payment from the patient accounts Deposit Slip Report and Journal Report Claimstronic PMS again recommends performing this f
38. Claim Process EMC Claims Deposit Slip Report Journal Report Figure 9 1 EndOfDay Menu Process Paper Claim Option 2 The Print HCFA window lists all accounts that have been prompted to print claims to paper From the Print HCFA window do any of the following Claimstronic PMS User s Manual 9 Version 5 1 4 May 19 2001 Insurance and Billing FiDOS Paid Adjusted Balanced 412 01 4 12 01 A 0 00 0 00 45 00 414 01 4 14701 i 0 00 0 00 65 00 4 3 01 4 3 01 9500 5 00 0 00 90 00 4 14 01 4 14 01 A HFHP 10000 0 00 0 00 100 00 a a View HCFA Flag HCFA ReFlag HCFA Print HCFA Cancel Print Print HCFA Print Armes PrintL ist ves cra PrintL ist PrintList Grid Job Close Provider Resume printing at ode claim number Figure 9 2 Print HCFA Window HCFA Window Data Descriptions Print HCFA This option will allow you to print an individual claim form after selecting an account from the list Print All HCFAs This option prints all claims listed View HCFA After all HCFAs have been successfully printed Printlist choose this option to receive a listing of all claims that were produced View HCFA This option allows a view of the actual layout of the HFCA form of the selected account prior to printing Flag HCFA This option updates the billing status codes refer to Printlist Section 7 2 Entering A New Claim Manually Reflag HCFA This optio
39. Claimstronic PMS User sManuals i sSsSSSSS 2l Version 5 1 4 May 19 2001 System Setup and Customization XctwinNdataF acility mkd 2 BJ XJ Fac Code THE Mamt LITTLETOWN PEDIATRICS Address i23 MAIN STREET Address suITE2000 City VIENNA sits State va Zip 223180 Phone 222 222 2222 Fax a EMal Contact Mame ELIZABETH FRANK wnt en ot per ea n Facility Id Table FacCode nsCode InsType Facilityld Eq Figure 4 21 Add Edit Facility Data Window Note Do not forget the carrier specific information needed in the lower table FACILITY ID TABLE DATA ITEMS FAC CODE The code assigned to the facility that the physician will use to treat the patient INS CODE Duplicate of the INS CODE assigned in the Insurance Table INS TYPE Designates the insurance type commercial Medicare etc FACILITY ID The unique identification number assigned by the payor for this facility Claimstronic PMS User s Manual 4 22 Version 5 1 4 May 19 2001 System Setup and Customization 4 4 3 Practice Information The following window appears when you select Practice Info from the Maintenance Menu pull down list Practice Table m User Defined Code X Change Index PracCode OrgName Addr ddr ity O eee gt p ABC CLINIC Add Edit Delete Print KIKI File Maintenance gt CI Close Figure 4 22 Practice Table Screen To customize the Practice Data
40. Create or Edit patient notes b Create or Edit patient s case management file 4 Enter all necessary data and click OK or Alt O to save your changes Claimstronic PMS User s Manual 6 3 Version 5 1 4 May 19 2001 Entering Patient Information Patient Guarantor Information Window Account zz Last First Name is EE MID Sufix Guarantor T Addessi 7 000000 Status FFF NickName Lie Address 2 oO Show Quick Note City State Zip p 6o eot Sex BihDae HomeTe HFrex Marital ssN WwokTe wa Employed Driverlic SSS Et Emil aaa Provider Assign Benefit 7 yos No Practice o O SSS Info Release v ic Bep oss IfoReleaseDae Ref Source Print Statementto Guarantor 7 Yes No Charge Balance Ss Patient Responsible Payment A Deposit EE Insurance Responsible Adjustment SS On Hold Amount Patient Info Dependent Account Employer Account tc lt gor aoo oe feno gt gt vo X cos RP cose Figure 6 4 Patient Guarantor Information Window 6 2 2 Adding a New Patient Account After choosing the Add option select from one of the following account types e Guarantor Account The account that is financially responsible and or the guardian of a child This account must be created first before you can add a dependent e Dependent Account The account to be added to a guarantor or employer account Note that when choosing this option the account th
41. End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figurel0 14 Reports Menu Print Patient Demographic Labels Option 2 From the Patient Demographic Data Confirmation window specify the appointment date and the provider of service You may choose to print only the demographics page or the chart labels You can also choose to print both m Patient Demographic Data Confirmation Sheet February 2001 Appointment Date Provider Mo 07 BROWN DAVE 20 29 yu o uH 4 5 SB 7 B 93 10 11 12 13 14 15 16 1 18 18 20 4 2 23 4 Print Patient Demographic page Z3 5 UU eo Wl x s 4 5 amp 7 8 9 10 Print Seiko Chart Label 9 Today 4 14 01 This module prints a patient demographic form for each patient in the appointment book if an account number exits Ifthe account number i not found this module will consider that this i a new patient and will skip this entry W Let me edit the list before printing Print Cancel Figurel0 15 Patient Demographic Data Confirmation Window Claimstronic PMS User s Manual 10 10 Version 5 1 4 May 19 2001 Producing System Reports 3 If you have selected to Let me edit the list before printing option a window will appear with instructions on how to select or deselect an account Figure 10 16 Include Exclude Data to Process Windo
42. For an existing patient click on the magnifying glass next to the Account field to search for the patient s account Note If you chose for Claimstronic PMS to create an account within the appointment scheduler failure to provide an account number for an existing patient will result in a duplicate account being made 54 Using the Appointment Scheduler Patient Search Ea Search for Last Name Search Results double click patient to select Account Last Name FirstName Mi Sex m M Date r TRIER EROM DAVID S555 553 111411 CODO SMITH JOHN 332232920 2 22 E 555555555 1 15 000003 BROWN n00004 WILSON Cancel Figure 5 4 Patient Search Dialog Box 5 You can search by last name Social Security Number or Account number Click to highlight the desired record and double click to copy the patient s account information into the Patient Information window For more information on the Patient Information window refer to Section 3 2 The Patient Guarantor Information Window 6 For a new patient simply enter the patient s data directly into the Patient Info window This information 1s then utilized to book the appointment and create a temporary patient account Claimstronic PMS User s Manual 5 5 Version 5 1 4 May 19 2001 Using the Appointment Scheduler T Click on the Appointment Info tab Appointment ET a struction CHOLESTEROL LIVER FUNCTION Figure
43. PM To 4 1401 Number of Pages 3 Fage 1 Account Guarantor ClaimNo Patient Name Stamped Date Serviced Date Trans Type SubType Amount Paying InsCode Insurance Name Ins1 Ins2 Ins3 Status 000008 000003 1 DEBBIE GIORGIO 4 3 01 4 3 01 CLAIM 95 00 DDDA 000002 000003 2 JACK YOUNG 4 3 01 4 3 01 CLAIM 65 00 DDDD 000008 000003 3 DEBBIE GIORGIO 4 3 01 4 3 01 CLAIM 95 00 BCBSO1 BLUECROSS AND BLUE BCBSO1 BCBSO1 PDDA 000008 000003 3 DEBBIE GIORGIO 4 3 01 4 3 01 ges KEE piaj gt Figure 10 4 Sample Journal Report Claimstronic PMS User s Manual 10 3 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 10 1 2 Producing System Reports Printing a Deposit Slip Report Follow these steps to print a report that automatically totals the day s checks cash and coin for making the bank deposit It also provides a separate total of all electronic transactions This allows you a full view of the daily deposit and allows an easy method for reconciling bank statements l From the Claimstronic PMS menu bar click on EndofDay and select Deposit Slip Report File Appointment Fatient Billing EndOfDay Reports Maintenance View Help Far Process Paper Claim Process EME Claims Deposit Slip Report Journal Report 2 Figure 10 5 End Of Day Menu Deposit Slip Report Specify the user and the date range The system will automatically calculate the deposit amount Print the report S CLA
44. Report for instructions on producing these reports Entering Adjustment Information From the Claimstronic PMS menu bar click on Patient Billing then on Payment or click on the Payment icon 3 from the toolbar When the Payment window appears select the account that you want to post a payment or adjustment refer to Section 6 2 Finding an Existing Patient for instructions Fields that are underlined are required data Claimstronic PMS will not save your entry until the fields have been completed Click on the Adjustment Only field 8 5 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Payment and Adjustment Entry Payment X Account Fe 000004 TA T S Mont o a All Claims medici sh ea E Claim Bal gt 0 Date 4 26 01 Amount 0 00 Expired Date Payment Type CHECK Remain 0 00 Authorization ID Payor J Close Account Guaranto Claim tt StpDate FirstDOS Ins 1 Ins 2 111213 G Dr Allowable Charged Paid_ _ Adjusted Balanced I 000004 O00004 25 4 24 01 4 24 01 BCB10C D D D Aj 01 320 00 145 00 10 00 165 00 Pay Claim Print HCFA Print Superbill Print Statement Edit Notes Figure 8 5 Payment Window Adjustment Only Option 4 Verify the claim that the cursor is on 1s the claim that you are applying the adjustment and hit enter If not with the arrow keys scroll to the correct claim and hit enter 5 Enter the
45. Server field will automatically default to the name of the computer system that Claimstronic is being installed on For example if the name of your computer system is DDOO1 then the name of the Server shown in the screen below will be DDO001 Create Database Wizard for Peryasive SQL 2000 Choose a server to connect You can select a server in which You want to create a database To begin with creating database you must specify a Pervasive SOL server and database interface type Server Interface Engine 7 User name Password Click Next to continue Specify database information Create Database Wizard for Pervasive S0L 2000 E 4 X Specify database information S Enter the name of the new database and its directory location M ame ctwinBOT Directory Jo ctwinkdata E Use DEM ANSI Conversion v Use advanced settings Select advanced settings to specify the following options otherwise default values will be applied Internal database name Data file and dictionary file location s Data Source options Back Cancel a For Name type ctwin001 b For Directory type cActwin data C Click Use advanced settings Click Next to continue 2 37 Software Installation 5 Specify advanced database options Create Database Wizard for Pervasive SQL 2000 Specify advanced database options Set database properties and select or
46. Statistics Ledger Report Patient Procedure Financial History DODD Claims with Balance gt 0 Statement Evaluation Management EIM Procedure Line Report Immunization History Report Patients with Selected Insurance Appeal Claim Report Print Patient Demographic Labels Figure 10 45 Reports Menu Immunization history Report 10 3 7 Patient with Selected Insurance s CLAIMSTRONIC DEMODATA Hew Patient Reser Patient Report Aging Report Month Year Up To Date Tickler Report End OF Month Statistics Ledger Report Patient Procedure Financial History DDDD Claims with Balance gt 0 Statement Evaluation Management EIM Procedure Line Report Immunization History Report Patients with Selected Insurance Appeal Claim Report Print Patient Demographic Labels Figure 10 46 Reports Menu Patients with selected Insurance Claimstronic PMS User s Manual 10 36 Version 5 1 4 May 19 2001
47. The Change Index button will re sort the records in the table based on the category heading you specify Note It does not re order the columns Q The Delete button will remove the highlighted record Note Use the Delete button cautiously you can t restore or undo 3 6 Navigating the Claimstronic PMS Software Q The Print button will print out the table contents Q The Add and Edit buttons present identically formatted windows with a different view of the record s data For the Add window shown below the entry fields will be blank In the Edit window you can change or overwrite the information in the entry fields cctwinidata F acility mkd Fac Code BEEN Mame ee Address Addess City O State zip sd Phone Fax EE ELEM Contact Mame vn en rn per ma nn Facility Id Table _ FacCode InsCode InsType Facilityld ENS md Figure 3 4 Add Edit Window Q Function and navigation buttons specific to these windows which appear on every Add Edit window for all of the Maintenance windows are e Update commits the changes you made while in the window e Eyit closes without committing your changes e First finds and highlights the first record in the table e Previous finds and highlights the previous record in the file e Next finds and highlights the next record in the table e Last finds and highlights the last record in the table Claims
48. Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 4 Producing System Reports Click on New This will open the Account Claim Notes window a CLAIMNSTRONIC Account Claim Notes 10 11 ADD NEW CLAIM NOTE Account nooo Alarm Date 4779 01 Claim Number Created Date 4712701 User ID ETSE Statement Flag C ves No Note PATIENT TO MAKE ADDITIONAL PAYMENT NEXT WEEK Add X Cancel ETI Llose Figure 7 14 Account Claim Notes Window Claimstronic PMS automatically assigns the account number the claim number that the note 1s attached to the user creating the note and the date the note was created Type your note in the Note section of the window Assign the Alarm Date follow up date This will drop the note to the Tickler Report refer to Section 10 Tickler Report If you want this note to print on the patient s statement select yes in the Statement Flag box Claimstronic PMS defaults to no To commit your entries click on Add or Alt A To disregard your entry click on Cancel Click on the Close button x to close the window 7 16 Producing System Reports 7 5 Printing a SuperBill and Patient Statement A SuperBill is a slip receipt issued to the patients after the visit is complete and a claim created This slip is generated based on the information specified by the doctor in the Routing sheet The SuperBill can be used to submit to the pat
49. Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports e S Sent The file has been sent to the appropriate clearinghouse e T Printed The file has been successfully printed and ready for delivery to the payor e D Done The claim has been paid e H Hold Temporarily holds the processing of the claim e G Statement to Gua Refers to Gua specific claims e C Statement to PAT Refers to PAT specific claims e lt A Active This code is valid only for Guarantor s Balance It signifies that the guarantor still has a balance 10 After making your selection click on Close Billing Status D x E ELECTRONIC PAPER Cattode CatDescription 0000000000 gt E S SENT PRINTED D DONE H HOLD G Statement to Gua Statement To PAT ACTIVE Close Figure 7 17 Billing Status Window 11 To check if the claims gets submitted electronically and if the insurance payor accepts electronic file or paper form a From the Claimstronic PMS menu bar click on Maintenance and select Insurance Code This will lead you to the Insurance Table screen 7 19 Producing System Reports E STFRM 5tata Farm Ins EN sT Man st TRIGON 109 Figure 7 18 Insurance Table Screen b From the Insurance Table Screen select the insurance company and click on Edit c ctwinidataulnsFile mkd Fig
50. ae E Zoom 100 AGING REPORT ABC CLINIC Responsible Party Insurance Doctor DAVE BROWN em i isi SINT TuE Date Tuesday April 17 2001 Sort by Balance Pages 1 ACCOUNT DR NAME STP DATE DOS 0 30 31 60 61 90 91 120 121 STATUS INS CODES DIAGNOSIS CODES PROCEDURE CODES ooo00s 01 DEBBIE GIORGIO 4n 2701 4n 2701 187 00 EDDA BCBSO1 008 8 99214 73510 000008 01 DEBBIE GIORGIO 4 3 01 4 3 01 140 00 PDDA BCBS 1 008 8 99215 000008 01 DEBBIE GIORGIO 4 1 2 01 4n 2701 100 00 EDDA BCBS 01 008 8 99203 PATIENT TO MAKE ADDITIONAL PAYMENT NEXT WEEK 000008 01 DEBBIE GIORGIO 4 14 01 4 14 01 100 00 PHDA HFHP BCBS01 008 8 99203 000008 01 DEBBIE GIORGIO 4 12 01 41 2 01 95 00 EHDA HFHP BCBS01 008 8 99214 ooo00s 01 DEBBIE GIORGIO 413101 413101 90 00 PDDA BCBS T BCBS01 008 8 99214 Pages MK 4 fi 9 Figure 10 22 Sample of Generated Aging Report 10 After checking the report click on the Print icon dah to proceed with the printing If you want to save the report as a file click on the Export icon E and specify the filename in the Export dialog box 10 17 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports Save irr x My Documents File name Save as type HTML htm html Cancel C Pages from ta Figure 10 23 Export Dialog box 11 When printing is done click on the Close button x to close the preview window 12 Click on Close to exit the Aging Re
51. ay 8 9 10 11 12 Wee 14 09 30 AM 15 eTE9 17 18 19 20 21 10 00 AM 22 23 24 25 26 27 28 299 30 1 2 3 4 amp 5 TIED TM n Today 4 16 01 11 30 AM Appointment Detail 12 00 PM Lunch Patient Sex 12 30 PM Birth Date 01 00 PM Hame Phone 01 30 PM Work Phone Phusician al p hd Diagnosis Default J5 Last Cut Appt To Do List Template Moo AHB D M Figure 3 6 Appointment Scheduler Window Claimstronic PMS User s Manual 3 9 Version 5 1 4 May 19 2001 Navigating the Claimstronic PMS Software 3 6 Claimstronic PMS Keyboard Shortcuts Will access the HELP section Will allow you to SEARCH within a field Will take you to the EDIT area of the maintenance window Will CLEAR the field Will SAVE an entry ALT TAB Will switch you between open windows within different programs ex Patient Demographic Window and Appointment Scheduler CTRL TAB Will switch you between open windows within the same program ex Patient Demographic Window Quick Notes and Pre Copay List ALT Will perform the function indicated within the window Ex Alt E EDIT in the Patient UNDERLINED Demographic Window will open the account for LETTER editing HOME Will return the cursor to Patient Account field SHIFT TAB Will take you back to the previous field TAB Will advance you through the fields without saving any entries made ENTER Will advance you through the fields and save the entries made Claimstronic PMS User
52. create an internal database name How do you want to describe the new database Description E ES EERRI B S ot ge a geld eet Do you want to create a system or user DSM DSN Type System e Which open made da you want ta use Far the connection call DSN Open Made Normal To which internal database name do you want the database linked Database name CTDBOO Create Back Cancel Click Next to continue 6 Click Finish to complete installation Create Database Wizard For Pervasive SQL 2000 Completing Create Database Wizard fou have successtully completed the steps required to create a new database The new database will be created as defined below Database name ctzys Linked to internal database name ctdbO01 Data Source interface type Engine Data Source type System Data Source Open Mode Normal Data dictionary file location c elwin sdata Data file locationis k Back Cancel Claimstronic PMS User s Manual 2 38 Version 5 1 4 May 19 2001 Software Installation 7 Click Close Create Database Wizard for Pervasive SQOL 2000 E X A Completing Create Database Wizard Database cteps successfully created ces 2 2 9 Microsoft HTML Help L Click on Microsoft HTML Help This program will update your computer enabling you to view the help files in your web browser For proper installation pl
53. for the connection call DSM Open Made Normal To which internal database name do you want the database linked Database name DEMODATA Create Back Cancel Click Create to continue Enter the database name Create Database Name for Pervasive S0L 7000 Database name ctabom v Integrity enforced Bound DDF created Cancel Dictionary location csetwinkdata Data file locations X coy chwin data Change database name to ctdb001 Click OR Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 T Software Installation Click Next to continue Create Database Wizard for Pervasive S0L 27000 Specify advanced database options Set database properties and select or create an internal database name How do vau want to describe the new database Description Fervasive ODBC Engine Interface Do You want to create a system or user DSN DSN Type System rm Which open mode da you want to use for the connection call DSW Open Made Normal To which internal database name do vou want the database linked Database name Erben Back M est gt Cancel 2 12 Software Installation 8 Click Finish to complete installation Create Database Wizard for Pervasive SL 7000 Completing Create Database Wizard Tou have successful
54. melolo Figure 3 1 Claimstronic PMS Main Window The main system functions are accessed via the menu pull down lists or the shortcut icons on the toolbar Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 3 1 1 Menu Bar Navigating the Claimstronic PMS Software The Claimstronic PMS menu bar includes the following options File Appointment Patient Billing End Of Day Reports Maintenance Tools View Help Lets you select printers modify system configuration and exit the application Gets you into the Appointment Scheduler Lets you select the data entry windows for Patient information Payment information and the Payment Ledger Offers windows to Process Paper Claims Process Electronic Media Claims EMC produce a Journal Reports and perform a Ledger search by check number Lets you select from a number of reports the system can generate Provides direct access to the internal data tables Provides direct access to the routing sheet superbill Lets you turn the tool bar on or off It also lets you turn on or off the status bar at the bottom of the window that shows which Practice file you are working in along with the date and time Presents a list of topics pertaining to Claimstronic PMS usage for which online documentation is available 3 2 3 1 2 Toolbar Navigating the Claimstronic PMS Software The Claimstronic PMS toolbar consists of the following icons
55. policy this s considered as his secondary insurance To enter the information regarding the secondary insurance policy insurance click on the Secondary Insured tab and then do steps 2 and 3 5 If there is a tertiary insurance policy click on the Tertiary Insure d tab then do steps 2 and 3 6 Click on OK to commit your entries then click on Close to exit the window 7 If the patient s insurance changes Claimstronic recommends that you add the new insurance to the account as well as keeping the old insurance on file The new insurance will default as the active carrier You can also determine who the active carrier is for the patient by referring to the Current Insured Info section on the Patient Guarantor Information Window Claimstronic PMS User s Manul CCC OG Version 5 1 4 May 19 2001 Entering Patient Information 6 4 Changing Default Insurance Active Order You can change the default insurance active order in the Patient Guarantor window Primary Secondary and Tertiary Insured pages To make the insurance active order changes Q If you have only one entry in each Insured page 1 From the Patient Guarantor Information window select desired account to check Refer to Section 6 2 Finding an Existing Patient for instructions 2 Click on e Primary Insured to change the main insurance policy information e Secondary Insured to change the secondary insurance policy information e Terti
56. provided to the insured individual Claimstronic PMS UsersManual 68 Version 5 1 4 May 19 2001 Entering Patient Information Table Insurance Information Data Items Dea Deseription Effective Date The date on which the patient s insurance policy becomes effective Must be entered as MM DD YYYY i e 12 10 1962 Termination The date on which the patient s insurance policy is Date terminated Must be entered as MM DD Y Y Y Y i e 12 10 1962 Co pay Amt The dollar amount the insured is responsible for at the time of visit Deductible The dollar amount that must be paid by the insured before Amt benefits become payable Percent The coverage percentage that your insurance states it will Coverage pay for allowed charges 80 3 Enter all required data regarding the guarantor s insurance policy For the Primary Insured page you must enter the information on the main insurance policy Note For those fields proceeded by a button with an ellipsis if click on the button or press F2 to see a pull down list or a window containing a list of options available for the selected field Select the desired option from the list To edit an entry in a field proceeded by a button with an ellipsis 2 simply press F3 This will lead you to the Add Edit window available for the selected field From this window you can add a new entry or make your modifications 4 If the guarantor has another insurance
57. representations or warranties either expressed or implied with respect to the contents hereof and specifically disclaims the implied warranties of merchantability or fitness for a particular purpose TABLE OF CONTENTS L Introduction to Claimstronic PMS 1 1 E Intended Audience osos caer steteer cc cutienetincansemevectaceatunenaumccatinetdecent 1 1 1 25 DV SICH OV AUS TT 1 1 1 3 Usine this Manual us eas scanecccearoncensdent a 1 2 zs Installation of Claimstronic Practice Management Systen2 1 2 41 Installation Process for Windows NT 2000 Professional 2 2 4 4 System IROGBHUETDPIES accimascassctsiiecnianieaasexsicnntmunianascesibecsssasmess 2 2 1 2 Pervasive Workgroup Enigine Component 2 2 1 3 Claimstronic Practice Management System Component 2 6 2 1 4 Microsoft Data Engine Component sess 2 8 2 1 5 Database Setup Component uie na SER Eu abr plata dabo bad 2 9 LLD Create a Second LIRIAS eG Le east he penkelicuan ta bee tPYI Eia tu iUt 2 4 c1 Caine Your User ACC cts 2 18 22 Installation Process for Windows 98 ccccccceessseeseeeeeees 2 19 2 241 System CU IES esie dieaad uni BatuR o Hoo RRE FERA IMP RERER ODE Bo av Edid 2 9 2 2 2 Microsoft DCom for Windows 95 98 sss 2 9 2 2 3 Pervasive Workgroup Enigine Component 2 21 2 2 4 Microsoft Data Access Component
58. s Manual 3 10 Version 5 1 4 May 19 2001 System Setup and Customization 4 System Setup and Customization Initial setup requires identifying the users of the system setting up databases for the individual practices you support as well as the physicians and facilities associated with each practice Several of the system s data tables come pre loaded for your convenience However you may add delete or modify items to the data tables to customize your system Once the initial set up is complete information can be added changed or deleted as required by day to day business operations 4 1 System Configuration The System Configuration table stores defaults for different areas of the program that will assist you during data entry To begin the system setup click on File from the task Claimstronic PMS menu bar and then choose Options The following window will appear Options System Startup Folder CNETWIN 000000 V HCFAPIn Preview Racked Tare Fa Seea Routing Sheet B m podias C sot Video Camera Quick Note On Cancel Apel Figure 4 1 Options Menu System Tab 4 1 1 System Tab a Startup Folder This determines from which drive your data is stored and retrieved This is determined during installation b HCFA Print Preview Check this if you want to view your HCFA forms prior to printing and or submitting electronically c Routing Sheet Bar Code Check this if you have chosen to utilize the Bar Cod
