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5. HWI Claims Manager User Manual

1. Saan Log Screen Review Response Transmission Log Screen Review Log Response Report Healthware Figure 1 0 HWI Claims Manager Functional Flow Chart On successful completion of the transmission of a Sent batch to Healthware a copy of the Current batch 1s saved called the Saved batch and the Current batch 1s deleted The Sent Rejected and Saved batches are kept in the computer for future reference they are named using a common file naming scheme The batch files names are of the form XOMMDDSS where the X 1s a character den oting the batch type V for Sent verified J for Rejected for Saved Copy MMDD is calendar month and day when the batch was created and SS is a 2 digit sequence number designating which batch that day allowing for multiple batches on one day For example if a batch edit were run on July 4 the first Sent batch that day would be named V0070401 Rejected claims would be stored in batch 70070401 and the copy of Current batch on successful transmission of the claims would be Saved in the batch 0070401 The major functional processes in the HWI Claims Manager are indicated by the numbers in the process rectangles of the chart and each is outlined in the sections below 1 Create Electronic Claims Before this step can be performed electronic images of the ADA forms that are to b
2. 5 18 02 1 bz 13 Dental Cl ICD Andrew J 06 18 02 4 202 00 14 Healthware Dental CI 1CD Aet Release Jordan M 06 18 02 196 00 15 Healthware Dental 160 Tony E 06 1 02 3 131 00 16 Healthware Dental DEL Detail Amanda 5 18 02 4 217 00 17 Healthware Dental CI Gua check Disposition Ichell Doug 06 18 02 2 36 00 18 Dental Cl chell Joshua 0618 02 165 00 18 Healthware Dental CI 1 0 DEL Rewiew Notes Adam 06 18 02 4 696 00 20 Healthware Dental ICD Print Form sley Brionka 06 19 02 4 134 00 21 Healthware Dental CI ACD ASF seen James 06 19 02 1 157 00 Healthware Dental elD SBC Jessie 5 18 02 3 199 00 23 Healthware Dental 160 Delta earce Dorothy OG 04 02 1 25 00 24 Dental CI Delta Dental Of MI Slusser Ashley 06 19 02 4 149 00 4 k 24 Total Claims Bb Services 5844 00 Charges List Batch Crean ave Cancel Figure 2 2 1 1 View Claims Batch Window The Claim Type is 3 character code where the first character is 1711 the patient has single coverage 2711 there is dual coverage The second character is C 1f the claim is claim for service or the claim is an estimate only pre determination The third character is D if the insurance pays the doctor or a P 1f it pays the pati
3. CETTE TE 3 M ret E Haaxitnzaire F orket 15 P a Bax 140601 haket DONE Ev d pip P L i aa 2 a a a 11 Haalbnwirs Cambal Ob imig niab payr md d bum md 1621 44th L m BEBE orl SRITLLATE Pr ail Rae 10 0802 gait 4 Ac JE 2 gt American Dental Association 1884 JADA term 25104 HealfrWare Ine St y Trag MI Fubenipa Delta Dental HI 9085 Farmington Hills HI 83 krmearj Stabe Of Hinhigan B7UDs1D21 UH Hara aei sida eee zB
4. 48 Find Saved Batch Previous Make Current 0120501 20120301 20120201 C0112601 C0111802 C0111208 0010601 20111901 C0110832 C0110831 C0110806 Cancel C0110804 0110002 Pick Date C0110801 7 Figure 2 2 3 1 Find Saved Batch Window 2 2 4 Review Sent Batch This option is disabled if there are no Sent batches A Sent batch is a copy of a batch that was transmitted to Healthware When you select this option a window like the one shown in figure 2 2 3 1 above will display except that Sent batches will be displayed in the ist box titled Previous Batche s You may select a previously saved batch exactly as described for Sent batches in section 2 1 5 above When you click Okay button a window like the example in figure 2 2 1 1 above will display The operation of the program is identical for a Saved batch as it 1s for the Current batch as described in section 2 2 1 except that the claims displayed will be those of the Saved batch which you selected 2 2 5 Review Reject Batch 2 2 6 Review Edit Report 2 2 7 Review Response Report 49 2 3 Drop down Setup Menu When you click the Setup menu bar selection on the HWI Claims Manager main window the drop down menu shown in figure 2 3 1 below appears m HWI Claims Manager Options view Setup About M Provider Setup B Environment Setup Printer Setup Claim Screening Setup Procedure Gro
5. 121 00 Exit Figure 2 2 1 3 View Claim Window This window displays all of the key data elements of the claim Basic patient information is shown in the Patient frame at the top of the window Below that treating provider information is shown in the Doctor frame The Payor frame middle left of the window includes claim payer and insured information To the right of that other payer information 1 shown in the Other Payor frame there 1s one If the claim has no other payer this frame is disabled At the bottom of the window all procedures in the claim are listed in list box Up to six can be displayed at once and if there are more scroll bar will appear at the right edge of the list box If there are any notes attached to the claim they are recorded in appended procedure items which will be displayed in the procedure list with procedure code NOTE and the actual note text shown in the procedure Description column s of the list box The total number of procedures in the claim is shown in the text box at the lower left of the window and the total charges in the claim 1s displayed at the lower right 38 Six action buttons are available the screen one at the bottom center Change Notes and five erouped at the lower right of the window You click the Change Notes button to review change any notes on the claim Claim notes are any text that would print in the Remarks for unusual services box on the
6. the screen even when the Desk top 15 not Between the Quick Start icons and the Sys Tray on the task bar small windows are displayed for each open application running in the system In the example above there are two applications running the Word word processor and the HWI Claims Manager These small windows look like Action buttons but they have labels that contain the first few words of the application s Title Bar text The window representing the currently active application looks like button that 15 pushed HWI Claims Manager in the example above 1 3 HWI Claims Manager Functional Overview The flow chart shown in Figure 1 0 below depicts the overall functional flow of the HWI Claims Manager In the diagram symbol legend is shown to indicate the meaning of each of the shapes used in the flow chart The process begins at the top of the chart when the Office Management system OMS produces hard disk images of ADA claim forms Finally at the bottom of the chart an electronic version of these forms is transmitted to Healthware The chart depicts the major functional steps performed by the HWI Claims Manager The details of how to perform them are discussed in Section 2 of this guide In addition the chart shows the key elements of data storage that are created and stored by the system There two categories of stored data reports and claims batches There are three types of reports edit reports transmission log and r
7. up to 6 months later online storage and instant retrieval of all claims batches submission and response reports for 9 12 months the ability to produce an ADA2000 or ADA1994 hard copy claim for any electronic claim stored of these facilities any many more are discussed in detail in the following sections 1 2 Terminology To best understand the contents of this guide you should be familiar with basic windows terminology used in the narrative These terms are used in all windows books and manuals and are common to most windows applications If you are very familiar with windows jargon you may skip this section The following terms describe the elements of a windows screen display OWindows 95 95 SE ME 2000 are trademarks of Microsoft Corporation Window rectangular section of the screen displaying information related to specific program application The size of the window can vary from the as large as filling the entire screen to a tiny box on the screen Several windows can exist on the screen at one time meaning that several tasks are using the computer at once and they can display separately or they can overlap Usually only one window 1 active at any one time The active window is the one that accepts operator input any responds to that input with changes in the window display Title bar the bar along the entire top of a window which contains the title of the program application displaying the wind
8. Electronic Claims Batch Before this step can be performed electronic images of the ADA forms that are to be sent to Healthware must previously have been produced by the OMS The details of performing this 11 task are outlined in Appendix In general special printer is set up in your Windows system that is defined so that when forms are printed to it they are written to the hard disk rather than going to a printer All electronic claims are printed by the OMS to this printer The HWI Claims Manager Create Electronic Batch process 1s initiated by clicking the button to the left of the Claims to Batch message in the main window see figure 2 0 above This 1s only possible of course when there are some claims to batch When you click this button a window will appear showing the progress of the conversion with a message and progress bar indicating the percent completion of the process as shown below Creating HWI Electronic Batch Converting Form 5 Of 29 7 In the special case where the OMS uses raster graphics to print insurance forms this window will also contain a large grey box used to display raster image fields found on the insurance form This in only done when the program detects a character in a raster image field that it has not previously seen before and it displays it for you to confirm what the character 15 The window below shows an example of this procedure Creating HWI Electronic Batch Conve
9. When you click the Query Batch Status option the Find Sent Batch process described in section 2 1 5 above is started Once you have selected the batch you wish to query and clicked the Okay button the confirmation screen described in section 2 1 5 2 will appear and you should confirm the claims services and dollar amounts before proceeding The big difference here is however when you click Yes to query batch confirmation you are not sending the batch to Healthware rather you are sending a request Healthware to tell you if it has received that batch and to report to you the details of what it thinks are in that batch As the query transmission proceeds it behaves just like it does when you are sending a batch as described in section 2 2 0 2 but an actual batch 1s not being sent On conclusion of the transmission the expected Received Counts Verified message in the case of a query means that Healthware has that batch and it contains exactly what your system says 1s does claims services and total charges 2 1 8 Review Change Raster Table Option This option as enabled ONLY if you have an OMS that produces claim forms that include raster graphics eg Dentrix version 9 Raster graphics is a special form of image printing that requires a table of raster images to extract data from the OMS printed claim form This menu option allows you to view and maintain that raster table Figure 2 1 8 1 below shows the window that displays when you choo
