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Medisoft 17 User Manual

1. T Medisoft Home Page Online Updates 2 Training Technical Support T Products Show Hints Me Show Shortcut keys r r e E About Medisoft Shortcut Bar At the bottom of the screen above the Status bar is a shortcut bar that describes the available shortcut function keys available in the active window This bar may also be referred to as the function help bar Medisoft at a Glance Setting up Your Practice The Provider window contains important information about the providers associated with your practice 24 Getting Started with Medisoft Provider new IL Address Reference Provider IDs i i Save one If the Code is left blank Beste O Ss the program will assign one Last Name o First Name J O O Y Help J Middle Mame Po Credentials Street Pn Set Default Pe City PO State ip Code wi ooo Oifice Fax Po Home Cell PO Signature On File Signature Date Medicare Participating License Number Each provider in the practice needs to have his or her own record set up in the database You can use the Provider Class window to enter classes or groups for providers Provider Class new Class Hame d Cancel Class ID EE Descriptor i Help Inactive Classes can be used when assigning rules For more information on assigning rules see
2. From Practice 8 Click OK This rule appears on the grid and when a claim is generated for Dr Lee that goes to A1 Insurance Partners these settings will appear on the claim 9 Click Save Click Close Setting Up a Referring Provider Record Dr Terry Cooper has begun referring patients to your clinic You will need to create a referring provider record for Dr Cooper 1 Click the Lists and select Referring Providers Click New 2 On the address tab Create a record for Terry Cooper MD 178 Warner Road Gilbert AZ 85234 Enter tcooper 21medical com in E Mail address 4800981234 in the Office phone 4800981233 as the Fax 6026789123 as the Home phone number and 4805432109 as the Cell Phone number Dr Cooper is a Medicare participating physician Also enter 5551212900 in the License Number field and select from the Specialty list General Practice 3 Dr Cooper s UPIN is 2X3XC12 That s all the information needed right now 187 Tutorial Activities Referring Provider new Address Referring Provider IDs If the Code is left blank Code the program will assign one Inactive Last Mame Cooper First Hame Teny Middle Name Credentials MD Street 1178 Warmer Road City Gilbert State jaz Zip Code 85234 E F ail Office 480 098 1 233 Fax 602J678 91 23 Home Cell UFIN 283X012 License Number 5551 129000 Extra 1 Extra 2 Medicare Participating
3. O Save ga Cancel Set Default Specialy General Practice 001 Click the Referring Provider IDs tab Click the New button Click the All button for Insurance Click the Person button for Type Click the None buttons for National Provider ID and Taxonomy 4 Click the Legacy Identifier 1 button and enter Dr Cooper s Federal Tax ID of 23YX0444 Select the qualifier of El Employer s ID Number z New Referring Provider ID OK Insurance Carrier n Ce All Insurance Class amp Cancel Entity Type Person Non Person Help cancel None National Provider ID None Taxonomy OO O None e Legacy Identifier 1 2 El Employer s ID Mumber None Legacy Identifier 2 5 Click OK 188 Tutorial Activities 6 When information is entered in both tabs click Save Click Close Creating a New Address Record 1 Click Lists and select Addresses The Address List window appears Click New 2 Leave the Code field blank this time and let the program automatically assign one based on the Name field The code is not assigned until all information is entered and saved 3 Inthe name and address fields enter Pizza Planet 1234 Fifth Avenue Anywhere IA 85000 1234567890 this is the phone number In Fax Phone enter 1234567899 Be sure the Type field reflects Employer 4 The contact for this entry is Murray NOTE The Extra 1 and Extra 2 fields are
4. Entering Appointments 1 John Smith calls and needs to see Dr Lee today Dr Lee actually has an opening at 11 30 am In all views except Monthly Advanced and above and Multi View Advanced and above select Dr Lee in the provider box to the right of the Exit speed button in the toolbar In any Multi View be sure to locate Dr Lee s appointment column You see that the 11 30 time slot is open for Dr Lee so double click it to open the New Appointment Entry window New Appointment Entry Chart SMIJOOOO v 2 Smith John Home Phone 5131224 4668 CellPhone 61312241111 ce Resource TREADM Treadmill Mote Emergency physical for work Esa ll e Back pain Reason CHECKUP v F Routine Check Up Length 15 5 minutes Date 2 1 2010 Time 11 30 am Prowider FL w E Lee Kris Repeat No Repeat 2 In the Chart field select John Smith Press ENTER In Resource enter T to help locate the treadmill resource Highlight the correct resource and press ENTER 3 In the Note field enter the following information Emergency physical for work 217 Tutorial Activities 4 The Case defaults to Mr Smith s most recently opened case In the Reason field although we have not yet created reasons of our own we can select one from
5. F1 Look up Case Condition Tab Retum To Work Indicator hl CJ Save g Cancel Help Eligibility Face Sheet Set Default The Miscellaneous tab contains supplemental information features like lab work charges whether the lab is in house or outside Referral and Prescription Dates Local Use A and Local Use B fields case Indicator code and prior authorization It also provides space for recording information concerning a primary care provider outside your practice 94 Setting up the Practice lt Case AGADWOOO Again Dwight Broken Hand Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition Miscellaneous Medicaid and Tricare Comment EDI Custom One Outside Lab Work Lab Charges 0 00 Local Use A HCFA bos 10d Local Use B HCFA box 19 Indicator MEDICARE Referral Date Y Prescription Date i gt Eligibility Prior Authorization Humber HCFA box 23 Face Sheet Extra 1 Extra 3 Set Default Extra Z Extra 4 Primary Care Provider Outside of This Practice Outside Primary Care Provider l e 2 Date Last Seen e Patient Information Mame Again Dwight Home Phone 434 57 7 Address 1742 N Bard Ave work Phone Phoenix 47 Cell Phone colle Date of Birth 34307 932 F1 Look up Case Miscellaneous Tab The Policy
6. Report Transmission Code po Attachment Control Number Mame Again Dwight Home Phone 434 57 77 Address 1742 N 63rd Ave Work Phone Fhoenis A Cell Phone 85021 a Date of Birth 330 1 932 2 5 F1 Look up Case Diagnosis Tab The Condition tab allows for entry of information pertinent to the illness pregnancy or injury and tracking of symptoms It also includes dates relative to the condition plus Workers Compensation information 93 Setting up the Practice Case AGADWUUU Again Dwight Broken hand Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Personal Account l Diagnosis l Policy 1 Policy 2 l Policy 3 Condition Injurpllllnezs LMP Date 242742008 Date Similar Symptoms Illness Indicator Injury Initial Treatment Date Related To Vez we From Estimated Date of Birth Mame Again Dwight Address 1742 H 83rd Ave Phoenix 47 850 21 ty Same Similar Symptoms Employment Related Emergency Last 4 Aay Date 371 1999 State i Nature OF Injured dunng Recreation 3 Unable to Work pO Pp Total Disability f Partial Disability Hospitalization po J Ta Last Worked Date Pregnant Date Assumed Care Percent of Disability he Date Relinquizhed Care 4 a G w p 2 w 2 w 2 10 11 12 v 6 w 5 v p w p Home Phone 434 577 Work Phone Cell Phone Date of Birth 3 3041 932
7. 190 Tutorial Activities lt Procedure Payment Adjustment Test Code General Amounts Allowed Amounts Code 1 RYZ Inactive Description Test Code Code Type Procedure charge w Account Lode OvSP Alternate Codes zez spz Type of Serice m Place of Service a 11 Time To Do Procedure 0 service Classification A w Don t Bill To Insurance Orly Bill To Insurance Default Modifiers Revenue Code Default Units National Drug Code Code ID Qualifier T axable _ HIPAA Approved Purchased Service Require Co pay HCPCS Code UB HCFCS Code v2 10 Click the Amounts tab and enter 50 in field A as the amount you want charged for this procedure 11 Enter 20 in the Cost of Service Product field and 50 in the Medicare Allowed Amount field Click Save 191 Tutorial Activities lt Procedure Payment Adjustment Test Code General Amounts Allowed Amounts Charge Amounts A 50 00 OO OO OO OO 0 00 OO Cost of SernviceProduck 20 00 Medicare Allowed Amount 50 Creating a MultiLink Code 1 Goto the Lists menu and select MultiLink Codes Click New 2 Inthe MultiLink Code new window enter SCHOOLPHYS in the Code field Enter a description in the Description field such as Physical School In Link Codes 1 enter 80050 the general health screen panel in Link Codes 2 enter 81000 a routine urinalysis in Link Codes 3 enter 93000 an EKG and in
8. Condition Bl Save Assigned Provider EL Ww El Kris Lee MO Cancel Referring Provider coooo e 2 Terry Cooper MO Hel Supervising Provider Ww 2 ote Operating Provider e Bj Other Prowider w Referral Source P TOD w Patient Referral Attore w Facility Set Default Case Biling Code 4 Default Billing Code Price Code A Other Arrangements Treatment Authorized Through 2 15 4010 e Visit S erez Authorization Number 6489211 Last Visit Date Authorized Number of Visits 12 ID A Last Visit Number lO Patient Information Mame Smith John Home Phone 51 3 224 4668 Address 46 Center Street Work Phone 123 345 6789 Gilbert A l Cell Phone 51312441111 00 34 Date of Birth 1712 1975 7 Open the Diagnosis tab 8 In Principal Diagnosis enter 724 2 197 Tutorial Activities lt Case SMIJOO00 Smith John Back pain Miscellaneous peuraig a Tricare Comment EDI Custom One Personal Account i Policy 1 Policy 2 Policy 3 Condition Low Back Pain RES E Default Diagnosis 2 w eo Default Diagnosis 3 E Default Diagnosis 4 E Allergies and Notes EDI Notes uos allergic to penicillin Set Defaut Default EDI Rep
9. EQO1 Service Type Code Loop 2110C New codes have been added In addition there is a new data element that takes the value from the appointment If that value is null it takes the value from practice preferences If that value is null 30 Health Benefit Plan Coverage is hardcoded The latter is current functionality NM107 Name Suffix Loop 2100D The patient name suffix is added NM112 Name Last or Loop 2100D This is a new element for Organization Name 5010 REFO04 Reference Identifier Loop 2100D This is a new element for 5010 N407 Country Subdivision Loop 2100D This is a new element for Code 5010 DMG10 Code List Qualifier Loop 2100D This is a new element for Code 5010 DMG11 Industry Code Loop 2100D This is a new element for 5010 EQO1 Service Type Code Loop 2110D New codes have been added In addition there is a new data element that takes the value from the appointment If that value is null it takes the value from practice preferences lf that value is null 30 Health Benefit Plan Coverage is hardcoded The latter is current functionality REFO04 Reference Identifier Loop 2110D 5010 e The following PER segments have been deleted from Loop 2100B Min Max Usage Values Req Getting Started with Medisoft PER Information 3 S Receiver Contact Information PERO1 Contact 2 2 E Code PERO2 Name o 1 4 60 PERO3 Nane AN 2 2 PH EM FX Number TE Qualifier PERO4 Commun
10. FHP v 2 DEDUC Bl FHPWH s E FHP w a ho eA E Date Procedure Charge Remainder Payment Deductible withhold Allowed Adjustment Take Back Complete Rejection Provider EL 0207 42010 35214 65 00 22 00 10270172010 82954 10 00 0 00 25 00 10 00 0 00 0 00 0 00 0 00 0 00 I Alert When Claims 4re Done Alert When Statements Are Done i There are charge entries Bill Remaining Insurances Mow Fate Petya e Pt Print Statement Now Write off Balance Mow pele Me ces 10 If the Print Statement Now box is checked the Open Report window is opened to select a statement form You can print it or click Cancel 11 To review what you just did click Detail in the Deposit List window 213 Tutorial Activities 12 The Deposit Detail window shows which transactions were affected and what was applied This window is only for reviewing the details of a deposit You cannot edit any transaction in this window 13 If needed you can print item details by selecting the line item and clicking print grid For more information see F1 Look up Print an Entry from the Deposit List 14 Click Close after reviewing the details 15 Click Close again to close the Deposit List window If you return to the Transaction Entry window a new entry has been created in the Payments Adjustments And Comments section this insurance carrier payments Tutorial Practice 8 Collections Creating Colle
11. If you want to use a code you have not previously entered click New or press F8 and the window for a code and description appears Billing Code Default Billing Code Inactive Code Q Save dd Cancel Description MEE a al Help A billing code range is a filter available in most reports printed in Medisoft F1 Look up Billing Code Entry Contact List NOTE This is an Advanced and above feature The Contact List contains a ready reference of people with whom you have had contact during the course of business The Contact window has space where you can add notes concerning your conversations to help you keep track of what was discussed and any conclusions or information shared during the conversation Click Lists and select Contact List 84 Setting up the Practice Contact List Contact Category Phone Part Time Employee Alice Arthur Personal 400 777 7776 Aetna Corey Jackson Insurance 80011 2221 Phizicon Horacio Sanchez Drug Rep 602 999 9988 Philos Pharmacy Philo Martineau Pharmacy 460 1 23 456 Camelback Medical Supply Roger Wwirthiin Other 604131 3331 am To create a new contact click New to edit an existing contact click Edit Contact Camelback Medical Supply Roger Wirthlin SEE Category Business MEMA Em E Mame Roger Wiirthlin Phone 602 331 3331 Inactive Address 99 E Camelback Ad City Scottsdale State az Zip 8521 3 Motes Roger is our
12. Practice Practice IDs Practice Pay To Statement Pay To Practice Name Phone Extension Street Fax Phone City State Extra 1 Zip Code Extra 2 2 Enter the pay to information in the Practice Name Street City State Zip Code etc fields NOTE the Extra 1 and Extra 2 fields are only used if a carrier requires extra data on a claim 3 Click Save EDI Receiver Records The EDI Receivers window displays parameters used for transmitting information to a clearinghouse Go to the Lists menu and select EDI Receivers The EDI Receiver List window opens Click Edit to modify an existing record The EDI Receiver window opens The settings in Medisoft on the EDI Receivers window are used for setting rules for electronic claims generation The actual transmission of claims is driven by Revenue Management If you make changes on these tabs in Medisoft the changes transmit to Revenue Management and changes made there are also transferred to Medisoft When sending electronic claims you will set up your clearinghouse or direct payors in Revenue Management Once an EDI receiver is set up Revenue Management will synchronize the EDI settings in Medisoft For users upgrading to Medisoft 17 Revenue Management can use the existing settings for the payors set up on the EDI Receivers window but you will need to reconfigure receivers to work with Revenue Management NOTE The Group Practice box on the EDI Receivers window IDs tab a
13. Ready to send Electronic Sent Rejected Initial Billing Date s ed Batch 0 er Done Submission Count O Pending Billing Date Insurance 1 USOO0 v 8 U S Tricare EDI Receiver k Frequency Type o The detail also indicates submission method assigned to the claim paper or electronic as well as the claim status Claim status options include Hold Ready to send Sent Rejected Challenge Alert Done or Pending The status of the claim can be changed at this point Any time a claim is sent a batch number is assigned That number shows in the Batch data box in the center of the window of the claim you are reviewing If a claim needs to be resubmitted the batch number coincides with the number shown in the Claim Management window and the one you use to designate those claims that need to be resubmitted The Transactions tab reveals a listing of all transactions applied to the selected claim You can split add or remove qualifying transactions in this tab The Comment tab provides an empty box in which to place whatever comments you feel are necessary concerning this claim and or any transactions relating to it If you have Medisoft Advanced or Medisoft Network Professional these notes are represented by a note icon in the Claim Management window Double click the icon to view or edit the note F1 Look up Edit Claim Printing Claims Once claims are
14. This shows the file names which are mrcol numbered sequentially type and date and time last modified F1 Open the Collection Letter Wizard and then look up Collection Letter Selection Small Balance Write off This feature lets you automatically write off remainder balances of a certain amount The balance written off is the patient remainder balance You can write off small remainder balances as a batch in the Small Balance Write off window or for one patient at a time in the Apply Charges Adjustments to Payments window F1 Look up Small Balance Write off Overview Writing off a Balance 134 Managing Collections and Small Balance Write Ofts To access the Small Balance Write off window select Small Balance Write off from the Activities menu Small Balance Write off Patient Selection Write off a All Delinquent Patients Write off Preview List O all Selected Items a Chart Number Last Mame First Name Wi rite olf Last Pa gt Wiite off Code SBWD y Cutoff Date Maximum Amount 5 00 Simt Submission Count The window Is divided into two sections In the first section select criteria for the type of remainder balances you want to write off and click apply In the second section a list of the patients who meet the criteria appears in the Write off Preview List The default is set to write off all records in the list You can select individual records to write off by clicking on
15. go to the Activities menu and select Claim Management or click the Claim Management speed button This window features several sections used for various tasks Claim Management SEE Seach Pate o ele Claim Number Chart Mum Carter Status 1 Medial Batch BilDate1 ED Receiver Camer2 Status 2 1 SIMTAGOO AETOO Sent Paper 1 12 3 2002 AGADWOOO MEDO Done Paper 2 11 21 2002 AETOO Sent 3 BRIJ4 000 ciang Sent Paper d 3725 2002 BLUO Sent 4 BRISUODO Clang Done Paper 5 12 5 2002 BLUOO Sent FWAGJEOOO BLUOO Sent EDI 01612002 NATOO BOUMIOOO USO00 Ready To Seno Paper O T AGADWOOO MEDO Sent Paper 21262002 aT Header Search Enter values for which you want to search in the grid This field is affected by the variable in the Sort By field Sort By Click the down arrow to select the variable by which you want to search For more information see F1 Look up Grid Columns List Only Click this button to list only certain claims in the grid For more information see F1 Look up List Only Claims that Match Change Status Click this button to change the status on a batch of claims For more information see F1 Look up Change Claim Status Billing Method Navigation Buttons These buttons in the upper right corner of the window allow you to move through the displayed records The button at the right end of the navigation buttons refreshes the information in the grid 112 Creating Claims Grid This section shows you i
16. show me window that lets the Claim Manager review all that is in the program The claims that come before her can be given a final check for accuracy and completeness She can select specific or all carriers to review She can group all electronic media claims Besides these three focus areas the Claim Manager also has responsibility to mark claims that are paid and those that are rejected Marking paid claims The date of submission in the Claim Management window indicates when the claims were shipped or transmitted Claims are marked under the designation of Sent and the date is automatically inserted The claims stay in Claim Management marked as Sent until they are manually changed in the Claim edit window as having been received 111 Creating Claims and dispatched by the carrier When a payment is received use the EOB to enter all payments through transaction entry lf selected in Program Options Payment Application tab Mark Completed Claims Done field the status for paid claims is automatically changed to Done Handling rejected claims When a paper claim is rejected for payment by the insurance carrier change the payment status in the Claim Management window from Sent to Rejected Now put yourself in the picture Picture yourself as the Claim Manager The tools by which you get the job done are found in Claim Management The Claim Management Window To perform any claim management functions
