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User`s Manual

1. of type application csv Click More Info to learn how to extend Navigators capabilities Click once on Save File This will save the file as a comma separated value file or CSV Mac Users with Internet Explorer Explorer users on Mac will see something similar to this Unhandled File Type Internet Explorer doesnt know how to handle the type of file you have selected You can choose to save this file to your disk or you can configure a Helper Application for this file MIME Type application csv File Name Patients csv Save File As Application Click once on Save File As This will save the file as a comma separated value file or CSV www medrium com lt 14 gt 8 29 01 Wh Wp Adding Submitting a New Claim Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click once on Claims 2 Click once on Add Claim Two Ways to Submit a Claim There are currently two ways to add submit a new claim the Add Claim Form and the E Bill The following instructions are specific to the Add Claim Form only If you would like instructions on how to add a new claim using the E Bill please refer to the section of this manual titled Using the E Bill to Add a New Claim 1 In the space titled Patient type the first few letters of the patient s last name or type the patient ID number in the space titled ID
2. Box 24a of the HCFA 1500 form 6 If you wish to post a patient payment along with claim type the payment amount the payment type cash check or credit card and the reference number if any 7 Select the diagnoses codes you wish to use by checking the box to the left of each code See Below Box 21 of the HCFA 1500 form 4939 Asthma Select the diagnasis codes in the order 2299 Benign Neoplasm wou wish ther ta appear on the caim I 472 Chronic Rhinitis 25001 Diabetes Mellitus Type I 2500 Diabetes Mellitus Type II Diagnosis Codes Selected www medrium com lt 21 gt 8 29 01 W X 8 Select the procedure codes you wish to use by checking the box to the left of each code See Below Box 24c and 24d of the HCFA 1500 form Select the procedure codes Office Visit Est E veo75 Due in the order you wish therm to appear on the claim 99245 High Complexity 76075 26 i 39214 Moderate Complexity Pp 99343 Low Complexity 45854 Rer Office Visit New 9 In the spaces provided at the bottom of the e bill type the number of units for each procedure code as well as the appropriate diagnosis pointers Box 24e and 24g of the HCFA 1500 form You will then have the following options Validate Modity Click once on validate to continue with the claim subrrission Click once on Modify to edit further detail on the claim Once you click on Validate you will have the option to cha
3. 2 Click once on Providers 3 Click once on Add Hew Provider 1 Type the referring provider s full name address and phone number in the spaces provided 2 Under Professional Information Referring Provider should be the ONLY provider type checked See Below Professional Informaton Provider Type E Billing Provider E Supervising Provider ma Referring Provider 3 Type the provider s UPIN number in the space provided 4 When you are finished click once on Add Provider www medrium com lt 50 gt 8 29 01 Viewing the Messages in Your Inbox The Communication Center allows you to securely send and recetve messages to any other user in your account You can also send messages to technical support for questions regarding your account The Communication Center is designed to look and feel just like real email When you have a new message you will see an envelope icon at the top of the page See Below If you see this ican it means that you have an unread message in your inbox Click anit ance to view the messages in your inbox Log Out Help Financials Es Maintenance B Communication Center You may also click once on Communication Center to view the messages in your inbox Once you are viewing the messages in your inbox you can click on any message to read it The circles indicate that ttan AARP Providers 4ddress the message has mot yet Teen SORP SIE Change been read
4. 38 Payment date Josfozf2001 a Type the check number Type the total ammount of the Type the date the check was in the space provided check in the space provided issued in the space provided Payment Date This date will determine how and where the payment appears on your Daysheet Both the Daysheet and the Daysheet Summary can be run either by transaction date or posting date In regards to insurance payments the transaction date is the date you type in The posting date is the actual day you posted the payment 4 You may have more claims listed than there is on the EOB so make sure you posting to the correct claim Each claim listed will display the patient s name the patient s insurance ID number the claim ID and the amount previously posted if any The patient name insurance ID and amount previously posted can all be clicked upon for more detail See Example on Next Page www medrium com lt 26 gt 8 29 01 f If any previous insurance payments Click once on the patient s name have been made to the claim you to view the patient information can click on that amount to view the detail of those payments Patient Doright Dudley InsurancelD 888888888 ClaimID 106 Amount previously posted 95 00 If you are posting the primary payment and wou need to print the claim for the secondary insurance click ance on the claim ID This will allow you to view the detail of the clairn andor print it ta a HOFA 5 For each
5. 7 BEAN COUNTER BEANCOUNTER Your Year End Financial Status Is Complete MRBILLER MRBILLER Need Work Comp Form Click once on the F message to read it To view messages in other folders sirnply Click once on Manage Folders to create click once on the folder you wish to view new folders or rename existing ones Manage Folders 4 New Message Empty Trash Show so l messages per page Messages Previous 1 1 Page Next If you have more messages than you can display 50 is the maximum per paged you can click once onthe next or previous arrow to display the next or previous 50 messages www medrium com Select the numb e of messages per page you wish to view 8 29 01 Reading Your Messages While you are reading a message you will have several options available to you See Below Click once on Reply All to send a message back to the sender and to everyone else who received the message Click once on Reply to send a message back to the sender Manage Folders gt gt amp New Message Reply Reply All Forward Delete Empty Trash Click once on Forw ard to forward the Click once on Delete to delete message to another user in your account the message permanently If you wish to move a message out of your inbbox select the folder you wish to mowe it ta ie Previous 2 7 3 Next G6 Date Tue Aug 29 11 46 55 POT 2001 From BEAN COUNTER BEANCOUNTER Mo
6. Bill to Add a New Claim Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click ance on Claims 2 Click once on Add Claim 3 Click ance on E Bill 1 If you use multiple e bills you should first select the e bill you wish to use from the space titled E Bill If you wish NOT to use the e bill select the option Use Add Claim Form 2 In the space titled Patient type a portion of the patient s name or type the patient s ID number in the space titled ID The patient you select will determine the information required in boxes 1 9 11 and 26 of the HCFA 1500 form Once You Have Selected a Patient you can click on Get Last Values to fill in the Prior Auth the Referring Provider and the Diagnoses Codes that were used on the last claim you added for that patient See Below Click once on Get Last Values to retrieve the information you used the last time you added a clainn for this patient Get Last Values 2 a 3 Accident Information 3 Select the rendering provider and the location where services were performed in the spaces provided The provider and location you select will determine the information required in boxes 24b 24k 25 32 and 33 of the HCFA 1500 form 4 Select the referring provider and type the prior authorization number if any 5 Type the dates of service in the spaces provided
7. Event Follow Up Office Closed Select the event type for the Lunch Break appointment you wish to schedule sales Rep Vacation 2 If the appointment you are scheduling is for a sales representative or for a patient that has not yet been added to the system type the last name first name and phone number in the spaces provided If the appointment is for an existing patient type the first few letters of the patient s last name in the space provided If there is only one patient that matches what you type in that patient s full name and phone number will automatically appear in the appropriate spaces If more than one patient matches what you type in you will be presented with a list of patient s to choose from For example if you type in PRES in the space titled Last Name you may see something like the example below Click once on the appropriate patient and the system will fill in the full name and phone number of that patient Please select patient name from the list below PRESSLEY HENRIETTA IG 741 SSN 123 45 7550 ELVIS PRESLEY A ID L090 SSM 511 11 2222 LISA PRESLEY M ID 1102 S5N 131 31 3131 Cancel www medrium com lt 32 gt 8 29 01 d 3 Verify that the date time provider location and duration of the appointment are correct If the date the time or the duration is incorrect type the appropriate changes If the provider or location is incorrect you must click once on appoint