10. held batch 1s used automatically by the program to store claims waiting for the transmission of electronic attachments to NEA if you have activated this feature in the program see Appendix B When this feature 1s installed claims are automatically held when claims requiring attachments are created and released when attachments are transmitted to NEA 206 When you are finished holding claims from the batch and want to save the results save the current batch with held claims removed you must click the Save button at the bottom of the batch display window When you do confirmation window asking Update Batch will display exactly as it does when you save after deleting claims described in section 2 2 1 1 above If you click Yes the selected claim s will be removed from the current batch and all claims that had been held will be appended to the held batch If you click No the application will resume without taking any action If you click Cancel the HWI Claims Manager application will terminate 2 2 1 5 Release Claim s The function of releasing claims refers to removing them from the held batch and placing them in the current batch If you have never previously held any claims there is NO held batch and the release function will not be enabled The first time you hold a claim the held batch will be created There is only one held batch and it is maintained perpetually on the computer Note therefore that once you have hel
11. that 9 months of saved batches will take around 10 20 Megabytes of disk space When you click this option a window like the one in figure 2 1 11 1 below will appear This display informs you of the total number of batches of ALL types that are currently saved on your computer and the number of them that are older than 9 months It also tells you the total amount of disk space that is used by the saved batches as well as the amount of space that will be freed up if you remove the batches older than 9 months If you want to use a purge limit different than 9 months you click the Select option on the first line of the window figure 2 1 11 1 If you do this a window will display asking you to enter the purge age number of months that you want to use After you have entered this new age the window below will re display with the figures changed to reflect the new purge limit you specified If you wish to proceed with the purge you click the Yes option on the first line in the window When you make this selection the Purge button at the bottom of the screen will become enabled To proceed with the purge you must then click the Purge button Purge Oldest Claims Batches Purge All Batches Older Than 9 Months C Yes No Select Of the 808 Total Batches 281 are Older Than 9 Months Total Space Used 23 016 MBytes Older Batches Use 4 310 Purge Figure 2 1 11 1 Purge Claims Batches Window When the purge is com
12. window like that shown below will appear Current Batch Exists A Curent Batch Already Exists with 29 Claims 22 Replace it With These Claims or Append These Claims to 1E Heplace Append This tells you that you have previously converted some claims into the current batch and they have not yet been sent to Healthware If you want to add the claims you just converted to those that were already there you click Append If you want to replace those that were already there with those that you just created you click Replace If you are not sure what to do and wish to abort the conversion you just did click Cancel and the results of the conversion process will be completely ignored When you click Replace or the claims you just converted will replace add to the current batch The second line on the HWI Claims Manager main window Claims to Transmit message will be updated to reflect the total number of claims in the current batch At this point you may wish to examine the claims that are the current batch in detail This 15 done by choosing the View menu option on the HWI Claims Manager window then the View Current Batch option see Section 2 21 below With this feature you may examine delete individual claims in the batch print them to ADA forms and or add notes to them 2 0 2 Editing Sending the Claims Batch When you have completed the preparation and manipulation of all clarms you wish to send to
13. you to review and or change any note text attached to the claim selected When you select this option the window described in figure 2 2 1 4 will display This window contains several text boxes verifying the patient doctor payer and a large text box titled Note Text where the note textis displayed Note text can only be a continuous stream of text without indentation tabulation or paragraphs You can edit the contents of the note using standard windows cut and paste The Erase button on the screen can be used to clear out all of 22 the text and the Save button in clicked to signal you want to save any note changes you made If you click the Exit button none of the changes you made if any will be recorded 2 2 1 9 Print ADA Form Option The Print ADA Form drop down menu option will print one or more copies of an ADA form for the all claims that have been selected on the batch view window When you choose this option the process of selecting a printer ADA form type and number of copies described in section 2 2 1 6 2 above will occur 2 2 2 Review Held Batch This option is disabled if there 1s no Held batch there is only one Held batch The Held batch only exists if at any time you chose to Hold a claim or claims from the Current batch OR if you are using the NEA Fast Attach system see appendix B You can use the hold release scheme to place remove claims in the Held batch even if you are NOT using the NEA Fast Attach prog
14. 0 75 00 021028H 0006 021028 0030 021028 0033 02102840035 102801 041 Lee McFall DDS BCBS MI Alt Philip 10 25 02 120 00 Print List Exit 021028H 0041 Figure 2 1 2 2 Claim Look Up Display Screen actions are available as shown in the figure above The Review Notes Check Disposition and Print ADA Form sub menu selections are also described in section 2 2 1 below 2 1 3 Recheck Counts Sub menu Option This option causes the system to recheck the status message counts shown on the main screen This is done automatically each time the HWI Claims Manager is started so the only time you would need to do this is if the HWI Claims Manager were already running and something happened that might affect these counts like more OMS claims were printed to the HWI Forms Printer and you want to update the counts without closing the program Closing and re starting the HWI Claims Manager would accomplish the same thing 2 1 4 Install Program Updates Sub menu Option This option allows you to install any outstanding program updates that are pending on your system Periodically program updates may be transmitted to you automatically when you connect to transmit to us but they will never be installed without your knowledge When this 1 done you will be notified by Healthware via email enotes or telephone about the updates what they are and why they are needed and any special installation instructions Only when you are aware
15. 1 0 Introduction 1 1 HWI Claims Manager Overview The HWI Claims Manager is set of programs written for the Windows 95 98 SE ME 2000 family of operating systems It has been adapted to work with all major Windows based Dental Office Management System OMS software packages It provides a generalized interface between the OMS and the Healthware Inc s electronic claims clearinghouse Without any direct interaction with the OMS the HWI Claims Manager gathers claims from the OMS by capturing electronic images of paper claims forms produced by it It then converts these images into an electronic batch which is stored verified displayed manipulated and then sent to Healthware for forwarding to the insurance companies Extensive claims batch management features are provided that include editing of the content of the claims for basic data integrity before submission allowing the addition of manually keyed notes to any claim providing the facility to electronically hold and later release any claim that needs to synchronized with other office clerical action online storage and instant retrieval of all claims for 9 12 months the ability to instantly access any of these stored claims by patient name or claims reference number the ability to electronically cancel any claim that was sent to the clearing house only on the day it was sent the ability to electronically verify any transmission that has been completed after the fact
16. 1s displayed The frame at the top of the window contains nine Yes No option button pairs indicating various processing selections you must make Not all of the questions are used The set up questions you must answer are the following 51 HWI Manager Environment Setup Options Dr s Sig On File Force Assignment Auto Screen IG Ya C No Yes No 4042000 Form Option 5 EA Attachments P e Yes Internet Access Suppress Warnings Option 9 IG Yes C ET G No ADA Form nro Data Path Forms File forms ada67000 pel Figure 2 3 2 1 HWI Manager Environment Setup Window Dr s Sig On File Do you want to print SIGNATURE ON FILE in the treating Provider s signature box at the bottom of the printed ADA form Force Assignment Do you want to flag every electronic claim as Pays Doctor regardless of whether SIGNATURE ON FILE is printed on the OMS generated claim form in the assign benefits signature box If you choose No in this option the electronic claim will be flagged as Pay Patient if this SIGNATURE ON FILE is not present and Pay Doctor if it is present Auto Screen Not Used ADA2000 Form Do you want the default format ADA form to be the 2000 version If you choose No the default format will be the 1994 version Option 5 Not Used NEA Attachments Do you want to enable the automatic hold releas
17. 2 2 1 6 Review Change Claim Detail Window Doctor Tab 42 Review Change Claim Detail Flan Name No State OF Michigan Group 8700 1 021 Payor Insured s Employer Mame Delta Dental Mame State Of Michigan Addresst Box 9085 Sheet Address FEN City Addrezz3 Farmington Hills MI 484000 State vi Zip Insured Pays Doctor f Yes No 1st Name Dea Last Haverdink 4752 5 dire 5 Release Info Address renadire E Male amp Female ES Addess 7 Signature On File City wvaming Fhone C Wes No State MI zip 49509 Insured ID 2375 54 0053 Other Paid i Birth Date Patient s Relationship to Insured Erase All Sel C Spouse Child Other os 1352 Mon Day Year Changes Figure 2 2 1 7 Review Change Claim Detail Window Payor Tab Review Change Claim Detail Flan Consumer Energy Group 508538 Other Other Insured z Employer Mame U s Healthcare Mame Consumer Energy Address P o Bos 14091 Sheet Address Addrezz3 Lexington 40812 State vi Zip Other Insured Pays Doctor Yes C lat warren Last Haverdink Eo Felease Info Address 314 ves Male 4 Female Address Signature On File City wvaming Fhone Wes No State MI z
18. A form for the claim currently being viewed When you click it the following window will display _ 39 Print ADA Form Ready to Print Claim 1 x On 1994 404 Form to 24 Or Choose Another Printer Form gt Choose Ves If you click No the program will continue as if you hadn t pressed the Print ADA button If you click Cancel the HWI Claims Manager will terminate If you click Yes the claim s specified will print one copy each in the format specified ADA 1994 format or ADA 2000 format on the printer specified If you wish to change any of these printing parameters you click Choose and the following window will display Choose Printer Insurance Form Printer Insurance Form OKIPAGE 24 f ADA 1994 ADA 2000 Properties Other Cancel This window lets you choose which printer you want set its properties and which ADA claim format you want 1994 ADA format 2000 ADA format or Other a special format custom designed by request to Healthware You may also specify from 1 to 4 copies of every form be printed Once you make your selections on this window you begin the actual printing by clicking Okay on the Choose Printer Insurance Form window then click Yes on the Print ADA Form window 2 2 1 6 3 Review Chg This button allows you to see every item that is included in the electronic record of each claim When you click it the display will show