17. 1 2 and 3 tabs let you connect up to three insurance carriers to the patient record including policy and group numbers and Insurance Coverage Percents by Service Classification how much the carrier pays for certain types of procedures The service percentage classification is tied to each procedure code F1 Look up Procedure Payment Adjustment Entry A Deductible Met check box is provided in the Policy 1 tab When the patient meets his or her deductible obligation for the year click this box and the status is displayed in the patient account detail of the Transaction Entry window The three tabs have the same layout except Policy 1 asks about Capitated Plan and Co Pay Amount and has the Deductible Met check box Policy 2 asks if this is a Crossover Plan and Policy 3 can be set up for tertiary or third party involvement 95 Setting up the Practice Case AGADWOOO Again Dwight l Miscellaneous Medicaid and Tricare L Personal Account Diagnosis Policy Insurance 1 MECOT Policy Holder 1 4G50 000 Relationship to Insured Self FE Hack F an Multimedia Comment Policy 2 Policy 3 ED Custom One Condition e e Medicare e e Again D wight w Folicy Number 780340761 Start Group Number 23c End hd Group Mame Claim Number Assignment of BenetitsAccept Assignment Capitated Plan Deductible Met Annual Deductible 0 00 Copayment Amount Treatment 4uthorizat
18. 1 To edit the statement highlight the SMIJOO00 statement and then click Edit or press F9 to open the Statement editing window 2 Open the Comment tab Type the following message Notify attorney when statement paid Press ENTER and then press CTRL T to set a date time code Click Save 208 Tutorial Activities Statement 13 Statement 13 Statement Created 2412010 Guarantor SMIJOOOO Remainder 60 00 John Smith General Transactions Comment notify attorney when statement paid Sending Statements 1 Once the statements are ready to go in the Statement Management window click Print Send to open the Print Send Statements window 2 We are only dealing with paper statements in this tutorial so leave the setting at Paper and click OK Print Send Statements Select statement method Paper Electronic Electronic Statement Type Exclude Billed Paid Entries 3 The Open Report window opens so you can select the statement form on which to send the statement For now highlight NEW Patient Statement 30 60 90 and click OK 209 Tutorial Activities 4 The Print Report Where window pops up to indicate whether you want to preview the statement before printing or just send the statement directly to the printer For now leave the setting on Preview and click Start 5 The program assembles the information and then displays the Data Selection Questions window In
19. 119 Statement Management WindOW cccccconcncnncccconccnnccononcnonononancnnnnnnnnncnnnnnonnnnnnnnnnnanrnnnnnnnanennnns 119 A E A E E N 119 BUON Sonane a a A es 120 Creating Statements ins a aaa a ieee aa a a On 120 Editing Statement dao aba 121 GCONVEMING StAleMEINS o ela 122 Errata otatements andare 122 Reptnting otatements aii dai iia 123 SIRO State MG IN Saa in ada 123 Haga Statement SAUS a ct aie eee aki aot a neta ee eh tec 124 ENS I AUG Wieder Sables ad es tl utile dak cd ail e a E et dat tol 124 Selecting Multiple StateMentS occccccccocncnnccccnnnconnnonnnncnnonononncnnnnononnnnnnnonnnnnnnononancnnnnnnnanenss 125 JA desahtenasavtamictasteeacne R e RE 125 Claim Rejection Messages suscita 125 Troubleshooting Statement Printing iii naar 126 Patent Remainder Statements sde la ale Sees 126 APPIYINO DEDOS IS aaa 127 Deposit Payment Application oooonccnccccconccnncnnnoncnnnonnnnnconnnnnnnncnnnnnnnnncnnnnonnnncnnnnnnnnrnnnnnnnanens 127 OA eee O teenies Varin at deta tck tet teadata ta west inad teats 129 Managed AA o o ta eine ie teh dne PO eee RG 129 Gapitation PAV lbs c5 aoe a cas eta aa a aa ce tt eels cha owe rates et eet aes 129 Managing Collections and Small Balance Write OF S cocoooonccnncccconncnncnonannnnnononanenononnnanennnoss 130 SONS CC o A pose ee eee eae ee 130 Ada Collection LiIStItem Sacccieet decane es esse teach aa hes eke 131 Patent Payment NUNS ysis A AAA AN A Dee lela add aa 132
20. Aging Reports Productivity Reports Network Professional Activity Reports Network Professional Collection Reports Advanced and above Audit Reports Patient Ledger Report Guarantor Quick Balance List Network Professional only and Standard Patient List Reports You can print a title page that shows all the filters used in preparing the report F1 Look up Program Options Day Sheets Day Sheets are available in three reports The Patient Day Sheet lists each patient s name showing all transactions and a summary of activities for the day The Procedure Day Sheet breaks down by procedure code the activities of the day summarizing patients treated for each procedure The Payment Day Sheet shows the payments made on the requested day and the charges to which the payments are applied F1 Look up Patient Day Sheet Procedure Day Sheet and Payment Day Sheet Analysis Reports Billing Payment Status Report Advanced and above One of the most powerful tools in Medisoft the Billing Payment Status Report provides a thumbnail sketch of the current billing and payment status of each claim The report shows what has been billed and not billed what is delayed for some reason if the carrier is not responsible or has refused the claim or if the claim is paid in full An asterisk next to an amount indicates that entity has paid all it is going to pay and the balance if any should go to the next responsible payer F1 Look up Billing P
21. Click Save 211 Tutorial Activities oF Deposit new Deposit Date 2 1 2010 w Payment Method Check Number 5237 Description Bank Mo United Southwest Savings Payment Amount 125 00 Deposit Code Insurance Al 000 Ww Al Insurance Partners 41000 Code Name Street 1 City A1000 41 Insurance Partners 11223 Hartford L Aetna 112 Aetna Wray Nowhere BLUOO Blue Cross Blue Shield 1 oo w Bell Ad Fhoenis JELUO Blue Cross Blue Shield 225 oo 4 Bell Ad Fhoenis JCIGOU Cigna 525 Big Bucks Ln Mesa FHPOO FHF Health Plan 4576 E WW PowerAd Mesa MEDOO Medicaid 985 Thunderbird Glendale bdi PA AA bd dt ee 4444 Ilah af men Mm CN ee TEN PE E Payment Code Adjustment Code withhold Code Deductible Code Take Back Code In the Deposit List window be sure this new deposit is selected and then click Apply The Apply Payments Adjustments to Charges window is opened In the For field select John Smith s chart Locate the 65 charge click the Payment column of that record and enter 20 In the box below part of the 10 00 charge record enter 5 Click Save Payments Adjustments and then Close A message is displayed letting you know that both claims will be marked Done for the primary carrier This is based on a selection made in Program Options If the Print Statement Now box is checked the Open Report window is opened to select a statement form You can pr
22. Cross Shield Commercial PPO HMO Medicaid Group ID BC BS Group ID Other Group ID LIPIN Extra 1 EDI ID CLIA Number Hospice Emp Extra Z Payee Number TAT Number 66 Setting up the Practice 7 Option Assign a provider to a provider class by clicking the Provider Class list and selecting a class NOTE Provider classes are set up in the Provider Class List When generating claims the provider class can be used on the Practice IDs tab to limit a grid entry rule to a class of providers You can change a provider s class on this tab to put the provider in a different class which in turn would impact the grid entry that is selected on the Practice IDs grid 8 Click Save if you are finished with the record or click the Provider IDs tab and go to the next section Entering Provider IDs Grid Entries Entering Provider IDs Grid Entries Use the Provider IDs tab and Provider IDs grid to enter or edit key data elements associated with a provider tax ID social security number NPI taxonomy legacy numbers etc You will set up at least one entry rule on the Provider IDs grid for each provider in your practice and associate this information to all insurance carriers or insurance classes and all facilities or a particular insurance carrier or an insurance class or any combination of these elements When creating or editing a provider IDs record you will first create modify a rul
23. Default Use Quick Entry for New Patient Case FS Use Quick Entry for Edit PatientCase F9 Transaction Force Document Number Case Default Newest Case Force payments to be applied Multiply units times amount _ Auto Create Tax Entry Default Place of Service Code 11 Use Serialized 5 bill L Use Serialized Superbills Default Tax Code TAX Suppress Co pay Message Date of Deposit Today s Date Remittance Date Prompt for Date Mark zero payments complete Separate remittance files Automatically calculate blank PIN qualifiers Work Administrator Edit task when created by a rule In the Global section you can indicate whether to use ENTER as a toggle to move between fields to force payments to be applied and to multiply unit times amount Using the zip code to enter city and state information can save a lot of time When the Suppress UB04 Fields check box is selected UB 04 fields do not appear throughout the program If you do not process UB 04 claims check the box If you do process UB 04 claims uncheck the box so that all the fields you need to populate the claim form will be available For more information on UB 04 functionality in Medisoft F1 Look up UB 04 In the Patient section you can choose to use numeric Chart numbers the default is to use an alphanumeric code and or have the program automatically hyphenate Social Security Numbers The Patient Quick Entry Default list and the Use Qui
24. E hal Print Patient Statement Guarantor SMNOO00 8 Smith John WF Student Status UBOA Marital Status E Set Default Emplormernt Employer BEADO 2 Bean5prout Express Status Full time Ww Retirement Date i Work Phone 602 453 9999 Location Extensions Patient Information Mame Smith John Home Phone 51 3 224 4668 Address 246 Center Street Work Phone 123 345 5789 ee Cell Phone 51 31224 1111 85234 ell Phone 51144 Case Date of Birth 1121975 w 5 3 Open the Account tab 4 Inthe Assigned Provider field select Kris Lee In Referring Provider select Terry Cooper 5 Mr Smith was also referred by another patient In Referral Source select Patient Referral 6 You have already received information from Mr Smith s insurance carrier and you know that treatment is authorized through February 15 Enter 2 15 2010 in the Treatment Authorized Through field In Authorization Number enter 6489211 in Authorized Number of Visits enter 12 and in the ID field enter A 196 Tutorial Activities lt Case SMIJOO00 Smith John Back pain Miscellaneous Medicaid and Tricare Comment EDI Custom One Personal Account Diagnosis Policy Policy2 Policy 3
25. Employer BEA00 BeanSprout Express 607 453 9968 Employer DOOOO Doorrnart Employer MIEDO Micro Mania Inc 602 46 2154 Employer NEWOO Mews Channel 11 Employer FESOUO Realy Useful Trucking Co 602 457 3326 Employer WINGO Windham Gallery 602893 424215 Employer S4000 5 andA Bank Employer To set up Address Records 1 Click New on the Address List window OR Option to edit an existing record select the record on the Address List grid and click 19 Setting up the Practice Edit Address new ane TO If the Code i left blank the eee O program will assign one Name Street City State ip Code Phone Exterslorr oo Fas Phone pO Cell Phone pO Office Contact Pn EMail Extra 1 pO Extra 2 pO Set Default 2 Inthe Address Code field enter a code for a new address record or leave the field blank and let the program create a unique code 3 From the Type list select Attorney Employer Miscellaneous or Referral Source NOTE A facility record is entered on the Facility window Lists Facilities For more information see Facility Entry Enter other demographic data such as name telephone numbers email address etc 4 Click Save Procedure Payment and Adjustment Codes Procedure codes are used to communicate procedure information between patient provider and third party payers These codes can be accessed by going to the Lists menu a
26. O when Medisoft closes None of the above Patient Remainder Balances may also be recalculated All of the above through File Maintenance TIP Best Practice consider backing up data files every day using a program of rotating backup disks so you can restore lost data to the most recent date before the files were damaged or corrupted If you are working with multiple practices each practice should have its own set of backup files Doing your backups within the Medisoft program is a dependable method Consider selecting the Backup Root Data option to back up your root data directory that is C Medidata The information backed up can include registration information and other files shared among all your practices Go to the File menu and select Backup Root Data The Backup Root Data window opens F1 Look up Backup View Backup or Restore F1 Look up Backup Root Data Hide Inactive Closed ltems Accessed from the General tab on the Program Options window or by right clicking a list the Hide Inactive Closed Items option provides quick filtering options for data display for inactive or closed items Users can apply a setting on the Program Options tab and as needed override this setting by right clicking as needed to view or hide data in a list 161 Performing File Maintenance The default setting for this option is not enabled users can selectively override this setting to enable the feature as needed or permanentl
27. Report List icon displays the Open Report window and lets you print any of the documents listed such as Statements Walkout Receipts Patient Lists CMS 1500 Superbills etc See Custom Report List The Quick Ledger icon opens the Quick Ledger You can access the ledger by clicking this icon or pressing F7 at almost any time the program is open If you have already selected a chart number the Quick Ledger defaults to that chart number The Quick Balance icon opens the Quick Balance window which displays a selected guarantor s remainder balance The Enter Deposits and Apply Payments icon opens the Deposit List window where you can create and print deposit lists and apply payments to patient transactions The Show Hide Hints icon is a toggle on off icon A Hint is a context sensitive help feature that displays a short description of that portion of the program or window on which the pointer is resting A written description of the function is also displayed in the Status bar at the bottom of the window The Help icon opens the Help files The Launch Work Administrator icon opens the Work Administrator program where you can create tasks for users and user groups Launches the Medisoft Reports Engine for Medisoft Advanced and Medisoft Network Professional only Complete all reporting tasks in this window The Medisoft Report window offers several key features not available when running reports off the Reports menu including new reports
28. Statements Electronic Statements Ssuperbills Blank Super bill Custom Report List y 7 i Default Printer Options E F T ho b E Load Saved Reports Design Custom Reports and Bills 1 Medisoft Reports Tools Menu The options available in this menu help you access peripheral programs and information to assist in the management of your practice 22 Getting Started with Medisoft Tools Window Help Calculator E EN T 22 8 Medisoft Terminal View File Add Copy User Reports ql Design Custom Patient Data ay E Communications Manager a Administrative Dashboard Statement Wizard Ji E i ll Collection Letter Wizard Customize Menu Bars System Information Modem Check fi NE I A P T User Information Patient Motes Patient Narrative l A ta a om a E gt Check For Updates Window Menu This menu contains options that control the display of windows in the program T Close All Windows Minimize All Windows Tile Windows Horizontally Tile Windows Vertically Show Side Bar Ctrl s a Clear Windows Positions Cal Clear Custom Grid Settings Help Menu The Help menu contains access to information on how to use the program as well as how to register 23 Getting Started with Medisoft Medisoft Help T ns Getting Started l Uporaders From Medisoft For DOS
29. and features to enhance productivity For more information see the Medisoft Reports overview topic 18 Getting Started with Medisoft The Edit Patient Notes in Final Draft icon opens the Final Draft program It is 5 a word processing program that is integrated with your patient accounting A program and can be used for creating letters notices notes etc using data already stored in the patient accounting database Clicking Exit takes you out of the program entirely If you have the Remind to Backup on Program Exit option activated in Program Options you are reminded to back up your files before the program is shut down File Menu The File menu contains options for managing your practice files File Edit Activities Lists Reports Open Practice Hew Practice Convert Data Backup Data Task Scheduler View Backup Disks Restore Data Backup Root Data Backup Restore Medisoft Reports Program Options a Set Program Date Practice Information Login Password Management Security Setup Global Login Management File Maintenance Exit Alt F4 Edit Menu The functions of the Edit menu are Cut Copy Paste and Delete These deal primarily with the handling of text 19 Getting Started with Medisoft Delete Activities Menu This is the center of much of the daily routine of the practice e m Enter T
30. and or time slot and either press CTRL V or select Paste in the Edit menu If you want to move the appointment to another time slot showing on the appointment grid whether the same provider or not click the appointment hold the left mouse button down and drag the cursor to the desired time slot Release the mouse button Deleting an Appointment There are multiple ways to delete or remove an appointment click the appointment slot on the appointment grid and press DELETE highlight the appointment in the Appointment List and click Delete or right click on the appointment either in the Appointment List window or on the 145 Scheduling Appointments appointment grid and select Delete or Delete item respectively You can also edit the appointment and change the status to Cancelled F1 Look up Moving Deleting an Appointment Patient Recall NOTE This is an Office Hours Professional Integrated feature The program includes a complete patient recall system with a recall appointment list to assist in contacting patients to schedule appointment dates and times or to make reminder phone calls This feature is available through both the Medisoft and Office Hours programs F1 Look up Patient Recall Multiple Booking Columns NOTE This is an Office Hours Professional feature If you want to multi book appointments that is schedule more than one patient in the same time slot simply right click the column heading in the appointmen
31. appear in the Quick Balance feature These balances are the guarantor remainder balances so if there are charges that the insurance company has not paid on yet then they are not reflected in this report F1 Look up Guarantor Quick Balance List NOTE Medisoft Network Professional provides this report on the Reports menu This report is also available when using the Medisoft Reports Print Engine feature for Medisoft Advanced users F1 Look up Medisoft Reports Print Engine Standard Patient Lists The Patient by Diagnosis and Patient by Insurance Claim reports provides users a means to sort data in meaningful chunks for analysis and reporting purposes F1 Look up Patient by Diagnosis Report F1 Look up Patient by Insurance Claim Report Custom Report List Design capabilities in the program let you generate a variety of custom reports to meet the needs of your practice To access the customized reports go to the Reports menu and select Custom Report List When you create a customized report it is included in the Custom Report List There are numerous reports already formatted that are included in the program and can be accessed These include Address List Billing Code List Birthday Card Birthday Labels Claim List Diagnosis Code List EDI Receiver List CMS 1500 Forms Insurance Carrier List Insurance Payment Tracer Claim Mgmt Laser CMS 1500 forms Patient Birthday List Patient Face Sheet Patient List Patient Recall Labels Pat
32. are in Medisoft help is not far away Access the online Help screens to find detailed information on each feature in the program Online Help is available in two different ways Context Sensitive Help For help in a particular part of the program click the area for which you need help and press F1 The help topic for that area should appear Main Help File To access the main help file click the Help menu and select Medisoft Help The main help file will appear displaying the Contents tab Use the Contents tab to view categorized topics for the program Use the Index and Search tabs to find out additional or specific information about the program Medisoft Knowledge Base The Knowledge Base is a searchable online database containing technical information relevant to the use of Medisoft products To access the Knowledge Base go to the following web site http www medisoft com kb When accessed you can search for information concerning Medisoft products All current technical information is contained in the Knowledge Base Training There are various training options available Please contact your local Value Added Reseller or the Medisoft Sales Department at 800 333 4747 for information concerning these options Independent Value Added Resellers There are Value Added Resellers in your market area who are knowledgeable and efficient in selling installing troubleshooting and supporting your Medisoft program You can contact the Med
