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Medisoft 18 User Manual and Guide

1. 0 0 0c eee eee eese 19 Generating Claims and Statements cerere vices sees rud aum Rr sere dod eds beans 19 Chapter 3 Creating a Practice and Setup Overview llllees 21 Gras wages sebari d oq beca d ad a Sod d eesiniag id REIR pae did poca 21 Creating the Practice Database 0 cece ee 21 OpOnING BP ISCHeB oduad ER ReELe3 RP LBQUASARASGS Ee dedu eis ATS 23 SO OHNE 4644 2 ay ELE d e PI VR EDO INERMIS Dude di mE M 24 Greating RUBS EVEIVIGW iau tee ed doe Upton EROR Rr dCEs 1 oe quau dbop eal as 24 If you are a solo provider file claims as an individual lues 26 If you are a group file claims as a group 0 0 0 eee eee 29 Semio Program OPIS ei ci od REPE A eet RP RICE d bb Rew Meese MP 32 User Guide September 2012 Release 18 Table of Contents Chapter 4 Security Setup Overview lllleeeeeeeeeeeeeee ree 35 Ceao UEG e ERE ECL PE PL PC e E pa 35 Lagom Password Mondd mall saorsa duce arbos eqs ga n wd deir E o ESA 37 Setting Permalesibns c iesus epe hme Rep x Rue med hares a erede a ed 38 Chapter 5 Entering Practice Information llle 41 Entering Basic Practice Information llle 41 Entenng Practica DS BUG sau Se d aAA ERR URP PESE Rea cR Papa fits 42 Entering Practice Information for a Billing Service llle 44 Elng SORAUBSG ue kd pines eod Qa Oh golrdbdi sd ki Od qd Ard a E 44 BillelashUGelS siueeso
2. amp Patient Use numeric chart numbers 2 Auto format Soc Sec Patient Quick Entry Default ve Use Quick Entry for New Patient Case F8 Use Quick Entry for Edit Patient Case F9 Transaction al Force Document Number Case Default Newest Case v v Force payments to be applied Multiply units times amount _ Auto Create Tax Entry Default Place of Service Code 11 Use Serialized Superbills p Default Tax Code TAX ve Suppress Co pay Message EDI S Mark zero payments complete Today s Date Separate remittance files a Hatena Dale Automatically calculate blank PIN qualifiers Prompt for Date Work Administrator V Edit task when created by a rule Figure 153 Program Options screen Data Entry tab In the Global section you can indicate whether to use the ENTER key to move between fields to force payments to be applied and to multiply unit times amount When the Suppress UB04 Fields check box is selected UB 04 fields do not appear throughout Medisoft In the Patient section you can choose to use numeric chart numbers the default is to use an alphanumeric code and or have Medisoft automatically hyphenate Social Security numbers The Patient Quick Entry Default list and the Use Quick Entry for New Patient Case F8 and Use Quick Entry for Edit Patient Case F9 check boxes provide setting options for the Patient Qu
3. Amounts Tab The Amounts tab links to the Price Code field on the Account tab of the Case screen Medisoft Advanced and Medisoft Network Professional allow 26 charge amounts for each code entered in User Guide 70 Release 18 September 2012 Chapter 11 Procedure Payment and Adjustment Codes and Diagnosis Codes Allowed Amounts Tab Advanced and Medisoft Medisoft The applicable charge amount is selected in the Account tab of each patient s Case Screen Procedure Payment Adjustment App of Finger Splint Static SEE General Amounts Allowed Amounts Charge Amounts 10 00 Help B E 0 00 D 0 U 0 00 E z G 10 00 Cost of Service Product 15 00 Medicare Allowed Amount jo oo Figure 72 Procedure Payment Adjustment screen Amounts tab Allowed Amounts Tab Advanced and Medisoft Network Professional The Allowed Amounts tab keeps track of how much each insurance carrier pays for a particular procedure Medisoft calculates the allowed amount based on the amount paid any applicable User Guide September 2012 Release 18 71 Allowed Amounts Tab Advanced and Medisoft Network Professional Chapter 11 Procedure Payment and Adjustment Codes and deductible and the service classification This amount is used in calculating the patient portion of any transaction entered in Transaction Entry Procedure Payment Adjustment App of Finger Splint Static SEE General Am
4. Fi Cancel O p Tue Sat End Time 5 00 pm Wed Heb Reason el Figure 140 Find Open Time screen 2 Complete the fields and click Search Office Hours shows you the next available time on the grid Go To Date If you need to locate a date that is a given length of time in the future use the Go To Date screen To do so User Guide 144 Release 18 September 2012 Chapter 23 Scheduling Appointments Wait List 1 From the Edit menu click Go to Date The Go to Date screen appears x Date From 7 1 6 2012 amp Go Go Days Weeks Months and Help Years from the currently selected date Cancel ii Figure 141 Go To Date screen The date that defaults in the Date From field is the date that is currently selected in the calendar If you want to change the date in the Date From field replace it by either highlighting and typing in a new date or click in the field or on the down arrow to the right of the field and the calendar opens 2 Enter a number in one of the selection boxes to indicate how far in the future you need to make the appointment For example if you need an appointment in six months type the number 6 in the Months field 3 Click Go Wait List The Wait List is available to track any unexpected patients who need to be seen that day If no openings are available when patients call in you can put them on the Wait List If a time sl
5. Figure 101 Claim Management screen with new claims Editing Claims If a claim is rejected by the carrier you will have to edit it so that it contains all of the information that the carrier wants User Guide September 2012 Release 18 105 Editing Claims Chapter 18 Creating Claims To edit a claim 1 On the Activities menu select Claim Management The Claim Management screen appears 2 Highlight the claim you want to edit and click Edit The Claim screen appears with the claim detail Claim 10 9 C 2 2 AETOD 2 m Figure 102 Claim screen The Claim screen has several tabs that contain the information for the claim Tab Description Carrier 1 2 3 Use this tab to change the Claim Status Billing Method and the insurance carrier or EDI Receiver Transactions Use this tab to see all of the transactions that are part of the selected claim You can split add or remove transactions here Comment Use this tab to place whatever comments you feel are necessary concerning this claim and or any transactions relating to it If you have Medisoft Advanced or Medisoft Network Professional these notes will appear as a note icon in the Claim Management screen EDI Note Use this tab to add information for EDI notes 3 Revise the information on the tabs as necessary 4 Click Save User Guide 106 Release 18 September 2012 Chapter 18 Creating Claims Print
6. Set Default Figure 51 Provider screen Reference tab 8 Assign a provider to a provider class by clicking the Provider Class list and selecting a class NOTE Provider classes are set up in the Provider Class screen When generating claims you can use the provider class on the Practice IDs tab to limit a rule to a specific class of providers 9 Click Save if you are finished with the record or select the Provider IDs tab Entering Provider IDs Rules Use the Provider IDs tab to enter or edit key data associated with a provider tax ID social security number NPI taxonomy legacy numbers Set up at least one rule on the Provider IDs grid for each provider in your practice and associate this information to all insurance carriers or insurance classes and all facilities or a particular insurance carrier or an insurance class For information on creating these rules see Creating Rules Overview on page 24 To enter rules for a provider 1 Select the Provider IDs tab User Guide September 2012 Release 18 49 Entering Provider IDs Rules Chapter 6 Setting up Providers and Provider Classes 50 2 Click New to create a new rule OR To edit a rule select the record on the grid and click Edit 7 New Provider ID Insurance Carrier OK All G all O Facility Help File Claim As Individual Group Insurance Class O L Cancel S From Practice National Provider ID S From
7. Statements Use Cycle Billing Cycle Billing Days Q Save v Standard Statement Detail Only EE V Remainder Statement Detail Only Cancel J _ Add Copay s to Remainder Statements a Help Biling Notes v Create statement billing notes Statement Billing Note Code STATEMENT s 9 Create claim billing notes Claim Billing Note Code CLAIM v 9 Quick Formats v Use Statement Management for Quick Statements Receipt Walkout Receipt All Transactions v Statement Remainder Statement 0 30 60 v Face Sheet Patient Face Sheet v Quick List v Figure 158 Program Options screen Billing tab When you select Create statement billing notes Medisoft adds a note to statements when printed Be sure to select a default note in the Statement Billing Note Code field When you select Create claim billing notes Medisoft adds a Comment transaction line in both Transaction Entry and Quick Ledger whenever a claim is billed The note includes the carrier name date billed claim number and the name of the provider associated with the claim Be sure to select a default Claim Billing Note Code User Guide September 2012 Release 18 175 Audit Tab Chapter 25 Program Options Audit Tab The Audit tab lists all tables available in the database The tables you choose here become available in the Audit Generator when preparing the Data Audit Report Program Options
8. User Guide 92 Release 18 September 2012 Chapter 16 Entering Transactions Use the Transaction Entry screen to enter charges for procedures performed on patients You can also enter co payments here or adjustments to the patient s bill When you open the screen and select a Chart patient and case number Medisoft automatically collects information from the patient and case records and displays it in the screen The top right section of the screen shows you the patient s balance insurance information and aging Medisoft is an Open Item Accounting program meaning that transactions entered are marked when paid but remain on the active ledger as long as the case is active There is no clearing of the ledger and bringing up a total to start a new month as with a balance forward program To open Transaction Entry 1 On the Activities menu select Enter Transactions The Transaction Entry screen appears Transaction Entry DER Procedure Units Amount Total Diag1 Diag2 Diag3 Diag4 1234 Provider POS TOS Allowed M1 Co Pay o Description Provider Amount Check Number Unapplied Figure 91 Transaction Entry screen User Guide September 2012 Release 18 93 Chapter 16 Entering Transactions 94 2 Select or enter a Chart patient The screen fills with patient information including a Case number Transaction Entry BAE COLANDOD w g 2 oema O RT oat 0 00 Procedure Units Amount Total Diag Diag2 Diag3
9. You can use the Scheduled Tasks feature to schedule a daily time to send a batch of eligibility inquiries To schedule a batch 1 On the Activities menu select Eligibility Verification Select Schedule The Medisoft Task Scheduler screen appears Click New The Select Type screen appears 2 3 4 Select Eligibility 5 Click OK The Select Practice screen appears 6 Select the practice and click OK The New Eligibility Task screen appears o Medical Group Tutorial Data New Eligibility Task H200AM 7 28 2012 C s Ges 9 se Figure 137 New Eligibility Task screen User Guide September 2012 Release 18 139 Task Scheduler Chapter 22 Using Electronic Services 7 Complete the options and click Save The new task appears on the Medisoft Task Scheduler Screen o Medisoft Task Scheduler Description Category Practice Name Next Run gt Eligiblity Eligibility Medical Group Tutorial Data 7 28 2012 Figure 138 Medisoft Task Scheduler screen The task will automatically make inquiries for patients scheduled in the appointment grid up to a week in advance User Guide 140 Release 18 September 2012 Chapter 23 Scheduling Appointments In this chapter you will learn about Office Hours and some of the basic features available for creating and managing patient appointments Office Hours Overview Office Hours is an appointment scheduling program that helps keep track of appointments for
10. 24 Medisoft claim processing for both print and electronic claims depends on a series of flexible rules that you define When setting up your practice you will create a series of grid entries rules on the Practice IDs screen see Entering a Practice IDs Rule on page 42 and Provider IDs screen see Entering Provider IDs Rules on page 49 Depending on your practice you may also use the Facility IDs screen see Entering Facility Information on page 63 and Referring Physician IDs screens see Entering Referring Provider Rules on page 55 These rules contain your basic practice information such as group or individual NPI numbers taxonomy tax IDs and claim filing status group or individual They also connect this information to the insurance companies that your patients use and the physicians in your practice You begin by creating rules for each provider on the Provider IDs screen and at least one rule on the Practice IDs screen These rules will contain information that would apply to the most generic situations Then you will create other rules that apply to a specific insurance company insurance User Guide Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview Creating Rules Overview category facility provider and so on See If you are a solo provider file claims as an individual on page 26 and If you are a group file claims as a group on page 29 for more detailed information When yo
11. BillFlash MS5 5 MissedCoPayStmt v17 Billing Code List Birthday Card Birthday Label 3 Columns Birthday Label One Column Claim List 1500 Primary Medicare Century 1500 Primary 1500 Secondary Medicare Century 1500 Secondary 1500 Tertiary 1500 HP DJ 500 Primary 1500 HP DJ 500 Secondary LT OQOOOOOOOO0S Figure 108 Open Report screen 3 Select the report form you use and click OK The form opens User Guide September 2012 Release 18 109 Reprinting Claims Chapter 18 Creating Claims 4 On the File menu select Report Properties The Report Properties screen appears Report Properties Figure 109 Report Properties screen 5 In the Form Offset section of the screen adjust the form as necessary from the top and or left margins The form is moved in increments of one hundredth of an inch 6 Click OK 7 Save the report and close Medisoft Reports Designer Reprinting Claims You can reprint claims if there is a problem with some of those that printed To do so follow the steps above on printing claims except select Reprint Claim instead of Print Send See Printing Claims on page 107 Changing Claim Status In the Claim Management screen all submitted claims are automatically marked Sent with an indication of the method of submission There may be occasions when you need to change this status for instance if you need to resend them from Revenue Management Entire Batch If
12. If you create several new formats in a single day you can distinguish them by the order in which you created them Click Show File Names to reveal the format file names This shows the file names type and date and time last modified Small Balance Write off This feature lets you automatically write off remainder balances of a certain amount The balance written off is the patient remainder balance You can write off small remainder balances as a batch in the Small Balance Write off screen or for one patient at a time in the Apply Charges Adjustments to Payments screen User Guide September 2012 Release 18 135 Writing off a Balance Chapter 21 Managing Collections and Small Balance Write Offs Writing off a Balance 1 On the Activities menu select Small Balances Write off The Small Balance Write off screen appears Small Balance Write off Chart Number Last Name First Name Write off Last Patient Payment Date Submission Count SBWO TE 7 27 2012 w Figure 135 Small Balance Write off screen 2 In the lefthand section of the screen enter criteria for the type of remainder balances you want to write off and click Apply In the right hand section a list of the patients who meet the criteria appears in the Write off Preview List The default is set to write off all records in the list You can select individual records to write off by clicking on the record Multiple records can be selected by pressing the CT
13. None O Legacy Identifier 3 Figure 35 New Provider IDs screen with Group selected If you have a provider that files claims using a personal NPI number for a specific insurance company create an extra rule for this provider specifying that particular insurance company Enter the unique NPI number for that rule Sv Provider ID Es CO Insurance Carrier ej vox Oa Z 3 Insurance Class Cancel S All O Facility Help File Claim As O Individual Group ID Qualifier XX National Provider Identifier From Practice 4562234753 C Tax Identifier From Practice Social Security Number National Provider ID From Practice Taxonomy None O Mammography Cert None CO Care Plan Oversight None Legacy Identifier 1 S None O Legacy Identifier 2 None Legacy Identifier 3 September 2012 User Guide Release 18 NPI Considerations Chapter 3 Creating a Practice and Setup Overview Figure 36 New Provider IDs screen with NPI for specific insurance company NPI Considerations Enter your NPI information on the Practice IDs screen Then on the Provider IDs screen select From Practice If you have insurance companies that require mixed NPI numbers some require individual while some require a group enter your group NPI number on the Practice IDs screen Then create
14. fields for Capitated Plan and Co Pay Amount and has the Deductible Met check box Policy 2 has a field for Crossover Plan and Policy 3 can be set up for tertiary or third party involvement Medicaid and TRICARE Multimedia tab Network Professional only Comment Advanced and Medisoft Network Professional EDI 5 Click Save September 2012 Enter all submission numbers reference and data for each carrier Also enter branch of service information Within the Medicaid and Tricare tab are EPSDT and Family Planning indicators required submission numbers and reference data for the case It also includes service information for TRICARE claims Add bitmaps to your patient records Enter notes to be printed on statements Enter information for electronic claims specific to this case User Guide Release 18 89 Copying a Case Chapter 15 Cases Copying a Case In Medisoft you can copy an entire case to help save you time To do so 1 On the Lists menu select Patient Guarantor and Case The Patient List screen appears 2 Highlight the patient whose case you want to copy The existing cases for that patient appear in the right pane of the Patient screen 3 Highlight the case you want to copy patient List Field Chart Number v O Patient Case BORJOO0O Bordon John M eoo PE Date of Bith Soc Sec Nur List of cases for Collins Anorie L 4 Number Case Descr
15. it locks the practice and requires re entry of a password to access Medisoft again If you select this check box and have not used the Security Setup feature in Medisoft a message pops up telling you that security has to be set up before the backup will function For more information on security see When the Warn on Unapproved Codes check box is selected Medisoft alerts you if a code entered or selected is non HIPAA compliant This warning pops up every time you save transactions and Medisoft finds a code that has not been marked HIPAA compliant User Guide September 2012 Release 18 173 Color Coding Tab Chapter 25 Program Options Color Coding Tab NOTE This is an Advanced and Medisoft Network Professional tab Transactions If you want to use color coding for transactions in Transaction Entry and Quick Ledger select the Use Color Coding check box Select colors for each of six types of transactions unsaved no payment partially paid overpaid charge unapplied payment and overapplied payment These colors appear in both screens letting you know at a glance the status of the transaction Program Options Default Colors Gu MENO Auto Accident Aqua C C7 HMO Patient Yellow D Medicare Patient Blue Capitation Patient Delinquent Account I Fuchsia ERI Maroon M Inactive Patient Green Credit on Account Olive Navy Needs Referral Minor Under 18 Purple Teal Lime Special Needs Copay Due
16. on page 81 User Guide September 2012 Release 18 Setting up Your Practice Overview Chapter 2 Medisoft at a Glance Setting up Your Practice Overview You will first set up your practice The Practice Information screen contains the basic information on your practice Practice Information E mg Practice Practice IDs Practice Pay To Statement Pay To Practice Name Academy Wellness Center Phone 770 555 5000 Extension a sw Street 1145 Sanctuary Parkway Fax Phone l E City Alpharetta State GA Type Medical v Zip Code 130009 Federal Tax ID Practice Type Individual Group Extra 1 Entity Type Person Non Person Extra 2 Figure 15 Practice Information screen The Provider screen contains important information about the providers physicians who are part of your practice Pro rider new 4 ollx Address Reference Provider IDs If the Code is left blank j Save Code the program will assign one Ll Inactive Cancel Last Name e First Name o O Middle Name Credentials Chase E Set Default puuu City State Zip Code EMak 000 Office Fax i yO Home Cell L Signature On File Signature Date C Medicare Participating License Number Figure 16 Provider screen Each provider in the practice needs to have his or her own record set up in the database User Guide 12 Release
17. v 2 Q Cancel Hep Description Set Default The first payment is due on the o day of the month Payment is expected every fo days Copy Address Payment Amount Due Appointments C gt View eStatements Figure 132 Patient Guarantor screen Payment Plan tab 4 Select the appropriate code in the Payment Code field The details of the plan appear on the tab 5 Click Save Medisoft records and tracks the scheduled date for the next payment and the amount to be applied If the patient follows the payment plan their account will not be included when you process collection letters If the patient does not follow the payment plan their account will be included when you process collection letters User Guide September 2012 Release 18 133 Collection Letters Chapter 21 Managing Collections and Small Balance Write Offs Collection Letters Once you put a patient responsible account in collections you can create collection letters to follow up with the patient To print collection letters 1 2 On the Reports menu select Collection Reports Select Patient Collection Letters The Print Report Where screen appears You must print the Collection Letter Report before you print collection letters 3 9 10 Select one of the options and click Start The Data Selection Questions screen appears Collection Letter Report Data Selection Questions Figure 133 Data Selection
18. 1 On the Lists menu select Insurance 2 Select Carriers The Insurance Carrier List screen appears Insurance Carrier List Search for Code E E LUOO BLUO1 ciGoo FHPOO MEDOO MEDOT WOROO m Cross Blue Shield 231 Blue Cross Blue Shield 225 Cigna FHP Health Plan Medicaid Medicare Workers Compensation Type 1 AETOO Blue Cross Shield Blue Cross Shield HM Dther Medicaid Medicare Worker s Comp w Bell Rd 88 W Bell Rd 2525 Big Bucks Ln 4576 E W Power Rd 3875 W Thunderbird 1111 Hohokam Cir 77 W Bethany Home Rd 4 ii Figure 59 Insurance Carrier List screen 3 Click New OR Select an entry on the Insurance Carrier List and click Edit Insurance Carrier new Address Options and Codes EDI Eligibilty Allowed Code Carrier Address program will assign one State City Zip Code Plan Information Plan Name If the Code is left blank the Name Street Fax J Inactive Phone Extension Contact Set Default Note Figure 60 Insurance Carrier screen September 2012 User Guide Release 18 59 Insurance Carriers Chapter 8 Insurance Classes and Insurance Carriers 60 4 Enter the carrier s information 5 From the Class list select an insurance class to assign to the carrier 6 Select the Options and Codes tab 10 11 Insurance Carr
19. 192 User Guide Release 18 September 2012
20. BOEGODI coedasceskke rset che aee ee RR RR oray okaert kanro 124 Figure 123 Deposit List screen with new payment highlighted liil 124 Figure 124 Deposit LISE SOFGOEI 225 00 cece steerer RR ERREUR EERO PENRO RE eee RR e e RO e 125 Figure 125 Apply Payments Adjustments to Charges Screen 1 2 0 eee 125 Figure 126 Apply Payment Adjustment to Charges screen eese 126 Figure 127 Collecion LIGE STOOD oasis dede oe reti x ere RR Ep ira erarere qus ird ad emeehewedon adi d ds 129 Figure 129 Tickler tem SGN sorc cccctsepoceeierrebotedemsge bor ter e bee Ro bac eae 130 Figure 129 Add Collection List Items screen 2 cic ceca cade baba wade ed eed aber deed ERR 131 Figure 130 Patient Payment Plan List screen 2455022100 re rrr m me m xe 132 Figure 131 Patient Payment Plan SOBO uua zacacssgure be qas dd Edd er e ode aa e E C bote d a 132 Figure 132 Patient Guarantor screen Payment Plan tab liilsiieli lees 133 Figure 133 Data Selection Questions screen wc ck ccd eke sue dac dake eee eee header E 134 Figure 134 Collection Letter Selection Scre n 24 00 200e0 e hmm e my 135 Figure 135 Small Balance Write off SCREEN aassecari ar bu bue baked EE dd OR ORE iow Fdo E Red 136 Figure 136 Patient List with Eligibility Verification highlighted 0 0 00 eee 139 Figure 197 New Eligibility Task Sheen sa sso sae cbr RR Skea PRAT SEAS REG RIGORRRE AR 139 Figure 138 Medisoft Task Scheduler screen 2 022000 220 ee m he beeen ew RR 140
21. BORJOOOO v 2 Bordon John Account Alert RB C View Open Items Only TE m Global Coverage Until From Description Provider Procedure Case Units Amount Stmtt Statement Claim Bill a a I M eB E 3 5395 4 M 35 8 00 WE 8 00 D No b iu gt Account Total 106 00 Remainder 8 00 amp Quick Statement Figure 97 Guarantor Ledger screen To get quick and easy access to a patient s ledger from almost anywhere in Medisoft press F7 or click the Quick Ledger speed button To open the Guarantor Ledger On the Activities menu select Guarantor Ledger While no new transactions can be made in the ledger itself you can edit and print the ledger and gain valuable detail on patient accounts You can change responsibility for a selected transaction in the Quick Ledger screen Right click a transaction to change its responsibility between insurance carriers or from an insurance to the patient This feature lets you skip entering the zero dollar insurance payment to indicate that no payment is coming from the insurance carrier Click Edit or press F9 to open the Transaction Entry screen where charges payments and adjustments can be reviewed and edited as needed Both the Patient and the Guarantor Ledgers let you view the notes entered for transactions and also add a note Click Payment Detail to display all payments adjustments made toward a specific charge TIP If you click Quick Statement
22. Cell Phone 0 Office Contact FO EMak Extra 1 NEM Extra 2 I Figure 69 Address screen 3 Enter a Code for a new address record or leave the field blank and let Medisoft create a unique code Enter demographic data for the address From the Type list select Attorney Employer Miscellaneous or Referral Source Enter other demographic data such as phone numbers and email address Click Save NY ODO 0 A User Guide 68 Release 18 September 2012 Chapter 11 Procedure Payment and Adjustment Codes and Diagnosis Codes In this chapter you will learn about entering procedure and diagnosis codes that are used when you enter charges for your patients Procedure Payment and Adjustment Codes Procedure codes are used to communicate procedure information between patient provider and third party payers The Procedure Payment Adjustment List screen shows what codes have been set up Procedure Payment Adjustment List Search for 2 Field Type Code 1 Description Amount Type Description gt E 29130 App of Finger Splint Static 30 00 Procedure charge 43220 Esophageal Endoscopy 275 00 Procedure charge 70250 X Ray Skull 4 Views 55 00 Procedure charge 70360 X Ray Neck 45 00 Procedure charge 71020 X Ray Chest 2 Views 53 00 Procedure charge 71030 X Ray Chest Min 4 Views 55 00 Procedure charge 71040 Contrast X Ray of Bronchitis 50 00 Procedure ch
23. Diag4 1234 Provider POS TOS Allowed M1 Co Pay v DS IKE INNEN Ni Description Provider Amount Check Number Unapplied Save Transactions Figure 92 Transaction Entry screen with patient selected You can choose a default for the case number that appears on the Data Entry tab in Program Options 3 4 If necessary change the case number To add a new charge click New in the Charges section of the screen Select a Procedure and complete the remainder of the fields on the new charge line Some of the information will be filled in automatically Enter further charge lines as necessary If you need to enter a patient s co payment or other payments adjustments click New in the Payments Adjustments and Comments section of the screen User Guide Release 18 September 2012 Chapter 16 Entering Transactions 8 Select a Pay Adj Code and complete the line 7 Transaction Entry COLANOOO ze 5 Eee Date Procedure Units Amount Total Diag1 Diag2 Diag3 Diag4 1234 Provider POS TOS Allowed M1 Co Pay 7 23 2012 __ 70373 aoo 45 00 0059 mmm o ooo N 7 26 2012 117110 1 15 00 15 00 005 9 TEEN BE 11 0 00 Ni Pay Adj Code Who Paid Description Provider Amount Check Number Unapplied 7 26 2012 CHKCOPAY Collins Anorie Guarantor Standard Copayment 5 ERI 234 15 00 S oey Figure 93 Transaction Entry screen with payment 9 To apply this payment to a charge click Appl