19. Forms ada93007 30702 06 18 02 16 53 d pp meg Dre Form s 30468 06 18 02 16 53 FO110505 HWI Forms adas33004 View Claim 30770 06 18 02 16 53 0110504 HWI Forms adas3005 Print Form 30836 06 18 02 16 53 HWI Formzs adaS93006 30326 06 18 02 16 53 HIT Forms ada93007 Exit 30442 06 18 02 16 53 F0103001 F0102806 F0102805 20102804 Pick Date Select Batch Figure 2 1 10 1 Restore Review Previous Printed Forms If you select View Claim the selected claim s will be converted and a batch display window as depicted in figure 2 2 0 2 below will display If you select Print Claim the selected claim s will be printed exactly as if you printed it from your OMS system 30 2 1 11 Purge Saved Batches This menu choice provides the ability to remove old claims batches from your hard disk when they are no longer needed Unless you perform this function periodically claims batches will be kept indefinitely on your hard disk In addition to using unnecessary disk space this will tend to be confusing since batch files are named by using month and day that they were created an NOT the year If you keep batch files more than year you will see batches on your computer that appear to be current but are in fact a year old It is a good idea to purge older batches from your computer and keep only the most current 6 9 months A typical one doctor office will find
20. Healthware you click the button to the left of the Claims to Transmit message on the HWI Claims Manager main window to start the Edit Send process 13 After confirming that you wish to perform the process detailed edit is performed the batch summary of the edit results is displayed in a window like the example if figure 2 0 2 1 below EDI Claims Batch Edit Pre Iransmission Edit Summary For Batch 0020201 Clamms Fre Auths Charges Frepared 29 83 5 870 00 Rejected 0 0 0 00 To Transmitted 29 83 56 870 00 First Claim Reference 020702H0001 Report Transmil Cancel Figure 2 2 0 1 Claims Batch Edit Summary Window The summary shows the number of claims and services and the total dollars in the Prepared Current batch as well as these numbers for the Rejected and To Be Transmitted Sent batches If you do not like the results of the summary you can click the Cancel button to abort the process To examine the reports created by the edit you click the Report button The window shown in figure 2 0 2 2 below will display You may scroll through the reports using the Scroll Page buttons at the bottom of the screen or the scroll bar on the right of the display window The Report Status boxes at the bottom of the screen display the position line and page number of the current display window in the report at any time The buttons in the Print frame allow you to prin
21. all you need to know you may click the Okay button to return to the HWI Manager main window If you want to see more detail about the transmission as well as all other recent transmissions press the Report button to display a successful transmission report like that shown in figure 2 1 9 1 below Review Print HWI kay txt 11 1172002 Successful Batch Transmissions 1 Batch Date Time Claims Secs Amount 1 0050603 5 37 2002 Pet Sa AM 2 4 2 086 00 2 90051601 5 20 2002 2 04 01 PM d 17 7 524 00 3 90051601 6 6 2002 1 47 07 PM 12 17 7 524 00 4 190061402 6 14 2002 2251736 PM 1 3 134 00 190081402 BET 2002 4 52 34 PM 19 4 359 00 amp 90091601 I 16 2002 5 03 03 PM amp l4 934 00 7 90092401 9240 2002 4 52 59 2 2 850 00 a wu nsz 7 z SET 0 23 31 AM 14 45 4 655 00 90092703 2002 2 49 29 PM 1 3 177 00 10 10102401 1072572002 1 26 29 AM 1 3 76 00 11 Wolozsol 10 28 2002 8 38 71 AM z9 5 844 00 Report Stats Current Page 1 Line 1 Page 1 Line 14 Figure 2 1 9 1 Review Successful Transmissions Report You may browse through the report on the screen or print a hard copy on the printer as described in section 2 0 2 above 29 2 1 10 Restore Printed Form s Option This option allows you to restore examine or print previously processed claim forms exactly as they were originally produced by the OMS When you create an electronic batch from the OMS p
22. at the bottom of the Edit Summary window in figure 2 0 2 1 the top window of figure 2 0 2 5 will appear This window displays a message indicating the status of the modem transmission in the box with the black background The status message 15 yellow to indicate that an operation 1 in progress green when an operation has completed successfully and red when an operation has completed with an error 47 Facility 7099999 Sending Batch 0111206 Tools About Vig Transmission Status Timeout Countdown Evil xl Tools About view Transmission Status Connect Tools About View Transmission Status Connect Figure 2 0 2 5 Modem Batch Transmit Windows When you see the status message Modem Ready Click Connect or Exit y ou normally click to Connect button to begin transmission The program will begin by dialing the Healthware modem number toll free and log on gain access with identification and password exchanges to the Healthware computer The progress of this process will be reported by messages displaying in the status box After log on is successful transmission of the batch will begin and a progress bar will appear at the bottom of the window as shown in the middle window in figure 2 0 2 5 indicating the progress of the transmission When the batch transmission is completed any response from payers concerning previously sent batches waiting at Healthware will be transmitted to you
23. atus messages in the body of the screen with small buttons to the left of each The first status message indicates the number of claims that have been printed by the office management system and are ready to batch into an electronic batch The second status message indicates the number of claims that have been batched and are ready to transmit to Healthware If you are using the National Electronic Attachment NEA Fast Attach software an additional status message will appear below the second message indicating the number of claims that are being held waiting for you to transmit electronic attachments with Fast Attach see appendix Using the NEA Fast Attach Interface amp HWI Claims Manager HN _ rl x Options View Setup About TP aims tof Fa i d fy i p Figure 2 0 HWI Claims Manager Main Window If you click the button to the left of the first message this button 1 only enabled if there are claims to batch the system will begin the process of converting the printed claim images into the electronic batch If you click the button to the left of the second status message this button is only enabled if there are claims to transmit the system will begin the process of editing then transmitting the electronic claims batch to Healthware These operations are described in detail in the Sections 2 01 and 2 02 below Section 2 1 below describes each of the Drop down menu options in detail 2 0 1 Creating the
24. bled will not respond to the operator If you click an enabled button this is a signal for the program to begin some pre defined action The action buttons in the example below are Choose Yes No and Cancel Print ADA Form Ready to Print 1 22 1994 Form to Okidata OL 9106 Or Choose Another Pinter Form Choose ves Example Action buttons Frame rectangular section of window enclosed by single line that contains title in the top left corner of the rectangle frame is used to enclose group of window elements boxes buttons and lists that are all related in some way eg all of the payer information on claim may be enclosed in frame on the claim display window The example below shows window frame enclosing all of the information relating to the Payer on claim Notice that there is an Insured frame within the Payer frame Text Box small usually single line box in window that contains single data element Usually text box has title displayed near the box which designates what the box contains Often the operator can position the screen cursor in box by clicking the contents of the box and can enter data into the box by typing on the keyboard There several Text boxes in the example above Name Address City Ste Zip etcetera Payor Name Delta Dental Of Michigan Address Po Box 9085 City Ste Zip Farmi
25. claims in the Reject batch will equal the claims that started in the Current batch There are many Sent and Reject batches one for every time you completed an Edit Claims process These batches are saved for 9 to 12 months after they are created The Held batch only exists if at any time you chose to Hold any claim or claims from the Current batch If and when you do so claim 15 removed from the Current batch and placed in the Held batch Claims remain in the Held batch until you later come back and Release them into the Current batch Whether and when you Hold and Release claims is entirely under your control this feature is provided for your convenience and is used in a variety of different ways in different offices to synchronize the submission of claims with other clerical activities OMS HWI Claims Manager Process Delete Printed Claim Forms EE M Report Ir OnHard Vy li j Disk Restore Saved Eu i TE ADAClaim Fa dl Form Images SYMBOL See Ls LEGEND Report Create 1 Electronic Batch Screen Batch Claim Review Saved PCL Forms Screen Display Batch Listing View Claims lt lt Review 5 Edit Report 2 35 TI o D Edit Report Review Review Response ER ue Transmissi Report
26. click No the batch you were viewing will be left the way it was before you started viewing it If after deleting a claim or claims on the window display you decide you do NOT want the deletions to take place you may click the Cancel button at the bottom of the batch display window When you do so the following confirmation window displays Abandon Changes X 7 Da You Want to Batch Changes gt JR cm If you click the Yes button in the above Abandon Changes window the original batch before you viewed it will be retained and none of the deletions will be permanently recorded If you click No the program will return to the display window as 1f you had not clicked the Cancel button 55 2 2 1 2 Cancel Claim s Canceling claim refers to the process of notifying Healthware over the modem that claim you previously sent to them should not have been sent and 15 NOT to be forwarded to the payer Since Healthware forwards these claims every night about 11 00 PM Eastern time claims may only be canceled from sent batch that was sent today Clicking the cancel drop down menu selection will cause any selected claim s to be removed from the displayed batch When you are finished canceling claims from the batch and want to save the results save batch with canceled claims removed you must click the Save button at the bottom of the batch display window When you do a confirmation window will di
27. closed Icon a small cartoon like picture displayed on the desk top or any other window which is associated with a particular application program action Each Icon has a text description below it on the desk top describing what the Icon represents You double click on an Icon to start the application action associated with it Task bar The bar along the bottom edge sometimes the right edge of the desk top It contains the Windows Start button at the left end of the task bar at the Sys Tray at the right end The Sys tray contains an Icon for each hidden Windows system task running in your computer programs permanently running behind the scenes that very infrequently need the attention of the user Ordinary users seldom have to concern themselves with the Sys tray it 1s really there for the systems administrator The Start button can be used to start all applications in the computer The most frequently used applications will have Desk top Icons but all applications will appear on the program menu list when you click the Start button Start button Quick start icons Open task windows Active task Sys Tray start MESNA mHwIUser doc Microso amp HWI Claims Manager SMO 4 42PM Example Desk Top Task Bar The icons just to the right of the Start button are called Quick Start icons They are placed on the Task bar for quick access to very frequently used applications since the task bar is visible on