33. as their primary care provider Payment is made to your practice on a per patient basis regardless of whether the patient ever visits the office When a patient does come in for treatment he or she pays a set co pay amount The co pay is charged only by the primary care facility or the facility to which the patient is referred by the primary care facility After a patient s visit to the doctor s office a claim is filed and sent to the carrier When the EOB is returned there is seldom a payment included since payment is made under the capitation program for managed care organizations F1 Look up EOB Payments Managed Care Capitation Payments Capitation Payment The basis for capitation payments is to provide healthcare for a fixed cost irrespective of the amount of service required by each individual patient This is done in connection with the managed healthcare services such as HMOs and PPOs There is no direct relationship between the capitation payment received by the practice and the number of patients covered by the plan who actually visit the practice for treatment Capitation payments are not posted to patient accounts but are entered in the Deposit List window If it is necessary to zero out a patient account create a zero deposit for the carrier For each patient covered by the capitation payment who has an outstanding balance zero out the account by entering the remainder in the Adjustment field When it is applied the payment sh
34. centers on the Claim Management window from which you can create edit and print send claims Medisoft also provides support for UB 04 claims And you can use the Statement Management window available in Medisoft Advanced or Network Professional to create billing statements for patients For more information see Medisoft Claim Generation FAQ and Electronic Claims Overview Running Reports You can use the robust reporting capabilities of Medisoft to keep track of your office s performance Medisoft offers a rich list of reports to manage office functions and analyze your practice s performance Running Utilities Medisoft also provides easy automation of several functions via the Task Scheduler and EMR interfacing via the Communications Manager Medisoft Advanced and Network Professional users can also take advantage of the Dashboard a utility that monitors and displays key functions of the practice Keystrokes and Shortcuts Special keyboard shortcuts reduce the number of times you have to click the mouse or press keys to accomplish a task Keystrokes Common to Most of the Program Keystroke Action S Fa Opens Help files inmost windows rs Saves Fe Opensasearchwindow 3 3 F8 Opensawindowtocreateanewrecord F9 Opens a window to edit the selected record ri 2 Opens the Quick Balance window Opens Medisoft Office Messenger Toggles Sidebar display Cuts selected text CTRL C Copies selected text CTRL V Pastes selected tex
35. each of the Chart Number Range fields enter SMI and press TAB to print only Mr Smith s statements Click OK 6 The statement is displayed in the Preview Report window Click the Print Report speed button Answer whatever questions you may need in the Print window and then click OK 7 Click Close in the Preview Report window You may briefly see an Update Billing Status window and then are returned to Statement Management and the statement for Mr Smith is printed The statement status has been automatically changed to Sent a batch number assigned and the current date entered in the Bill Date column for both statements Changing Statement Status 1 Through Statement Management all submitted statements are automatically marked Sent with an indication of the method of submission The status needs to be changed when the statement is paid completely or for some other reason Time has passed since you printed and sent the statements for John Smith and you have received a correction notice from the patient You have already corrected the errors and are ready to resend the statements To locate Mr Smith s statements we will use a different portion of the program Click List Only and select John Smith s chart in the Chart Number field Click Apply In Statement Management select the statement and click Change Status 2 Select the Batch button and make sure the batch number in the box matches that shown in Statement Management NOTE Since w
36. electronic claims Select the Signature on File box to indicate that the provider s signature is on file Select this box if the provider has signed an agreement with Medicare to accept its charges and an affidavit is on file If it is checked the Signature Date field becomes active to display the date on which the signature was placed on file To enter a date in this field either type the date or click in the Signature Date field or click the down arrow to the right of the field and the calendar opens In the License field enter the provider s license number Click Save if you are finished with the record or click the Reference tab The Reference tab displays data and values before the data was converted to Medisoft 17 and moved to the Provider IDs grid to create rules for claim creation The tab shows data from the Default Pins and Default Group IDs tabs which were replaced in Medisoft 17 with the Provider IDs tab This tab is mostly used for reference purpose only You can update data on this tab for your reference purposes but none of this data is pulled for claim generation the rules engine does not pull any of this data from this tab The only field that still impacts claims is the Provider Class list Bele a Cancel FINS Group Numbers Medicare O Heb Medicaid Group Number Tricare Medicare Group ID lt Provider new Address Reference Provider IDs EQ Receiver Override e Set Default Blue
37. field The program also updates the submission count the number of times the statement has been sent and the billing date The Transactions tab shows all the transactions that appear on the statement You can split add to or remove transactions from statements in this tab The Comment tab provides an empty box in which to place whatever comments you feel are necessary concerning this statement and or any transactions relating to it If you add a note here an icon is displayed next to the statement in Statement Management You can double click the note to view or edit the note F1 Look up Edit Statement Converting Statements To make it easier to use Statement Management you can now easily convert old statements into Statement Management statements in the format s report properties This is done through the Design Custom Reports and Bills option in the Reports Menu F1 Look up Converting a Statement Format to a Statement Management Format Printing Statements Once statements are created click Print Send to process them Indicate whether you are sending the statements on paper or electronically If you are sending statements electronically specify the format for the statements Then apply filters on the Data Selection Questions window to select only those statements you want to send 122 Creating Statements Print Send Statements Select statement method Paper Electronic Electronic Statement Type Exclude Bill
38. has been activated in the patient and provider records The Print name option prints the name of the patient insured or physician The Leave blank option prints nothing 7 From the Print PINs on Forms list select PIN Only or Leave Blank When setting up Medicare and Medicaid carriers for printed claims select PIN Only otherwise select Leave Blank 8 From the Default Billing Method 1 2 and 3 lists select either Paper or Electronic for handling primary 1 secondary 2 and tertiary 3 claims Select Paper if claims are to be printed select Electronic if claims are to be transmitted electronically 9 Inthe Default Payment Application Codes box select default payment codes Payment Click the down arrow to select a default payment code Adjustment Click the down arrow to select a default adjustment code Withhold Click the down arrow to select a default code for entering withhold amounts Deductible Click the down arrow to select a default code for entering deductibles Take Back Click the down arrow to select a default code for entering take backs 10 Click the EDI Eligibility tab The EDI Eligibility tab is mostly used for electronic claims Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Primary Recelver EDI Receiver Claims Paper ID 0 B Eligibiity PayerID A National Plan ID PO Carer EDI Settings Alternate Carrer ID fs HOC Record Code EDI Max
39. important information about the labs and facilities associated with your practice Facility new Address Facility IDs i Save Inactwe C Type 8 Facility O Laboratory Name o Phone pO Extension f Street Fax Set Default PO Cell Phone pO City PO State Office pO Ap Code fo Contact fe Extra 1 Po Extra 2 E Mail Purchased Services The Addresses window is used to enter address information important to your practice 27 Getting Started with Medisoft lt Address new IF the Code ts left blank the Code program will assign one Inactive E Melis a Cancel Street P Help City State ip Code Set Default Type Employer w Phone Extenzlor Faz Phone pO Cell Phone pO Office Contac FO E Mail FO Extra 1 fo Extra 2 The Diagnosis List window displays all diagnosis codes that have been entered into the database and controls to edit or enter new codes Diagnosis new E E Alternate Code Sets Lode e Lode 3 HIPAA Approved Inactive Code You will use the Procedure Payment Adjustment Code window to enter and edit etc procedure codes 28 Getting Started with Medisoft Procedure Payment Adjustment new General Amounts Allowed Amounts Code 1 l Inactive Descriptions Code Type Procedure charge 44 Account Code Alternate Codes Type of Service c
40. one in the green band 3 Click the Text Field speed button in the toolbar and then click the cursor in the space between CityLine and Phone Double click this new text field to open the Text Properties window In the Text field enter Zip Code Click Font and in Font style click Bold Click OK Click OK again To be sure the heading is aligned properly hold down the Shift key and click CityLine Zip Code and Phone Right click over one of the selected fields and select Align Fields in the Speed menu 4 Inthe Alignment window choose Bottoms and click OK You re halfway there 5 In order to align the Phone heading and the Phone 1 field in the green band right click Phone and select Properties In the Text Properties window locate and make note of the value in the Position Left field Click OK Now right click over the Phone 1 field and enter the same value in the Position Left field of this window Click OK The Phone heading and Phone 1 field are now aligned 6 Next you need to enter the Zip Code field in the document you need to insert a Data Field in the green band Click the Data Field speed button and then click the green band below the Zip Code heading 7 Double click this new field to open the Data Field Properties window Click New Data Field In the Select Data Field window the Patient file should automatically be selected Be sure it is In the Fields section scroll down until you see Zip Code Select Zip Code and clic
41. so leave those fields blank This provider is a Medicare participating provider Click the Signature on File check box then select or enter 4 3 2008 as the Signature Date Click the Medicare Participating check box Enter Dr Lee s License Number as ZYX1111110 184 Tutorial Activities lt Provider new Save Hep 77 Guadalupe Road set Default Gilbert 23443 2564 4ra 200g 2141111110 The Reference tab is mostly used to display converted legacy data for reference only and is not pulled for claims The only setting on this tab that impacts claim generation is the Provider Class list for the purposes of this tutorial we will not set up a provider class 3 Click Provider IDs tab Click New On the New Provider ID window select the All buttons for insurance and facility These choices will make theis rule applies to all insurance carriers and facilities unless you create a more specific entry Since Dr Lee is a member of a group practice select the Group button 4 Select the From Practice buttons for NPI taxonomy and tax identifier to pull these values from the practice level Leave None select for the other values 185 Tutorial Activities New Provider ID O Insurance Carrier Ok all Insurance Class i all C Facility Help File Claim 4s Individual Group 2 From Practice National Provider ID a From Practice
42. sure the Tax ID is entered on the Practice Information window Practice IDs grid You must also enter information in the Providers Insurance Carriers and Patients windows You must also apply security to your practice and create at least one user For more information on Medisoft security and setting up users see Setting up Security F1 Look up Eligibility Verification Overview Practice Information Click File and select Practice Information Click the Practice IDs tab On the Practice IDs grid make sure there is an entry on the grid with the Practice Tax ID populated Providers Click Lists and select Provider and Providers On the Provider List window open the provider whose patients you want to verify Make sure the following fields are populated Provider IDs Tab On the Provider IDs grid make sure there is an entry on the grid with the Tax ID populated Insurance Carriers Click Lists and select Insurance and select Insurance Carriers On the Insurance Carrier List window select the insurance record for which you want to verify coverage Make sure the following field is populated EDI Eligibility tab Click the magnifying glass in the Claims Payer ID field to search for the payer associated with this insurance company The Payer ID Lookup window opens If you select the payer and the Eligibility Payer ID field is blank then the clearinghouse to which Medisoft sends verification requests does not support that payer at this time fo
43. tabs if there is secondary and or tertiary coverage e Acharge has been posted in the patient case e Aclaim has been created e An insurance payment or adjustment has been posted applied and marked as Complete to the account for each applicable carrier 126 Applying Deposits Applying Deposits Deposit Payment Application NOTE This is an Advanced and above feature This feature makes creating a deposit list and applying payments especially EOB payments from insurance carriers an easy process In many ways it is a more convenient place to apply payments than Transaction Entry because you enter one deposit then distribute the payment to as many cases as necessary then click one button and all the transactions are created at one time If necessary within the same window open a different patient record and continue distributing payments F1 Look up Deposit Entry F1 Look up Apply Payment Adjustments to Charges and Program Options Go to the Activities menu and select Enter Deposits Payments to open the Deposit List window Deposit List Deposit Date ARAN d Sort Eu Date Description a a d Show Unappled Only hs G3 az Deposit Date Description Payor Hame Payor Type Fapment Unapplied a OS OOOO O IE IES In this window you can select a payment to apply edit a payment or create a new payment The deposit date does not have to be the current date but the transactions entered still appear on the cur
44. the Case window to accommodate changes that allow condition codes to be used in professional claims Condition Codes will not be copied if the user uses Copy Case Getting Started with Medisoft Case AGADWODO Again Dwight Back Pain Eligibility Set Default New Fields added Several new fields have been added throughout the program Below is a table describing the window where the new field is located the field name and its purpose Window where the field is Field Name Purpose located Practice Information Practice Email Enter the general email Tab address for the practice Case Window Case Policy 2 Medicare Secondary Allows you to specify the Tab Reason reason why Medicare coverage is secondary Visible only if an insurance with Type of Medicare is selected Patient Guarantor Name Date of Death Enter the date on which the Address Tab patient died if necessary Patient Guarantor Name Suffix Allows you to enter a suffix Address Tab for the patient s name such as Jr Windows that show the patient s name will now display the suffix as well Getting Started with Medisoft Patient Guarantor Name Race Select the patient s race Address Tab Patient Guarantor Name Ethnicity Select the patient s Address Tab ethnicity Case Window Medicare and Special Program Code Allows you to select any Tricare Tab special program from the drop down list Provider Window Address Tab Middle Name Allows
45. two types of Quick Ledgers in Medisoft the Patient Ledger and the Guarantor Ledger The Patient Ledger displays transaction information and account totals for individual patients The Patient Ledger is the default ledger in Medisoft 107 Entering Transactions Quick Ledger Chart AGADY O00 e Again Dwight Account Alert RB DL View Open Items Only Global Coverage Until Date From Document Description Provider Procedure Case Amount Stmt Statement Claim Bill FEL COMMENT 11 21 2002 0211210000 Carrier MEDOT was billed REL COMMENT 7 0 00 2No B O 12 4 2002 0211210000 23664 REL E E 0 48 00 0 No 12 4 2002 0211210000 23664 REL 63 00 0 No 12 4 2002 _ 0211210000 2366 a Ee a E El 12 4 2002 MA 0000 Carrer ET 00 was billed SIS a 0D Ho Account Total 196 00 A Quick Statement The Guarantor Ledger provides the same information as the Patient Ledger but allows you to view guarantor totals as well In the Program Options General tab you can select Guarantor Ledger as your default ledger Guarantor Ledger Guarantor BOAJOOOO w Bordon John Account Alert RE Family Total 106 00 Char BORJOOOO w Bordon John Account Alert RB View Open Items Orly Global Coverage Until Date From Document Description Provider Procedure Case Units Amount StmtH Statement Claim Bili A 2 9 2006 3921 _ 16 Account Total 106 00 Remainder 2 00 28 Quick Statement To get q
46. used for any other information you may want to enter to identify this entry 5 When finished click Save Click Close Address Pizza Planet If the Code iz left blank the Code program will assign one Inactive Marne Pieza Plane Street 11234 Fifth Avenue City Anywhere rote l ip Code 85000 Phone Extensions az Fax Phone 23456 7999 Cell Phone pO Office Contact Mura E Mail PO Extra 1 A Extra 2 PO Set Default 189 Tutorial Activities Creating and Editing Procedure Codes New Procedure Codes 1 oe UA Click Lists and select Procedure Payments Adjustment Codes In the Procedure Payment Adjustment List window click New In the General tab enter XYZ in the Code 1 field and then enter Test Code in the Description field Select Procedure charge in the Code Type field The Account Code is an internal code for in house bookkeeping It can be any configuration of letters or numbers you want to assign to each accounting function i e cash checks etc Enter OVSP for Office Visit School Patient Leave Type of Service empty Enter 11 as the Place of Service and leave Time to do Procedure empty Leave the Service Classification field alone It defaults to A Leave the Alternate Codes fields alone Click the Taxable box to mark this code as needing tax charges added to it Click the Patient Only Responsible box No other fields in this window are applicable so skip them
47. user as an Administrator which grants the user access to the Security Setup window and the ability to create users If you are creating an administrator make sure that you select the Administrator check box The first user needs to be designated the Administrator Through the Security Setup window you are also able to assign users to groups Grouping users by job function or security level can help you easily assign tasks or send messages to a number of people at once Security Group New ig E E Group ID Group Mame da Cancel Description a Help F1 Look up Medisoft Standard Security If desired Level One users can also set up and apply the Global Login feature The Global Login function provides an extra layer of security and added convenience for users that access multiple practices and applications F1 Look up Global Login Overview Login Password Management 43 Setting up the Practice In Login Password Management the supervisor sets the requirements and application of login rights and password usage For example you can set the length of valid passwords the valid time frame in which a password can be used before it has to be changed how long a user has to wait before reusing a password etc lt Login Password Management Password Renewal Interval tc o days Reuse Period Oo o days Minimum Characters oO Maximum Characters CES Require Alphanumeric Login Maxinurn allowed attem