8. The patient you select will determine the information required in boxes 1 9 11 and 26 of the HCFA 1500 form Once You Have Selected a Patient you can click on Get Last Values to fill in the Prior Auth the Referring Provider and the Diagnoses Codes that were used on the last claim you added for that patient See Below Click once on Get Last Values 7 to retrieve the information you used the last time you added a clainn for this patient Get Last Values il eA af eta Accident Information 2 If you wish to post a patient payment along with claim type the payment amount the payment type cash check or credit card and the reference number if any 3 Select the rendering provider and the location where services were performed in the spaces provided The provider and location you select will determine the information required in boxes 24k 25 32 and 33 of the HCFA 1500 form 4 Type the Medical Record Number if any select the special program if any and select the patient s current status in the spaces provided 5 In the space titled Date of Current select either Illness if any or LMP pregnancy Then type the start date of the current illness or pregnancy in the space to the right of that Box 14 of the HCFA 1500 form 6 If the patient has had a similar illness or injury type the date of the similar illness or injury in the space provided Box 15 of the HC
9. and BS If you are searching for a Blue Cross or a Blue Shield use BC BS or BCBS instead of the full name Nothing Is Case Sensitive Don t worry about correct capitalization because it doesn t matter what you do or do not capitalize Payer ID Equals Recommended 1 Select Payer ID Equals from the space on the left 2 Type the complete payer ID in the space on the right 3 Click once on Search www medrium com lt 47 gt 8 29 01 N E d What Is a Payer ID The payer ID is an insurance carrier s electronic address When submitting claims electronically the payer ID determines where the claim is sent The payer ID is usually a number four to six characters in length and every insurance carrier that accepts electronic claims has a payer ID You can always learn a carrier s payer ID by calling them and asking two questions Do they accept electronic claims submission and if so what is their payer ID Some major carriers have even started to print the payer ID on their patients insurance card When you search for an insurance carrier you may get several results all with the same payer ID You only need to add one of them regardless of the different print mail addresses For example you have two patients with Prudential Healthcare one with a claims address in Millville NJ and the other with a claims address in Iselin NJ You search using the search type Insurance Name Starts With
10. charges for by clicking once an the box to the left of the provider s name 4 Select the action Procedure Charges 5 Click once on Gaol 6 In the box titled Insurance select the insurance carrier you wish to add charges far 7 Click once on Search 8 Click ance on Add Charges If You Use the E Bill Each e bill you create gives you an opportunity to add charges for each procedure on the e bill The directions below are a way to define a set of alternate charges for each billing provider in your account When you add a claim using the e bill you should see this MW Use e Bill Procedure Charges as Default If you leave the above space checked the e bill will use the charges defined in the e bill If you uncheck this box the e bill will use the alternate charges defined for that provider If you do NOT use the e bill to add a claim the alternate charges will be used 1 Type the procedure code and modifier s If any in the spaces provided 2 Type the charge for each procedure code in the space provided 3 Click once on Add Procedures with Modifiers If you sometimes use a procedure code with a modifier and sometimes use the same code without any modifiers they must be added as separate charges even if the amount is the same See example below T procesare O moane O O oae Eas wa mma ma COs aa oo jss213 AJ 2 A W A i5000 eas A eoa ma COS Oe oo mas Sl BEA Eeoa PS Ps Dow Any co
11. click once on Search 3 Once you have the list of patients you wish to download check the space titled Select All Patients and select the action Export Patient Info See example below Search Results Select the patient names below Then select an action Select an Action Export Fatient Info Go M Select all patients 4 Click once on Go PC Users with Netscape Navigator Netscape users on PC will see something similar to this Unknown File Type E4 y You have started to download a file of type applicationi css Click More Info to learn how to extend Havigator s capabilities Pick App Save File Cancel Click once on Save File This will save the file as a comma separated value file or CSV Give the file any name you wish and save it to your desktop www medrium com lt 12 gt 8 29 01 PC Users with Internet Explorer Explorer users on PC will see something similar to this File Download Ld Uther Programs 9 Photoshop 5 5 tej Acrobat Reader 4 0 Ee Adobe Acrobat 4 0 at Microsoft Works Netscape Communicator Give the file any name you wish and save it on your desktop In the example above we are calling the file Patient Data csv www medrium com lt 13 gt 8 29 01 N CA Mac Users with Netscape Netscape users on Mac will see something similar to this You have started to download the file Patients csv
12. current posting you can manually type the appropriate changes www medrium com lt 28 gt 8 29 01 W 8 View Update Existing Insurance Payments Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click once on Claims 2 Click once on Search Claims 3 Search for the claim you wish to view the insurance payments for 4 Select the claim you wish to view the insurance payments for by clicking once on the bax to the left of the claim 5 Select the action View Insurance Payments 6 Click ance on Gol Update an Insurance Payment 1 Select the insurance payment you wish to update 2 Select the action Update Insurance Payment 3 Click once on Go 4 Type the necessary changes in the spaces provided 5 Click once on Update Remove an Insurance Payment Administrator Only 1 Select the insurance payment you wish to remove 2 Select the action Remove Insurance Payment 3 Click once on Go www medrium com lt 29 gt 8 29 01 EN X Posting a Capitation Payment Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click once on Claims 2 Click ance on Post Capitation Payment Insurance Payments Vs Capitation Payments Posting an insurance payment serves several purposes It keeps a clean audit trail reconciles the claim and determines what portion of
13. less is more rule and search by patient name typing only the letter d That would bring up every single patient whose name starts with the letter d Or you could use the search type Last Name Sounds Like This way you can type how you think the last name is spelled and still find the patient even if you spell it wrong For example typing the name Steel would bring up patients with the last names Steele Steal and Steale What Patient ID If you haven t noticed already patients are automatically assigned a permanent ID number when you add them to your account This ID number can always be substituted for the patient name saving you an extra step whenever you add a claim search for a claim or add an appointment The patient ID is also invaluable between patients with the same or similar names So it may just help you in the long run to start memorizing the ID numbers of patients that have a lot of account activity www medrium com lt 4 gt 8 29 01 Adding a New Patient Who Has Access To This Feature User Type Receptionist Biller Provider or Administrator How Do I Get Here 1 Click once on Patients 2 Click once on Add Hew Patient Save Yourself Some Unnecessary Typing Whenever you are entering data or even typing search criteria keep these five rules in mind Nothing is case sensitive This means you never have to capitalize anything Or if you
14. line item on the claim type the allowed amount the amount applied to the deductible the co insurance amount co pay the amount paid and the write off amount The disallowed amount should already be calculated for you If you wish to record any notes or remarks with the posting click once on the Addtl Info box next to the line item Select the adjudication reason s type your remarks in the space provided and click once on Save Save Yourself Some Unnecessary Typing While posting insurance payments keep the following tips in mind Use the Tab key Once you have typed the allowed amount use the Tab key on your keyboard to move the curser to the deductible space When you do the system will use that number to calculate the disallowed and the amount paid Type the amount applied to the deductible and hit Tab again The system will then recalculate the amount paid The same rule applies for the co insurance amount or co pay Don t Type Zeroes If the amount applied to the deductible is zero you do not have to type in 0 00 You can simply tab over to the next space While posting insurance payments any space that you leave blank is automatically recognized as a zero Use the Auto Write Off You can save your self some time by clicking on Auto Write Off This will automatically write off any remaining balance for each line item on the claim 6 Once you have typed the appropriate amount