24. Figure 159 Program Options screen Audit tab User Guide 176 Release 18 September 2012 Chapter 25 Program Options BillFlash Tab BillFlash Tab The BillFlash tab allows you to control some of the information that appears on the statements you send electronically via BillFlash the web based company that is set up to process electronic statements in Medisoft Program Options 3 4 Digit Sec Code For Billing Inquiries Call 800 333 4747 Figure 160 Program Options screen BillFlash tab User Guide September 2012 Release 18 177 BillFlash Tab Chapter 25 Program Options User Guide 178 Release 18 September 2012 Chapter 26 Backup and Restore Data In this chapter you will learn how to back up and restore data using both the regular and hot backup restore features Backing Up Your Data Making regular backups is essential to good maintenance of your data TIP Best Practice consider backing up data files every day so you can restore lost data to the most recent date before the files were damaged or corrupted If you are working with multiple practices each practice will have its own set of backup files Doing your backups within the Medisoft program is a dependable method To make a backup 1 On the File menu select Backup and then Backup Data User Guide September 2012 Release 18 179 Restoring Your Data Chapter 26 Backup and Restore Data 2 Click OK on the warning message The Medisoft B
25. Foot 110 4 110 4 847 2 Back Spasm 847 2 847 2 786 09 Breathing Difficulty 786 09 786 09 490 0 Bronchitis 490 0 490 0 Figure 76 Diagnosis List screen 2 Click New The Diagnosis screen appears Diagnosis new Alternate Code Sets Code 2 Code 3 l C HIPAA Approved Inactive Code Figure 7Z Diagnosis screen 3 Enter the correct Code and a Description 4 f necessary enter Alternate Code Sets You can use these for entering codes for different carriers but for the same diagnosis 5 Click Save User Guide September 2012 Release 18 75 Diagnosis Codes Chapter 11 Procedure Payment and Adjustment Codes and User Guide 76 Release 18 September 2012 Chapter 12 Billing Code List A billing code is a user defined two character alphanumeric code used in sorting and grouping patient records for billing purposes A billing code range is a filter available in most reports printed in Medisoft as well To enter a billing code 1 On the Lists menu select Billing Codes The Billing Code List screen appears Billing Code List Search for um 2 Field Code Code Description gt Cash Patient GYN Patient HMO Patient Medicare Patient Non Smoker DB Patient PPO Patient Smoker Figure 78 Billing Code List screen 2 Click New The Billing Code screen appears Billing Code new Code Inactive Code C dic Figure 7
26. List screen appears Deposit List DAR ae Deposit Date Description Payor Name Payor Type Payment Unapplied 12 5 2008 Zimmerman Anthony Patient 188 00 0 00 12 6 2008 0912060000 Doe Jane S Patient 10 00 0 00 12 11 2008 Medicaid Insurance 56 00 0 00 12 22 2008 0312220000 Medicaid Insurance EOB Only 0 00 12 22 2009 0912220000 Austin Andrew Patient 10 00 10 00 12 22 2009 0912220000 Cigna Insurance 200 00 0 00 12 22 2009 091 Austin Andrew Patient 10 00 0 00 12 22 2009 0912220000 Austin Andrew Patient 25 00 0 00 12 27 2009 Simpson Tanus J Patient 25 00 7 25 2012 Collins amp norie L Patient 30 00 7 26 2012 Collins Anorie L Patient 15 00 Figure 124 Deposit List screen TIP To save time and increase work efficiency you can close a case after applying payment by right clicking the line item in the grid and then selecting Close Case 2 Highlight a payment and click Apply The Apply Payment Adjustments to Charges screen appears gt Apply Payment Adjustments to Charges Date Procedure Charge Remainder Payment Deductible Withhold Allowed Adjustment Take Back Provider Co pay L l L d 0 00 0 00 0 00 000 0 00 0 00 View Tastes Figure 125 Apply Payments Adjustments to Charges screen 3 Select the patient chart number if you have chosen an insurance payment User Guide September 2012 Release 18 125 EOB Payments Chapter 20 Applying Deposits Payments 4
27. Personal Enter general information on the new case and employer information Account Enter the provider referral and attorney information set up in the Address file Also enter billing and price codes and information on visit authorization including the number of visits Diagnosis Enter diagnosis codes for this case Condition Enter information pertinent to the illness pregnancy or injury and tracking of symptoms Also enter dates relative to the condition plus Workers Compensation information 88 User Guide Release 18 September 2012 Chapter 15 Cases Creating a Case Tab Description Miscellaneous Enter supplemental information such as lab work charges whether the lab is in house or outside Referral and Prescription Dates Local Use A and Local Use B fields case Indicator code and prior authorization Policy 1 2 3 Enter up to three insurance carriers for the patient including policy and group numbers and Insurance Coverage Percents by Service Classification how much the carrier pays for certain types of procedures The service percentage classification is tied to each procedure code A Deductible Met check box is provided in the Policy 1 tab When the patient meets his or her deductible obligation for the year select this check box and the status is displayed in the patient account detail of the Transaction Entry screen The three tabs have the same layout except Policy 1 has
28. Practice Taxonomy Tax Identifier From Practice Social Security Number None O Mammography Cert None O Care Plan Oversight None O Legacy Identifier 1 None Legacy Identifier 2 None CO Legacy Identifier 3 Figure 52 New Provider ID screen Select either All Insurance Carrier or Insurance Class Select a carrier or class if necessary Select either All or Facility Select a facility if necessary Select either File Claim As Individual or File Claim As Group Select either From Practice or National Provider ID Enter an ID if the NPI is for this provider only If you do not want to send an NPI number on a claim select From Practice and then on the Practice IDs screen create a matching entry for the provider in which you select None for the NPI option 7 Select the From Practice button to pull the NPI number from the Practice IDs grid WARNING By selecting From Practice for the NPI it will put the Practice NPI in the Rendering Provider in Loop 2310 8 Select either From Practice or Taxonomy If you do not want to send a taxonomy number on a claim select From Practice and then on the Practice IDs screen create a matching entry for the provider in which you select None for the Taxonomy option User Guide Release 18 September 2012 Chapter 6 Setting up Providers and Provider Classes Entering Provider IDs Rules 10 11 12 13 14 Select the From Practic
29. Practice Information P Log In As Another User Login Password Management 4 Security Setup I Global Login Management m Permissions Report Permissions File Maintenance Alt F4 Figure 7 File menu The File menu contains options for managing your practice files September 2012 User Guide Release 18 Edit Menu Chapter 1 Navigating in Medisoft Edit Menu Delete Figure 8 Edit menu The functions of the Edit menu are Cut Copy Paste and Delete Activities Menu Enter Transactions Claim Management Statement Management BillFlash 14 Enter Deposits Payments E Unprocessed EMR Charges 4 Patient Ledger Guarantor Ledger 4 Quick Balance L Patient Quick Entry Biling Charges d Small Balance Write off Collection List Add Collection List Item Launch Work Administrator Final Draft 4 Add New Task Appointment Book Eligibility Verification Revenue Management Figure 9 Activities menu You will use the options on this menu for much of your daily routine Here is where you enter transactions and payments create claims view balances and open Office Hours User Guide 4 Release 18 September 2012 Chapter 1 Navigating in Medisoft Lists Menu Lists Menu Patients Guarantors and Cases Patient Recall Patient Treatment Plans j Patient Entry Template Procedure Payment Adjustment Codes MultiLink Codes Diagnosis Codes Addres
30. Release 18 September 2012 Chapter 14 Patients One of the most important functions in getting your practice set up is entering patient data Complete patient information is important for filing claims and processing statements to bill your patients Chart Number Considerations Every patient or guarantor must have a chart number and be set up in the database before you can enter transactions for the patient You can choose to allow Medisoft to create your patients chart numbers as you enter their records or you can use your own system f you want Medisoft to create your chart numbers simply leave that field blank when you create a patient record f you want to use your own system complete the Chart field as you enter the new patient s information If you want to use numeric chart numbers only open Program Options select the Data Entry tab and select the Use numeric chart numbers check box There is no need for corresponding numbers within a family the number sequence has little bearing on grouping of patients Each patient is set up individually in Medisoft and individual bills are prepared for each guarantor Once assigned the Chart Number cannot be changed To correct a wrong chart number you must delete the entire patient record and create a new one with the proper chart number All other data in the patient record can be modified User Guide September 2012 Release 18 81 Entering Patient Information Chapt
31. Reports Available Reports Not only does Medisoft build an accounts receivable file and handle statements insurance claims and electronic billing it also provides a variety of reports that can give you a better understanding of the day to day workings of your practice Among the reports generated within Medisoft are Day Sheets Analysis Reports Aging Reports Productivity Reports Network Professional Activity Reports Network Professional Collection Reports Advanced and Medisoft Network Professional Audit Reports Patient Ledger Report Guarantor Quick Balance List Network Professional only and Standard Patient List Reports You can also print a title page that shows all the filters used in preparing the report Day Sheets Day Sheets are available in three reports Report Description Patient Lists each patient s name showing all transactions and a summary of activities for the day Procedure Breaks down by procedure code the activities of the day summarizing patients treated for each procedure Payment Shows the payments made on the requested day and the charges to which the payments are applied User Guide September 2012 Release 18 161 Analysis Reports Chapter 24 Reports Analysis Reports Report Description Billing Payment Status Report Advanced and Medisoft Network Professional Provides a thumbnail sketch of the current billing and payment status of each claim T
32. a Practice To open a practice 1 On the File menu select the appropriate option Open Practice Medical ved E EL Cancel w Delete Figure 30 Open Practice screen 2 Choose the practice you want to open and click OK User Guide September 2012 Release 18 23 Setup Overview Chapter 3 Creating a Practice and Setup Overview Setup Overview Steps to setting up your basic practice can be found at Entering Basic Practice Information on page 41 Once you have created your practice database the next step is to enter data into each of the different areas of Medisoft such as insurance carrier records in the Insurance Carrier screen procedure codes in the Procedure Payment and Adjustment Codes screen and so on Here is a sequence for practice setup that will help you enter your practice information in the most economical way Creating rules overview Setup security Setup preferences Enter basic practice information e Setup EDI Receivers for electronic claims and eligibility Enter insurance carrier records Enter facility records Enter provider records Enter referring provider records Enter other address records Enter procedure codes and multi link codes Enter diagnosis codes Enter billing codes Enter guarantor and patient records Keeping in mind your practice structure and your filing needs will help you set up your practice Creating Rules Overview
33. a facility or a lab attached affiliated with your practice you will need to create a record for it There are two components to the record contact demographic data entered on the Address tab and billing specific information entered on the Facility IDs tab A facility or lab is a location to which mail might be sent or calls directed that has a separate address from your practice Entering Facility Information 1 Click Lists and select Facilities The Facility List screen appears Facility List Search for Field Type Ce Name T Extension CTENRETUETTITTTEHITUIIITENNU man RR JO000 J Duckworth Mallard and TEO 4237 MESOO Mesa Community Hospital 602 967 8792 Facility NEWO1 New Age Medical Laboratc B02 473 2241 Laboratory DESO Desert Diamond Labs 602 333 1111 Laboratory Figure 64 Facility List screen User Guide September 2012 Release 18 63 Entering Facility IDs Rules Chapter 9 Facility Information 2 Click New OR Select a record on the Facility List and click Edit Facility new Address Facility IDs Save Code C Inactive um Cancel Type Facility O Laboratory Name 1 Phone i Extension Street Fax Set Default Help thon City NEN State Office Zip Code Contact Extra 1 Extra 2 E Mail C Purchased Services Figure 65 Facility
34. be used before it has to be changed how long a user has to wait before reusing a password and so on Login Password Management Password Renewal Interval tc days Reuse Period jo days Minimum Characters jo Maximum Characters 5 Require Alphanumeric Login Maximum allowed attempts fo Account disable period jo minutes Reset to Defaults Figure 41 Login Password Management screen User Guide September 2012 Release 18 37 Setting Permissions Chapter 4 Security Setup Overview Setting Permissions NOTE This is an Advanced or Net Pro feature The Permissions feature provides five levels of access to Medisoft Once you have created at least one user for your practice and logged into your practice using someone s login and password the Permissions options will be available To set permissions 1 On the File menu select Permissions The Medisoft Security Permissions screen appears 7 Medisoft Security Permissions Window Process Level 1 Level 2 Level 3 Level 4 Level 5 V Activities P Quick Ledger v v v oO oO Addresses Quick Balance o o Appointment Breaks Billing Charges L1 L1 L1 L1 Appointments Billing Codes Claim Management Claim Rejection Message Communication Manager Condition Codes Data Entry Data ptions Design Custom Patient Case Data Diagnosis Codes EDI Receivers Eligibility Enter Deposits Payments Enter Transactions Facilities File Maintenance
35. can access Level 1 users have the most access while Level 5 users have the least access The first user you will create is the system administrator who must be a level 1 and have access to all areas of the practice 2 Assign permissions to users using the five access levels Creating Users You create users of the practice in the User Entry screen To create a practice 1 On the File menu select Security Setup The Security Setup screen appears This screen shows you a list of all users 2 Click New The User Entry screen appears User Entry Main Question Group m Login Name Inactive Full Name Password E Recontirm Access Level 1 v Expire Date Figure 39 User Entry screen 3 Complete the fields on the screen User Guide September 2012 Release 18 35 Creating Users Chapter 4 Security Setup Overview 4 Click Save The Security Setup screen appears and shows you the new user Security Setup User Group Full Name Login Name Access Level gt 2 2 1 Figure 40 Security Setup screen User Guide 36 Release 18 September 2012 Chapter 4 Security Setup Overview Login Password Management Login Password Management Use Login Password Management to set the requirements and application of login rights and password usage For example you can set the length of valid passwords the valid time frame in which a password can
36. cee eee tees 37 Figure 42 Medison Security Permissions SCEBOI 2sde asd ere d PE dor d Ede PL RO eed E EIEE 38 Figure 43 Practice Information SOPOBEL tow d eed uie tob qo eco ood tbe ra e bd oido Race 41 Figure 44 Practice DS SOFGOUL uou xor Soiree s riorik rnin Erra EEEE d debe db blo dre beer 42 Figure 45 New Practice IB Sreo usi cese dd oS pd rs dbi bad Ee docu Re EU Ed SS ERE REELS 42 Figure 46 Practice Information screen Practice Pay To tab uau uaaa 44 User Guide September 2012 Release 18 List of Figures Figure 47 Practice Information screen Statement Pay To tab iiiiiiiilliseele eren 45 Figure 48 EDI Receiver Screen nacccomicesescvesdcewmeccanse came Skagen C A Ron cee Pe RUE ay 46 Figure 49 Provider ist Shree saque qiios qubd Pedes dd bd diu dd qc iba Rd dide du 47 Figure 50 Provider SCr6Gtlie sc on dep dese cosh edad be RR HR ESE OS PRESEN SE OEE wp os OH OHSS woes 48 Figure 51 Provider Screen Reference labia esie cus deba acer bd Rari daa seek kc baer dad a SSE 49 Figure 52 New Provider ID SCOM iue esee mede oe mh Rar xe Reed odes dde end ce dammed ax 50 Figure 53 Referring Provider List Scfeens 24 2 54042 0042650446 544650040 5886555044 DEP idddd du 53 Figure 54 Referring Provider new screen 2 2 02 e00ss 200s cece see rm rm m Y mp hs 54 Figure 55 Provider screen Provider IBS taD 44a daba sem bebuc ke uen debuar iab au ies 55 Figure 56 New Referring Provider ID screen uices eem mmm em emm em hee 5
37. done by Revenue Management If you make changes on these tabs in Medisoft the changes flow automatically to Revenue Management and changes made there are also transferred to Medisoft When sending electronic claims set up your clearinghouse or direct payors in Revenue Management Once an EDI receiver is set up Revenue Management will synchronize the EDI settings in Medisoft For users upgrading to Medisoft 18 Revenue Management can use the existing settings for the payors set up on the EDI Receiver screen but you will need to reconfigure receivers to work with Revenue Management 7 EDI Receiver new Address Modem ID Extras ERA Code p If the Code is left blank the n program will assign one Name RelayHealth Street City State Zip Code Inactive Phone 1 Extension Phone 2 fo Fax Phone fo E Mail FO Web Address FO Contact Comment Po Figure 48 EDI Receiver screen User Guide 46 Release 18 September 2012 Chapter 6 Setting up Providers and Provider Classes Set up your providers physicians in Medisoft so you can add them to patient records and transactions entered In this way their information will be put on claims Entering Provider Information Enter provider records on the Providers screen To do so 1 On the Lists menu select Provider 2 Then select Providers The Provider List screen appears This screen shows you all of the providers currently set up in t
38. field enter the Medigap number The number entered is the COBA Medigap claim based identifier received from the national Coordination of Benefits Contractor COBC The EDI Extra 2 field is used by Revenue Management Select the Complimentary Crossover check box if you are filing complimentary crossover claims Secondary insurance will not be sent in the claim file However Medisoft will mark the secondary as sent If you are sending Medigap claims do not select this box User Guide September 2012 Release 18 61 Insurance Carriers Chapter 8 Insurance Classes and Insurance Carriers 20 Select the Delay Secondary Billing check box if there is a secondary insurance company and you want to delay printing the secondary claim form until a response is recorded from the primary carrier To print the secondary claim form at the same time the primary is printed leave the box empty 21 Select the Send Ordering Provider in Loop 2420E check box to send ordering provider information on an electronic claim 22 Select the Send Practice Taxonomy in Loop 2000A check box to send taxonomy in Loop 2000A for electronic claims Loop 2000A is usually used to report taxonomy for individual providers Contact your carrier for more information on their taxonomy requirements 23 Select the Allowed tab This displays the amount last paid by the selected carrier for each procedure code available in Medisoft If you do not enter anything in this table each
39. it down by hour and minutes Standard appointment Intervals can be established by scrolling with the up and down arrows You can also set colors to distinguish appointments breaks and conflicts Make decisions concerning all the other default settings in this tab Designate one of the reports in the Speed Report box and it will automatically print when you click the Print speed button You can now choose to use Deposit Entry or Transaction Entry when entering a copay To use Transaction Entry rather than Deposit Entry click the Use transaction Entry to Make Copays check box User Guide 154 Release 18 September 2012 Chapter 23 Scheduling Appointments Multi Views tab Multi Views tab Program Options Complete Dr Mallard Figure 149 Program options Multi Views tab Office Hours provides one Multi View setup which automatically includes all providers and all resources each with its own column You can create as many Multi Views as you need in the Multi Views tab The open data entry field lists all Multi Views that have been set up This is where you can group providers and or resources rooms or facilities scheduled for appointments in any combination desired or modify or delete existing multiple view setups Click New to set up a new Multi View select a view and click Edit to make changes User Guide September 2012 Release 18 155 Multi Views tab Chapter 23 Scheduling Appointments 15
40. it will automatically show the last inquiry made for each patient You can also set it to show all inquiries To make a real time eligibility inquiry from the Eligibility Verification Results screen Highlight the patient and click Verify Patients 138 To make a real time eligibility inquiry for a specific patient 1 Right click the patient s case in the Patient List and select Eligibility Verification z Patient List Search for I Field l Chart Number y O Patient 9 Case I Chart Nu Name CATSAD00 C S y 6 17 1964 CLIWAO0D linger Wallace COLANOOO Collins Anorie L 1 3 1972 lt Date of Birth Soc Sec Nur List of cases for Again Dwight PEERS 3 30 1932 BORJOOD0 Bordon John 111 00 1010 Y LL jsw Edit Case 9 New Case Delete Case Copy Case s Print Grid Number gt MEN 17 Back Pain Case Description Edit Case New Case Delete Case Eligibility verification F10 Locate Ctri L Show Closed Cases Print Grid User Guide Release 18 Guarantor CI reru r3 September 2012 Chapter 22 Using Electronic Services Task Scheduler Figure 136 Patient List with Eligibility Verification highlighted 2 The Eligibility Verification Results screen appears 3 Click Verify to make the inquiry TIP Press F10 to launch the Eligibility Verification Results screen to verify a patient s eligibility Task Scheduler
41. screen when Eligibility is enabled For more information on this screen see Eligibility Verification on page 137 User Guide 10 Release 18 September 2012 Chapter 2 Medisoft at a Glance This chapter provides a brief overview of the setup and use of Medisoft in the general order in which you will want to set up your practice For instance you will first want to enter basic information on your practice such as practice name and address Then you ll move on to entering information on the physicians in your practice Providers the insurance carriers your patients have and then diagnosis and procedure codes For more detail on each area of the program use the following table For more information about setting up see your practice Creating a Practice and Setup Overview on page 21 and Entering Practice Information on page 41 your providers Setting up Providers and Provider Classes on page 47 referring providers Referring Provider Records on page 53 insurance carriers Insurance Classes and Insurance Carriers on page 57 facilities addresses procedure payment adjustment codes diagnosis codes patients Facility Information on page 63 Attorney Employer or Other Addresses on page 67 Procedure Payment and Adjustment Codes and Diagnosis Codes on page 69 Diagnosis Codes on page 75 Patients
42. several rules on the Provider IDs screen specific to the insurance companies that require mixed NPI numbers For insurance companies that require the group NPI select From Practice for the NPI number This will pull that number from the Practice IDs screen For insurance companies that require an individual NPI number select National Provider ID and enter the number on the Provider IDs screen Insurance Company Considerations 30 If an insurance company requires dual taxonomy you must create a rule on the Practice IDs screen for that insurance company and enter the taxonomy number there Then open the Insurance Companies screen and select the Send Practice Taxonomy in Loop 2000A checkbox Most likely though you will probably have at least one or more insurance companies that require different information In that case you must create other rules that are specific to that insurance company and the information needed for instance a legacy qualifier such as a medicare number as shown in Figure 37 New Provider ID SEE 2 Figure 37 New Provider IDs screen specific to an insurance company Each of these additional rules needs to be complete since the claims processing pulls all the information in a rule and not just one field An incomplete rule for instance no NPI number will leave fields empty in the claim causing rejection In the case of Figure 37 you would need to include t
43. status but they will all change to the same status when you complete this procedure Click Edit In the Change Claim Status Billing Method screen select Selected Claim s Select the appropriate buttons in the Status From and Status To sections If you have chosen claims with varying statuses select Any status type in the Status From section Click OK User Guide September 2012 Release 18 111 Selecting Multiple Claims Chapter 18 Creating Claims User Guide 112 Release 18 September 2012 Chapter 19 Creating Statements In this chapter you will learn how to create statements for billing your patients and updating them on charges to their accounts Statement Management NOTE This is an Advanced and Medisoft Network Professional feature This section explains briefly how to manage statements within the Statement Management screen and includes creating editing printing reprinting and listing statements as well as changing statement status You can use Statement Management to create bill and rebill statements all from one place You can also view information about the statement such as the guarantor the status the initial billing date and the type You can also generate statements to track missed copays Creating Statements When you want to bill your patients create statements You can print your statements to paper or you can use BillFlash to send them electronically BillFlash will print and sen
44. the status of an entire batch needs to be changed you can change all the claims at once User Guide 110 Release 18 September 2012 Chapter 18 Creating Claims Selecting Multiple Claims 1 2 4 5 Highlight one of the claims on the Claim Management screen and note the number listed in the Batch 1 column Click Change Status The Change Claim Status Billing Method screen appears Change Claim Status Billing Method Change Status Billing Method of Claims For Batch IE Selected Claims OK Status From Status To O Hold Hold Ready to send Ready to send O Sent O Sent Rejected Reject Challenge O Rejected O Alert Challenge O Done O Alert Pending Done Any status type Pending Billing Method From Billing Method To Paper Paper Electronic Electronic For Carrier Primary O Tertiary Secondary all Figure 110 Change Claim Status Billing Method screen Select Batch and enter the batch number from the Batch 1 column in the Claim Management screen Choose the appropriate buttons in the Status From and Status To sections Click OK Selecting Multiple Claims 1 a A Cc Im When only one or a few claims within the same batch or claims from multiple batches need a status change on the Claim Management screen hold down the CTRL key and click each claim that needs the status changed Note that the selected claims do not need to have the same claim
45. time a carrier makes a payment on a particular procedure code Medisoft takes the amount paid plus any deductible and divides it by the established Service Classification percentage to arrive at the allowed amount 7 Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Code Procedure Allowed b 17110 Wart Removal 29130 App of Finger Splint Static 36215 Lab Drawing Fee 43220 Esophageal Endoscopy 70250 X Ray Skull 4 Views 70360 X Ray Neck 70373 X Ray Laryngography 71020 X Ray Chest 2 Views 71030 X Ray Chest Min 4 Views 71040 Contrast X Ray of Bronchitis 72052 X Ray Spinal Complete 73130 X Ray Hand Min 3 Views 73562 X Ray Knee Mn 3 Views 73610 X Ray Ankle Complete 74246 MRI Gastrointestinal Tract 74283 Barium Enema Therapeutic 76818 U S Fetal Age 80050 General Health Screen Panel 81000 Urinalysis Routine ooo oo cocco e ce cooooooocococo0o0 oo eoo Set Default oOoooooooooooooooo ooog coooo0 e o e Figure 63 Insurance Carrier screen Allowed tab This allowed amount is used when calculating the patient portion estimate of any procedure in the Transaction Entry screen The existing allowed amount can be changed in the Transaction Entry screen by clicking the Allowed Amt column and entering the corrected amount 24 Click Save User Guide 62 Release 18 September 2012 Chapter 9 Facility Information Setup Scenarios If you have