59. select Statement This will lead you to the Statement Report window CLAIMSTRONIC DEMODATA File Appointment Patient Biling EndofDay Reports Maintenance Tools View Help Mew Patient Report Patient Report Aging Report Manth rear Up To Date Ticker Report End Of Manth Statistics Ledger Report Patient Procedure Financial History DODD Claims with Balance gt 0 Statement Evaluation Management EJM Procedure Line Report Immunization History Report Patients with Selected Insurance Appeal Claim Report Print Patient Demographic Labels Figure 9 23 Reports Menu Statement Option 2 From the Statement Report window specify your parameters for the billing run to prepare your statements 9 14 Insurance and Billing CLAIMS TRONEIC DEMODATA E loj xl Pils Appoin trent Patent filing Endolbs Reports Maintenance Took Wee Heb Safe nee WIHPT5 Statement Report Statements Order by Petent Simus Types m C Hane C Zp T Dnver Lip Inda f Aging Method Aging Period hacsegas mie o 30 Include Messaqe i Stamped ces HG te Inzurance Corners Mo Jeice dee B a P Ye Include P Senda Loc Mis Ede 2s ore Billing Insuranca Types Provider 01 xj os mH MW eue ol Min Esame Tm Pau Fnnt Options Fencing Hamr Zero Belence Clum s Niobe Skhpireurance pending claims Tee
60. system comes with an automatic installation utility pre loaded databases with diagnosis codes procedure codes and city state zip address codes and for users of the previous MS DOS version of Claimstronic PMS a database conversion utility 1 3 Using this Manual We recommend you review this manual from beginning to end to become familiar with how the Claimstronic PMS software is used We have organized the manual according to how the system is used Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Introduction to Claimstronic PMS Gives you an overview of this user s manual and a brief introduction on Claimstronic PMS Software Installation Describes how to install Claimstronic PMS create a User Account for login and access Navigating the Claimstronic PMS Software Describes the functions of each menu and buttons found in the Claimstronic PMS main screen This will guide you in navigating through the software System Setup and Customization Tells you how to customize Claimstronic PMS according to your preferences It also gives instructions on how to create and load entries into the database tables Using the Appointment Scheduler Gives an overview of the features of the scheduler followed by a compete discussion of all the ways the scheduler can be customized to suit your office operations It also contains step by step instructions on how to create a new appointment view or edit an appomtment move an appointment
61. 0 02 30 PM m Default J5 Last Cut Appt Appt Detail teplte o Ry BP Figure 5 7 Highlighting an Appointment Claimstronic PMS User s Manual 5 0 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Schedu 2 Right click to get a pop up menu Position the highlight over Cut Appointment and click Open Appointment New Appointment Cut Appointment Paste Appointment Tati Sheet Change Fort Figure 5 8 Selecting the Cut Appointment Option 3 Use the calendar to bring up an appointment grid for the desired date Highlight the cell with the desired time and right click again to get the pop up menu Position the highlight bar over Paste Appointment and click on it Appointment Scheduler File Search Reports Settings Help Monday April 23 2001 M Show Complaints ler bar Sun Mon Tue Wed Thu ah pedes MA aiu oS scd o ee D 12 00 PM 12345 8 939 10 11 12 C O O O O TEn OLOO PM 00 22 GD 4 5 2 0130 PM E 22 30 1 2 3 0 08 2 C pe Open Appointment Cut Appointment Faste Appointment m oning fs eal Default J5 Template 3 23 07 4 20 PM Z Figure 5 9 Selecting Paste Appointment The appointment and all associated information will have been moved to new time 5 5 Deleting an Appointment the To delete an appointment highlight the appointment on the grid right click and select Cut Appoi
62. 0 Expired Date Payment Type CHECK Remain 0 00 Authorization l iD Payor sf Close i Ee ee eS a e E C NN Balanced 000004 000004 26 6 01 4 265 01 BCB10C DIDIDIA O1 95 00 95 00 3 00 0 00 000004 D D D A O1 320 00 172 00 Pay Claim Print HCFA Print Superbill Print Statement Edit Notes Claims Claim s Procedures Claim s Notes Figure 7 10 Payment Window 3 Utilizing the tab key to advance through the fields enter the payment type and payment amount Claimstronic PMS will automatically fill in the payor information 4 Verify the claim that the cursor is on is the claim that you are applying the payment and hit enter If not with the arrow keys scroll to the correct claim and hit enter 3 Choose the correct payor making the payment on the account from the Claims Payor List Producing System Reports a WINPMS Claim s Payor List Figure 7 11 Claims Payor List 6 Enter the payment amount into the C Pay column If you are not posting an adjustment click Okay or Alt O to save the payment e Claimstronic PMS keeps a running tally of the amount posted to each line item in the Payment box found on the left side of the payment screen 7 If you are entering an adjustment in addition to the payment enter the adjustment amount in C Adj column Enter the appropriate adjustment code by manually entering the code number or by utilizing the drop down b
63. 2001 Software Installation Select Installation Directory X Please enter the installation directory for Pervasive SUL 2000 PEI ASN E Click Next to use the Default Destination Director click Browse FTWA to change the default directory Destination Folder CAPAC A Browse Back Cancel You may accept the default by clicking Next or click the browse button to re direct the installation of the directory 7 Pervasive SQL 2000 Data Engine will be automatically installed This make take up to two minutes Do not proceed until the screen in Step 8 appears 8 To continue installation click Next 32 bit Btrieve Functionality Check X PSPV NSIS The Transactional interface is now installed short test 30 seconds will AWE TS be performed to ensure that these new interfaces are communicating az expected This test iz strongly recommended however yog may click Skip if you wish For the Transactional test please select the Samples directory on the server eri where your database engine is installed Server Path CAP Sw samples Browse Help Back i M Skip Claimstronic PMS User s Manual 2 4 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 9 10 Software Installation Click Finish to complete installation of Pervasive SQL 2000 Testing 32 bit Btrieve API PERVASI E Transactional access test completed
64. 2001 System Setup and Customization Options IY Check Copay Before Save Appeal Claim Appeal Claim Percentage t Difference of 9 DK Cancel Apply Figure 4 4 Options Menu Claim Tab 4 1 3 Claim Tab Check Copay Before Save Check this to prompt Claimstronic PMS to ask if you want to post the patient s copay prior to saving charge entry information You must also indicate in the patient s demographics what the copay amount is Appeal Claim Claimstronic PMS has the ability to prompt for an appeal of a claim if a payment is not within the parameters you have set Indicate a Percentage and Dollar Amount in the appropriate boxes If during payment posting these parameters are not met Claimstronic PMS will ask if you wish to appeal the claim The information will then be dropped into the Claims Appeal Report refer to Section 8 10 Appeal Claim Report 4 4 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 System Setup and Customization Options When Posting Auto Add Payment Schedule Iw Auto Update Payment Shedule Let User Select Claim s Payor DK Cancel Apply Figure 4 5 Options Menu Payment Tab 4 1 4 Payment Tab a Auto Add Payment Schedule Claimstronic PMS has the capability of building a payment fee schedule for various insurance plans Choosing this option prompts Claimstronic PMS to add the dollar amount posted from an insurance company directly to the Pro
65. 5 10 Finding an Open Time Slot 0 0 0 0 ceeeeseseccececeeeeeeseeeeeees 5 11 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 5 7 5 8 5 9 5 10 5 11 25 12 5 13 5 14 6 1 6 2 6 2 1 6 2 2 6 3 6 4 6 5 6 6 6 7 6 7 1 6 7 2 6 7 3 7 1 12 7 3 Toul Tod 7 3 3 7 4 7 5 7 6 7 6 1 7 6 2 7 6 2 1 Finding a Patient s Appointment cccccccceeeeeeseeeeeeeees 5 12 Printing Appointment Related Reports 5 13 Printing the Appointment Grid eeeeeessss 5 4 Printing an Appointment Listing eeeeeeeeereee 5 15 Printing Patient Reminders 52 2 Gio RE hte ot ecu 5 16 Printing Practice Appointment Statistics ssss 5 18 Prntin a Routine Seele o rer de ure enr addons 5 20 Printime a C hart Deli ntis aethere tied 5 21 Panent ENUN t 6 1 Finding an Existing Patent essere 6 1 Entering Patient Information eese 6 3 Editing an existing Patient Account cccccccecesssseeseeeeeees 6 3 Adding a New Patient ACCOUMNL ccseecssceceeeceeeeesseeeeeeeees 6 4 Creating Insurance Insured Information 6 7 Changing Default Insurance Active Order 6 10 Printing Patient Routing Sheet and Chart Label 6 12 Patient QUICK NOC cione te beta eet ie E bete ood 6 12 Additional Patient Informa
66. 8 Insurance Table Screen To customize the Insurance Table l Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last Use the vertical scroll bar to access the remaining fields in the screen 2 After you made your entries changes click on Update Click on Exit to close the window cActwindatailnsFile mkd Vodete ent rust prev nest tase Figure 4 19 Add Edit Insurance Record Window Claimstronic PMS Users Manual I8 Version 5 1 4 May 19 2001 System Setup and Customization INSURANCE TABLE DATA ITEMS INS CODE The code assigned that will be used to designate this insurance company assigned to a patient s account MASTER CODE This code is utilized to link all multiple insurance addresses to the same company and or product This is also used as the Payment Schedule ID and is necessary for linking the insurance company to the procedure code table PHONE The phone number associated with the insurance company FAX The fax number associated with the insurance company EMAIL The email address associated with the insurance company ATTENTION The provider relations and or claims personnel associated with the insurance company INS TYPE Press F2 for a list of options for designating the type of i
67. Address 1 1029 MAIN Address 2 Po City HOUSTON State m Zip 77074 E mail Home Fhone 512 920 9209 work Phone 512 929 2929 Ext Date OF Birth 12 12 55 Social Security H 382 92 9392 Dex Patient Eligibility Verified M Male C Yes Print File Label Female Ma OF Cancel Figure 5 26 Appointment Window Patient Window 5 21 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 2 Click on the Patient tab and check if the information displayed is the one that you want 3 Click on the Print File Label The following figure shows a sample of a file label s printout 00000 mno 00000 22v cC6L EUZI dod NSS Y 9nod NMOHD BROWN DOUG A realy DOB 12 12 1955 Ace BODL Guar 0000s Figure 5 27 Sample of File Label You can use the printed chart label for tagging the folder or binder that holds the printed documents of the patient This is very useful when document filing is done manually 5 22 Entering Patient Information 6 Patient Entry Claimstronic PMS was designed with the flexibility and functionality to conform to the workflow of a typical doctor s office Here s how Claimstronic PMS is used in daily office practices to make them more efficient in their handling of patient insurance payment and claim related data 6 1 Finding an Existing Patient To find an existing patient 1 From the Claimstronic PMS menu bar c
68. Appeal Claim Letter CLAIMSTRONIC Practice01 Eile Appointment PatientBiling EndOtDay Reports Maintenance Tool View Help 2 mwala Edit Routing Sheet Content ippeg laim Letter Figure 4 41 Tools Menu Edit Appeal Claim Letter Option 2 Click on the Letter rtf file found in the Task Bar on the bottom of the Claimstronic PMS Main Window CLAIMSTRONIC Practice01 e x Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View Help maala mse Rev i Brother CLAIMS 33My Docu R7 Microsoft E Letter rtf Figure 4 42 Claimstronic PMS Main Window 3 The Letter rtf Wordpad window will appear Claimstronic PMS User s Manual 4 40 Version 5 1 4 May 19 2001 System Setup and Customization B Letter rtf WordPad a ps m z uvj amp kABC Clinic 123 Main St Vienna VA 12333 703 625 5021 gt lt Appeal Department gt lt According to our policy the amount enclosed has not been paid yet Please pay this amount in 2 weeks If you already made a payment please disregard this letter If you have any questions about this letter please call us at the number above Thank you for let us serving you gt lt Please pay the total amount enclosed Thank you Figure 4 43 Letter rtf WordPad Window 4 Using basic techniques for creating a letter customize the format for your specific practice 9 After making changes to the Claim Appeal Lette
69. CO Paien Room Dud Check Ou Values Indicate X af cam pleted Racards and Lhe zverage Lime in mindes Example 2 19 Hin indicates J cam pleted raconde wih an arera d 19 mindes K fi rim Pages Figure 5 23 Sample Appointment Statistic Report Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 lolx 5 19 Using the Appointment Scheduler 5 13 Printing a Routing Sheet There are two ways to print a routing sheet Q Via the Appointment Scheduler window allows you to print the routing sheets for patients with appointment on the specified date Q Via the Patient Guarantor window allows you to print an individual routing sheet per patient refer to Section 6 5 Printing Patient Routing Sheet and Chart Labe I To print a routing sheet via the Appointment Scheduler window 1 Access the Routing Sheets option via Reports in the Appointment Scheduler Appointment Scheduler File Search Reports Settings Help Print amp ppointmenet Grid Appointments Report Saturday Patient Reminders Appontment Histan Statistical Reporta Routing Sheets Figure 5 24 Selecting Routing Sheet from the Appointment Scheduler Routing Sheets By Appointment Print the Routing Sheets to quickly track and complete a patient claim Use the bar code option if you have 4 bar code scanner Date xm Time Frame 7 r200 C AM Only Physicians PM Only v All Dav C Custom 5 00 AM Ta
70. CTED Claims for a selected account ACCOUNTS ACC WITH Claims for a selected insurance company INSCODE CLAIMS FOR Claims for a specific date of service DATE CLAIM OPTIONS BALANCE gt 0 Claims with balances greater than zero INSURANCE NOT Claims that have not had any insurance activity PAY YET AGE BETWEEN Claims that fall within a range of delinquency DATES ACCOUNT Provides basic patient information for a selected INFORMATION claim SUMMARY Provides total number of claims and aged balances for claim search 3 You can utilize this report to access a range of claims quickly By double clicking on a claim item you are able to edit the claims information Refer to Section 7 6 Editing Correcting and Resubmitting Claims Claimstronic PMS User s Manual 9 19 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports 10 Producing System Reports Claimstronic PMS System Reports allow you to produce and print valuable reports that provide the tools necessary for maintaining and operating a your practice The reports have been divided into Daily Reports and Monthly Reports sections as well as a Miscellaneous Reports section We recommend that you run daily and monthly reports at least once during the recommended time frame Claimstronic PMS operates on real time meaning you will not experience down time while the system updates or closes out daily and mo
71. Claim page as the default view Claim Entry X Account 000012 Name ACCOUNT TEST Doctor 01 BilTo ITTTNEA Bil To Name ACCOUNT TEST Claim st wc c UsePat p UseBilTo Insurance Insurance Billing Status Carrier Name Insured s Name Sent Date D Payor 1 D Payor 2 D Payor 3 a A Guarantor s Balance 0 00 Signature o Assignment v Empl Related Auto Related Authorization Ref Dr o Ins Verified Encounter Surgery Facility Cover For Acc State 2nd Opinion Outside Lab JN Lab Code L Of DOF Illness XRay Date Special Prog Ind b p us Pd DOF Cons ma PFTH Ind C Ha 2 Hospitalized From Unable To Work EET EPSDT Hospitalized To Unable To Work To Family Planning Claim ICD8s amp CPT4s 5 10 01 6 39 49 PM w Save AX Cancel Figure 7 16 Claim Entry Screen Locate the Billing Status column In the textbox you can either type in the status code or press F2 to access the Billing Status window and select the desired status The options available are e E Electronic The payor accepts electronic file of the claim After the electronic file has been sent to the appropriate clearinghouse this status must be updated to S Sent e P Paper The payor accepts claims only in paper form After printing the file this status must be updated to T Printed Claimstronic PMS User s Manual
72. ESC1 The code description that appears in the Charge Entry screen Type of Service Press F2 to retrieve a list of service Place of Service Press F2 to retrieve a list of service options MOD A C Modifier To permanently assign a modifier to a procedure enter the modifier here you also have the ability to assign a modifier during Charge Entry HCPCS CODE HCFA Common Procedural Coding System The five digit code used to describe physician services not included in CPT These codes usually begin with an alpha character followed by four digits TOS options Claimstronic PMS Users Manual 0000000000000 AA Version 5 1 4 May 19 2001 System Setup and Customization PROCEDURE CODE DATA ITEMS CONT MEDICARE CODE Same as HCPCS code ANES BASE Base unit of time for anesthesia code FEE 1 10 These fields contain the physician charges If you use more than one Fee Schedule you can specify which fee to charge an insurance in the Insurance Table PCODE FEE TABLE This area is utilized to create individual Payment Fee Schedules for various Insurance Companies If you chose to Auto Add Payment Schedule or Auto Update payment Schedule complete all fields except PlanPay Amount This code should duplicate the PCODE of the procedure you are creating PAYMENT SCHEDULE This code should duplicate the PAYMENT ID SCHEDULE ID assigned in the Insurance Table This code is used to link the procedure code and ins
73. Find button or the arrows on the bottom of the window to locate and or scroll through the various sets of messages Claimstronic PMS Users Manual BG Version 5 1 4 May 19 2001 System Setup and Customization 3 Select Edit Delete Update Cancel or Refresh to make changes to existing sets of messages Statement Message Set Detail Description Message for 61 90 Message for balances that are 61 90 days old Message for 90 120 Message for balances that are 90 1200 days old Message for 121 Message for balances that are over 120 days old Claimstronic PMS Users Manual o 444 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 Using the Appointment Scheduler The Appointment Scheduler tracks appointments schedules patient information and practice resources It manages time for multiple physicians tracks double bookings finds open appointment slots prints reports and tracks a variety of statistics 5 1 Components of the Appointment Scheduler The main components of the Appointment Scheduler are shown and explained below Appointment Scheduler File Search Reports Settings Monday April 09 2001 lM Show Complaints Help Sun Man Tue wed Thu Fr Sat Time Dr John Smith 25 96 27 28 29 og 5 GOD AM 2 3 4 E B 7 9 30 AM 8 ei io 11 12 13 14 15 16 17 18 18 20 21 000 AM 22 23 24 25 26 27 28 Q 30 AM eg 3031 2 3 4
74. IMSTRONIC Bank Deposit BIE BANK DEPOSIT SLIP REPORT GIORGIO Day Perigg 4 Fram 4 17 01 To 44r ie View Print Close Figure 10 6 Bank Deposit Slip Report3 10 4 WINPMS File Preview Producing System Reports FILE PREVIEW BANK DEPOSIT SLIP REPORT From 04 01 2001 To 04 14 2001 No CHECK NUMBER UNIT_ALLOCATED AMOUNT PAY DATE STAMP DATE i 123 i 60 00 04712 2001 04 12 2001 z 12333 I 60 00 04 14 2001 04 14 2001 3 1234 1 65 00 04 09 2001 0470972001 4 lz4 I 10 00 0470372001 04 03 2001 5 125 i 5 00 04 03 2001 04 03 2001 6 142 I 65 00 0471272001 04 12 2001 f 4458 i 40 00 04 12 2001 04 12 2001 8 4568 l 140 00 04 12 2001 04 12 2001 3 569 1 50 00 04712 2001 04 12 2001 10 789 I 90 00 0471272001 04 12 2001 11 987 1 15 00 04 12 2001 04 12 2001 SUMMARY CURRENCY COIN Currency amp Coin Total 40 00 Check amount Total 600 00 Total Deposit This Period 640 00 Other Credit Cards v Font 4 14 01 4 27 20 PM Print Close Figure 10 7 Sample Deposit Slip Report 10 1 3 Tickler Report A Ticker Report can also be called a follow up report It is generated from all patient notes refer to Section 6 7 1 Patient Notes and claim notes refer to Section 7 4 Creating Claim Notes that were created with an alarm date l From the Claimstronic PMS menu bar click on Reports
75. Insured to change the main insurance policy information e Secondary Insured to change the secondary insurance policy information e Tertiary Insured to change the tertiary insurance policy information To reactivate a payor highlight the entry that you want to make as your default and then click on Edit This will lead you to the Insured Insurance Information window From this window click on OK or Alt O The default insurance entry shown should change to the entry that you have selected Click Close or Alt S to exit the Patient Guarantor Information window 6 11 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information 6 5 Printing Patient Routing Sheet and Chart Label 1 To print and or view a patient s routing sheet from the Patient Guarantor Information Window Select either Print or View option at the bottom of the window This will print an individual routing sheet for that patient 2 To print a chart label from the Patient Guarantor Information Window select the Print option at the bottom of the window This will print the designated number of labels from setup options for this patient Both of these functions can be performed through the Appointment Scheduler as well 6 6 Patient Quick Note You can control the patients QUICK NOTE by choosing the ON OFF function of the SHOW QUICK NOTE area found in the PATIENT GUARANTOR INFORMATION WINDOW With the QUICK NOTE on si
76. L LU LE UL UON ALLE ORIOA VOLO LUE UIAA UL LAETI VOVON DOOR TIU UVP UI UU LI VOUELUE DLE UTI ULL ILI LUI UI 99204 Level Four 99383 Well 5 11 Yr W9881 Epsdt medicaid 99354 Prolonged Servc 92551 Audioscope cv gnenerr Let eee PULMONAR MISC PROCEDURE A A A 5 Level Five 4 Well 12 17 yr Tympanometry DE ELLE ELTE LEE VU001 VOU BUN LOA VUL LLL UL CINIO ALI HOMI OTT DE ELE ERE BRETT DUET TIT EIL ELLE LUE LUI HIE LLL OTT STABLISHED PAT 99385 Well 18yr 94664 Nebulizer Tx 69210 Cerumen Rem 99173 Vision Screening ALLE ORIOA COUO LUE MOOI LU ALLE ORIOA LLL EH LUE LUE T VALUE DELL UU ILU EI UL PT TE DOT 99211 Level One 99432 Newborn 24 D c 94665 Subsequent Tx 54150 Circumcision Pope mentee operit tte NN LO NEDA DUIM UTI herpet Level Two W9881 Epsdt medicaid 94760 Pulse Oximetry 54152 Circ Over 28 Dys EET EHE BRETT EHI T DULL ELTUETTLET LITER MON IANI DE ELLUUELUETE E HERITE TTE T TIT f 99213 Level Three 94761 Pulse Oximetry 44550 Surg Tray Circ ALLE URNO VOMO 100I MOI HO KURAIA ORIOA VOLO LUE LEUR MOTION LLLI OO VOUI OT VAULT OLEI LOU UTE UL UONI 99214 Level Four 99391 Well 0 1 Yr K0180 Nebulizer Mask 10120 Rem Of Fb Skin Figure 7 1 Routing Sheet Bar Code Format Claimstronic PMS User s Manul S a2 Version 5 1 4 May 19 2001 Producing System Reports 7 2 Entering a New Claim Manually There are two ways to access the Claim Entry window O From the Claimstronic PMS menu bar click on Patient Billing and select Patient or click on the Patient icon FF
77. Listing 1 Access the Appointments Report option via Reports in the Appointment Scheduler Appointment Scheduler File Search Reports Settings Help Print Appointmenet Grid Appointments Report Patient Reminders Appontnient tal Slory Tuesday Api Statistical Reports Routing Sheets Figure 5 15 Search Function Location 2 From the Appointments Report menu choose the provider and date of service you wish to print Appointments Report Doctor Is Dr John Smith D ate 40 01 Print Summary Details gt gt Figure 5 16 Appointment Report Window 3 You will receive a view of the report you requested You may print this report by simply clicking on the printer icon AppSchDIl rptAppointmentSummary DataReport ox zx e Zoom 100 Appointment Detail for Dr John Smith Monday April 09 2001 Account Time Length Patient Place Reason HomePhone 000011 10 00 AM 10 30 AM 30 Min SMITH DAVID Lab Office Visit 956 8421 Complaint HEADACHE Instruction 000009 11 00 AM 11 30 AM 30 Min GIORGIO PETER Stress Test Complaint CHEST PAIN Instruction 000007 02 00 PM 03 00 PM 60 Min YOUNG JACK General 321 173 9876 Complaint FATIGUE Instruction Total Number of Appointments Pages M 4 Lad M 1 a E Figure 5 17 Sample Appointment Report Claimstronic PMS User s Manual 5 15 Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 11 Printing Patient Reminders 1 A
78. O ENEE Figure 4 7 Maintenance Menu User Info Option 2 From the User Info Table window see Figure 4 2 click on Add User Info Table User Defined Code FirstName UserCode Middlelnitial LastName Addressi J Address2_ Search BTSC GIORGIO iki File Maintenance IM Figure 4 6 Selecting Add from the User Info Table Window 3 Enter all the information required then click on Update Claimstronic PMS Users Manual A Version 5 1 4 May 19 2001 System Setup and Customization C ctwinidata CtU ser_mkd fs Po e e p an Figure 4 9 Add User Info Window To delete a user account l From the Claimstronic PMS menu bar click on Maintenance and select User Info from the pull down menu list see Figure 4 1 2 From the User Info Table window see Figure 4 2 highlight the account that you want to delete and click on Delete 3 When the selected account has been removed from the User Info Table screen click on Close 4 2 1 Changing Your User Information To change your user information l From the Claimstronic PMS menu bar click on Maintenance and select User Info from the pull down menu list see Figure 4 1 2 From the User Info Table window see Figure 4 4 highlight the user record to be changed and click on Edit TETTE Address Address2 Search GIORGIO EE E MATA Fie Martenance OOOO MM Figure 4 10 Selecting Edit from the User Info Tab
79. PETING DATE SERVICE BATE CHARGE Oo212 LIMITED OF EST PATIENT DE 10 2000 Of Lara 000 20 00 xj SS Figure 10 37 Sample of Generated Ledger Report 11 After checking the report click on Print to proceed with the printing 12 When printing is done click on Close button to close the preview window 13 Click on Close to exit the Ledger Report window Claimstronic PMS User s Manual 10 31 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports 10 3 3 Patient Procedure Financial History Report The Patient Procedure Financial History Report provides a line item detail of procedures and payment associated with an account 1 From the Claimstronic PMS menu bar click on Reports and select Patient Procedure Financial History Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View Ff ga ge 2 49 32 New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management EM Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 38 Report Menu Patient Procedure Financial History 2 From the Patient Procedure Financial History window type in the patient s account number date period and type of history report you are generating
80. PMS System icon this is your first time to click the icon Claimetranic Figure 0 1 Claimstronic PMS System Icon 2 When the Welcome New User screen appears enter all requested information Underlined items are minimum required fields 3 After confirming your entries click on the Create User Account button Note Remember your User Code This will be your LOGIN ID Claimstronic PMS User s Manual 2 41 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 4 Software Installation After you create your user account the Login screen will now appear every time you start up Claimstronic PMS Loinid Password Cancel Enter your LOGIN ID and password then click OK to login to the system 2 42 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Navigating the Claimstronic PMS Software 3 Navigating the Claimstronic PMS Software Claimstronic PMS is organized to simplify complex data entry procedures Claimstronic PMS makes it easy to switch between practices as well as between administrative data entry and system maintenance and reporting tasks Common features are implemented across similar types of windows wherever possible 3 1 System Functions After you enter your LOGIN ID and password the Claimstronic PMS main window appears CLAIMSTRONIC Practice01 File Appointment Patient Biling EndOfDay Reports Maintenance Tools View Help 2
