PTOS 5.0 New Features Guide
Contents
1. is a drop down in the Patient Editor HCFA tab Locate the button in the top section Additional CMS 1500 HCFA Boxes eClaims Attach Info This is where this new option has been added eClaims Attachment Information Attachment Control Number Remember to remove this information after processing the claims that require attachment information in order to avoid having these details sent on all future claims generated eClaims 5010 Zip Code Requirement The eClaims 5010 standards require a 9 digit zip code for both Billing Provider address and Service Facility Address Please note this change and update your zip codes for those addresses in PTOS prior to sending 5010 eClaims in order to avoid getting eClaims rejection messages 12682 071411 11 PTOS 5 0 New Features Guide2. the defaults if necessary or simply save the payment if all the defaults are correct Claims There is improved flexibility managing claims and ERA Select and Close Multiple Claims from the Claim Queue Multiple claims may now be closed at one time in the Claim Queue through Billing Claims Check all the claims that are to be closed and click the Close Claim button The Closing Insurance Claim window will appear for each claim prompting the user on how to handle additional insurance or adjustments once the claim is closed 6 PTOS 5 0 New Features Guide II tt AP Puy o A e Close Claim from Patient Editor When inactivating insurance if there are outstanding claims for this insurance the user will be taken to the Claim Queue to close the claims After reviewing and closing the claims the user must close the Claim Queue and then will return to the patient insurance window to complete the insurance inactivation This happens from Patient Editor Insurance Tab select insurance and choose the Inactivate gt 2 ind cn hase Fo Me lere e Pr A owe Hae fee ta tr rbado A wet Le e Path Mos eh be herset Ati eet Type ma ed Lea Ne Adipentes Sure Ier eid Pen bac h bvss mes LITT ny Wow ct Mira S frui ral Pg hans lepat 4 ben rm remet sil tamstos bon theres orm Change the Patient s Insurance but Leave Current Claims Open If Inactivate is selected and there are open claims or unprocessed charg
3. PTOS 5 0 New Features Guide Volume 1 O 2010 Patterson Medical Supply Inc All rights reserved Microsoft and Windows Explorer are trademarks of Microsoft Corporation All other trademarks which appear in these pages are the property of their respective owners COPYRIGHT NOTICE This software and operations manual are both protected by U S Copyright Law that Title 17 United States Code This software and publication have been provided subject to a license agreement which restricts their use No part of this software or user manual may be copied or distributed disclosed transmitted or reduced to any electronic medium without the express written permission of PTOS Software A Patterson Medical Company Infringement of copyright can result in criminal prosecution fines and imprisonment in addition to civil damages DISCLAIMER This software and manual are provided on an as is basis Except for the warranty described in the PTOS software license agreement there are no warranties expressed or implied including but not limited to implied warranties of merchantability or fitness for a particular purpose and all such warranties are expressly and specifically disclaimed In no event shall PTOS Software A Patterson Medical Company be responsible for any indirect or consequential damages or lost profits even if PTOS Software A Patterson Medical Company had been advised of the possibility of such damage Patterson PTOS 2202 A
4. e Filled Out On the HCFA Forms Primary Insurance Secondary Other Insuran Leave blank ARALAR AR Box 9 Fill out with other insurance infor y Box 9 FTETTITTPPTTTETTTTPTPPETTTTPPEPTTTPTPTETTTTEPEPETEPTPPEPPPTTTETTTTPTTTTTTTTTTTETTTTTTTTTTT Box 11 11C Fil out with primary information y Box 11MC Fil out with primary information Box11D Y m BoxlID 7 Print Primary Care Physician in Box 17 Leave box 24J WHITE Blank HCFA Box 17A UB04 Box 76 Qualifier D 1 Use Provider SSN HCFA 25 UB04 5 Print UPIN in Box 17A 7 Print One Date Per Page Include Taxonomy for eClaims V The Following Boxes are Filled Qut On the UBO4 Forms UBO4 Print Entire Date Range in Box 6 i Print Rev Code in Box 44 of UB04 Summary Y Add Leading 0 to Rev Codes Print Modifier on HCFA UBO4 Iv mi For UBO4 use only UB04 VISIT Rev Code Y Modifier prints in BOX 42 N Default code prints in BOX 42 Print NPI in Box 56 l Blank Default code prints in BOX 42 Modifier prints in BOX 44 Enter Charges Charge Limit Warning Provider charge limits will now automatically reset according to the effective date entered for the patient To access Charge Limit go to Patient Editor Bill tab It is located in the upper right hand of the Screen 4 PTOS 5 0 New Features Guide 12682 071411 ld mt 4 2 a be dee bm c o oe nal S i ononpi n EOD a A A j tare Esqui al bo