46. will see the notification on the screen Edit Appointment AGADWOOO 9 F Save Q Cancel PS a E enn co Er Figure 145 Edit Appointment screen with future appointment notification 4 Click the magnifying glass to open the Scheduled Appointments screen You can see all of the patient s appointments from this screen You are not limited to the next 60 days User Guide 150 Release 18 September 2012 Chapter 23 Scheduling Appointments Rescheduling an Appointment Rescheduling an Appointment You can reschedule an appointment by opening it and changing its status to Rescheduled The Wait List will open allowing you to find an open appointment time for the patient To reschedule an appointment 1 On the Appointment grid right click the appointment and select Reschedule The Wait List screen appears office Hours Professional Medical Group Tutorial Data m nj x File Edit View Lists Reports Tools Help soea lezint i n o v July 16 2012 n Sun Mon Tue Wed Thu Fri Sat 1 12 3 4 5 8 7 8 3 10 1 i12 13 14 15 KI 77 18 19 20 21 22 23 Bi 25 26 27 28 29 30 1 2 PODES aa oer reaps xi E Sort E zl Provider el Dlandria McBlithe TUDIN 15 7 EW Catera Sammy 227 7722 15 URGENT Again Dwight 434 5777 15 15 S View eStatemenis z Appointment L
47. you will print statements from the Reports menu If you click Statement you will print statements from Statement Management For more information in creating and printing statements see Creating Statements on page 113 User Guide 100 Release 18 September 2012 Chapter 17 Quick Ledger and Quick Balance Quick Balance Quick Balance NOTE This is an Advanced and Medisoft Network Professional feature The Quick Balance is a summary of all remainder charge totals for a selected guarantor record To open the Quick Balance screen Onthe Activities menu select Quick Balance Quick Balance Chart COLANOD0 v 9 Collins Anorie L Chart Number Patient Name COLANOOO Collins Anorie L Guarantor Remainder Total 0 00 Figure 98 Quick Balance screen If the record selected is a guarantor s record the Quick Balance screen displays each patient for whom the guarantor is responsible and the total qualifying remainder charges for each If the record selected is not a guarantor s record you will see a listing of all the selected patient s balances TIP If you click Print in Quick Balance you will print statements from the Reports menu For more information in creating and printing statements see Creating Statements on page 113 User Guide September 2012 Release 18 101 Quick Balance Chapter 17 Quick Ledger and Quick Balance User Guide 102 Release 18 September 2012 Chapter 18 Creat
48. your practice It is automatically installed with Medisoft Starting the Program From the Windows Desktop Click the Office Hours Professional icon on your computer desktop From Within Medisoft Onthe Activities menu click Appointment Book User Guide September 2012 Release 18 141 Office Hours Setup Chapter 23 Scheduling Appointments Office Hours Setup There are several sections of the program that must be set up before you start scheduling 1 First set up provider records If you are booking appointments for lab work or therapy each of those technicians will have a provider number and schedule and so will each office member whose schedule will be included in the Office Hours program 2 Set up your patient records 3 Create your resource records You can include all treatment apparatuses in this list as well as consultation and treatment rooms so that you do not double book a room or equipment 4 Set up program options such as establishing appointment length creating whatever views you need for viewing multiple columns at once and deciding how much information you want displayed in your appointment blocks in the appointment grid 5 Setup breaks and recurring breaks to show lunch hour set coffee type breaks seminars and so on 6 Set up security User Guide 142 Release 18 September 2012 Chapter 23 Scheduling Appointments Using Office Hours Using Office Hours Entering a New Appointmen
49. 17 Back Pain AGADWOL Fe CLIWAO000 Clinger Wallace COLANODO Collins Anorie L 1 3 1972 111 003010 y z am jam gt Edit Case 9 New Case l w Delete Case Copy Case s Print Grid g View eStatements Figure 86 Patient screen with Case selected User Guide September 2012 Release 18 87 Creating a Case Chapter 15 Cases 3 Click New Case The Case screen appears Case COLANOOO Collins Anorie L new Miscellaneous Medicaid and Tricare Comment EDI Custom One A Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition j Save Case Number 0 Cancel Description Cash Case Help Global Coverage Until v V Print Patient Statement Guarantor COLANOO0 v S Collins Anorie L Marital Status v Student Status b d Employment Employer v 2 Set Default Status v Retirement Date v Work Phone Location Extension v lt gt Name Collins Anorie L Home Phone 770 555 1000 Address 2320 Sweetwater Lane Work Phone 404 555 2000 Roswell GA C A 30010 ell Phone 770 555 4000 Date of Birth 1 3 1972 v 2 Figure 8Z Case screen Medisoft will pull information from the patient s record into the case record automatically 4 Complete the fields on since much of this info Personal tab each tab as is applicable for the new case Be as complete as you can rmation will be sent when you file claims Tab Description
50. 18 September 2012 Chapter 2 Medisoft at a Glance Setting up Your Practice Overview The Referring Provider screen contains information about the referring providers associated with your practice Referring Provider new Not Listed Figure 17 Referring Provider screen You will use the Insurance Carrier screen to enter insurance carrier records Keep a complete a te Set Default record of each ot your insurance carriers so that claims will be filed properly Insurance Carrier new Address Options and Codes EDI Eligibility Allowed E ri If the Code is left blank the Code program will assign one C Inactive Carrier Address esin See C fo aeaf wf ef ZipCode oo Plan Information Pantone us a Note Figure 18 Insurance Carrier screen User Guide September 2012 Release 18 Set Default 13 Setting up Your Practice Overview Chapter 2 Medisoft at a Glance The Facility screen contains information about the labs and facilities associated with your practice Use the fields on this screen to enter information that is specific to the facility for claim filing purposes Facility new Address Facility IDs Code L Inactive E Save Cancel Type Facility O Laboratory Name Phone o Extension Street LO Fax Set Default Cell Phone I City ot State Office I Zip Code NEM C
51. 5 4000 Fax Ohe Birth Date 1 3 1972 v Sex Female Birth Weight jo Units v Social Security E 11 00 1010 Entity Type Person v Race Caucasian C w Ethnicity Non Hispanic v Language English v Death Date v Figure 23 Patient Guarantor screen User Guide 18 Release 18 September 2012 Chapter 2 Medisoft at a Glance Entering Transactions and Payments Entering Transactions and Payments You enter charges via the Transaction Entry screen You can also apply payments using this feature Transaction Entry one Pen Procedure Units Amount Total Diagl Diag2 Diag3 Diag 1234 Provider POS TOS Allowed M1 Co Pay 7 23 2012 70373 1 45 00 45 000053 EED iti 0 00 a 7232012 v g 1 000 000003 v DS 0 00 o Description Provider Amount Check Number Unapplied ee a eee ee Figure 24 Transaction Entry screen Generating Claims and Statements Claims processing centers on the Claim Management screen from which you can create edit and print send claims Medisoft also provides support for UB 04 claims Claim Management EIE lt lt gt Je Claim Number Chat Num Carrier 1 Status 1 Media 1 Batch1 BillDate1 EDI Receiver Carrier 2 Status 2 gt 1 SIMTA000 AETOO Sent Paper 1 12 3 2008 2 AGADW000 MEDOT Done Paper 2 11 21 2008 AETOO Sent 3BRMADOO0 CIGOO Sent Paper 4 3 25 2009 BLUOI Sent 4 BRISUODO CIGOO Done Paper 5 12 5 2008 BLUOO Sent 5 WAGJ
52. 5 Gradi SER saset enri S SAMS 108 Figure 106 Data Selection Questions screen 0 0 0c cee ee eee eee hne 108 Figure 107 Claim Management screen with Status of Sent 0002 c eee ee 108 Figure 108 Open Report Screen 24 66 ain d dpt dee ae oben soared Hore dnsa ed oe d db Re d 109 Figure 109 Report Properties SCreen Lu cece de sie eae dA Dea REGE Ead Ed dada e ACE ACE dcos d 110 Figure 110 Change Claim Status Billing Method screen 1 0 2 0 cee 111 Figure 111 Statement Management screen iius seauaedauar aed aebxar e s REA whiawend bea a 113 Figure 112 Create Statements screen ies ase cece eed dorem boe ie dece Gea ec idc eRe 114 Figure 113 Statement SBEeO 2 22 cca reb AU rea Geox d es Ae SKE SADA DA d Rd dudes 115 Figure 114 Print Send Statements screen 2245 cesses rh mae dem e once n ey hex eens 116 Figure 115 Open BODOFUBORBOIN 22 1 dud baa i4 pd dob dioe ded da de Sob oar dob qur cba bdo sa 116 Figure 116 Print Report Where screen 5 045002 eee cscs eee eee map Rem P em e Xo o de 117 Figure 117 Data Selection Questions screen ii ccc cae ccu cR REGERE RA dd 117 Figure 118 Statement Management screen with Status of Sent lllilllsi else 117 Figure 119 Change Statement Status Billing Method screen 0 000 cee eee 118 Figure 120 Program Options screen Billing tab 0 250222000 c8 Rm mmm meg 119 Figure 121 Deposit List Seen iat ccread base d dd bord Od bct Dre E Rb Ra bbb dde DR SL d Adis 123 Figure 122 Deposit new
53. 6 In the New View screen assign a name for the new view For the first column indicate the type Provider or Resource the Code provider number or resource code then the width of the column in pixels Set up each column you want in the view and click Close when finished lox View Multi Name 3 Close Column Type Code width LES Delete Column Insert Column Figure 150 New View tab If you want to add a column between columns that have already been created place your cursor where you want the new column and click Insert These views can be also edited or reverted to default views through the View menu User Guide Release 18 September 2012 Chapter 23 Scheduling Appointments Appointment Display tab Appointment Display tab Program Options Figure 151 Appointment Display tab In the Appointment Display tab you can specify up to five rows of information to display in the grid for an appointment Be aware that the length of the appointment determines how much data is actually displayed on the grid An appointment must be at least 75 minutes long to display five rows of information User Guide September 2012 Release 18 157 Appointment Display tab Chapter 23 Scheduling Appointments User Guide 158 Release 18 September 2012 Chapter 24 Reports In this chapter you will learn about reports in Medisoft Reports Overview Medisoft offers flexib
54. 6 Figure 57 Insurance Class List Screen uci czd aen d nez kc hl RE E EEEE R RIO RUM Dad eed da 57 Figure 58 Insurance Class BOlODIT c o y adeb gre ee va ce Gees Get eee ded deba wed du eSEE 58 Figure 59 Insurance Carrier LIStSOFOB I Leraxuracaszdiikkei oa Rune Rua EROR RR a SEE Eob Seas 59 Figure 60 Insurance Carner SCIOBPIL seu uem maps per ex ucre eieabk each sonda wee Rea 59 Figure 61 Insurance Carrier screen Options and Codes tab 2000 00 ee eee sees 60 Figure 62 Insurance Carrier screen EDI Eligibility tab 2 csse rr I 61 Figure 63 Insurance Carrier screen Allowed tab i i sssasssaashisad emu bua s ta Eee rre da 62 Figure 54 Facility List SCFGOFI secedere mg der gg aer Em RR qe aem pce qo ae ns 63 Figure 65 Faeility screen Address tab vcick sc coach bbidi bic REED ORE DePRR dE e IRI PEN E 64 Figure 66 Facitly Sheets 424 sewer kiere Ea rrr eer E EH PE ARUK PW Sep edie we See be dem enr 65 Figure o7 New Facility Ib SOROBEI 42s deed Das Er Erben pP eb eee Ped aa ees Pad caca 65 Figure 68 Address LIST SCIOGIe ouais xmi und bebe eee ba pR OU Reed aed dec ond koe dede d 67 Figure 59 Adds SEFODIT sud 223540 buerb bbb dc du bp eub Eae AR ES dd DEE ae id iudi eben 68 Figure 70 Procedure Payment Adjustment List screen 2 0 20 0 6 69 Figure 71 Procedure Payment Adjustment screen uus can aues ra ede as dew Stade Roe eure 70 Figure 72 Procedure Payment Adjustment screen Amounts tab liliis isis 71 Figure 73 Procedure
55. 6 Release 18 September 2012 Chapter 19 Creating Statements Printing Statements 4 Select which form you want to print and click OK The Print Report Where screen appears Print Report Where Figure 116 Print Report Where screen 5 Select your option and click Start The Data Selection Questions screen appears Patient Statement All Payments Data Selection Questions Figure 117 Data Selection Questions screen 6 Make your selections for the various ranges and click OK 7 The Status of the claims will be updated to Sent on the Statement Management screen Statement Management p EEG Gm Guarantor Phone Status Initial Biling Batch Media Type 3 4 CATSA000 227 7722 Ready To Send 0 Remainder CI 11 SIMTA000 480555 5555 Hold 0 Standard 5 DOOJAO00 Ready To Send 0 Remainder i DDEJODOO 480 8898999 Sent 12 11 2008 3 Paper Standard 9 AGADWODO 434 5777 Sent 7 26 2012 4 Paper Standard 10 BRIJAOD0 222 342 3444 Sent 7 26 2012 4 Paper Standard 32 YOUMIOO0 602 222 3333 Sent 7 26 2012 4 Paper Standard 15 BORJOOOO 4347771234 Sent 7 26 2012 4 Paper Standard gt 14 AGADWO00 434 5777 Sent 7 26 2012 4 Paper Standard Figure 118 Statement Management screen with Status of Sent User Guide September 2012 Release 18 117 Reprinting Statements Chapter 19 Creating Statements Reprinting Statements If necessary you can reprint statements with
56. 8 overview 44 setting up 44 statement processing 137 BillFlash tab 177 Billing Code List window 77 billing codes September 2012 creating 77 billing cycles 119 175 Billing tab 175 C Capitation Payment 127 Care Plan Oversight number 185 providers 51 case setting up 87 Case number 94 case setup 87 Case window 88 customizing 92 Cases Account tab 88 cases Comment tab 89 Condition tab 88 copying 90 creating 87 defined 87 Diagnosis tab Diagnosis tab cases 88 EDI tab 89 Medicaid and TRICARE tab 89 Miscellaneous tab 89 Multimedia tab 89 overview 87 Personal tab 88 Policy tabs 89 changing claim status 110 changing statement status 118 charges entering 93 chart number setup 81 chart numbers 81 numeric only 81 chiropractic practice 41 claim filing status 24 claim form not centered 109 claim management overview 103 Claim Management window 104 claim manager User Guide Release 18 187 Index EDI receiver 103 EOB 103 role 103 Claim window tab defined 106 claims changing status 110 creating 103 editing 105 filing 103 printing 107 reprinting 110 troubleshooting 109 Claims Payer ID field 61 CLIA number 185 providers 51 Collection Letter Wizard 134 collection letters 134 customizing 134 printing 134 collection list items adding 130 Collection List window 129 Collection Reports 166 collections managing 129 Color Coding tab 174 Comment tab cases 89 common keystrokes 9 Communication
57. 8 43 Entering Practice Information for a Billing Service Chapter 5 Entering Practice Information Entering Practice Information for a Billing Service Billing Services If you are a billing service enter your client s information in the Practice tab Enter your information in the Practice Pay To tab If you want to use Medisoft to keep track of your own accounts receivables a separate database can be set up with each client listed as a patient Separate procedure codes can be created to cover the various services of your billing service To set up a billing service 1 On the File menu select Practice Information The Practice Information screen appears 2 Select the Practice Pay To tab Practice Information Practice Practice IDs Practice Pay To Statement Pay To Practice Name Happy Valle Medical Billin Phone 480 480 4800 Extension 2222 Street 1944 N Kluge Dr Fax Phone 480 480 4801 Suite 8381 City Gilbert State jaz Extra 1 Zip Code 85234 Extra 2 Figure 46 Practice Information screen Practice Pay To tab 3 Enter the pay to information in the Practice Name Street City State Zip Code fields 4 Click Save BillFlash Users BillFlash is the online service available to you if you want to send your statements electronically Once you enroll with BillFlash you can create statements and upload them to BillFlash BillFlash then takes care of printing and sending them to your p
58. 9 Billing Code screen 3 Enter a Code and Description 4 Click Save User Guide September 2012 Release 18 77 Chapter 12 Billing Code List 78 User Guide Release 18 September 2012 Chapter 13 Contact List NOTE This is a Medisoft Advanced and Medisoft Network Professional feature The Contact List is available to track people with whom you have had contact during the course of business On the Contact screen you can add notes regarding your conversations with the contact to help you keep track of what was discussed and any conclusions or information shared during the conversation To add a contact 1 On the Lists menu select Contact List The Contact List screen appears Contact List Search for 5 Field Contact Business Category Business Contact Category Phone Dat D Pat Time Employee Alice Arthur Personal 480 777 7776_ Aetna Corey Jackson Insurance 800 221 2221 10 Pfizicon Horacio Sanchez Drug Rep 602 999 9988 7 1 Philos Pharmacy Philo Martineau Pharmacy 480 123 4567 127 Camelback Medical Supply Roger Wirthlin Dther 602 331 3331 Cm Figure 80 Contact List screen User Guide September 2012 Release 18 79 Chapter 13 Contact List 80 2 Click New The Contact screen appears Contact new Figure 81 Contact screen 3 Select the Category for the new contact 4 Enter information as necessary to complete your record 5 Click Save User Guide
59. AWETSVBPNXCQRPJC RAN PASqge vq 155 Appomiment Display TAD s oso S cuadro ranri ni NU SNP ERE I PRESE SEN 157 CGh hapter 24 ioo RnB 159 apos VOD eoo bere hace beens UVNICPEI EIE I de videi dm 159 PEDO FEOCOOUDDS ai bae cs br apex Rak ble Bod bor eU eae a d pp URN 159 Viewing a Rapo ircre rrieta e EPERIIVEP E HPRUR PX PSI RR RP PRA 159 FPE e FRSDOEL s saos s ve oie a XX GobRRARRTARPESRAG GE GRE Sawada 159 lxpar ng AROPO oed svo ie yx ets 445 Eh Ree di VA d ER 160 Searching for a Specific Detail in a Report 0020 cee ee eee 160 Available REDONS 25 50 66 52464 40ebod DEPO tee e RT PRG RpPRe S ea d e rETS 161 Dav SIS bd 13d 2 581 iomp dud A abra dag Edad dp aub dedu fciafiamu 161 Analysis REPONS cia iid eO Vd RIEN Ree EVER IF pd d bg d ees 162 PONG MEWS quist Aan RV Lobes weed laa Mee beet d PE asst 165 Producton Repons lt 5 04 5540 0504692 444484465086040800944 40005508804 165 AGUNY NCDONS cscenapeet kinn Anarsia Or ERELT N Aa 166 ael cio p PD EE 166 DUSCHE x o pLEITEMEUEUTT 167 User Guide vi Release 18 September 2012 Table of Contents Chapter 25 Program Options icsoe ease A haRRa pA RR RR AR RR ARRA RE ERA 169 Genes Tab desea 354b de eh dtr d d qup psu aqq d qq dud Jgd d panics 169 DIS ERI TED LL edad so dad ved caseuoenb edades equ Dueb qudd ps 170 Payment Application Tab sesso re hm gc Er ex e uo wg 171 iind MOSBOIIS TD sc obs Sabes Dp ota cud bet oso Ut deside Spann a Sas 172 HIPAA Tasa chiese b eRIVATXIcHOR
60. Apply the portion of the payment to the applicable charge s Apply Payment Adjustments to Charges Collins Anorie L Ins 1 Aetna AETOO es Amount 0 00 A Ins 2 Show Remainder Only For COLANOOD v 2 olins Anorie L Ies Show Unpaid Only Payment Procedure Codes CHECK v 9 9 wROFF v 8 9 CHKCOF v 9 Date Procedure Charge Remainder Payment Deductible withhold Allowed Adjustment Take Back Provider Co pay X oz 286 2002 z02560 5500 4000 3000 o0 ps 0 00 10 00 30 00 0 00 0 00 0 00 0 00 0 00 0 o0 e When Claims Are Done E qestseeen tanto CO eronata Ja te Apply To Oldest There is 1 charge entry Ivi Bill Remainina Insurances Now E Save Payments Adjustments Close Pont Stak Ne View Transactions C A View eStatements Apply To Co pay write off Balance Now Figure 126 Apply Payment Adjustment to Charges screen 5 Click Save Payments Adjustments TIP If you select the Print Statement Now check box and click Save Payments Adjustments you can print statements from Statement Management 6 If you need to apply payments from the same deposit to another patient record select the next patient chart number and continue making payment applications This screen is also tied to the Payment Application tab of Program Options Unless deactivated all payment applications are automatically checked as paid in full by the payer allowed amoun
61. EOOO BLUOO Sent EDI 0 5 1 2008 RM 6 YOUMIOO0 USOO0 Ready To Senc Paper 0 AGADWOOO MEDO1 Sent Paper 7 12 6 2003 Create Claims 4 amp Print Send a Reprint Claim M HE Figure 25 Claim Management screen User Guide September 2012 Release 18 19 Generating Claims and Statements Chapter 2 Medisoft at a Glance 20 After you have created claims in Medisoft you can either print them from Medisoft or file them electronically using Revenue Management see Electronic Claims Processing on page 137 an integrated electronic claims filing application You can use the Statement Management screen available in Medisoft Advanced or Network Professional to create billing statements for patients Statement Management Sort By Batch Number Te Stmt Guarantor Phone 4 CATSAO00 227 7722 5 DO0JA000 S AGADW DU 434 5777 10 BRIJADOD 222 342 3444 11 SIMTAO00 X 480 555 5555 12 YOUMIOOO 502 222 3333 2 DOEJOO00 480 339 3333 3 WAGJEOOO 121 419 7127 5 Edt Create Statements a Print Send amp Rebill Statement Delete Status Ready To Send Ready To Send Ready To Send Ready To Send Hold Ready To Send Sent Sent Initial Billing Batch Media 12 11 2008 1 Paper 5 18 2008 1 Paper Figure 26 Statement Management screen User Guide Release 18 Type Remainder Remainder Standard Standard Standard Standard Remainder Remainder v g View eStat
62. Figure 139 ADDOIIIRONE GNA mixa is caw tank E REO debole eae d od o Ld pn de aa e eade ds 143 Figure 140 Find Open Time SCOM uu soc ieeceibkdereeegmm xi eges Qon ape Ode arn XXE PH RR 144 Figure 141 G6 To Dale SOLO 2 adsis Rar enhe edocti RR Lede Dds PRAE ES EU 145 Figure 142 Confirm Phone Change Sheen cues ev orret etes taani desdo ee RU eu dd e ied os 147 Figure 143 Scheduled Appointments Screen ccascacac dda acces Gh aU ROLE GRO RXUR OG RE EEX ea 148 Figure 144 Future Appointment List next 60 days screen 1 eee 149 Figure 145 Edit Appointment screen with future appointment notification 150 Figure 146 Appointment Grid with Wait List screen open liliis sil 151 Figure 147 Patient Recall List SB OOEY scnccrccakcowsr deb oan aed eda eade a rade waded 153 Figure 149 Program Options Options Tab oua sun Sekt medie den oeneee wena ness 154 Figure 149 Program options Multi Views tab soc sucia E Dee RE De donee Tae addons 155 Figure 150 Now VIGW tab 2 2500 uer RUE RRRU ERE RU esses d epe rd OSHA ESOP ep 156 User Guide September 2012 Release 18 List of Figures Figure 151 Appointment Display TER a sue dde bs od dc md dux dw E biat saria Rau des mds 157 Figure 152 Program Options screen General tab lllllll llis 169 Figure 153 Program Options screen Data Entry tab 0 000000 cece tee 170 Figure 154 Program Options screen Payment Application tab 0 000 eee eee 171 Fi
63. Final Draft Help Insurance Carrier List Ledger Login Password Management Multilink Codes v Figure 42 Medisoft Security Permissions screen This screen comprises two sections The screen section displays all the areas of the practice for which security can be set up The Process section shows the individual elements features or screens that make up the selected area in the screen section Level 1 is for unlimited access and is designed to be used exclusively by the Supervisor or administrator to restrict access to Medisoft For Levels 2 3 4 and 5 the supervisor defines what access goes with each level and assigns users based on that User Guide 38 Release 18 September 2012 Chapter 4 Security Setup Overview Setting Permissions 2 Select a program area in the screen section The options for that area appear in the Process section 3 Select or clear check boxes for each option and level in the Process section of the screen 4 Click Close when you are done The Security Supervisor who has unlimited access and full control of security can assign or remove rights for any level of security with one exception Level 1 access cannot be removed from any of the three options listed in the Process section of the Permissions screen when Security is selected in the screen section User Guide September 2012 Release 18 39 Setting Permissions Chapter 4 Security Setup Overview 40 User Guide
64. Link Code 1 Link Code 2 Link Code 3 Link Cod E 33000 37128 DS 73 MultiLink Codes Chapter 11 Procedure Payment and Adjustment Codes and 74 2 Click New The MultiLink Code screen appears MultiLink Code Catheterization 2 3 4 5 B 7 8 Code CATHET0000 Inactive Description BELEGE Link Codes il 99213 v g Office Visit Est Patient EEL 87087 v 2 Commercial Kit 97086 v 2 Catheterization BO vol al e Figure 75 MultiLink Code screen 3 Enter a Code and Description for the procedure 4 Select the procedures for this code from the Link Code fields 5 Click Save User Guide Release 18 September 2012 Chapter 11 Procedure Payment and Adjustment Codes and Diagnosis Codes Diagnosis Codes Diagnosis Codes Diagnosis codes describe the medical reason s a service is provided The procedure code tells what the physician did and the diagnosis code tells what the physician found To create a new diagnosis code 1 On the Lists menu select Diagnosis Codes The Diagnosis List screen appears Diagnosis List SEE Search for B Field Description 4 Code 1 Description Code 2 Code 3 gt 493 9 Allergic Bronchitis 493 9 493 9 995 3 Allergic Reaction Allergies 335 3 335 3 783 0 Anorexia 783 0 783 0 716 8 Arthritis Multiple 716 8 716 9 716 94 Arthritis Hand 716 94 716 94 110 4 Athlete s
65. MCKESSON Empowering Healthcare Physicians Practice Solutions Medisoft 18 User Guide September 2012 Produced in Cork Ireland Copyright notice Copyright notice Copyright 2012 McKesson Corporation and or one of its subsidiaries All Rights Reserved Use of this documentation and related software is governed by a license agreement This documentation and related software contain confidential proprietary and trade secret information of McKesson Corporation and or one of its subsidiaries and is protected under United States and international copyright and other intellectual property laws Use disclosure reproduction modification distribution or storage in a retrieval system in any form or by any means is prohibited without the prior express written permission of McKesson Corporation and or one of its subsidiaries This documentation and related software is subject to change without notice Publication date September 2012 Produced in Cork Ireland Product Medisoft Release 18 Corporate address McKesson Corporation 5995 Windward Parkway Alpharetta GA 30005 404 338 6000 User Guide ii Release 18 September 2012 Table of Contents Table of Contents Preface 24424 E RRERERARRARERARGY RARE RESERPTAEORAWREG OSES URS kE errana EKER ER xiii Where to Find Help sss seme mm meom en mee nme e OR e erm xiii adl TX xiii TAMING eas eor REO ERE PP QNere eed cau qe eim ed qe eset de xiii Independent Va
66. Manager focuses on three principal areas not necessarily sequential review batch and final review Watchdog The Claim Manager is first of all the watchdog of the claims The Claim Manager checks each claim and verifies the numbers having the authority to edit the claim and make needed changes If there is something in the claim that should go to a different carrier than indicated or if the EDI receiver information is incomplete the Claim Manager corrects the record The Claim Manager also has access to the insurance carrier records and checks the billing date and how the claim is to be sent either by paper or electronically Then the Claim Manager can indicate the status of the claim Batch em up The function of creating claims serves to group claims that are headed to the same destination The Claim Manager gathers and sorts by range of dates or chart numbers Transactions can be selected that match by primary carrier Billing Code case indicator or location Random Billing Code numbers can be selected The Claim Manager can also indicate a minimum dollar amount for creating the claims eliminating claims too small to be worth billing User Guide September 2012 Release 18 103 Creating Claims Chapter 18 Creating Claims Reviewer There is also a List Only button that allows the Claim Manager to retrieve claims that match certain criteria that have been determined The List Only Claims That Match screen is a show me scr