81. Press F2 to display a list of acceptable values Auto Related Enter Y or N to indicate whether this claim is automobile accident related Press F2 to display a list of acceptable values Authorization The code for authorizing this claim often times assigned by a claims officer or the insurance organization The code for the referring doctor Press F2 to display a user definable list of referring doctor codes Ins Verified Enter Y or N to indicate whether insurance has been verified to exist Press F2 to display a list of acceptable values Enter Y or N to indicate whether this claim is an encounter claim in which the provider has contractually agreed to see this patient Press F2 to display a list of acceptable values Claimstronic PMS UsersManual T6 Version 5 1 4 May 19 2001 Producing System Reports CLAIMS DATA ITEMS CONT Surgery Enter Y or N to indicate whether this claim involved surgery Press F2 to display a list of acceptable values Facility The code for the facility other than the provider s office where services were rendered Press F2 to display a list of acceptable facility codes Cover For The code for the doctor that is being substituted Press F2 to display a user definable list of doctor codes The code for the state in which the accident occurred Press F2 to display a list of acceptable state codes 2nd Opinion Enter Y or N to indicate whether this claim is a 2nd or 3rd opinion for the patie
82. Press the PAGE DOWN key to see the rest of the agreement Pervasive Software Inc Pervasive SUL License Agreement workstation workgroup Edition IMPORTANT DO NOT INSTALL THE ENCLOSED SOFTWARE UNTIL YOU HAVE HEAD THIS LICENSE AGREEMENT Br INSTALLING THE SOFTWARE OF AUTHORIZING ANY OTHER PERSON TO BO SO YOU AND SUCH OTHER PERSON IF APPLICABLE ACCEPT THE TERMS AND CONDITIONS OF THIS LICENSE AGREEMENT IF VOL DO NOT AGREE TO THE TERMS OF THIS LICENSE AGREEMENT RETOURN THE ENTIRE PACKAGE WITHIN TEM G 44 S OF PURCHASE FOR amp REFLND 1 DEFINITIONS 1 1 Pereasive means Pervasive Software Inc a Delaware corporation 12365 Riata Trace Parkway Building Il Austin Texas LI 5 5 872 Do you accept all the terms of the preceding License Agreement If you choose No Setup will close To install Pervasive SOL 2000 you must accept this agreement Click Yes to accept license agreement 5 Click on the set up you prefer x Click the type of Setup you prefer then click Nest PERJASIVE oOrFTWARHE Custom Description Recommended for most users Installs all components including Transactienal and Relational Workstation Interfaces Client Requesters Utilities and Online Documentation lt Back Cancel Typical is recommended for most users Click Next to continue 6 Select the installation directory Claimstronic PMS User s Manual 253 Version 5 1 4 May 19
83. Skin V70 9 General Exam 707 1 Ulcer Foot VALUE II UU LUE LLL AUOOUOLUIOUI OOOO UE VEN VN UON ALIE MUU DDE LUE DIDIA IMION ALIE DUI VOU OOOO VOLO UN UEN MUTT 477 9 Allergic Rhinitis 174 9 Cancer Breast 623 8 Cyst Vaginal 271 3 Glucose Intolera 465 9 Upper Respiratory Infect VEL eer DLE ULT DOLO HL LT T PT LU UT rr opener n Once Allergy Due To 112 1 Candidiasis Yag 311 Depression Headache Urinary Tract Infection FULL THEE LI AUR LUI OTT IONI FUEL LEUEE LI LI ENN AIOI UO FULL RU LUE LUI UNII IONI TELLE LEUUETU TT ELO E FULL WIL LUI LUE UU UTI IONI 285 9 Anemia 380 4 Cerumen Impaci 692 9 Dermatitis Allerg 550 9 Hernia Inguinal 623 8 Vaginal Bleeding eee ETETA eA NNI ene Anxiety 0 Cervicitis 0 Diabetes Mellitus 6 Vaginitis VEN OOOO OLE OUIA OU VL AOAOIAU EU UPON NOUN MN DLE LEE ITE EO HET LT ALLE DUE LU UELLE UL BLUE LEE TTET ULT 716 9 Arthritis Lower Li574 1 Cholelithiasis 780 4 Dizziness 272 0 Hypercholesterol 10 Page Down FULL EHE LL LUE TUI LETT IONI EULLL PUE LAETI B LUI UTE LI FULL LIE LUE LU LUI IANI FULL LLL UU ENN UT IANI DUET EL UBRETTE TUE LETT 493 9 Asthma Acute 414 9 Chronic Ischemi 782 3 Edema Lower Ex 272 4 Hyperlipidemia 100 Save Perae AURAI OODUA OIIO DOUA EHE DOT T pren pe peere E ETE TA 7 3 Atrial Fibrillation 460 0 Cold Syndrome 627 4 Estrogen Replace401 9 Hypertension 0 10 00 Co pay ALL IO OU OUIA OOTO OU UONI ALL OODUA OOOO VOIO UELLE ONI T VALE PAULI OUIA OOII UL ALL EI OOOI OOOO UELLE ULT AUI LI LUE UELLE ULL AU UONI 216
84. Statistics Ledger Report Patient Procedure Financial History DODD Claims with Balance 7 O Statement Evaluation Management E M Procedure Line Report Immunization History Report Patients with Selected Insurance Appeal Claim Report Print Patient Demographic Labels Figure 10 41 Reports Menu DDDD Claims with Balance 0 10 3 5 Procedure Line Report The Detail Procedure report contains a summary of the patient s account information diagnosis and procedures performed by the doctor and or the referral doctor This report will also show how much the charge is for each procedure done to the patient Claimstronic PMS User s Manual 10 33 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports To generate a Detail Procedure Report l From the Claimstronic PMS menu bar click on Reports and select Procedure Line Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View Ff alala New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 42 Reports Menu Detail Procedure Report Option 2 From the Procedure Line window specif
85. Table 4 Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last 5 Complete the requested information for each of the practices then click on Update 6 Click on Exit to close the window To add the provider s DEA and Medical License numbers 1 In the Provider Insurance ID Table insert the assigned PracCode 2 If applicable type in the InsCode that requires the license number for filing insurance 3 Type in the license name in the InsType field In the NetworkID type in the license number Claimstronic PMS Users Manual TAG Version 5 1 4 May 19 2001 System Setup and Customization ctwin data Practice mkd Bl x Prac Code AYC Org Name ANVICARECLINIC gt Addri 1200 GALLOWS Addr2 ine City VIENNA o State va Zip 22027 Phone k9 Fax ly c Modem EMail PO T Ej Tax Id Type Specialty Solo Group Flag EMCFlag f Clearing House Id ni ct en pev wea Practice 7 Insurance Id Table Figure 4 23 Add Edit Practice Record Window PRACTICE TABLE DATA ITEMS PRAC CODE The code assigned to identify the various locations within your practice TAX ID The identification number assigned to your practice Tax Identification Number or Social Security TAX ID TYPE The c
86. The method of CoPay payment Click on the button to display a list of acceptable payment types The code or number associated with the payment type i e if payment is made by a credit card the ID would be the credit card number If payment is made by a check the ID would be the check number Exp Date The expiration date of the credit card if payment was made by a credit card The authorization code of the transaction if necessary Producing System Reports 7 3 Entering a Payment At times a patient may make a copayment partial payment or pay the claim in full at the time of service The copayment amount due will appear in the bottom left corner of the ICD9 amp CPT4 screen Simply type in the amount of the payment and save the claim If you determined through the Patient Guarantor Window refer to Section 6 3 Creating Insurance Ins ured Information the copay amount due and designated the system to Check Copay Before Save refer to Section 4 1 3 Claim Tab Claimstronic PMS will prompt for a copayment before allowing to the claim being saved 7 3 1 Pre Copayment List The Pre Copay function is a valuable resource for documenting and keeping track of copayments received and posted Especially if you collect the copays prior to the patient being seen L From the Claimstronic PMS main menu screen choose Patient Billing and select PreCopay Eile Appointment Patient Biling EndOfDay R S alaga Patient Claim
87. activated these keys are used to e Commit or cancel any changes e Close the Window Claimstronic PMS User s Manual 3 5 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Navigating the Claimstronic PMS Software 3 3 Maintenance Windows All of the Claimstronic database Maintenance windows are standardized for easy use For example the layout buttons and sliders on the Facility Table shown below are just like the Maintenance windows for Practice Physician Diagnosis Code and Procedure Code Facility Table ES User Defined Code Change Index Address Address2 Civ ESSE HOLMES REGIO MELBOURNE File Maintenance Close KIKI 3E Figure 3 3 Facility Table Window Q The active record being viewed from the list in the table will be highlighted and indicated with an arrow OQ To view the complete record in the table click on either arrow or slide the gray box at the bottom of the record list Q To rapidly advance through the records in the file use the bottommost arrows Left arrows take you to the first record or the previous record right arrows take you to the next record or the last record Q The blank space in between the two navigation sliders is a search tool that functions the same as the Search button on the upper right Type a term and press enter and the system will reposition and highlight the first record located containing the search term O
88. adjustment amount in C Adj column Enter the appropriate adjustment code by manually entering the code number or by utilizing the drop down box for a list of options Save by clicking Okay or Alt O CLAIMSTRONIC Practice01 Eile Appointment Patient Biling EndOfDay Reports Maintenance Tools View Help awaasa Payment x SITZT IE VOL IMIE Auancannzanun AllClei Account 000003 13 amp ucE YOUNG BCBSOT7 Ir Adjustment Only e alCleims Date 41 2 01 Amount 65 00 Expired Date Payment Type CHECK Remain 65 00 Authorization ID 142 Payor BcBso1 BLUE CROSS AND BLUE SHI sij Close 4 Payment 50 00 Approved Adjust 5 00 Adjust Code 4 PROFESSIONAL COUR Charged Units LineCharged Paid Allowable Balanced C Adj C AdiCode P 4 12 01 99203 100 00 100 00 5 00 0 00 50 00 95 00 5 00 4 PROFE w ok wear Xx Cancel Figure 8 6 Payment Window Claim s Procedures Option Payment and Adjustment Entry 8 3 Resume Posting Payment As mentioned in Section 8 1 Entering Payment Information when you choose to continue with posting outstanding money your Journal Report and Deposit Slip Report will be affected From the Claimstronic PMS menu bar click on Patient Billing then on Resume Posting Payment CLAIMSTRONIC Practice 1 File Appointment Patient Billing EndOfDay Repi ma pe es se Patient Claim Fre Co
89. aimstronic PMS User s Manual 5 18 Version 5 1 4 May 19 2001 Practice Appointment Statistics g Zoom 100 x Using the Appointment Scheduler Practice Appointment Statistics March 11 2001 April 10 2001 There are a total of 246 hrs during this time period A Appointments Percentage 10095 Description Amount 1 of Aopointments El of No Shows J t of Cancellations tof No ShowsCancellations g Physicians Doctor of Apps Lr John smith if C Places amp Resources Scheduled Hrs 1 of 248 Hrs BARS UMA z06 Resource of Apps Lab 1 ad m Scheduled Hrs 1 of 248 Hrs OARS 30 fin 96 4 Glee Fare Lic D Appointment Types Resource EST PATIENT WELL Genera Checkun New Patient Naw Patient Sick New Patient Sick Office Visit Physica Examination otress l est A RaW riat of Apps Cj c c dX 039 OG c bo C3 Scheduled Hrs I af 246 Hrs Hrs Min Q6 1 Hrs 320 Mn 156 Q Hrs 320 MIn Q6 Hrs O Ain Q6 Hrs O Min Q6 2 Hrs Min 156 Hrs 30 Mn Q6 OARS 20 Min o6 Hrs Olin Q6 E Average Times All Doctors Time Period Check in Patient Room In 0 Patient Room in Doctor In 0 Doctor Out Patient Room Qut 0 Patient Room Oul Check Qut 0 Recorded Average Time F Average Times By Doctor Doctor CI PRI Lr John Smith CEPA Chazt InTime Paien Room In Time PREOI Paien Room InTime Dogar In Time PRI DI DO PRO PRO CO OG PRO 7 Dacor Dd Paien Room Cut PRO
90. ancel ZA Figure 9 12 Choose File Menu Drive Selection 19 Open the Data folder Choose file ok in E Ckir c save C1 routingsheet xml is ACBtr7 32 ocx Aging fil Aging bet w File name Files af type JalFiles m Cancel l Jomitted files for this session Size Server No fas sustenstrad Figure 9 13 Choose File Menu Data Folder Option 20 Open the EMC folder Means Lieb oe eT Choose file Look in Sy Data l amp c emc 02Routing xml Arps 2RoutingSheet xml b prsi loc 12340uLSCR 01 routing xml ls 9200 get scr O1rautingsheet xml s 3200 out scr E E Files of type Jal Files Cancel a thrmmnitted files fnr this secssian live zanunr 9 8 Insurance and Billing Figure 9 14 Choose File Menu EMC Folder Option 2 Select the Batch claim file to upload The Batch will be formatted accordingly e The Batch Number assigned during EMC processing e The User ID as assigned by FreeClaims com e The suffix NSF example 0011234 nsf e Click on Open a mmm a Choose file EN gt x Look in E emc El c a 00011234 dat 00011234 nsf 700011234 prt Filename 00011234nsf Files of type Jal Files Cancel a jibrmitted files for this session Size Semer Wa fas suhmirradg Figure 9 15 Choose File Menu Batch File 25 From the FreeClaims com home page Upload Claim File window
91. and select Tickler Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View H aala New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 8 Reports Menu Ticker Report Option Claimstronic PMS User s Manual 10 5 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports 2 In the Alarm Date box specify the period that you want to check in the From and To fields by either typing in the date or clicking a date from the displayed calendar WINPMS Tickler Report BEES inl xf TICKLER REPORT Alarm Date From 200 Ta ionev20n1 Figurel0 9 Tickler Report Window 3 Click on Preview Print to view the generated report before printing 4 After checking the report click on the Print icon dh to proceed with the printing If you want to save the report as a file click on the Export icon E and specify the filename in the Export dialog box 3 When printing is done click on the Close button x to close the preview window 6 Click on Close to exit the Tickler Report window 10 6 Producing System Reports 2 5 x
92. appeal A Appeal Claims APPEAL CLAIM LIST Account Guarantor laimMumber StpD ate Frogs Ins Code Ine Paid Charged Faid ooo002 QOO 19 2001 04 14 2001 04 14 amp ETUT 60 00 65 00 60 00 Figure 10 12 Appeal Claim List Window 3 Choose the Custom Letter option to view the individual letters to be printed Claimstronic PMS User s Manual 10 8 Version 5 1 4 May 19 2001 Producing System Reports WINPIVIS Appeal Letter Customization Black Abadi MT Condensed Extra Bol 10 B U Z Z 2 Z S w ABC Clinic 123 Main St SampleLetter rtf Vienna VA 12333 Saturday April 14 2001 Appeal Department AETNA INSURANCE CO Print Letter Dear Sir or Madam fe All According to our policy the amount enclosed has not been paid yet Please pay this C Curent amount in 2 weeks If you already made a payment please regard this letter I lt Tf you have any auestions about this letter please call us e number above _ Patient Name Address lt Account Insured ID Groun ID gt DOS CPT Billed Allowable Paid Difference gt Total underpaid amount Please pay the total amount enclosed CLOSE Thank vou 10 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Figure 10 13 Appeal Letter Customization Window Choose the letter color style font size and various other word document options by utilizing the menu bar found at the top of the window
93. ary Insured to change the tertiary insurance policy information 3 Select the entry and click on Edit This will lead you to the Insured Insurance Information window 4 Highlight the Payor Code field and click on the button with ellipsis mark or press F2 This will lead you to the Insurance List window INSURANCE LIST Searching Text Search By Column InsCode Like Search InsCode InsName Address State Zip Phone Fax NEI WS AETNA AETNA TRGON TRIGON BC BS 7 29 00 3 13 09 PM Ok Close Figure 6 7 Insurance List Window Claimstronic PMS User s Manul OO 6410 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information From the Insurance List window you can enter the insurance code in the Search field then click on Search or browse the list to find the desired insurance information Click on OK or Alt O to exit the Insurance List Window The change that you have made will reflect in the Payor Code Field Make the appropriate information changes for that Payor Click on OK or Alt O to exit the Insured Insurance Information window Click Close or Alt S to exit the Patient Guarantor Information window Q If you wish to reactivate an expired insurance From the Patient Guarantor Information window select desired account to check Refer to Section 6 2 Finding an Existing Patient for instructions Click on e Primary
94. at is showing in the Patient Guarantor Information Window will be the account the dependent is added Partial demographics and insurance information will automatically populate into the dependent s account from the guarantor or employer account e Employer Account The account that is financially responsible ex worker s compensation employee drug windowing etc 1 Patient Info tab will allow you to make changes regarding the patient s personal demographics 2 Additional Pat Info tab will allow you to a Create or Edit patient note b Create or Edit patient s case management file Claimstronic PMS User s Manual 6 4 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information Patient Window Data Items Data Description Displays a patient s account number Accounts can also be accessed directly by entering an account number here Displays the guarantor s account number You can add a guarantor to an existing account directly by entering the guarantor s account number here or F2 to search for guarantor Nicknam Patient s name other than their legal name User Defined User s assigned account number in lieu of using the Claimstronic PMS automatic numbering system MWe patents mide Sufix The patient s suffix i e Jr Sr Ill etc If you do not want this account to receive a billing statement type in the letter H fo
95. at match the selected network s information will be updated Figure 9 20 FreeClaims com Home Page Auto Update Network ID and Group Network ID To Claims 6 This will access providers that are missing either the individual or group insurance network identification number Complete the Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing information per provider This will correct all pending and future claims for the provider Choose the Submit button found at the bottom of the page Note If you need assistance locating a Payor ID number or determining what insurance is missing the Network ID number Click on the Payor List button on the menu bar and follow the search instructions 7 To correct claims that have errors other than payor or network identification numbers select View Error Claims from the Manage Claims option J FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSpring Internet Expl MEE Eile Edit View Favorites Tools Help e Em E Back Eomard Stop Refresh Home Search Favorites History Mail Print Edit RealGul Address e https secure freeclaims com rc FRCLmember ceGo Links FreeClaims com Payor List Logout View PayorID Pending Claims 2001 Kb 2 D 3430 155 THIN REPOR E NetworkID Pending Claims 1017 n 97 70 Kb r View Errored Claims 3 3430 Batch 4474 Confi View Ignored Claims cull ae pairs O View Claims by Account No
96. atient Biling EndOfDay Reports Maintenance Tools View Ff ga ge 75 49 52 New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 26 Reports Menu End of the Month Statistics Option 2 If you are creating a report for a specific doctor enter the doctor s code in the Provider Code List field You may also select the code from the pull down list Then enter the doctor s practice code 1 e organization or group to which the doctor belongs to in the Practice Code List field or simply select from the pull down list If you are creating a report for a specific group simply leave the Provider field blank and enter the code of the desired group in the Practice field 3 In the Date Type box select the date type that you want to include in your report The options are Stamped Date Serviced Date and Sent Date 4 Enter the period that you want to check in the From and To fields by either typing in the date or clicking a date from the displayed calendar 5 In the Group On box select the information that you want to check and include in your report by clicking on the desired option e Facility This reports provides total charges payments adjustments and balances for each facility a serv
97. ccess the Patient Reminders option via Report in the Appointment Scheduler File Search Reports Settings Help Print Appointmenet Grid Appointments Report Patient Reminders ADDO Minienl al Slots Tuesday Api Statistical Reports Routing Sheets Figure 5 18 Search Function Location 2 From the Appointments Report menu choose the provider and date of service you wish to print 3 By selecting the Edit Report option you are able to further customize the Patient Reminder Letter Patient Recall _ n X Fatient Reminder Report E dit Report From Date To Date E 10 0 5 8 01 E Doctor Dr Jahn Smith Print Figure 5 19 Patient Reminder Window 4 You can add a field by choosing from one of the available fields found to the right of the letter 5 Youcan deselect a field within the body of the letter by highlighting the field and hitting the delete key on your keyboard Claimstronic PMS User s Manual 5 16 Version 5 1 4 May 19 2001 Using the Appointment Scheduler Patient Reminder File Edit Miew Insert Format Data Help Dee al Lucida Handwriting is BZ Ug zszs a i 2 3 4 5 E Just a Reminder About Your Appointment Jackson Street Medicine 12345 Main Street Anytown Virginia 12345 For zPatientNamae zAddress1 z amp ddressz zCitySstateZip Home Phone zHamePhane Work Phone lt WorkPhone gt SoM z5ocialSecurity gt Pease notify our office of any changes to th
98. cedures Table refer to section 4 3 2 Procedure Table and section 4 4 1 Insurance Codes b Auto Update Payment Schedule Check this function if you want Claimstronic PMS to update your payment fee schedule during payment posting This function will override the existing dollar amount in the fee schedule c Let User Select Claim s Payor Checking this option will allow you to choose which payor paid on an account This option is useful when an account has multiple insurance companies 4 1 5 Reports Tab Reserved for future use Claimstronic PMS Users Manual ES Version 5 1 4 May 19 2001 System Setup and Customization Figure 4 6 Options Menu Others Tab 4 1 6 Others Tab a Images and Photos If you have chosen the to utilize the digital camera and or the scanning function this tab determines where your pictures are stored within Claimstronic PMS After you have completed your configuration click Apply and OR You have the option to turn any of these functions off or on at anytime Claimstronic PMS Users Manual AG Version 5 1 4 May 19 2001 System Setup and Customization 4 2 Adding or Deleting a User Account The User Account contains the User Name and Password necessary for logging on to the Claimstronic PMS To add a user account l From the Claimstronic PMS menu bar click on Maintenance and select User Info from the pull down menu list User Info Ld of el ee Oe U a Peters teaed el L
99. ck In Time The time at which the patient arrived for the appointment Click on the 5 button to use the current time as the check in time Patient Room In The time at which the patient is actually seen by Time the doctor Click on the 5 button to use the current time as the patient room in time Check Out Time The time at which the patient leaves the appointment Click on the 5 button to use the current time as the check out time 5 8 Using the Appointment Scheduler 5 3 Viewing or Editing an Appointment To refer to or change information about an appointment you can right click on the entry in the Appointment Grid and open appointment or choose edit from the Appointment Detail window The Appointment window will be presented with all of the information entered previously Change as appropriate and click on OK 5 4 Moving an Appointment There are two ways to move an appointment from one time slot to another Q You can view and edit the appointment as described above changing the appointment date and time Q Or you can cut and paste it 1 First click on the grid to highlight the appointment you want to move Appointment Scheduler File Search Reports Settings Help Monday April 23 2001 I Show Complaints 0900AM o 0930AM mm Sun Mon Tue Wed Thu Fri iB wb x dB d 3 ERST 5 a J 10 12 15 16 17 13 22 eda 24 26 293 3 1 2 3 t Today 4 23 01 LL RE oro0PM S 0130PM_ o 0200PM 000000 000000000
100. click printing form in the View box then select view print FILE PREVIEW EVALUATIONM MANAGEMENT E M REPORT DOCTOR TIM DAVIS COMPANY TIM DAVIS MD DATE TYPE Date of Service FROM 10 13 1988 To 11 15 2000 NEW PATIENTS E M CODE COUNT COUNT LINE CHARGE 99201 T 0 004 0 00 99202 D 0 004 0 00 99203 5 27 785 520 00 99204 13 72 225 1 612 00 99205 o 0 004 0 00 TOTAL 18 2 132 00 Figure 10 30 Generated Evaluation Management Report Textual View 10 25 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 10 3 Miscellaneous Reports 10 3 1 Patient Report Producing System Reports The Patient Report provides a quick method of obtaining a snapshot of the account insurer and insurance information associated with claim l From the Claimstronic PMS menu bar click on Reports and select Patient Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Jools View Ff olala New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 31 Report Menu Patient Report Option 2 If you are creating a report for a specific doctor enter the d
101. d even as detailed as the Payor ID The Employer s Name field is currently not being used Additional customization of this report includes options such as Procedure Type of Service and Place of Service Click on Preview Print to view the generated report before printing After printing the report click on Close to exit the Detail Procedure Report window WOR FS File Pera z FILE PREVIEW Ca 0i s 200 PROCEDUDE LINE REPORT E rPnoulIDER OL FROM Dz adi z ann TO Da3 01 2n0adn FRAZTICE PROCEDURE CHARGE CIT LINE CHABGE PAYMENT ADJUCIMENT CARRIER 60054 3212 LIMITED OUEST PATIENT 55 00 i 55 xi z0 0 1 00 C994 WELL YIS3IT 12 1770 go 0o i go od o oo TOTAL o5 00 a gs Dn 20 00 i D CARRIER STFREM TIDO CHEST E BAY PA amp LAT 55 0D 1 55 00 0 00 0 00 B 5115 ALLERGEN IMNUMOTHERAPY La on 1 10 00 0 00 0 00 B5115 ALLERGEN IBRUWOTHERAPY 20 00 1 20 00 0 00 0 00 S212 LIMITED OV EST PATIENT 55 00 1 55 00 0 00 0 00 53212 LIMITED OW EZT PATIENT 60 00 E Da 15 00 O cai LIMITED OW EST PATIENT 55 00 1 55 xj o 00 0 00 TOTAL 55 amp 755 00 16 00 n o ENT wawa nanm Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Figure 10 44 Sample of Generated Procedure Line Report 10 35 Producing System Reports 10 3 6 Immunization History Report CLAIMS TRONS DEMODATA New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End oF Month