28. d Once the batch you want to resend is highlighted you click the Okay button and the message box shown in figure 2 1 5 3 will appear Resend Batch X Resend Batch 0062102 Contains 53 Claims 143 Services and 9994 00 Charges Resend IE Ves Cancel Figure 2 1 5 3 Resend Batch Verification Message Box You must confirm that this 1s the batch you think it 1 by cross checking the claims services and dollar amounts If you are not sure you may view the batch by clicking the No button and proceeding to the View Sent Batch process described in section 2 2 4 below There 15 Resend option available on the View Sent Batch detail window When you are sure that this 1 the correct batch click the Yes button and the batch transmit process described in section 2 0 2 above will begin If you press the No button the program will return to HWI Claims Manager screen and if you press the Cancel button the HWI Claims Manager program will end 2 1 6 eNotes Sub menu Option This option invokes the eNotes window shown in figure 2 1 6 1 below On the top portion this screen lists a summary of all eNotes currently posted created and yet not deleted on your computer Once you create an eNote it stays posted until you subsequently Delete it The bottom part of the screen shows the details of any note that you want to create review or change To read the contents of an existing note you click in it in the li
29. d a claim it will stay in the held batch forever unless you subsequently delete it or release it The held batch is used automatically by the program to store claims waiting for the transmission of electronic attachments to NEA if you have activated this feature in the program see Appendix B When this feature is installed claims are automatically held when claims requiring attachments are created and released when attachments are transmitted to VEA You may use this release function if a claim to an NEA payer was held automatically when initially processed then you decide that you will not send an NEA attachment and thus release it automatically In this case you can release it manually with this function When you are finished releasing claims from the batch and want to save the results save the held batch with released claims removed you must click the Save button at the bottom of the batch display window When you do a confirmation window asking Update Batch will display exactly as it does when you save after deleting claims described in section 2 2 1 1 above If you click Yes the selected claim s will be removed from the held batch and and all claims that had been released will be appended to the current batch If you click No the application will resume without taking any action If you click Cancel the HWI Claims Manager application will terminate 2 2 1 6 View Detail Clicking the View Claim drop down menu option will displa
30. e claim linkage between the HWI Claims Manager and the NEA Fast Attach program Internet Access Do you want to access the Healthware clearinghouse through the internet If you choose No access to Healthware will be made via direct dial toll free modem Suppress Warnings Do you want to suppress error messages on the pre transmission edit report that are warning only Warning edit errors will not prevent a claim from being submitted but may cause it to go to paper rather than electronic Option 9 Not used 52 2 3 3 Printer Setup This option initiates the standard windows Printer Maintenance dialogue window It will allow you to view and or change any of the standard printer settings for the windows default printer This 15 the printer that the HWI Claims Manager assumes is the printer it should use when it first starts up At any time you decide to print something you will have the opportunity to change to any available printer on the system 1f you wish and at that time you may invoke the standard windows Printer Maintenance dialogue window for that printer at that time 2 3 4 Claim Screening Setup Claim screening 1 an automatic process whereby certain claims can be excluded from an electronic batch based upon their destination payer and or the procedures that they contain The payer s involved and or what procedures will be selected are specified by the screening rules which are set up with this option The wind
31. e sent to Healthware must previously have been produced by the OMS The details of performing this task are very OMS specific and are outlined in Appendix A In general a special printer 1 set up in your windows system that is defined so that when forms are printed to it they are written to the hard disk rather than going to a printer electronic claims are printed by the OMS to this printer When this has been done the HWI Claims Manager can scan these form images to extract the claims detail to be forwarded electronically to the payers The detailed steps to perform this process are given in Section 2 01 below 2 Edit Batch This process is initiated after you have completed the preparation and manipulation of all claims you wish to send to Healthware The process consists of an extensive edit of the claims contents to verify basic data integrity such as the presence of mandatory items such as payer name procedure codes and the correctness of dates states and zip codes The resulting verified and rejected claims are separated into Sent and Reject batches respectively Reports are produced that list all claims processed verified and rejected detailed error explanations and claim control numbers used to track claims further in the system These reports may be printed to paper and or reviewed on the screen The detailed steps in performing this process are outlined in Section 2 02 below 3 Send Batch On completion of the Batch Edi
32. ent The list starts by displaying in claim number sequence If you wish you can re sequence the display by clicking in any of the heading bar column title boxes If you do the list will automatically re sequence itself in order of the column you clicked This can be useful if for example you are viewing a large batch and looking for a certain patient If you re sequence the list by patient name you can quickly home in on any particular patient The total number of claims in the batch is shown in the text box at the lower left of the window You can scroll through the batch if there are more that 24 claims in the batch with the scroll bar at the right edge of the ist box Several functions are available to perform operations on a specific claim or group of claims in the displayed batch None of these functions effect claims the OMS in any way they only effect the electronic claims records in the HWI Claims Manager To begin any of these functions you select a claim in the batch by clicking on that claim any column in the list box When you do so the line you select will be highlighted turn blue Whenever you click on a claim without pressing any keyboard key any previously selected claim s will be de selected To select more that one claim first select one then while holding the Ctrl key down on the keyboard click on the others you want to select To select a group of 34 consecutive claims on the list click the fi
33. esponse reports It 1s important to note that the ZWI Claims Manager stores all of these reports on hard disk for a period of 9 to 12 months and while you may choose to print each of these reports to paper each day that they are created this 1s really not necessary since they may always by reviewed in the screen if you need to see them later Each report 1 stored as a single file on the computer s hard disk and 1s named in a way that it 1s easily retrieved at a later time There are 5 types of claims batches indicated by the Cylinder symbol on the flow chart A claims batch in HWI Claims Manager terminology is a collection of related claims prepared or processed together Each claims batch 1 stored as a single file on the computer s hard disk and all batches are saved there for a period of 9 to 12 months The Current claims batch is the batch of claims that is in the process of being prepared transmission to Healthware but have not yet been sent Therefore there 1 only one current batch if any on the computer at one time The Sent batch 1 the group of claims that 1s sent or ready to be sent to Healthware Sent batch 1 created form the Current batch each time you edit the Current batch before sending to Healthware Yt can be different from the Current batch 1f any claims are rejected by the edit The Reject batch contains all claims that are rejected by the edit After any given edit process the claims in the Sent batch plus the
34. g the accepted claims to Healthware you click the Transmit button at the bottom of the Edit Summary window When you do depending on whether you have set up internet or direct modem dial up access to Healthware either the window in figure 2 0 2 3 for internet or the first of the three windows in figure 2 0 2 5 for direct dial up will appear Facility w7099999 Sending Batch 0111208 Tools View About Internet Session Status Beady for Internet Operation E Get Response Figure 2 0 2 3 Internet Batch Transmit Window 15 If you use internet access the window above will display Normally you click the Send Batch button to begin the internet batch send As the transfer proceeds its status will be displayed in the Internet Session Status window When the transfer finishes you will be notified of the success or failure of the batch transfer and the Get Response button at the bottom of the window will activate turn from gray to black letters if there is a response at Healthware for you to retrieve If there 1s a response and you wish to retrieve it now click the Get Response button Under certain circumstances you may want to use some features provided under the Tools menu item at the top of the window shown in figure 2 0 5 4 below Facility w 7099800 Sending Batch 0102801 _ ols View About wa Any File Review Host Filets verify Transmission Success m Figure 2 0 3 4 Internet Tool
35. ility of searching all response reports on your computer to determine what disposition was reported for claim This function is available only for Sent batches If you choose this option the program searches all response report files that are stored on your hard disk you must have retrieved responses from Healthware for this to work for the claim selected When the claim 1s found the disposition status shown on the report will be displayed in a window like the one below Claim Disposition Electronically to by Healthware on 12 1 Claim Ref No 021112HO010 was Sent 2002 See Response RUTT1211 It tells you what happened to the claim after you sent it to Healthware whether it was sent electronically or printed to paper the date of that disposition and the response report name where that was reported to you If this is all you need to know you click Okay to continue If you would like to review and or print the report named in the window you can click the View button and a display exactly like that described in section 2 2 7 View Response Report below will be shown If the claim selected 1 not found in any response report on your computer then you have not yet received the report telling you what happened to the claim and a the following window 1s displayed Disposition X AN MO Disposition Found Far Selected Claim 2 2 1 8 Review Notes Option The Review Notes menu option will allow
36. ip 49509 Insured ID 374 46 61 Insured s Relationship to Patient Erase All C Selif Spouse Parent Other 04 05 1947 Mon Day Year Changes Figure 2 2 1 8 Review Change Claim Detail Window Other Payor Tab 44 Review Change Claim Detail Auto Accident Ortho amp ppliance Placed C Yes No Yes Mon Remng Original D ate Jab Accident Hon Day Year Yes Descr Prosthesis C Yes 4 Replaced Other Accident fe No Original Date Descr 14 21 Hon Day Vear Descr Accident Date Mon Day Year Mon Dau Wear ID Number Tat Visit Current Series 10 08 2002 Erase All Changes Figure 2 2 1 9 Review Change Claim Detail Window Other Info Tab 45 Review Change Claim Detail FE pisa onse ceo i P Periodic Exam 00120 1 Vis HEEN 01110 3 2 Bitewings 00272 10 00 02 4 D esensitizing Med 09910 10 08 02 Selected Procedure Tth Surf Quad Date 10 08 02 Amt 62 00 Erase All Code D1110 Description Adult Frophy Save Lhanges Mew Procedure Changes Figure 2 2 1 10 Review Change Claim Detail Window Procedures Tab Review Change Claim Detail Mote Text Erase All Changes Figure 2 2 1 11 Review Change Claim Detail Window Notes Tab 46 2 2 1 7 Check Disposition The Check Disposition drop down option provides the ab