67. Payment Adjustments screen Allowed Amounts tab lllllssesn 72 Figure 74 Multibink LISE SOPGGA uas edes o pacc a rea ger rE EIE erar tw ed a dob Foe eds 73 Figure 75 Multilink Coda Sale glb audes a aed qiiod x doo bos RR ini EUER e dd acad 74 Figure 76 Diagnosis List SGre auus emere eee mde one aacra bk ecd o esce bo en de ee ae 75 Figure T Diagnosis BODOBIT ida Da FP IERI Edd bac bad Gcr idc pd eee eb bbb 75 Figure 79 Billing Code List SCEN ise rer Re torako yer kE RR E INEENS 77 Figure 79 Biling Code SCOB iaa aas aueb ada s boob Ra Ea Edo dba s A OR bd a P EEREN e 77 Figure BO Contact LISESOIGOlla coeant aci RE E EEEE IEEE S 79 Figure ol GODapESCFOON scisti d beaten bid bu dbi db ash Cod A 80 Figure 82 Patient LISESCIOBFI osa eae woe ee ew ERU Sae war Fees e E EE ec oy wor abri d Rc 82 Figure 83 PallentGuarantor Screen iu iusreczr done ad ee acer belge d EE bia s ERE dad 83 Figure 84 Patient Guarantor screen Other Information tab 000 00 e eee e eee 84 Figure 85 Patient Guarantor screen Payment Plan tab 0 00000 eee eee 85 Figure 66 Parent screen witht Case Selegted aues uie dee e REP are PR PH dee ede Sagegeks 87 Figure 87 Case screen Personal tab us srssaadakdedcoena s aub Rma doer blade dedi rb oes 88 Figure 88 Patient List screen with case selected 2 25 2 c4 00 cee scene ene RR me hes 90 ligure os Case SCORN na ced a SA Niches E BRE A dd Bast bd PE ee Dub dtt RO rica OER dl 91 Figure 90 Case scree
68. Provider Class button and click the magnifying glass to select the provider class 5 Select the All Insurance Carrier or Insurance Class button Select the All button to apply the rule to all insurance carriers associated with the practice To apply the rule to a specific insurance company select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select the Insurance Class button and click the magnifying glass to select the insurance class 6 Select either the All or Facility button 7 Select National Provider ID and enter an NPI number to associate that NPI number with the rule TIP if your practice has a group NPI number enter it here Then if providers in your office need to file claims as individuals you can create a rule for that provider using the provider s individual NPI number that you enter on the Provider IDs grid 8 Select either None or Taxonomy 9 Select the Tax Identifier button and enter the tax ID number to associate with the rule 10 Select the Social Security Number button and enter the social security number to associate with the rule 11 If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s 12 Click Save User Guide September 2012 Release 1
69. Questions screen Make your selections for filtering data Select the Exclude items that follow Payment Plan check box to activate the Generate Collection Letters box Select the Generate Collection Letters check box Click OK Click Yes to the question Do you want to print collection letters The Open Report screen appears Select the form and click OK The Print Report Where screen appears Make your selection and click Start Customizing Collection Letters Customize the collection letter format through the Collection Letter Wizard 134 User Guide Release 18 September 2012 Chapter 21 Managing Collections and Small Balance Write Offs Small Balance Write off 1 On the Tools menu select Collection Letter Wizard The Collection Letter Wizard screen appears i Collection Letter Selection Please choose which items you want to be included on your Collection Letter Click DK when you have completed your selections Name and Address Preference Cancel Practice C Provider C Third Party Address Preview Contact Phone Number Restore Settings Same as above C Other Help Sender Name Same as above C Practice C Provider C Other Figure 134 Collection Letter Selection screen 2 Make your selections and click either OK or Preview Access the new format through the Custom Report List New formats are named WzCollections date using the date on which the format was revised
70. RL key and clicking the record 3 Click Write off to write off the selected remainder balances Use the Stmt Submission Count field to define a maximum amount of times that you want to send a statement before writing off the balance Once this number is met the small balance is written off Medisoft selects patients whose statements have been sent submission count more than the value entered in the field Once this number is met the small balance is written off This field works in conjunction with the other fields on this screen If a value is entered in this field the balance is only written off if it meets the criteria for this field completed the statements and the other fields such as Maximum Amount field For instance if you enter 3 in this field and 10 in the Maximum Amount field small balances would be written off after three statements are sent and if the balance is under 10 00 When Medisoft writes off the remainder balances it updates a number of other areas of the database Write off entries are created and applied to all patient responsible charges associated with the selected patient Medisoft also updates the associated Collection List items refreshing balances and marking zero balances as deleted After a remainder balance write off statements are changed to the status of Done and a note is added to the write off entries User Guide 136 Release 18 September 2012 Chapter 22 Using Electronic Services This chapter
71. RPIC REN P ERReg CU bad New eo pPRPP CEDE 173 Dolor COIN Lab atu iusticia Qresod arre od ainns BES raid aura e d wear dis Dried 174 BH uro rn 174 ESRB oon d eucnis he tas da eugene ee x Ready en UE A A E I A SIE 174 Blind Fab quos oue ri ou VeRO RU e PE bene ee been odqub E eques qd 175 UCM ENS c as IUe aei aah Daas arto rad da cR a Waka n OR d ra d ane aes 175 sies AP D gee 175 OT ora a a a a a r a a a a HE 176 RIFES TED eerren Do aea r era eer aT 177 Chapter 26 Backup and Restore Data cece eee eee eee 179 Backing Up Your Dalia s55 23849 5 5 9 058 Veg CE GSS AGT RSS ETAT Va qu SETS 179 FIosIoriDB TOU Dau issued psp que beh SISSE QUE h TEA SP 180 Makmg a Hol BackUp 2uzsueorerberererieeeteLpRIEX qew3ue pe YY o 9 RRPPPTrYGS 181 Hosibring Your Hot BackUp 27 da pex AER ERDQORAD RS SORORE TR RR ADR 182 too p ArP PTTTTTTTUTMTTUTIT 185 jl m 187 User Guide September 2012 Release 18 vii Table of Contents User Guide viii Release 18 September 2012 List of Figures List of Figures Fro d dO BE s soeur emend atte a s cp cundis ups aS ME Ld Si t EE 1 Figure 2 Menu Bal zou lise cree DEPO iE roi REORPPIOmERG DARE KD I AN q FPE Eque RR RES 1 IJOure S TOODI ci2cnccawends ses Sued es Pwu sdb BS Sud ddii dq dum d dud mons D Eres 1 Figure 4 Medisoft toolbar with icon highlighted oe eee mnm mem mtm rmt oko mee 1 Figure 9 Cust
72. Release 18 September 2012 Chapter 5 Entering Practice Information Enter basic practice information that the system uses for reports statements and filing claims Be sure to enter complete information so that your claims will be complete Entering Basic Practice Information To enter practice information 1 On the File menu select Practice Information The Practice Information screen appears Practice Information aa ital 8222 E Baseline Rd Po d a n DO Figure 43 Practice Information screen On the Practice tab enter the contact information for the practice The address must be a physical address not a PO Box If you have a P O Box to which payments are sent that information will go in the Practice Pay To tab From the Type list select your practice type When you select Chiropractic the Level of Subluxation field appears in the Diagnosis tab of the Case screen for entering the level of subluxation In addition five treatment fields are displayed in the Miscellaneous tab of the Case screen In the Federal Tax ID field enter the practice s federal tax ID 5 6 From Practice Type select Individual or Group From Entity Type select Person or Non Person NOTE Extra 1 and Extra 2 are optional fields that may be used if a carrier requires extra data on a claim They can hold up to 30 characters User Guide September 2012 Release 18 41 Entering a Practice IDs Rule Chapter 5 E
73. Type Patient Patient Insurance Insurance Patient Insurance Patient Patient Patient Patient Payment 188 00 10 00 56 00 EOB Only 10 00 200 00 10 00 25 00 25 00 30 00 Unapplied 0 00 0 00 0 00 0 00 10 00 0 00 0 00 0 00 25 00 30 00 a 7 26 2012 1207260000 Collins Anorie L 15 00 0 00 Figure 121 Deposit List screen September 2012 User Guide Release 18 123 Entering a Payment Chapter 20 Applying Deposits Payments 2 Click New The Deposit new screen appears Deposit new 7 26 2012 v mmm v d s Figure 122 Deposit new screen 3 Select the appropriate Payor Type Depending on your selection the fields on the screen will change 4 Complete the remaining fields as necessary specifying the insurance or patient who paid 5 Click Save The new payment appears on the Deposit List screen and is highlighted It is now available to be applied to charges Deposit List PayorName Payor Type Payment 0312220000 Medicaid Insurance EOB Only 12 22 2008 0912220000 Austin Andrew Patient 10 00 Aetna Insurance 100 00 100 00 m o i oo 9 5 9 n T9 oe Figure 123 Deposit List screen with new payment highlighted User Guide 124 Release 18 September 2012 Chapter 20 Applying Deposits Payments Applying a Payment Applying a Payment 1 On the Activities menu select Enter Deposits Payments The Deposit
74. YAGAS 141 From Within MBOIBOIE 45333 2 952001 RODA oa QE ROCA RU ER a DN F RUE 141 Oca Hours Setpoint rA won bbe Ie tee EE Led qu iA 142 Being Oros MOUs ud soi Vise das butane ete eid aora abd dien pa Sed hp dedos 143 Entering a New Appointment sso proh eRR Go RRRITPRPRT RR Y REA 143 Find Obs TITIO ud ox QE diae d Ad ad Qe dris TSS ARORA Cem bed 144 ID RO DE ope ET RIP TEE I DM sob eg diodes diet apnetebeq dod d 144 WAS d 4 copay ER EO REA CR ecd Sun s dle diu d EIS TETIT 145 Editing an Appointment so vio d aee RPRETARRAIURRHARERSEqU tt titir RETQCHMPbRO 147 Changing a Telephone Number or Cell Phone 00000 eee eae 147 Changing Other IIONEHS UD uis picto way beak DR USES E PE QR E 147 Viewing Scheduled Appointments lllleels eel 148 Viewing Future Appointments iussa eiese here RR RRERERER RE A 149 Using the Future Appointment List screen lille elles 149 Using the Edit Appointment screen 0200 eee eee 149 Hoscheduling an Appointment t seeds Sad ede capa EE EX Pop Re REA 151 Moving Deleting an Appointment 00 0c eects 158 MOVING an APPOINT cacy eee d REO RED 205 OSG ihan GR RPG RR 152 Deleting an Appolniment srs css es qb enEXO CER VOEP Y iar RE TA ERES 152 F3ocallifio Pa E eona bane A php qi Qd AIR iaa e 153 Seting Prodam Doe re resite rrtt riere EPEE EP ESERE RERE ED 154 ORION AD isobaw Tod rniou eaa aee p i qr enn tipa d dd 154 Mui Views tab ud sey kd UEREPPPUHRUAGPGOIGG
75. ackup screen appears o Medisoft Backup 2012 mbk mw 7 23 2012 mbk Figure 161 Medisoft Backup screen 3 Complete the fields on the screen 4 Click Start Backup 5 Click OK on the message that the backup is complete Restoring Your Data You will very seldom have to restore a backup it is only necessary if the data becomes corrupted or you have to print reports that are no longer accessible because of the addition of new data McKesson highly recommends that you create a new backup of your current data BEFORE you restore your backup You may need this backup to restore your files to their current state To restore a backup 1 On the File menu select Restore User Guide 180 Release 18 September 2012 Chapter 26 Backup and Restore Data Making a Hot Backup 2 Select Restore Backup 3 Click OK on the warning message The Medisoft Restore screen appears o Medisoft Restore C mw07 23 2012 mbH mw 7 23 2012 mbk Start Restore 9 Close Help Figure 162 Medisoft Restore screen 4 Select a backup on the list of existing backups or click Find to find a different backup 5 Click Start Restore A confirmation screen appears 6 Click OK The backup is restored 7 Click OK 8 Click Close on the Medisoft Restore screen Making a Hot Backup This feature is for Medisoft Network Professional only Hot Backup allows you to make a backup of your data while other users are still working in the
76. arge 72052 X Ray Spinal Complete 80 00 Procedure charge E Figure 70 Procedure Payment Adjustment List screen At the top of the screen there are two fields to help you find a procedure code Search for and Field Field defaults to Type but you can change it to Code 1 or Description If you are not sure of the complete code description or type enter the first few letters or numbers in the Search for field As you type the list automatically filters to display records that match User Guide September 2012 Release 18 69 General Tab Chapter 11 Procedure Payment and Adjustment Codes and General Tab Enter a new code number description and type in the General tab Procedure Payment Adjustment new General Amounts Allowed amp mounts Code 1 _ Inactive Save T Description Code Type Procedure charge v Account Code Type of Service 2 jo v Place of Service Time To Do Procedure Service Classification Don t Bill To Insurance Only Bill To Insurance Default Modifiers Revenue Code v 2 Default Units o National Drug Code NDC Unit Price NDC Unit of Measurement v Code ID Qualifier Purchase Service Amount _ Taxable Patient Only Responsible HIPAA Approved Purchased Service Require Co pay L HCPCS Code HCPCS Rate Code Figure 71 Procedure Payment Adjustment screen
77. as the same format as the Patient Aging but there is a key difference in how it works A charge does not show up on the Patient Remainder Aging report until all insurance responsibility has been marked complete Patient Remainder Aging Detail Advanced and Network Professional only Has the same criteria as Patient Remainder Aging Detail However it also lists each insurance company on the patient s account and the date the insurance payment was marked complete Insurance Aging and Summary Track aging of claims filed with insurance carriers The summary versions are similar but no patient information is included Production Reports NOTE This is a Network Professional only feature Insurance and Summary each provider procedure or insurance carrier respectively Production by Provider Procedure and Gives incoming revenue information for September 2012 User Guide Release 18 165 Activity Reports Chapter 24 Reports Activity Reports NOTE This is a Network Professional only feature Report Description Daily Monthly Activity Report Presents financial activity based on the date range selected The report displays the total number and the total amounts of the charges payments and adjustments entered during a date range The report also details the net effect of the financial information entered on the Accounts Receivable balance for the day month Activity Summary b
78. atients If you use Bill Flash for electronic statement processing complete the Statement Pay To tab Data on this tab is used to create a separate pay to address location for the statements for instance a PO Box instead of a physical address To complete the Statement Pay To tab 1 On the File menu select Practice Information The Practice Information screen appears User Guide 44 Release 18 September 2012 Chapter 5 Entering Practice Information BillFlash Users 2 Select the Statement Pay To tab Practice Information Practice Practice IDs Practice Pay To Statement Pay To Practice Name Phone Extension Street Fax Phone Cancel City State Extra 1 Zip Code Extra 2 Figure 4Z Practice Information screen Statement Pay To tab 3 Enter the pay to information in the Practice Name Street City State Zip Code fields NOTE the Extra 1 and Extra 2 fields are only used if a carrier requires extra data on a claim 4 Click Save User Guide September 2012 Release 18 45 EDI Receiver Records Chapter 5 Entering Practice Information EDI Receiver Records The EDI Receiver screen displays parameters used for transmitting information to a clearinghouse To open the EDI Receiver screen Onthe Lists menu select EDI Receivers The settings in Medisoft on the EDI Receiver screen are used for setting rules for electronic claims generation The actual transmission of claims is
79. ave an unapplied amount Co Payment Report Advanced and Medisoft Network Professional Shows all patients who have co payment transactions It shows the amount of the required co payment how much was applied and what was left unapplied If a patient does not have any co payment transactions he or she is not included in the report Outstanding Co Payment Report Advanced and Medisoft Network Professional Shows all patients who have outstanding co payment transactions The report shows the Co payment amount expected the actual amount paid and the amount due If a patient has no outstanding co payment transactions he or she is not included in the report Appointment Eligibility Analysis Detail Report Shows patients with appointments whose eligibility has been checked based on criteria entered It includes detail about the patients their appointment date and time the provider name and reason code It is an ARRA report designed for showing that the practice is verifying eligibility electronically September 2012 User Guide Release 18 163 Analysis Reports Chapter 24 Reports Report Description Appointment Eligibility Analysis Summary Shows a summary of appointments whose Report eligibility has been checked based on criteria entered It is an ARRA report designed for showing that the practice is verifying eligibility electronically Electronic Claims Analysis Detail R
80. ber 2012 Chapter 23 Scheduling Appointments Editing an Appointment Editing an Appointment To edit an appointment 1 Double click the appointment or right click the appointment and click Edit from the drop down menu The Edit Appointment screen appears 2 Make the changes you want 3 Click Save Changing a Telephone Number or Cell Phone If you update a patient s appointment with a new telephone number you can also update all future appointments with the new phone number When you enter the new phone number and click the following screen appears Confirm Phone Change xj Do you wish to update the patient s home phone for all future appointments Do not show this message again 99 ow Figure 142 Confirm Phone Change screen f you click Yes all future appointments are updated f you click the Do not show this message again check box the Confirm Phone Change screen will not appear in the future when you change other telephone numbers the system will automatically update the phone number f you click No the patient s phone number for all future appointments will remain the old phone number Changing Other Information If the field has an arrow key you can click the arrow and then select from the drop down list If the field has a Search icon you can click the icon and search for the corrected information User Guide September 2012 Release 18 147 Viewing Scheduled Appointments Viewing S
81. ce between the calculated allowed amount and the practice charge is offset in the Adjustment column In addition any claim that has received payment from all responsible payers is automatically marked Done In the lower half of the screen select default billing codes to be applied when using this feature User Guide September 2012 Release 18 171 Aging Reports Tab Chapter 25 Program Options Aging Reports Tab The Aging Reports tab lets you alter the starting date for patient aging reports and to redefine aging columns for both patient and insurance aging reports Program Options Figure 155 Program Options screen Aging Reports tab User Guide 172 Release 18 September 2012 Chapter 25 Program Options HIPAA Tab HIF The HIPAA tab offers features designed to help protect patient information from unauthorized access J m vptiorns General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash Health Insurance Portability and Accountability Act O Save C Auto Log Off n5 minutes Cancel w am on Unapproved Codes Heb Figure 156 Program Options screen HIPAA tab The Auto Log Off check box is designed to protect your data files from unauthorized tampering Select the check box and then enter a number of minutes up to 59 in the field With Auto Log Off activated any time Medisoft remains unused for the amount of time designated
82. cheduled Appointments 148 You can view all the appointments scheduled for a patient 1 On the Lists menu click Patient List The Patient List screen appears 2 Highlight the patient whose appointments you want to view and click Edit Patient The Patient Guarantor screen appears 3 Click Appointments The Scheduled Appointments screen appears Scheduled appointments for Again Dwight iol x E 8 8 Sott By E Appointments from today forward Show all appointments ejName Date jLength Provider Resource Repeat P Again Dwight 5 10 2012 15 Every day Again Dwight 5 11 2012 15 i Ever day Again Dwight 6 9 2012 15 JM Every day Again Dwight B 7 2012 15 JM Every day Again Dwight 5 8 2012 15 JM Every day Again Dwight 6 12 2012 15 JM Every day Again Dwight 6 16 2012 15 JM Every day Again Dwight 6 17 2012 15 JM Every day Delete Print 3 Close Figure 143 Scheduled Appointments screen Click Show all appointments to view all appointments for this patient Click the Edit button to edit the selected appointment Click the New button to create a new appointment Click the Delete button to delete the selected appointment Click the Print button to print the appointments in the grid Click the Close button to exit the screen User Guide Release 18 September 2012 Chapter 23 Scheduling Appointments Chapter 23 Scheduling Appointments Viewing Future Appointments Vie
83. ct PIN Only otherwise select Leave Blank From the Default Billing Method 1 2 and 3 lists select either Paper or Electronic for handling primary 1 secondary 2 and tertiary 3 claims Select Paper if claims are to be printed select Electronic if claims are to be transmitted electronically In the Default Payment Application Codes box select default payment codes User Guide Release 18 September 2012 Chapter 8 Insurance Classes and Insurance Carriers Insurance Carriers 12 13 14 15 16 17 18 19 Select the EDI Eligibility tab The EDI Eligibility tab is used for electronic claims Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Save Primary Receiver Secondary Receiver EDI Receiver v EDI Receiver Y Claims Payer ID 9 Claims Payer ID Eligibility Payer ID IO Eligibility Payer ID National Plan ID National Plan ID Cancel Help Carrier EDI Settings Type Other C Complementary Crossover Alternate Carrier ID C Delay Secondary Billing NDC Record Code C Send Ordering Provider in Loop 2420E EDI Max Transactions C Send Practice Taxonomy in Loop 20004 Set Default EDI Extra 1 Medigap EDI Extra 2 Figure 62 Insurance Carrier screen EDI Eligibility tab In the Primary Receiver panel on the EDI Receiver list select the EDI receiver you use when sending electronic claims for primary insurances If you do n
84. d insurance carriers Superbill The superbill is designed to be a physician s worksheet The superbill displays a list of what procedures can be performed by the provider and the diagnoses related to it displayed in a list format Taxonomy Number This is a number that specifies the type of practice the physician is in for example family practice or emergency medicine UB 04 This is a form used by institutions to file claims to insurance carriers Unique Physician Identification Number UPIN The Unique Physician Identification Number UPIN is a number assigned to physicians and others who are enrolled in the Medicare Program User Guide Release 18 September 2012 Index Index A access levels users 38 Account tab cases 88 activities menu 4 Activity Reports 166 Add Collection List Items window 131 Add Copays to Remainder Statements check box 175 adding collection list items 130 adding ticklers 130 addresses entering 67 Aging Reports 165 Aging Reports tab 172 Allowed Amounts tab 71 Alternate Code Sets 75 Analysis Reports 161 applying deposits 123 applying patient payment plans 133 applying payments 125 Appointment Display 157 Appointment Display Office Hours Professional 157 Appointment Length 154 Audit Generator 176 Audit Reports 167 Audit tab 176 177 Auto Log Off check box 173 available reports 161 backing up 179 181 backup 179 181 Benefits Assigned field 60 BillFlash defined 44 ePayments 12
85. d your statements to your patients for you 1 On the Activities menu select Statement Management The Statement Management screen appears For more information on BillFlash see BillFlash Users on page 44 Statement Management Search Sort By Batch Number v e Stmt t Guarantor Phone Status Initial Biling Batch Media Type b 4 CATSA000 227 7722 Ready To Send Remainder 5 D00JA000 Ready To Send Remainder 9 AGADWOO0 434 5777 Ready To Send Standard 10 BRIJAO00 222 342 3444 Ready To Send Standard 11 SIMTAOOO 480 555 5555 Hold Standard 12 YOUMIOQO 602 222 3333 Ready To Send Standard 3 cx 9 Create Statements s Print Send s Rebil Statement w Delete S View eStatements Figure 111 Statement Management screen User Guide September 2012 Release 18 113 Creating Statements Chapter 19 Creating Statements 2 Click Create Statements Create Statements Range of Create Transaction Dates v to Chart Numbers v 9 to Select transactions that match Billing Codes Case Indicator Provider v Create statements if the remainder total is greater than Enter Amount Statement Type Standard Remainder Figure 112 Create Statements screen 3 Enter ranges of transaction dates and or chart numbers to control which statements are created as well as other data for filtering the data 4 Click Create The system tells you how
86. de hoa 19 Figure 26 Statement Management screen 0 00 c eet ren 20 Figure 27 Create Data SOOO saa Da dows nur b bob gares ea eoe X acies Sp Rob cada es eae oa d 21 Figure 28 Create a new Set OF dale uuo dou tgosoner dom eco ox Roe dud Rt REDRE E EE ENEE EREE 22 Figure 29 Practice Information Screens i052 sha doktor ti icu aed Shon QULA GR hed Ex does dd ibn 22 Figure 30 Open Pracuce Screen sss aus cceesce dedi ne enced s ERE EO ES TESI eed EES pied 23 Figure 31 Practice IDs screen with grid headings highlighted 2 0c 25 Figure 32 New Practice ID SCIO used esie hon tue abe see SOoenes eon dadwedeteondne bemoan 26 Figure 33 New Provider IDS SOIGOD uus ous sg bue pe decks iinei kana bdo E Soda Meus eus 27 Figure 34 Edit Provider IDs screen specific to an insurance company lslssslsssss 28 Figure 35 New Provider IDs screen with Group selected lllllillelslelslelleres 29 Figure 36 New Provider IDs screen with NPI for specific insurance company 04 30 Figure 37 New Provider IDs screen specific to an insurance company l l seres 31 Figure 39 Program Options SCl GBli es veccsepesevetr P aT eR NR PERSE ard Reg edcnbe ag eds 32 Figure 39 User Enity SORGE isi cna icccrasecd shor sas ver hivhes suai owed robe ond AE and 35 Figure 40 Security Setup SCEN sc cc cccewe cee Gat odeawoniweddeepe dada de dri dese P tee eceme oan 36 Figure 41 Login Password Management screen 0000
87. de items that follow Payment Plan check box 134 exporting reports 160 exporting reports 160 F F8 84 facilities creating 63 entering 63 rules 64 file claims as a group 29 file menu 3 filing claims 103 G General tab 169 Generate Collection Letters check box 134 Global section Data Entry tab 170 H help menu 8 Hide Inactive Closed Items 170 HIPAA Auto Log Off checkbox 173 Warn on Unapproved Codes check box 173 HIPAA Tab 173 hot backup 181 hot restore 182 I institutional claims UBOA fields institutional claims suppress UB04 fields 170 insurance carriers creating 59 Insurance Class 185 insurance classes creating 57 K keystroke shortcuts 9 L Legacy identifier 185 September 2012 Level of Subluxation field 41 lists menu 5 login password management 37 M Mammography Cert number providers 51 Mammography Certificate number 185 managed care defined 127 managing collections 129 Medicaid and TRICARE tab cases 89 Medisoft menus 3 Medisoft Task Scheduler window 140 Menu Bar 1 menus 3 activities 4 edit 4 file 3 help 8 lists 5 reports 6 tools 7 window 7 menus in Medisoft 3 Miscellaneous tab cases 89 MultiLink Codes 73 multimedia tab cases 89 Multiple Booking Columns 154 N Name Address tab 83 navigating in Medisoft 1 New Eligibility Task window 139 NPI 27 providers 49 NPI considerations 27 NPI number 26 30 practice level 43 numeric chart numbers only 81 O Office Ho
88. dem Check User Information Patient Notes Patient Narrative Services Figure 12 Tools menu The options available in this menu help you access peripheral programs and information to help you manage your practice Window e CX Menu Close All Windows Minimize All Windows Tile Windows Horizontally Tile Windows Vertically Show Side Bar Ctri S Clear Windows Positions Clear Custom Grid Settings Figure 13 Window menu This menu contains options that control the display of screens in Medisoft September 2012 User Guide Release 18 Help Menu Chapter 1 Navigating in Medisoft Help Menu Medisoft Help Getting Started Upgraders from Medisoft For DOS Medisoft Home Page Online Updates Training Technical Support Show Hints Products Show Shortcut Keys About Medisoft Figure 14 Help menu The Help menu contains access to information on how to use Medisoft as well as how to register User Guide 8 Release 18 September 2012 Chapter 1 Navigating in Medisoft Keystrokes and Shortcuts Keystrokes and Shortcuts Special keyboard shortcuts reduce the number of times you have to click the mouse or press keys to accomplish a task Common Keystrokes Keystroke Action F1 Opens Help files in most screens ESC Closes or cancels the current function or screen F3 Saves whatever you are working on F6 Opens a s