15. rates and write offs for each procedure This report can be sorted either by procedure or by insurance Procedure Summary This report breaks down each procedure for any given date range and lays out the number of procedures billed the total charges the total payments and the total amount of write offs for each procedure code used Financial Summary This report will show you each provider s total numbers Charges receipts and adjustments for any given date range It also shows the total A R net A R and the percentage of the charges that have been accounted for This is an excellent report for end of the year or quarterly analysis Capitation Summary This report summarizes the total number of charges and procedures performed for capitated patients along side the amount received in capitation checks It also shows any payments received on non capitated procedures performed on capitated patients This is a good report to determine which capitation contracts are working out in your favor and which ones are not www medrium com lt 40 gt 8 29 01 W X Editing Your Web Site Who Has Access To This Feature User Type Provider or Administrator How Do I Get Here 1 Click once on Maintenance 2 Click ance on My Web Page Your Web Site Each billing provider in your account already has a Web site and listing in our provider directory where patients can search for physicians by specialty and location The Web pages
16. the left of the claim Select the action Update Claim Status Click once on Gol mama ces om an 1 Select the new claim status from the options provided 2 Click once on Update Status The options provided will vary depending on the current status of the claim Below are few brief explanations of each possible status and their effect Submit Primary Submits the claim to the primary insurance carrier Primary Submitted Changes the status but does NOT submit the claim to the carrier Resubmit Primary Resubmits the claim to the primary insurance carrier Submit Secondary Submits the claim to the secondary insurance carrier Secondary Submitted Changes the status but does NOT submit the claim to the carrier Resubmit Secondary Resubmits the claim to the secondary insurance carrier Submit Tertiary Submits the claim to the tertiary insurance carrier Tertiary Submitted Changes the status but does NOT submit the claim to the carrier Resubmit Tertiary Resubmits the claim to the tertiary insurance carrier Claim Reconciled Reconciles the claim Any remaining balance is forwarded to the patient You may sometimes see a claim that has a status not listed above Below are explanations Primary Rejected Secondary Rejected Tertiary Rejected This means that the insurance carrier reyected the claim You can view the payer response by clicking once on the word Rejected The payer response will give you a brief exp
17. to the procedure and modifier codes The place of service can be determined from the location you selected previously and the type of service can often be determined from the procedure code that you type I Don t Have a CPT HCPC Book Handy No problem You can search for the procedure modifier place of service and type of service codes you need by clicking once on the magnifying glass next to each appropriate space Dates of Service l Place of Type of CPT HPCS E G A O G E E E E 19 Type the number s 1 4 of the corresponding diagnosis codes as well as the number of units for the procedure code you typed Box 24e and 24g of the HCFA 1500 form Save Yourself a Step If the procedure corresponds with ALL of the previously entered diagnosis codes then you can skip that step And if the number of units is equal to one then you can skip that step as well When you leave Diag Code and the Units spaces blank they will be automatically filled when you validate the claim 20 If the service was rendered on an emergency basis check the space titled EMG by clicking on it once Box 241 of the HCFA 1500 form 21 If you wish to make any additional remarks regarding this service click once on the icon titled Remarks Type your remarks and click once on Save Box 19 of the HCFA 1500 form Repeat steps 17 through 21 for each additional line item on the claim When you are finished cl
18. wish you can type everything in all caps It makes no difference No slashes hyphens spaces etc No hyphens or parentheses are necessary when typing phone numbers No spaces or hyphens are needed when typing social security numbers And you ll never have to type the slashes when typing dates Type abbreviated dates If a patient s birthday is July 24 1969 all you need to type is 072469 The 19 and the slashes will automatically appear for you Type the first or last name If you are searching for a patient and the last name is NOT specifically asked for you can type all or a portion of the patient s first name if you wish Use the Tab key Whenever vou are adding a new patient adding a new claim posting an y y g p g P g EOB etc use the Tab key on your keyboard to move your cursor to the next space Use j y y y y p Shift Tab to move the cursor to the previous space Personal Information 1 Type the patient s last name first name and middle initial in the spaces provided Box 2 of the HCFA 1500 Form 2 Type the patient s nine digit social security number in the space provided 3 Type the chart number in the space provided 4 Type the patient s date of birth IMMDDYY in the space provided Box 3 of the HCFA 1500 Form 5 Select the patient s sex in the space provided Box 3 of the HCFA 1500 Form 6 Select the patient s marital status student s
19. you re your Web site looks like to anyone browsing the World Wide Web www medrium com lt 41 gt 8 29 01 Adding a New User Who Has Access To This Feature User Type Administrator How Do I Get Here 1 Click once on Maintenance 2 Click once on Add User Type the User ID in the space provided The User ID must be between five and twelve characters in length N Select the user type from the options provided The user type you select will determine which features that user will have access to See chart below SN Type the user s password and then the exact same password again Keep in mind that both the User ID and password are NOT case sensitive so capital letters make no difference The password must be between five and twelve characters in length 4 In the space titled Password Hint type any word or phrase that will remind the user of his her password incase it is forgotten JI In the space provided select the provider if any you wish to restrict this user s access to Click once on Add oN There are currently six types of users you can add to your account They are Administrator Biller can delete claims Biller can NOT delete claims Provider Receptionist and Accountant Below is a chart that details which features each user type will have access to The X indicates that the usert DOES HAVE ACCESS to that feature Only Administrato
20. FA 1500 form 7 Select the referring provider in the space provided The ID of the referring provider should appear in the appropriate space Box 17 and 17a of the HCFA 1500 form www medrium com lt 15 gt 8 29 01 Wh i 8 If the current services are related to a hospital stay type the admission date in the space titled Hospitalization From Type the discharge date in the space titled To Box 18 of the HCFA 1500 form 9 Type the prior authorization number if any in the space provided Box 23 of the HCFA 1500 form 10 In the spaces titled Diagnosis Codes 1 4 type the diagnosis code or codes you wish to use Box 21 of the HCFA 1500 form I Don t Have an ICD 9 Book Handy No problem You can search for the diagnosis code you need by clicking once on the magnifying glass next to each diagnosis space Prior Auth j j iF Diagnosis Codes T E 2 A 3 a 4 a Lab Charges Accident Information Disability 11 If there are outside laboratory charges click once on Lab Charges Enter the lab information and click once on Save Box 20 of the HCFA 1500 form 12 If the patients treatment is accident related click once on Accident Information Enter the accident information and click once on Save Box 10 of the HCFA 1500 form 13 If the patients treatment is related to a disability click once on Disability Enter the disability information and click o
21. Users Manual For further support please call 877 633 7486 MEDRIUM commn 1850 Polk Street San Francisco CA 94109 U SA 415 202 8600 415 202 8620 fax www medrium com Copyright 2000 M edrium com Table of Contents Every feature in your account can be found in one of six categories Appointments Claims Patients Financials Maintenance and Communication Center See Below Lo Out Help OPsbents Obinangals O Maintenance Communication Cente Account ID CBO User 1b EDGAR Appointments Scheduling an Adding a Searching Reports Adding a Viewing Your Appointment New Claim for Patients Reports New User Inbox Page 32 34 Page 15 17 Page 3 4 Reports Page 42 43 Page 51 Page 40 Viewing Print Searching for Adding a Changing Your Reading Your Appointments Claims New Patient Password Messages Page 35 38 Page 18 19 Page 5 7 Page 44 Page 52 Searching for Updating an Updating an Using a Sending a Appointments Existing Claim Existing Different Message Page 39 Page 20 Patient Credit Card Page 53 54 Page 8 Page 45 Using the Posting a Defining Your E Bill to Add Patient Procedure a New Claim Payment Charges Page 21 22 Page 9 Page 46 Printing a Printing Adding an Claim to a Patient Insurance HCFA Form Statements Carrier Page 23 24 Page 10 Page 47 49 Posting an Viewing a Editing Your Insurance Patient s Web Site Payment History Page 41 Page 25 28 Page 11 View Existing Downloading Adding a Insura