37. king Howdy Doody Sent 4 020510 01 Bob Heidi Hi Sent HKH 020522 01 Jake Give the news and get the Sent b 0 20606 01 bob Chris Blah Blah Sent Note Details Mate ID Subject Contents Add Note enden Erase Figure 2 161 HWI Claims Manager eNotes Window paste delete and insert as much as you like but no indenting newlines or tabulation 1s possible Once you have completed a new note you must click the Save button to record it If you decide that you do not wish to save it after all you can click the Abandon button The Status and status Date of a note 1s controlled by the system When a note is first created it is stamped as note and the status Date is set to the date is was created Whenever you establish a modem connection to Healthware any New notes are automatically transmitted to them At that time the note status is changed and the status Date 15 updated to the date of the transmission If ever you change anything in a note after it has been sent the Status is updated to Revised and that note will be transmitted to Healthware on the next connection to them as before Once Healthware has responded to your note by adding text to its contents the Status of the note is updated to Answered NUT 2 1 7 Query Batch Status Sub menu Option This option allows you to confirm whether batch you sent correctly arrived at Healthware
38. l comm ports on the machine for a connected modem It will tell you if and where it finds a modem and as you if that is the modem connection you want to make The next Tools drop down menu option is Install Program Updates This option is used to install any program updates that are ready to install on your computer The detailed operation of this process is described in section 2 1 4 below The last Tools drop down menu option 1s Verify Successful Transmission s Choosing this option will cause the transmission log t o be scanned to determine what the last successful was The detailed operation of this process is described in section 2 1 9 2 2 1 Drop down Options Menu When you click the Options menu bar selection on the HWI Manager main window the drop down menu shown in figure 2 1 1 below appears Some of the sub menu selections shown may be displayed in gray rather than black letters grayed out or disabled indicating they are not available options due to the particular status of your system For example if you have NO printed claims waiting to be batched the Delete Printed Claims option will be disabled Each of the sub menu selections 15 described in detail in the following sections HWI Claims Manager loj xj Options View Setup About d Printed Lookup Claim Recheck Counts Install Program Updates Resend a Sent Batch eMail Query Batch Status Review Change Raster Table verify Last Transmission
39. m SME und Edel Br t cr ECCE MN AP In al Ta IE ce misiis aT ince stet BIJHATURE FILE o diam mer pmp pn naa 05 d H ne gi Gallery Sete ze Derin Ertp Hnalbhexrs Dental Climiz i care 2 Pace 1821 4 amp 4Eh EE gt LO OG 2003 One Done 82 on rede 7 ____ Fenes Come beder derme m ie reker ota Ives H TA rnit or gt Rae Lo abimi Beg cam JE Dagrun OE Bt 52 gt na d J 1 fee canti Esel Far parrer gn meier DOOGQMBG BOLME DUE Prnt sena re Geek deb _ phase ama ripe iz polet bor Buom 1671 iteh JE au SIUHATUHE ZH FILE 141606 IF LU X Wyoming I MEE E ADA 2281 56 i Check ore I Denisa nt pamats Dentists staberent of actual services camp ee FET Cualasa Haverlay 3192 Grandviev 9318 himek memg by 152 Hera endi
40. ng for all claims sent by you in the last month If you wish to review or print a hard copy of any one of these reports you can select it by clicking its name in the window above then clicking the View button at the bottom of the window If you wish to print a hard copy of ALL of the reports click the Print button at the bottom of the window When review of the responses is complete the Transmission Status message will say Transmit OK Receive OK Click Exit at which point you click the Exit button and the HWI Claims Manager will end Certain tools are provided for your convenience These are activated by clicking the Tools menu option at the top of the window shown in figure 2 2 0 5 The following drop down menu will appear zT Program Updates verify Successful Transmissions 19 The first Tools menu choice is Setup Modem When you click it the following window will appear Modem Settings Lamm Baud Fate C 300 1200 2400 C 4800 9500 19200 Part Flow Control Xonsolf None Modem Initialization String vi Dial Prefix Phone Humber 8 TOLL FREE Figure 2 0 2 7 Modem Setup Window This option should never be used without consultation with Healthware It allows you to adjust the various settings that effect the operation of your modem It should only be necessary to do this when you are first setting up the HWI Manager software or if there has been m
41. ngton Hills MI 48000 Insured Ident Ma 367 80 7841 Group 45120001 Subscriber woods Milletta Address 1 890 Parkerest Dr 5 City wyoming 49509 Employer Spectrum Health Flan Pays Relation Birth Date E actor Child 02705772 Example Text Boxes inside a Frame List Box a large box containing multiple lines each of which represents one member of a set of data such as one claim in a batch or one procedure in a claim A list box often contains a Heading Bar it the top which designates the titles of each of the elements columns in the lines listed in the list The List box in the example below shows the details of each of six procedures in a claim The Heading Bar at the top shows the names of each of the columns of data procedure no tooth Tth surface Surf quadrant Quad etcetera Sut Quad Description Code Date Amount Us Hesin z surface post per 02386 158 00 2 U4 ceramic D zu 9 10 00 3 04 Frefab in add t 02954 195 00 4 12 OD Hesin z surface post per 02396 158 00 13 Hesin z surface post per 02386 158 00 b 18 Resin 2 surface post per 02396 158 00 Example List Box with headings Scroll bar appears along the right edge and sometimes the bottom edge of a list box if there too many items in a list to be displayed because of its size The scroll bar has an Up arrow button at its top and Down arro
42. odem related hardware change performed on your computer If you change any of these settings incorrectly your modem will not work properly You should only use this window if you are asked to by Healthware The Modem parameters that are controlled by this setup window are Comm Port The serial port number to which the modem is attached 1 8 Baud Rate The speed bits per second at which the port communicates with the modem 300 1200 2400 4800 9600 or 19200 Parity The type of parity checking performed between the modem and the comm port none even or odd Port Flow Control the type of flow control used between the modem and the comm port none hdwe hardware xonxoff software Data Bits The number of data bits in each character frame 7 or 8 Stop Bits The number of stop bits each character frame or 2 Dial Prefix The number if any to be dialed to access an outside line often if this is needed it is 49 Phone Number The number to be dialed to access the Healthware EDI system this should be set to TOLL FREE to use our normal 800 number 20 Modem Initialization String The modem commands that are to be sent to the modem each time new connection is being established this should normally be V1Q0 If you do not know where the modem 1 connected to your computer but you know that it has a modem you can click the Find modem button This will cause the program to search al
43. of all of this should you select this option when it is enabled 24 2 1 5 Resend Sent Batch Sub menu Option This option 1 used to resend batch to Healthware which has already been sent This should only be done when you have contacted Healthware and they have instructed you to do so When you click this option the Find Sent Batch screen shown in figure 2 1 5 1 below will appear Find Sent Batch to Resend Previous 0062101 0061 402 0061 401 40050803 0050802 0050702 YOOS0501 Pick Date 0042301 7 Figure 2 1 5 1 Find Sent Batch Window This window lists all previously sent batches in the system They are listed in sequence with the most recently sent batch first You may scroll through the list of batches looking for the particular batch you want or you may click the Pick Date button to choose particular send date 9 30 3 3 4 Tf 18 13 20 2 20 Figure 2 152 Pick Date Window If you click the Pick Date button the calendar window shown in figure 2 1 5 2 above will display On this screen you may scroll through the months of the calendar by clicking the arrow buttons at the top of the calendar and you pick particular day by clicking that day on the 55 calendar After you have chosen date this way press the Okay button and the Find Send Batch window above will reappear with the first batch of the date selected highlighte
44. ohn P Dinsmore D 101801 001 FATIN YOUSIF 0 0 5 dT 101801 002 FATIN YOUSIF D D S 101801 003 FATIN YOUSIF D D S 101801 004 FATIN YOUSIF D D S 101801 005 FATIN YOUSIF D D S 101801 006 FATIN YOUSIF 0 0 5 101801 007 FATIN YOUSIF D D S 102307 001 Lee McFall 005 102307 005 C Lee McFall 005 ATHANS RITA 10 10 02 3 103 00 021011 0005 Anderson Renee 10 09 02 02101 6HO011 Anderson Renee 10 09 02 02101640034 037 05 02 Jo 021018H0001 09 26 02 021018 0002 09 28 02 021018 0003 09 05 02 021018 0004 09 26 02 021018 0005 09 2802 600 00 021018H0006 09 28 02 200 00 021018H0007 09 30 02 97 00 021023H0061 O7 31 02 91 00 021023H0065 10 02 02 156 00 021023 0079 10 08 02 120 00 021023 0119 UNITED CONCORDIA Ligna Healthcare Ligna Healthcare 1000 00 600 00 600 00 1000 00 View Detail Review Notes Check Disposition MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID BCBS MI E Benefit Planners HumanaD ental Claims Offic CIGNA Print ADA Form Anderson Dale Arends Lucas Anderson Virginia 102307 023 C Lee McFall 005 10230 0635 Lee McFall 005 102901 006 102801 030 102801 033 102801 035 Andrew H Knowlton C Lee McFall ODS Lee McFall ODS Lee McFall 005 Met Life Harrington Inc Harrington Inc Harrington Inc Arechiga Joel Arends Ayan Adkins Taylor Adkins Rachel 10 23 02 10 24 02 10 24 02 10 24 02 71 00 132 00 143 0
45. ot depending on the application When window been maximized the icon in the maximize button changes to two small overlapping squares If you click this button in this case the window will return to its normal non maximized size Close button the third square button at the right end of the title bar 1s that contains an A If you click this button the application will terminate quit execution and the window will disappear Menu bar a bar that appears just below the title bar of a window that contains text see above example Options View Setup and About Each word of the menu bar designates a choice of action that the operator may instruct the application to take hence the name menu If a menu word is displayed in black letters then that menu choice is enabled If a menu word is displayed in gray letters then that menu choice is disabled clicking on it will do nothing When you click any of the enabled menu words an action may be taken by the application or more commonly a small window box of additional choices will be displayed called a drop down menu You may then click one of these words to make your action choice Action button a small usually rectangular shape on the main body of a window that contains a word or words describing a program action If the word or words 1 displayed in black letters the button 1s enabled If the words are displayed in gray letters the button is disa