89. e button to pull the taxonomy number from the Practice IDs grid Select From Practice Tax Identifier or Social Security Number Select From Practice to pull the tax ID social security number from the Practice ID grid If you file mammography claims select Mammography Cert and enter the certificate number to associate with the rule If you file laboratory claims using a CLIA number select CLIA and enter the CLIA number to associate with the rule If your carrier requires a care plan oversight number select Care Plan Oversight enter the care plan oversight number and select an ID qualifier to associate with the rule If needed enter up to three legacy and qualifiers to associate with the rule using the Legacy Identifier 1 2 and 3 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s Click Save User Guide September 2012 Release 18 51 Entering Provider IDs Rules Chapter 6 Setting up Providers and Provider Classes User Guide 52 Release 18 September 2012 Chapter 7 Referring Provider Records Many patient visits come to a practice as a result of a referral from another provider When a patient is referred to your practice create a record for the referring provider Add data such as the Unique Physician Identification Number UPIN NPI tax ID and so on In this record you can link the provider to a particular insurance company category if needed Entering Re
90. e paid and designate how much goes to each Managed Care One of the important sources of patients and income in many practices are managed care organizations An HMO or PPO provides a list of patients who have selected your practice as their primary care provider Payment is made to your practice on a per patient basis regardless of whether the patient ever visits the office When a patient does come in for treatment he or she pays a set co pay amount The co pay is charged only by the primary care facility or the facility to which the patient is referred by the primary care facility After a patient s visit to the physician s office a claim is filed and sent to the carrier When the EOB is returned there is seldom a payment included since payment is made under the capitation program for managed care organizations Capitation Payment The basis for capitation payments is to provide healthcare for a fixed cost irrespective of the amount of service required by each individual patient This is done in connection with the managed healthcare services such as HMOs and PPOs There is no direct relationship between the capitation payment received by the practice and the number of patients covered by the plan who actually visit the practice for treatment Capitation payments are not posted to patient accounts but are entered in the Deposit List screen If itis necessary to zero out a patient account create a zero deposit for the carrier For each pati
91. earch screen F7 Opens the Quick Ledger screen For more information on this screen see Quick Ledger on page 99 F8 Opens a screen to create a new record F9 Opens a screen to edit the selected record F11 Opens the Quick Balance screen For more information on this screen see Quick Balance on page 101 SPACEBAR Toggles a check box check uncheck ENTER Depends on settings in the Program Options screen For more information see Program Options on page 169 CTRL S Toggles the Sidebar display CTRL X Cuts the selected text CTRL C Copies the selected text CTRL V Pastes the text ALT DOWN ARROW Opens drop down lists Keystrokes List screens Keystroke Action F2 Changes the value in the field F3 Saves the record F8 Creates a new record F9 Edits the selected record September 2012 User Guide Release 18 9 Keystrokes Transaction Entry Chapter 1 Navigating in Medisoft Keystrokes Transaction Entry Keystroke Action F2 Opens the MultiLink screen For more information on this screen see MultiLink Codes on page 73 F4 Opens the Apply Payment to Charges screen For more information on this screen see NOTE Deposits Payments is an Advanced and Medisoft Network Professional feature on page 123 F5 Opens the Transaction Documentation screen Keystrokes Eligibility Keystroke Action F10 Opens the Eligibility Verification Results
92. een that lets the Claim Manager review all that is in Medisoft Besides these three focus areas the Claim Manager also has responsibility to mark claims that are paid and those that are rejected Marking paid claims The date of submission in the Claim Management screen indicates when the claims were shipped or transmitted Claims are marked under the designation of Sent and the date is automatically inserted The claims stay in Claim Management marked as Sent until they are manually changed in the Claim edit screen as having been received and dispatched by the carrier When a payment is received use the EOB to enter all payments through transaction entry Handling rejected claims When a paper claim is rejected for payment by the insurance carrier the Claim Manager can change the payment status in the Claim Management screen from Sent to Rejected Creating Claims 104 To perform claim management functions use the Claim Management screen Here is where you create edit and print claims Claims that will be sent electronically are created here but sent with Revenue Managemert an integrated application that will send claims and receive payments For more information on Revenue Management see Electronic Claims Processing on page 137 To create claims 1 On the Activities menu select Claim Management The Claim Management screen appears Claim Management DER m Boo Claim Number Chart Num Carierl Statu
93. ember 2012 Release 18 159 Exporting a Report Chapter 24 Reports 3 Click Start Depending on the report selected the Data Selection Questions screen or the Search screen opens 4 Select ranges and click OK The Print screen appears 5 Click OK Exporting a Report You can export a report into another format For example you could export a Patient Aging report to a Microsoft Excel spreadsheet To export a report 1 On the Reports menu select the report you want to export The Print Report Where screen appears 2 Select Export the report to a file and click Start The Save As screen appears 3 Select a file format for exporting and a destination 4 Click Save The Search screen or the Data Selections Questions screen appears depends on the report or statement selected 5 Select appropriate criteria and click OK The report is exported Searching for a Specific Detail in a Report Once you have generated a report you can further refine the report and search for a more detailed data element When using this feature you essentially re run a report using more specific data criteria To refine your data criteria and search for specific data 1 View a report See Viewing a Report on page 159 2 Click Search The Search screen appears 3 Select specific data ranges 4 Click OK The report displays using the new search criteria User Guide 160 Release 18 September 2012 Chapter 24 Reports Available
94. ements September 2012 Chapter 3 Creating a Practice and Setup Overview In this chapter you will learn how to create a database for your practice and learn about program options Creating a Practice The first step in setting up Medisoft is creating the database that holds the data in your practice Creating the Practice Database 1 When you first open Medisoft after installation you must either create a new data set if this is the first time you have ever installed Medisoft or convert previous Medisoft data Create Data Do you want to Create a new set of data Convert existing Medisoft Data Add tutorial data to list Figure 27 Create Data screen If you have been using Medisoft Version 5 5x or 5 6x and above and have just installed Version 18 a message displays stating that data must be converted before you can access Medisoft If you have not already created a backup on your existing data create a backup now Then click OK to perform the automatic conversion If you work with multiple practices each will have to be converted User Guide September 2012 Release 18 21 Creating Multiple Practices Chapter 3 Creating a Practice and Setup Overview 2 If you choose to create a new data set the Create a new set of data screen appears Create a new set of data Enter the practice or doctor s name to identify this set of data x9 Create or m Cancel Enter the data path Help C Med
95. ent covered by the capitation payment who has an outstanding balance zero out the account by entering the remainder in the Adjustment field When it is applied the payment shows as zero and the patient s balance shows as a write off in the Adjustment field in the Transaction Entry screen User Guide September 2012 Release 18 127 ePayments Chapter 20 Applying Deposits Payments ePayments If you have enrolled with BillFlash and patients are making payments online directly to BillFlash you can download these payments to your practice by clicking ePay on the Deposit List screen Medisoft will capture these payments and display them in the Deposit List screen Then you can apply them to charges User Guide 128 Release 18 September 2012 Chapter 21 Managing Collections and Small Balance Write Offs In this chapter you will learn about managing collections and writing off balances that you know will never be paid Collection List The Collection List is a central place where you can manage accounts that are in collections Ticklers or collection reminders are displayed as collection list items To open the Collection list Onthe Activities menu select Collection List The Collection List screen appears You must activate Security and create user logins before this feature can be used For more information on security see Security Setup Overview on page 35 Collection List Date 7 27 2012 vto 7 27 2012 L Sho
96. eport Shows the status of claims providing a summary of total claims and those that have been filed electronically or by paper It includes the percentage of claims filed electronically In addition it shows detail such as the billing date insurance carrier sequence claim number patient chart and name and the status of the claim It is an ARRA report designed for showing that the practice is sending claims electronically Electronic Claims Analysis Summary Report Shows the status of claims providing a summary of total claims and those that have been filed electronically or by paper It is an ARRA report designed for showing that the practice is sending claims electronically User Guide 164 Release 18 September 2012 Chapter 24 Reports Aging Reports Aging Reports Report Description Patient Aging Shows patient aging Default aging criteria is based upon the number of days between the creation of the transaction or claim and the date of the report you are generating The columns break down the amounts due that are 30 60 and 90 days old Aging is from actual date of the transaction so it reflects the true age of the account The aging criteria and columns can be altered in Program Options This report includes all unapplied amounts in the totals The Date filter has been removed as it would return invalid values Patient Remainder Aging Advanced and Network Professional only H
97. er 14 Patients Entering Patient Information 1 On the Lists menu select Patients Guarantors and Cases The Patient List screen appears patient List Search for mg i 2 Field Chart Number v e e ase Chart Nu Name Date of Birth Soc Sec Nur List of cases for Again Dwight gt 3 Number Case Description Guarantc 2 Broken Hand AGADWI 17 Back Pain AGADWI CLIWA000 Clinger Wallace DOEJADOD DoeJaneS 4 28 1962 123456789 sil x g Figure 82 Patient List screen User Guide 82 Release 18 September 2012 Chapter 14 Patients Entering Patient Information 2 Click New Patient The Patient Guarantor screen appears Patient Guarantor new Set Default Copy Address View eStatements Figure 83 Patient Guarantor screen 3 On the Name Address tab enter all known or necessary information Tip In Medisoft Advanced and Medisoft Network Professional you can establish default information applied to all new patient records Enter the information that is the same for all of your patients and then click Set Default To remove your new default settings hold down CTRL and the button name changes to Remove Default When you enter a Social Security number Medisoft checks through the patient records for any duplications If a number you enter is a duplicate Medisoft displays the name and chart number of the patient having that Social Security Number 4 Select the Othe
98. er 2012 Chapter 8 Insurance Classes and Insurance Carriers Set up the insurance carrier records completely to ensure that your claims are processed in a timely manner You can create insurance classes into which you can group carriers based on a common feature In addition create your carrier records Insurance Classes Use this screen to create insurance classes such as Blue Shield or Medicare Use these classes to group insurance carriers for easier reporting and payment posting To create insurance classes 1 On the Lists menu select Insurance 2 Select Classes from the drop down menu The Insurance Class List screen appears Insurance Class List Search for 2 Field Id ID Class Name Description INS A Description of Insurance Class 4 INSC Medicare Description of Insurance Class C Figure 57 Insurance Class List screen 3 Click New User Guide September 2012 Release 18 57 Insurance Classes Chapter 8 Insurance Classes and Insurance Carriers 4 Enter an ID Name and Description for the class Insurance Class Blues Class ID Class Name Description INS A sae Blues Cancel Description of Insurance Help Inactive Figure 58 Insurance Class screen 5 Click Save 58 User Guide Release 18 September 2012 Chapter 8 Insurance Classes and Insurance Carriers Insurance Carriers Insurance Carriers
99. erent from the other lists because you can search for a record by its date When using the date as a search parameter there are various date formats you can use The following table explains the formats that are acceptable to use when searching 2 From this screen you can Click New to add a new entry Click Edit to update an existing entry Click Delete to remove an entry Click Print Grid to print a list of patients on this list User Guide September 2012 Release 18 153 Setting Program Options Chapter 23 Scheduling Appointments Setting Program Options There are several options you can choose from You can access Program Options from the Program Options option on the File menu Options tab x Options Multi Views Appointment Display Stat Time BE one intment ver Y End Time 5 00 pm rad Cancel Conflict Red gt Interval 15 mi Ps mmm peur z o Her Use Pictures Service Type Code 30 JV Break v Repeat v Use Enter to Move Between Fields v Note V Remind to Save View v Status v Use Automatic Word Capitalization MV Automatic Retresh seconds M Show Notes on New Appointments IV Use Automatic Zip Codes Use Transaction Entry to Make Copays Hide Icons in Menus Speed Report Quick Appointment List Figure 148 Program Options Options tab Set the starting and ending appointment times for the practice Enter the Starting Time and Ending Time breaking
100. estions screen a report can be generated showing what percentage of the entire practice has been referred 162 User Guide Release 18 September 2012 Chapter 24 Reports Analysis Reports Report Description Referral Source Report Advanced and Medisoft Network Professional Assembles the patient list by source other than provider and shows how much revenue comes from each source allowing the practice to identify those sources that send profitable referrals and or limit those that are costly or nonproductive This is another report for tracking the source of patients who come to the practice For the report to work however all referral sources must be entered in the Address Book A source can be an attorney a hospital friends other patients or anything else Most new patient application forms include the inquiry How did you hear about us Facility Report Network Professional only Tracks patients who are seen at different facilities The Facility Report assembles the patient list by facility and shows how much revenue comes from each facility helping you identify which generates the most money Unapplied Payment Adjustment Report Advanced and Medisoft Network Professional Shows any payment or adjustment that has an unapplied amount and where the transaction can be found Unapplied Deposit Report Advanced and Medisoft Network Professional Shows all deposits that h
101. estore A confirmation screen appears Click OK The backup is restored NY O 0 A Log back into Medisoft User Guide September 2012 Release 18 183 Restoring Your Hot Backup Chapter 26 Backup and Restore Data User Guide 184 Release 18 September 2012 Glossary This section defines terms used in the User Guide Care Plan Oversight Number This is the number physicians have if they have supervision of Medicare patients under the care of hospices or home health agencies that require complex or multidisciplinary care CLIA Number This is Clinical Laboratory Improvement Amendment Number This number is required for all laboratory claims Communications Manager This is a separate application installed with Medisoft that enables Medisoft to communicate with an Electronic Medical Records software such as Practice Partner EDI Receivers These are the organizations to which you send claims or eligibility requests EOB An EOB is one or more ready to mail forms containing claim specific information Each form lists the carrier s payments allowances and insurance filing activity EOBs are used mainly to inform secondary carriers of the payments and disallowances posted to a claim by the claim s primary carrier Insurance Class Insurance classes enable you to categorize insurance carriers into groups Legacy identifier This refers to a provider number or identification number other than NPI such as a BCBS provider n
102. ferring Provider Information 1 On the Lists menu select Referring Providers The Referring Provider List screen appears Referring Provider List Search for 2 Field Last Name First Name v Code Name License Number Medicare Part Last Name emm en Orenthal True e CADO Carson Ca a Coon Figure 53 Referring Provider List screen User Guide September 2012 Release 18 53 Entering Referring Provider Information Chapter 7 Referring Provider Records 2 Click New OR Select a record on the Referring Provider List screen and click Edit Referring Provider new c w o Figure 54 Referring Provider new screen 3 On the Address tab enter demographic information for the referring provider such as last name first name title Also if you are sending electronic claims select from the Specialty list the referring provider s special field of practice If you need to use a specialty code that is different than the usual code select Not Listed and enter your specialty code in the field that appears next to the Specialty list NOTE This field is not used for sending paper claims unless you have modified your claim form to include this information User Guide 54 Release 18 September 2012 Chapter 7 Referring Provider Records Entering Referring Provider Rules Entering Referring Provider Rules Use the Referring Provider IDs tab and grid to enter or edit
103. find out additional or specific information about Medisoft Training There are various training options available Please contact your local Value Added Reseller or the Medisoft Sales Department at 800 333 4747 for information concerning these options Independent Value Added Resellers There are Value Added Resellers in your area who are knowledgeable and efficient in selling installing troubleshooting and supporting your Medisoft program You can contact the Medisoft Sales Department at 800 333 4747 for the name of a qualified Value Added Reseller in your area to give you hands on help or search the Medisoft website at www medisoft com for a reseller in your area Technical Support Call Support at 855 675 8326 between the hours of 8 00 a m and 8 00 p m Eastern Standard Time User Guide September 2012 Release 18 xiij Medisoft Versions Preface Medisoft Versions Medisoft comes in three versions Product Features Basic Offers basic features for processing patient visits claims payments and reporting Advanced Offers all that Basic does but provides greater reporting power the ability to process secondary claims as well as sending patient statements and collections processing Network Professional Offers all the features of Basic and Advanced but enables you to integrate with an Electronic Health Records EHR system User Guide xiv Release 18 September 2012 Chapter 1 Navigat
104. g to it 3 Revise the information on the tabs as necessary 4 Click Save Printing Statements If you print and send paper statements to your patients use the printing feature on the Statement Management screen User Guide September 2012 Release 18 115 Printing Statements Chapter 19 Creating Statements 1 On the Activities menu select Statement Management The Statement Management screen appears 2 Click Print Send The Print Send Statements screen appears Print Send Statements Figure 114 Print Send Statements screen 3 Select Paper and click OK The Open Report screen appears Open Report BillFlash MS1 S StandardStmt V17 BillFlash MS3 S CollectionStmt v1 BillFlash MS4 S StandardLetter v16 BillFlash MS5 S MissedCoPayStmt v17 Copayment Remainder New Pat Stmt Comments 30 60 90 Color New Pat Stmt Comments 30 60 90 New Pat Stmt Comments Color New Pat Stmt Comments New Pat Stmt Guar Ins Est Balance New Pat Stmt Last Patient Pmt amp Amt New Patient Statement New Patient Statement 30 60 90 Color New Patient Statement 30 60 90 New Patient Statement Color Patient Statement All Payments Patient Statement All Pmts Deduct Patient Statement Combined Payments Remainder Statement 0 30 60 90 Remainder Statement All Payments Remainder Statement All Pmts Deduct Remainder Statement Combined Payments Figure 115 Open Report screen User Guide 11
105. gives a brief overview of the electronic services available in Medisoft Electronic Claims Processing Electronic claims send your insurance claims online either directly to the insurance carrier or to a clearinghouse which then sends the claims to the insurance carrier Medisoft currently ships with Revenue Management an integrated component that installed when you installed Medisoft To launch Revenue Management Onthe Activities menu point to Revenue Management and click Revenue Management Statement Processing You can send statements electronically through BillFlash the web based company that is set up to process Medisoft electronic statements Statements sent electronically through BillFlash get an instant response report that tells what information was sent BillFlash will receive your statement data and then print and send statements to your patients BillFlash can also receive payments from patients and you can download them to Medisoft and apply them to patient accounts Eligibility Verification The Eligibility Verification feature lets you check a patient s insurance coverage online Revenue Management conducts eligibility verification behind the scenes Eligibility Verification Setup Before you can perform eligibility requests electronically you must make sure certain information is in your practice records Use the following table to help you verify your records are complete Field s to complete sc
106. gure 155 Program Options screen Aging Reports tab llli 172 Figure 156 Program Options screen HIPAA tab 2 2 0 0 cect eh 173 Figure 157 Program Options screen Color Coding tab lt c c crrssrcasricritaneier nonnen 174 Figure 158 Program Options screen Billing tab liliis 175 Figure 159 Program Options Screen AUG uuu aues eod Saas Ri hk x buceo ranih babens week s 176 Figura 160 Program Options screen BillFlash fab 2 o dre iem ree tecta 177 Figure 161 Medisoft Backup screen 1s dabas Sa e REOR rinti nt nini A EREE ENR EE radios 180 Figure 162 Medisoft Restore SCI GGll ceu esae x wm hk x CE AUAOR ered burar Y RO ew RR wd 181 Figure 163 Modisoft Hot Backup SOOO esa 2px reae ac ded nebat den ode aca 182 Figure 164 Medisoft Hot Restore SCreBn sisse eee us re hm mr e ke e x dx ee 183 User Guide Xii Release 18 September 2012 Preface Where to Find Help Online Help Access the online Help screens to find detailed information on each feature in Medisoft Online Help is available in two different ways e Context Sensitive Help For help in a particular part of Medisoft click the area for which you need help and press F1 The help topic for that area will appear Main Help File To access the main help file click the Help menu and select Medisoft Help The main help file will appear displaying the Contents tab Use the Contents tab to view categorized topics for Medisoft Use the Index and Search tabs to
107. he report shows what has been billed and not billed what is delayed for some reason if the carrier is not responsible or has refused the claim or if the claim is paid in full An asterisk next to an amount indicates that the entity has paid all it is going to pay and the balance if any should go to the next responsible payer Insurance Payment Comparison Network Professional only Compares the payment records of all carriers in the practice Practice Analysis Summarizes the activity of a specified period for example a month listing each procedure performed the number of times it was performed and the total dollar amount generated by each procedure It shows the average charge includes any costs involved with that procedure and calculates the net monetary effect on the practice s income Insurance Analysis Advanced and Medisoft Network Professional Summarizes all claims filed by category Primary Secondary and Tertiary Claims totals are shown for charges and insurance payments in both dollar amount and percentage Referring Provider Report Advanced and Medisoft Network Professional Shows which patients were referred by other practices and the percentage each referral contributes to the overall referred income of the practice as of the date of that report The report also includes the UPIN of the referring provider By blanking out the Referring Provider range in the Data Selection Qu
108. he NPI number Taxonomy number and Social Security Number since those were included in the initial rule using the Provider IDs screen see Figure 36 If you used the Practice User Guide Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview Facility Considerations IDs screen you could select From Practice for these numbers and you would not need to specify them on the Provider IDs screen since Medisoft would pull these values from the Practice IDs Screen Facility Considerations If you have facilities attached to your practice you must create rules on the Facility ID screen for any numbers that are specific to that facility If you have entered a separate NPI number for a facility and need to send facility billing information specify the type of facility and qualifier including the unique facility NPI number If this information is sent on the claim select the Send Facility on Claim check box and do not include any other data Referring Physician Considerations If your practice has referring physicians create records for them on the Referring Physicians screen and use the Referring Physician IDs screen to enter any numbers unique to a referring physician User Guide September 2012 Release 18 31 Setting Program Options Chapter 3 Creating a Practice and Setup Overview Setting Program Options The Program Options screen contains various default settings that affect operations in different parts of
109. he practice Provider List Search for 2 Field Code v Code Name Credentials License Number s Part m Name gt MM Morris Melvin D C License number m m REL Lee Robert E M D True Lee WH Hinckle Wallace M D License Number False Hinckle Figure 49 Provider List screen User Guide September 2012 Release 18 47 Entering Provider Information Chapter 6 Setting up Providers and Provider Classes 48 3 Click New Provider new Address Reference Provider IDs 5 1 Save Code If the Cade is left blank Fl Inactive amp seve the program will assign one Last Name Middle Initia First Name NEM Crdenia Heb Street City 0 State Zip Code EMi Office Fex Home Cell NEN C Signature On File Signature Date C Medicare Participating License Number Figure 50 Provider screen On the Address tab enter demographic information for the provider such as last name first name title Options Select the Medicare Participating check box if the provider is considered a Medicare participating provider A Medicare participating provider agrees to accept assignment on all Medicare claims for covered services and supplies This field is generally used with electronic claims Select the Signature on File check box to indicate that the provider s signature is on file Select this b
110. hen only one or a few statements within the same batch or statements from multiple batches need a status change on the Statement Management screen hold down the CTRL key and User Guide 118 Release 18 September 2012 Chapter 19 Creating Statements Billing Cycles click each statement that needs the status changed Note that the selected statements do not need to have the same status but they will all be changed to the same status 2 Click Edit The Change Statement Status Billing Method screen appears 3 Select Selected Statement s 4 Select the appropriate buttons in the Status From and Status To sections 5 If you have chosen statements with varying statuses choose Any Status Type in the Status From section 6 Click OK Billing Cycles The cycle billing feature lets you print statements every certain number of days If you want to print statements every 30 days you can set up a billing cycle of that length Follow these steps to set up a billing cycle 1 On the File menu select Program Options The Program Options screen appears 2 Select the Billing tab 3 Select the Use Cycle Billing check box Program Options CLAIM 8 Walkout Receipt All Transactions Remainder Statement 0 30 60 v Patient Face Sheet Figure 120 Program Options screen Billing tab 4 Enter a number in Cycle Billing Days The number of days indicates the length of your billing cycle 5 Click Save Now after you cl