48. when integrated with Medisoft The patient flag colors in the Program Options window are fixed and cannot be edited In the box to the right of a color box assign your own description to that flag color To activate the edit boxes click Use Flags Patient flags are connected to patient records in the Other Information tab of the Patient Guarantor window as you edit or set up a new patient record F1 Look up Program Options Color Coding Tab Billing Tab NOTE This is an Advanced and above feature Statements Options in the Statements section deal with billing cycles If you want to use billing cycles when sending statements click Use Cycle Billing If you choose to use cycle billing be sure to enter a cycle billing days interval e g every 30 days The Add Copays to Remainder Statements is used to add missed copays when patients do not immediately pay their copay to the patients Copay Remainder statement 167 Performing File Maintenance F1 Look up Tracking Missed Copays F1 Look up Cycle Billing Program Options General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash Statements _ Use Cycle Billing Cycle Billing Days Standard Statement Detail Only Remainder Statement Detail Orly d Cancel Add Copay s to Remainder Statements Biling Notes Create statement billing notes Statement Billing Note Code STATEMENT w Create claim billing no
49. you to enter the middle name of the provider Referring Provider Window Middle Name Allows you to enter the Address Tab middle name of the referring provider Case Window Policy 1 2 and Group Name Enter the group name for 3 Tabs the insurance plan Procedure Payment Adjustment Purchase Service Amount Use this field to enter Window General Tab amounts you pay a lab or other vendor for technical services they performed for you for the procedure such as lab testing This amount will appear on the Transaction Entry window and a summary total of these amounts on the Claim window Procedure Payment Adjustment NDC Unit Price Use this field to enter the Window General Tab unit price of a drug or biologic Transaction Details Reference ID Qualifier Use this field to specify a qualifier for the Rx Reference ID Procedure Payment Adjustment NDC Unit of Measurement Use this field to enter the Window General Tab unit of measurement that is used for the drug or biologic Menu Changes The option for UB 04 Condition Codes has moved from the UB04 Code Lists menu to the main Lists menu Additional Options e Additional Diagnosis Codes The program now allows you to have up to 12 diagnosis codes for a case The following fields and windows are affected e Program Options Data Entry tab Number of Diagnosis can now be set from 4 12 e Transaction Entry You can now have columns for up to 12 diagnosis codes as well a
50. 10 v Time Provider Repeat No RA epeat 142 LJ Save a Cancel Hep Scheduling Appointments New Appointment Entry Status 2 Unconfirmed Confirmed Checked In gt Missed Cancelled Being Seen Checked Out minutes Rescheduled L Need Referral Date 1 29 2010 w Time Provider JM w 2 Mallard J D TANG AB Repeat No Repeat a Balance Enter or select the chart number of the person for whom the appointment is being set If the person s information has been entered in the program the name and phone number are automatically entered and the patient s last case is reflected in the Case field TIP After you select a chart number and move to another field click or TAB key if the patient has a future appointment scheduled the Patient Has Future Appointment warning field appears Click the magnifying glass or press ALT A to review the scheduled future appointments before finalizing the new appointment This feature is available for Office Hours Professional Assign a resource If the resource or room you need is not in the list press F8 to create a new resource record The Notes field lets you include a reminder message regarding the patient s need or condition Enter an appointment reason in the Reason field If necessary change the Length Date and Time fields here You can also change the appointment color If there is a need for repeat visits click Change
51. 11721 42002 37010 10 00 2 00 030922007 39273 60 00 60 00 0 00 31 00 0 00 0 00 0 00 0 00 0 00 0 00 I Alert When Claims are Done Alert When Statements Are Done There are 4 charge entries Bill Remaining Insurances Mow e Fens e aee Print Statement Now Write off Balance Mow Ae LES In this window select the patient chart number if you have chosen an insurance payment and apply the portion of the payment to the applicable charge s When finished click Save Payments Adjustments to create the transactions TIP If you check Print Statement Now and click Save Payments Adjustments you print statements from Statement Management Then if you need to apply payments from the same deposit to another patient record select the next patient chart number and continue making payment applications This window Is also tied to the Payment Application tab of Program Options Unless deactivated all payment applications are automatically checked as paid in full by the payer allowed amounts are calculated on all charges and any charges over the calculated allowed amounts are automatically entered in the Adjustment field 128 Applying Deposits TIP Be sure to click Save Payments Adjustments before closing this window or transactions cannot be created The payment application feature is designed specifically to closely match the format of an EOB When you receive an EOB with a payment fr
52. 40 Setting up Security 41 Setting up the Practice 35 Setting up the Program 32 Small Balance Write off 133 Standard Patient Lists 158 Statement Management Advanced and above 118 Statement Management Window 118 Statement Processing 135 T The Claim Management Window 111 Transaction Entry 200 Transaction Entry Overview 100 U Unprocessed Transactions 103 User Setup 174 Using the Wait List Office Hours Professional 218 y Viewing a Repot 151 Views Office Hours Professional 148 W What s New 1 Writing off Small Balances 215
53. 493 9 995 3 Allergic Reaction Allergies 995 3 995 3 foo Anorexia fos fos 716 9 Arthritis Multiple 16 4 716 3 216 94 Arthritig H and 716 94 16 94 110 4 Athlete s Foot 110 4 110 4 atr Back Spasm 0d 2 mE 786 039 Breathing Difficulty 786 09 786 039 490 0 Bronchitis 490 0 490 0 ob Print Grid At this point you can review codes in the list or search for one you do not see Clicking New F8 or Edit F9 opens up a window where you can create a new code or edit an existing one Diagnosis Arthritis Hand AE Code 1 1716 94 Description E Alternate Code Sets Code 2 16 34 Code 3 716 94 _ HIPAA Approved Inactive Code The Diagnosis new window displays fields for the code number and description You also have the option of entering Alternate Code Sets These can be used later for entering codes for different carriers but for the same diagnosis F1 Look up Diagnosis Entry Billing Code List A Billing Code is a user defined two character alphanumeric code Billing Codes can be effective in sorting and grouping patient records Go to the Lists menu and select Billing Codes 83 Setting up the Practice Billing Code List Code Description d Default Biling Code C Cash Patent Liv Patient HMO Patient Medicare Patient Non Smoker DB Patient PPO Patient Smoker S Print Grid The Billing Code List window lets you review and edit the codes contained in the program and create new ones
54. Add Copy User Reports Medisoft User Reports Report Title CMS 1500 Primary Medicare Pay gt Delete e Close Help Show Report Style A List Ledger Label O Walkout Receipt Insurance Form O Statement _ Show File Names Superbil O Statement Management Collection Letter UB Insurance Form NOTE This function supports reports and statements that use the mre extension F1 Look up Medisoft User Reports 160 Performing File Maintenance Available Program Options General Tab Backing Up Data The General tab deals with backups which are an essential part of maintaining a computer generated billing program and with general default settings Program Uptions eal General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash _ Remind to Backup on Program Exit Max Automatic Backup Count 3 1 E Save Backup Program IMBACKUP EXE Cancel Cancel Command Line PA A Help Show Windows on Startup Show Hints Patient List Show Shortcuts _ Transaction Entry Enforce Accept Assignment Print Report Title Page _ Enable Electronic Prescribing Data Version Number 28 C Use Server Time Hide Inactive Closed Items Menu T oolbar Options _ Use Guarantor Ledger for Quick Ledger Hide Icons in Menus Calc late Pa lent and Statement Ri m Inde f Bi lanc e Accoun Alert Settin C when Medisoft first opens
55. Also indicated in this window are the type of service place of service time to perform the procedure whether to allow the code to print on insurance forms Alternate Codes and if applicable whether only the patient is responsible There is also a check box to indicate if the code is inactive Modifiers help pinpoint the exact procedure performed If needed for claim filing add modifiers The HIPAA Approved field indicates whether the code is HIPAA approved The Revenue Code is used with the UB92 claim form You can adjust the number of units associated with this code in the Default Units field If the code is used only with a service that the practice purchased usually from a lab click this check box F1 Look up Procedure Payment Adjustment Entry General Tab Amounts Tab The Amounts tab is linked with Case information Account tab Price Code field Medisoft Advanced and Medisoft Network Professional allow 26 charge amounts for each code entered in the program The applicable charge amount is selected in the Account tab of each patient s Case window 19 Setting up the Practice lt Procedure Payment Adjustment App of Finger Splint Static Ela lx General Amounts Allowed Amount Charge Amounts Ay 0 00 0 00 0 0 00 a Cancel Help E L OO 0 00 D 0 0 00 0 00 E F E OU 0 00 OU 0 00 OU Cost of Service Product 5 00 Medicare Allowed Amount 0 00 F1 Look up Procedure Payment Adjustm
56. An individual patient s account balance can be recalculated in the Transaction Entry window by clicking the Account Total amount Click OK in the Transaction Entry window and the program begins the process To recalculate all account balances click the Recalculate Balances check box To recalculate all unapplied amounts click the Recalculate Unapplied Amount check box Click the Recalculate Patient Remainder Balances to recalculate all patient remainder balances 173 Performing File Maintenance File Maintenance Rebuild Indexes Pack Data Purge Data Recalculate Balances Recalculate Balances will review every patent s record and recalculate the patient s account balance Recalculate Unappled Amount will recalculate the unappled amount for all payments Recalculate Patient Remainder Balances will review every patient s record and recalculate the patient s remainder balance This process can take a LONG time Press START to begin the process C Recalculate Balances Recalculate Unapplied Amount Recalculate Patient Remainder Balances F1 Look up File Maintenance 174 Start g Cancel Tutorial Activities Tutorial Activities Tutorial Practice 1 Program Setup Initial Program Setup Go to the File menu and select Open Practice The sample data set up in this tutorial is under the practice name Medical Group Tutorial Data Select that name and click OK If this practice name does not appear click the Add Tu
57. Billing Tab Audit Tab BillFlash Tab Security Setup Overview Medisoft Standard Security Basic security in Medisoft is practice based with each practice having various users and groups Multiple practices require security setup for each database Set up security when nobody else is using the program You create users in the User Entry window click File select Security Setup and click New User Entry Main Question Group Login Marne Inactive Recontirm Access Level After you set up security close and open the practice to apply the changes Users that you create are displayed in the Security Setup List window 42 Setting up the Practice Security Setup Full Name Login Hame Access Level yr IO TO ee E 2 1 CEE Security in Medisoft Advanced and Medisoft Network Professional allows restricted levels of access to those areas of the program that the security supervisor designates The supervisor has unlimited access and full control of security while other users are restricted to varying degrees See Permissions You can also manage password settings such as how frequently a user must change the password Once at least one Level 1 user has been entered you can add more names edit entries or delete entries as necessary F1 Look up Login Password Management In Medisoft Basic you can define a
58. Card Payment CRDCOPAY Copay Credit Card Adjustment AOFF we Insurance Ye rte 0 E Small Balance write off Patient write off Code SED e Small Balance write Off Maimun d rte off Amount 5 00 If you choose to accept the default settings any amount applied to a charge is automatically marked as paid by that particular payee the allowed amount is automatically calculated and 164 Performing File Maintenance the difference between the calculated allowed amount and the practice charge is offset in the Adjustment column In addition any claim that has received payment from all responsible payers is automatically marked Done In the lower half of the window select default billing codes to be applied when using this feature F1 Look up Program Options Payment Application Tab Aging Reports Tab The Aging Reports tab lets you alter the starting date for patient aging reports and to redefine aging columns for both patient and insurance aging reports Program Uptions General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash Patient Aging Insurance Aging Q Save Transaction date from Aging Columns Days Cancel O Date of first statement jo ha EM _ ea Aging Columns Days a1 ta 60 SS o te fo El to 90 31 to 60 91 to 120 Bl to 90 121 to 121 Ji ta J F1 Look up Program Options Aging Reports Tab HIPAA Tab The HIPAA ta
59. Collection Letters le asebaes seca epdindes dossaacdeaduadibast eaeealiedsbaasseast 133 Customizing Collection Letters acces sceseacice ove igeceeds sedleced aaa 134 Small Balance Willem rn eo 134 WANG Ola Balcon mena a a R anton aaie ommamuuneamentateuma se 134 Using Electronic Services ll eee eee aes 136 Electronic Claims Processing ist ia 136 Statement PROCESSING arse cis sees hie ae a a aut eect ee 136 Receive Send Reports through Medisoft Terminal ooccccccoccnncnncccnnnncnncnononncnnnnonanncnnnnnnnns 136 ENGIDINY Vertical Maria ia is 136 Eligibility Verification Seti idas 137 ENGIDIMYventica ton Re SUIS ardid 137 Scnedtlind ADDO NIMIEN Suda A a acpiada 139 OMC Hours OVElVICW arse ua led a 139 SaN OMC SAQUES ras 139 Accessing Office Hours from Other Programs cccccccocccnnccccnoccnnccnnnnccnncnonannnnnnononnronnononanennnoss 139 MICS nn eemacecee 139 OMICS Hours SO Diosas ae 139 Setting Up Provider Records siestas adi da cota 140 Setting Ub Pauen RECOS a ii o rere eee elle eee ee 140 Setting up Case AS oe A ee 140 setting Up AESOUICE Records esla ESEE iments 141 Setting AN APpOIMtMeNt ccccooooccnncccnnnccnnnnnnnncnnnnnonnnncnnnnnnnncnnnnnrnnnnnnnnnnrnnrnnnnnnnnnnnnnnnnnnnrnnnrrnanarinnos 141 Seting Ah A o is 141 Repeating FAD OO IMTS AUS acicate 143 yi ENCINA 144 ENtEnng Be Sun odas 144 Setting Up Repeating Breaks a 145 Moving Deleting Appointments oooocnnccccnnncnnnnccnnncnncnncnnncnocnnonnncnncnnonnncn
60. Data Selection Questions window select a single claim number in the Claim Number Range so only one page prints Click OK TIP Use the Claim Number Range and not the Chart Number range because there must be an available claim before the form prints from the Report Designer 8 Click OK in the Print window We made a great adjustment and the right left adjustment is perfect 9 Now repeat the process opening the Report Properties window This time enter 6 in the Top field Click OK 10 Again print the form and check to see if the alignment is OK 11 Unfortunately aligning the CMS 1500 form is a trial and error process You may have to make a number of adjustments to get the printing just right When you do get the adjustments right save the form and close the Report Designer Use this revised form each time you print paper claims 12 If you are short on CSM 1500 forms you can print the report on plain paper Place the test paper on top of a pre printed form and hold them up to the light to see if the text is lined up properly How To Revise an Existing Report 1 You decide that you want the Zip Code included on your patient lists In the Report Designer click the Open speed button Locate Patient List and click OK 2 First you need to add the column heading and you have to make a little space for it Move the Phone heading a little to the right by clicking and dragging the field This is the heading in the blue band not the
61. ETE to delete all ID entries in the Practice Provider Referring Provider or Facilities IDs grids Use this with caution since all your entries will be removed If you have numerous legacy ID entries that no longer apply and only a few rows that need to be set up you save time by deleting all entries and setting up the few rows you need 1 Click the Provider IDs tab Click the New button to create an new grid entry OR To edit an entry select the record on the grid and click Edit The New Edit Provider ID window opens 68 Setting up the Practice New Provider ID SE Oo S all O Facility fs A m de Insurance Carrier all Insurance Class File Claim 4s Individual Group From Practice National Provider ID e From Practice O Taxonomy Tax Identifier e From Practice O Social Security Number e None O Mammography Cert None O Care Plan Oversight None Legacy Identifier 1 None Legacy Identifier 2 2 None Legacy Identifier 3 PO 2 Select either All Insurance Carrier or Insurance Class Select the All button to apply the rule to all insurance companies associated with the provider To apply the rule to a specific insurance carrier select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select the Insurance Class button and click the magnifying glass to sele
62. ETE to delete all ID entries in the Practice Provider Referring Provider or Facilities IDs grids Use this with caution since all your entries will be removed If you have numerous legacy ID entries that no longer apply and only a few rows that need to be set up you save time by deleting all entries and setting up the few rows you need 1 Click Referring Provider IDs tab This grid contains two elements The first displays all current entries rules The second element the New Edit Referring Provider IDs window is used to edit or create entries The grid displays insurance carrier insurance class NPI Taxonomy and legacy data lt Provider new Address Reference Provider IDs Insurance Insurance Facility Taxonomy Tax ID Carrier Class Code Code SSM Set Default Delete Print Grid 2 Click the New button to create a new grid entry OR Select an entry on the grid and click Edit The Referring Provider ID window opens 73 Setting up the Practice New Referring Provider ID O Insurance Carrier All O Insurance Class Entity Type 6 Person O Non Person Help None O National Provider ID None O Taxonomy None Legacy Identifier 1 None 5 Legacy Identifier 2 3 Select either All Insurance Carrier or Insurance Class Select the All button to apply the rule to all insurance carriers associated with the referring provider To apply the rule to a specific i
63. Health Claims Total Visits Rendered Oo Discipline Type Code UN Total Visits Projected Oo Ship Deliver Pattern Code UN Number of Visits OO Ship Delivers Time Code E Duration CS Frequency Period UN Number of Units o Frequency Count U Mame Again Dwight Home Phone 434 5777 Address 1742 M 53rd Ave Work Phone Fhoenis AZ Lal Eha 85027 o Date of Birth 3730 1932 F1 Look up Case EDI Tab Default Printer Selection O Save da Cancel Hep Eligibility Face Sheet Set Default 2 v 2 Setting a default printer for printing various superbills claims and statements involves a series of simple steps to first identify items to be assigned to a specific device followed by any additional print setup selections Open Medisoft and select the Default Printer Options command from the Reports menu window The Default Printer window will open 99 Setting up the Practice permissions in the Permissions window If you are not using security any default printer settings are saved to the workstation Default Printer Report Title Printer Mame er D Address List A Appointment List BilFlash MS1 P Ee BillFlash MS7 5 BillFlash MS 3 F Help BillFlash M5 3 5 BillFlash MS 4 P BillFlash MS4 5 Show Report Style BillFlash 5 5 P BilFlash MS5 S gt is l Biling Code List G Birthday Card Ledger Birthday Label 3 Columns O Label Birthday Label One Column O Walko