46. oup 5 group 5 would mean crown and bridge If you then check box 5 in the screening rules screen under the title Include Procedure Group s whenever you performed claim screening all claims containing any procedure you flagged as being in group 5 would be selected In a similar way you can specify what payors you wish to select claims for 2 3 5 Procedure Group Setup Review Setup Procedure Code Info Code Flags Description 00120 YNNNY 00140 YNMNN 00150 YNNNN 00160 YNMNN 00210 HYNNN 00220 00230 HYMNEN 00240 YNMNN 00250 00260 MNMNN 00270 YNYYN 00272 Limited tal Examination Comprehensive Oral Examination Detailed Extensive Ural Examination Full Mouth Periapical x ray First Film Periapical x ray Each Additional Film Intraoral Occlusal Film Extraoral First Film Extraoral Each Additional Film 1 Bitewing x ray Bitewing x rays Change Procedure Information Code 00120 Save Description Periodic Oral Evaluation Help Include in Groups ft li Quit 2 3 6 Payor Group Setup 54 Review Change Payor Information Code Flags Description SHIELD BL BS YNNMN Blue Cross Blue Shield HMIchigan MICH CONF TEAMSTERS YNNMN LOCAL LODGE PM 2848 YNMNM Local Lodge PM 2646 Insurance UNENOUN INSURANCE CO YNMNN Unknown Insurance Co WEYCO INC YNNNN Weyco Inc HERTS CLAIM YNNMNM He
47. ow claim reference number of the claim you are looking for you can type it in the box provided otherwise you can specify the name of the patient you are looking for You can type the ast name or any leading letters of the last name as well as the first name or any leading letters and the middle initial of the patient on the claim you are looking for Claim Look Up Look In Months From he To 0 Claim Ref Look For Patient M ame s Last First Initial Search Cancel Figure 2 1 2 1 Claim Look Up Selection Window If you leave any of there name elements blank the system will find all claims with anything in that element of the name For example if you typed LAN in the last name box ROB in the first name box and left the initial box empty the system would find all claims for patients whose last name begins with LAN and whose first name begins with ROB and whose middle initial could be anything When you have filled in the selection criteria you click the Search button to begin the search If you decide you do not want to continue the search click the Cancel button When you click the Search button the system will scan all sent batches in the range of months you selected looking for the claim reference number OR patient name s you selected It may take several minutes depending on the speed of your machine and range of months you specified If any claims a
48. ow It is usually colored blue with white lettering The example window below has a Title Bar containing HWI Claims Manager HWI Claims Manager Options View Setup About ix laims to Vh TY ET Ti E p rk vi F p 1 Usually three small square buttons are displayed at the right end of the title bar see example above they are Minimize button the first square button at the right end of the title bar that contains When clicked the application displaying the window will minimize the window that is it will disappear from the main part of the Windows desk top screen and shrink to a small window on the task bar at the bottom of the windows desk top The program displaying the window 1s still running in the computer s memory but the window interacting with the operator 1 not visible To return the program s display window to its normal display state you click on its minimized window in the task bar Maximize button the second square button at the right end of the title bar that contains a single square or two overlapping squares When the maximize button contains one large square the window can be maximized increased to a maximum size A window s maximum size depends on the application but the largest possible maximum size is of course the whole screen Sometimes maximizing an application s window allows it to display more information and sometimes it does n
49. ow shown in figure 2 3 4 1 will be displayed when you choose this option Review Change Claim Screening Rules 5 to Select Include Procedure Group z Exclude Procedure Group s Selected Claim Disposition Highlight Only Print ADA Form Only Print ADA Form and Delete Delete Only Except For Payor s Payor s to Select Include Payor s Add Remove to Add Figure 2 3 4 1 Review Change Claim Screening Rules Window In order for this process to work you must define all procedure codes that you will be specifying in the screening rules and indicate what group each of these procedures is part of This is done with the Procedure Group Setup process described in section 2 3 5 below In addition you must define all payors that you will be specifying in the screening rules and indicate what group each of these payors 1 part of This 1s done with the Payor Group Setup process described in section 2 3 6 below The screening rules specify what payors you want to select claims for and what procedures you want to select claims for Procedures are specified by procedure groups The meaning of 53 procedure groups 15 entirely up procedures to be selected You to you For example you may want all crown and bridge would define all crown and bridge procedures as described in section 2 3 5 as belonging to say gr
50. plete a window like the one below will display that tells you the number of batch files that were successfully removed and the amount of disk space that was freed up as a result Purge Completed E X d 281 Batches Deleted to Free 4 310 MBytes of Disk Space E Um 2 1 12 Exit Sub menu Option This menu choice closes the HWI Claims Manager application exactly the same as clicking the close button in the title bar 2 2 Drop down View Menu When you click the View menu bar selection on the HWI Manager main window the drop down menu shown in figure 2 21 below appears w HWI Claims Manager Options View Setup About View Current Batch View Held Batch View Saved Batch ir EE ee View Sent Batch AE PME vie Reject Batch Fr ae view Edit Report Figure 2 21 HWI Claims Manager Drop down View Menu Some of the sub menu selections shown may be displayed in gray rather than black letters grayed out or disabled indicating they not available options due to the particular status of your system For example if you have NO held claims the View Held Batch option will be disabled Each of the sub menu selections is described in detail in the following sections 2 2 1 View Current Batch This option 1s disabled if there 1s no current batch When you click this option a window like the example in figure 2 2 1 1 will display The description that follows ap
51. plies to not only the current batch but to held sent saved and rejected batches as well Any features that are specific to these other batch types are discussed in the following sections The list box in this window shows one line for each claim in the batch indicating for each claim Claim number sequential within the batch Doctor Treating Provider Name Type Claim Type Code Payor Payer Name Patient Patient s Name Svc Date Date of Service Svcs Number of Procedures Amount Total Amount of Claim 33 m Current Batch loj x EE EEE ee 1 Healthware Dental Delta Dental Of MI Haverley Dealsea 10 08 02 131 00 2 Healthware Dental CI Delta Dental OF Michigan Baker Bunn 06 19 02 1 143 00 3 Healthware Dental 160 Dental Claims Beeman Catherine 5 18 02 3 399 00 4 Dental Cl DELTA DENTAL Benson Barbara 06 18 02 2 99 00 Fr Healthware Dental glanon Delia 06 1 ar02 24 00 Healthware Dental 1 0 mk Delete arboneau Wendy 06 18 02 4 141 00 Healthvare Dental 160 Pres his Faye 06 19 02 1 far 00 8 Healthware Dental CI ICD DEL d Bruce 06 19 02 2 104 00 9 Healthware Dental Cl bone T Varrus 06 18 02 4 210 00 Healthware Dental Cl 1CD DEL Cancel him David 06 17 02 2 274 00 11 Healthware Dental ASF er tz Barry 06 19 02 3 123 00 12 Dental cs lowicz
52. printed ADA form If you click this button a window like that shown in Figure 2 2 1 4 below will display Review Claim Notes Patient Service Date Provider Total Charges Healthware Dental C 13 00 Paver Deta Detal Mote Text Patient very nervous requires Nitrous Figure 2 2 1 4 Review Change Claim Notes Window This window contains several text boxes verifying the patient doctor payer and a large text box titled Note Text where the note text is displaye d Note text can only be a continuous stream of text without indentation tabulation or paragraphs You can edit the contents of the note using standard windows cut and paste The Erase button on the screen can be used to clear out all of the text and the Save button in clicked to signal you want to save any note changes you made If you click the Exit button none of the changes you made if any will be recorded In the lower right part of the View Claim window five other action buttons are provided These are Prev Claim Next Claim Print ADA Review Chg and Exit 2 2 1 6 1 Next Prev Claim The Prev Claim and Next Claim buttons will only be activated if you are viewing more that one claim you selected multiple claims then chose View Detail You click one these buttons to switch the claim viewed in detail to the previous or next claim selected for viewing respectively 2 2 1 6 2 Print ADA The Print ADA button can be clicked if you wish to print an AD
53. r computer If there was NO response for you the process will end with the third window in figure 2 2 2 5 above The message Transmit OK NO Response Click Exit in green tells you that your 18 batch was transmitted successfully and there was no response sent back to you You simply click Exit to end the program If response was returned to you the process will end with display like the one shown in figure 2 0 2 6 below Last Response Received Ede I ___ BOL stc NSD 10 07 20111211 1133 11 13 02 10 07 Print View Cancel Figure 2 0 2 6 Review Response Received Window One or more response files will be listed in the window depending on how long it has been since you last connected to Healthware Normally there will be two response files as shown above One report will be named ROmmdd10 and the another named ROmmdd1 1 where mmdd is the month and day when they were created The ROmmdd10 file is the rep ort from CPS the wholesale clearing house showing the disposition of all claims sent to them for forwarding to the payers The ROmmdd11 file is the report from Healthware showing the disposition of all claims sent directly to the payers by them At the beginning of each month an additional report file named ROmmdd0O1 will be added to your response reports mmdd is the date of the last day of the previous month This report is a summary and billi
54. ram interface If you are using the NEA interface holding and releasing of claims 15 done automatically as claims requiring attachments are held pending the transmission of electronic attachments and released after you have sent attachments When a claim is Held it is removed from the Current batch and placed in the Held batch Claims remain in the Held batch until you later come back and Release them into the Current batch or you transmit an attachment with the NEA Fast Attach system When you click this option a window like the example in figure 2 2 1 1 above will display The operation of the program is identical for the Held batch as it 1s for the Current batch as described in section 2 2 1 above except that the claims displayed will be those in the Held batch 2 2 3 Review Saved Batch This option 1 disabled if there are no Saved batches Saved batch 1 a copy of the Current batch as it was when that batch was originally transmitted to Healthware When you select this option a window like the one shown in figure 2 2 3 1 below will display You may select a previously saved batch exactly as described for Sent batches section 2 1 5 above When you click Okay button a window like the example in figure 2 2 1 1 above will display The operation of the program is identical for a Saved batch as it 1s for the Current batch as described in section 2 2 1 except that the claims displayed will be those of the Saved batch which you selected