111. iData Figure 28 Create a new set of data 3 Fill in the practice name and the practice data path The data path is the location within the MediData folder in which the practice data is stored 4 When you click Create the Practice Information screen appears On this screen on the Practice tab enter your basic practice information such as the name of the practice address and telephone number Practice Information Academy Wellness Center 770 555 5000 1145 Sanctuary Parkway Suite Alpharetta 30003 Figure 29 Practice Information screen For more detailed information on this screen see Entering Basic Practice Information on page 41 Creating Multiple Practices It is not necessary to install Medisoft for each new practice When the first practice is set up Medisoft assumes there is only one practice and establishes a default directory for the data for that practice Each time you set up an additional data set with totally unrelated patients and procedure files you must create a different subdirectory This establishes a completely separate database for the new practice Changing the Program Date You can change the program date for back dating a large number of transactions This affects all dates in Medisoft except the Date Created setting which always reflects the System date User Guide 22 Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview Opening a Practice Opening
112. ick Print Send on the Statement Management screen Medisoft will automatically print statements based on the Next Statement Date of each statement If the Next Statement Date is on or before the current date the statement prints If you have never printed statements with the User Guide September 2012 Release 18 119 Billing Cycles Chapter 19 Creating Statements billing cycle turned on statements are printed according to the Last Statement Date stored in the statement record If the Last Billing Date plus the billing cycle interval is on or before the current date the statement prints NOTE Statements might not print if they are filtered out by report selection questions or by predefined statement processing rules The program updates the statement s Next Statement Date for the next time you process statements User Guide 120 Release 18 September 2012 Chapter 19 Creating Statements Troubleshooting Statement Printing Troubleshooting Statement Printing Patient Remainder Statements NOTE This is an Advanced and Medisoft Network Professional feature If you are having trouble printing patient remainder statements check to be sure the following items have been performed The patient has insurance coverage other than Medicare This is indicated in the patient Case screen Policy 1 tab Insurance 1 field also Policy 2 and Policy 3 tabs if there is secondary and or tertiary coverage Acharge has been posted in the pat
113. ick feature which provides a custom method for creating records User Guide Release 18 September 2012 Chapter 25 Program Options Payment Application Tab G il Payment Application Tak NOTE This is an Advanced and Medisoft Network Professional tab In the Payment Application tab you can establish default settings that affect payments when you apply them to patient balances Program Options r General DataEnty Payment Application Aging Reports HIPAA Color Coding Billing Audit BilElash Mark Paid Charges Complete C Save v v Calculate Disallowed Adjustment Amounts Q Cancel v Mark Completed Claims Done Calculate Allowed Amount Help Update Allowed Amount IS Default Patient Payment Codes Payments Co payments Cash CASH v F Cash Payment Thank Youl COPAYCASH v Cash Copayment Check CHECK v P Personal Check Payment CHKCOPAY v P Copay Check Credit Card CRCDPAY v g Eredit Card Payment CRDCOPAY v Copay Credit Card Adjustment WROFF v 2 Insurance Write Off Small Balance write off Patient write off Code SBwO v 9 Small Balance Write Off Maximum Write off Amount 5 00 Figure 154 Program Options screen Payment Application tab If you choose to accept the default settings any amount applied to a charge is automatically marked as paid by that particular payee the allowed amount is automatically calculated and the differen
114. ient case Aclaim has been created Aninsurance payment or adjustment has been posted applied and marked as Complete to the account for each applicable carrier User Guide September 2012 Release 18 121 Patient Remainder Statements Chapter 19 Creating Statements User Guide 122 Release 18 September 2012 Chapter 20 Applying Deposits Payments NOTE Deposits Payments is an Advanced and Medisoft Network Professional feature Although you can enter payments in transaction entry for patient copays you can also enter payments using Deposit Payment This option makes creating a deposit list and applying payments especially payments from insurance carriers an easy process The advantage to this option is that you can apply a payment toward several cases and charges from the same screen Entering a Payment To enter a payment 1 On the Activities menu select Enter Deposits Payments The Deposit List screen appears Deposit List Deposit Date 2 Show All Deposits C Show Unapplied Only Sort By Date Description v gg Deposit Date 12 5 2003 12 6 2003 12 11 2003 12 22 2008 12 22 2008 12 22 2008 12 22 2008 12 22 2008 12 27 2008 7 26 2012 Description 0312060000 0312220000 0312220000 0312220000 0312220000 0312220000 Payor Name Zimmerman Anthony Doe Jane S Medicaid Medicaid Austin Andrew Cigna Austin Andrew Austin Andrew Simpson Tanus J Collins Anorie L Payor
115. ier Aetna Cancel Cp soe Signature on file Signature on file Signature on file PIN Only Figure 61 Insurance Carrier screen Options and Codes tab From the Procedure Code and Diagnosis Code Set lists select a procedure code set 1 2 or 3 and a diagnosis code set 1 2 or 3 to apply to the insurance carrier Medisoft gives you the ability to assign up to three codes to the same procedure By using this field the claims for each carrier can contain the correct code From the Patient Insured or Physician Signature on File lists for each option select Leave blank Signature on file or Print name These fields control what is printed in the signature Boxes 12 13 and 31 respectively on the CMS 1500 claim form if you are printing claims These fields do not control whether anything is printed in these boxes but what is printed Whether anything prints is controlled by settings on the Case screen Policy tab Accept Assignment and Benefits Assigned field and Provider screen Address tab Signature on File field The Signature on file option prints Signature on File if the Signature on file field has been activated in the patient and provider records The Print name option prints the name of the patient insured or physician The Leave blank option prints nothing From the Print PINs on Forms list select PIN Only or Leave Blank When setting up Medicare and Medicaid carriers for printed claims sele
116. ighlight the appointment by clicking the grid cell 2 On the Edit menu select Cut 3 Move to the new date 4 Click the new appointment time 5 On the Edit menu select Paste Deleting an Appointment To delete an appointment 1 Highlight the appointment on the grid by clicking it 2 Right click and select Delete NOTE When you delete an appointment to which a numbered superbill is attached the superbill is also deleted The number may be released for reassignment User Guide 152 Release 18 September 2012 Chapter 23 Scheduling Appointments Recalling Patients Recalling Patients The Patient Recall List screen displays all patients who have been set up for appointment recalls The recall list provides staff a list of patients who need to be contacted for various reasons for instance contacting a patient regarding a follow up visit or paying a bill This screen is for information purposes only and it does not integrate with any other part of Office Hours To open the Patient Recall List 1 On the Lists menu select Patient Recall The Patient Recall List appears zin Search for I aj Fie Provider Date Of Recall CS a NN ES oe Again Dwight 1 27 7 2008 Doe Jane 5 TIE T Appointment E 2 28 2008 Lewis Monique 564 992 3747 Appointment Set Mb 3 8 2009 Catera Sammy 227 7722 Call JM 12 2 2008 wagnew Jeremy 121 418 7127 Call JM Figure 147 Patient Recall List screen This screen is diff
117. ing Claims Printing Claims If you print and send paper claims to clearinghouses and carriers use the printing feature on the Claims Management screen 1 On the Activities menu select Claim Management The Claim Management screen appears 2 Click Print Send The Print Send Claims screen appears Print Send Claims Select claims with a billing method of Paper O Electronic Electronic Claim Receiver Figure 103 Print Send Claims screen 3 Select Paper and click OK The Open Report screen appears Open Report Feats O I Tea N CMS 1500 Primary Medicare Century 1500 Primary Cancel 1500 Secondary Medicare Century Q Cancel 1500 Secondary 1500 Tertiary 1500 HP DJ 500 Primary 1500 HP DJ 500 Secondary Insurance Payment Tracer Claim Mgmnt Laser CMS Primary Medicare w Form Laser CMS Primary Ww Form Laser CMS Secondary Medicare W Form Laser CMS Secondary W Form Laser CMS Tertiary W Form Laser UBO4 Primary w Form UBO4 Primary Figure 104 Open Report screen User Guide September 2012 Release 18 107 Printing Claims Chapter 18 Creating Claims 4 Select which form you want to print on and click OK The Print Report Where screen appears Print Report Where Figure 105 Print Report Where screen 5 Select your option and click Start The Data Selection Questions screen appears CMS 1500 Primary Medicare Ce
118. ing Claims In the chapter you will learn how to create claims in Medisoft Claim Management This section explains briefly how to manage claims in Medisoft and includes creating editing printing reprinting and listing claims as well as changing claim status The Claim Manager s Job To help you better understand the function of claim management consider this shipping analogy Whereas Cases are containers filled with claims for specific diagnoses claim management is the process by which the cases are checked sorted and delivered In other words claim management is the process of making sure all shipments are correct ready to be sent and shipped to the right companies insurance carriers The Claim Manager the person performing claim management checks the claims makes sure the boxes are properly marked and sends them on their way The Claim Manager determines whether the shipment goes by truck paper claims or by air electronic claims When a box is returned rejected claim the Claim Manager makes whatever changes are necessary with help from the EOB see EOB on page 185 or Audit Edit Report and ships the box again resubmits the claim One person sees and treats the patients another person enters data from the superbill see Superbill on page 186 to begin the billing process Once all the data has been entered it must go through the Claim Manager s office before being sent to an insurance carrier The Claim
119. ing in Medisoft In this chapter you will learn about the basics of navigating in Medisoft using the menus and keyboard shortcuts Toolbars There are four toolbars that you use to help you navigate in Medisoft Title Bar The top bar on the screen is the Title bar and it displays the name of the active program and contains Minimize Maximize and Close buttons on the right side Medisoft Advanced Medical Group Tutorial Data Figure 1 Title Bar Menu Bar Just below the Title bar is the Menu bar which shows categories of activities available in Medisoft Click one of the headings such as File Edit Activities Lists Reports Tools screen and Help to open a submenu with a list of all the options available in that category For more information on each drop down menu see Menus on page 3 t File Edit Activities Lists Reports Tools Window Help E Figure 2 Menu Bar Toolbar Below the menu bar is the toolbar with an assortment of speed buttons or icons that are shortcuts to accessing options in Medisoft 89531585333 2 2 8 3 OB 474 9 5 5 5 9 Figure 3 Toolbar Select the option you want by clicking the appropriate button To see the function of the toolbar button hover the mouse cursor over it The value will appear Figure 4 Medisoft toolbar with icon highlighted User Guide September 2012 Release 18 1 Customizing the Toolbar Chapter 1 Navigating in Medisoft Customizing the Toolbar Y
120. iption Guarantor C M22 Step Throat COLANOOL Fe Figure 88 Patient List screen with case selected 4 Click Copy Case 90 User Guide Release 18 September 2012 Chapter 15 Cases Copying a Case 5 The Case screen appears with the data copied Case COLANOOO Strep Throat Figure 89 Case screen 6 Modify the case data for the new case 7 Click Save September 2012 User Guide Release 18 View eStatements Eligibility Face Sheet Set Default 91 Customizing the Case screen Chapter 15 Cases Customizing the Case screen In Medisoft Advanced and Medisoft Network Professional you can customize the display of the tabs If you do not need a tab you can hide it To do so 1 With the Case screen open right click on any tab header A list of the tabs appears A check mark appears next to the tabs that are currently displayed Case COLANOOO Collins Anorie L Strep Throat v Personal v Account v Diagnosis v Policy 1 v Policy 2 v Policy 3 v Condition v Miscellaneous v Medicaid and Tricare v Comment iew eStatements v EDI osmo iy Face Sheet Set Default i L Mj Figure 90 Case screen with tab list displayed 2 Click one of the tabs to deselect it The tab is now hidden 3 To display the tab again right click any tab header 4 Click the hidden tab to place the check mark on it The tab appears again
121. ist i Monday July 16 2012 system Figure 146 Appointment Grid with Wait List screen open On the Wait List screen click Find The Find Open Time screen appears On the Find Open Time screen select modify criteria for selecting a new appointment Click Search The Confirm screen appears ao fF oO N On the Confirm screen select one of these options Click Yes to set the appointment Click No to reject the appointment Click Retry for the next available appointment User Guide September 2012 Release 18 151 Moving Deleting an Appointment Chapter 23 Scheduling Appointments Moving Deleting an Appointment Moving an Appointment To move an appointment select one of the following methods Drag and Drop changing to same day only 1 Click the appointment and hold the mouse button down 2 Move the cursor to the new appointment time 3 Release the mouse button Using accelerator keys 1 Highlight the appointment by clicking the grid cell 2 Press ALT X to cut the appointment 3 Move to the new date on the Appointment Grid 4 Click the new appointment time 5 Press ALT V to paste the appointment in the new location Using the Speed menu 1 Highlight the appointment by clicking the grid cell 2 Right click the mouse and select Cut 3 Move to the new date or new time 4 Click the new appointment time 5 Right click the mouse and select Paste Using the Edit menu 1 H
122. key data elements associated with a referring provider NPI taxonomy legacy numbers You will set up at least one entry rule on the Referring Provider IDs grid for each referring provider that works with your practice and associate this information to all insurance carriers or insurance classes or a particular insurance carrier or an insurance class For more information on creating rules see Creating Rules Overview on page 24 1 Select the Referring Provider IDs tab Provider new Address Reference Provider IDs Insurance Insurance Facility Carrier Class Code Figure 55 Provider screen Provider IDs tab User Guide September 2012 Release 18 55 Entering Referring Provider Rules Chapter 7 Referring Provider Records 56 2 oa Qo Click New to create a new grid entry OR Select an entry on the grid and click Edit New Referring Provider ID Figure 56 New Referring Provider ID screen Select either All Insurance Carrier or Insurance Class Select either Entity Type Person or Entity Type Non Person Select either None or National Provider ID Select either None or Taxonomy If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s Click Save User Guide Release 18 Septemb
123. le reporting options You can run reports in Medisoft by selecting various reports from the Reports menu In addition you can launch the Medisoft Reports application for Medisoft Advanced and Medisoft Network Professional only and complete all reporting tasks there The Medisoft Report application offers several key features not available when running reports from the Reports menu including different reports and features to enhance productivity Report Procedures Viewing a Report You can view or preview a report before printing or exporting it For example you could preview a Patient Aging report before printing it to make sure that you have selected the most appropriate data criteria After previewing you can export or print the report To view a report 1 On the Reports menu select the report you want to view The Print Report Where screen appears 2 Select Preview the report on the screen 3 Click Start Depending on the report selected the Data Selection Questions screen or the Search screen opens 4 Select ranges and then click OK The report appears NOTE For some reports that use a different format such as statements the controls in this screen are slightly different and include a Save Report to Disk option Printing a Report To print a report 1 On the Reports menu select the report you want to print The Print Report Where screen appears 2 Select Print the report on the printer User Guide Sept
124. lity If you have entered a separate NPI number for a facility and need to send facility billing information specify the type of facility and qualifier including the unique facility NPI number If this information is sent on the claim select the Send Facility on Claim check box and do not include any other data Referring Physician Considerations 28 If your practice has referring physicians create records for them on the Referring Physicians screen and use the Referring Physician IDs screen to enter any numbers unique to a referring physician User Guide Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview If you are a group file claims as a group If you are a group file claims as a group First complete at least one rule on the Practice IDs screen for the practice Then create at least one rule on the Provider IDs screen for each provider Set your claim filing status on the Provider IDs screen by selecting Group for each provider in your practice New Provider ID n O Insurance Carrier o OK All ME Insurance Class 2 cancel ail O Facility Help Individual File Claim As From Practice C National Provider ID From Practice Taxonomy 7 O Tax Identifier C From Practice Social Security Number None O Mammography Cert None Care Plan Oversight None Legacy Identifier 1 None O Legacy Identifier 2
125. lue Added Resellers 0000 0c xiii Techaical SUDDO nex Drame ERE REO atte a ea REIR wie e eres xiii Medol VERON qe P ETE xiv Chapter 1 Navigating in Medisoft 00 cece eee eee eee eee eens 1 Uno e rM 1 jn cope TUM 1 Menu Bat vs cosh e285 bs Sac GPE SEGSE RESETS SEE EH ES FRE C RE e iR RS 1 ee o ITT SET pue qd qeu gae Enpades sabi dud dues isis dran 1 chmod rrt 2 MB Sos aquis Seka cd albida eee aed LS SM UE Odd I nak 3 slo OU dioses egg os Bei REI PES ia PO dde ed d adi eui ot aes dde 8 ICE MGM s on ac dee coke ahaa Wea uda qu ku etd e edu MR a 4 ACUVNES ee Gn 4 LIS saos 5 nsns piter dub sudes conta ask hen E d iie cet ca 5 Hepors MO a eoo cgRPIIC REIS RE otare dads Er e eR PERPE ERE 6 TOO SENI s dios oriadtbd dni s deo Re hoes QUA E nud dub ba en ur S etse us 7 Window Al T 7 IGI 22555 ond p Sead dua uc ideo Celudaop dod dd e etes eae camas Bes 8 Koystrokes and SIoftellls 11 59 bro rieten DANS R OWN dede depu Ed 9 comi ove OR so qaared ux ac reds dua dca ate wurde wa phd atari d ens DA ds ys 9 Keystrokes LIS SCICON esses en todo deen reseed n RR xr xe em dos 9 Kaystrokes Transaction EDIT lino lakaonmd ee debeo Res a 10 Keystrokes Eligi sues ode RERERI RR ER RUE RR UR ERE PREX C ERR 10 Chapter 2 Medisoft at a GlanCe o cc scccsscvaveresa sn prar Ras rag aas ees 11 Setting up Your Practice Overview ciini lusus en ipee RR a eee wees 12 Entering Transactions and Payments
126. m Silver Tricare Patient Figure 157 Program Options screen Color Coding tab Patients This feature called patient flagging lets you color code patient records to alert you to various situations when viewing records The patient flag colors in the Program Options screen are fixed and cannot be edited In the box to the right of a color box assign your own description to that flag color To activate the edit boxes select Use Flags Patient flags are connected to patient records in the Other Information tab of the Patient Guarantor Screen as you edit or set up a new patient record User Guide 174 Release 18 September 2012 Chapter 25 Program Options Billing Tab NOTE This is an Advanced and Medisoft Network Professional feature Options in the Statements section deal with billing cycles If you want to use billing cycles when sending statements select the Use Cycle Billing checkbox If you choose to use cycle billing be sure to enter a cycle billing days interval for example every 30 days For more information on billing cycles see Statements sent through BillFlash are also affected by the billing cycle The Add Copays to Remainder Statements is used to add missed copays when patients do not immediately pay their copay to the patient s Copay Remainder statement Program Options x General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing l Audit BillFlash
127. many statements were created 5 Click OK The new statements appear on the Statement Management screen User Guide 114 Release 18 September 2012 Chapter 19 Creating Statements Editing Statements Editing Statements 1 On the Statement Management screen highlight a specific statement 2 Click Edit You can modify general statement information the transactions that appear on the statement and any comments attached to the statement When you make changes in the Statement edit screen you modify only that statement and do not affect the defaults for other statements Statement 11 Statement 11 Statement Created 12 22 2003 Guarantor SIMTAO00 Tanus J Simpson Remainder 386 00 General Transactions Comment Status Billing Method Hold Paper O Ready to Send Electronic Sent O Failed Type S Standard Challenge Initial Billing Date Done Batch 0 Submission Count 0 Billing Date Figure 113 Statement screen The Statement screen has three tabs that contain the information for the claim Tab Description General Use this tab to change the Claim Status Billing Method and the billing date Transactions Use this tab to see all of the transactions that are part of the selected statement You can split add or remove transactions here Comment Use this tab to place whatever comments you feel are necessary concerning this statement and or any transactions relatin
128. ment Plans To help patients make consistent payments on their accounts you can create payment plans You can create as many plans as necessary to accommodate your patients Creating a New Plan 1 On the Lists menu select Patient Payment Plan The Patient Payment Plan List screen appears From here you can see all of the existing payment plans You can add a new plan edit an existing plan or delete a plan Patient Payment Plan List Code Description 1st Payment Due on Interval in Days amp mount Due Date Modified AA Code AA 5 30 5 00 7 27 2012 6 5 AB Code AB 10 25 15 00 7 27 2012 6 5 Code AC 20 25 00 7 27 2012 6 4 Figure 130 Patient Payment Plan List screen 2 Click New The Patient Payment Plan screen appears Figure 131 Patient Payment Plan screen 3 Complete the fields for the new plan 4 Click Save User Guide 132 Release 18 September 2012 Chapter 21 Managing Collections and Small Balance Write Offs Applying a Plan to a Patient Applying a Plan to a Patient Once you create a plan add it to the patient s record 1 On the Lists menu select Patients Guarantors and Cases The Patient List screen appears 2 Highlight the patient whose record you want to update and click Edit Patient 3 Select the Payment Plan tab Patient Guarantor Collins Anorie L Name Address Other Information Payment Plan Custom G Save Payment Code
129. n Figure 34 New Provider ID EIE vox EE 566456546 2332432323 2 2 2 Figure 34 Edit Provider IDs screen specific to an insurance company Each of these additional rules needs to be complete since the claims processing pulls all the information in a rule and not just one field An incomplete rule for instance no NPI number will leave fields empty in the claim causing rejection In the case of Figure 34 you would need to include the NPI number Taxonomy number and Social Security Number since those were included in the initial rule using the Provider IDs screen see Figure 33 If you used the Practice IDs screen you could select From Practice for these numbers and you would not need to specify them on the Provider IDs screen since Medisoft would pull these values from the Practice IDs screen If an insurance company requires taxonomy you must create a rule on the Practice IDs screen for that insurance carrier and enter the taxonomy number there Then open the Insurance Companies screen and select the Send Practice Taxonomy in Loop 2000A checkbox If your practice requires dual taxonomy then you must also create a rule on the Provider IDs screen for that number specifying the provider and insurance company Facility Considerations If you have facilities attached to your practice you must create rules on the Facility ID screen for any numbers that are specific to that faci
130. n with fab list CISplayBd s uo i ub buen beo ERE oe d ruo Re qd xdcbae eredi 92 Figure 91 Transaction Enty Screen 200 1 cence epe bi xa kd dtii dE ed ELA EARNE ER du 93 Figure 92 Transaction Entry screen with patient selected 0 500 eee eee eee eee 94 Figure 93 Transaction Entry screen with payment 21 22 40 0240 ec ed lt Rb EERRR AE 95 Figure 94 Apply Payment to Charges screen csse er n mnm er vere rus 95 Figure 95 Unprocessed Changes SGre uissassueaurasbaca edebat ara EE tob Ra eb dew ed d Ra sra 97 Figure 98 Quick Ledger SCEN i onum tcs em v CER Ee X RUP SR E e e dos uc deu ete bee dir iege ws 99 Figure 97 Guarantor Ledger screen ias Saks duse eee eee ed amie d A Sd Edd s d dies 100 Figure 98 Quick Balance SGIGOn aissseuss crx hw c wc eee Pee d w seb RE a ov DRM ER RR 101 User Guide x Release 18 September 2012 List of Figures Figure 99 Claim Management Steen cov tccateonsesaonekcowy deb dan EELEE ender ke dur dob b ab acid 104 Figure 100 Create Claims SCOS iuo us eem x mmm eem mx e kd eei ip Rom d de tg ce x 105 Figure 101 Claim Management screen with new claims 0 00000 eee ae 105 Figure 102 Claim SCIGBllc uates ah bese eset ER Rr dole ERO baee n ER eee be Re 106 Figure 103 Prin Saehd Claims Sheen uaa d bara baurCacs ache 6 durdes bd necs ESAS Err p dedos ria 107 Figure 104 Open Repot SCEE uio sess ER Ea acit ah ot actio diea SER d aic edis RO ds 107 Figure 105 Print Report Where Screen 12242353 2252422 5044508
131. nd Small Balance Write Offs 129 Cole Han Si e Cr Los 129 Pn 8 TIGNIGE UL Soda oe Sura Te Saucen odd Sem Rea m usque 130 Adding Collection List REMS eec b epo 9 RR C RERO Y PR ES UR EE 130 Patient PRURIGBEPIBEIS aa uno pocas re eat Padus PR EE IESS iau NS EE 132 Crema Mew PES sued tob Ren rendo vosmet sre book e cete as 132 Applying a Plan t a Patient scm dass ate s tepido So obs set ere tk ede 133 Collection Leet uiis ou yp I SOT I SR P ree P ERRESISQX s E PE eo ead 134 Customizing Golleetion Lenets 2 a dau serons uet Ro oon ecd bode castos are oe 134 Small Balance WMO i025 cess kee Pe Ree eee ee hes tcm SCR Prom ee 135 User Guide September 2012 Release 18 Table of Contents Chapter 22 Using Electronic Services 000 e eee e eee eee eee eee 137 Electionic Claims Processing ose 3 piopor rankisiki hanta Sad PE OPx eque qb 137 Slatemenb PIOCEOMNO a e cias shed oaa ibd aque aa ku adres E Ede SB ore 137 Eligibility VEMICHIGH sauna so mer mem Recte Re me ken eR Rm se 137 Eligibility Venicatiom SAUD o uas a a obe Draco bor CC BUx Y ee e 137 Eligibility Verification Results sica re Rh RR REI RR ERR D RES 138 Chapter 23 Scheduling Appointments 0 0c e eee eee eee eee eee 141 Nice Hours OVelvieW vue dosi e dip NEDPPEYRPEERURUM E USE IM EIE edd 141 SAMA COMO vs qi Ph paced d E RR a e dpiose d dedic RU ER Ee ames 141 From the Windows Desktop icio ecco RR ORI RPRRLIPBPR SE REYTIC