64. ISS costaria di iii 159 CUSTOMMAC DON ii oe ie e et e inet ed id at 159 Other Report FUncuon Sii ci id 159 Load Saved Repons anaconda tea 160 vil Add Copy User REDONS nirien a A 160 Avallable Program COONS at n eN 161 General Tabs do 161 BACKING UN DAT ut A A A A ita 161 Hide Inactive Closed lItems cccccoconncnncccconncnncnononcnnnononancnnnonnnnncnnnnnonancnnnnnnnnnrnnnnnnnnncnnennnnns 161 Detalles 162 p la Enty Tarro rota 162 FaymenttApplcalo Taiana tardaba ais 164 AGING FACDOMS Nab oirnn a A N 165 a ea 2 V A ener ee dla eee eee 165 GOlOt Coding TaD niece ee oe ee A 166 TRANS CUOMS irradia lala 166 e AA 167 A o o A 167 Jo S eer sete er ee een eee re nS ree Re ene eee ee ee 167 A A O 168 QUIEXBO MA Stan 168 Audit A ee eee ee eee eee een 169 lll TAD as O o tbat O actus tunes coatteastund stores ext enad tees a a a E aat 169 PeMonning File MalntenanCO vostra e aE NE a iaa 170 Pile MaltenancOusni asma rara 170 ReBuld Mises escote ciel R aianusonsadcuaaees 170 Race Dada A 171 Purge Dalai nada 172 necalculate Balances a ida iia 173 T tornal ACUVIE AA OPA RA PP E O O O aa daaa 175 Tutorial Practice T Program Sel ala 175 ntal Program SecllDierontsi ic neacuuan tack cate neadeec ta eau sree suecsaral atau 175 User SetuP A 175 Er D E EE EEE E E A E A RE AAA AOT 176 A A o e ers de echo 177 Login Password Manage Men lar aa 178 Tutorial Practice 2 Practice Setup ooooccnncccnonncnncccnonnnnnononanenonononanennn
65. Letters 2 Click Start in the Print Report Where window 3 Inthe Collection Letter Report Data Selection Questions window skip the range fields and click Exclude items that follow Payment Plan 4 Click Generate Collection Letters This also activates and enables the Add To Collection Tracer field Keep this field clicked Then click OK 215 Tutorial Activities 5 Preview the report and then click Close unless you really want to print it first 6 When asked if you want to print collection letters click Yes 7 Select the Collection Letter format or any customized format available and click OK 8 Click Start to preview the letters 9 Review the letters and print them 10 When you open an account in Transaction Entry Quick Ledger Quick Balance or an Appointment window the words Account alert appear near the patient s name to indicate that the account is in collections Customizing Collection Letters 1 2 Go to the Tools menu and select Collection Letter Wizard Choose the Third Party Address radio button The Third Party Billing Information section opens at the bottom of the window In the other fields enter Happy Valley Associates 9825 W Baseline Road Suite 263 Gilbert AZ 85234 480 111 2222 In Sender Name choose Provider Click Preview After previewing the sample letter click Create A little box appears in the middle of the window stating that the format is being updated Then a c
66. Link Codes 4 enter 99241 office consultation When you have selected all of the procedures you want linked click Save Click Close 192 Tutorial Activities MultiLink Code Physical School f Eg If the Code ts left blank the Lode SCHOOLPHY S program will assign one Inactive Descriptions Physical School Link Codes 1 80050 Ww General Health Screen Panel 2 81000 e Urinalysis Routine 93000 ka Electrocardiogram nterp Rep 99241 Ww Office Consultation FFS Description Office Visit Est Patient MMS Office Visit Est Patient FFS Office Visit Est Patient EEL Office Visit Est Patient ODM Office Visit Est Patient CCH Hogpital lnitial Eh DOS Hospital Visit Subseg FFS Creating a New Diagnosis Code 1 Click Lists and select Diagnosis Codes Click New 2 Enter TEST in the Code 1 field In the Description field enter Test Diagnosis Code Click Save Click Close lt Diagnosis new Siz E Code 1 TEST Description Test Diagnosis Coded Alternate Code Sets Code 2 TEST Code 3 TEST HIPAA Approved Inactive Code Tutorial Practice 3 Patient and Case Records Setting Up a New Patient Record 1 Click Lists and select Patients Guarantors and Cases Click New Patient 2 The Patient Guarantor new window opens on the Name Address tab Chart Number is the first field Skip this field and let the program cr
67. MEKESSON Empowering Healthcare medisoft Getting Started with Medisoftt 17 User Guide November 2010 Copyright Medisoft and documentation Copyright 2010 McKesson Corporation and or one of its subsidiaries All Rights Reserved Software registration required You must register your Medisoft program Full instructions on how to register are part of the installation instructions you printed out prior to installing the program Proof of ownership KEEP YOUR SERIALIZED SOFTWARE even if damaged or obsolete It is your proof of ownership McKesson Provider Technologies Physician Practice Solutions 1145 Sanctuary Parkway Suite 200 Alpharetta Georgia 30009 Sales 800 333 4747 Support 800 334 4006 Fax 916 267 6281 Web site www medisoft com Table Of Contents LO ican igh taalncu a a X Were to Fma e Dic a a a a a X Ea A m 0 A X A A E a a he es X Main help Fl td da X Medisoft Knowledge Base oncccccccconconccccooccnnnoconancnnnononancnnnnonnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnanrnnnnnnnanennnos X A S A headuna ee RuleGateadscasthy X Independent Value Added Resellers ooccccccccconconccccnonconcnononncnnnnononnnnnnnononnnnnnonnnnrnnnononanenns X Technical SUI a a X GetnoStanred With MEGISON ea E TE NS 1 NEWInNINS MES de ia 1 MeEGISOTOVEIVICW e O O do 16 Step By Step PI ES di iaa 16 Navigating in MedisSoft oooonccncccoconccnncnononcnnnonnnancnnnonnnnncnnnnnnnnnnnnnnonnnrnnnnnnnnnrnn
68. O Taxonomy Tax Identifier From Practice Social Security Number one ammography Cer On Om hy Cert one are Plan Oversig SN O Care Plan Oversight None 0 Legacy Identifier 1 None 0 Legacy Identifier 2 None 0 Legacy Identifier 3 5 Click OK The rule appears on the Provider IDs grid 6 Click New Select the Insurance Carrier button and from the list select A1 Insurance Partners Leave All selected for Facility 7 Since Dr Lee is currently the only provider that takes this insurance select the Individual button Select the National Provider ID button and enter 1234567892 Select the Taxonomy button and enter 987654321s Select the Social Security Number button and enter 678976566 Select the Legacy Identifier 1 button and enter 11223344 Select the qualifier of BQ HMO Code Number 186 Tutorial Activities New Provider ID e Insurance Carrier 4 OE Call Insurance Class all C Facility Help File Claim 4s 2 Individual Group ID Qualifier From Practice 2 National Provider ID 1234567892 me National Provider Identifier O From Practice Taxonomy 9876543215 ff Provider Taxonomy Tax Identifier Social Security Nurnber 78 97 6566 Social Security Number e Plone O Mammography Cert None Care Plan Oversight None 2 Legacy Identifier 1 1 1223344 a Number None Legacy Identifier 2 None 0 Legacy Identifier 3
69. Phone Status Initial Biling Batch Media Type SA4GADWOOO 434 5777 Ready To Send O Electronic Standard 10 BRIJAOOO 2221342 3444 Ready To Send 0 Standard A 11 SIMT4000 480 555 5555 Hold 0 Standard 12 YOUMIO00 602 222 3333 Ready To Send 0 Standard 2 DOEJOOOO 480 999 9999 Sent 12 71 2009 1 Paper Remainder SWAGJEOOO 12119 7127 Sent 6 19 2009 1 Paper Remainder 4 CATSA4DDO 227 7722 Sent 226 2010 3 Electronic Remairider 5 50044000 Sent 2672010 3 Electronic Remainder a Print Send af Rebill Statement Delete Header Search Enter values for which you want to search in the grid This field is affected by the variable in the Sort By field Sort By Click the down arrow to select the variable by which you want to search If you want to sort by Submission Count you have to add that column to the grid to see the counts For more information see F1 Look up Grid Columns List Only Click this button to list only certain statements in the grid For more information see 119 Creating Statements F1 List Only Statements that Match Change Status Click this button to change the status on a batch of statements For more information see F1 Change Statement Status Billing Method Navigation Buttons These buttons in the upper right corner of the window allow you to move through the displayed records The button at the right end of the navigation buttons refreshes the information in the grid Buttons Edit Cl
70. RE Account Total 0 00 Procedure PP Units Amount Total Diag 1 Diag 2 Diag 3 Diag4 1234 Provider Payments Adjustments 4nd Comments Date Pay Ad Code Who Faid Description Provider Amount Check Number Unappled A 2 1 2010 COPAY TO Smith John Guarantor Co Fayment EL 10 00 0 00 212010 CACSYDISE Courtesy discount EL 5 00 0 00 Y Calculate Totals 4 Update al J 8 Quick Receipt ely Print Claim yt Transaction Documentation 1 You need to add a note to the first transaction Locate that transaction in the Charges area and click Note in that same area You can add a note to either a charge transaction or a payment adjustment transaction 2 The default Type is Transaction Note internal use only Enter the following in the Documentation Notes area of this window Follow up with the carrier on this charge 3 Press the ENTER key and then press CTRL T to enter a date and time stamp in the note Click OK Click Save Transactions In the column to the right of the selected transaction there is a small icon which indicates that a note has been added This indicator is also displayed in the Quick Ledger window next to this transaction Transaction Documentation Type Transaction Note internal use only wl ee DK Documentations Motes Follow up with carrer or this charge fff 2010 9 21 52 AM SUPERVISOR 4 Click Close to close the Transaction Entr
71. Referring Provider Report Referral Source Report Advanced and above This is another report for tracking the source of patients who come to the practice For the report to work however all referral sources must be entered in the Address Book A source can be an attorney a hospital friends other patients or even the Yellow Pages Most new patient application forms include the inquiry How did you hear about us The Referral Source Report assembles the patient list by source other than provider and shows how much revenue comes from each source allowing the practice to identify those sources that send profitable referrals and or limit those that are costly or nonproductive F1 Look up Referral Source Report Facility Report Network Professional only This report tracks patients who are seen at different facilities The Facility Report assembles the patient list by facility and shows how much revenue comes from each facility helping you identify which generates the most money F1 Look up Facility Report Unapplied Payment Adjustment Report Advanced and above This report shows any payment or adjustment that has an unapplied amount and where the transaction can be found F1 Look up Unapplied Payment Adjustment Report Unapplied Deposit Report Advanced and above The Unapplied Deposit Report shows all deposits that have an unapplied amount F1 Look up Unapplied Deposit Report Co Payment Report Advanced and above The Co Payme
72. Select the Group tab Click the check box next to the DCTRS group Click Save Repeat these steps to create another group and to assign a user to that group Click Close to exit the Security Setup window Permissions 177 Tutorial Activities If you are using Medisoft Advanced or Medisoft Network Professional and are logged in as Supervisor the level 1 Pat Smith user you can create revise the rights of each level of security Be sure you are still in the Tutorial database when you perform the following steps For this exercise we will change the settings for Billing Charges function 1 Go to the File menu and select Permissions 2 Select Activities In the Process section give Level 2 and 3 users the rights to Billing Charges by clicking in those boxes Click Close Click OK on the Information box Medisoft Security Permissions Wi indy Process P Activities F Quick Ledger Addresses Quick Balance Appointment Breaks Billing Charges Appointments Biling Codes Claim Management Claim Rejection Message Communication Manager Condition Codes Data Entry Data Options Design Custom Patient Case Data Diagnosis Codes ED Receivers Eligibility Enter Deposits Payments Enter Transactions Facilities File Maintenance Final Draft Help Insurance Carrier List Ledger Login Password Management Multilink Codes Login Password Management 1 Go to the File menu and select Login Password Management 2 Enter 30 in th
73. Seres a Authorization Number 6489271 Last Visit Date 9 3 2002 we Authorzed Number of visits 12 ID A Last Viet Number 1 Patient Information Mame Again Dwight Home Phone 434 57 7 Address 1742 N Bard 4 ve Work Phone Phoenix 47 Cell Phone 6501 21 Date of Birth 34301 932 F1 Look up Case Account Tab The Diagnosis tab allows for entry of up to four default or permanent diagnosis codes for this case plus entry for allergy and EDI notes Information in the Allergies and Notes section is displayed in Transaction Entry and the New Appointment Entry window of Office Hours when a Chart number is selected 92 Setting up the Practice Case AGADWUOU Again Dwight Broken Mand Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition El Save Principal Diagnosis 359 4 v Injury Hand fue i E Cancel Default Diagnosis 2 v E i O leo Help Default Diagnosis 3 w 52 E Default Diagnosis 4 w p i E OBOA Default Diagnosis 5 w 5 il al Default Diagnosis 6 v p E Eligibility Default Diagnosis 7 w E Face Sheet Default Diagnosis 6 i caps Set Default Default Diagnosis 3 w 5 il Default Diagnosis 10 ho 2 a Default Diagnosis 11 ll 2 i Default Diagnosis 12 w p il Report Type Code
74. Transactions 0 E EDI Extra 1 Medigap po Secondary Receiver EDI Receiver bs Claims Paper ID CN E EligibiityPayer ID National Plan ID C Complementary Crossover L Delay Secondary Billing L Send Ordering Provider in Loop 2420E L Send Practice Taxonomy in Loop 20004 57 SEE C Save Set Default Setting up the Practice 11 12 13 14 15 16 T7 18 19 20 21 22 In the Primary Receiver panel on the EDI Receiver list click the magnifying glass and select an EDI receiver you use when sending electronic claims for primary insurances If you do not enter an EDI receiver in the EDI Receiver field electronic claims will not be created or sent for this insurance company In the Claims Payer ID field enter the payer ID for the insurance carrier Refer to the enrollment information you received from the carrier clearinghouse and look up the commercial identification number submitter identification numbers assigned to the insurance company by the clearinghouse Option click the Payer ID magnifying glass to look this up using the pre loaded database which contains many payer IDs If you use the eligibility verification service and want to verify eligibility with this insurance carrier in the Eligibility Payer ID field enter the payer ID for some carriers the eligibility payer ID is different from the payer ID Refer to the enrollment information you received
75. Under Provider choose All Click Save To double check click the appropriate Month and Day buttons to locate November 20 2009 If necessary use the scroll bar to show the seminar 3 To return to today s calendar click the Go to Today speed button Creating Reason Codes 1 Go to the Lists menu and select Reasons List Click New to open the Appointment Reason Entry window 2 Leave the Code field blank In the Description field enter Sports Accident 3 The default appointment length is 15 minutes Change this number to 30 In the Default Appointment Color field the drop down arrow lets you select a color that fills the appointment space on the schedule grid Choose red for this emergency accident response In Default Template Color Advanced and above select Light Red Click Save 218 Tutorial Activities Creating Templates NOTE This is an Office Hours Professional feature 1 Go to the Lists menu and select Templates List Click New 2 In one of the six Template Reasons fields use the drop down arrow to enter NEW in the Code field In the Description field describe the template s use as See New Patients Using the drop down arrows select Dr Lee as the Provider and the Resource is Exam Room 2 3 Click the arrow on the Date field to display the calendar and highlight the designated date Use the arrows on either side of the month name to change to an earlier or later month if necessary Type 10 00 a in the Time fie
76. a Select that name and click OK If this practice name does not appear click the Add Tutorial button Then select the practice and click OK The practice name appears in the Title bar of the main Medisoft window Entering Practice Information 1 Click File and select Practice Information Click the Practice tab 179 Tutorial Activities Practice Information Practice Practice IDs Practice Pay To Statement Pay To Practice Name Phone 800 333 4747 Extension po Street 5222 E Baseline Rd Fax Phone pO sts Type Medical v City Gibet State laz Federal Tax ID Pp 0 ZipCode 85234 Practice Type 3 Individual Group Extra 1 Entity Type Person Nor Person Extra 2 2 On the Practice tab you would enter the contact information for practice including practice name address telephone number etc 3 You would also select from the Type list your practice type Choices include Medical Chiropractic and Anesthesia When you choose Chiropractic or Anesthesia other areas in the program change accordingly Medical is the default practice type and does not add any additional fields When you select Chiropractic the Level of Subluxation field appears in the Diagnosis tab of the Case window for entering the level of subluxation F1 Case Diagnosis In addition five treatment fields are displayed in the Miscellaneous tab of the Case window electronic claims Treatment Months Years No Treatments Mont
77. a more detailed data element When using this feature you essentially re run a report using more specific data criteria To refine your data criteria and search for specific data 1 Generate a report 2 Click the Search button 3 On the Search window select specific data ranges 4 Click OK The report displays using the new search criteria Exporting a Report In Medisoft you are able to export a report into another format For example you could export a Patient Aging report to an Excel spreadsheet To export a report complete the following steps 153 Running Reports 1 On the Reports menu select the report to be exported The Print Report Where window opens 2 Click the Export the report to a file button and click Start The Save As window appears 3 On the Save As window window select a file format for exporting and a destination Click Save The Search window or the Data Selections Questions appears depends on the report or statement selected 4 On the window select appropriate criteria if needed Click the OK button The report is exported Available Reports Available Reports Not only does the program build an accounts receivable file and handle statements insurance claims and electronic billing it also provides a variety of reports that can give you a better understanding of the day to day workings of your practice Among the reports generated within the program are Day Sheets Analysis Reports
78. actices each will have to be converted For more conversion information F1 Converting from Windows Version 5 4x or Lower to Medisoft Version If you choose to create a new data set the Create a New Set of Data window is displayed Fill in the practice name and the practice data path The data path is the location within the MediData folder in which the practice data is stored Create a new set of data Enter the practice or doctor s name to identity this set of data w Create cae SeSEe e eem d amp g Cancel Enter the data path Help C MediD ata When you click Create the Practice Information window appears On this window on the Practice tab you will enter your basic practice information such as the name of the practice address telephone number 33 Setting up the Program and Setting up the Practice TIP When initially setting up your practice considering entering the practice name only You can then complete this tab and the other tabs on the window later in the setup process Some of the settings on the other tabs especially the Practice IDs tab require setup first Practice Information MER IE cea For more information on these settings see the topics Entering Practice Information and Entering Practice Information for a Billing Service Other Setup Information Creating Multiple Practices It is not necessary to install the program for each new practice To set up multiple practic
79. ade to the functionality and workflow of Revenue Management to reduce the number of times that the user must click to achieve the desired result Among these changes are e Claims will be auto checked so that the user does not need to click Check Claims There is a new option on the Medisoft tab in Revenue Management Preferences called Auto Check Claims Selecting this option will enable the program to auto check the claims when the user selects Process gt Claims Preferences lt Save Cancel Ha Revenue Management E Claims Edito Security me Auto Log OFF Log OFF Minutes 15 Claims A Create Billing Motes al Billing Mote Code CLAIM Auto Check Claims Getting Started with Medisoft e Claim edit checks and IG edit checks have been combined into one step and executed when you select Claims from the Process menu Errors are displayed on the Claims Preview report as well as under each individual claim e One click removal of all claims marked with a red X eliminating the need to click Remove Claim many times An icon a appears next to the Remove Claim button on the Claim Preview window Clicking this icon will remove all claims marked with a red X e Addition of a Failed Claim report that will be displayed when the Send button is selected from the Claim Preview window This report will display all claims that were removed eliminating the need to preview this report separately e Claims that fail any edit and a