102. diagnosis associated with the selected claim e Procedure Lines Shows the procedures associated with the selected claim e Detail Allocations Shows the payments associated with the selected claim e Insurer Insurance Information Shows the insured and insurance associated with the selected claim e Claim Information Shows the date of service date of posting insurance information and balance information of the claim e Guarantor Information Shows the guarantor information associated with the selected claim To return to the options click on the Back button 9 Under View Options select Allocation if you want only the allocation information to appear in your report Select Ledger if you want to include the details for each allocation 10 Click on Preview Print to view the generated report before printing Claimstronic PMS User s Manual 10 30 Version 5 1 4 May 19 2001 Producing System Reports WEP eS Fie Envie Fok PATLEHT ACCOUNT CODD FATIEHT o00 G0 COM TO 1000 HATH COMED LORTHG VA 2z z7 Oo 03 Sra siTo GUARANTOR ODDO DA YU i00 HATH AHNEAMDALE VA 22000 T03 Bes To ICLAIH Wo IH amp SUEER i DAN UT POL Ib JG 00 0220 Group ID O Espl Ib O LOCO HAIN OON LORIN VE 22027 368 000 0050 j703j 75 003 T IH amp URRMCE is amp TFRH Slate Farm Il PAYOR IDs O00000 23D Bain Sc Alecendgr La TR 22010 asi m zua 22231 DIGESTS CODE DERE PIPTICE 700 00 ABDOMINAL PAIN PROCEBDUPE CODE DESPA IPT OSH
103. dure line You must do this through the Claim tab e You can delete a procedure line by highlighting and selecting Delete Proc Line Careful consideration should be taken when deleting a procedure line The deletion is permanent and should only be used during current day posting for correcting errors prior to the claim be submitted to the insurance carrier e f you have do not have a copayment to post to this claim click on the Save button or Alt S to save this claim Claimstronic PMS User s Manul ER Version 5 1 4 May 19 2001 Producing System Reports cla BIE ADATA Es Rr UTE DRESS ELLs Tre Figure 7 6 Claim Window ICD9 amp CPT4 Page Diagnosis Code ICD 9 and Description MA MB MC Charged Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 ICD9 amp CPT4 DATA ITEMS The code and the description of the diagnosis associated with this claim Click on the button or press F2 to display a user definable list of diagnosis codes The start date or service date for each consultation service or performed procedure Must be entered as MM DD YYY Y i e 12 10 1962 The end date for each consultation service of performed procedure if the service end date is different from the service start date Must be entered as MM DDJ YY Y Y i e 12 10 1962 The code used to classify the service supply or procedure rendered Press F2 to display a user definable list of CPT4 codes The modifi
104. e Figure 4 26 Referral Doctor Table Screen To customize the Referral Doctor Code Table l Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last 2 Enter the requested information for a referring doctor then click on Update 4 Click on Exit to close the window Claimstronic PMS User s Manual 4 29 Version 5 1 4 May 19 2001 System Setup and Customization ctwin data RefDr mkd Bl xj Ref Dr Code LastName JAMES FirstName BRENDA MI B Generation Address 342 SOUTH STREET iw Address sure334 Ciy RESTON State va Zip 22090 Phone 999 999 9999 Fax k9 EMail ooo S Tax ld Texld Type Specialty UPin National ID License Id wnt ct eu pev wea Referring Doctor Id Table Figure 4 27 Add Edit Referral Doctor Record Window REFERRAL DOCTOR TABLE DATA ITEMS Claimstronic PMS Users Manual SSS 4 230 Version 5 1 4 May 19 2001 System Setup and Customization REFERRAL DOCTOR TABLE DATA ITEMS CONT TAX ID The identification number assigned to the referring doctor Tax Identification Number or Social Security TAX ID TYPE The code used to designate if the referring doctor s identification number is a Federal ID Number
105. e Installation Create Database Wizard for Peryasive SQL 2000 Choose a server to connect Tau can select a server in which You want to create a database To begin with creating database you must specify a Pervasive SUL server and database interface type Server Interface User name Password Back Cancel Click Next to continue Specify database information screen will appear Create Database Wizard for Pervasive SQL 2000 E x Specify database information M Enter the name of the new database and its directory location Name ctsvs Directory c Sctwin data ES M Use EM ANSI Conversion Iw Use advanced settings Select advanced settings to specify the following options othenwise default values will be applied Internal database name Data file and dictionary file locations Data Source options Back Cancel a For Name type ctsys b For Directory type cActwin data C Select Use advanced settings Click Next to continue Specify advanced database options 2 10 Software Installation Create Database Wizard for Pervasive S0L 7000 Specify advanced database options Set database properties and select ar create an internal database name How do you want to describe the new database Description Meritt ERR B Pe a DET Do you want to create a system or user DSN DSM Type System v Which open mode do you want to use
106. e Maintenance gt gt t Close Figure 4 24 Provider Table Screen To customize the Provider Data Table l Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last 2 Complete the requested information for all the physicians in each of the practices being support by the Claimstronic PMS system then click on Update 3 Click on Exit to close the window To add the provider s DEA and Medical License numbers 5 In the Provider Insurance ID Table insert the assigned ProvCode and PracCode 6 If applicable type in the InsCode that requires the license number for filing insurance T Type in the license name in the InsType field 8 In the NetworkID type in the license number Claimstronic PMS User s Manual 4 26 Version 5 1 4 May 19 2001 System Setup and Customization c ctwin data Provider mkd E 101 x Prov Code i o Prac Code oOo Last Name GENERE First Name NEN Middle Initial Address City 1 State E zip NEED Phone K3 Fax k3 EMail CO Sex DOB uu l SS Special Ty Credential Credential2 m Update Exit First Prey Next Last Provider Insurance Id Table PracCode Networkld Figure 4 25 Add Edit Provider Record W
107. e Scanner for charge entry This function determines how your data is setup on the encounter form Claimstronic PMS Users Manual ssi A Version 5 1 4 May 19 2001 System Setup and Customization d Video Camera Check this if you have chosen to utilize the digital camera function for storing pictures of patients and or their information e Quick Note On Check this if you want the patient s Quick Note function to be on at all times You have an override option in the patient s demographics to turn the function off f Background Color You have the ability to customize the background colors of your current and skipped data entry fields in the patient demographics screen Click on the select option and choose a color from the color box that appears Q HE x EI T NHI NEUSI C EI NINH S NN EI FEET HN EH NN UN E E E S E EN EH ENDO ON Jf aT Custom colors TT T T FS NN E BS mS NN EN EN EDD NN Define Custom Colors gt gt Cancel Figure 4 2 Options Menu System Tab Background Color Palette Note Choosing a dark color may make it difficult to read the information within the patient fields Claimstronic PMS Users Manual SSS 42 Version 5 1 4 May 19 2001 System Setup and Customization Options Number of copies to print tor Chart Label 1 Default ZipCode Auto Account When To Create New Account from Appointment C Newer When an appointment is created C At check in time
108. e codes IEEE The code for the referring doctor Click on the button or press F2 to display a user definable list of referring doctor codes Assign Benefit Click Yesor No to indicate whether the provider has a signed form authorizing the payor to pay the provider and whether the provider accepts such a payment arrangement Info Release Click Yesor No to indicate whether the patient s information will be released to the insurance company Info Release Date Date when patient signed an information release waiver Print Statement to Click Yesor No to indicate whether a statement Guarantor will be printed and sent to the guarantor Charge The current dollar amount charged to the guarantor Payment The current total dollar amount that has been received as payment The dollar amount that the claim was adjusted for the provider Balance The current remaining dollar amount the guarantor owes to the provider Deposit The current dollar amount allocated from received payments 6 6 Entering Patient Information Patient Window Data Items Patient The portion of the charge that the guarantor is Responsible responsible for paying Insurance The portion of the charge that the guarantor s Responsible insurance company is responsible for paying On Hold Amount The portion of the charge that has yet to be allocated to either the guarantor or the insurance company 6 3 Creating Insurance Insured Information You can ente
109. e day Frafile Details Doctors Places David Jones Office C Susan Smith Hav Room Alan Ingle Lab John Smith Figure 4 33 Profile Details Entry Box Claimstronic PMS Users Manual sss 434 Version 5 1 4 May 19 2001 System Setup and Customization 4 Define your Time Settings by using the up and down arrows for both your beginning and ending of day as well as lunch 5 The appointments can be set by a single defined interval every 15 minutes or by wave settings that allow you to alternate appointment intervals To add an interval select the number in the minutes between appointments window and click the right arrow button to add it to the sequence of settings In the example shown appointment interval pattern is 30 minutes 15 minutes and 30 minutes until the end of the day Time Settings Begin Day 02 00 Abd Begin Lunch a OO PM End D ay 05 00 PM End Lunch 02 00 PH Minutes Between Wave Settings Wave Example Appointments pos 15 E ess Figure 4 34 New Profile Dialog Box Claimstronic PMS Users Manual SS 4385 Version 5 1 4 May 19 2001 System Setup and Customization 7 Designate your appointment types by clicking on the Appointment Types button Appointment Types 4 You are now able enter specific codes and descriptors for the types of appointments to be scheduled as well as color schemes to complete the customization of the Appoin
110. e done performing the appropriate roll back procedure click on the Close button x to close the preview window ie Re Allocabe Oam Detal anla L Ax Chan aged Pa A0 ED 00 za BME OFFICE VISIT LINL Ow 00 5 00 na TBST 3415 LAB HANDLING FEE Payment Bares Procedumi Fe DOS tPT3 Oesa Linus Charges 1 1 eve eane sl T1B UD emar bo be alipcabed batie vou nay save Pie parmis Cancel Figure 6 11 Re Allocate Detail Funds Window Reallocation of Payment Claimstronic PMS User s Manual 8 10 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Payment and Adjustment Entry 8 5 Find Check Information This function allows you to search for a specific check that has been posted or to view all payment transaction for a particular time frame L From the Claimstronic PMS menu bar click on Patient Billing and select Find Check Information CASS TRO AIC MERIDA TA Fie Appob ment Patent Bling EnikfDey Pacts Menbenaws Tooke Wie Hab al M Inizurence Code u wee em heck Card Numbes 7 I i Figure 6 12 Search For Ledger Information Window Date Option 2 Enter your search parameters You can perform various types of searches depending on how much information you have on the payment 8 11 Payment and Adjustment Entry FIND CHECK INFORMATION DATA ITEMS DATE The From and To date for the search Choose thi
111. e entered as MM DDJ Y Y Y Y i e 12 10 1962 Claimstronic PMS User s Manual 5 7 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler Appointment Scheduler Data Items Data Description Appointment Info Tab Cont Time The time of the patient s appointment Click on the button to display a list of available times Must be entered as HH MM AM PM i e 03 30 PM Length The duration of the patient s appointment in minutes Appointment Type The code and the description of the type of appointment Click on the button to display a user definable list of appointment types The code and the name of the doctor the patient will be seeing during the appointment Click on the button to display a user definable list of doctors The code and the name of the location of the appointment Click on the button to display a user definable list of locations Co Pay Am t The dollar amount the insured is responsible for at the time of wsit Complaint The patient s complaint or reason for visit Check the Print box to have this information printed on the various reports Any specific instructions for the doctor Check the Print box to have this information printed on the various reports Any additional notes or comments related to the appointment Appointment Claimstronic PMS numbers and keeps track of all appointments At Time of App t Tab Che
112. ear Report There are three variations to this report In the Resolution area specify the amount of detail you want to include in the journal report By choosing one of the following e Transaction This report provides the total charge payment of adjustment in a line item format A summary of all transactions is produced and provides a grand total of all services and is referred to as the Journal Summary Report e Line Detail This report provides a break down of each line item within the claim The detail includes transaction types diagnosis procedure codes etc e Month This report provides a summary of all the month to date charge payment and adjustment totals If you have selected Transaction and did not click any item under the Include area all information regarding the claim will be included in the report Charge Payment and Adjustment However you are able to further customize the report by selecting any combination of the items in the Include area In the Date area specify the period that you are producing the report for Click on Preview Print to view how the report will look like when printed Then click on Print to proceed with the printing of the report When printing is done click on Close to exit the window Producing System Reports WINPMS Journal Report 5 E Zoom jos Journal Report Date Method Stamped Date Provider DAVE BROAN Date 4 14 01 From 4 1 01 Practice ABC CLINIC Time 4 22 36
113. ease click on each component in the top down order Suppor Information 2 Click Yes to update HTML Help Do vou wish to install HTML Help 1 3 Update now Claimstronic PMS User s Manual 2 39 Version 5 1 4 May 19 2001 Software Installation 3 The installation of this component may take more several minutes When completed click OK There is no need to restart your computer HTML Help 1 3 x i HTML Help 1 3 Update complete 4 For proper installation please click on each component in the Top down order ww Microsoft DCOM for Windows 95 98 Pervasive Workgroup Engine Pervasive Database Microsoft Data Access Components v Ulamstronic Practice Management System w Microsoft Data Engine Database Setup Microsoft HTML Help Support Information 5 Click Exit to end the Claimstronic Installation program Thank You Thank you for choosing AnviCare Software Practice Management System NOTE Please remove the CD ROM and restart your computer BACK EXIT Anvyilom Inc Ht Ana anv COM Support Information 2301 Gallows Ad Suite 110 Phone 6 6170 Dunn Loring VA 22027 Fax 703 876 3115 Toll Free 877 Claimstronic PMS User s Manual 2 40 Version 5 1 4 May 19 2001 Software Installation 2 2 10 Creating Your User Account After the installation the Claimstronic PMS System icon will be added to your Windows desktop To create your user account 1 Click on the Claimstronic
114. ecify advanced database options Set database properties and select or create an internal database name How do you want to describe the new database Description E ES EERRI B S ot ge a geld eet Do you want to create a system or user DSM DSN Type System e Which open made da you want ta use Far the connection call DSN Open Made Normal To which internal database name do you want the database linked Database name CTDBOO Create Back Cancel Click Next to continue 6 Click Finish to complete installation Create Database Wizard For Pervasive SQL 2000 Completing Create Database Wizard fou have successtully completed the steps required to create a new database The new database will be created as defined below Database name ctzys Linked to internal database name ctdbO01 Data Source interface type Engine Data Source type System Data Source Open Mode Normal Data dictionary file location c elwin sdata Data file locationis k Back Cancel Claimstronic PMS User s Manual 2 16 Version 5 1 4 May 19 2001 Software Installation 7 Click Close Create Database Wizard for Pervasive SQL 7000 EH X p Completing Create Database Wizard Database clsys successfully created M 8 Click Close to exit installation program CLAIMSTRONIC For proper installation please click on each component in
115. eports Maintenance View Help 2 maea Account Information Name DANG VU Address 1200 MAIN City State Zip DUNN LORING VA 22027 Home Phone 703 320 3208 000001 00001 000001 00001 000001 000001 Guarantor 000001 nm Detail of Selected Transaction _ Diagnoses _ Procedure Lines _ Detail Allocations Ledger Report _ View Account As Transaction Date Account 000001 Patient Begin C Guarantor End z Account List View Transactions Sex M DOB 12 12 60 SSN 582 92 9292 Driver Lic 2000 06 13 2000 06 13 PAYMT 2000 06 13 2000 06 13 PAYMT 50 00 INS1 TRGI 4 2000 06 13 2000 0613 ADJMT 500 HMO RE 2nnn ne 13 1 2nnn ne 13 PAYAT AFT View Options Allocation Back Ledger b View Print Close _ Insurer Insurance Information __ Claim Information __ Guarantor Information Figure 10 35 Ledger Report Window Or you may click on the Account List button to open the Data Source List Patient List window From this window enter the account that you want in the Searching text field or select the account from the list After you find the account number click on OK to confirm your selection Then click on Close to exit the window CLAIMSTRONIC Dr Smith File Appointment Patient Biling EndOfDay Reports Maintenance View Help S mealea f a Data Source List Searching Text PATIENT LIST Search By Column
116. er code from the HCPCS uniform classification system used to identify special circumstances associated with the corresponding procedure code entered The dollar amount associated with the performed procedure or service The quantitative measure of e identical medical or surgical services e performed 7 9 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports e the supply units provided for the e corresponding procedure code The diagnosis indicator i e 1 2 3 4 for which this service or procedure is being performed The code for the place where services were rendered Click on the button to display a user definable list of acceptable place of service codes TS The code used to classify the service supply or procedure rendered Click on the button to display a user definable list of acceptable type of service codes Enter Y or N to indicate whether emergency care was rendered in response to the sudden and unexpected onset of a medical condition a severe injury or an acute exacerbation of a chronic condition which was threatening to life limb or sight an which required immediate medical or surgical treatment Prov The code for the provider rendering the service or procedure Press F2 to display a user definable list of provider codes The description associated with the CPT4 code The dollar amount paid by the patient for this claim as the CoPay Payment Type
117. er to Connect Note You should not have to enter the name of a Server The Server field will automatically default to the name of the computer system that Claimstronic is being installed on For example if the name of your computer system is DDOO1 then the name of the Server shown in the screen below will be DDO001 Create Database Wizard for Peryasive SQL 2000 Choose a server to connect fou can select a server in which you want En create a database To begin with creating database vou must specify a Pervasive SOL server and database interface type Server Interface Engine User name Password Click Next to continue Specify database information Create Database Wizard for Pervasive SQL 2000 E X Specify database information M Enter the name of the new database and its directory location M ame Jctwin001 Directory Jo ctwindata x Use DEM ANSI Conversion v Use advanced settings Select advanced settings to specify the following options fothenwice default values will be applied Internal database name Data file and dictionary file locationis Data Source options Back Cancel a For Name type ctwin001 b For Directory type cActwin data C Click Use advanced settings Click Next to continue 2 15 Software Installation 5 Specify advanced database options Create Database Wizard for Pervasive SQL 2000 Sp
118. etup will close To install Pervasive SOL 2000 you must accept this agreement Click Yes to accept license agreement 4 Click on the set up you prefer x Click the type of Setup you prefer then click Nest PERJASIVE oOrFTWARHE Custom Description Recommended for most users Installs all components including Transactienal and Relational Workstation Interfaces Client Requesters Utilities and Online Documentation lt Back Cancel Typical is recommended for most users Click Next to continue 5 Select the installation directory Claimstronic PMS User s Manual 2 23 Version 5 1 4 May 19 2001 Software Installation PERVASIVE Please enter the installation directory For Pervasive SOL s client software Note Due to a known limitation of InstallShield under acd Wind this dialog box does not have a Browse button Please type in the target folder Folder Back Cancel You may accept the de fault by clicking Next or click the Browse button to re direct the installation of the directory 6 Pervasive SQL 2000 will be automatically installed This may take up to two minutes Do not proceed until the screen in Step 7 appears Claimstronic PMS User s Manual 2 24 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Software Installation To continue installation click Next 32 bit Btrieve Functionalit
119. formation In addition to a convenient set of tabs to help you move through each form as needed the view also has a set of navigation and function keys in the lower left and lower right If a field name is underlined it is a required field and you are unable commit your entry until information has been entered To move from field to field use the Tab key Many of the fields have pull down lists associated with them such as those preceded by a button with an ellipsis Click on the button or press F2 to access a pull down list or a search window containing a list of options available for the selected field To edit an entry in a field proceeded by a button with an ellipsis simply press F3 This will lead you to the Add Edit window available for the selected field From this window you can add a new entry or make your modifications Patient Guarantor Information Window Ass Sou TT icc qm Civis mem emm On eor Sx BithDae HomeTelf HFexf Marital ssN woke wrex Employed DriverLicf Et Ema Provider Assign Benefit 7 Yes No Practice A a Info Release V Yes No RefDr Jum Info Release Date Ret Source Print Statementto Guarantor 7 Yes No Charge Balance ERE Patient Responsible zr Payment Deposit oo Insurance Responsible Adjustment OnHold moun Ix c EDT ADD c Evo gt gt Figure 3 2 Patient Guarantor Info
120. g Most payors will send a confirmation and error report for claims received To access the reports choose View Reports and then select one of the payor reports They are the reports received other than the batch confirmation report A list of claims submitted will be listed You will need to review the report for error information listed You have and option to correct the claim online by accessing the account under the Manage Claim menu Your search options are by Account Number Patient Name or Batch Trace Number Make the corrections and resubmit To correct claims through Claimstronic PMS refer to Section 7 6 2 Correct and Existing Claim and Re Queue to Submit for instructions Claimstronic PMS recommends that you edit and correct your electronic files daily This will prevent delays in claims processing Note Errors that are related to patient demographics date of birth identification number etc also need to be corrected within the billing system to prevent future claims from being rejected 9 13 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 9 3 Preparing Patient Statements There are two ways to prepare and print patient statements O Via the Statement Report window for batch processing QO Via the Patient Guarantor window Refer to Section 7 5 Printing a Superbill and Patient Stateme nt for an individual statement l From the Claimstronic PMS menu bar click on Reports and
121. graphic Labels Figure 10 20 Report Menu Aging Report Option 2 If you are creating a report for a specific doctor enter the doctor s code in the Provider field You may also select the code from the pull down list Then enter the doctor s practice code 1 e organization or group to which the doctor belongs to in the Practice field or simply select from the pull down list If you are creating a report for a specific group simply leave the Provider field blank and enter the code of the desired group in the Practice field 10 15 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports WINPMS Aging Report Options Aging Report ersc GIORGIO kasr Absolute Provider o1 DAVE BROWN Regular Practice mi gt aec CLINIC C Summary Responsible Party C All insurance Patient C Hold Code Type Master Code Aging Method r Aging Day Period Order by u Iv Include Note Stamped Date I 31 60 amp Account ae C Serviced Date a C Balance TI 91 120 120 Close Figure 10 21 Aging Report Window Indicate which data you want Claimstronic PMS to retrieve the information from by choosing one the these options Absolute This aging process is based on when a claim was created Regular This aging process is based on when an insurance company was created for an account Summary This aging option is based on when the pa
122. he database linked Database name DEMODATA Create Back Cancel Click Create to continue 6 Enter the database name Create Database Name for Pervasive S0L 7000 Database name ctabom v Integrity enforced Bound DDF created Cancel Dictionary location csetwinkdata Data file locations X c chwn sdata Change database name to ctdb001 Click OK Claimstronic PMS User s Manual 2 33 Version 5 1 4 May 19 2001 Software Installation 7 Click Next to continue Create Database Wizard for Pervasive SQL 2000 E x Specify advanced database options M Set database properties and select or create an internal database name s How do vau want to describe the new database Description Pervasive ODBC Engine Interface Do vou want to create a system ar user DSN DSN Type System rl Which open made do you want to use for the connection call DSM Open Made Normal To which internal database name do vou want the database linked Database name CTDBoO1 Back Ment gt Cancel 8 Click Finish to complete installation Create Database Wizard for Pervasive SQL 2000 E X Completing Create Database Wizard Tou have successfully completed the steps required to create a new database The new database will be created as defined below Database name clays Linked to internal database name ctdbt Data S
123. ice management enhanced patient communications streamlined billing a lower claims error rate and faster payment The system also uses data collected to calculate useful statistics and produce accurate financial reports 1 1 Intended Audience This manual is written for office professionals who are already performing medical practice billing and are familiar with its terminology data structures and procedures It also assumes the user has experience operating modern Windows based computer applications using keyboard and mouse devices 1 2 System Overview Claimstronic PMS is a complex system for properly managing an extraordinary amount of data pertaining to the administration of patient care from an easy to use interface It consists of the following OQ Multiple databases O Utilities for maintenance of the databases Q Administrative security a Intuitive data entry screens or windows that capture new patient insurance and diagnosis procedure data and uses that data as input for claims submittals ledgers journals and reports o The report generation utility is flexible and easy to use Q In addition to pre loading fields with patient information from the database and allowing appointments to be added located moved and deleted the appointment scheduler can be customized extensively to accommodate the specifics of the daily structure of the practice being supported 1 1 u Introduction to Claimstronic PMS The