132. ng on changes to their insurance treatment diagnosis and so on For instance you are treating a diabetic patient regularly and he is injured on the job His visits regarding the work related injury should be kept in a Workers Compensation case totally separate from regular visits for legal and reporting reasons Ideally you would have a case for each different malady from which the patient suffers Then you can pull up groupings of case visits to help you evaluate the patient s overall health status By pulling a case that contains all diabetic treatments one for high blood pressure one for angina and one for cancer you get a better picture of the full range of health problems TIP If a patient comes for a one time treatment you can create a transaction for that treatment without creating an entirely new case Just select different diagnosis codes in Transaction Entry when creating the transaction Creating a Case To create a new case for a patient 1 On the Lists menu select Patients Guarantors and Cases The Patient List screen appears 2 In the top right of the screen select Case The buttons on the Patient screen change Patient List Search for I5 Field Chart Number 2 Patien Chart Nu Name Date of Birth Soc Sec Nur List of cases for Again Dwight d AGADWDDD 30 D 9 Number Case Description Guarantor CIA IL 2 Broken Hand AGADWOL Fe BORJOOD0 Bordon John 1 20 1872 444 55 6666
133. nges made and by whom Some PHI personal health information will be included in the Data Audit Report no matter what selections are made or excluded in the Program Options screen or the Audit Generator NOTE This report does not support printing a report title page even if the Print Report Title Page option was set in the Program Options screen September 2012 User Guide Release 18 167 Audit Reports Chapter 24 Reports User Guide 168 Release 18 September 2012 Chapter 25 Program Options This chapter gives a brief overview of the different program options available in Medisoft General Tab The General tab has options for backups which are an essential part of maintaining computer generated billing programs and general default settings such as which screen to open on startup and several options to show or hide data Program Options MBACKUP EXE iv iv L dl dl nanag Figure 152 Program Options screen General tab User Guide September 2012 Release 18 169 Data Entry Tab Chapter 25 Program Options Data 170 Entry Tab The Data Entry tab gives you many options for various sections of Medisoft Program Uptions General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash Global v Use Enter to move between fields Use zip code to enter city and state Number of Diagnosis m Suppress UBD4 fields lt
134. nomy and tax ID numbers 2 Second create one rule on the Providers IDs screen for each provider a total of three rules You must include one rule for each provider on the Provider IDs screen since claim filing status individual or group is specified there Each of these rules would be general and could apply to all insurance companies and facilities Select Group for your claim type and select From Practice to pull NPI taxonomy and Tax IDs from the Practice IDs screen 3 If one of the insurance companies requires a legacy identifier create a second entry on the Practice IDs screen By creating a second entry on this screen instead of the Provider IDs Screen you save time and effort This one rule can be applied to all the providers at the practice level instead of creating a rule for each provider at the provider level To do this for this second Practice IDs rule select the specific insurance company and select all providers Importantly include your NPI taxonomy and Tax IDs since each rule needs to be complete Finally enter the legacy number the insurance company requires When the application gathers claim data it will select this row for the specific insurance company and pull the data for the claim User Guide September 2012 Release 18 25 If you are a solo provider file claims as an individual Chapter 3 Creating a Practice and Setup Overview If you are a solo provider file claims as an individual 26 As a sol
135. ntering Practice Information Entering a Practice IDs Rule Use the Practice IDs tab and Practice IDs grid to enter or edit key data elements associated with your practice tax ID social security number NPI taxonomy legacy numbers You will set up at least one rule on the Practice IDs grid and associate this information to all providers insurance carriers and all facilities For more information on entering data on the IDs grid see Creating Rules Overview on page 24 1 Select the Practice IDs tab The Practice IDs tab appears Practice Information Practice Practice IDs Practice Pay To Statement Pay To Insurance Insurance Facility Carrier Class Code Legacy 2 E save Cancel BCBS Group BCBS Group Figure 44 Practice IDs screen 2 Click the New button to create a new rule OR To edit an entry select the record on the grid and click Edit New Practice ID DER Help Figure 45 New Practice ID screen 3 Select the All Provider or Provider Class button User Guide 42 Release 18 September 2012 Chapter 5 Entering Practice Information Entering a Practice IDs Rule 4 Select the All button to apply the rule to all providers associated with the practice To apply the rule to a specific provider select the Provider button and click the magnifying glass to select the specific provider To apply the rule to a specific provider class select the
136. ntury Data Selection Questions sis fo OOK je Figure 106 Data Selection Questions screen 6 Make your selections for the various ranges and click OK 7 The Status of the claims will be updated to Sent on the Claim Management screen Claim Management Claim Number Chart Num Carier1 St Media1 Batch BillDate 1 1 SIMTA000 AETOO 112 3 2009 2 AGADWO00 MEDDI 2 11 21 2009 3 BRIJAOD0 CIGOO 4 3 25 2003 4 BRISUO00 CIGOD 5 12 5 2003 5 WAGJEOOO som 06 1 2003 RM 6 YOUMIODO USODO Ready To Senc Paper 7 AGADWODO HEROI Sent Paper 7 12 6 2008 10 COLANO00 AETOO Sent Paper 12 7 26 2012 Figure 107 Claim Management screen with Status of Sent User Guide 108 Release 18 September 2012 Chapter 18 Creating Claims Troubleshooting Insurance Claims Troubleshooting Insurance Claims Claim Form Not Centered If your insurance claims are printing off center you can fix this with the following steps 1 On the Reports menu select Design Custom Reports and Bills The Medisoft Report Designer opens 2 On the File menu of Medisoft Reports Designer select Open The Open Report screen appears Open Report n st Appointment List m BillFlash MS1 P StandardStmt v16 Cancel BillFlash MS1 S StandardStmt V17 BillFlash MS3 P CollectionStmt v16 BillFlash MS3 S CollectionStmt v1 BillFlash MS4 P StandardLetter v16 BillFlash MS4 S StandardLetter 154 BillFlash MS5 P MissedCoPayStmt v16
137. o G0 ROVE debe a dE URS E RR d 104 Editing GIGING suo ios arte PI Vip Spei o EQ REM Dd beeen BU rd 105 Pini ae aia s cue nid api FR ua d Basi OS Lid qu QUE E ORO DP de 107 Troubleshooting Insurance Claims lille 109 Glaim Form Not Cemer saa 1inq 29d sepe TR RR AER ETL REG Gd e PAAR 109 Bep ng CM f s oed tO IEEE E WEE D Db dep dior 110 CNanNG Clam AS yasai n T TI TL 110 Chapter 19 Creating Statements 0 00 ee eee eee eee 113 Statement Management 0000 cece eee 113 Greanng tabem DES iuo anas d odora d oe bes dE dS Dad ah eek dda Ans 113 Editihg SISSIES ies da eec nee Rare xen ERE RR AE E E Was e eas 115 EBD spite nelle is cu sobre dete aed Syed cb uu Duae sea as cents 115 Reprinting Statements oru vascos ee cr PR ee Pia dd vg 118 Ghanoino Statement SINS ices ccs ees ead dre ns ee dw S Rd d dad eee 118 silpeps o C r O sease ee 119 Troubleshooting Statement Printing llle 121 Chapter 20 Applying Deposits Payments eeeeeeeeeeeeennee 123 Entennga PaymQolib iusso ees eme mx m ees wn Ae xb ad EU RUE E He eo meee 123 Appiying OUS DOE ns Sese a 2a sotbecieiub Domi dite ire Sox das dota stud 125 EOB PAVIDONIS S iei brupOU ieee Mees BR PpRepeid REQUE SAEC MUI eO eR 126 itis Ee i pP 127 Gopitatlon Payrmbnb iussa ose Rm ERE REED Dex Seer eR i aono eis 127 ca um me EC C os Gene ede dG eck and Guloa edi E 128 Chapter 21 Managing Collections a
138. o provider you have two options when entering key ID numbers such as NPI taxonomy and tax ID social security number Enter this information at the practice level using the Practice IDs screen see Entering a Practice IDs Rule on page 42 With this method enter these numbers on the Practice ID screen Then select From Practice for all values on the Provider IDs screen see Entering Provider IDs Rules on page 49 New Practice ID gt KTE ESO coa 4534554334 8472342224 Figure 32 New Practice ID screen Enter this information at the provider level using the Provider IDs screen see Entering Provider IDs Rules on page 49 In this case on the Practice IDs screen select None for NPI taxonomy tax ID social security number and so on and enter a minimal amount of information Then on the Providers screen specify your NPI taxonomy tax ID social security number and so on Also User Guide Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview NPI Considerations select Individual for the File Claim as The result will be the same and Medisoft will correctly pull these IDs when filing claims New Provider ID Cel Help 4566456546 O 2332432323 e Figure 33 New Provider IDs screen NPI Considerations If you have the same pay to address as your billing address you can enter your NPI information on the P
139. omize SOTEBL 23 adu Ak d dedit dd RR dud e he See d d dei RU I eA ead 2 Foure E SNONCUEBAr sor tcsidenrrerid iane erara e E eae a Eak A 2 aeran a a OAE EEr E ET E E E E E E E EE 3 FOGO ng P T m 4 Foure Wace 2 1 MENU CC PT 4 Figure TOLES MENU 2o sees oR ERE OCA OUC EC POI SU REPORTER Oqees e pp PEERS E DESEE 5 Faure I dep BEI c sanscr uid iaa s a rac erue outa 6 BUG rgo eria Datus ddr 6 Foue 12 TOSS MEN CC eee 7 Figure TS Ines NENG cris iaee E a so ek a aa Mee aes eS aad en T Figure T4 Mep mbil deer ra erp e SE re E aera S UC BE 8 Figure 15 Practice hiomaton SCIOBEL i e oe uq tsaera rr kirana a AE a a E Eon eee Se 12 Figure 1G Provider SOFGOlic quaere ia cade aaa Roe xo a E ER 12 Figure 17 Refeming Provider SCIES cocos Dub tls Ree I bcd ed EE uq ERE 13 Figure 18 Insurance Carrier screen llli hne 13 JOUI dO EBEN SCION soos oos eos sce awaken teed i qure qu S RO edet End bred qt d 14 Figure 2U Address SCIEN uu ceo ew eeccuw a EE mre tease RR RR RAM EHE Rr Oe een Ge dre n 15 Figure 21 Diagnosis SOLGD uus uns ee as ed E Pc bed ED auicm aa a Sup b 16 Figure 22 Procedure Payment Adjustment screen 0 0000 c eee 17 Foure 23 Patent Guaramar BOLBODI conc diea rar g dob dae aie ierra Saks EECA a cna dara a RU d 18 Figure 24 Transaction Entry SCreen scoici ses mec rec xem m reae e eR os d rds 19 Figure 25 Claim Management screen uus sess sese dn CAUCA RR D AUN edhe eee e
140. ontact OO Extra 1 LE j Extra 2 isd E Mail OO C Purchased Services Figure 19 Facility screen User Guide 14 Release 18 September 2012 Chapter 2 Medisoft at a Glance Setting up Your Practice Overview The Addresses screen is used to enter address information important to your practice such as addresses of attorneys employers or referral sources Address new Code hz If the Code is left blank the oa program will assign one Name Street City State E Zip Code Type Employer v Phone Extension EN Fax Phone Cell Phone Office Contact PO E Mail FO Extra 1 Extra 2 Figure 20 Address screen September 2012 User Guide Release 18 Cancel Set Default 15 Setting up Your Practice Overview Chapter 2 Medisoft at a Glance The Diagnosis List screen displays diagnosis codes that have been set up for the practice You can also identify codes that are HIPAA Approved Use diagnosis codes in patient records as well as during transaction entry These will be part of each claim that is filed 7 Diagnosis new Code 1 Description Alternate Code Sets Code 2 HIPAA Approved Code 3 Inactive Code Figure 21 Diagnosis screen User Guide 16 Release 18 d Cancel September 2012 Chapter 2 Medisoft at a Glance Setting up Your Practice O
141. ot becomes available you can use the Wait List to help you determine whom to call first for that opening Moving a Patient from the Wait List to an Open Appointment 1 On the View menu click Wait List The Wait List screen appears 2 Use the Search Sort by fields to search for a record Select the field by which you want to search in Sort by and then enter the value for which you want to search in Search 3 Select the Provider 4 Choose a patient from the list and click and drag their name to an open time slot in the Appointment Grid Adding a Patient to the Wait List To create a new entry for the Wait List 1 On the View menu click Wait List The Wait List screen appears 2 Click New in the Wait List The New Wait List Appointment screen appears 3 Select a patient in the Chart Number field The patient s name and phone number are automatically entered in those fields when you tab past them User Guide September 2012 Release 18 145 Adding a Patient to the Wait List Chapter 23 Scheduling Appointments NOTE Entering a phone number here does not store that number in the patient s record To include a phone number in the patient s permanent record enter the phone number in the Patient Guarantor screen You can move the cursor back to the Name field and then press F9 to edit the patient record 4 Complete the remaining fields on the New Wait List Appointment screen 5 Click Save User Guide 146 Release 18 Septem
142. ot enter an EDI receiver in the EDI Receiver field electronic claims will not be created or sent for this insurance company In the Claims Payer ID field enter the payer ID for the insurance carrier Refer to the enrollment information you received from the carrier clearinghouse and look up the commercial identification number submitter identification numbers assigned to the insurance company by the clearinghouse If you use the eligibility verification service and want to verify eligibility with this insurance carrier in the Eligibility Payer ID field enter the payer ID for some carriers the eligibility payer ID is different from the payer ID Refer to the enrollment information you received from the clearinghouse and look up the commercial identification number submitter identification numbers assigned to the insurance company by the clearinghouse From the Type list select a type for the insurance company Leave Alternate Carrier ID blank Revenue Management will populate this field if needed If needed select from the EDI Max Transactions list a maximum number of transactions accepted by the carrier This field is available for those carriers that limit the number of transactions per claim accepted electronically If you submit more than the maximum number of transactions per claim Medisoft automatically splits the claim If the insurance carrier is used as both a primary EDI insurer and a Medigap insurer in the EDI Extra 1 Medigap
143. ou can customize the toolbar to fit your needs You can change the order of the buttons in the toolbar or remove them so they do not appear You can create a new toolbar with only the buttons or file names that you want In addition you can move the toolbar to the top bottom or either side of the screen or return it to its original position and layout To customize the toolbar 1 Right click an open space on the toolbar and select Customize The Customize screen appears Customize Toolbars Commands Options Toolbars IE Main Menu 0 OO Ol IV Tool Bar Sidebar Figure 5 Customize screen 2 Use the options on the tabs to make your choices 3 Click Close when you are done Shortcut Bar Figure 6 Shortcut Bar At the bottom of the screen above the Status bar is a shortcut bar that describes the available shortcut function keys available in the active screen This bar may also be referred to as the function help bar User Guide Release 18 September 2012 Chapter 1 Navigating in Medisoft Menus Menus There are eight drop down menus from the menubar that have options that allow you to work in Medisoft File Menu Open Practice New Practice Convert Data Backup Data Task Scheduler View Backup Disks Restore Data Backup Root Data Restore Root Data Backup Restore Medisoft Reports Program Options Set Program Date
144. ounts Allowed Amounts Insurance Name Code Modifiers Amount Aetna AETOO Blue Cross Blue Shield 225 BLUOI Cancel Blue Cross Blue Shield 231 BLUOO Cigna I Help FHP Health Plan Medicaid Medicare U S Tricare Workers Compensation Figure 73 Procedure Payment Adjustments screen Allowed Amounts tab User Guide 72 Release 18 September 2012 Chapter 11 Procedure Payment and Adjustment Codes and Diagnosis Codes MultiLink Codes MultiLink Codes MultiLink Codes are groups of procedure codes combined under one access code They are for procedures that are normally performed at the same time for example for a physical exam or a routine set of treatments There are two advantages to using MultiLinks You reduce data entry time by creating several transactions at once with a single code You reduce omission errors since you ve already included all applicable codes in your MultiLink code To create MultiLink codes 1 On the Lists menu select MultiLink Codes The MultiLink List screen appears MultiLink List Search for 2 Field Code Code Description DIABETOOO0 Diabetes Screening 99214 Lovooo0000 LOW 99213 TRUCKEOOOO Trucker Physical 99214 WELLCOO000 Well Check Exam 2 months 29130 Kam Figure 74 MultiLink List screen User Guide September 2012 Release 18 82947 97260 93000 36215 36215 97010 99000 36215
145. out regard to their status To reprint an entire batch the status must be changed for the batch Changing Statement Status In the Statement Management screen all submitted statements are automatically marked Sent with an indication of the method of submission There may be occasions when you need to change this status Statements sent electronically through BillFlash get a report that marks each statement as either accepted or rejected Entire Batch If you need to change the status of an entire batch you can change all the statements at once 1 On the Statement Management screen highlight one of the statements and note the number listed in the Batch column 2 Click Change Status The Change Statement Status Billing Method screen appears Change Statement Status Billing Method Change Status Billing Method of Statements For Batch 3 Selected Statement s 9 OK Status From Status To O Hold Hold O Ready to send Ready to send Sent O Failed S Pilas Failed Challenge Done Any Status Type Challenge Billing Method From Billing Method To Paper Paper Electronic Electronic Figure 119 Change Statement Status Billing Method screen 3 Select the Batch button and enter the batch number from the Batch column in the Statement Management screen 4 Select the appropriate buttons in the Status From and Status To sections 5 Click OK Selecting Multiple Statements 1 W
146. ox if the provider has signed an agreement with Medicare to accept its charges and an affidavit is on file If it is checked the Signature Date field becomes active to display the date on which the signature was placed on file Enter a date in this field In the License Number field enter the provider s license number Click Save if you are finished with the record or click the Reference tab The Reference tab displays data and values before the data was converted to Medisoft 18 and moved to the Provider IDs grid to create rules for claim creation The tab shows data from the Default Pins and Default Group IDs tabs which were replaced with the Provider IDs tab User Guide Release 18 September 2012 Chapter 6 Setting up Providers and Provider Classes Entering Provider IDs Rules This tab is mostly used for reference purpose only You can update data on this tab for your reference purposes but none of this data is pulled for claim generation The only field that still impacts claims is Provider Class Provider new Address Reference Provider IDs EDI Receiver Override v 8 Provider Class v 9 N PINS Te Group Numbers Medicaid Group Number Tricare NEM Medicare Group ID NEED BueCoss Shelk Medicaid GroupID Commercial NEN BC BS Group ID PPO Dther Group ID HMO UAN Extra 1 o Extra 2 EDI ID Payee Number fo CLIA Numbe f TAT Number 5 C Hospice Emp
147. p your practice order of activities 24 setup overview 24 Shortcut Bar 2 Signature Date field providers 48 Signature on File box 48 Small Balance Write off window 136 small balance write offs 135 Social Security number 26 83 solo provider 26 statement changing status 118 troubleshooting 121 September 2012 statement billing notes setting up 175 statement billling notes activating 175 statement management 113 Statement Pay To tab 44 statement processing 137 BillFlash 137 statements creating 113 editing 115 printing 115 reprinting 118 status changing claims 110 changing statement 118 Stmt Submission Count 4 field 136 superbill 186 Suppress UB04 Fields check box 170 T task scheduling eligibility verification 139 tax ID 26 taxonomy 26 Taxonomy number 186 taxonomy number 25 tickler defined 130 Tickler Item window 130 ticklers adding 130 defined 130 Title Bar 1 Toolbar 1 toolbar customizing 2 tools menu 7 Transaction Entry window 93 transactions entering 93 troubleshooting insurance claims 109 troubleshooting statement printing 121 U UB04 fields 170 Unique Physician Identification Number UPIN UPIN 186 Unprocessed Charges window 97 unprocessed transactions 97 Use numeric chart numbers check box 81 User Guide Release 18 191 Index user access levels 38 users creating 35 V viewing reports 159 W Warn on Unapproved Codes check box 173 window menu 7 WzCollections date 135
148. poperFRCRYCFC RAW YR RES CHRRISCPPETPS ER CEPIT TERRY 44 EDI Receiver REcords xa o xS dG hd ERIHOLERRTAARARG S AQURRARFERERREQESRAG 46 Chapter 6 Setting up Providers and Provider Classes 47 Entering Provider Iniormation s s eee qam e CEVEA ERTTPSPP T E EY 3 4 47 Entering Provider IDs RUGS usadas sud ERA RARE ENG eo A RRCOHE RE RU ER Rd 49 Chapter 7 Referring Provider Records leseseeeeeeeeeeeeeeee 53 Entering Referring Provider Information 0 002 eee eee ee ees 53 Entering Referring Provider Rules iacssua ano m ah dang RR ERR aes oa RR MG 55 Chapter 8 Insurance Classes and Insurance Carriers lllesu 57 insurance Class Sennan es RE ERRORE E E E e EE E 57 Guroo RS aaa a ED arae vi oO a Bal a a da Dess a 59 Chapter 9 Facility Information 2 2 22 issued rho ha RR rh hh Rn 63 Setup SCahallOg o erot neha aD wes dheterec dene hw EE xq Gier pv dumme 63 Entering Facility Infomation cius dee s mde jos aec EO itni re ae SR eS 63 Entering Facility IDS Rules 222s sodes Pu RR ERE RR dees ee em 64 Chapter 10 Attorney Employer or Other Addresses 67 Chapter 11 Procedure Payment and Adjustment Codes and Diagnosis Codes 69 Procedure Payment and Adjustment Codes 0 0000 cece ellen 69 spur eM TETUER 70 AMOS TO o derEq E PURI EAE ib Vee EIER PER EU ep ir ode f spi pd 70 Allowed Amounts Tab Advanced and Medisoft Netwo
149. practice Hot Backup will ensure that processes are completed before creating the backup Once the backup is complete you will be logged out of Medisoft and must log back in to resume work User Guide September 2012 Release 18 181 Restoring Your Hot Backup Chapter 26 Backup and Restore Data To make a hot backup 1 On the File menu select Backup and then Hot Backup The Medisoft Hot Backup screen appears Medisoft Hot Backup Figure 163 Medisoft Hot Backup screen 2 Complete the fields on the screen 3 Click Start Backup 4 Click OK on the message that the backup is complete Restoring Your Hot Backup You will very seldom have to restore a hot backup it is only necessary if the data becomes corrupted or you have to print reports that are no longer accessible because of the addition of new data McKesson highly recommends that you create a new backup of your current data BEFORE you restore your backup You may need this backup to restore your files to their current state User Guide 182 Release 18 September 2012 Chapter 26 Backup and Restore Data Restoring Your Hot Backup To restore a hot backup 1 On the File menu click Restore 2 Click Hot Restore 3 Click OK on the warning message The Medisoft Hot Restore screen appears Medisoft Hot Restore Figure 164 Medisoft Hot Restore screen Select a backup on the list of existing backups or click Find to find a different backup Click Start R
150. r O Insurance Class Cancel C Send Facility On Claim ID Qualifier Help CO National Provider ID Taxonomy Oca O Legacy Identifier 1 O Legacy Identifier 2 Figure 67 New Facility ID screen 3 Select either All Insurance Carrier or Insurance Class To apply the rule to a specific insurance carrier select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select Insurance Class and click the magnifying glass to select the insurance class User Guide September 2012 Release 18 65 Entering Facility IDs Rules Chapter 9 Facility Information 66 To include facility information on a print or electronic claim select the Send Facility on Claim box and select an ID Qualifier Select either None or National Provider ID Select National Provider ID and enter an NPI number to associate the facility NPI number with the rule Select either None or Taxonomy Select either None or CLIA If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s Click Save User Guide Release 18 September 2012 Chapter 10 Attorney Employer or Other Addresses The Address file is your address book in Medisoft It keeps the names addresse
151. r Information tab User Guide September 2012 Release 18 83 Entering Patient Information Chapter 14 Patients 5 Complete the fields here Patient Guarantor new Set Default n Copy Address _ View eStatements Figure 84 Patient Guarantor screen Other Information tab If the patient s employer record has been set up in the Address file see Attorney Employer or Other Addresses on page 67 select it on the Employer field If you want to create a new address record place the cursor in the Employer field and press F8 The Addresses screen will appear User Guide 84 Release 18 September 2012 Chapter 14 Patients Entering Patient Information 6 Select the Payment Plan tab Select a Payment Code to set up the payment terms for the patient Patient Guarantor new Other Infomation C sae vg Code Description f Code AB AC Code AC E Set Default Copy Address View eStatements Figure 85 Patient Guarantor screen Payment Plan tab User Guide September 2012 Release 18 85 Entering Patient Information Chapter 14 Patients User Guide 86 Release 18 September 2012 Chapter 15 Cases Transactions in Medisoft are generally case based A case is a grouping of procedures or transactions generally sharing a common treatment facility or insurance carrier You can set up as many new cases as needed for your patients dependi
152. ractice IDs screen Then select From Practice on the Providers IDs screen This will ensure that the NPI number appears on all claims If you have different billing information and pay to information see Entering Practice Information for a Billing Service on page 44 enter your NPI information on the Practice IDs screen Also enter any unique NPI on the Provider IDs screen If you have insurance companies that require mixed NPI numbers Some require individual while some require group enter your group NPI number on the Practice IDs screen Then create several rules on the Provider IDs screen specific to the insurance companies that require mixed NPI numbers For insurance companies that require the group NPI select From Practice for the NPI number This will pull that number from the Practice IDs screen For insurance companies that require an individual NPI number select National Provider ID and enter the number on the Provider IDs screen Insurance Company Considerations You might only need one rule grid entry Most likely though you will probably have at least one or more insurance companies that require different information In that case you must create other rules that are specific to that insurance company and the information needed for instance a legacy User Guide September 2012 Release 18 27 Facility Considerations Chapter 3 Creating a Practice and Setup Overview qualifier such as a medicare number as shown i
153. reen or tab on which the field is located Practice Tax ID Practice Information screen Practice IDs rules Tax ID Providers screen Provider IDs tab if this value is different from the Practice Tax ID above User Guide September 2012 Release 18 137 Eligibility Verification Results Chapter 22 Using Electronic Services Field s to complete screen or tab on which the field is located Claims Payer ID Insurance Carriers screen EDI Eligibility tab Last Name First Name Date of Birth Gender Social Security Number Patient Guarantor screen Name Address tab Assigned Provider Patient Guarantor screen Other Information tab Insurance Policy Holder Relationship to Insured Policy Number Case screen Policy tabs Assigned Provider Case screen Account tab You must also apply security to your practice and create at least one user For more information on Medisoft security see Security Setup Overview on page 35 Eligibility Verification Results There are multiple places in Medisoft from which you can make eligibility verification requests the Eligibility Verification Results screen the Patient List screen Office Hours and the Task Scheduler screen The type of eligibility inquiry you make either real time or scheduled depends on the screen from which you are making the request Eligibility Verification Results If you access this screen from the Activities menu