80. age A 130 E 0 E 80 G 180 Percents by Service l l l l Classification B 100 D 80 F 80 H E Name Smith Jr John Home Phone 51 3 224 4668 Address 46 Center Street Work Phone 123 345 6789 a Cell Phone 5121224 1111 85234 alpha ESTES Date of Birth 17127 1975 a9 w 2 13 Mr Smith has a secondary insurance policy Open the Policy 2 tab Select FHP Health Plan as his secondary coverage Policy Number 00034526Z and the Group Number is 888B Policy Start and End dates are January 1 2010 and December 31 2010 respectively Click Assignment of Benefits Accept Assignment Your carrier assigns a Claim Number for this example use 283 8765D 200 Tutorial Activities Lase SMIJUOU0 Smith John new Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Personal Account l Diagnosis l Policy 1 Policy 2 Policy 3 Condition Insurance 2 FHPOD Ww FHP Health Plan Policy Holder 2 SMIJOO00 v Smith Jr John Relationship to Insured Self n Policy Number 000345262 Stark 17172010 we Group Number 8888 End 12 31 2010 fe Group Mame o Medicare Secondary Reason Claim Number 293 87 650 al Crossover Claim Treatment Authorization E Percents by Service gt gt O 6 1100 D 80 F 80 H 180 Classification Mame Smith Jr John Home Phone 513 224 4668 Address 46 Center Street Work Phone 1231345 6789 Gilbert 47 Cell Phone 81312241111 Date o
81. aims Print Send Reprint Claim Sending Claims 1 Once the claims are ready to go in the Claim Management window click Print Send to open the Print Send Claims window 2 We are dealing only with paper claims in this tutorial so leave the setting at Paper and click OK 205 Tutorial Activities Print Send Claims Select claims with a biling method of 4 OK Paper Electronic Help Electronic Claim Recelver 3 The Open Report window opens so you can select the claim form on which to send the claim For now highlight CMS 1500 Primary and click OK 4 The Print Report Where window pops up for you to indicate whether you want to preview the claim before printing or just send the claim directly to the printer For now leave the setting on Preview the report on the screen and click Start 5 The program assembles the information and then displays the Data Selection Questions window In each of the Chart Number Range fields select Mr Smith s chart number Click OK 6 The claim is displayed in the Preview Report window If you have preprinted CMS 1500 claim forms put a couple in your printer Click the Print Report speed button Answer whatever questions you may need in the Print window and then click OK 7 Click Close in the Preview Report window You may briefly see an Update Billing Status window and then are returned to Claim Management and the claim for Mr Smith is printed The claim status ha
82. am Options window and whether a table has been edited You choose which tables fields users and activities are included in the template This report is intended as a protection for the practice to keep track of changes made and if desired by whom Some PHI personal health information will be included in the Data Audit Report no matter what selections are made or excluded in the Program Options window or the Audit Generator NOTE This report does not support printing a report title page even if the Print Report Title Page option was set in the Program Options window F1 Look up Audit Generator Patient Ledger This report reflects the account status of each patient Charges are shown until a payment is entered to remove a specific procedure paid You may include all patient accounts or select a few The patient ledger is similar to a ledger card in a manual accounting program Since the Medisoft program is a true Open Item Accounting program it can show all or part of the financial activity for a patient including the current balance and what procedures have not been paid Past activity in the account includes a listing of all transactions indicating those that have been paid The report marks those transactions that have been paid and the amounts 158 Running Reports F1 Look up Patient Ledger Guarantor Quick Balance List NOTE This is a Network Professional only feature This report lists the guarantor quick balances that
83. an set up aS many new Cases as needed Each new case that is set up needs to contain the patient s pertinent information If you click New Case or press F8 with the case list selected only the Guarantor designation is copied to 89 Setting up the Practice the new case To save time click Copy Case to copy all the current case information and then revise those portions of the data that are different for the new case You definitely want to open a new case if the treatment comes under a different insurance carrier Suppose you are treating a diabetic patient regularly and he is injured on the job His visits regarding the work related injury should be kept in a Workers Compensation case totally separate from the regular visits for legal and reporting reasons The ideal situation is to have a case for each different malady from which the patient suffers Then you can pull up groupings of case visits to help you evaluate the patient s overall health status By pulling a case that contains all diabetic treatments one for high blood pressure one for angina and one for cancer you get a better picture of the full range of health problems TIP If a patient comes for a onetime treatment you can create a transaction for that treatment without creating an entirely new case Just select different diagnosis codes in Transaction Entry when creating the transaction Existing case numbers are found in the Patient List window through which you
84. and click Edit Review the data on the Address tab and update as necessary Click the Provider IDs tab 4 The conversion process will have created at least one entry for the provider On the Provider IDs grid select the first entry and click Edit The Edit Provider IDs window opens 6 If you file claims as an individual make sure the Files Claims As Individual button is selected 7 If you file claims as a group make sure the Files Claims As Group button is selected 8 Click OK Repeat steps 4 7 for any other entries in the grid When complete repeat the steps for any other providers in the practice To provide the highest level of data integrity and accuracy the conversion process for Medisoft 17 provider practice setup does not delete information while creating grid entries that might still be needed such as legacy information Blue Cross provider numbers Medicare provider numbers etc but converts this data to a grid entry in Medisoft 17 Before filing claims you will also need to finalize your grid entries making sure to remove unnecessary data such as out of date legacy numbers This activity is especially important for any data entered on PINs tab in previous versions of Medisoft and also if you used the NPI Only check box on the Insurance Carriers window Since data was converted instead of deleted to provide a high level of data accuracy in Medisoft 17 you will need to remove out of date legacy numbers from the new g
85. and then select Patient Collection Letters You must print the Collection Letter Report before you print collection letters 133 Managing Collections and Small Balance Write Ofts In the Data Selection Question window click the Exclude items that follow Payment Plan check box to activate Generate Collection Letters box Check the Generate Collection Letters box F1 Look up Collection Letters and Collection Letter Report Customizing Collection Letters Customize the collection letter format through the Collection Letter Wizard Go to the Tools menu and select Collection Letter Wizard A Collection Letter Selection Please choose which items you want to be included on your Collection Letter Click OF when pon have completed your selections Mame and Address Preference le Practice f Provider f Third Party Address _ Preview Contact Phone Number l Restore Settings f Same as above C Other Help Sender Hame f Same as above C Practice C Provider C Other The things you can customize are the name and address contact phone number and sender s name Make your selections and click either OK or Preview Access the new format through the Custom Report List New formats are named WzCollections date using the date on which the format was revised If you create several new formats in a single day you can distinguish them by the order in which you created them Click Show File Names to reveal the format file names
86. ars 3 Click the Address tab 71 Setting up the Practice Referring Provider new Address Referring Provider IDs If the Code is left blank Cj Save Code the program will assign ore Inactive a Cancel Last Name Middle Initial First Mame Credentials Street CO Set Default City State Help ip Code pO E Mail Pe Office pO Fax pO Home pO Cell pO LIPIN License Number Extra 1 Extra 2 Medicare Participating Specialty e Mot Listed 44 4 Onthe Address tab enter demographic information for the referring provider such as last name first name title etc Also if you are sending electronic claims select from the Specialty list the referring provider s special field of practice If you need to use a specialty code that is different than the usual code select Not Listed and enter your specialty code in the data entry box that appears next to the Specialty list NOTE This field is not used for sending paper claims unless you have modified your claim form to include this information 5 Click Save if finished or go to the next section for information on entering data on the Referring Providers IDs tab Entering Information on the Referring Provider IDs Grid Use the Referring Provider IDs tab and grid to enter or edit key data elements associated with a referring provider NPI taxonomy legacy numbers etc You will set up at least one entry rul
87. assigned by the program and is used for reference and filtering purposes whether the field is displayed in the Transaction Entry window or not You can replace this number with your own if you want If you use superbills you can enter a superbill Serial Number in this field to help keep track of the superbill To use superbill numbers in Transaction Entry open Program Options and click both Force Document Number and Use Serialized Superbills in the Data Entry tab You can also print blank serialized superbills that are not assigned to an appointment Before using the feature if you have security applied to your practice you will need to give access to this feature to appropriate users The default setting is for level 1 users only For information on changing permissions see Setting Permissions F1 Look up Permissions The same options you selected to use Superbills also applies if you want to print blank superbills the Force Document Number and Use Serialized Superbills options on the Program Options window Data tab must be selected Once enabled you can print a blank Superbill by selecting the Blank Superbill command on the Reports menu and at a later date assign the blank superbill to a chart and case in the Transaction Entry F1 Look up Printing Blank Superbills F1 Assigning a Blank Superbill to a Patient and a Case Sometimes there is a need to provide more documentation about a transaction This can be done in a special Transact
88. at which gives you one button printing of a statement from Quick Ledger When you click Quick Statement from either of these windows the default statement is automatically printed for the selected patient record If you do not specify a default format here the first time you click Quick Statement from Quick Ledger you are required to select a format 168 Performing File Maintenance You can print a Face Sheet directly from the patient Case window To set a default form click the down arrow in the Face Sheet field and select one of the options The selected default form prints each time you click Face Sheet in the patient Case window The Quick List provides report options for selecting a default list report for the Quick List on the Patient Quick Entry window You can print a quick list directly from the Patient Quick Entry window each time you click Quick List in the Patient Quick Entry window F1 Look up Program Options Billing Tab Audit Tab The Audit tab lists all tables available in the database The tables you choose here become those tables available in the Audit Generator when preparing the Data Audit Report If you deselect MultiLink here it will not be available in the Audit Generator Program Options General Data Entry Payment Application Aging Reports HIPAA Color Coding Billing Audit BillFlash NOTE By leaving or unchecking any of the following tables you will be turning off all audits for that table Perf
89. atus type Pending Biling Method From Biling Method To O Paper Paper Electronic Electronic For Carrier Primary Tertiary Secondary e Al Choose the Batch radio button and enter the batch number from the Batch 1 column in the Claim Management window Then choose the appropriate radio buttons in the Status From and Status To sections All claims with that batch number have the status changed when you click OK Selecting Multiple Claims When only one or a few claims within the same batch or claims from multiple batches need a status change hold down the CTRL key and click each claim that needs the status changed Note that the selected claims do not need to have the same claim status to begin with but they are all changed to the same status Click Edit In the Change Claim Status Billing Method window choose the Selected Claim s radio button then choose the appropriate radio buttons in the Status From and Status To sections If you have chosen claims with varying statuses choose Any status type in the Status From section When finished click OK F1 Look up Change Claim Status Billing Method and Marking Claims Sending Claims to a File Medisoft has the ability to print CMS or UB 04 claim data to a text file You process the claims like you are sending electronic claims through one of the electronic claims modules only you create the file on your desktop instead of sending it to the clearinghouse or
90. ayment Status Report Insurance Payment Comparison Network Professional only The Insurance Payment Comparison report compares the payment records of all carriers in the practice F1 Look up Insurance Payment Comparison 154 Running Reports Practice Analysis This report summarizes the activity of a specified period e g a month listing each procedure performed the number of times it was performed and the total dollar amount generated by each procedure It shows the average charge includes any costs involved with that procedure and calculates the net monetary effect on the practice s income F1 Look up Practice Analysis Insurance Analysis Advanced and above This report summarizes all claims filed by category Primary Secondary and Tertiary Claims totals are shown for charges and insurance payments in both dollar amount and percentage F1 Look up Insurance Analysis Referring Provider Report Advanced and above lt is good to keep track of the source of your patients The Referring Provider Report shows which patients were referred by other practices and the percentage each referral contributes to the overall referred income of the practice as of the date of that report The report also includes the UPIN of the referring provider By blanking out the Referring Provider range in the Data Selection Questions window a report can be generated showing what percentage of the entire practice has been referred F1 Look up
91. ayment to Charges window shows each of the charge entries that have been made and a white column marked This Payment Apply Payment to Charges Payment From G SEN For Smith John a 21 2010 1002010000 99214 65 00 85 00 0 00 E 0142010 1002010000 82954 10 001 10 00 000 There are 2 charge entries 8 With the 10 to apply select the charge that is 65 00 click in the This Payment column of that transaction and enter 10 9 Click Close 10 You need to make an adjustment so click New in the Payments Adjustments and Comments section of Transaction Entry Enter the adjustment code CACSYDISC in the Pay Adj Code field Courtesy Discount in the Description column and 5 as the adjustment amount Click Apply 11 The Apply Adjustment to Charges window is similar to the Apply Payments to Charges window 12 Locate the 55 balance and enter 5 in the This Adjust column Click Close to return to the Transaction Entry window 202 Tutorial Activities Chart SMIJOODO F Smith John 141241975 A1 Ins FHP He Patient Mi AT Co pay Overdue 0 00 Adjustments 0 00 e E MIE Back pan i oan aeo erao o E E l Last Payment Date 0 00 0 00 0 00 0 00 Payment 0 00 Last Payment mount 0 00 Total 0 00 Balance 0 00 Last Visit Date Policy Copay 0 00 DA Visit 0 01412 la l A Deductible 0 00 TE 0 00 Changes Global Coverage Until ae Sie oie lt Transaction Entry y E
92. b offers features designed to help protect patient information from unauthorized access 165 Performing File Maintenance Program Options General Data Entry Parment Application Aging Reports HIPAA Color Coding Billing Audit BillElash Health Insurance Portability and Accountability Act Auto Log Of minutes am on Unapproved Codes The Auto Log Off check box is designed to protect your data files from unauthorized tampering Click the check box and then enter a number of minutes up to 59 in the data box If you click this box and have not utilized the Security Setup feature in the program a message pops up telling you that security has to be set up before the backup will function Click OK to clear the message See Security Setup for information on setting up security for the program With Auto Log Off activated any time the program remains unused for the amount of time designated it minimizes to a User Login window which requires reentry of the user s password in order to access the program again You can also click Close Program to turn the program off completely When the Warn on Unapproved Codes check box is checked the program alerts you if a code entered or selected is non HIPAA compliant This warning pops up every time you save transactions and the program finds a code that has not been marked HIPAA compliant To mark an existing code compliant you need to edit each code entered in the program determ
93. be performed by the provider and the diagnoses related to it displayed in a list format If you use Office Hours integrated with any version of Medisoft you can print superbills for the day through Office Hours Go to the Reports menu and select Print Superbills In Medisoft select the Reports menu and then select Print Superbills For a discussion on how superbills work and how to track superbills F1 Look up How Superbills Work F1 Look up Tracking Superbills For more information on creating new superbill report formats editing an existing Superbill format or converting an existing superbill format F1 Superbills Deleting a Superbill If you delete an appointment to which a superbill is attached the superbill is also deleted from the program When a numbered superbill is deleted from the program the number may be released for reassignment For more information on superbill deletion and reassignment see F1 What Happens to the Number When You Delete a Numbered Superbill Printing a Blank Superbill This feature allows you to print blank serialized superbills that are not assigned to an appointment Before using the feature if you have security applied to your practice you will need to give access to this feature to appropriate users The default setting is for level 1 users only For information on changing permissions F1 Look up Permissions You will also need to select the Force Document Number and Use Serialized Superbills opti
94. ber from the Provider IDs grid For more information see F1 Entering and Editing Provider Information Entering Provider Information 1 Click Lists select Provider and select Providers The Provider List window opens 64 Setting up the Practice lt Provider List Credentials License Number Medicare Part Last Name e MC55749 Mallard Mors Melvin License number True Morris Lee Robert E D True Lee Hinckle Wallace License Number False Hinckle 2 Click New OR Select an entry on the Provider List window and click Edit The Provider window opens Eele lt Provider new Address Reference Provider Ds If the Code is left blank O Save Code the program will assign one Inactive j g Cancel Last Name Middle Initial Ml po Help First Mame Credentials a Street City State Set Default ip Code hm E Mail PO Office fo Fax Po Home Cell fo Signature On File Signature Date Medicare Participating License Number 65 Setting up the Practice 3 Click the Address tab and enter demographic information for the provider such as last name first name title etc 4 Options Select the Medicare Participating Provider box if the provider is considered a Medicare participating provider A Medicare participating provider agrees to accept assignment on all Medicare claims for covered services and supplies This field is generally used with