124. ice was performed e Service Type This report provides information on the number 10 21 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports description and total count of each type of service that was performed e Service Place This report provides information on the number description and total count of each place of service that was performed e CPT4 Code This report provides the procedure code and description total number of times performed and total charge amount By choosing the View Detail option the report will generate the same information but will include the account claim information e CD9 Code This report will provide the diagnosis code description and the total number of times used e nsurance This report will provide the total charges payment and adjustments associated with all the insurance companies the have had activity within the specified time period e Referral Dr This report will provide the name of the referring physician and total number of referred patient Click on Preview Print to view the generated report before printing After checking the report click on the Print icon 1 amp to proceed with the printing If you want to save the report as a file click on the Export icon E and specify the filename in the Export dialog box see Figure 10 22 10 22 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Report
125. ient s account number Case Number Claimstronic PMS automatically assigns a case number Person responsible for creating the case Physician that the case applies to RefDr Code The referring doctor that either sent the patient to you or to whom you obtained an authorization number for Insurance authorization number Information pertaining to the case Date user started the case Date user ended the case Type of visit as it relates to the case The onset date of symptoms or accident Determines is the case is active or inactive 6 7 3 Updating Dependent Address Information Claimstronic PMS offers the ability to update all dependent address information at one time from the guarantor account L Refer to Section 6 1 Finding an Existing Patient and Section 6 2 1 Editing an Existing Patient Account for instructions on how to update the guarantor s information 2 From the Additional Patient Information window click on the AddrUpd button Claimstronic PMS User s Manul S 645 Version 5 1 4 May 19 2001 Entering Patient Information Patient Guarantor Information Window Figure 6 11 Additional Patient Information Window AddrUpd Option 3 The following message will appear Figure 6 12 AddrUpd Message 4 Click on OK to update all dependent accounts or click Cancelto close without committing any updates Claimstronic PMS User s Manul S 6416 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1
126. ient s insurance company A Patient Statement is an itemization of a claim s that shows the account activity such as charges and payments To print a SuperBill l Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 From the Claimstronic PMS menu bar click on Patient Billing then on Patient or click on the Patient icon 141 from the toolbar From the Patient Guarantor Information window click on the Claim tab to open the Claim window From the Claim window click on the Print button and select Superbill From the Claim Window click in the Print button and Select Stateme nt You will have an option to choose the current claim or all claims for the account For instructions on monthly statement billing refer to section 9 Patient Statements After successfully printing click on Close to exit the window CLAIMSTRONIC Practice01 File Appointment Patient Biling EndOfDay Reports Maintenance Tools View Help u Gol ee lt 9 Gi se Patient Guarantor Information Window 000003 ALICE 000002 000008 000009 JACK DEBBIE PETER 000010 DONNA BCBSO1 Account 000008 Guarantor Account Guarantor ClaimNumber StpD ate LasvFustName STORE SERERE MEE sut E Address 1 220 RIVER UREA WANEIGRT TT croc 2 FIDOS IH 12 13 Charged Show Quick Note C On Off looo008 000003 14 4 12 01 4 12 01 E D D I8
127. indow PROVIDER TABLE DATA ITEMS pac cone Claimstronic PHS Users Manual 0000000000000 00000 427 Version 5 1 4 May 19 2001 System Setup and Customization PROVIDER TABLE DATA ITEMS CONT Pn OOOO ACCEPT ASSIGNMENT SS C The provider agrees to submit and accept on the patient s behalf payment of claims as well as any other contractual obligations ROUTING The encounter form SuperBill designated to the physician SHEET NAME The practice code assigned for the various practice locations The insurance code assigned in the Insurance Table for the plan that has designated a Network ID specific for the physician NETWORK ID The unique Network Identification Number assigned to the physician BCBS UPIN etc Claimstronic PMS Users Manual SSS 428 Version 5 1 4 May 19 2001 System Setup and Customization 4 4 5 Referral Doctor Information Claimstronic PMS lets you build a database of the physicians who refer patients to you This data is required for some insurance claims and is useful for doctor to doctor correspondence as well as general contact information The following window appears when you select Referral Dr Code from the Maintenance Menu pull down list Referral Doctor Table X User Defined Code Change Index RefDiCode LastN ame FirstName MI Generation Address Address2 SENE gt p JONES HARRY Add Edit Delete Print Tiki File Maintenance b Cl Clos
128. int to view the generated report before printing Claimstronic PMS User s Manual 10 13 Version 5 1 4 May 19 2001 Producing System Reports 10 After printing the report click on Close to exit the New Patient Report window HEE PATIENT FEPL URT ECVIDER TIE DAVIE FROG 3159 2000 TC diriz aioi RACTISE TIE DAVIS HD ACCOUNT NAHE INSCODE IHSUBAMCE MAKE Doe REF DF D0303 G16 DANG HC ARED HEDICAhE FART H of20 2000 A mm f e BRBEXAEA HOLES AETHERE RETHA USHT HO 107 2072000 AA w10 ANANDO BATUOT ACAIF DEPT OF MEDICAL ASSISTANCE 310 15 300D AA Figure 10 19 Sample Generated New Patient Report Claimstronic PMS User s Manual 10 14 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 10 2 2 Aging Report Producing System Reports The Aging Report contains information about the claims that have lapsed the warning period overdue and have not been paid yet l From the Claimstronic PMS menu bar click on Reports and select Aging Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDbay Reports Maintenance Tools View E u za ge 3 Gil se New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Detail Procedure Report Account Detail Procedure Report Appeal Claim Report Print Patient Demo
129. is Information When lt AnpointmentDate gt lt Appointment TimePeriod gt With lt Dactor gt Purpose zAppaointmentTypez Comments Comment Help us serve our patients better If you need to cancel or reschedule please call 24 hours in advance of the scheduled appointment time Figure 5 20 Sample Patient Reminder Letter Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 igix PatientM ame Address Addressz CityStatezip HomePhone WarkPhone SocialSecurity AppointmentD ate AppaintmentTimaeF Doctor Comment 5 17 Using the Appointment Scheduler 5 12 Printing Practice Appointment Statistics 1 Access the Statistical Report option via Reports in the Appointment Scheduler Appointment Scheduler File Search Reports Settings Help Print Appointmenet Grid Appointments Report Patient Reminders Appointment HISO Statistical Reports Tuesday Api Routing Sheets Figure 5 21 Search Function Location 2 Choose the From and To dates that you want Claimstronic PMS to calculate your report This report breaks down all appointments by provider as well as the practice as a whole Practice Statistics MEA Practice Statistics Report From Date To Date Print E 11 0 4 10 01 Figure 5 22 Statistical Reports Window 3 You will receive a view of the report you requested You may print this report by simply clicking on the printer icon Cl
130. it Routing Sheet Option 2 Click on Edit from the Manage Routing Sheet window to obtain the template A Claimstronic Manage Routing Sheet SES t Routing Sheet Number Of Column Number Of Column E Font Size Font Size 08 T Show Values Show Values TRUE Print Seperate Page for ICD9 and CPT 4 TRUE v Figure 4 37 Manage Routing Sheet Window 3 From the document Open window double click with the mouse on the RoutingSheet xml file Note For customization of multiple Routing Sheets contact the Claimstronic PMS support department Claimstronic PMS Users Manual gt SSS 437 Version 5 1 4 May 19 2001 System Setup and Customization Open Look in E bwin ce oa ctup c save Data HCF A xmi Help E Poutingsheet xml Lead 2 RoutingSheetSchema xml Jede gt File name Routingsheet ml Files of type KML Files ML Cancel Open as read only VE Figure 4 38 Document Open Window RoutingSheet xml File 4 The ICD9 and CPT4 information will populate into the Manage Routing Sheet window Note The Claimstronic PMS comes preloaded with a Routing Sheet template Claimstronic Manage Routing Sheet X Manage Routing Sheet Heading Your Practice Name Goes Here 2301 Gallows Rd Dunn Loring VA 22027 703 876 6170 TaxlD 00 0 ACNE VULGARIS 706 1 New Patient ALLERGIC RHINITIS 477 9 LEVEL ONE 99201 ALLERGY DUE TO OTHER ALLERGE 477 8 LEVEL TWO 989202 LEVEL THREE
131. justment click Okay or Alt O to save the payment e Claimstronic PMS keeps a running tally of the amount posted to each line item in the Payment box found on the left side of the payment screen I If you are entering an adjustment in addition to the payment enter the adjustment amount in C Adj column Enter the appropriate adjustment code by manually entering the code number or by utilizing the drop down box for a list of options Save by clicking Okay or Alt O CLAIMSTRONIC Practice01 Eile Appointment Patient Biling EndOfDay Reports Maintenance Tools View Help ee 25 lt 9 se Payment Eq Account ES 000003 us eti edhe Me iiad Ir Adjustment Only E ascia Date fart 2 01 Amount 65 00 Expired Date Payment Type CHECK Remain 65 00 Authorization IB 142 Payor BcBso1 BLUE CROSS AND BLUE SHI sij Close 4 Payment 50 00 Approved Adjust 5 00 Adjust Code 4 PROFESSIONAL COUR Units LineCharged Paid Allowable Balanced C AdiCode 1 0 4 12 01 33203 100 00 wv Ok sie ar Xx cancel Figure 8 3 Payment Window Claim s Procedures Option 8 Claimstronic PMS will automatically return the cursor to the Account field on the Claims window 9 If the full amount of the check was not posted the remaining balance will appear in the Remain field on the Claim window 10 You may choose to enter payments to the same account by simply clicki
132. l Claim Report Print Patient Demographic Labels Figure 10 28 Reports Menu Evaluation Management Report Option 2 Specify the desired parameters from the report generation window including whether you want to see a graphical or textual representation of the data To see a chart click on Chart in the View box then select View Print The Chart is currently a view only option 3 Evaluation Management Report MESE Evaluation Management E M Report Date Type f Date of Service C Stamp Date Provider Practice From 41701 F To 4 10 o View 417701 4 58 41 PM Chart Printing form Figure 10 Evaluation Management Report Window Claimstronic PMS User s Manual 10 24 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports Evaluation Management E M Report r Bate Type Date of Service Stamp Date Provider Practice From 10 13 1888 To 11 13 2000 11713 2000 7 30 13 AM CHART SUMMARY ON UNITS OF CPT4 CODES MEN PATIENTS ESTABLISHED PATIENTS 14 14 20 12 12 10 10 Ux B B 1 B B 4 4 5 xs z 99701 99202 33203 33204 38205 38211 383212 38213 33214 33215 CPT4 Codes CPT4 Codes Figure 10 29 Generated Evaluation Management Report Chart View 2 To see a textual report
133. laimstronic PMS User s Manual 2 28 Version 5 1 4 May 19 2001 Software Installation 2 Claimstronic may need to configure the windows installer which will prompt you to restart your computer to finish the installation of the software Click Yes and the computer will restart and continue the installation For proper ins Windows Installer the top down i You must restart your system for the configuration changes made to Windows Installer to take effect Click Yes to restart now or Ma if vou plan ta manually restart later Support Information 3 Claimstronic Practice Management System will be installed This may take up to two minutes Note If you receive an error message click continue ie Claimstronic Practice Management System Installing Claimstronic Practice Management System Claimstionic Practice Management System is being installed Copying new files Claimstronic PMS User s Manual 2 29 Version 5 1 4 May 19 2001 Software Installation 4 Installation complete Ta Claimstronic Practice Management System Installation Complete Elaimstronic Practice Management 5 vstem has been sucessfully installed Click Close to exit Cancel Previous mm Click Close to complete installation 2 2 6 Microsoft Data Engine Component L Select Microsoft Data Engine by left clicking on the component For proper installation please click on each component in the
134. ld match the Profile Name PHYSICIAN The provider of service MAX The number of appointments allowed per time slot BOOKINGS Claimstronic PMS Users Manual 433 Version 5 1 4 May 19 2001 System Setup and Customization Resource Settings Code Location Max Bookings jo Office Susan Smith EN Xf sRom 2 EN jb 0 SS o d Places Equipment CODE The code utilized to identify the place of service LOCATION Description of treatment room or equipment MAX The number of appointments allowed per time slot BOOKINGS Note You must use the enter key to complete each entry and advance to the next column while setting up the Appointment Types 4 Create your Profile s by clicking on the New button Enter a profile by typing in an identifier preferably the Physician Code that was assigned in Resource Settings and click on OK You can later modify or delete any aspects of a profile by selecting it with your cursor and deleting retyping as appropriate The profile name will be the identifier that appears on the window tabs on the Appointment Grid Hew Profile E4 Profile Hame jal OF Figure 4 32 Time Settings Area 5 The Profile Detail controls the grouping together of providers and places of service as well as how they appear on the appointment grid The profile detail can be an efficient way of scheduling a treatment room or equipment that is shared by the providers during the sam
135. le Screen Claimstronic PMS Users Manual TFA Version 5 1 4 May 19 2001 System Setup and Customization 3 After you click on Edit the Edit window for the selected user record will appear on your screen The Edit window will allow you to change the user information except for the User Code information To move from one user account to another click on the First Prev Next or Last button Make your changes and click on Update to commit them c ctwin data CtUser mkd E Eoix User Code PSTAR FirstName Mary Middle Initial je LastName Brown Address 2345 MAIN STREET Address2 NEED City anyrown State va Zip 22222 Phone 555 555 5555 Sex F SS 123 45 6789 Password kokk k tnt tea per nea te Figure 4 11 Edit User Info Window 4 Enter all the information required then click on Update Claimstronic PMS User s Manual 4 9 Version 5 1 4 May 19 2001 System Setup and Customization 4 3 Customizing Data Tables Efficient operation of Claimstronic PMS relies heavily on usage of data codes Claimstronic PMS comes pre loaded with tables containing industry standard Common Procedural Terminology 4 Edition CPT 4 Procedure Codes Internal Classification of Diseases 9 Revision ICD 9 Diagnosis Codes and City State Zip address codes You may modify add or customize the data tables found in this application according to your practice needs You can also attach mnemonic or practice specific alphan
136. lick on Patient Billing and select Patient or click on the Patient icon FF from the toolbar CLAIMSTRONIC Practiced1 File Appointment Patient Billing EndOfDay R Ege NN ET Claim Pre Copay Payment Continue with Payment Figure 6 1 Patient Billing Menu Patient Option 2 From the Patient Guarantor Information window click on the Account field and press F2 Claimstronic PMS UsersManual 64 Version 5 1 4 May 19 2001 Entering Patient Information Patient Guarantor Information Window Sx BithDae HomeTel He x Marital sN WorkTel wrex Employed z Dierlic E Em Assign Benefit vesto Info Release v Yes No Info Release Date Print Statementta Guarantor P veso Charge EI Balance ERN Patient Responsible m Payment Depst InsuranceResponsible Adustment OnHoldAmount Patient Info Additional Pat Infa Secondary Insured cle gor ooo ve mno gt gt t vo xS o Figure 6 2 Patient Guarantor Information Window 3 Use the Search function from the Patient List window to specify a search parameter such as Last Name to bring up a list of matching patient records from which you can select the desired record ae Window Seanch Results alal x PATIENT LIST search By Searching for Last Name Burisl Sacunty Humber C Patiert Account Crete of Birth Gum
137. ls in the fields for you Practice Statistics Shows a variety of statistic pertaining to appointments schedule d including time and resource utilization Routing Sheet You can print a routing sheet for patients from within the Appointment Scheduler File Label A print of the patient s account number which you can use as a tag for manual filing of documents Patient Demographics Window You can print out a copy of the patient s personal information This can be used to verify current home and work information as well as the patient s current insurance plan 5 13 Using the Appointment Scheduler 5 9 Printing the Appointment Grid 1 Access the Print Appointment Grid option via Reports in the Appointment Scheduler File Search Reports Settings Help Print Appointmenet Grid Appointments Report Patient Reminders APO eth HISOR Statistical Reports Tuesday Api Routing Sheets Figure 5 13 Search Function Location 2 Click on the print icon Es Print Preview a i P n f H zmo qq amp gs Close Appointments 04 09 2001 Time Time Dr John Smith 9 00 AM 9 30 AM 0 00 AM 0 30 AM 1 00 AM 1 30 AM 2 00 PM Lunch 2 30 PM 1 00 PM 1 30 PM 2 00 PM 2 30 PM 3 00 PM 3 30 PM 4 00 PM 4 30 PM 05 00 PM Figure 5 14 Appointment Grid Report Claimstronic PMS User s Manual 5 14 Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 10 Printing an Appointment
138. ly completed the steps required to create a new database The new database will be created as defined below Database name clays Linked to internal database name ctdbt Data Source interlace type Engine Data Source type System Data Source Open Mode Normal Data dictionary file location c chwin data Data file locationis 9 Click Close Create Database Wizard for Pervasive SQL 2000 E E X M A Completing Create Database Wizard Database ctsys successfully created mes Claimstronic PMS User s Manual 2 13 Version 5 1 4 May 19 2001 Software Installation 2 1 6 Create a second database 1 At the main menu right click on the button next to Database Setup The component will no longer be grayed out Left click on the component to continue Select Next to continue installation CLAIMSTRONK For proper installation please click on each component in the top down order Zz Create Database Wizard for Pervasive SQL 2000 This wizard will create database and will guide you through all the necessary steps To continue with creating database click Nest button Copyright c 1999 2000 Pervasive Software Inc All Fights Reserved amp Back Cancel Click Next to continue Claimstronic PMS User s Manual 2 14 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Software Installation Choose a Serv
139. mpletely Free Online Medical Claims Clearinghouse Mind Spring internet Exel MOA P y g pring Bile Edi Mew Favorites loo Lb Fil ee ee MEE E A 4 2 ww a gt Oo a Back Dp E Kp Ralrash Hama Cw Fibes Hicho Pitail Frini ERI RenGi Address dnas E hipstere oadama View Reports Lizred bel ce are al the repa you snime clicking an he repna ican Cdl bring the repan Po rear Por pte ep red es poinr gre vou mac mark a recor for deleri bn bx checking The box re ro The repit name To Hoc aos rhe jalericn of The sel exred repens click the Rect Fepore burn Mare Deleted ports am nor recone Erpa Vimewamp ize OF FIM 1E 1 2009 BT 2001 12 58 rh Pier DI 3330 AER Reno 85 172001 rr r Fia TEIG Sor ET Say 35 71 tb E r r Pi sa32 174 THIM FEFORCI LG Teu May 17czp B EDT TOG m 3007 th Fus My 15 PB BOT O0 eh r35 1 D 34323 MERC Feprri c5 112001 taz Won Pay UE 3615 pent 5 63 rli i 324320 Bairh 4543 Zonfirmatian Fapar ici 132320 ERS Esp eri 142001 is Tou Muay TO TIAE S5 EDIT 124 72 i CURA Figure 9 17 FreeClaims Com Home Page View Reports Option IG eom a om eem nom e e VT M o 25 To begin correcting claim errors select Correct Claims with Missing Payor ID from the Upload Claim File option FreeClaims com Payor List Logout Upload Claim File Correct Claims with Missing Payor ID Correct Claims with Missing Network ID View Repo
140. mply type in your comments and choose ADD The QUICK NOTE does not print on statements or claims form This is an area that can be used to store important health issues or collection comments 6 12 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information 6 7 Additional Patient Information The Additional Pat Info section of the Patient Guarantor Information Window provides a place to store valuable data related to the patient Patient Guarantor Information Window Hn Account pa Last First Name M Suffix m Guarantor 000012 Address 1 Status E NickName Address 2 Show Quick Note City State Zip C On Off E Code Primary Seconday Tertiary Fourth Ex AlamDate CreatedDate CaseNo CaseStatus Case Description PricnAuthorization DateOfDccurenc uere Em js Gen Emo 97 eo em Exe w ok X Cancel MP o Figure 6 8 ere Information Window Additional Pat Info 6 7 1 Patient Notes To enter or edit a patient note Select on new or edit in the top section of the Additional Pat Info to access the Patient Note window CLAIMSTRONIC Account Claim Notes ADD NEW PATIENT NOTE Account DOO Alarm Date Ff Claim Number I Created Date 4 5 1 User ID ETSC Hote v Add X Conca ETI Close Figure 6 9 Patient Notes Window 2 Type a note pertaining to this patient and choose the Add button This i
141. mstronic PMS will not save your entry until the fields have been completed Claimstronic PMS User s Manual 8 1 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Payment and Adjustment Entry Payment x Account m 000004 25 DAN BROWN scm r Adjustment Only A Bae 0 Date 4726 01 Amount 50 00 Expired Date Payment Type CHECK Remain 20 00 Authorization ID 082147 Payor GUA DAN BROWN sf Close _ Account Guaranto Claim StpDate FirstD0S Ins1_ Ins2 1 1 2 3 G Dr Allowable e Charged Paid Adjusted Balanced 4 24 01 4 24 01 BCB10C D D DB 4 01 320 00 320 00 140 00 10 00 170 00 Pay Claim Print HCFA Print Superbill Print Statement Edit Notes Claims Claim s Procedures Claim s Notes Figure 6 1 Payment Window PAYMENT DATA ITEMS Account Patient s account number current claim number and insurance associated with that claim Adjustment Only For adjustments only requires no payment information All Claims View the list of all claims for the patient Claim Bal gt 0 View the list of all claims with balances for the patient __ Required for checks and credit cards Dollar amount left if the full amount of payment was not posted The responsible party associated with the selected claim Expired Date Expiration date of credit card Authorization Approval number for electronic transactions Claims List View of patient claims
142. n allows you to set the billing codes back Printlist to their previous status Print HCFA Grid Prior to printing HCFAs choose this option to receive a list of all claims to be printed Cancel Print Job This option will stop the printer from printing This option will exit the HFCA Print Screen Provider Code This option allows you to prnt HCFAs for an individual provider Resume Printing at This option allows you to restart printing if a section Claim Number of your claims did not produce without having to reprint the entire list Claimstronic PMS User s Manual 9 2 Version 5 1 4 May 19 2001 Insurance and Billing Note For details regarding the changing of the billing status of the claims refer to Section 7 6 2 1 Reflag A Claim Note Secondary forms will automatically default to a Paper Claim 3 For successful processing of Paper Claims Claimstronic PMS suggest the following format e Select a Provider Code to print HCFAs for or leave blank for all e Print HCFA Grid to receive a list of claims to be printed e Print All HCFAs The system will indicate how many claims were to print Reconcile this number with the actual number of HCFA forms If all forms printed answer Yes or Alt Y e View HCFA Printlist to receive a list of claims printed e Flag Printlist to update billing status codes e Close to exit the Print HCFA window 4 Should an error occur during processing do one of the following to correct and
143. nding claims and uncollected copay and coinsurance amounts smart total Statement Data Descriptions Cont Print insurance Prints all outstanding transactions on the account pending claims and total Patient Status Types Allows you to designate patient types to include or exclude from the billing run Medicaid Professional Courtesy etc Leave blank for all patient types Insurance Carrier Allows you to designate insurances to include or exclude from the billing run Medicaid Worker s Comp etc Leave blank for all insurance companies Insurance Types Allows you to designate insurance types to include or exclude from the billing run Medicaid Professional Courtesy etc Leave blank for all insurance types Zero Balance Answer Yes or No to include accounts with balances Claim s Note Answer Yes or No to include any claim notes Global Statement Allow you to attach a customized note that prints Message on all statements Note Be sure you have loaded the statement forms into the printer and have verified alignment Claimstronic PMS User s Manual 9 16 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 9 4 Insurance and Billing Click on Print Preview to view how the statements will look Then click Print to proceed with printing of the statements Click on Close to exit the preview and again on the Statement Report window Preparing Electronic Patient Statements
144. ng on the next claim or use the arrow keys on your keyboard to scroll to the claim line 11 If you are posting payments to multiple accounts follow steps one through seven until the full amount of the check has been posted 12 Save your entries by clicking on Ok or Alt O 13 Exit the window by clicking on Close or by selecting the x on the top right side of window Claimstronic PMS User s Manual 8 4 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 8 2 Payment and Adjustment Entry Note Upon exiting the Payment window if there is any money remaining from the check the following message will appear Claimstronic P You have not finished allocating this check Do vou want to continue at a later time Figure 6 4 Claimstronic Warning Statement Answering No will return you to the Claims window so you can complete the posting process Answering Yes prompts the system to place the remaining amount in a holding area to be posted later Review Section 8 3 Resume Posting Payment for instructions Very Important If you have any pending money to be posted be aware that your Deposit Slip Report will show the full amount of the check and your Journal Report will only show the actual money posted Unless you Resume Posting Payment on the same day your reports will not balance properly Refer to Sections 10 1 1 Printing Journal Report and 10 1 2 Printing a Deposit Slip