55. re found matching your search criteria the screen shown in figure 2 1 2 2 below will display In this example the search criteria displayed in the title bar on top of the window was months 10 thru 10 no claim reference number last name A and no first name or initial This window shows for each claim meeting the criteria the batch month day and sequence in which the claim was sent and the claim number the treating provider claim type payer patient date of service number of procedures total charges and claim reference number The claim type code is a three character code as follows Character I is for single coverage and 271 dual coverage Character 2 is E if the claim is an estimate only pre determination or a C 1f it 08 is a claim for service Character 3 15 D 1f the policy pays the doctor or a P 1f it pays the patient You may print this list of claims by clicking the Print List button at the bottom of the screen If you wish to examine any claim in detail right click on that claim to select it and it will become high lighted turn blue and a drop down menu will appear see figure 2 1 2 1 for example then click the View Detail sub menu selection This will display the detailed claim display screen described in detail in section 2 2 1 below Additional All Claims in Month 10 for Patients With Last Name A 101101 005 AYAN WALLIN 005 101601 011 John Dinsmore D 101601 034 J
56. rent Batch below will appear Refer to this section for detailed description of the contents and functions of this detail display window d Hast Batch Y0111201 Contains 28 Claims This function of reviewing the contents of your host batches on line 15 only available if you are using the internet access feature If you are not using internet access to send your claims you can verify the contents of batches at the Healthware computer using the Query Batch Status function described in section 2 1 7 below The internet host computer contains a separate hard disk area for every facility using the service This hard disk area is called a folder Generally your host computer folder starts each day containing only a response file containing disposition reports from your previous day s transmission s As the day progresses and you send one or more claims batches they will accumulate in your host folder At the end of the day approx 11 00 PM EST Healthware removes all of your batches processes them and forwards all claims to the appropriate payers Any responses from the payers are collected at that time and are accumulated in one file response zip and placed in your host folder for you to retrieve the next day or what ever time you next connect to us If you have chosen not to use internet access when the HWI Manager was set up connection to Healthware will be made via direct dial modem In this case when you click the Transmit button
57. required details Only 50 Billing Treating Provider Maintenance Billing Provider E ntity Facility ID Fractice Mame w7 39833 H ealthware Dental Clinic Street Address 48945 VanDyke Suite 4 1 City State ip Code Shelby Township Mi 4831 Phone Number ID 556 99 7 2500 29 8932765 Treating Provider s Choose Existing Provider Billingsly Arland Add Code First Mame Last Mame f rland Bilingaly S pecialt State Provider ID License General BCBS Delta Clear All Medicaid Undo License MI 20911 Delete Gave Figure 2 3 2 Provider Maintenance Window licensed dentists can be reported to payers as treating providers Their S tate of registration and License number must be included in the boxes at the bottom of the section The Code box specifies the code by which you identify the provider in your office If the provider submits work to either Blue Cross Blue Shield Delta Dental or Medicaid and uses a unique provider identification you must complete the corresponding boxes specifying the State and Provider ID that applies To record any additions or changes made to the provider information you must click the Save button 2 3 2 Environment Setup This drop down menu option 1 provided to set up the various options available with the Claims Manager When you click it the window shown in figure 2 3 2 1
58. rinted forms the original printed forms are saved on disk in compressed form Normally there 1 no need to refer back to them but on rare occasions you may want to see what form was produced by the OMS When you choose this option the window shown in figure 2 1 10 1 above 1 displayed You select the printed forms batch you wish to restore review by highlighting it in the small list box titled Printed Batches to the left of the window then clicking the Select Batch button below the box The program will display a listing of all forms files in the selected batch in the large list box to the right of the window titled Printed Forms in Batch XXXX Generally one forms file equals one insurance form but not always You may select all click Pick All button some or only one of the forms files displayed by right clicking the selected forms file s A drop down menu as shown in the figure 2 1 10 1 will appear and you may click whichever menu option you want If you click Restore Form s the selected forms file s will be added to the current forms batch just as if you had printed them from the OMS You will notice that the restored forms will add to the Forms to Batch count displayed on the Claims Manager main window Restore Printed Forms Printed Batches Printed Forms in Batch 0111102 Filename Size Date Time 0111101 HWI Formz ada93000 pcl 31212 10 15 02 15 24 0110701 HUT Forns ada s00l prl 20799 06 18 02 15 53 _ HUI
59. rst claim in the group then while holding the Shift key down on the keyboard click on the last claim in the group When you have selected the desired claim s you right click and drop down menu will appear as shown in the figure 2 2 1 1 above containing the various functional options available to you All possible options are listed on the menu with only those available to you depending on the type of batch you are displaying in this case the current batch enabled displayed in black To perform any available function on the selected claim s you click on and available option in the drop down menu possible functions are described in the sections that follow and applicability of each function to the various batch types 1 spelled out 2 2 1 1 Delete Claim s Claims may only be deleted from the current or the held batch Clicking the delete drop down menu selection will cause any selected claim s to be removed from the displayed batch When you are finished with the batch and want to save the resulting batch with deleted claims removed you must click the Save button at the bottom of the batch display window and a confirmation will display as follows Update Batch 2 X 2 Do You Want to Update Batch with Changes JO If you click the Yes button in the above Update Batch window the original batch before you viewed it will be replaced with the batch in the display window claim s have been removed If you
60. rting ADA Form 18 Of 76 Cheryle O Neil m Assign ASCII Characters to Patient Full Name E al x Claim Raster Bit Graphics Chery e ONEI GET Skip Claim Okay Cancel The entire raster image field is displayed in the top portion of the window and a character by character decoding of the field will be displayed in the lower window of the display In the lower window any characters that are unknown will be indicated by an empty yellow box representing the ASCII character You enter the ASCII character s that the raster image represents in the yellow box below the raster image an apostrophe in the example above then click the Okay button When you have 12 completed this proceedure the results will be stored permanently and it will be temembered from then on Upon completion of the batch creation process a confirmation message window will display asking you to verify the contents of the batch as follows Save Claims X 7 29 Claims Converted With 83 Services amp 5870 00 Charges Save Them gt Ves Cancel If the batch contents claims services and dollars do not match what you expected you may click No to return to the HWI Claims Manager main window or Cancel to close the application If you are sure that the claims converted are correct click Yes If any claims are currently present in the current batch a message
61. rtz Claim MTG HERTZ CLAIM MANAGEME YNMNM Hertz Claim Management AMERICAN COMMUNITY YNNNN American Community ROUFERS 149 SEC BEN YNMNM roofers 149 sec ben fd BCBS MI FED Hobs mi fed emp DENTMAX YNNNN dentmax Change Delete Add Gave Cancel Change Payor Information Code ECES MI Save Description BLUE CROSS BLUE SHIELD Help Include in Groups M Cancel 2 3 7 NEA Payors Setup Ex Dental Claim Form American Dental Ascciation version 2000 Delta Dental Of MI Boa 9085 Cum Farm rdgton Hills Pasar gel H v rler m 3081 Ow andi eu Bue Das ar Pars AAF Ej Peart o4 OB 1352 375 54 00 t 20 1 amm 21 ned dommer Be mme gn 2 357 243 5900 14 700 1021 dp 15 17 Drea Oei Marra 2 Hzveariwy Hard irt Vie Dn 4 05 1547 z Chaine Mace Faen Bible Haverley Daalsua 3192 Brzandvimse kun Zr 48218 L L E 5 21 Lwm p Ber Ok DETT zm Fue 18 Hdrand strepbryer Hal ak 04708 Er Dresser Pcr vre Fana Parse arr 1 nex TEC Ol MGE TAE CES 1 mem bbp nad deni
62. s Restore Printed Formis Purge Saved Batches Exit Pil dan E 222 x T gaki 3844 4 i me 2 p 5 be E LET i TE 7 Figure 2 1 1 HWI Claims Manager Drop down Options Menu 2 1 1 Delete Printed Claims Sub menu Option This option allows you to delete all claims that have been printed by the OMS to the HWI Forms Printer and are waiting to be batched If there NO such claims this sub menu option 1 disabled You very rarely will need to perform this option but it may be needed if say you accidentally printed some claims from the OMS to the HWI Forms Printer and you meant to print them to paper When you select this option a message will ask you to confirm your action in case you selected it in error When you have completed this option the first status message on HWI Claims Manager screen will always say Claims to Batch 2 1 2 Look Up Claim Sub menu Option This option provides a powerful facility to find claims that have previously been processed by the HWI Claims Manager It will allow you to retrieve any claim that was batched electronically in the past and has not been purged from the files since When you click on this option the selection window shown in figure 2 1 2 1 below will appear 22 The Look Months frame allows you to specify particular range of months in which you want to search for claim or claims thereby limiting the search time If you kn
63. s Drop Down Menu The first 1s a function that lets you send any file you wish to Healthware over the internet This of course would only be done with instructions from Healthware When you choose this option window will display asking you to enter the name of the file you wish to transfer Here you would enter the name of the file that Healthware has instructed you to send Another Tools option lets you review the contents of your internet folder at any time You click the Review Host File s option and window like the one which follows will appear w 099999 Files on Host 111208 170111201 Retrieve Examine Exit 16 of the batches and if present response file response zip on the internet host will be listed in the list box as shown You may click on any batch in the window then right click to get the drop down menu shown You may choose the Delete menu option to completely remove the batch from the internet host computer Retrieve to retrieve copy of the batch back to your computer or Examine to display batch s contents on your screen When you choose Examine a summary window of the batch contents like the example below will display on your screen Batch Contents Br amp 5117 00 Charges Detail Okay If you wish to see complete detail of the batch click on the Detail button If you do batch contents display almost identical to the one described in section 2 2 1 View Cur