154. rk Professional 71 nk CoOdOS osoadeqdrbpREHTLEMPEPERLUEDNPI 000040465000 re ERIS T3 Diagnosis OBS omar eden APECduppe ohe aa oon a dq aa Pad i 75 Chapter 12 Billing Code List coocecao e sere Retro Re rr rr ERRAT 77 Chapter 19 Contact List 22 icc cts dec eei eR uec POSER a mr EE AT PEE TREES 79 Crepe Th PROBE naues hosi REP SRSPAREQREEPFE enact cosas cecageees NE EE Ms 81 Chart Number Considerallons ausser REI Rem RE I X AERE 81 Entering Patient IOHTIBT IDEE cui quee te Scop db pd gale eae REDE 82 Chapter 15 8508 ioco soa RAE RRELRRRRERRRARAARARE S RRARESRASRPEPARREGAT 87 CRAIG Casi MESE 87 User Guide iv Release 18 September 2012 Table of Contents CONVINCE Gale add otter staan daas ae iara dui EEA Ede bk ees 90 Customizing the Casa SOROBI eau ses cim memor mew ede canes wrap aed awe a 92 Chapter 16 Entering Transactions iiioi iua saso osa osi hb organ nha 93 Unprocessed Transactions x Lega osea eh ERG ERQRCOPRDY VES P E LIE RR PEE 97 Chapter 17 Quick Ledger and Quick Balance eeeesllees 99 Quick Ledge uod xc ar edicta qd eue Gd a dog d e ER a toph Rud 99 GK BANC voss cb eppP ERR P PRI RUE PERI NEMIRUSpORCEi eq PP 101 Chapter 18 Creating GIGI iuuounocesesct imt emrehuise REI mU REFERRE MEE REE 103 Cait Manageme sss con unease dd sp 4 3 pde qq QR saw tienes 103 The Glam Manage S JOD uu vs aqueppr erkPRPRPPPa pLOCRPRRPROFRDRREARSS 103 Great CAINS chen sb a Fa d p Dad
155. s and phone numbers of important outside contacts such as attorneys employers referral sources and so on The Address file will include all important contact persons whose phone fax cell and e mail numbers the practice needs The addresses maintained in Medisoft are classified by type assigned to help you select them in a drop down list These types include Attorney Employer Miscellaneous and Referral Source To set up address records 1 On the Lists menu select Addresses The Address List screen appears Address List Search for 7 Fiet Type a Code E i Extension CIONES T NN 01703 T RN RN RN ANGOO ems Mason cum 1666 ems ARMOO Army Employer BEA00 BeanSprout Express 602 453 9988 Employer DOOD0 Doormart Employer MICOO Micro Mania Inc 602 746 2134 Employer NEWOO News Channel 11 Employer READ Really Useful Trucking Co 602 457 3326 Employer WINOO Windham Gallery 602 893 4215 Employer SA000 S andA Bank Employer Figure 68 Address List screen User Guide September 2012 Release 18 67 Chapter 10 Attorney Employer or Other Addresses 2 Click New on the Address List screen The Address screen appears Address new If the Code is left blank the ue Code program will assign one Inactive Name Cancel Street City State Zip Code Type Employer Set Default xj Phone Extension Fax Phone
156. s 1 Medial Batch1 BillDate1 EDI Receiver Carier2 Status 2 1 SIMTA000 X AETOO Sent Paper 1 12 3 2009 2 A4GADWO00 MEDOI Done Paper 2 11 21 2008 AETOO Sent 3 BRIJAO00 CIGOO Sent Paper 4 3 25 2009 BLUOT Sent 4BRISUO00 CIGOO Done Paper 5 12 5 2003 BLUOO Sent 5 wAGJEO00 BLUOO Sent EDI 06 1 2009 RM 6 YOUMIODO USOO0 Ready To Senc Paper 0 7 AGADWO0O MEDOI Sent Paper 12 6 2003 10 COLANOOD AETOO Ready To Senc Paper 0 aal 3 Create Claims s Print Send s Reprint Claim ww Delete Close Figure 99 Claim Management screen User Guide Release 18 September 2012 Chapter 18 Creating Claims Editing Claims 2 Click Create Claims The Create Claims screen appears Create Claims Figure 100 Create Claims screen 3 Use the fields on this screen to filter the ranges of dates chart numbers insurance carriers and so on 4 Click Create The Claim Management screen appears and displays the claims that were created Claim Management Claim Number Chart Num Carrieri Status 1 Media 1 BillDate1 EDI Receiver 1 Carrier 2 2 AGADWOOD MEDOI Done Paper 11 21 2009 AETOO 3BRIJAO0D CIGOO Sent Paper 3 25 2008 BLUOT 4BRISUODD CIGOO Done Paper 12 5 2009 BLUOO 5 WAGJE000 BLUOO Sent EDI 6 1 2009 RM 6 YOUMIOOO USO00 Ready To Senc Paper AGADWO000 MEDOT Sent Paper 12 6 2009 10 COLANO00 AETOO Ready To Senc Paper 11 COLANOOO AETOO Ready To Senc Paper Kam a cane Gare 3 Pree
157. s Manager 185 Complimentary Crossover box 61 Condition tab cases 88 Contact List window 79 Contact window 80 copying cases 90 Create Claims window 105 Create Data window 21 creating address records 67 billing codes 77 cases 87 employer recordes 67 facilities 63 insurance carriers 59 insurance classes 57 patient payment plans 132 users 35 creating a database 21 creating a practice 21 188 creating claims 103 creating multiple practices 22 creating patient records 82 creating rules 24 creating statements 113 creating users 35 customizing Case window 92 customizing collection letters 134 customizing the toolbar 2 D data restoring 180 182 Data Audit report 176 Data Entry tab 170 Data Selection Questions window 159 Day Sheets 161 Deposit new window 124 deposits applying 123 Diagnosis List window 75 E EDI Extra 1 Medigap field 61 EDI Receiver records 46 EDI Receivers 185 EDI tab cases 89 EDI Eligibility tab 61 edit menu 4 editing claims 105 editing statements 115 electronic claims processing 137 Eligibility Payer ID field 61 eligibility verification 137 Office Hours 139 Patient List window 138 setting up 137 employer records creating 67 EMR defined 97 EMR and Medisoft 97 entering 27 entering charges 93 entering payments 123 entering transactions 93 EOB defined 126 EOB payments 123 126 User Guide Release 18 September 2012 Index ePayments 128 Deposit List window 128 Exclu
158. screen Address tab 3 Enter contact data associated with the facility including a name address telephone number 4 If the facility is a lab select the Laboratory button if the facility is not select Facility Entering Facility IDs Rules Use the Facility IDs tab to enter or edit key data specific to the facility NPI number taxonomy number CLIA number legacy numbers If your practice is associated with a facility or a lab set up at least one rule on the Facility IDs screen and associate this information to a specific insurance carrier or an insurance class If you have entered a separate NPI number for your facility and need to send facility billing information for box 32 of the CMS 1500 form specify the type of facility and qualifier along with the facility NPI number If you need to send it on claims select the Send Facility on Claim check box For more information on creating rules see Creating Rules Overview on page 24 User Guide 64 Release 18 September 2012 Chapter 9 Facility Information Entering Facility IDs Rules 1 Select the Facility IDs tab The Facility screen appears Facility new Address Facility IDs i l Insurance Insurance Save Carrier Class Legacy 1 Legacy 2 Cancel Help Figure 66 Facility screen 2 Click the New button to create a new rule OR Select the record on the grid and click Edit New Facility ID O Insurance Carrie
159. se 18 September 2012 Chapter 17 Quick Ledger and Quick Balance In this chapter you will learn about the Quick Ledger and Quick Balance features in Medisoft Quick Ledger NOTE This is an Advanced and Medisoft Network Professional feature The Quick Ledger gives a quick reference for transaction and other information in the patient s account There are two types of Quick Ledgers in Medisoft the Patient Ledger and the Guarantor Ledger The Patient Quick Ledger displays transaction information and account totals for individual patients The Patient Ledger is the default ledger Quick Ledger COLANOOO v 2 ccc Note JEDI Notes Edit J Payment Detain Fiter Case Number v Cra e JL E Date From Description Provider Procedure Case Units Amount Stmtit Statement Claim Bili Bil2 Bil3 ACETATE NE NE RR RN NU RUN 7 28 01 2 Dm DS 17110 1 15 00 No No No 7 26 2012 1207260000 Standard Copayment DS CHKCOPAY z 1 15 00 d No No s et cick stone ow Figure 96 Quick Ledger screen To open the Patient Ledger On the Activities menu select Patient Ledger User Guide September 2012 Release 18 99 Quick Ledger Chapter 17 Quick Ledger and Quick Balance The Guarantor Ledger provides the same information as the Patient Ledger but allows you to view guarantor totals as well Guarantor Ledger Guarantor BORJO000 E Bordon John Account Alert RB Family Total 105 00 Chart
160. ses EDI Receivers Referring Providers Facilities Provider Billing Codes 34 Contact List Condition Codes Claim Rejection Messages Patient Payment Plan Figure 10 Lists menu This menu provides access to the various list screens available in Medisoft Here is where you will set up your patients providers insurance companies diagnosis codes and other basic data you will need to file claims and send statements to patients September 2012 User Guide Release 18 Reports Menu Chapter 1 Navigating in Medisoft Reports Menu Analysis Reports Proced A Day Sheet Aging Reports f Payment Day Sheet Collection Reports Audit Reports Patient Ledger Standard Patient Lists Patient Statements Electronic Statements 4 Superbills 4 Blank Superbill Custom Report List Default Printer Options Load Saved Reports j Design Custom Reports and Bills LI Medisoft Reports Figure 11 Reports menu Reports within Medisoft are accessible through the Reports menu A wide variety of reports enable to you to track your practice and see the state of your practice at any time User Guide 6 Release 18 September 2012 Chapter 1 Navigating in Medisoft Tools Menu Tools Menu Calculator Medisoft Terminal View File Add Copy User Reports s Design Custom Patient Data J Communications Manager 1 Customize Menu Bars System Information Mo
161. ssary 3 Click Save The new item is added to the Collection List Once a tickler is created for this patient you can create collection letters Adding Collection List Items Use this screen to create multiple ticklers at once based on criteria you enter here User Guide 130 Release 18 September 2012 Chapter 21 Managing Collections and Small Balance Write Offs Adding Collection List Items 1 On the Collection List screen click Add Items The Add Collection List Items screen appears Add Collection List Items Add items based on Statements Claims Carriers C all Primary Secondary O Tertiary Claim Status All O Rejected O Challenge Range of Insurances v 9 to v Initial Biling Date vito Biling Date v to v Add item if submission count is greater than Enter Number Add item if patient remainder balance is greater than Enter Amount Add Delinquent Payments for Patient Payment Plan Assign To he 2 C Add Billing Comment to Office Notes Figure 129 Add Collection List Items screen 2 Make your selections here from the various filters and options Note that you can also assign these new ticklers to a specific user 3 Click Add Items The new items appear on the Collection List User Guide September 2012 Release 18 131 Patient Payment Plans Chapter 21 Managing Collections and Small Balance Write Offs Patient Pay
162. t You can enter a new appointment on the Appointment Grid that opens when you start Office Hours To create a new appointment 1 Select a provider in the provider field in the top right of the grid office Hours Professional Medical Group Tutorial Data T m ni xj File Edit View Lists Reports Tools Help E 1 51 32 209 237101 72 4 39020 July 11 2012 Sun Mon Tue Wed Thu Fri Sat 1 2 3 4 5 8 7 8 9 10 MRM 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 2 858 eim 3 1 2 3 4 3 pn 3 4 Day gt 4 Month 4 week gt 4 Year gt C 2 View eStatements y Vem Statene zi Hif Wednesday July 11 2012 svsrem Figure 139 Appointment Grid 2 Double click the timeslot for which you want to enter an appointment The New Appointment Entry screen appears TIP If you want to set up an appointment for someone who is not a patient and has no chart number skip the Chart field and enter the person s name in the Name field Enter all other necessary information You can also print the appointment list showing blank appointments and manually write in appointments Also If a patient s case has an Authorized Number of Visits set on the Account tab of the Case screen the program will warn you when the patient approaches the maximum number of authorized visits 3 In the Chart field type or select the patient s chart n
163. the EMR appear here in an unposted state As long as they are unposted they will not be part of patient accounts and you cannot file claims on them or bill patients for them To open this screen 1 On the Activities menu select Unprocessed Transactions 2 Select Unprocessed EMR Charges The Unprocessed Charges screen appears with a list of transactions that have yet to be posted 7 Unprocessed Charges DER C ID Post Transaction Status Chart_Number Case Provider Date_From 696c996c837d4001897e520e5fa0721b PALTIODO 1 JM 3 9 2007 8 47 00 4M a001 7aSebe2646bebed67c1 305705621 JACTHOOO JM 3 9 2007 8 56 00 AM 4328970191 cc4c8dae76028fd521 786 AGADW O00 17 JM 3 9 2007 8 58 00 AM 440a606fea254fdeabe8456d1c2d7f5a PETMOOO0 18 JM 3 9 2007 8 59 00 AM d67ed966ea254a6b95e5fb2ec03eb9ae BRIJAODO 3 JM 3 9 2007 9 01 00 AM O 0 O 0 5c168 98729d409b8c2bb2a82e7df4doe BRIJAOO0 3 JM 3 3 2007 3 01 00 amp M EET CNN RET 3 9 2007 9 01 00 AM dl 2c2bf8c5deca44a7b03070b974326ec3 v gt Figure 95 Unprocessed Charges screen If there is a red x in the Transaction Status column for a line click Edit to open the details and see the problem with the transaction 3 Select the check boxes in the Post column for the transactions you want to post 4 Click Post to update your patients accounts User Guide September 2012 Release 18 97 Unprocessed Transactions Chapter 16 Entering Transactions 98 User Guide Relea
164. the program To open Program Options Onthe File menu select Program Options Program Options a MBACKUP EXE LT LMSE K SEES Figure 38 Program Options screen TIP For most users the default settings on the various tabs on the screen are sufficient for initial use You can customize these settings at a later date Each tab features settings for different functional elements in the application For more information on the available options and settings see General Tab on page 169 Data Entry Tab on page 170 e Payment Application Tab on page 171 Aging Reports Tab on page 172 e HIPAA Tab on page 173 Color Coding Tab on page 174 Biling Tab on page 175 e Audit Tab on page 176 User Guide 32 Release 18 September 2012 Chapter 3 Creating a Practice and Setup Overview Setting Program Options BillFlash Tab on page 177 User Guide September 2012 Release 18 33 Setting Program Options Chapter 3 Creating a Practice and Setup Overview 34 User Guide Release 18 September 2012 Chapter 4 Security Setup Overview Basic security in Medisoft is practice based with each practice having various users and groups Multiple practices require security setup for each database Setting up security is a two step process 1 Create users giving them a login name password and access level 1 5 The access level determines which areas of the practice a user
165. ts are calculated on all charges and any charges over the calculated allowed amounts are automatically entered in the Adjustment field You can open and change Program Options that are applicable to this screen by clicking Options in the bottom left of the screen TIP Be sure to click Save Payments Adjustments before closing this screen or transactions cannot be created 7 Click Close EOB Payments Part of the payment structure to a healthcare office from an insurance carrier involves a check and an Explanation of Benefits Widely known throughout the industry as the EOB it lists claims for which payment is being made and in some cases an explanation of what is not being paid and why Not every insurance claim that is filed with a carrier is paid in full It may be that payment is 80 percent of the claim or it may be 50 percent Other times a claim may be totally or partially disallowed The EOB explains in these cases Normally the part that is not paid by the carrier is picked up by a secondary carrier or charged back to the patient User Guide 126 Release 18 September 2012 Chapter 20 Applying Deposits Payments Managed Care When a payment is received a transaction must be entered to offset the charges This is done by creating a deposit in the Deposit List screen If the payment covers several charges distributing a payment to specific charges can be handled by clicking Apply Then select the patient records and claims to b
166. u create claims using Revenue Management Medisoft gathers data for each claim using these rules looking first at rules that apply to an insurance company or provider It will compare these rules against rules set up for facilities or referring physicians The specific order in which Medisoft analyzes rules follows the order of fields on the level it is working on For instance when looking at practice information it will look first at Providers then Insurance Carrier and so on moving from left to right on the grid Practice Information DER Practice Practice IDs Practice Pay To Statement Pay To Provider Insurance Insurance Facility Taxonomy Tax ID Provider Class Carrier Class Code Code SSN Legacy 1 Legacy 2 MM all All All All GRPID REL all All All All Lee Grp ID WH All All All All Hen Grp ID MM all all all All Med Grp ID MM All all All All Caid Grp ID Al All Al All Blue Grp ID MM Pe a REN 77777 NN a Edit x9 New Delete 3f Print Grid Figure 31 Practice IDs screen with grid headings highlighted For instance if you are setting up a group practice with three physicians 1 Create at least one rule on the Practice IDs screen for general information that is common to all claims Apply this rule to all providers all insurance companies and all facilities assuming you have no facilities associated with your practice or all facilities would use the same details Include your group NPI taxo
167. umber 4 Select a value for the Resource field User Guide September 2012 Release 18 143 Find Open Time Chapter 23 Scheduling Appointments 5 Enter any notes about the appointment in the Note field If you want to create a new line in the note press CTRL ENTER 6 In the Case field the newest case entered for the patient appears To change the case to which the appointment is tied click the arrow to select the case Tip You can right click the field to create a new case edit the selected case or copy the selected case 7 Select a value for the Reason field 8 Enter the appointment length of time in the Length field Enter the date in the Date field 9 Enter the time in the Time field 10 Select a button for the Status of the appointment The default value is Unconfirmed 11 If necessary click Need Referral to indicate the patient does not have a referral for his or her visit 12 If the patient must make a co payment click Enter Copay This will open the Enter Copay screen on which you can enter the patient s co payment 13 Click Save The appointment appears on the Appointment Grid Find Open Time You can use the Find Open Time feature to have the program search for the next available opening for an appointment To do so 1 On the Edit menu select Find Open Time The Find Open Time screen appears Find Open Time x Day of Week 1 L th 15 i S ido Sun Thu Start Time 8 00 am M Mon
168. umber Unique Provider Identification Number UPIN Medicare number or Medicaid number Level One user This is a user with the highest access level in Medisoft often an administrator List screen These are screens that show lists of information such as providers insurance carriers and so on From these screens you can select an item to edit or create a new item for the list Mammography Certificate Number The Mammography Certification Number is assigned to a provider certified to perform a mammography and is required on all mammography claims National Provider ID This refers to a unique number for a physician or practice that identifies them User Guide September 2012 Release 18 185 Glossary 186 Open Item Accounting A type of accounting where charges and payments for patients remain on the books and are not lumped together at the end of a fiscal period or year Provider Class The provider class is a way of categorizing providers into groups Quick Ledger The Quick Ledger is a feature of Medisoft that gives a quick reference for transaction and other information in the patient s account Revenue Management This is the application that is bundled with Medisoft that enables a user to transmit claims and eligibility payments electronically Rules Rules are logic patterns set up in Medisoft to ensure that claims are processed correctly for providers and practices based on requirements set by the government an
169. urs Program Options 154 Office Hours Overview 141 Office Hours Setup 142 Open Item accounting 186 User Guide Release 18 189 Index opening a practice 23 Options and Codes tab 60 Other Information tab 83 overview reports 159 setting up a practice 12 overviews setup 24 P patient flagging 174 color coding 174 Patient Ledger 99 Patient List window 82 Patient Payment Plan List window 132 Patient Payment Plan window 132 patient payment plans 132 applying to patients 133 creating 132 patient records setting up 81 patient remainder statements 121 patients creating 82 entering 82 Payment Application tab 171 Payment Code 85 Payment Plan tab 133 payments applying to charges 125 entering 123 Payor Type field 124 permissions 38 Personal tab cases 88 Physician Signature on File 60 Policy tabs cases 89 practice creating 21 opening 23 Practice Information 41 Practice Information for a Billing Service 44 Practice Pay To tab 44 practice setup the right way 24 practices multiple creating 22 printing reports 159 troubleshooting 121 printing claims 107 190 printing collection letters 134 printing statements 115 procedure codes Amounts tab 70 General tab 70 Production Reports 165 program date changing 22 Program Options general tab 169 program options aging reports tab 172 audit tab 176 BillFlash tab 177 billing tab 175 color coding tab 174 HIPAA tab 173 Provider Class List 49 Provider IDs
170. verview You will use the Procedure Payment Adjustment Code screen to enter and edit procedure codes Procedure Payment Adjustment new General Amounts Allowed amp mounts Code 1 C Inactive Description Code Type Procedure charge v Account Code Altemate Codes rr Type of Service i Place of Service i Time To Do Procedure jo Service Classification A v Don t Bill To Insurance Only Bill To Insurance Default Modifiers Revenue Code Default Units National Drug Code Code ID Qualifier C Taxable C Patient Only Responsible HIPAA Approved C Purchased Service C Require Co pay HCPCS Code HCPCS Rate Code Figure 22 Procedure Payment Adjustment screen User Guide September 2012 Release 18 17 Setting up Your Practice Overview Chapter 2 Medisoft at a Glance The Patient screen is the main space for entering editing patient and information g 7 Patient Guarantor Collins Anorie L Payment Plan Custom Name Address Other Information Chart Number COLANOOO Inactive Last Name Collins Suffix First Name Anorie Set Default Middle N ame Lexie Street 2320 Sweetwater Lane Copy Address m City Roswell State GA Zip Code 30010 Country jusa EMail Anorie Colins myemai com Home 770 555 1000 Work 1 404 555 2000 Celt 770 55
171. w All Tickles Search Sort By Date Created w ListOny C Show Deleted Only ere elated Responsible T Patient Acti Statement Remainder Insurance Claim Claim Stat Follow L A Party Busch SE mU Number Balance Estimate Number Total SEE Date 3 16 AETOO COLANODO Call patient 0 44 00 0 0 00 Open 772772 M gt Add Items J Reassign s Print Grid s Print List Delete l Close Figure 127 Collection List screen What appears in the collection list depends on the user login Medisoft displays the collection list item for the current user unless the user has administrative access Administrators can choose to view all or selected users collection list items User Guide September 2012 Release 18 129 Adding a Tickler Chapter 21 Managing Collections and Small Balance Write Offs Adding a Tickler Ticklers are notes you enter for the Collection List that remind you to make efforts to collect on overdue patient accounts To create a new tickler 1 On the Collection List screen click New The Tickler Item screen appears Tickler Item new Tickler Office Notes Save Action Required l Cancel Responsible Party Type Patient Insurance Help Chart Number vol Guarantor vg Responsible Party v 9 Assign T o w e 1 Status v Follow Up Date Date Resolved Figure 128 Tickler Item screen 2 Complete the fields as nece
172. window 30 providers entering 47 setting up 47 providers rules rules providers 49 Q Quick Balance 101 Quick Ledger 99 Quick Statement option 100 R referring physicians rules creation 29 31 referring provider records 53 referring providers records 53 setting up 53 report searching for detail 160 report procedures 159 reports available 159 exporting 160 overview 159 printing 159 procedures 159 viewing 159 Reports in Office Hours 157 reports menu 6 reports overview 159 User Guide Release 18 September 2012 Index reprinting claims 110 reprinting statements 118 restoring hot backup 182 restoring data 180 182 Revenue Management 46 137 186 rules creating 24 facilities 64 S Save Report to Disk option 159 searching for specific detail in a report 160 security 35 setting up 35 security supervisor role 39 Send Facility on Claim check box 28 31 Send Ordering Provider in Loop 2420E box 62 Send Practice Taxonomy in Loop 2000A box 62 Setting an Appointment 143 setting permissions 38 setting Program Options 32 setting up eligibility verification 137 referring providers 53 setting up a case 87 setting up a practice overview 12 Setting up Case Records 143 setting up insurance carriers and nsurance classes 57 Setting up Patient Records 143 setting up patient records 81 Setting up Provider Records 143 setting up providers 47 Setting up Resource Records 143 setting up security 35 setting u
173. wing Future Appointments You can see the future appointments for each patient Future appointments can be scheduled for up to a year in advance When you open the Future Appointments screen however only the next 60 days of appointments based on the current system date will appear The future appointments that appear in this screen will change as the system date advances Using the Future Appointment List screen 1 Right click the patient s appointment on the Appointment Grid and select Future Appointments The Future Appointments List screen appears It will show you appointments for this patient for the next 60 days Future Appointment List next 60 days ni x Search for Fe Date Provider Time DEDE a es NN ESI LESUS 4GA4DWO000 22 Again Dwight 8 15 am 22 Again Dwight 7A 6 2012 3 00 am 15 MM 3 Print Grid 3 Close Figure 144 Future Appointment List next 60 days screen 2 Click Print Grid to print the list or click Close to exit Using the Edit Appointment screen Medisoft will also notify you if the patient has future appointments scheduled when you open the Edit Appointment screen 1 From the Appointment grid right click an appointment and select Edit 2 Press Tab to move the cursor to the Home Phone field User Guide September 2012 Release 18 149 Using the Edit Appointment screen Chapter 23 Scheduling Appointments 3 If the patient has future appointments scheduled you
174. y The Apply Payment to Charges screen appears Apply Payment to Charges oreren Dese osse ce ues rom oro rive wwe ume __ sss sonam eme peel ear cn M MEL anM Figure 94 Apply Payment to Charges screen 10 Click in the This Payment check box and enter the amount to be applied Option Use the Apply to CoPay or Apply to Oldest buttons to automatically apply the payment 11 Click Close Note that the Unapplied amount on the payment line changes WARNING McKesson recommends that you apply all payments and adjustments to charges Failure to do so results in other parts of Medisoft not functioning properly i e remainder billing and the delay secondary billing feature Advanced and Medisoft Network Professional to name only two In addition some report results will be incomplete or inaccurate 12 Click Tax if you need to add sales tax to the charges 13 Click Note if you need to add further detail for a charge line This may include detail for claims User Guide September 2012 Release 18 95 Chapter 16 Entering Transactions 96 14 Click Save Transactions User Guide Release 18 September 2012 Chapter 16 Entering Transactions Unprocessed Transactions Unprocessed Transactions The Unprocessed Charges screen provides an interface between an Electronic Medical Records EMR service and Medisoft via Communications Manager see Communications Manager on page 185 Transactions that come from
175. y Provider Insurance Breaks down financial activity by day or and Procedure month The summary reports summarize financial information entered for each provider procedure or insurance carrier respectively Collection Reports NOTE This is an Advanced and Medisoft Network Professional feature Report Description Patient Collection Report Contains information based on statements marked Sent in the Statement Management screen showing what has not been paid statement date and so on Also select this Patient Collection Report to generate the report with statement notes included Insurance Collection Reports Shows the claim data what amount is outstanding and so on These reports also offer variants that include claim notes Patient Collection Letters Printed in preparation of collection letters It contains information from the collection list and is used to help evaluate collections Collection Tracer Report Reports how many collection letters have been sent and when Each time collection letters are printed Medisoft by default keeps track of each letter sent User Guide 166 Release 18 September 2012 Chapter 24 Reports Audit Reports Audit Reports Report Description Audit Generator Creates a data audit report that contains only the information you want included in the report This report is intended as a protection for the practice to keep track of cha

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