145. nnect You can select a server in which You want to create a database To begin with creating database you must specify a Pervasive SOL server and database interface type Server Interface Engine 7 User name Password Click Next to continue Specify database information screen will appear Create Database Wizard for Pervasive SQL 2000 E E E x Specify database information M Enter the name af the new database and its directory location Name tsps Directory c Sctwin data A M Use OEM ANSI Conversion M Use advanced settings Select advanced settings to specify the following options othenwise default values will be applied Internal database name Data file and dictionary file locations Data Source options Back Cancel a For Name type ctsys b For Directory type cActwin data C Select Use advanced settings Click Next to continue 2 32 Software Installation 5 Specify advanced database options Create Database Wizard for Pervasive 5OL 7000 Specify advanced database options Set database properties and select ar create an internal database name How do you want to describe the new database Description EE BRIT oN a gti alt eee Do you want to create a system or user DSN DSH Type sem v Which open made do you want to use far the connection call DSM Open Mode Normal Ta which internal database name da you want t
146. nsurance product Medicare BCBS HMO etc MAX PROCS PER Maximum number of line items per insurance claim form NEIC ID The number assigned by the insurance company designating acceptance of electronic claims Also known as the Payor ID Claimstronic PMS Users Manual amp l9 Version 5 1 4 May 19 2001 System Setup and Customization INSURANCE TABLE DATA ITEMS CONT NEIC CLM OFFICE Additional number assigned by the insurance company for electronic submission of claims DUNNING SET ID Identification number that links the insurance company to the Statement Dunning Messages Refer to Section 4 9 Statement Dunning Message Setup EMC FLAG Y designates to send the insurance claims electronically N designates the insurance claim to be printed at the office MEDIGAP ID The number assigned by Medicare for insurance companies the have automatic crossover for secondary claims FEE SCHEDULE Assign the appropriate FEE SCHEDULE created in the PROCEDURE CODE to assign the correct charge amount EST PAYMENT The time period in which an insurance company proposes TIME to pay their claims ACCEPT The provider agrees to submit and accept on the patient s ASSIGNMENT behalf payment of claims as well as any other contractual obligations CAPITATION FLAG This designates the insurance plan as having a Capitated Arrangement with the provider PRINT STATEMENT Designates if the patient is
147. nt Press F2 to display a list of acceptable values Outside Lab Enter Y or N to indicate whether services were rendered outside the provider s facilities Press F2 to display a list of acceptable values Lab Code The code for the laboratory outside the provider s lab where services were rendered Press F2 to display a list of acceptable lab codes Date Of Using the radio buttons the date of the patient s first symptom accident or LMP Last Menstrual Period can be defined here Must be entered as MM DDJ Y Y Y Y i e 12 10 1962 The date of the patient s first illness Must be entered as MM DD YYY Y i e 12 10 1962 I XRay Date The date of the patient s initial XRay Must be entered as MM DD YYY Y i e 12 10 1962 DOF Cons The date of the patient s first consultation Must be entered as MM DD YYY Y i e 12 10 1962 Recall Date The date the patient is scheduled to return for further consultation Must be entered as MM DDJ Y Y Y Y i e 12 10 1962 Hospitalized From The date on which the patient s hospitalization began Must be entered as MM DDJ Y Y Y Y i e 12 10 1962 Unable To Work The date on which the patient was unable to work From Must be entered as MM DDJ Y Y Y Y i e 12 10 1962 Hospitalized To The date on which the patient s hospitalization terminated Must be entered as MM DD YYYY i e 12 10 1962 Claimstronic PMS User s Manul DE Version 5 1 4 May 19 2001 Producing System Repor
148. nt s and claim s that you want to a post payment until the pending amount of money is zero Close the Payment window when you have completed your posting transactions Click on the Refresh button to update the Ledger window To exit the Ledger window click on Close or Alt C Deleting Roll Back a Payment or an Adjustment Special attention and care should be given to the Roll Back function of Claimstronic PMS e Deleting a check from Claimstronic PMS will affect your Deposit Slip Report and Journal Report Perform this option only on the same stamping date posting date as the check e Reallocated money will not appear on the Deposit Slip Report of date the money was reallocated It will appear on that day s Journal Report From the Claimstronic PMS menu bar click on Patient Billing then on Patient or click on the Patient icon 144 from the toolbar When the Payment window appears click on the Transaction tab The Roll Back function only pertains to payments or adjustments 8 8 Payment and Adjustment Entry From Transaction window select the line item you want to Roll Back DL APSR DA Sa eT A Pie Sopomtment Pajam Ding Emo oftes Reports TUsnbenanee Tog Yee Helo w Ole nie Daten lanranbor Inhenmaben Window U7 EST RETSIN 007757 ME GAM acun M One GATS Guarantor 107756 Adress 1 ao ante fl TA Addrass 2 Shove Quick Hoa chui pmurmare TK renee Con oH munt Eria Cian Ledger A Tren A
149. nthly totals This means you are able at any time to create or recreate data with any of the Claimstronic PMS reports 10 1 Daily Reports 10 1 1 Printing a Journal Report This report is recommended for balancing and reviewing the day s charges payments and adjustments 1 From the Claimstronic PMS menu bar click on EndOfDay and select Journal Report This will lead you to the End of Day Month and Year Report window File Appointment Patient Billing EndofDay Reports Maintenance View Help alalaga Process Paper Claim Process EMC Claims Deposit Slip Report Journal Report Figure 10 1 End Of Day Menu Journal Report 2 From the End of Day Month and Year Report window enter the provider and or practice code s of the doctor that you are creating the report for in the Codes area Provider and Practice fields 3 The Date Type area allows you to specify the Stamped Date the date the transactions were posted or the Serviced Date the actual date the transactions occurred 10 1 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports li End of Day Month and fear Report b E i a x Journal Report Codes im f St d Dat Provider Tp sik mo x amped Date C Serviced Date Resolution Transaction Line Detail C Month Include r Date Charge Payment From 1048 2000 To 1048 2000 zl Adjustment Figure 10 2 End of Day Month and Y
150. ntment from the pop up menu The other option is to choose the delete option from Appointment Detail 5 10 Using the Appointment Scheduler 5 6 Finding an Open Time Slot Use the Search function located on the Scheduler s top menu bar to find an open time slot within a specified set of parameters Appointment Scheduler File Search Epa SE Heb Figure 5 10 Search Function Location In the Open Appointment Search window indicate all the attributes of the appointment desired and then click on Find Now Open Appointment Search Start Date 6 5 00 App t Length i 5 Minutes Select Days Select Doctors Select Places IL Ma Preference C Ma Preference C Sunday David Jones Rav Room C Monday C Susan Smith Lab Tuesday Wednesday C Thursday Friday C Saturday Find Now Wednesday June 07 2000 Alan Ingle 12 15 00 PM 2 30 00 PM 1 00 00 PM u nn nn ru d Search Previous Day Search Next Day gt Figure 5 11 Open Appointment Search Window Claimstronic PMS will present a range of candidate times Navigate to view previous or upcoming days and double click on the time selected An appointment window will be presented Claimstronic PMS User s Manual 5 11 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 7 Finding a Patient s Appointment The search feature also hel
151. o the practice by Freeclaims com 5 Click on the Create button to collect and batch all claims the have a billing status of E Refer to Section 7 6 1 Changing the Billing Status for more information on billing status 6 From the Claimstronic PMS menu bar click on Browse and select 9 4 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing List File File Browse i Send File Batch File Report File Figure 9 5 Browse Menu Error File Option a The List File option produces a report of all claims to be submitted electronically Included in this report are claims that have errors and did not pass the initial Claimstronic PMS editing process Print the List File report epee File Preview me x FILE PREVIEW Cnt Acc ClmnNo RefDr PatientName pos StpDate Insl T Charged Paid ADJ BAL Dr Status 1 oo0o000s8 15 DEBBIE GIORGIO 20010412 20010412 BCBSO1 187 00 0 00 0 00 2 o0000s8 14 DEBBIE GIORGIO 20010412 20010412 BCBSO1 100 00 0 00 0 00 Total Claims Processed Total Claims Fowarded Z Total Claims Rejected Font Font 5 14 01 12 26 48 PM Print Close Figure 9 6 Error File Report 8 Review and correct the rejected claims 9 Return to the Electronic Claim Module window and click on the Create button again This will update the batch to reflect the changes made 10 Repeat steps 6 and 7 to retrieve the updated List File re
152. octor s code in the Provider field You may also select the code from the pull down list Then enter the doctor s practice code 1 e organization or group to which the doctor belongs to in the Practice field or simply select from the pull down list If you are creating a report for a specific group simply leave the Provider field blank and enter the code of the desired group in the Practice field 10 26 Producing System Reports CLAIMSTRONIC Dr Smith at WINPMS INSURER AND INSURANCE INFORMATION Patient Insurer Insurance Information Provider T Practice AT c ode ss Tne Show Claims Figure 10 32 Patient Insurer Insurance Information Window 3 In the Insurance box enter the Insurance code that you want to check in the Code field by doing any of the following e Type in your entry e Click on the button with ellipsis mark to go to the Data Source List Insurance window and select the desired insurance from the list e Highlight the textbox and press F2 to go to the Data Source List Insurance window and select the desired insurance from the list CLAIMSTRONIC Dr Smith x Data Source List me Ss Search AETNA AETNA Figure 10 33 Data Source List Insurance Window Claimstronic PMS User s Manual 10 27 Version 5 1 4 May 19 2001 Producing System Reports 4 If you want to create a report for a specific type of insurance you may specify it in the Ty
153. ode used to designate if your identification number is a Federal ID Number or Social Security Claimstronic PMS Users Manual 0000000000000 0000000000 424 Version 5 1 4 May 19 2001 System Setup and Customization PRACTICE TABLE DATA ITEMS CONT SPECIALTY Only applicable if the practice is a single specialty practice SOLO GROUP Identifies the practice as a solo or group practice Press F2 for FLAG a list of options EMC FLAG Y indicates the practice will electronically file insurance claims CLEARING Electronic code assigned by Freeclaims com HOUSE ID PRACTICE INSURANCE ID TABLE PRAC CODE The code assigned to identify the various locations within your practice INS CODE The insurance code assigned in the Insurance Table for the plan that has designated a Network ID specific for this practice INS TYPE Designates the insurance type commercial Medicare etc NETWORK ID The unique Network Identification Number assigned to your practice BCBS UPIN etc Claimstronic PMS Users Manual SSS 425 Version 5 1 4 May 19 2001 System Setup and Customization 4 4 4 Provider Information The following window appears when you select Providers Info from the Maintenance Menu pull down list Provider Table X User Defined Code Change Index EtoyCode PracCode LastName FistName Middlelriti Seach 01 01 SMITH JOHN Add E dit Delete Print i Fil
154. oducing System Reports L Claims Information Claims Information Claim Options Claim Options Practice n _ ABC CLINIC co PAT C GUAR Balance gt 0 Insurance not pay yet Selected account fooooos Provider Age between days n 1 AVE BROWN REDE with insurance pu Claims for date Account Information Name Home Phone Address Driver Lic City State Zip Eccc ccc RN NUN LE T esol oa tom ee slr 000008 o0003 3 2001 04 03 PODA ecesor 95 00 O00 500 oooj sooo 000008 O0003 4 2001 04 03 PODA BCBS0 14500 ooo 500 9 Q00 140000 000008 000003 5 2001 0403 TDDD BCESO 95 00 00 7500 2000 QOO 000008 o0003 7 2001 04 09 TODA BCBSO 5500 ooo 500 Q00 soooja ioo omoes 1220 0412 Epp feces 1000 000 Tim 100 __ 2 00 01 000008 000003 13 2001 04 12 EDDA BCBSO 10000 ooj 5500 500 soooja rbo0os o0000s 142800412 EDDA feces i ooo oo ao Ton oolot 000008 On0003 15 2001 0412 EDDA BCBSO 95 00 ooo 000 ooo oooi 000008 000003 16 2001 04 12 EHDA BCESO 95 00 Q00 Q00 ooo HOON mmay 2 40 25PM_ 4712 01 10 Clim vsu o eso 350 Figure 7 22 Generated Claims Listing 7 6 2 1 Reflag A Claim L From the Claim editing window locate the claim to edit Locate the Billing Sta
155. on cccsceesseeceeeeceeeessseseeeeees 8 1 8 2 Entering Adjustment Information esses 8 5 8 3 Resume Posting Payment dore Iron Parr 8 7 8 4 Deleting RollBack a Payment or and Adjustment 8 8 8 5 Pind Check Monnd ON o tecto rote oet e orbe eene 8 11 9 Insurance and Billins eee ee eere eene tore nera ee no reU e eua ss 9 9 1 Prepare Paper Clans surcvate cia ite e Rec dat pi von FRE 9 9 2 Preparing Electronic Claims 3 2 ai ehe nho E UD enne 9 4 9 2 Viewing and Correcting Electronic Claims 9 10 9 3 Preparing Patient Statement cccceeeesssccceeceeeesseeeeeeeees 9 14 9 4 Preparing Electronic Patient Statements 9 17 9 5 Quick View of CLAIMS 052255 eet sacs eed urba te EP PIDE Redes 9 18 10 Producing System Reports ee ceereee 10 1 10 1 Day RepOPtsosuse eodd tes snek udin tee bisae deed epos endi io toad 10 1 10 1 1 Printing a Journal Report eseeeeeeses 10 1 10 1 2 Printing a Deposit Slip Report eeeeeeeeeese 10 4 OLES TiCkElet RODOLtuinen aeui io Ita Pe dca die o rect ido fata cens 10 5 10 1 4 Appeal Claim Report 10 8 10 1 5 Print Patient Demographic Labels 10 10 10 2 Monthly IReDORS 5n asiesiak esto aree Rd dh aaies tabem tus 10 12 I0 2 New Patient RepOLL cuocere tec
156. on the component For proper installation please click on each component in the to p d own order Suppor Information CLOSE 2 Installation of component will begin Note Wait until component is completely installe d before proceeding This process will take three to four minutes depending on the speed of your processor 3 Proceed with the installation of the next component Database Setup Claimstronic PMS User s Manual 2 8 Version 5 1 4 May 19 2001 Software Installation 2 1 5 Database Setup Component 1 Select Database Setup by left clicking on the component For proper installation please click on each component in the top down order 2 Create Database Wizard for Pervasive SQL 2000 This wizard will create database and will quide you through all the necessary steps To continue with creating database click Next button Copyright c 1999 2000 Pervasive Software Inc All Fights Reserved Back Cancel 3 Choose a Server to Connect Note You should not have to enter the name of a Server The Server field will automatically default to the name of the computer system that Claimstronic is being installed on For example if the name of your computer system is DDOO1 then the name of the Server shown in the screen below will be DDO0OI Claimstronic PMS User s Manual 2 0 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Softwar
157. on you want to review e Month Year This option provides a daily listing of charges payments and adjustments for the indicated month e Year This option provides a monthly listing of charges payments and adjustments for the indicated year e All Years This option provides a yearly listing of charges payments and adjustments 10 19 Producing System Reports ABC CLINIC Provider DAVE BROWN Tuesday April 17 2001 Year 04 2001 DATE CHARGE PAYMENT ADJUSTMENT 3 495 00 30 00 20 00 8 120 00 70 00 12 917 00 475 00 50 00 14 230 00 50 00 1 762 00 635 00 Figure 10 Sample Month Year Up To Date Report Month Year Option 4 Click on View Print to view the generated report before printing After checking the report click on the Print icon Eh to proceed with printing 6 When printing is done click on the Close button x to close the preview window T Click on Close to exit the Month Year Up To Date Report Claimstronic PMS User s Manual 10 20 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports 10 2 4 End of Month Statistics The End of Month Statistics generates a report based on the number of times a service was performed and the dollar value associated for a specified time period l From the Claimstronic PMS menu bar click on Reports and select End of Month Statistics CLAIMSTRONIC Practice01 Eile Appointment P
158. or Social Security SPECIALTY Physician s practicing specialty UPIN Physician s Unique Provider Identification Number NATIONAL ID Physician s National Identification Number LICENSE ID Physician s State Medical License Number REFERRING DOCTOR ID TABLE REF DR CODE The code assigned to the provider INS CODE The insurance code assigned in the Insurance Table for the plan that has designated a Network ID specific for the physician REF DR ID The unique Network Identification Number assigned to the physician BCBS UPIN etc Claimstronic PMS Users Manual SSS 431 Version 5 1 4 May 19 2001 System Setup and Customization 4 5 Configuring the Appointment Scheduler The final Claimstronic PMS setup activity involves configuring features within the Appointment Scheduler to make it work most efficiently for the physicians and facilities within your practice You can pre define the following Resources Provider of service Office treatment rooms shared equipment etc Combinations of physicians and rooms that appear on the appointment grid the electronic appointment book to be scheduled Claimstronic PMS can work with up to 8 profiles Profiles The start and end of the day lunch periods and Units of Time l intervals between appointments Customized appointments within your practice which Mp s can be color coded Appointments Refresh The time assigned for the appointment scheduler to Appointments
159. ource interlace type Engine Data Source type System Data Source Open Mode Normal Data dictionary File location c chwin data Data file locationis k Back Cancel Claimstronic PMS User s Manual 2 34 Version 5 1 4 May 19 2001 Software Installation 9 Click Close Create Database Wizard for Pervasive SQL 2000 2 E X we p Completing Create Database Wizard Database clays successfully created mes Claimstronic PMS User s Manual 2 35 Version 5 1 4 May 19 2001 Software Installation 2 2 8 Create a second database L At the main menu right click on the button next to Database Setup The component will no longer be grayed out Left click on the component to continue Select Next to continue installation CLAIMSTRONK For proper installation please click on each component in the top down order 2 Create Database Wizard for Pervasive SQL 2000 This wizard will create database and will quide you through all the necessary steps To continue with creating database click Nest button Copyright c 1999 2000 Pervasive Software Inc All Fights Reserved amp Back Cancel Click Next to continue Claimstronic PMS User s Manual 2 36 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Software Installation Choose a Server to Connect Note You should not have to enter the name of a Server The
160. ox for a list of options Save by clicking Okay or Alt O Faryl xcauni Tz ni i PE Adpetrenttiniy s hod M Em F ClaimstronicPMS User s Manul DT Version 5 1 4 May 19 2001 Producing System Reports 7 4 Creating Claim Notes Claim notes are a valuable tool for billing and collections and can provide a follow up method to assist in those departments L To add a Claim Note to an account access the patient s account From the Claimstronic PMS menu bar click on Patient Billing and select Patient or click on the Patient icon FF from the toolbar 2 From the Patient Guarantor Information window select the account that you want to check refer to Section 6 2 Finding an Existing Patient for instructions and then click on the Claim tab to view the Claim page 3 From the Claim page choose the claim you want to add a note and click on Edit or Alt d and then click on the Claim Note tab to view the Claim Note page Claim Entry X 7 l Edit Claim Note AlamDate CreatedDate StatementFlag 4 12 01 QYes No PATIENT ICD9s amp CPT4s Claim Note 4 12 01 10 26 03 AM v Save Xx Cancel Figure 7 13 Claim Window Claim Note Page Note You cannot add a claim note while creating a new claim You can only add a claim note to an existing claim Claimstronic PMS UsersManual S75
161. pay Payment Resume Posting Payment Find Check Information Figure 8 7 Patient Billing Window Resume Posting Payment Option 2 You will be taken to the Ledger window that stores all unallocated money DLAPSSTRDNIE ENT AX Pile pitna Patent Ging Doofer Hepatis Manensme Tods Yew Heb ze aaae Transactions of the Selected Ledger Accord Gumeni Carbarbes bedgeiunien E EipDas dr aa a Talem TO Fe Tian urbi Barani nada Eie Figure 6 8 Resume Posting Payment Ledger Window Claimstronic PMS User s Manual 8 7 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 8 4 Payment and Adjustment Entry Access the Ledger List by choosing the View option e All for every payment posted in Claimstronic PMS or e Pending gt 0 for only payments that have unallocated money The Ledger window provides two separate transaction views e The top view Ledger List provides a detail listing of all payments that have unallocated money You are able to view the check information posting date total amount of the payment the pending amount and the user responsible for posting e The bottom view Transactions of the Selected Ledger provides a detail listing of all accounts and individual transactions that are associated with the selected payment from the Ledger List To post the unallocated money click on Allocate Payment or Alt A to access the Payment window Select the accou
162. pe field 5 After you have entered your data click on Show Claims The requested information will appear in the center box 6 To scroll within the generated report use the scroll bar located just below the center box 10 3 2 Ledger Reports A Ledger Report is also called an Account report You can generate this report to check important information about a specific account Information to be included in this report depends on the data that you specified in the Ledger Report window To generate a Ledger report From the Claimstronic PMS menu bar click on Reports and select Ledger Report CLAIMSTRONIC Practice01 File Appointment Patient Billing EndOfDay Reports Maintenance Tools View Ff mes essel New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 34 Reports Menu Ledger Report Option 2 From the Ledger Report window locate the Account field and specify the account number that you want to check Then click on the account type whether the specified account belongs to a guarantor or a patient Claimstronic PMS User s Manual 10 28 Version 5 1 4 May 19 2001 CLAIMSTRONIC Dr Smith Producing System Reports File Appointment Patient Biling EndOfDay R
163. port Print the report and keep hard copy as proof of claims that were submitted Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 11 Click on the Flag button in the Electronic Claim Module window This will update the billing status from E to S to indicate the claims have been sent Note Once you have flagged a batch follow the procedures in Section 7 6 2 Correct and Ex isting Claim and Re Queue to Submit for claim corrections 12 Access your Internet Explorer log on to the Internet 13 In the address field type www freeclaims com and hit enter 23 Welcome to MSN com MindSpring Internet Explorer Eile Edit View Favorites Tools Help gt 9 a Ga d By d T Fonverd Stop Refresh Home Search Favorites History Mail Print Edit RealGui www freeclaims com Go Links www freeclaims com http www freeclaims com frcl contentManager jsp msn http www freeclaims com frcl newWWinManager jsp content payorlist http www freeclaims com rclinewVVinManager jsp content payorlist amp payorName brevard Figure 9 7 Internet Address Window 14 From the Freeclaims com Home Page select Member Login 4 FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSpring Internet Expl BEIEIES Eile Edit View Favorites Tools Help Back Ind Stop Refresh Home Search Favorites History Mail Print Edit RealGui Address ja http www freeclaims com frcl con
164. port window 10 2 3 Month Year Up To Date Report The Month Year Up To Date Report provides a running total of all charges payment and adjustments This report is useful for tracking monthly and yearly totals to check for productivity trends From the Claimstronic PMS menu bar click on Reports and select Month year Up To Date Report CLAIMSTRONIC Practice 1 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View t S mag New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 24 Report Menu Month Year Up To Date Option 10 18 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports If you are creating a report for a specific doctor enter the doctor s code in the Provider field You may also select the code from the pull down list If you are creating the report for the group simply leave the Provider field blank WINPMS MONTH YEAR UP To ME Ea MONTHFYrEAR UP TO DATE REPORT Alarm Date From 4 17 01 Ta 4 17 01 Provider o DAYE BROWN Month rear Monthfrear t Year C Al rears Figure 10 Month Year Up to Date Window In the Month Year box select the informati
165. proceed e Cancel Print Job if the printer has jammed or you have claims that should not be printing e Resume Printing at claim number to restart the claims processing e ReFlag HCFA Printlist if you need to reprint all or a mass majority of the claims list e Complete the process as instructed in line 3 above Claimstronic PMS User s Manual 9 3 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 9 2 Preparing Electronic Claims Follow these procedures to prepare electronic claims 1 From the Claimstronic PMS menu bar click on the EndOfDay menu and select Process EMC Claims Fil Appointment Patient Billing EndofDay Reports Maintenance View Help alalaga Process Paper Claim Process EMC Claims Deposit Slip Report Journal Report Figure 9 3 EndOfDay Menu Process EMC Claims 2 From the Electronic Claim Module window type a zero 0 in the Batch Number field Create Batch Mumber Send File Practice Code Get Report Submiter arme jasc CLINIC Submiter Id Account EDOS P H 2h13 G Ins1_ Charged Prov Prac H nonons 000003 4 12 01 4 12 01 BCBSO1 01 D zb oooo0s oooo0s 14 412 01 42 0 E E D amp BCBSU1 Figure 9 4 Electronic Claim Module 3 Type in the appropriate Practice Code Claimstronic PMS will automatically complete the Submitter name 4 Type in the Submitter ID number assigned t