22. and type in PRUD You get the following results PayerID Enroll Regd Prudential p o Box 2000 millville nj 08332 ge 8241 Prudential Encounters Although there are two different 68245 mailing addresses you will only Prudento Porhesieh need to add one to your list since 682441 TE inne etna the payer ID 68241 is the sare Prudential Plus p o Box 4046 iselin nj 08830 6s241 E Prudential Plus Select 624l Notice that both the Millville and the Iselin addresses have the same payer ID 68241 This means that you only need to add one of them to your list of carriers Even though the two patients have different addresses printed on their cards both can use the same prudential since the electronic address is the same You may even have a Prudential with the same payer ID already on your list of insurances in which case you do not need to add any of the above Adding two insurance carriers to your list with the same payer ID will only cause confusion when it comes time to post insurance payments Insurance Name Contains 1 Select Insurance Name Contains from the space on the left 2 Type any portion of the insurance name in the space on the right 3 Click once on Search Insurance by City 1 Select Insurance by City from the space on the left 2 Type the city of the insurance address in the space on the right 3 Click once on Search www medrium com lt 48 gt 8 29 01 W 8 Insuranc
23. are automatically created using the information provided when the account was originally created You can view these Web pages by selecting the action Preview See below However if you wish to differentiate your Web site from the rest of the web sites in our provider directory there are several ways to do so Below is an overview of how to customize your site to suit your needs 1 Select the provider whose Web site you wish to update from the space on the left 2 Select an action from the space on the right 3 Click once on Gol Dr Jean smith Update Home Page Gol Update Office Page Select the sae whose Update Insurance Page web site you wish to edit Update Hospital Affiliations from the space on the left Change Home Page Address Ch T late Styl Select the action you anne emplate Lyle wish to perform from Preview the space on the right Update Home Page Add your photograph edit your introduction your professional information and your health tips Update Office Page List your offices and office hours Update Insurance Page List the insurance carriers you participate with so patients can be sure that their visit with you will be covered Update Hospital Affiliations List your hospital affiliations for those who need to know Change Home Page Address Change your Web address to www whatever _you_want com Change Template Style We offer several Web templates to choose from Preview See what
24. ate is the actual day you posted the payment You can always change the transaction date by updating the payment However the posting date can never be changed www medrium com lt 9 gt 8 29 01 L X d Printing Patient Statements Who Has Access To This Feature User Type Receptionist Biller Accountant Provider or Administrator How Do I Get Here 1 Click once on Patients 2 Click once on Batch Statements 1 Select the provider you wish to print statements for 2 In the space provided type the minimum dollar amount you wish to print statements for 3 Specify which statements to print and which not to print in the spaces provided 4 Type the name of whom to make checks payable to in the space provided 5 Type the address city state and zip code to send the payments to in the spaces provided 6 Type the phone number area code first that you wish to appear on the statement in the space provided 7 Type any messages you wish to appear on the statements in the spaces provided 8 Click once on Print www medrium com lt 10 gt 8 29 01 EN X Viewing a Patient s Financial History Who Has Access To This Feature User Type Receptionist Biller Provider ar Administrator How Do I Get Here aly 2 a 4 aly Click once on Patients Specify A Search for the patient whose financial history you wish to view and click once an Search Select the patient by clicking on
25. ave selected your recipients they should appear in the space titled To See Below To Tech Support techsupport www medrium com lt 53 gt 8 29 01 The Subject and the Body Type the subject of the message in the space titled Subject The subject is what will appear as the message title when the recipient checks his or her inbox Type the tithe of the message Ta Tech Support techsupport in the space titled Subject a Subject fUnsubrmitted Claims Dear Tech Support I have several claims that curre Type your message _ Does this mean that the claims in the space below Please advise Sincerely Mer Biller Message If you wish to save a copy of this message check the box titled Save copy of When vou are ready to send your message click once on Send Empty Trash Send Cancel J O I Save copy of outgoing message in Sent folder Address Book www medrium com lt 54 gt 8 29 01
26. ce on the box to the left of the patient s name Select the action View Patient History Click once on Gal If you wish to view the detail for any transaction on the patient s history click once on the claim ID or reference number for that transaction The balance you see in the financial history is the patient s total account balance with the selected provider It is NOT necessarily the amount due from the patient since insurance payments may still be outstanding To determine the amount due from the patient click once on View Statement For Multiple Providers You can view the patient s financial history with any other provider by using the Select a Provider box at the top of the page Patient History Select a Provider Provider or JEAN SMITH www medrium com lt 11 gt 8 29 01 L x d Downloading Your Patient Data 1 Click once on Patients 2 Specify a search for the patients you wish to download I Want a List of ALL Patients There are two good ways to generate a list of all your patients The first is to use the search type Date of Birth Greater Than Simply type 01 01 1850 and you ll get a list of all patients born on or after January 1 1850 Of course this will not work if you have any patients born before then That would be something In that case use the search type Last Name Starts With type the percentage symbol shift 5 on your keyboard and
27. cess To This Feature User Type Biller Accountant Provider or Administrator How Do I Get Here i Click once on Financials About Financial Reports The best way to get to know the reports is simply to run them all until you find the one that s right for you They can all be manipulated in one way or another So the best thing to do is play around with them until they make sense Below is a very general breakdown of each report and what they do Daysheet This report will show every transaction for a given day 1 e charges added patient payments posted and insurance payments posted The daysheet can be run either by the posting date or by the transaction date You can run user specific daysheets if you want to know who performed what transactions and when Daysheet Summary This is like the day sheet except that you can provide a date range rather than a single day Although this report doesn t give you all the details of the daysheet it does have direct links to each daysheet in your date range Patient Aging This report will list every patient with a balance per provider It also has direct links to the statements for each patient Insurance Aging When it s time to do your follow ups this report can help point out which carriers have the oldest outstanding balances This report also has direct links to outstanding claims in question Adjustments Summary This report illustrates your average charges reimbursement
28. ck once on Yes YOU MUST ACCEPT THIS CERTIFICATE or you will not be able to print any claims to a HCFA 1500 form To ensure that you have access to all of your account features you should ALWAYS erant or accept certificates issued by Medrium com www medrium com lt 24 gt 8 29 01 L x d Posting an Insurance Payment Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click ance on Claims 2 Click once on Post Insurance Payments Insurance Payments Vs Capitation Payments Posting an insurance payment serves several purposes It keeps a clean audit trail reconciles the claim and determines what portion of the balance is the patient s responsibility This is not the same as posting a capitation payment Even if the amount paid is zero as with capitated contracts you post the appropriate amounts to each line item on every claim Posting monthly capitation payments is a separate function Its only purpose is to keep records of all monies received so that capitation analysis reports can be created with the appropriate financial data If you wish to post a monthly capitation check please refer to the section of this manual titled Posting a Capitation Payment Step One Search Claims 1 In the space titled Insurance select the insurance carrier that issued the check See Below Search Criteria Insurance LIFEGUARD 1199 MEMBER CHOICE Star