95. ber of transactions from a different date you can change the program date by clicking the date in the lower right corner of the program window and selecting a new date Be sure to change the date back to the current date when finished The Transaction Entry window displays on a tabbed panel the current insurance carriers assigned to the patient s case along with the aging columns The aging columns appearance is dictated by setting on the Program Options tab Enter information in the Procedure column and any other information that is necessary to complete this charge transaction To create a second charge transaction click the down arrow key or click New Sort the columns in the Transaction entry by clicking a column header to sort the grid by that value Medisoft Advanced and Medisoft Network Professional feature For instance click the Procedure header to display transactions sorted by the procedure numbers of the line items The default sorting pattern is based on date and sorts in a descending order and the last sort selection is also saved for next use For more information see F1 Look up Sorting the Transaction Entry Grids Entering a Payment or Adjustment in Transaction Entry After selecting patient chart and case numbers in the Transaction Entry window you can enter a payment by clicking New in the Payments Adjustments and Comments section of the window The current date is inserted in the Date field Select the Pay Adj C
96. ce File Maintenance Recalculate Balances Pack Data Purge Data Rebuild Indexes Star The list below represents the data files used by this program Place a check mark by each file for which pon would like to verify and rebuild Depending on the size of the file this process may take a LONG time di Cancel Press START to begin the process Address Allowed Amount Audit Audit Detail Biling Code Biling Practice Case Claim Claims Condition Codes Contact Credit Card Custom Data Database Password Default Deposit Diagnosis ELI Purge Data EDI Receiver Electronic Remittance Electronic Remittance Trkng Eligibility Eligibility Werfication Status Group IDs AL Trigger Insurance Carrier Insurance Class Login Management MultiLink Multimedia Decurence Codes Decurence Span Codes Office Hours Option Patient Patient Discharge Status Patient Quick Entry Patient Recall Payment Log Payment Plan Physician Practice Practice Settings Printer Defaults Procedure Procedure Flan Provider Class Retfering Provider Rejection Repeat Task Report Tree Report Users Revenue Codes Security C All Files Security Statement Superbill Tracking Transactions Treatment Plan Trigger Control T able 0804 Form Fields Unprocessed Invalid Records Unprocessed Transactions User Groups Value Codes Warehouse Wizard T able Work Administrator Work List ip Code The decision to purge data fi
97. ce structure and your filing needs will help you set up your practice Also consider reviewing the Assigning Rules topic before completing grid entries on the Practice Provider Facility and Referring Provider IDs tabs since these entries or rules determine what information is pulled included in a print or electronic claim Rules Creation and IDs Grid Row Selection Medisoft claim processing for both print and electronic claims depends on a series of flexible rules that you define on the various ID grids in the application When setting up or updating your practice data you will create a series of grid entries rules on the Practice IDs and Provider IDs grid You may also use the Facility IDs and Referring Provider IDs grids depending on your practice structure The grid entries that you complete contain your basic practice information such as group or individual NPI taxonomy tax IDs and claim filing status group or individual and connect this information to the insurance carriers that your practice accepts and the doctors in your practice as a series of rules 36 Setting up the Practice You begin by creating general entries for each provider on the Provider IDs grid and by creating at least one entry on the Practice IDs grid level NOTE The setup for solo providers offers more flexibility Also taxonomy requirements or NPI setup considerations can impact how you create your practice For more information see F1 An Overview of Se
98. ceivables a separate database can be set up with each client listed as a patient Separate procedure codes can be created to cover the various services of your billing service Billing Service or Different Pay To Address If your pay to address is different from your service address you will also need to complete the Practice Pay To tab You will also complete this tab if you are a billing service 1 Click File and select Practice Information Click the Practice Pay To tab Practice Information Practice Practice IDs Practice Pay To Statement Pay To Practice Name ENTRE Phone 480 480 4800 Extension 2222 Street 1944 N Kluge Dr Fax Phone 480 480 4801 Suite 8381 City Gilbert State AZ EM Zip Code 85234 Ea 0 2 Enter the pay to information in the Practice Name Street City State Zip Code etc fields NOTE the Extra 1 and Extra 2 fields are only used if a carrier requires extra data on a claim 3 Click Save Bill Flash Users If you use Bill Flash for electronic statement processing you will also complete the Statement Pay To tab Data on this tab is used to create a separate pay to address location for the 91 Setting up the Practice statements for instance a PO Box instead of a physical address When you generate Bill Flash report forms in Medisoft data is pulled from this tab 1 Click File and select Practice Information Click the Statement Pay To tab Practice Information
99. ch you specify the insurance company and select to pull the provider s NPI number from the Provider IDs grid For more information see F1 Entering and Editing Practice Information For more information see F1 Entering and Editing Provider Information Billing Service or Different Pay To Address If your pay to address is different from your service address you will also need to complete the Practice Pay To tab You will also complete this tab if you are a billing service Bill Flash Users If you want to send statements electronically you must use Bill Flash You will also complete the Statement Pay To tab Data on this tab is used to create a separate pay to address location for the statements for instance a PO Box instead of a physical address When you generate Bill Flash report forms in Medisoft data is pulled from this tab Practice Type The practice Type field is a drop down list Click on the arrow to view the entry options e Medical Chiropractic and Anesthesia Each option controls special fields within the program Medical This is the general setting for all healthcare groups except Chiropractic and Anesthesiology Chiropractic Choosing Chiropractic activates the Level of Subluxation field in the diagnosis section of the patient case file When set as Medical or Anesthesia this field is not avallable Anesthesia The Anesthesia choice adds a Minutes field in the Transaction Entry window for entering charg
100. cific order and follows the left to right layout on the IDs grid For instance on the Practice IDs grid the logic looks at provider code first then insurance carrier then facility etc For instance if you are setting up a group practice with three doctors you would need to have at least one rule grid entry on the Practice IDs grid and one rule on the Providers IDs grid for each provider three rules You must include an entry for each provider on the Provider IDs grid since you define your claim filing status individual or group here For this general rule on the Practice IDs grid you could apply it to all providers all insurance carriers and all facilities assuming you have no facilities associated with your practice or all facilities would use the same details NOTE for more information on setting up a facility see the topic Facility Information In this entry you could include your group NPI taxonomy and tax ID numbers Then on the Providers ID grid you would create one grid entry for each provider Each of these initial entries would be general and could apply to all insurance carriers and facilities You would also select Group for your claim type and could select From Practice to pull NPI taxonomy and Tax IDs from the Practice IDs grid If one of the insurance carriers that your practice accepts requires a legacy identifier you would create a second entry on the Practice IDs grid By creating a second entry on this grid in
101. ck Entry for New Patient Case F8 and Use Quick Entry for Edit Patient Case F9 check boxes provide setting options for the Patient Quick feature which provides a custom method for creating records For more information on the Patient Quick Entry feature in Medisoft F1 Look up Patient Quick Entry Choices in the Transaction section primarily affect Transaction Entry Check the Force Document Number to apply a document number to each transaction in Transaction Entry It forces the Documentation Number field to appear If you uncheck this option no document number is applied to the transactions and the Document Number field is not displayed in the Transaction Entry window If this option is unchecked the serialized superbill function is also disabled Selecting this option along with the Use Serialized Superbill box also provides the option to print blank superbills For more information on this feature see F1 Printing Blank Superbills F1 Assigning a Blank Superbill to a Patient and a Case 163 Performing File Maintenance Use Serialized Superbills Click this box to use the serialized superbills feature For more information see F1 Tracking Superbills If you click Force payments to be applied the program makes you apply every payment before exiting Transaction Entry If you choose to Multiply units times amount the program automatically adjusts the cost of the procedure based on number of units If you click Auto Create Tax Entry th
102. click Signature on File and enter the signature date of 9 15 2009 5 Inthe Employer field select Bean Sprout Express Mr Smith s status is Full time When finished click Save Click Close 194 Tutorial Activities lt Patient Guarantor Smith John Payment Plan Custom Name address Other Information Assigned Provider J D Mallard M D Patient IDH2 Patient Billing Cade Default Billing Code Patent Indicator pO Set Default Healthcare ID PO Medical Record Signature On File signature Date 9 15 2009 Emergency Contact Name Home Phone Cell Phone Default Employment Information for Mew Cases Employer BEANO e Beansprout Express Work Phone 602 453 9988 Extension Location Retirement Date Copy Address Opening a New Case 1 Click Lists and select Patients Guarantors and Cases Select John Smith in the left section of the window Then click the Case button at the top right of the window Click New Case 2 Enter Back pain as the description of this case Change Marital Status to Single All the other information is taken from the patient record 195 Tutorial Activities Case 5MIJ0000 Smith John Back pain Sets Miscellaneous Medicaid and Tricare Comment EDI Custom One Personal Account Diagnosis l Policy 1 l Policy 2 Policy 3 Condition D Save Case Humber O Description Back pain Cash Case e Help Global Coverage Until a
103. cnncnonnnncnnnnnnnnccnnononanenns 103 Apply Payments or Adjustments to Charges occcccococcncccoccnncconcnnncnnnnnnononcnnnnnnnonnnnannnconancnnnnnas 103 Unprocessed Tras aci adas 104 Communications Manager OVErVieW coooocccncccnnnccnnncononncnnnnononncononononnrnnnnonnnnrnnononannnnnnnonanens 105 Paten Treatment PlaNS id dia colinas 106 Pint Recep Oreate iS ll tia cias 106 ES NEM NCH Shar eS onda 106 QUIE 107 Qui A acia oia 109 Srs atinada Cial Na eae 111 Caim Manage Meta li 111 The Claim Manager S JOD ocooccccccnccccnccncnccccnononononnnonnnonnconnnnnnnnnnnnnncnnrnnnnrnnnnnnnnnnnrnrnonannnnaninos 111 The Claim Management WiNdOW ccccccocccnnccccccncnncnononccnncnononcnnnononancnnnnonnnennnnonnnnrnnnonnnnennnnnnnas 112 nn E e 112 A 113 BUON Sa o ia eee ies 113 Greatina Claims io od o died 113 EIN OIM di 114 PINUNO GIAN AAA PA PRE O iuemnenadanecead intanavadneenodsubhaasdeetcansd ebaaaseaneetats 115 Troubleshooting Insurance ClaiMS oooccccccccncncnncccnnnncnnnnononnnnnnnonnncnnnnnnnannnnnnnonnnrnnnnnnnanennnoss 116 As A A A a 116 SIRO GIAN e EA E E E E E OA iio ida 116 changing Claim tatUS iena a a ico ere a 117 Js a a a a ee nth a o i 117 Selecting Multiple Claims icsse renane aena eaa aana anea an Erana 118 Sending Claims to a File occcccccconncnncccconncnncnononncnnnnnnoncnnnnnonancnnnnnnnnncnnnnnnnnnnnnnnnnnnnrnnnnnnnnncnnnnss 118 Creating State MIC INS nreno a do eel oo 119 Statement Managen eN essre aaeain
104. con if the transaction has a note F1 Adding a Note to a Line Item on the Quick Ledger Click Payment Detail to display all payments adjustments made toward a specific charge Click Filter to search which transaction data to display Real power comes with using multiple filters Navigation buttons in the Payment Adjustment Detail window are for selecting other entries in the Quick Ledger to review without having to exit the Payment Adjustment Detail window first TIP If you click Quick Statement you print statements from the Reports menu If you click Statement you print statements from Statement Management F1 Look up Quick Ledger Payment Adjustment Detail and Transaction Filter Quick Balance NOTE This is an Advanced and above feature Quick Balance is a quick summary of all remainder charge totals contained within the program for a selected guarantor record Click Activities and select Quick Balance or press F11 to access the feature lt Quick Balance EJ Chart AGADWODO_w 2 Again Dwight Chart Humber Patient Mame 4G4DVW000 Agan Dwight 0 00 Guarantor Remainder Total 0 00 109 Entering Transactions If the record selected is a guarantor s record the Quick Balance window displays each patient for whom the guarantor is responsible and the total qualifying remainder charges for each If the record selected is not a guarantor s record a listing of all the selected patient s guarantors is displaye
105. contact for ordering supplies fou can also talk to his assistant Suzie For more information on the use of this feature see 85 Setting up the Practice F1 Look up Contact Entry Setting Up Patient Records One of the most important functions in getting your practice computerized is entering patient data Go to the Lists menu and select Patients Guarantors and Cases Patient List Search for is Field Chart Number e De ase Chart Hu Name _ Date al Birth Soc Sec Nur A List of cases for Again Dwight a 4GADWO00 Again Cwight 2 Mumber Case Description Guarante A 2 Broken Hand AGAD WH gt BORJOO00 Bordon John 59 17 Back Fain AGAD AI BRIELOOO Brinley Elmo BRWAOOO Brinley Jay BRAISUOO0 Brimley Susan CATSAQ00 Catera Sammy CLIWAQOO Clinger Wallace ij You can search for an existing patients record by entering the first few letters of his or her last name in the Search for field If you want the Patient List window to open automatically each time you open the program go to Program Options and click Patient List in the Show Windows on Startup section of the General tab Clicking New or pressing F8 opens an entry window to set up a new patient Each of the data windows during setup lets you edit change or delete the information contained in window The importance of entering correct information into the patient data files cannot be overemphasized Fr
106. created you can print them by clicking Print Send Indicate whether you are sending the claims on paper or electronically then apply filters to select only those claims you want to send F1 Look up Print Send Claims 115 Creating Claims Print Send Claims Select claims with a Gilling method of e Paper 4 OK aa Cancel Electronic e Help Electronic Claim Recelver Troubleshooting Insurance Claims Claim Form Not Centered If your insurance claims are printing just a little off center this can be fixed by entering the Report Designer Reports menu Design Custom Reports and Bills Open the insurance form you use for printing claims Go to the File menu and select Report Properties In the Form Offset area of the window adjust the form as necessary from the top and or left margins The form is moved in increments of one hundredth of an inch When the form is adjusted save the form exit the Report Designer and reprint your claim F1 Look up Report Designer Reprinting Claims If necessary you can reprint claims without regard to their status To reprint an entire batch the status must be changed for the batch F1 Look up Reprinting Claims Listing Claims The Claim Management window has a claims viewing feature that lets you retrieve claims that match a set of criteria that you define Click List Only A Creating Claims List Only Claims That Match Chart Number Ww Claim Created w Se
107. ct the insurance class 3 Select either All or Facility Select the All button to apply the rule to all facilities associated with the provider select this option if there are no facilities associated with the provider To apply the rule to a specific facility select the Facility button and click the magnifying glass to select the specific provider 4 Select either File Claim As Individual or File Claim As Group Select the Individual button if the provider is a solo practitioner or files claims as an individual Select the Group button if the provider is a member of a group practice or files claims as a group 5 Select either From Practice or National Provider ID TIP If you do not want to send an NPI number on a claim select From Practice and then on the Practice IDs window create a matching entry for the provider in which you select None for the NPI option 69 Setting up the Practice Select the From Practice button to pull NPI number from the Practice IDs grid Select the National Provider ID button and enter an NPI number to associate that NPI number with the rule 6 Select either From Practice or Taxonomy TIP If you do not want to send a taxonomy number on a claim select From Practice and then on the Practice IDs window create a matching entry for the provider in which you select None for the Taxonomy option Select the From Practice button to pull the taxonomy number from the Practice IDs grid Select the Tax
108. ctice When you enter a Social Security Number the program checks through the patient records for any duplications If a number you enter is a duplicate the program displays the name and chart number of the patient first showing that Social Security Number Do not include spaces or hyphens as you enter dates or phone numbers If you want the program to automatically hyphenate Social Security Numbers go to Program Options open the Data Entry tab and click Auto format Soc Sec in the Patient area Then enter Social Security Numbers without hyphens The Other Information tab contains fields for additional information relevant to the patient record such as the assigned provider identification codes and emergency contact numbers Patient Guarantor Bordon John E Bx Payment Plan Custom Name Address Other Information Cj Save a Cancel Assigned Prowider JM e J D Mallard M D Patient ID He Patient Billing Code M 4 Medicare Patient Patent Indicator Set Default 44 Fe Healthcare ID pO Signature On File signature D ate w Emergency Contact Mame Home Phone Cell Phone Default Employment Information hor Mew Cases Emploper BEADO vE BeanSprout Express work Phone 602 453 9988 Extension Location Retirement Date Help Appointments If you have chosen to use patient flagging Advanced and above the Flag
109. ction List Items Note Be sure that you have activated security in your Medisoft program Collections and Revenue will not work unless you have applied security A A A 10 11 12 13 14 15 16 17 18 19 20 Go to the Activities menu and select Collection List Click New In the Tickler tab enter Contact Attorney Choose the Patient radio button In the Chart Number field select John Smith s chart Select Mr Smith also in the Guarantor and Responsible Party fields Choose the person to whom you want to assign this tickler The names you see are those entered in the Security Setup window If no names appear you must set up Security first Choose Open as the status of the item By default the follow up date is today s date Leave that date for now Click Save Let s create an insurance responsible tickler also so you can see the difference between the two Click New In the Tickler tab enter Call insurance Select Insurance In the Chart Number field select John Smith s chart Select Mr Smith s chart also in the Guarantor field Choose Al Insurance Partners in the Responsible Party field Choose the person to whom you want to assign this tickler Choose Open as the status of the item By default the follow up date is today s date Leave that date for now Click Save 214 Tutorial Activities Adding a Collection List Item ils ON an ee 6 7 8 9 4 O Go to the Activities