166. ps you find appointments that exist in the system When you select Find Patient s App t from the Search function pull down you will be presented with a searchable table of all appointments in the system Double click on the appointment you are searching for in the table The appointment window opens allowing you to confirm and or modify the appointment Search for Iv Only In Future Search Results double click appointment to open a a SESS Se JLena HOO WILSON LINDA 55555599 5 5 00 02 00 4M BROWN DAVID 333333333 675700 13 30 AM 2434 000001 SMITH JOHN 6 5 00 10 15AM 20 2435 COOPER LORI 6 500 0 amp 45AM 30 2432 000002 MOORE REEDA 462168748 EA14 00 11 00AM B0 Cancel Figure 5 12 Appointment Search Window 5 12 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 8 Printing Appointment Related Reports The Appointment Scheduler can produce several reports These are accessed from the Scheduler s menu toolbar and include E Appointment Grid A printout showing all appointments on the specified active grid Appointment Reports A printout listing all appointments for a specified physician for a specified day Patient Reminder An editable form letter reminding patients of upcoming scheduled appointments Just click on the desired fields in the right hand margin to have them included in your letters The system fil
167. r click on File from the Letter rtf WordPad window and select Save B Letter rtf WordPad 3 625 5021 been paid yet Please pay this amount in 2 weeks If you already s at the number above Please pay the total amount enclosed Thank you Figure 4 44 Letter rtf WordPad Window File Menu Save Option 6 Exit the window by clicking on the x close button at the top right corner of the window Claimstronic PMS Users Manual gt SS 44D Version 5 1 4 May 19 2001 System Setup and Customization 4 8 Patient Statement Setup Due to various print configurations found within different printers 1t may be necessary at times to realign the preset statement parameters l From the Claimstronic PMS menu bar click on Reports and select Statements Refer to Section 9 3 Preparing Patient Statements for instructions on billing CLAIMSTRONIC Practice01 Statement Figure 4 44 Reports Menu Statement Option 2 From the Statement Report window select Setup Print Sample Page WINPIVIS Statement Report HAVE A SAFE AND HAPPY SUMMER Figure 4 45 Statement Window Setup Print Sample Page Option Because the print sample does not give a true sample of the statement I stopped here until further instructions as to if this will be changed or if I need to instruct user to go through PT demo screen to obtain sample Claimstronic PMS Users Manual SS 442 Version 5 1 4 May 19 2001 System Setup and Customization
168. r hold Show Quick Note Click on the On or Off buttons to control the patient s Quick Note window City State Zip The city state and zip code associated with the above address of the patient You can quickly enter the information to the account by typing the zip code within the City field Click on the l button or press F2 in the city or zip code fields to display a user definable list of cities and zip codes The gender of the patient Click on the button to display a list of acceptable values The marital status of the patient Click on the button to display a list of acceptable values Employed The employment status of the patient Click on the button to display a list of acceptable values Birth Date The patient s birth date Must be entered as MM DDJ YY Y Y i e 12 10 1962 6 5 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information Patient Window Data Items Data pescon ss mepatenesoosssnriymomber rax Trepatentstomearteephonenumber The patient s telephone extension number associated with the above work telephone number The patient s e mail address Provider The code and the name of the patient s chosen provider Click on the button or press F2 to display a user definable list of provider codes The practice code associated with the above provider Click on the button or press F2 to display a user definable list of practic
169. r your patient s insurance information in the Patient Guarantor window Primary Secondary and Tertiary Insured pages To access these pages do the following 1 Click on the Primary Insured tab located at the bottom of the Patient Guarantor Information window Patient Guarantor Information Window Account LasvFirstName MI Stix J Guarantor Addessi Status 7 NickName Address2 SSS Show Quick Note CiStis zi n n Con or Current Insured Info Primary Secondary Tetiary E F LastName FistName geni dh New fl eai Self Pay v Ok ETI Close Figure 6 5 Patient Guarantor Information Window Primary Insured 2 Click on New or Edit to access the Insured Insurance Information window Claimstronic PMS User s Manul OFF Version 5 1 4 May 19 2001 Entering Patient Information CLAIMSTRONIC Dr Smith jafx File Appointment Patient Biling EndOfDay Reports Maintenance View Help maaalal Insured Insurance Information Screen Patinsurer Rel o1 Payor Code 2 frRGoN TRIGON BC BS Last Name s Birth Date 12 12 1960 Age 39 First Name Social Security 582 92 9292 Sex M z Suffix Driver License Address 1 1200 MAIN Home Phone 703 920 9209 Address 2 Home Fax 703 929 2029 City State Zip lt DUNNLoRING fva 22027 Work Phone 703 929 2939
170. ram should launch automatically if not go to Start Run and type d setup If your CD ROM is not drive D substitute the appropriate letter for D Install needed components by left clicking once on the component s Start from the top of the menu select Pervasive Workgroup Engine first left click on component proceed in top down order You should install all components that are not grayed out 2 1 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 3 4 Software Installation Support Information After clicking on Pervasive Data Engine follow the prompts for installation PSP ASIN Ortws x J Welcome to the Pervasive SOL 2000 Setup program S j This program will install Pervasive SAL 2000 on pour computer t is strongly recommended that you exit all Windows programs before running this 5 etup program Click Cancel ta quit Setup and then close any programs you have running Click Next ta continue with the Setup program WARNING This program ig protected by copyright law and international treaties Unauthorized reproduction or distribution of this program or any portion of it may result in severe civil and criminal penalties and will be prosecuted ta the maximum extent possible under law Cancel Click Next to continue Software License Agreement Software Installation Software License Agreement E X Please read the following License Agreement
171. rance Lode Type Favor ID m gm 11 13 2000 B ze D4 AM Figure 10 18 New Patient Report Generation Window 3 Select the Date Type by choosing Date of Service actual transaction date or Stamp Date date the transaction was posted This determines the date range you are producing the report for 4 If you are creating a report for a specific doctor enter the doctor s code in the Providerfield You may also select the code from the pull down list Then enter the doctor s practice code i1 e organization or group to which the doctor belongs to in the Practice field or simply select from the pull down list If you are creating a report for a specific group simply leave the Provider field blank and enter the code of the desired group in the Practice field 5 If you are creating a report to determine the resource of referrals by using the pull down box choose a referring physician from the Ref Doctor field 6 From the Insurance option you are able to narrow your New Patient Report down by choosing an insurance company through the Code field the Type of insurance and even as detailed as the Payor ID 7 To create a report to track companies responsible for new patients or for worker s compensation claims type in the name of the company in the Employer s Name field 8 Additional customization of this report includes options such as Procedure Type of Service and Place of Service 9 Click on Preview Pr
172. ranipr Account T Perel Lazi Hame f Nick Hame Diver License Se ne ee Figure 6 3 Patient List Window Search Function Note In the Last Name option you are able to search by entering the patient s full last name and partial first name Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information 6 2 Entering Patient Information To enter a patient s information From the Claimstronic PMS menu bar click on Patient Billing and then select Patient or click on the Patient icon ant from the toolbar 2 When the Patient Guarantor Information window appears check if the current page on display is the Patient Info page check the highlighted tab at the bottom of the window If this 1s not the displayed page simply click on the Patient Info tab 3 Take note that if a field name is underlined it is a required field and you won t be able to commit your entry until the information is entered there For more information on the Patient Guarantor Information window refer to Section 3 2 The Patient Guarantor Information Window 6 7 1 Editing an Existing Patient Account 1 When you have located the correct patient you are able to update add or change any information related to this patient Click Edit or Alt E to do one of the following 2 Patient Info tab will allow you to make changes regarding the patient s personal demographics 3 Additional Pat Info tab will allow you to a
173. re and may include associated media printed materials and online or electronic documentation SOFTWARE PRODUCT By installing copying or otherwise using the SOFTWARE PRODUCT you agree to be bound by the terms of this EULA If you do not agree to the terms of this EULA do not install Do you accept all of the terms of the preceding License Agreement If you choose No Install will close To install you must accept this agreement Yes No d If the error message appears click OK a newer version of DCOM already exists so it is not needed CLAIMSTRONIC For proper installation please click on each component in op down orden 4 newer version of DCOM98 had been installed To override you must uninstall the current version first Support Information 2 2 3 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Note DCOM will automatically install if there is not a version already on the machine Pervasive Data Engine Component Select the Pervasive Workgroup Engine component from the menu by left clicking on the component 2 21 Software Installation Support Information 2 After clicking on Pervasive Data Engine follow the prompts for installation x m Welcome to the Pervasive SQL 2000 Setup program This program will install Pervasive SAL 2000 on pour BeRVAS W T computer t is strongly recommended that you exit all Windows programs before running this 5 etup program
174. rmation Window 3 4 Navigating the Claimstronic PMS Software The Patient Guarantor Information Window consists of the following commands The lower left navigation and function keys appear only when the first two tabs patient information are in use From left to right they are used to I lt Goes to the very first patient record in the file lt Goes to the preceding patient record EDIT the patient record ADD a new patient record DEL Delete a patient record FIND Search for a patient record gt Goes to the next patient record gt l Goes to the last patient record in the file PATIENT INFO Stores patient s personal demographics ADDITIONAL PAT INFO Stores patient notes and authorizations PRIMARY INSURED Stores primary insurance information SECONDARY INSURED Stores secondary insurance information TERTIARY INSURED Stores tertiary insurance information CLAIM Create Edit and Store all claims data Allows access to payment window TRANSACTIONS Itemized listing of transactions of all claims ROUTING SHEET Allows the option of printing or viewing patient s encounter form CHART LABEL Allows the option of printing a chart label SHOW QUICK NOTE Allows for storage of miscellaneous notes pertaining to patient L L L L EL d LH BH dB E ea ss E The lower right function keys become activated only when you are in the Patient Info page When
175. rooms to be scheduled The profile currently in use in shown in bold When a different profile is selected the Appointment Grid changes accordingly The Current Date Time is continuously displayed in the lower right corner The Show Complaints checkbox is used to indicate if you want the patient s ailment to appear on the calendar grid The To Do List option allows an area to place items that need to be addressed or other various notes The App t Detail when selected provides a quick view of the patient s demographics You also have additional options of either editing the patient s appointment or deleting it The Last Cut Appt allows you to review the last appointment that you cut from the scheduler From the Settings Option e For Schedule Configuration refer to Section 4 5 Configuring the Appointment Scheduler e The Template option is not available at this time e The Grid Font allows you to customize the size style and color of your appointment scheduler text e Align Complaints will line up the patient complaints for a more uniformed appearance on the grid e The Display No Shows allows you the option to either hide or view any appointments you have chosen as a No Show In the view option the appointments will remain on the grid and will have a line drawn through them e The Display Cancellations allows you the option to either hide or view any appointments you have chosen as a Cancellation In the
176. rral Doctor Code This information is not only required for claims but serves as a useful mailing list For each you use the standard Maintenance commands to rapidly enter the required data A thorough job done up front on each of these tables saves hours of repeated data entry and increased potential for errors during daily business operations You can always return to any table to add delete or change any of this information as required To customize the practice specific data tables do the following procedures l Select the desired data table from the Maintenance Menu pull down list 2 Select Add from the Table window of the selected data table 3 Enter the required data then click on Update to commit your entries changes 4 Click on Next to add a new record Click on Exit to exit the Add Edit window and proceed to your other tasks Claimstronic PMS Users Manual sss 4T Version 5 1 4 May 19 2001 System Setup and Customization 4 4 1 Insurance Codes The following window appears when you select Insurance Code from the Maintenance Menu pull down list Insurance Table _ _InsCode MasterCode JinsNamel_jinsName2 jAddess LLL Addressd Search ETOL AETNA AETNA INSURAN JAETIQAETNA AETNAINSURAN Too BCBI0 BCBHMO BLUE CROSSAN ie IBCBSO BCBHMO BLUE CROSS AN HFHP HFHP HEALTHFIRST BEEN Tiki File Maintenance SCI Figure 4 1
177. rts Listed below are all the reports you submitted Clicking on the report s icon D1 will bring the report forward for you to review print etc You may mark a report for deletion by checking the box next to the report name To initiate the deletion of the selected reports click the Remove Reports button Note Deleted reports are not recoverable Remove Reports Reset Report Timestamp Size Delete D 3430 MEIC Report 05172001 txt Fri May 18 10 20 09 EDT 2001 12 56 Kb O M aaan aoa minn maeman a Pei hano TO TA AAAS PT EAT er 13 wh m Figure 9 18 Upload Claim File Menu Correct Claims with Missing Payor ID Option 9 10 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing 3 This will access up to 25 payor addresses that FreeClaims com was unable to detect as an electronic payor Correct the insurance address by typing in the NEIC number choosing to print the claim form to paper or rejecting the claim all together By correcting the address at this level all pending claims associated with this address will be corrected and resubmitted automatically Future claims will be corrected as well Pee LTS com GO Bee Pree Oie Medical CMSs CMa ognause LI pr Iu pie internel EXT Paes PIT Completely Free Online Medical Claims Clearingt Mind Spring Exp MEE Bile Edit Wew Favorites Jods pep Fel ie ete AE ial a a ss 2 cc o a ISSN Litres ie cto cess Werte idle fh SR tal
178. ry for customizing the procedure code table this may include associate fees with procedures and data associated with each procedure that varies with different insurance carriers Use Change Index to sort the records in a way that is most useful Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit Then click on Update The same window appears for both functions To move from one record to another click on First Prev Next or Last After you make your entries changes click on Update Claimstronic PMS Users Manual ATS Version 5 1 4 May 19 2001 System Setup and Customization c ctwin data PCode mkd l E E 21 nl x Plode 10060 CPT 4 Code 10060 CPT4Descl ABSCESS I amp D TOS 2 PLS Fu Mad A Mad B Mode p HPCSCode Medicare Code Anes Base Feel 95 00 Fee 0 00 Fees 0 00 Feed jooo Feed 0 00 Feeb 0 00 Fee 00 Fees 0 00 Feed 0 00 Feell o0 87 vn on ron per en PCode Fee Table ae eee en PCode PaymentSchedulelD PaymentScheduleDesc PlanPayAmount Ooo o S e G Figure 4 16 Add Edit CPT 4 Record Window PROCEDURE CODE DATA ITEMS This is the code you will key to the patient s account to designate the procedure during Charge Entry This does not print on the insurance claim form a Current Procedural Terminology The five digit code the practice uses for insurance filing CPT4D
179. s w Haho Hepa urrup en bec mm Uj xj ER Zoom 10x Statistic Report Charged 425 00 Faid jii Adjuied 125 00 Balanced 300 End of Report Date Methad Sendeed Dade oen a From Oe 20h Thicke di Ttz2 z3 AM Te KETIUDU Company dI Tail Murer of Pages Facility Dixirihusaz Poa d MAX MIN AVG TOTAL FACILITY CODE VAMIE COT T CHARGED eM ELO 31 14 HH PAD PO nd H TI E m ADJUETED IDEE RD FIT x BALAHCED mee gp yi a 342 JR gis oan TOTAL I Figure 10 27 Sample of Generated End of Month Statistics Report 8 When printing is done click on the Close button x to close the preview window 9 Click on Close to exit the End of Month Statistics Report window 10 23 Producing System Reports 10 2 5 Evaluation Management Report This report is extremely helpful in tracking the practice pattern of your evaluation and management codes With this tool you can determine if your physician or practice is over coding or under coding l From the Claimstronic PMS menu bar click on Reports and select Evaluation Management Report CLAIMSTRONIC Practice01 Eile Appointment Patient Billing EndOfDay Reports Maintenance Tools View H Ga 6 2 49 32 New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appea
180. s option when searching for cash payments CHECK CARD The check or credit card number associated with the NUMBER payment INSURANCE The insurance code associated with the check CODE USER CODE The user responsible for posting payments SEARCH Performs the ledger search SHOW Provides claim and transaction details related to the LEDGER payment DETAIL 3 When you search is complete click on the Close button x to close the preview window Claimstronic PMS User s Manual 8 12 Version 5 1 4 May 19 2001 Insurance and Billing 9 Insurance and Billing Now see how Claimstronic PMS is used to support the insurance and billing activities performed at most medical practices These include Q Printing the day s paper claims HCFA 1500 s Q Processing the electronically submitted claims and sending them to the appropriate clearinghouse s Printing patient statements Processing patient statements for electronic transmission 9 1 Preparing Paper Claims There are two ways to prepare and print paper claims Q Via the Print HCFA window for batch processing QO Via the Patient Guarantor window Refer to Section 7 6 2 4 Resubmitting Claims for an individual claim 1 From the Claimstronic PMS menu bar click on the EndOfDay and select Process Paper Claim This will lead you to the Print HCFA window File Appointment Patient Billing EndOfDay Reports Maintenance wiew Help e cape Ose Process Paper
181. s from section 7 6 2 Correct An existing Claim and Re Queue to Submit locate the claim you need to correct 2 From the ICD9 amp CPT4s claim tab make the appropriate changes Such as adding a modifier or diagnosis etc 3 If the claim has already been submitted click on the Claim and change the billing status Refer to Section 7 6 1 Changing the Billing Status and the Carrier Name 4 Save your changes by clicking on Save or Alt S 7 6 2 4 Resubmitting Claims Once you have made the appropriate changes to flag a claim for resubmitting you have two options in which to do so These two options are either individually or within a batch To submit within a batch Refer to Section 9 1 Insurance and Billing To submit individually a Resubmit a paper claim From the Claim tab within the Patient Guarantor Window click on Print Choose the HCFA 1500 option and the select the insurance you are resubmitting This will print an individual insurance form for that claim b Resubmit an electronic claim Refer to Section 7 6 1 Changing the Billing Status Claimstronic PMS User s Manul T723 Version 5 1 4 May 19 2001 Producing System Reports Patient Guarantor Information Window Figure 7 23 Choosing HCFA1500 From Patient Guarantor Window Patient Guarantor Information Window ELM J or wew mer vo Figure 7 24 Selecting An Insurance From The Patient Guarantor Window ClaimstronicPMS User s Manul
182. s very helpful for billing and collections patient health history and miscellaneous patient information Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Entering Patient Information 3 Claimstronic PMS keeps track of who created the note date note was created etc By assigning an Alarm Date this prompts the system to place the note in a Tickler File for future notification Refer to section 10 1 3 Tickler Report 6 7 2 Case Management Information To enter or edit a patient case l Select on new or edit in the bottom section of the Additional Pat Info to access the Case Management window CLAIMSTRONIC CASE MANAGEMENT ADD NEW CASE Account Start Date m Case Humber End Date v User ID ITSE Occurence Flag Ilhe Injury C LMP Prov Code ff Occurence Date E RelDr Code Case Status Open Close Prior Authonzation Case Note w UK X Cance ETI Close Figure 6 10 Patient Case Management Window The patient Case Management allows you to store information such as worker s compensation and litigation information It can also be used to keep track of authorization numbers obtained for the patient During claim entry you will be prompted to choose a case pertinent to that claim Claimstronic PMS will then populate the data into the claim automatically Refer to Section 7 2 Entering a claim Manually Entering Patient Information CASE MANAGEMENT TABLE ITEMS Account Pat
183. successfully 50FTWARHE 1 5 i Transactional databases are now functional wv Load Drivers Version 7 80 for requester Create Data File H Inzert Update Data t Read Data Ww Finish Up 7 Help Click Finish again to receive message that Pervasive SQL 2000 has completed installation Peryasive SQOL Setup Complete a Congratulations fou have successtully installed Pervasive SUL ASIM FTW ARE eee v View readme file Click Finish to complete Setup Note If you choose not to review the read me document de select the check box 2 5 Software Installation 2 1 3 Claimstronic Practice Management System Component L Select Claimstronic Practice Management System from menu by left clicking on the component For proper installation please click on each component in the top down order Support Information 2 Claimstronic Practice Management System will be installed This may take up to two minutes Note If you receive an error message click continue 3 Installation complete Claimstronic PMS User s Manual 2 6 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 2 Claimstronic Practice Management System Installation Complete Previous Click Close to complete installation Software Installation Software Installation 2 1 4 Microsoft Data Engine Component l Select Microsoft Data Engine by left clicking
184. t After you made your entries changes click on Update Note Address codes can also be added from within the Patient Data Entry screens Refer to Section 6 Daily Data Entry Processes for more information Claimstronic PMS Users Manual 0000000000000 G Version 5 1 4 May 19 2001 System Setup and Customization 4 4 Customizing Practice Specific Data Tables The most intensive set up task involves loading the data tables that are specific to your practice s unless the AnviCare staff has performed a custom data conversion or provided you with a conversion program The practice specific data tables can be accessed from the Maintenance pull down on the menu bar via the following commands Insurance Code Select this command to create a record for each of the major insurance carriers to whom you submit claims Facility Info Locations other than the doctor s office or the patient s home where services or procedures that are being billed were performed such as hospitals nursing homes clinics Practice Info Records basic business and insurance information Claimstronic PMS can support multiple practices and keeps track of which providers are members which insurances are accepted network Ids and which clearinghouses each uses for submitting claims Provider Info The most commonly needed information about the doctor s in the practice s for whom patient files are maintained and for whom charges are created Refe
185. t Size field e From the Show Values field choose one of the following False The ICD9 description only will appear on the Routing Sheet True The ICD9 description plus the ICD9 code will appear on the Routing Sheet e To determine how many pages your Routing Sheet has from the Print Separate page for ICD9 and CPT4 choose one of the following False This prints the Routing Sheet as one page True This prints the Routing Sheet as two pages e Clicking on the Exit button will leave the Manage Routing Sheet window without saving any changes 12 To accept the changes click on the Save button This will return you to the document Open window Click on Save once again Claimstronic PMS will prompt that it has accepted the changes Claimstronic Saving 1s completed Figure 4 40 System Prompt 13 Click on OK and then on Exit to leave the Manage Routing Sheet window Claimstronic PMS Users Manual SS 4 39 Version 5 1 4 May 19 2001 System Setup and Customization 4 7 Customizing the Claim Appeal Letter Utilize this option to setup the basic format of the Claim Appeal Letter For more information on using the Claim Appeal Letter refer to Section 10 1 4 Appeal Claim Report The Claim Appeal Letter can further customized by user or for a specific insurance company Refer to Section 10 1 4 Appeal Claim Report for additional instructions 1 From the Claimstronic PMS menu click on Tools and select Edit
186. tentManager jsp Go Links FreeClaims com Figure 9 8 Freeclaims com Home Page Member Login Option lisp Enter your Username and Password Click on Login or hit the Enter key Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Insurance and Billing iFreeClaims com Completely Free Online Medical Claims Clearinghouse MindS zt Solver https secure freeclaims comffrcl logon jsp FreeClaims com Member Login Join FreeClaims Contact amp nviCare Support You are in secure area All communication between your browser and FreeClaims com is encrypted with SSL technology It is important that you always verify this by checking the symbol below on your browser s status bar If you do not see the symbol in your status bar you will need to upgrade your browser Internet Explorer Netscape Navigator secure amp secure NN not secure not secure ABOUT ANVICARE WHAT IS FREECLAIMS t Sign on with your User ID and Password Your password is case sensitive Username fi 234 Password e regia Our Use of Cookies PAYOR LIST FREQUENTLY ASKED QUESTIONS PRODUCTS amp SERVICES FEEDBACK Can t login Figure 9 9 FreeClaims com Home Page Member Login 16 Highlight and select Upload Claim File from the menu listing 4 FreeClaims com Completely Free Online Medical Claims Clearinghouse MindSpring Internet Expl BEIEIE3 v gt fx A IET