29. e Select the provider and location you wish to search open slots for Event Follow Follow Up Provider Edgar Poe M D a Location House Of Usher Start Date fos i o 2001 End Date 08 24 2001 Search Select the time frame you wish to search for open slots in and click once on Search If you are searching for an open slot for a new appointment you may see results like this Click ance on the date to open anew window 0 00 am 09 15 am and display the current 08r i 2001 Friday 10 15 am 12 00 pm appointments on that day 01 00 pm 05 00 pm 08 00 am 12 00 pm 08 13 2001 Monday 01 00 pm 05 00 pm If you are searching for an open slot to reschedule an appointment you may see results like this Click once on the tire slot to automatically fill in the date and time above Click once on Go Reschedule event to fos 02001 at fos o0 AM Go ha to automatically reschedule the appointment ta that time slot a E E EE 0 00 am 09 15 am 08 10 2001 Friday 10 15 am 12 00 om 01 00 pm 05 00 pm 0 00 am 12 00 pm 01 00 pm 05 00 pm is 13 2001 Monday _ Click once on the date to open a new window and view the current appointments for that day www medrium com lt 34 gt 8 29 01 L X d Viewing Printing Your Appointments Who Has Access to this Feature User Type Receptionist Provider Biller or Administrator How Do I Get Here 1 Click ance on Appointments Once you click o
30. e by State 1 Select Insurance by State from the space on the left 2 Type the two letter postal abbreviation of the carrier s state in the space on the right yp p p 2g 3 Click once on Search Insurance Address Contains 1 Select Insurance Address Contains from the space on the left 2 Type any portion of the carrier s address in the space on the right 3 Click once on Search Once you find the insurance carrier you are looking for you can add it to your list by clicking once on the space to the left of the carrier name then clicking once on Add Adding a New Insurance Carrier You ve searched and searched but you still can t find the insurance carrier you are looking for In that case click once on Add New and you should see the following Add New Insurance Insurance TO Hame Insurance Type Commercial Address re City State Zip Phone FO 1 Type the name of the insurance carrier in the space provided If you know the payer ID type the name of the carrier with the payer ID in parentheses 2 Select the insurance type from the options provided 3 Type the claims address and phone number in the spaces provided 4 Click once on Add www medrium com lt 49 gt 8 29 01 f Adding a Referring Provider Who Has Access to this Feature User Type Biller or Administrator How Do I Get Here 1 Click once on Maintenance
31. ent s information view or print a statement for that patient e g ljam I Lee Anabell Click once on the patient s copay 9 30am to post a payment wom that patient gi 45am i0 00am Shakespeare Will E Copay 10 00 Click once on the pencil icon to edit Click once on the white box next to the or reschedule that appointment patient s name to add a claim for that patient Once you add a claim for a patient on your schedule the white box should be filled in Click once on the fille din box to update that claim See Below Qiisam M d 30am 0 45am aan M Shakespeare Will Ll opay 10 00 Lee Anabell E Bal 40 00 If the white box is filled in it means that a claim has already been added for that patient on that date of service Click once on the filled box ta update that clair www medrium com lt 37 gt 8 29 01 d Appointment Status There are five possible statuses that an appointment can be Confirmed Checked In Cancelled No Show and Unknown Every new appointment that you add to your schedule begins with the status Unknown To change the status of an appointment click once on the pencil icon next to the appointment See Below g 45am io oaan D Shakespeare Will E copay 410 00 Click once on the pencil icon to change the status of the appointment Select the new status from the options provided See Below Change status to Unknown Go Unknown Sy hecked
32. he Personal Information header for each patient See step 13 of Adding a New Patent 1 Type the necessary changes in the spaces provided 2 When you are finished click once on Update For mote detailed information on updating an existing patient please refer to the section of this manual titled Adding a New Patient www medrium com lt 8 gt 8 29 01 Posting a Patient Payment Who Has Access To This Feature User Type Receptionist Biller Provider or Administrator How Do I Get Here 1 Click ance on Patients 2 Specify a search for the patient you wish to post a payment for and click once on Search 3 Select the patient by clicking once on the bax to the left of the patient s name 4 Select the action Post Patient Payment 5 Click ance on Gol 1 Type the transaction date in the space provided 2 Type the payment reference number and select the type of payment in the spaces provided 3 Type the dollar amount of the patient payment in the space provided 4 Type any additional remarks you wish to make regarding this payment in the space provided 5 Click once on Post Patient Payment Transaction Date This date will determine how and where the payment appears on your Daysheet Both the Daysheet and the Daysheet Summary can be run either by transaction date ot posting date In regards to patient payments the transaction date is the date you type in The posting d
33. ick once on Validate At this point the system will check the claim over for any basic errors If any are found the page will reappear and the errors will be highlighted in red for you to correct If no errors are found you should see a summary of the claim You will then have the opportunity to enter or change the procedure charges and you will be left with three choices Click once on one of the following options to continue submit Claim Hold Claim Modify Claim This option adds the This option adds the charge to the database ae e ESE This option allow s you and submits the claim but does MOT cub cat to go back and make to the patient s primary Eere more changes to the insurance carrier clair before you add it www medrium com lt 17 gt 8 29 01 d Searching for Claims Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click once once on Claims 2 Click once on Search Claims Less Is More When searching for claims or anything for that matter the rule of thumb is this A broad search is better than a narrow search Basically this means that the less specific your search criteria the more you get See Example A and B Example A The search criteria shown here in Example A is very specific and would most likely result in a list of only one or two claims if any Bu Patient Last Name ID grey oo an 1 Insurance ID Ey Date of En
34. in ee nee SO Select the status you wish to change the Mo show appointment to and click once on Go Confirme The new status will then appear next to the appointment See Below O 154am i Lee nabell E Bal 40 00 0 30am 24330 q E 10 00am shakespeare Will Checked in Copay 10 00 The new status will be p next tothe appointment www medrium com lt 38 gt 8 29 01 d Searching for Existing Appointments Who Has Access to this Feature User Type Receptionist Provider or Administrator How Do I Get Here 1 Click once on Appointments 2 Click once on Search Patient Appointment Select the provider and location you wish to search appointments for Provider EDGAR A POE M D Location HOUSE MF USHER aj Start Date os 01 2001 Type a portion of the patient s first or last name in the space provided Or if Patient Hame LEE you know the ID of the patient you are searching for type that in the space Type the earliest date you wish your search to begin Click once on Search and you may see search results similar to below Click once on the patient s name a Fe ee ae ear ee to view or update the patient info 44 view that schedule 4nabell Lee HOUSE OF Edgar A Poe _ _ 1 USHER Md 08 09 2001 9 15AM Anabell Lee HOUSE OF Edgar A Poe eee te USHER M d 08 10 2001 3 15AM www medrium com lt 39 gt 8 29 01 a Reports Reports Reports Who Has Ac
35. itled Remember This Decision by clicking on it once Then click once on Grant Internet Explorer users will see something like this SIGNED WITH PERMISSIONS Pont Pe re i ek ee pa M F Sains er eal AAi TA ME A SETA E a TT ny Fe TER Fal 2 aS AE Pe eS ay Peed y P aL PEE aS Pe yy eee Netwek VU Peon EENI Check the box titled Always Trust Content from Medrium com by clicking on it once Then click once on Yes YOU MUST ACCEPT THIS CERTIFICATE or you will not be able to print any claims appointments or statements To ensure that you have access to all of your account features you should ALWAYS grant or accept certificates issued by Medrium com www medrium com lt 36 gt 8 29 01 To print your appointments for the day complete with patient phone numbers and appointment notes click once on the Print button found at the bottom of the appointment screen See Below Do NOT use the print button on your browser 4 45om Sodom I Hammett Dashiell E Copay 20 00 Print ae Click once on Print found at the bottom of your appointment page Each appointment in your appointment book will have the following options Edit reschedule the appointment view the patient s information add a claim from the appointment post a patient payment or view the patient s statement See below Click Anemon the patient s name to Click once on the patient s balance to view or edit that pati