5. es for this insurance a new warning will appear e Yes will take you to the claims queue where you can review and close any outstanding claims for this case prior to inactivating the insurance 12682 071411 7 PTOS 5 0 New Features Guide 12682 071411 e No will continue the insurance inactivation process for this case but will leave outstanding claims in the claims queue e Cancel will abort the insurance inactivation process Inachyating insurance JEST INSURANCE CO for case number 1031 There are processed or unprocessed charges for this insurance priority Would you like to review outstanding claims for this case now Selecting Yes will take you to the claims queue where you can review and close any outstanding claims for this case prior to inactivating the insurance Selecting No will continue the insurance inactivation process for this case but leave oustanding claims in the claims queue Selecting Cancel will abort the insurance inactivation process Recreate a Claim without having to Submit it for Processing Electronic or Print When the user chooses to recreate a claim he she now has the option to Send to Queue Open This option is available from the Recreate Claims window To get to the Recreate Claims window go to Patient Editor Cogwheel Recreate Claims This option is for all types of claims Primary Secondary etc and will be sent directly to the Claims Queue as Open s
6. ility If any other POS code is used Ex 12 Home 13 Assisted Living 14 2 Group Home 21 Inpatient Hospital the new button Alternate Place of Service Address will be enabled Location Address and identifiers can be entered for services performed outside of the office Complete the information for the Alternate Place of Service POS and click OK Alternate Place of Service Location Mame Address City State E ip Box 324 Box 326 Nis PTOS 5 0 New Features Guide 12682 071411 HCFA Box 11A C Secondary Claim PTOS allows several options for how to populate HCFA boxes 9 and 11A C With this release an additional option has been added allowing the user to print primary insurance information in boxes 11A C on secondary claims and also provides the option to leave box 9 blank To set this new option go to System Tasks Update Lists Account Types Patients Scheduling Documentation Biling Reports System Tasks Special Tasks Tools Window Help Exit f Patient Editor 5 Payments Adjustments gt WorkList 8 Scheduler Patient Chart NET tM Ll Account Type Code Name lec BCBS Place of Service m Co Pay Amount 0 00 Charge per day 10 00 Ins Cap Amount 10 00 Accept Assignment Inactive V Print Subtotal on Each Page Posting Note i Patient Statement Notes CCI Dataset Test 1 CCI zil LCD Dataset Test 1 LCD y The Following Boxes ar
7. kground Image and check this feature to have the main screen appear upon opening the software Uncheck if the main screen is not wanted upon startup HIPAA ASC X12 Version 5010 Standard The HIPPA 5010 standard for electronic claims and ERA is an industry mandate with a deadline of January 1 2012 This new standard is utilized when processing both eClaims and ERA 12682 071411 1 PTOS 5 0 New Features Guide Scheduling Documentation 12682 071411 Only the Professional Claims 837 P and Remittance 835 are included Institutional 837 is not included All Institutional UBO4 claims will be handled the same as in Version 4 5 If you are using PTOS eServices the transition to 5010 will be seamless If you are using another clearinghouse for electronic claims please visit www ptos com 5010 for instructions on downloading a 5010 test file to be sent to your clearinghouse for approval prior to loading PTOS 5 0 NOTE This change only applies to electronic claims If you are using print image output files or paper claims you will not be impacted See eClaims below for more information To inquire further about PTOS eServices call 800 824 4305 Scheduling has improved print options for various scheduler increments To access print preview go to Scheduler and click the Print Preview button in the upper right of the screen Click Ok The printout should match what is on the screen d Updates were made to various d
8. lthoff Dr Effingham IL 62401 Technical Support 800 824 4305 Technical Support Fax 217 342 4571 Sq PATTERSON 12682 071411 li PTOS 5 0 New Features Guide Contents Overview of New Features 4 PTOS 5 0 New Features and EnhancemMentS ccccccooccnnccccnnccnnccnnnnncnnnnnnnancnnononanncnnnnonnns 1 Main Screen coris eH ETT 1 HIPAA ASC X12 Version 5010 Standard occcccccnocccnncccconccnncnonancnnonononnnononononnnnnononannons 1 ejes 2 B sfetlisi quce m 2 Edi AAA e eE O regem tdeo Dur abu a culode V tartan alan 3 silo ial 4 EILer Gates arinaren q rut extus UnisvdioUELUM d UBUx s TURO a Vales m M Led tini 2s 4 A T m 5 dM A e e Uni oo PO EE ATETEA A ETTE 6 SC EE q y AAA AE oo o o e D E THE ETHER 10 12682 071411 iii PTOS 5 0 New Features Guide Overview of New Features PTOS 5 0 New Features and Enhancements This release is designed to enhance some of the existing features providing speed and flexibility in addition to new features that have been requested or required The following will provide additional information pertaining to PTOS 5 0 If after reading this you continue to have questions please contact our support team at 800 824 4305 Main Screen Graphics A new preference has been provided to allow for turning off on the Main Screen graphic logo To access this preference go to Special Tasks Show PTOS Bac