64. se this option The window displays up to 130 sets of raster bit images with the corresponding ASCII characters that they represent The table shown in figure 2 1 6 1 is provided to you when the software 15 installed Review Change Raster Character Table 77 01284567898 ABCDEFGHJK 9I fe fs LMNOPIQRSTUVWYZ4bCdef 9 hi PV WE likiImnopqrgstuvwxwyz Print Gave Cancel Figure 2 1 8 1 Review Change Raster Character Table Occasionally raster characters are printed so that the tail or head of one character overlaps the adjacent character eg fe and t j in the figure above When this occurs the two characters are decoded as a pair and must be entered in this table as a pair 28 2 1 9 View Last Transmission s Option This option gives you the ability to view the last successful transmission s that have occurred When you select it the program scans the transmission log a running record of all transmission activity and detects all successful transmissions that have occurred from the most recent backwards by time It displays the most recent successful transmission in message box like the one below Last Success Last Successful Transmission was Batch 10833 on 11 28 2002 at 4 15 17 If the batch name and date and time of the transmission 1
65. splay exactly as it does when you save after deleting claims described in section 2 2 1 1 above Unlike the delete claims function when you save the batch having cancelled one or more claims the program will immediately initiate the transmission of a Cancellation Batch to Healthware This transmission will proceed exactly like any normal batch transmission as detailed in section 2 0 2 above 2 2 1 3 Resend Claim s Claims may only be resent from Sent batch Clicking the resend drop down menu selection will cause confirmation window will display as follows Resend Claim If you click the Yes button the claim s you selected will be transmitted in a new batch to Healthware The transmission will occur exactly as described in section 2 0 2 above 2 2 1 4 Hold Claim s The function of holding claims refers to removing them fro m the current batch and placing them in held batch If you have never previously held any claims there 1s NO held batch The first time you hold claim the held batch will be created There is only one held batch and it is maintained perpetually on the computer Note therefore that once you have held a claim it will stay in the held batch forever unless you subsequently delete it or release it You may never need to use this function but it may be useful if you need to delay the transmission of certain claims pending the completion of some other related administrative function The
66. st at the top of the screen which will highlight it and enable the View Edit and Delete buttons If you click the View Edit button or alternatively double click the note in the list on top the detailed contents of the selected note will be displayed in the lower part of the screen You may simply review the contents of the note then select any other note to view by repeating the steps the above paragraph If you want to make any changes to the note you simply type the changes you wish in the appropriate part of the note then click the Save button when finished If you have typed any changes and then decide you do not want to save them permanently click the Abandon button and the changes will not be recorded To remove a note permanently you select it as described above then click the Delete button 26 To create new note you click the Add Note button at the bottom of the screen When you do this the bottom part of the screen will be cleared and new Note ID will be created The format of this ID is today s date yymmdd followed by two digit sequence number The From and Subject boxes can contain anything you wish The Contents box can contain any free form text but only as continuous string You can cut HWI Claims Manager eNotes eNotes Posted S NoteID From Status 1 020507 02 Bob Chris Show Plans Sent 020507 03 Bob Jim Installation Sent 020508 02 Slim Pic
67. t and review process the verified claims Sent batch are transmitted to Healthware Connection is made to Healthware via modem The Sent batch 1s transmitted and on completion any response for you resulting from previous activity are transmitted back to you Progress of and any possible problems with the connection are recorded in a Transmission Log This log may be viewed on the screen or printed to paper at any time Response reports returned to you from Healthware are recorded on disk and may be reviewed on screen or printed as well The details of performing this process are given in Section 2 02 below 4 View Claims Batch An extensive facility to view and manipulate claims 15 batches 15 provided in the HWI Claims Manager This facility may be used with any type of batch stored on the system You can screen review or print a summary of the contents of a batch review the details of any claim in the batch print ADA form s for any claim or review change claim notes When 20 necessary you can delete selected claims from batch divert claims into the Held batch or release claims from the Held batch with this facility Details of how to perform this process are outlined in Section 2 2 below 10 2 0 HWI Claims Manager Screen When you double click the HWI Claims Manager icon on the Windows desktop the main HWI Claims Manager screen appears see figure 2 0 below This screen has an action menu bar at the top and two st
68. t the entire report All the current page only Curr Page or any part of the report from the beginning To Mark or From Mark to the end of the report where the Mark is the line that is currently highlighted on the display The Choose button allows you to select which printer you wish to print to When you have reviewed and or printed to pre transmission edit report you click Exit button at the bottom of the Review window and the program returns to the edit summary window of figure 2 2 0 1 14 Review Print 20111101 Date 11 11 2002 HealthWare Inc Report Id Time 10 20 Healthware Dental Clinic Page w7022223 Submitter Report Version Total Claims Processed Verified Rejected Verified for Transmission All Claims Verified Date 11 11 2007 HealthWare Inc Report Id Hoole Time 10 20 AM Healthware Dental Clinic Page 2 Claims Verified Mum Fatient Payor Account Date Ste STUDS Amount 1 Haverdink Dea 375 54 0 10 08 02 4 T 131 00 Delta Dental Of MI Aetna U s Healthcare 2 Baker Quinn 06 18 02 4 T 149 00 Delta Dental Michigan 3 Beeman Catherine 374 72 1 06 18 02 3 389 00 Print All Curr Page From ie fo Mark Choose Scroll Page First Last Previous Mest Report Stats Current asinum Page 1 Line 1 Page Line HotePad Figure 2 0 2 2 Review Pre Transmission Edit Report If you wish to proceed with transmittin
69. the Review Change Claim Detail Patient Tab window given in figure 2 2 1 5 below This 1 the first of seven tab pages each of which contains the contents of the seven data elements that make up a claim The seven data elements of the claim being viewed are accessed by clicking the corresponding tab When you do the display will switch to displaying the contents of that element and the tab name at the top will be highlighted The items in each tab segment are somewhat self explanatory An example of each of the seven tab segments is shown in figures 2 2 1 5 thru 22444 40 Review Change Claim Detail BE Claim Retr No Patient Information First Mame Last Mame Patient Acct laim Type Dea ret 375 54 0 C Claim PD Address Line 1 4752 Grenadire Dual Insur Ea 5 BE on Day vear vas T C Female Wyoming Student State MI Zip 49509 f Part Time Full Time School Home Phone Medicaid ID SY Employment Status Marital Status C Full Singe Divorced Erase l Pat 0 Retired widowed f Unknown Unknown Changes Figure 2 2 1 5 Review Change Claim Detail Window Patient Tab 4 Review Change Claim Detail wyoming Dental Associates eel 1621 44th St Sy gt zo 6165329003 382711479 In 141660 Onto Ehanges Figure
70. up Setup Payor Group Setup etup Figure 2 3 1 HWI Manager Drop down Setup Menu Some of the sub menu selections shown may be displayed in gray rather than black letters grayed out or disable d indicating they are not available options due to the particular status of your system For example if you do not have the NEA attachments option set the NEA Payers Setup option will be disabled Each of the sub menu selections 1 described in detail the following sections 2 3 1 Provider Setup This option 1 provided to set up billing and treating provider information needed by the system Click on the Provider Maintenance option and the window in figure 2 3 2 below will appear A word of caution be very careful about filling out initially and or changing and data on the window The top section of this window contains all pertinent data about the billing provider or entity the provider or business the payer checks are to be made out to The bottom section of this window contains pertinent information about all providers who will be included on claims as treating providers Only one treating provider at a time 1s displayed in that section of the window If there are more that one on your office you select the one you wish to view change by choosing them the drop down box at the top of the section To add a new treating provider you click the Add Pvdr button and all the info boxes will clear waiting for you to fill in the
71. w button at its bottom that may be pressed to cause the data in the List box to scroll up or down See example in List box above Check Box a small square box that 1s either blank or contains a check mark Check boxes are used to designate the presence or absence of some option eg dual insurance checked yes unchecked no In the example below each check box indicated what group procedure is part of 1 2 3 4 or 5 Include Groups Example Check Boxes Option button sometimes called Radio button small circular box that appears in groups of two or more inside a Frame Each circle has title next to it and 1s either empty indicating not selected or contains large dot indicating selected option All options within the frame are mutually exclusive only one of them can be selected at any time so whenever you select an option by clicking the button or the title any previously selected option in the frame will be deselected In the example below a frame encloses all of the possible choices for patient s relation to the insured self spouse child or other Only one of them can apply Patient s Helationship to Insured Ic Sel Spouse Child Other Example Option buttons Desk top the name given to the main Windows screen that displays when Windows first starts up and which is displayed when you are not executing any applications on your computer all application windows are
72. y detailed claim information in a window like the example below 37 Current Batch Claim No 1 Contents n ia Mame Claim Type Patient ID Birth Date School Haverley Dealtea Claim For 5vc 375 54 0 Female 04 08 52 Address State zip License Provider ID Healthware Dental Clinic 1 bz 44th St Sy wyoming MI 49509 4166 1 41660 Payor Other Payor Name Deta Dental OFM Name Aetna U s Healthcare Address Box 905 Address PoBox 409 O00 City Ste Zip Farmington Hills MI 480002 City Ste Zip Lexington KY 4012 Insured Other Insured Ident 2357 54 5900 Group 8700 1021 Ident 347 54 5093 Group 609598 Subscriber HaverleyDeabea 0000000 Subscriber Havelep Ward 000000 Address 3192 Grandview Ave Address 3192 Grandview Ave 00000 City St Zip Wyoming 49319 5 2 wyoming MI 48313 Employer State Of Michigan Employer Consumer Energy Plan Pays Relation Birth Date Paid mount Plan Fays Relation Birth Date Doctor Sel 04 08 52 0 00 Doctor Spouse 04 05 47 Sut Quad Description Cede Date Amount Prey Claim 1 Periodic Exam 00120 gt 10 08 02 34 00 e Adult Prophy 01110 100802 Mest Elam 3 2 Bitewings DOS 107 08 02 zr 00 4 Desensitzng Med 09910 1008 02 9 00 E Patient is very nervous NOTE required MOTE Total Procedures Change Notes Total Amount

5. HWI Claims Manager User Manual

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