36. lanation as to why the claim was rejected so that the appropriate changes can be made before you resubmit the claim Hold Primary This means that when the claim was created it was never submitted but put on hold instead Not Submitted This could mean one of two things A The patient has no insurance for that date of service B The claim was created today All new claims begin with the status Not Submitted since technically we have not submitted them yet Normally we submit all new claims at the end of every business day If you check the status of a new claim at least 24 hours after it was created you will see that it has been automatically changed from Not Submitted to Primary Submitted www medrium com lt 31 gt 8 29 01 d Scheduling Rescheduling an Appointment Who Has Access to this Feature User Type Receptionist Provider or Administrator How Do I Get Here 1 Click once on Appointments 2 Select the provider location and date you wish to add an appointment for 3 Click ance on the time you wish to add an appointment for 1 The first thing you must do is select the appropriate event type for the appointment you are scheduling See Below The event type will determine the duration availability and the color of the appointment you are scheduling To add a new event type or to edit the specifics of an existing event type click once on Event Types Add Follow Up
37. lows you to select the type of patient search you wish to conduct The space on the right is where you type your search criteria See Example Below Search Patient Last Hame starts with Search Last Mamme starts with First Mame starts with Social Security Insurance ID Select one of eight Last Hame sounds like y different ways to search Date of Birth greater than from the space on the left PatientID Chart Patient Ph Type your search criteria in the space on the right www medrium com lt 3 gt 8 29 01 S Helpful Tips for Searching Patients I Want a List of ALL Patients There are two good ways to generate a list of all your patients The first is to use the search type Date of Birth Greater Than Simply type 01 01 1850 and you ll get a list of all patients born on or after January 1 1850 Of course this will not work if you have any patients born before then That would be something In that case you can generate a list of all patients by using the search type Last Name Starts With typing the percentage symbol shift 5 on your keyboard and clicking once on Search I Don t Know How to Spell the Patient s Name You know it starts with the letter d but you couldn t spell it if your life depended on it You don t know the social security number the insurance ID or the patient ID Basically this limits you to only two choices You could follow the
38. mbination of a procedure and modifier code not specified will result in a charge of 0 when you validate the claim At that time you will have an opportunity to add the appropriate charge manually www medrium com lt 46 gt 8 29 01 W X Adding an Insurance Carrier Who Has Access To This Feature User Type Biller or Administrator How Do I Get Here 1 Click once on Maintenance 2 Click once on Insurance 3 Click once on Add Search Insurances Before you add an insurance carrier you should first search our database for a carrier to add using one or more of the following six search types search Type your search Insurance name starts with Insurance name starts with PayerlD equals Insurance name contains Select a search type from the space on criteria in the Insurance by City the left space on the right Insurance by State Insurance Address Contains Insurance Name Starts With 1 Select Insurance Name Starts With from the space on the left 2 Type the first few letters of the insurance carrier name in the space on the right 3 Click once on Search Search Tips When using the search type Insurance Name Starts With keep the following seatch tips in mind Less Is More If you re looking for an insurance carrier named National Health and Life Inc do NOT type the entire name Instead type National or even just Nat Use BC
39. ments and select the appropriate provider and or location Type any remarks you wish to make regarding the appointment in the space provided See Below wWerify that you are adding the appointment to the correct provider and or location Provider Edgar A Poe M D Location House Of Usher Last name LEE First ANABELL mil phat 415 555 1212 Date logy 02001 tart Time fa 15 AM Curation a0 min Remarks Anything that you type in the remarks box Werity that the date time and duration are will appear next tothe appointment on all correct If not make the appropriate changes printed copies of the schedule 4 When you are finished click once on Add To reschedule an appointment click once on the pencil icon next to the appointment you wish to reschedule See Below g 45am 10 00am D Shakespeare Will E topay 410 00 Click once on the pencil icon to edit or reschedule that appointment In the spaces provided type the date time and duration you wish to reschedule the appointment to Click once on Update when you are finished or click once on Remove to completely remove the appointment from your schedule www medrium com lt 33 gt 8 29 01 d Searching for Open Slots Whenever you schedule a new appointment or reschedule an existing appointment you can search for available times by clicking once on Find Open Slot Select the type of appointment you wish to search open wy a
40. n Appointments the small calendar on the left side of your screen will help you navigate through the different days See below Click here for the Click here for the previous month next month January a L242 2 4 2 Za 9 10 11 az a3 71 25 33 34 35 26 sia Click on the calendar day 78 39 30 31 _ you wish to view the appointments for Today is January 5 2001 in Click on the word Today to return to the current day s appointments Use the date provider and location fields at the top of your appointments to view other schedules See Below Date 08706 2001 Edgar A Poe M D Location House Of Usher N To quickly view the appointments Select the provider you wish for another day type the date and to view the appointments for Select the location you wish press Enter on your keyboard to view the appointments for To add an appointment click once on the time closest to the actual time you wish to add the appointment for See Below For more detailed information regarding adding appointments please refer to the section of this manual titled Scheduling Rescheduling an Appointment 10 30am To add a new appointment click 10 45am T once on the appropriate time 11 00am 11 154m www medrium com lt 35 gt 8 29 01 Certificates The first time you view your appointment screen a security warning will appear Netscape users will see something like this Check the box t
41. nce Your Patient Referring Payments Data Provider Page 29 Page 12 14 Page 50 Posting a Capitation Payment Page 30 Updating the Claim Status Page 31 www medrium com lt 2 gt 8 29 01 d Searching for Patients Who Has Access To This Feature User Type Receptionist Biller Provider or Administrator How Do I Get Here 1 Click once on Patients Less Is More Searching for a patient is the action you will perform more than any other It s the first thing you have to do before you post a patient payment view a patient statement update a patient s insurance information or view the patient notes You even have to search patients when you add claims and appointments No matter what you re trying to do the best advice for searching patients is this A broad search is better than a narrow search When you search patients or anything for that matter less is more Basically this means that when you are trying to find a patient by name you ll get better results if you only type a portion of the name rather than the whole thing Of course this will only work when you are searching by name When searching by the patient s social security number patient ID number or insurance ID you must get it exactly right to find the patient Whenever you click on Patients the first thing you will see is this Search Patient Search Patent Last Hame starts with Search The space on the left al
42. nce on Save Box 16 of the HCFA 1500 form 14 If you are billing on the patient s behalf and would like the payment to go directly to the patient uncheck the space titled Accept Assignment Boxes 13 and 27 of the HCFA 1500 form 15 If the provider s signature is NOT on file uncheck the space provided Box 31 of the HCFA 1500 form 16 If the release of patient information is NOT authorized uncheck the space provided Box 12 of the HCFA 1500 form 17 In the spaces titled From and To type the dates of service Box 24a of the HCFA 1500 form Use the Tab Key If the dates of service From and To are the same you only need to type the date once Simply type the date of service in the space titled From and press the Tab key on your keyboard twice This should automatically fill in the date of service To with the same date you typed in From If the From and To dates of service are the same as the current date then you don t need to type any dates at all Today s date will automatically appear in those spaces when you validate the claim 18 Type the place of service code type of service code procedure code and modifier code in the spaces provided Box 24b 24c and 24d of the HCFA 1500 form www medrium com lt 16 gt 8 29 01 Save Yourself a Step In most cases you can skip the place of service and type of service codes and go directly