9. n Dale Paint ed e Md Veet tome Tate Fui m ate LA BATES t3 pr ILS Thee gt west bond santium emer om D aat ms on Uerum per Duy te Pa Pat mnt frt Perast netus Pom LII xl Them Pred E attend U rd Pa Mel tayip Tm e hoyr Debes mbr Aa Posting Payments Multiple Users There is improved functionality for users posting payments simultaneously in various payment windows Multiple users may now post payments at the same time Default Adjustment Group and Reason Code The default Adjustment Group Code and Reason Code will now default when using the Auto Adjust feature in Config Parameters 1 To set the Auto Adjust feature go to System Tasks Supervisor Config Parameters On the upper right hand side select Billing In the lower table select Billing Auto Adjust Yes Select Edit to change the appropriate value of Yes or No 5 PTOS 5 0 New Features Guide 12682 071411 2 To set the default Adjustment Group Code and Reason Code go to Billing Insurance Billing eClaims Setup tab The eClaims Provider must be set to Emdeon This feature is NOT available to those using Other clearinghouses To the right there are two drop down fields This is where the Default Adjustment Group Code and Default Adjustment Reason Code are set Click Save Now when making adjustments through the Insurance Payments and or Bulk Payment windows these codes and adjustment amounts will be defaulted The user can change
10. ocumentation templates to no longer require the user to enter comments in order for a selection to print 4 i ated A ET ates Siw Bao den Tm Sperwlatje Tp wo Heb EM Favor ES T Paynet Adhecmerts Woa Schedue Facer Cat EIE 2l E 2 PTOS 5 0 New Features Guide Insurance Billing 12682 071411 HCFA Box 32A Enter an Alternate Place of Service POS There is a new ability to enter an alternate address for Box 32 on the HCFA form This area allows for entry of place of service name address and Box 32A 32B identifiers To enter an alternate POS go to Patient Editor HCFA UBO4 tab In the top section for Additional CMS 1500 HCFA Boxes there is a new button next to Place of Service 24b Alternate Place of Service Address Pailin S atus E CATE TETTEI Ont apes Cute gt hr TS Ad howto Pep treet to Office L9 H Hem LOCUM fee A dsl hm ti ad n Pr M omes oem Fira Codi aee gt i helado 116 S Sel tt pattern Mase hasi tame nuls Hbri qure Pet Gee 115 Prem Debes pation ads te arb ax corem excwppatass 114 final aliu bee daos cod bo cese vereor EH Pow bree ad Uwe onm 1 Server es perras by Du stie do 120 bot tory wenn ud and He eteeeteetes Cod 1 Pio nw Serm ric ehes ttn If the default POS of 11 is used the information in box 32 will print as it currently does using the treating facility information found under System Tasks Supervisor Fac
11. ogwheel to Recreate a Claim This can also be opened from Patient Editor Cogwheel Recreate Claims eClaims eClaims Attachment Information Additional types of attachments have been added to the drop down lists that relate to eClaims The drop downs can be located in the Patient Editor HCFA tab Locate the button in the top section Additional CMS 1500 HCFA Boxes eClaims Attach Info j m qe i gt r AA MIA mni B m o S A bbw mlt thew Poteet Sane DR muss feebend ated bes cand conser on gt Ass ghe fer dee n l r te Falani ii aredi D See Dam paient arch iu mr am A ri e L1 wd A 19 7 g imd fes Lan d uino Reo 18 VAM cmt dus Be Verum on pertieweest by hieste i ab N ber ona Mene Payant to LM e NCP A Ree LAD s 10 y e 206 Rosen sie T7 Mari an em TT at aate Pura ear ESAE CC Attachment Report Type Code In the Attachment Report Type Code drop down list additional codes have been added for more accurate reporting eClaims Attachment Information 1 bu O Attachment Transmission Code Remember to remove this information after processing the claims that require attachment information in order to avoid having these details sent on all future claims generated 12682 071411 10 PTOS 5 0 New Features Guide Attachment Transmission Code A new option of File Transfer FT has been added under Attachment Transmission Code There
12. tatus Create a New Claim without having to Submit it for Processing Electronic or Print When the user chooses to create a new claim there is now the option to Send to Queue Open This option is available from three locations the Insurance Billing Sort Tab Option 1 below from the Close Claim window Option 2 below and from the Create Additional Claims window Option 8 below 8 PTOS 5 0 New Features Guide 12682 071411 Option 1 E a y me y 0 ye po e ye j e ce ee ees m re te Option 2 Closing Insurance Claim me gt gt p 1 De a a gt a o c C _ e r Coy Patient Estimated Total Less Total Paid Amount Unpaid By Insurance D BILL TO Ok p Cancel a Option 3 Create Additional Clim Create Additional Claim For Insurance a 3 nd to Qu 5 end to Que e Process noig f ET Open PTOS 5 0 New Features Guide Recreate a Secondary Claim without having to Recreate the Primary Claim Offices may have the need to recreate or reprocess a secondary or additional claim without having the need to first recreate the primary claim PTOS 5 0 allows users to skip the step of recreating the primary From the Recreate Claims window users can highlight the secondary or additional claim and choose to recreate it This occurs under Billing Patient Transactions then access the C
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