187. ti Rode t dert 10 12 10 22 AGING REPO aeri ttt e odo stipes oue d dur a 10 15 10 2 3 Month Year Up to Date Report eeeeessssss 10 18 10 2 4 Erid of Month Statista ceo r eoi eL oe Eo IE Cx odes 10 21 10 2 5 Evaluation Management Report eeeessssss 10 24 10 3 Miscellaneous IeDpOEIS i552 n ded erae renret npe entes 10 26 OS Patient REDO telcos Ri Andere eti a a Aires ento 10 26 10 3 2 Ledger Reports recette aree ato ede Do cago 10 28 10 3 3 Patient Procedure Financial History Report 10 32 10 3 4 Procedure Line Report eeeeeeeeeeeeeeeee 10 33 IV Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Introduction to Claimstronic PMS Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 1 Introduction to Claimstronic PMS We re glad you selected the Claimstronic Practice Management System PMS from the AnviCare people Claimstronic PMS makes it easy to standardize your practice patient and insurance data from the point the data is created through its many accesses and updates throughout the patient encounter billing and claims processes This new release is based on software used by physicians nationwide for nearly a decade In the new version we have integrated a powerful Appointment Scheduler to record maximize and track time spent with your patients physicians and facilities Better data produces better pract
188. tient s account was created In the Responsible Party box specify what type of financial information you want the report to generate Specify the party by clicking on the desired option All This option will show all outstanding balances within the system Insurance This option will show all balances due by insurance companies Patient This option will show all outstanding patient balances Hold This option will show all claims that have not been released to insurance companies or to the patient You can narrow the Insurance search down even further by selecting a Code Type or Master Code In the Aging Method box select the date type that you want to include in your report by clicking on the desired option The options are Stamped Date date the transactions were posted or the Serviced Date the date the transactions occurred 10 16 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports ils In the Aging Period box select the date period to be checked and included in the report by clicking on the desired option 8 Specify the sorting order in the Order by box The options are e Account The report will print by patient account number e Name The report will print alphabetically by patient name e Balance The report will print in descending order with the largest balanced owed 9 Click on Preview Print to view the generated report before printing NIB cB
189. tion eeeeessssss 6 13 Patient NOL sisse UR on tai bep Anu Obi Ue e Dese ees 6 13 Case Management Information eseeeeeesssse 6 14 Updating Dependent Address Information 6 15 Clam EDU 5e e EHE RHOD RI REDEUNT 7 1 Entering a New Claim via Scanning sss 7 1 Entering a New Claim Manually sss 7 3 Enterin AX Payme nbena Eod iei et 7 11 Pre COpayment List ices deor Iis as reco reo pete seo tees 7 11 Postin d COPAVIBODE sue crit tene Seed M bio Reda Rae 7 12 Posting a Claim Payment and Adjustment 7 13 Creatine c onm NOTOS iH E tresses RARE eeu A S IRA DEL aac 7 15 Printing a Superbill and Patient Statement 7 17 Editing Correcting and Resubmitting Claims 7 18 Changing the Billing Status ccccccccssssseeeeeeeeeeeeeeeeeeeees 7 18 Correct an Existing Claim and Re Queue to Submit 7 21 Refla A ld T 7 22 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 7 6 2 2 Changing Updating Insurance on a Claim 7 22 7 6 2 3 Correcting Claim Line Items 2 0 0 0 ceeeceeceececeeeesseeeeeeeees 7 23 1 0 2 4 Re submittnb C Otis oec ee E IE n rto RT EE Ree Desi de sue 7 23 8 Payment and Adjustment Entry e eere 8 1 8 1 Entering Payment Informati
190. tion 4 3 2 Procedure Table Claimstronic PMS comes pre loaded with thousands of CPT 4 Procedure Codes To view these codes select Procedure Code from the Maintenance Menu pull down list The CPT 4 codes list appears as follows CPT4 Table X User Defined Code X Change Index PCode CPT4Code CPT4Descl TOS PLS Mod Mod eee EJ i0060 10060 ABSCESS I amp D 2 REMOVAL SKIN TAG Add 11740 MINOR SURGERY u Edit 20605 ASPIRATE FLUID BURSA 2 11 35 21501 21501 I amp D ABSCESS pg 35 Delete 29125 29125 SPLINT APPL SHORTAR 1 11 35 Print 29240 29240 ARM SLING STRAPPING 2 11 35 20515 29515 SHORT LEG SPLINT 1 31 95 36415 36415 VENIPUNCTURE Sonat 3 45355 45355 SIGMOIDOSCOPY 11 1 470220 70220 SINUSES X RAY 4 11 143 70260 70260 SKULL j4 11 143 71020 71020 CHEST X RAY PA amp LAT 4 11 94 71100 _ 71100 _ X RAY RIBS ii wp Tc 22 72020 SPINE XRAY 4 11 Tc WP 34 SPINE CERVICAL 4 VIE4 4 Tiki File Maintenance gt Cl Close Figure 4 15 CPT 4 Table Screen To customize the Procedure Code table and make it more manageable you may do any of the following Identify the codes that are most relevant to your practice s Use Search to quickly locate a procedure code Use Edit to create user codes PCode for often used items or to complete the information necessa
191. tment Scheduler Appointment Types MEEI Code Description Minutes Color av otice vst LM KRayViek PHE T D1 New Patient Sick Lk General Checkup NPSIC Mew Patient Sick Figure 4 35 Appointment Types APPOINTMENT TYPE DATA ITEMS CODE The code assigned to describe the appointment type This code can be up to six characters DESCRIPTION Detailed description of the appointment type The description fields holds up to twenty characters MINUTES Customized time allotment for appointment COLOR Color assigned to the appointment type Follow the same instructions for assigning a color scheme found in section 4 1 1 Background Color Note You must use the enter key to complete each entry and advance to the next column while setting up the Appointment Types Claimstronic PMS Users Manual gt SSS 4236 Version 5 1 4 May 19 2001 System Setup and Customization 4 6 Managing the Routing Sheet The Routing Sheet contains all provider information necessary for posting and creating claims Whether you chose to scan in your claims or enter them manually you must setup your routing sheet 4 6 1 Creating Editing the Routing Sheet 1 Select Tools from the Claimstronic PMS menu bar click on Edit Routing Sheet Content CLAIMSTRONIC Practiced File Appointment Patient Biling EndofDay Reports Maintenance Tools View eu z Me Edt TETE Cli Later Figure 4 36 Tools Menu Ed
192. to receive a statement for the insurance company PAYMENT The same as the MASTER CODE in the insurance table SCHEDULE ID and the PAYMENT SCHEDULE ID in the procedure code table Links the Insurance Company and the Procedure Code to maintain and or build the Insurance Payment plan Schedule Claimstronic PMS Users Manual SSS 420 Version 5 1 4 May 19 2001 System Setup and Customization 4 4 2 Facility Information The following window appears when you select Facility Info from the Maintenance Menu pull down list Facility Table User Defined Code Change Index FasCode Name TAddressi Address2 cmm Seach 001 HOLMES REGIOI MELBOURNE Add Edit Delete Print ia File Maintenance gt gt t Close Figure 4 20 Facility Table Screen To customize the Facility Table l Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions To move from one record to another click on First Prev Next or Last 2 FacCode is the code assigned to designate the facility that the physician will use to treat the patient 3 Facility ID Table is used to store payor assigned identification numbers ex UPIN etc 4 Complete the requested information for any location where your physicians deliver services then click on Update 5 Click on Exit to close the window
193. top down order Suppor Information CLOSE 2 Installation of component will begin Note Wait until component is completely installed before Claimstronic PMS User s Manual 2 30 Version 5 1 4 May 19 2001 Software Installation proceeding This process will take three to four minutes depending on the speed of your processor 9 Proceed with the installation of the next component Database Setup 2 2 7 Database Setup Component L Select Database Setup by left clicking on the component For proper installation please click on each component in the top down order 2 Create Database Wizard for Pervasive SQL 2000 This wizard will create database and will quide you through all the necessary steps To continue with creating database click Next button Copyright c 1999 2000 Pervasive Software Inc All Fights Reserved Back Cancel Claimstronic PMS User s Manual 2 31 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Software Installation Choose a Server to Connect Note You should not have to enter the name of a Server The Server field will automatically default to the name of the computer system that Claimstronic is being installed on For example if the name of your computer system is DDOO1 then the name of the Server shown in the screen below will be DDO001 Create Database Wizard for Peryasive SQL 2000 Choose a server to co
194. tronic PMS User s Manual 3 7 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Navigating the Claimstronic PMS Software 3 4 The Report Generator Although it produces a variety of reports the Report Generator uses some common techniques to help you specify the range of dates patients or other pertinent criterion values Most of them are used in the Statistics Report shown in the following figure WINP MS Statistic Report Statistic Report Practice Provider 01 Date Type Serviced Date Stamped Date From 3 24 01 To 4 23701 Group on Facility CPT4 Code Referal Dr Service Type CDO9 Code Service Place Insurance Preview Print Close Figure 3 5 Statistic Report Window QO Radio buttons or pull down lists are used extensively for your convenience Q The Print Preview button lets you see the resulting report before you print it Navigating the Claimstronic PMS Software 3 5 The Appointment Scheduler The Appointment Scheduler main window highlights the current item in yellow You can toggle between the grid and the calendar with the Tab key To open a highlighted appointment Right Click your mouse Appointment Scheduler Oy xX File Search Reports Settings Help Friday April 13 2001 F Show Complaints Apa 2001 _ Sun Mon Tue wed Thu Fn Sat Time Dr John Smith EIUS EEUU CETTE TEN 09 00 AM qoc A Gee
195. tronic PMS User s Manul S O O Ba Version 5 1 4 May 19 2001 Producing System Reports O From the Claims Information window click on Add New Claim to access the Claim Entry window Refer to Section 9 5 Quick View of Claims for information regarding the Show Claim List option L Claims Information fooooos ShowClimus Add New Claim DEBBIE GIORGIO F 3220 RIVER VILLA WAY 03 10 1965 MELBOURNE BEACH FL 123 45 6789 FHP BCBSO1 oma ems EA tune rem Ram 2001 04 18 DPDA HFHP 00008 oo008 00003 16 2001 04 12 DPDA HFHP 3500 35 00 00003 1520010412 EDDA BCBSO 18700 000 000003 14 2001 0412 EDDA BCBSO 10000 0 00 0008 O00003 13 2001 04 12 EDDA BCBSO 10000 5 00 o00008 000003 12 2001 04 12 EDDD BCESO 10000 11000 10 00 000008 500 000003 5 2001 04 03 TDDD_ X BCBSO 95 00 i 000008 ooo008 ooo003 3 2001 04 03 ODDA BCBSO 3500 3500 000008 000003 1 2001 04 03 popa 9500 95 00 e eieilelejelejlo e e ud eio e eio eo e Ojo mm e Djo o o co co co co co Figure 7 4 Claims Information Window Claim Entry Figure 7 5 Claim Window Claimstronic PMS User s Manual 7 4 Version 5 1 4 May 19 2001 Producing System Reports 1 Required data such as doctor s name billing status guarantor s balance etc automatically populate into their appropriate fields from the Patient G
196. ts Unable to Work To The date on which the patient was able to return to work Must be entered as MM DD YYYY i e 12 10 1962 Special Prog Ind The code used to indicate whether the services included within the claim are related to a special program Press F2 to display a list of acceptable special program codes EPSDT Well exam specifically related to Medicaid 2 Click on the ICD9 amp CPT4 tab to enter all data related to the service charge All fields have a search option While in the data field choose the F2 key or the click on the ellipsis to see a pull down list or a window containing a list of available options e You can manually enter your diagnosis codes or utilize the search option Only four diagnosis codes can be entered per claim e You can manually type in the from date of service or hit the enter key for the system to insert the current date into the procedure line If all services were performed on the same day you can hit the sign twice or choose the F5 key to insert the current date into the additional procedure lines As with the diagnosis codes you have an option to manually or by search option enter the ICD9 or procedure code The information previously entered for the procedure code refer to Section 4 3 2 Procedure Table will populate into the appropriate fields You can modify or add to a procedure line as necessary You are not able to change the provider of service from the proce
197. tus Claim tab and change it to the appropriate status For more details on how to change the billing status refer to Section 7 6 1 Changing the Billing Status and the Carrier Name 7 6 2 2 X Changing Updating Insurance On An Existing Claim From the Claimstronic PMS menu bar click on Patient Billing and select Patient or click on the Patient icon Hi from the toolbar 2 From the Patient Guarantor Information window select the account that you want to update refer to Section 6 2 Finding an Existing Patient for instructions and then click on the Primary Secondary or Tertiary tab to view the Insurance tab to be updated 3 Select New to add a new insurance or Edit to update an existing insurance company For instructions on entering an insurance company refer to Section 6 3 Creating Insurance Insured Information 4 Once the insurance information has been updated click on Ok or Alt O to save your changes 5 Following the instructions from section 7 6 2 Correct An existing Claim and Re Queue to Submit locate the claim you need to correct 6 Locate the carrier name to change utilizing the drop down box select from the list of insurance companies 7 22 Producing System Reports 1 Verify the billing status according to the carrier s parameters and save your entries Refer to Section 7 6 1 Changing the Billing Status and the Carrier Name 7 6 2 3 Correcting Claim Line Items 1 Following the instruction
198. uarantor Window Grayed fields are not configurable which means that you cannot change them e You can change the bill to and the provider of service by overriding the existing information with the new e You are able to choose which insurance company this claim is to be filed with by clicking on the drop down box and selecting the correct carrier This will not change the active carrier in the Patient Guarantor Window e If you have created a Case Management the information such as date of illness authorization number etc will populate into the correct fields If you did not create a case you will need to manually insert the required data e Complete the Claim information by inserting the remaining data and proceed to the next step CLAIMS DATA ITEMS Bill To The account to which the claim will be billed Bill To Name The name associated with the account number to which the claim will be billed L NND The code and the name of the patient s provider Enter Y or N to indicate whether this claim is to be filed under worker s compensation Press F2 to display a list of acceptable values Billing Status The code for the status of the billing procedure for the claim Press F2 to display a list of acceptable codes The file has been successfully printed and ready E Electronic for delivery to the payor The payor accepts claims only in paper form P Paper After printing the file this status must be updated to T
199. umeric codes to each entry in any of these tables These customizations are performed using the functions on the Maintenance pull down menu Maintenance View Help Diagnosis Code Procedure Code Insurance Code Address Code Heferrall Or Code Facility Info Practice Infa Provider Infa User Info Category Info statement hessage Anesthesia Watone Figure 4 12 Maintenance Menu Pull down List Claimstronic PMS Users Manual 0000000000000 00000 40 Version 5 1 4 May 19 2001 System Setup and Customization 4 3 1 Diagnosis Table Claimstronic PMS comes pre loaded with thousands of ICD 9 Diagnosis Codes When you select Diagnosis Code from the Maintenance pull down menu a window similar to the one shown in the following figure appears ICD9 Table x User Defined Code X Change Index _ DCode m ICDSDesc mgn r ICDSCode Search 008 8 VIRAL GASTROENTERITIS 008 8 011 90 PULMONARY TB NOS 011 90 Add 027 31 DON T KNOW ASK BETTY 027 31 E di 034 0 STREP 034 0 J034 1 SCARLET FEVER SCARLETINA 034 1 Delete 038 9 SEPSIS Print 052 9 VARICELLA CHICKEN POX 052 053 19 POST HERPETIC NEURITIS 23 053 9 HERPES ZOSTER 070 1 HEPATITIS INFECTIOUS 070 9 VIRAL HEPATITIS mos MONO INFECTIOUS 079 89 VIRAL SYNDROME 099 8 VENERAL DISEASE 110 1 ONYCHOMYCOSIS 110 4 TINEA PEDIS 114 9 PULMONARY GRANULOMA
200. unction during the same posting day prior to making your daily deposit Should you need to remove a check and all its transactions we suggest utilizing adjustment functions Refer to Section 8 2 Entering Adjustment Information e Level Two Claims Paid With Selected Check Transactions Displays detailed information regarding all claims associated with a check Selecting a claim will list 1n Level Three all individual transactions affiliated with the claim Choosing the Check Roll Back function at this level allows you to remove the claim and all associated transactions The Check Roll Back will be placed as pending Refer to Section 8 3 Resume Posting Payment to reallocate the payment As a reminder the reallocated money will not appear on the Deposit Slip Report unless the reallocation occurs on the same day as the Check RollBack If you reallocate the money on a different system day the Check Roll Back amount will appear on the Journal Report e Level Three Payment Allocations For Selected Transaction Details Displays the detailed line item allocation information regarding the selected claim in Level Two Choosing the Roll Back allows you to make changes to the line item allocations on the selected claim The Re allocate Detail Funds is activated and you must reallocate the Roll Back amount to another transaction or click on Save Payments to accept the changes or Cancel to return to the Check Payment Detail window After you ar
201. urance company together See Section 4 4 1 Insurance Codes PAYMENT SCHEDULE This field is not used at this time DESC PRAC CODE Practice Code Assign the appropriate practice code for this Plan Agreement PROV CODE Provider Code Assign the appropriate physician code for this Plan Agreement PLAN PAY AMOUNT You may leave this field blank or enter the negotiated payment amount for this insurance company Claimstronic PMS User sManualsss CisSSSSSSSS IS Version 5 1 4 May 19 2001 System Setup and Customization 4 3 3 Address Table The Address Table speeds the completion of city state zip fields in the various Claimstronic PMS screens that require address input Claimstronic PMS comes pre loaded with a list of addresses that can be modified using the Add Edit and Delete commands NcbwinsdabasAdidress mkd Me Ea AddrCode City State zip fo wnt en roa pee ot tas Figure 4 17 Add Edit Address Record Window To customize the Address Code table and make it more manageable you may do any of the following Use Search to quickly locate a particular city state zip combination Click the appropriate button to add or edit a record To enter a new record click on Add To overwrite a record click on Edit The same window appears for both functions Most practices use the zip code as the AddrCode for data entry To move from one record to another click on First Prev Next or Las
202. ure 7 19 Add Edit Insurance Record Window From the Add Edit Insurance Record window If the EMCFlag is Y this claim is sent from your office electronically If the NEICID field has a number in it this means the insurance accepts from the clearinghouse the claim electronically d Click on Exit to close the window Claimstronic PMS User s Manul S 7D Version 5 1 4 May 19 2001 Producing System Reports 7 6 2 Correct an Existing Claim and Re Queue to Submit Reasons for needing to correct and resubmit a claim can be anywhere from adding a modifier to a transaction incorrect insurance information or the claim was never received L To correct an existing claim and re queue to submit 2 From the Patient Billing pull down menu off the Claimstronic main menu first select Claim and then select Edit Add Claim Figure 7 20 Quick Access to Existing Claims 3 Specify the desired parameters on the Claims Information window to generate a list of matching claims and click Ok or Alt O Ha WAYHE SCOTT ies 2332 PUREST PANE MLY Sates FT WITH TX Tl 1H Figure 7 21 Claims Information Window 4 View the Account Information section to verify you have the correct claim Double click on the record for the claim to be edited This will lead you to the Claims editing window 7 2 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Pr
203. view option the appointments will remain on the grid and will have a line drawn through them e The Help option provides you with a tutorial for assisting with the appointment scheduler 5 2 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 5 2 Creating A New Appointment To create an Appointment l Before you proceed make sure the desired profile is selected and click on the calendar to bring up the desired day Right click on the appropriate cell in the Appointment Grid and select New Appointment to bring up the Appointment window shown below amp ppnmlm tent nee r aeee z Figure 5 2 Appointment Window 5 3 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Using the Appointment Scheduler 3 The Appointment window has three tabs each representing a data entry window for Patient information Appointment information and data captured at the Time of Appointment Click on the Patient tab Account pooo Q Guarantor ooooo4 First Mame LINDA MI B Last Name WILSON Generation Address 1 a2 WASHINGTON Address 2 FO E pwioRNG SS zu 22027 Email Home Phone Work Phone Ext Date OF Birth 1 71 55 Social Security tt 555 55 5555 Sex Patient Eligibility Verified F C Male C Yes Print File Label Female No OF Cancel Figure 5 3 Appointment Scheduler Patient Window 4
204. w 4 After making your selections click on Print Claimstronic PMS User s Manual 10 11 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 10 2 Monthly Reports 10 2 1 New Patient Report Producing System Reports This report shows is helpful in accessing new patients seen by the physician and the practice specified during the time interval specified To produce a new patient report l From the Claimstronic PMS menu bar click on Reports and select New Patient Report CLAIMSTRONIC Practice01 Eile Appointment Patient Biling EndOfDay Reports Maintenance Tools View t Gal 6 25 lt 9 42 New Patient Report Patient Report Aging Report Month Year Up To Date Tickler Report End Of Month Statistics Ledger Report Patient Procedure Financial History Statement Evaluation Management E M Procedure Line Report Appeal Claim Report Print Patient Demographic Labels Figure 10 17 Report Menu New Patient Report Option 2 From the New Patient Report generation window specify the desired parameters and click on View Print to obtain the report 10 12 Producing System Reports all Report Window E ol x NEW PATIENT REPORT gt Date Type Date of Service Stamp Date From 3 13 2000 Ta 11 13 2000 Diagnosis Procedure Type of service Provider Practice Ref Doctor Place of Service b gt rj B rj Facility Insu
205. x Cancel Figure 7 9 Selecting Copayment from PreCopay List 2 From the PreCopay List select the patient payment you wish to apply to the claim Using your mouse left click the control buttons while holding down on the button drag the payment to the copayment slot within the claim and release The payment will populate into the payment field S The payment is removed from the list Exit the PreCopayList window save your claim Claimstronic PMS User s Manual 1 12 Version 5 1 4 May 19 2001 Claimstronic PMS User s Manual Version 5 1 4 May 19 2001 Producing System Reports Note If you do not save your claim after posting the copayment the system will inform you that it will return the payment to the PreCopay List 7 3 3 Posting a Claim Payment and Adjustment This section refers to posting an individual payment to a patient s claim For instructions on posting multiple patient and insurance payments refer to Section 8 Payment and Adjustment Entry L Once you have entered and saved your claim you are now able to post a payment and adjustment to the claim 2 From the Patient Guarantor Window Claim Tab select the Payment button The payment screen will appear a e P Paymentt i eeecrC CUS t 2E AA All Claims a 0 0 0004 co PATS is LU wv p Account aaf 000004 25 DAN BROWN T Adjustment Only Claim Bal gt 0 Date 4 26 01 Amount 0 0
206. y Check PEIVASN The Transactional interface is now installed A short test 30 seconds will Jr be performed to ensure that these new interfaces are communicating az expected This test iz strongly recommended however you may click Skip if vou wish For the Transactional test please select the Samples directory on the server ey where your database engine iz installed Server Path CARY SW samples Browse Help M Sk Cancel Testing 32 bit Btrieve API X ilransactional access test completed successfully PERVASIVE Transactional databases are now functional w Load Drivers Version 80 for requester Create Data File Re Insert Lipdate Data k Head Data wv Finish Up Help Back 2 25 Software Installation 9 Click the appropriate button to view or not view the readme file a Pervasive SQL 2000 SP2 Setup Build 198 Pervasive SOL 2000 Workgroup Question ae Would you like ta view the readme file IF you choose es to view the readme vou might need to press Alt Tab to toggle back to your Browser amp Copyright Pervasive Software Inc 1997 2000 All Rights Reserved 10 You must restart your computer to finish the Pervasive setup Pervasive SQL Setup Complete In order to properly run your new Pervasive SOL software the PEI ASI machine must be restarted Would vou like ta restart now 5oOF TW ARE t hes want to restart my computer now
207. y the desired parameters and click view print to obtain the report V Report Window Procedure Line Date Type c C Stamp Date Diagnosis From 7 31 00 To 7 31 00 z P m Type of Service E Place of Service E Facility e Insurance C Summary Code Type Payor ID Employer s Name m View Print 7 31 00 1 14 50 PM Figure 10 43 Report Window for Procedure Line Window a Select the Date Type by choosing Date of Service actual transaction date or Stamp Date date the transaction was posted This determines the date range you are producing the report for 4 If you are creating a report for a specific doctor enter the doctor s code in the Provider field You may also select the code from the pull down list Then enter the doctor s practice code 1 e organization or group to which the doctor belongs to in the Practice field or simply select from the pull down list 10 34 10 Producing System Reports If you are creating a report for a specific group simply leave the Provider field blank and enter the code of the desired group in the Practice field If you are creating a report to determine the resource of referrals by using the pull down box choose a referring physician from the Ref Doctor field From the Insurance option you are able to narrow your Detail Procedure Report down by choosing an insurance company through the Code field the Type of insurance an

1. Introduction to Claimstronic PMS

Contents

Download Pdf Manuals

Related Search

Related Contents