43. new insurance carrier click once on Patients and search for the patient you were adding Select that patient select the action Update Patient Info and click once on Go Now you are free to finish adding the patient s insurance information 16 Type the patient s insurance ID number Box 1a of the HCFA 1500 Form and group policy number Box 11 of the HCFA 1500 Form in the spaces provided 17 Type the insurance carrier s telephone number and eligibility phone number in the spaces provided 18 If the patient is capitated with this insurance check the space titled Capitated 19 Select the patient s relationship to the insured from the options provided Box 6 of the HCFA 1500 Form 20 Type the insured s last name first name and middle initial in the spaces provided Box 4 of the HCFA 1500 Form 21 Type the insured s nine digit social security number in the space provided 22 Type the insured s date of birth MMDDYY in the space provided and select the insured s sex Box 11a of the HCFA 1500 Form 23 Type the insured s address and home phone number area code first in the spaces provided Box 7 of the HCFA 1500 Form 24 Under the heading titled Employer Information type the full name of the insured s employer Box 11b of the HCFA 1500 Form 25 Type the insured s employer ID number in the space provided 26 Type the address of the insured s employer in the space
44. nge the procedure charges on the claim You will then have the following options submit Claim Hold Claim Modify Claim This option adds the Zo charge to the database dae cphen sods me charge to the database This option allow s you and submits the claim but does NOT ubrit to go back and make to the patient s primary the clainn more changes ta the insurance carrier clairn before you add it www medrium com lt 22 gt 8 29 01 d Printing a Claim to a HCFA Who Has Access To This Feature User Type Biller Provider Gr Administrator How Do I Get Here Click once on Claims Click once on Search Claims Search for the claim you wish to view print Select the claim you wish to view print by clicking ance in the box to the left of the claim Select the action View Print Claim Click once on Gol PME man A Word About Certificates Before you can print a claim print appointments super bills or patient statements you must accept the certificate that allows these features to happen Once you have accepted the certificate you will not have to accept it again on that computer For more information on certificates see the next page 1 Put a HCFA 1500 form in your printer 2 Click once on Offset Print Page 3 Adjust you x and y offsets appropriately and click once on Save 4 Click once on Print to HCFA Form Offsetting the Print Page In order for everything
45. rs will have access to ALL features NOT delete Appointments View Appointments Feature seen ei p ptionist Provider Biller Can Appointments Everything Else Claims Delete Claims Claims Remove Ins Payments Claims X X X Everything Else Continued on Next Page www medrium com lt 42 gt 8 29 01 SS Continued Feature Accountant Receptionist Provider Biller Can Biller NOT delete Patients X View Patient Payments Patients Remove Pat Payments Patients X Everything Else Financials Entire Section My Web Page Entire Section X X Maintenance Account X X List amp View Users Maintenance Account Everything Else Maintenance Insurance X X List Insurances Maintenance Insurance Add or Remove Ins Maintenance Providers X List Provider Maintenance Providers Add a Provider Maintenance Providers Everything Else Maintenance Locations List amp View Locations Maintenance Locations Everything Else Maintenance E Bills List amp View Templates Maintenance E Bills Everything Else Maintenance Provider Numbers www medrium com lt 43 gt 8 29 01 sof pf o pf x e pf x Le pf x e L X d Changing Your Password Updating a User Who Has Access To This Feature User Type Administrator How Do I Get Here 1 Click once on Maintenance 2 Select the user whose information you wish to update b
46. s 1 To save a set of default values for a procedure code you must post those numbers at least once The first time you post a payment for a particular insurance you can save the set of numbers for each line item by simply checking the box titled Save as Default See Below That way the next time you post a payment from that insurance you can retrieve those numbers Saving a set of default values for a procedure code does NOT mean that you will be forced to use those numbers next time Default values can be manually altered after retrieval Patient Quince Peter InsurancelID 123 By checking the box titled Save as E i Save Default you are saving the set of as Dos Proc Charges Allowed B numbers you posted as your default derat values for that procedure code m O2 23 2001 99213 145 00 55 00 z O2 23 2001 86580 55 00 22 50 Change status to submit secondary Retrieving the Default Values 2 To retrieve the default values you previously set click once on Get Default Values This will bring up any previously set values for the entire claim See Below Charges Allowed Deduct Capay Paid Write Of Disallowed 145 00 5 00 10 00 fe5 00 50 00 50 00 22 00 22 50 22 50 22 50 22 50 aconciled a Get default values Auto Write Ott Re Clicking on Get Default Values w ill fill in all previously set numbers for each line item on the claim If any of the default numbers do not match with your
47. s for each line item make sure to select the status you wish to change the claim to See Below For more information on changing the status of a claim please the section of this manual titled Updating the Claim Status Change status to submit secondary a Current status primary submitted Change status to submit secondar kT Change status toa secondary submitted Change status to claim reconciled For each claim you post a pay rent ta be sure to select the appropriate status 7 Once you have typed the appropriate amounts for each claim on the EOB verify that the check totals at the bottom of the page match the totals on your EOB If everything is correct click once on Post EOBS to complete the entire posting www medrium com lt 27 gt 8 29 01 d Using the Default Values to Post Insurance Payments Default Values The default values are sets of numbers that are saved in the database to be retrieved again at a later time In the case of insurance payments the default values include the allowed amount the deductible the co insurance amount the amount paid the write off amount and the disallowed Basically for every insurance carrier on your list you can save an entire set of numbers for every procedure code you use This will not only save you from typing the same numbers over and over again but it is also a good way to make sure that you are receiving the full contractual amount Setting the Default Value
48. s provided 27 Type the city state and zip code of the insured s employer in the spaces provided www medrium com lt 6 gt 8 29 01 EN A Secondary Insurance If the patient does NOT have any secondary insurance skip to step 28 If you wish to add secondary insurance for the patient click once on Secondary Insurance and repeat steps 15 through 27 Tertiary Insurance If the patient does NOT have any tertiary insurance skip to step 28 If you wish to add tertiary insurance for the patient click once on Tertiary Insurance and repeat steps 15 through 27 28 Click once on Add www medrium com lt 7 gt 8 29 01 Updating an Existing Patient Who Has Access To This Feature User Type Receptionist Biller Provider or Administrator How Do I Get Here 1 Click ance on Patients 2 Specify a search for the patient whose information you wish ta Update and click once on Search 3 Select the patient by clicking once on the bax to the left of the patient s name 4 Select the action Update Patient Info 5 Click once on Go When a Patient Changes Insurance Carriers Before you change the patient s insurance make sure that all previous claims have been successfully submitted Any claims on hold may be affected by the insurance change Make sure that you change the insurance effective date as well or all outstanding claims will be affected This is found under t
49. t Aetna Date Jac CALIFORNIA BROW AAO TOLAND MEDICAL GROUP Champus Region 10 California Next CHAMPUS Region 2 Mid Atlantic LIFEGUARD Medicare of Na California SMSF IPA Selecting Lifeguard will only find the outstanding clairre that were submitted to Lifeguard If you have more than one insurance with the same or similar names you may instead type the insurance keyword for a broader search See Below or search by keyword life Typing the word life inthe keyword space will include all insurances containing any variation of the word life e g Lifeguard Mega Lite Insurance or American Lite www medrium com lt 25 gt 8 29 01 N E d 2 Type the date range of the EOB then click once on Next to continue See Below Type the earliest date of service on the EGB in the space titled Start Date Type the latest date of service on the EOB in the space titled End Date LIFESUARD sik 05726 2001 End Date 07 21 2001 ext Click once on Next to begin the claim search In this example you would find all outstanding ae clainne submitted to Lifeguard where the date of service is beww een 0S 26 01 and o7 21 01 Insurance Step Two Post Payments 3 Type the check number the total check amount and the payment date in the spaces provided at the top of the page See Below Post EOQBSs Found 9 procedures matching the search criteria Check Ref 225691 Check amt 426
50. tatus and employment status from the options provided Box 8 of the HCFA 1500 Form 7 Type the patient s address in the spaces provided Box 5 of the HCFA 1500 Form 8 Type the city state and zip code in the spaces provided Box 5 of the HCFA 1500 Form 9 Type the patient s home phone number area code first in the space provided Box 5 of the HCFA 1500 Form 10 Type the patient s work phone number and extension area code first in the spaces provided www medrium com lt 5 gt 8 29 01 SA 11 Type the patient s email address and pager number area code first in the spaces provided 12 Type the dollar amount of the patient s visit co pay in the space provided 13 Type the effective date of the patient s current or newest insurance in the space provided 14 If the patient does NOT have insurance skip to step 28 Otherwise click once on Primary Insurance and follow steps 15 through 27 Primary Insurance 15 In the space titled Insurance select the patient s current insurance carrier The Insurance Carrier I Need Isn t There You will only be able to select from the insurance carriers you have already added to your account If you need to add another insurance carrier make sure that first you click once on Add so that you won t lose any patient info you have already entered Then click once on Maintenance and once on Insurance When you are finished adding the
51. the balance is the patient s responsibility This is not the same as posting a capitation payment Posting monthly capitation payments is a separate function Its only purpose is to keep records of all monies received so that capitation analysis reports can be created with the appropriate data If you wish to post a line item insurance payment please refer to the section of this manual titled Posting an Insurance Payment Select the provider that the capitation check is for Select the insurance carrier that issued the capitation check EDGAR A POE M D Provider Insurance SMSF IPA Fayment Date josfo1f2004 Check Ref 006879395 Type the date of the check andthe check number in the spaces provided Post Capitation Payment H ai Amount 1136 34 of Patients Type the amount of the check and the number of capitated patients it represents inthe spaces provided Type any remarks you wish to make about the capitation check in the space provided When you are finished click once on Post Payment www medrium com lt 30 gt 8 29 01 SS TD Updating the Claim Status Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here Click ance on Claims Click ance on Search Claims Search for the claim you wish ta update the status of Select the claim you wish to update the status of by clicking once an the box to
52. tion Location an Locations Sa 6 f T Exclude managed care capitation claims The search criteria in Example B above will list ALL claims 1 Submitted to Aetna U S Healthcare 2 For ALL patients 3 Created on ANY date 4 With ANY rendering provider 5 For all types of claims regardless of status 6 Performed at ANY location 7 For both capitated and non capitated patients www medrium com lt 19 gt 8 29 01 EN X Updating an Existing Claim Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here Click once on Claims Click ance on Search Claims Search for the claim you wish to update Select the claim you wish to update by clicking ance on the box to the left of the claim Select the action Update Claim Click once on Gol Boe eek ee man 1 Type the necessary changes in the appropriate spaces 2 Click once on Validate Then choose one of the following options to continue Update Claim Update and Resubmit to Primary Insurance This option saves This option saves the changes the changes you you made and automatically made to the claim submits the updated clairn to the patient s primary insurance For mote detailed information on updating an existing claim please refer to the section of this manual titled Adding Submitting a New Claim www medrium com lt 20 gt 8 29 01 a Using the E
53. to print properly in each box of the HCFA form you may need to offset the print page for your printer And the only effective way to determine what your printer s offsets are is to change them several times until your claims print properly Every printer is unique and each one will have different offsets So once you figure out the x and y offsets for your printer WRITE THEM DOWN and store them with that printer Use the x offset to move ne the printing let lower offset by J 15 and right higher Offset Y by 5 Saye Cancel Restore Defaults the printing up Clow er J and dow n higher Use the offset to moye The numbers above represent pixels One millimeter is approximately equal to ten pixels or twenty five pixels per inch This means that changing the x offset from negative fifteen to negative sixteen will only move the printing to the left one tenth of a millimeter When testing different offsets it is recommended that you change the offsets by increments of at least five www medrium com lt 23 gt 8 29 01 Certificates The first time you view the claim info a security warning will appear Netscape users will see something like this Check the box titled Remember This Decision by clicking on it once Then click once on Grant Internet Explorer users will see something like this Check the box titled Always Trust Content from Medrium com by clicking on it once Then cli
54. try Start Date 12 23 2000 End Date 01 23 2001 Buy Provider Provider or JEAN SMITH _ _ 3 By Insurance Insurance all Insurances ay Bu Claim Type Claims Type Outstanding Claims a 4 By Location Location MAIN OFFICE z EENE ae 6 Exclude managed care capitation claims The search criteria in Example A above will list only the claims that meet all of the following requirements 1 The first four letters of the patient s last name must be GREY 2 The claim must have been created on or between December 23 2000 and January 23 2001 3 The rendering provider on the claim must be Dr Jean Smith 4 The claim must be outstanding This excludes claims that are rejected on hold recently submitted or paid 5 The claim must indicate that the service was provided at the location called Main Office 6 The patient must not have been flagged as capitated at the time the claim was created www medrium com lt 18 gt 8 29 01 Example B The search criteria shown here in Example B is very unspecific and would most likely result in a list of many claims Bu Patient ere tread Mame ID A ie a ID Ey Date of Entry eee SE Date RSS gh Date 3 By Provider Provider all Providers By Insurance Insurance AETHA US HEALTHCARE x l4 1 By Claim Type Claims Type all Claims _ _ 5 4 By Loca
55. ve Message to E To edgar poe EDGAR l 3 Subject Your Year End Financial Status is Complete Dear Dr Poe I have just finished working out you year end reports I have sent them to you along with my invoice Thank ou Martin Ross CPA a Previous 27 3 Next 6 Click ance on the previous or next arrow to view the previous or mest message in your inbox www medrium com lt 52 gt 8 29 01 Sending a Message If you are replying to a message or if you are writing a new message there are only three things that make up the message The recipient the subject and the body of the message Click once on New Mess age to compose and send a new message Hew Message The Recipient You will only be able to send messages to Tech Support or to people who have user names in your account Each user in your account can be found in your address book Folders Empty Trash Send Cancel dl Save copy of Sddress Book Click ance on Address Book ta open Your user address Book Once the address book is opened check the box for each recipient that you want to receive the message you ate about to write See Below Select the recipients of your message al ALBERT ALBERT BEAN COUNTER BEANCOUNTER edgar poe EDGAR MRBILLER MRBILLER Tech Support techsuppart 1417 Select all displayed users Done Cancel Once you have selected your recipients click once on Done Once you h
56. y clicking once on the bax to the left of the User ID 3 Select the action Update User 4 Click once on Goal 1 Make the appropriate changes in the spaces provided 2 Click once on Update User Changing Another Uset s Password Any user in your account can log in and change his her own passwotd but only an Administrator can change someone else s password www medrium com lt 44 gt 8 29 01 L x d Using a Different Credit Card Updating Your Account Who Has Access To This Feature User Type Administrator How Do I Get Here 1 Click once on Maintenance 2 Click once on Update Account 1 Type the necessary changes in the spaces provided 2 Click once on Update Credit Card Information When you are entering your credit card information be sure that you type the name EXACTLY as it appears on the card The Credit card billing address must also match exactly with the credit card statement The credit card verification system we use is EXTREMELY sensitive The slightest difference between what you type and what the credit card company has on file will cause your credit card to be rejected www medrium com lt 45 gt 8 29 01 W 8 Defining Your Procedure Charges Who Has Access To This Feature User Type Biller Provider or Administrator How Do I Get Here 1 Click once on Maintenance 2 Click once on Providers 3 Select the provider you wish to add

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