110. ction field found in the Apply Payment Adjustments to Charges window You can then 125 Creating Statements format a statement that prints transaction statement notes Using this reformatted statement the program prints the claim rejection messages on patient statements F1 Look up Format Design Reports Go to the Lists menu and select Claim Rejection Messages The Claim Rejection Message list window opens Click New to create a new rejection message or select an entry on the grid and click Edit Claim Rejection Message new KEX Code l Inactive Message TIP When applying a claim rejection message to a line item in the Apply Payment Adjustments to Charges window use the F8 and F9 keyboard shortcuts Click the Rejection column and click F8 to create a new rejection message or click F9 to edit an existing rejection message In the Code field enter the claim rejection message code In the Message field enter the message F1 Look up Claim Rejection Message Entry F1 Look up Apply Payment Adjustments to Charges Grid Troubleshooting Statement Printing Patient Remainder Statements NOTE This is an Advanced and above feature If you are having trouble printing patient remainder statements check to be sure the following items have been performed e The patient has insurance coverage other than Medicare This is indicated in the patient Case window Policy 1 tab Insurance 1 field also Policy 2 and Policy 3
111. cy numbers taxonomy etc for that carrier or insurance class in which you select the From Practice button instead of selecting the National Provider ID button and entering an NPI number Member of a Group file claims as a group If you file claims as a group you can enter your NPI information on the Practice IDs grid In this case you would select on the Providers IDs grid the From Practice button instead of selecting the National Provider ID button and entering an NPI number Mixed NPI Numbers If you have insurance carriers that require mixed NPI numbers some require individual NPI numbers while some require a group you would enter your group NPI number on the Practice IDs grid You would then create entries on the Provider IDs grid in which you would enter your the specific provider s individual NPI number on Provider IDs grid and apply it to a specific insurance carrier or an insurance category you could create several records if needed to address other issues such as legacy numbers taxonomy etc For more information see F1 Entering and Editing Provider Information Claim Filing Setup for Individuals and Groups You set your claim filing status on the Providers window on the Provider IDs matrix by selecting either the Individual or Group buttons If you always file claims one way either as an individual or a group you can select that button and apply this setting to all insurance carriers set up in the system by selecting t
112. d Choose a guarantor to see the quick balance TIP If you click Print in Quick Balance you print statements from the Reports menu F1 Look up Quick Balance 110 Creating Claims Creating Claims Claim Management This section explains briefly how to manage claims within the Claim Management window and includes creating editing printing reprinting and listing claims as well as changing claim status The Claim Manager s Job To help you better understand the function of claim management let s use a shipping analogy Whereas Cases are containers filled with claims for specific diagnoses claim management is the process by which the cases are checked sorted and delivered In other words claim management is the process of making sure all shipments are correct ready to be sent and shipped to the right companies insurance carriers The Claim Manager the person performing claim management checks the claims makes sure the boxes are properly marked and sends them on their way She determines whether the shipment goes by truck paper claims or by air electronic claims When a box is returned rejected claim the Claim Manager makes whatever changes are necessary with help from the EOB or Audit Edit Report and ships the box again resubmits the claim Someone else sees and treats the patients Another person enters data from the superbill to begin the billing process Once all the data has been entered it must go through the C
113. d to report taxonomy for individual providers though some carriers require here and in 2310 Contact your carrier for more on their taxonomy requirements For more information on setting up taxonomy in Medisoft see the topic Taxonomy 26 Options Click the Allowed tab Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Code Procedure Allowed 17110 Wart Removal 29130 a ae 36215 Lab Drawing Fee 43220 Esophageal Endoscopy F0250 Rar Skull 4 Views FO360 Raw Neck 033 Aa Larynigoagraphy 71020 Aap Chest 2 Views 71030 Hay Chest Min 4 Views 71040 Contrast Aay of Bronchitis T2052 Rar Spinal Complete 3130 Aap Hand Min 3 Views F35b2 Han Knee Mn 3 Views 22610 Aap Ankle Complete 74246 MRl Gastrointestinal Tract 4203 Barnum Enema Therapeutic 76818 U S Fetal Age 80050 General Health Screen Panel 81000 Urinalysis Routine This displays the amount last paid by the selected carrier for each procedure code available in the program If you do not enter anything in this table each time a carrier makes a payment on a particular procedure code the program takes the amount paid plus any deductible and divides it by the established Service Classification percentage to arrive at the allowed amount That amount is entered in this matrix and in a matching matrix that is part of the Procedure Payment Adjustment Code record This allowed amount is used when calculating the patient
114. di4dc BRIJAQ0OQ rg 2007 2c2bfIchdecad4a7bOSO70b974926ec3 W AT 3 9 2007 9 M gt F1 Unprocessed Transactions Overview Communications Manager Overview This product allows you to transfer data between Medisoft and EMR programs Currently you can create a connection to Medisoft Clinical InstantDx Practice Partner Patient Records MediNotes RelayHealth send patient demographics only and SpringCharts The product also provides a Standard HL7 connection type that supports sending patient demographics and scheduling data to any EMR that is HL7 and Communications Manager compliant There are two major components to the Communications Manager suite Communications Manager This portion of the program allows you to create connections between your practice management software and EMR programs One connection to an EMR programs can be created for each practice Communications Manager also allows you to define connection settings and manage connection errors Once you set up your connections it rarely requires additional maintenance Communications Messenger This portion of the program manages the transfer of data between your practice management software and EMR programs Once you have enabled the Communications Messenger and set up your connections through Communications Manager Communications Messenger will automatically deliver and receive data Once this program successfully sends its first message it rarely requires additi
115. e Place of Service Time To Do Procedure Semice Classification Don t Bill To Insurance Only Bill To Insurance Default Modifiers Revenue Code Default Units National Drug Code Code IO Qualifier Taxable Patient Only Responsible HIPAA Approved Purchased Service Require Co pay HCPCS Code HCPCS Rate Code If you process electronic claims you can use the EDI Receivers window to initially create EDI receivers EDI Receivers are also set up in the Revenue Management feature The Patient List window is the main space for entering editing patient and case information Another method for entering editing patient and case information when using Medisoft Advanced and Network Professional is the Patient Quick Entry window You can also take advantage of Medisoft s security features and set up different users with varying degrees of permissions to application functions Scheduling Appointments Scheduling appointments is simple using Medisoft s integrated appointment scheduling application Office Hours Entering Transactions and Payments 29 Getting Started with Medisoft You enter charges via the Transaction Entry window and you can also apply payments using this feature Users of Medisoft Advanced or Network Professional can take advantage of the Deposit List window for entering payments Generating Claims and Statements Claims processing
116. e on the Referring Provider IDs grid for each referring provider that works with your practice and associate this information to all insurance carriers or insurance classes or a particular insurance Carrier or an insurance class When creating or editing a referring provider IDs record you will first create modify a rule based a combination of all or of a specific insurance carrier or insurance class When processing claims the rules engine uses this information to select the correct entry on the grid 12 Setting up the Practice After the rules engine identifies the correct row on the grid this data is used in processing either print or electronic the claim The second part of creating or editing a referring provider record is associating data to pull for a claim including selecting whether the referring provider s entity type person or non person along with a combination of a specific NPI Taxonomy and legacy data For these values you can either include a value or select None to not include a value TIP when creating or editing IDs grid entries do not create matching wild card entries all selected for insurance carrier and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case modify one of the wild card rows and apply it to a specific insurance carrier or class TIP Press CTRL DEL
117. e Renewal Interval field This way a password must be replaced every 30 days In Reuse Period enter 90 as the number of days before a password can be reused Enter 6 as the minimum character requirement for a valid password Enter 25 as the maximum number of characters for a valid password DY Ol 2 Click the Require Alphanumeric check box You may notice that the password for the Supervisor already complies with these settings 7 Enter 5 as the maximum number of failed login attempts before a user is locked out of the program 178 Tutorial Activities 8 In Account disable period enter 5 as the length of time a user s account is on hold when the maximum number of attempts has been exceeded lt Login Password Management Password Renewal Interval ETS days Reuse Period ES days Mininmiurn Characters ES Maxinum Characters ES Require Alphanumeric Login Maxinurn allowed attempts 5 Account disable period E minutes Reset to Defaults 9 Click Save 10 Close the program and open it again This applies all the security changes you just set up 11 When you reenter the program the User Login box appears asking you to enter your login name and password Enter Supervisor and tn872284 Tutorial Practice 2 Practice Setup Adding Details to the Practice Record Go to the File menu and select Open Practice The sample data set up in this tutorial is under the practice name Medical Group Tutorial Dat
118. e based a combination of all or of a specific insurance carrier or insurance class and facility When processing claims the rules engine uses this information to select the correct entry on the grid This grid contains two elements The first displays all current entries rules The second element the New Edit Provider ID window is used to edit or create entries The grid displays insurance carrier insurance class facility NPI Taxonomy tax ID social security number mammography certificate numbers CLIA numbers care plan oversight numbers and legacy data 67 Setting up the Practice lt Provider new Address Reference Provider IDs Insurance Insurance Facility Taxonomy Tax ID q Save Carrier Class Code Code 55M g Cancel Help Set Default Print Grid After the rules engine identifies the correct row on the grid this data is used in processing either print or electronic the claim For more information on entering data on the IDs grid see the topic Assigning Rules TIP when creating or editing IDs grid entries do not create matching wild card entries all selected for insurance carriers and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case modify one of the wild card rows and apply it to a specific insurance carrier or class TIP Press CTRL DEL
119. e next step is to enter data into each of the different areas of the program e entering insurance carrier records in the Insurance Carrier window entering procedure codes in the Procedure Payment and Adjustment Codes window and so on Here is a sequence for practice setup that should help you enter your practice information without moving back and forth between windows You will set up elements records that are referred to in other records and grid entries TIP You can follow a different setup order for many of these activities the following setup order calls for you to create records that are associated with other records first to avoid having to go back and recreate them Depending on your office environment and business you might follow a different setup order if you have a large number of providers you might set that up earlier if you file very few EDI claims you might set that up later etc e Setup security e Set up preferences e Enter practice information on the Practice Information window Practice Settings tab e Set up EDI Receivers e Enter insurance carrier records e Enter facility records e Enter practice information on the Practice Information window Practice IDs tab e Enter provider records e Enter referring provider records e Enter procedure codes and multilink codes e Enter diagnosis codes e Billing Codes e Enter other address records e Enter guarantor and patient records Keeping in mind your practi
120. e program automatically adds tax to any selected procedure code that has been marked taxable and creates a separate line item in Transaction Entry Be sure you have created and selected a Default Tax Code Select the Suppress Co pay Message option to suppress the co pay collection message on the Transaction Entry for cases that require a co pay The Case Default field determines which case is selected in Transaction Entry The default is Last Case Used but you can change this to Newest Case or Oldest Case There is also a field where you can set the default Place of Service Code The default in this field is 11 When there is an occasional change of location simply type the new code to override the default entry F1 Look up Program Options Data Entry Tab Payment Application Tab NOTE This is an Advanced and above feature In the Payment Application tab you can establish default settings that affect the payment application function Program Options General Data Entry Payment Application Aging Reports HIPAA Color Cading Billing Audit BillElash Mark Paid Charges Complete Calculate Disallowed Adjustment Amounts Mark Completed Claims Done Calculate Allowed Amount Update Allowed Amount Default Patient Payment Codes Payments Co paymernts Cash CASH v 2 Cash Payment Thank You COPAYCASH 6 Cash Copayment Check CHECK v Personal Check Payment CHKCOPAY 6 Copay Check Credit Card CACDPAY se Credit
121. e program for which these procedures are available Navigating in Medisoft Once the program is open you can get a good look at the main program window Title Bar The top bar on the window is the Title bar and it displays the name of the active program and contains Minimize Maximize and Close buttons on the right side Medisoft Advanced Medical Group Tutorial Data Menu Bar Just below the Title bar is the Menu bar which shows categories of activities available in the program Click the various headings such as File Edit Activities Lists Reports Tools Window and Help and each opens a submenu with a list of all the activity options available in that category File Edit Activities Lists Reports Tools Window Help E Toolbar Below the menu bar is the toolbar with an assortment of speed buttons or icons that are shortcuts to accessing options within the program Select the option you want by clicking the appropriate button The toolbar can be customized to fit your organization s needs Change the order of the buttons in the toolbar or remove them so they do not appear Create a new toolbar with only the buttons or file names that you want In addition you can move the toolbar to the top bottom or either side of the screen or return it to its original position and layout 16 Getting Started with Medisoft F1 Look up Toolbar Customizing The Transaction Entry icon opens the Transaction Entry window where mo
122. e provider you selected is inactive Also in multi view View Multi View the inactive provider does not even appear on the Appointment grid Default Choices You have the option to show the Patient List and or Transaction Entry windows on startup by placing a check mark next to either or both options here You can indicate whether you want to show shortcuts and or hints or Enforce Accept Assignment You have the option to calculate patient remainder balances upon opening or closing the program You can set account alerts that appear in the Transaction Entry Deposit List and Appointment windows that tell you when a patient has a certain remainder balance is delinquent on a payment plan or is in collections In Medisoft Advanced and Medisoft Network Professional you can indicate whether to print a title page for every report Network Professional includes an option to synchronize your computer time with the time on the network server F1 Look up Program Options General Tab Data Entry Tab The Data Entry tab gives you lots of options for various sections of the program 162 Performing File Maintenance Program Options General Data Entry Payment Application Aging Reports HIPAA Color Cading Billing Audit BillFlash Global Use Enter to move between fields Use zip code to enter city and state Number of Diagnosis la Suppress UBO4 field Patient Use numeric chart numbers Auto format Soc Sec 4 Patient Quick Entry
123. e same pay to as your billing address the Pay To tab is blank you can enter your NPI information on the Practice IDs grid In this case you would select on the Providers IDs grid the From Practice button instead of selecting the National Provider ID button and entering an NPI number If you are a solo provider with different billing information and pay to information the Pay To tab is complete you can enter your NPI information on the Provider IDs grid In this case you would select on the Providers IDs grid the National Provider ID button and enter your NPI number Entering the NPI number on the provider level is required in this case to pull your NPI number in Loop 2010AB If you left it only on the practice level the NPI number would not pull for this loop If you are a solo provider that has insurance carriers that require mixed NPI numbers some require individual while some require a group you would enter your group NPI number on the Practice IDs grid You would then create an entry on the Provider IDs grid in which you would enter your individual NPI number on the Provider IDs grid and apply it to all insurance carriers an insurance class or a carrier you could create several records if needed to address other issues such as legacy numbers taxonomy etc For those carriers that require the group NPI you would create at least one other separate entry on the Providers IDs grid might need more depending on other issues such as lega
124. e used the List Only Statements that Match window to locate the statements the batch number is automatically entered in the Change Statement Status Billing Method window 3 In the Status From section choose Sent In the Status To section choose Ready to Send 210 Tutorial Activities US Change Statement Status Billing Method Change Status Billing Method of Statements For 2 Batch 3 Selected Statement s UF Status From Hold O Ready to send 0 Sent gt Failed O Done Challenge O Any Status Type Billing Method Fror 5 Paper Electronic 4 Click OK Hold Ready to send Sent Failed Done Challenge Billing Method To 5 Paper Electronic 5 You are now ready to send the statements for John Smith again 6 Click Close to close the Statement Management window Tutorial Practice 7 Deposits Creating a New Deposit 1 Click Activities and select Enter Deposits Payments 2 Click New 3 The payer is A1 Insurance Partners so be sure the Payor Type is Insurance A1 Insurance Partners conveniently paid 25 by check No 5237 enter the check number in the Check Number field The bank is United Southwest Savings Enter the amount in the Payment Amount field 4 Inthe Insurance field select A1 Insurance Partners Since you already set default codes when you set up the record for A1 Insurance Partners the remaining fields are automatically filled
125. eate a unique chart number 193 Tutorial Activities 3 Create a record with the following information Name John Smith Jr address 246 Center Street Gilbert AZ 85234 e mail address johnsmith gilbertonline com home phone number 513 224 4668 remember to not enter parentheses or hyphens in phone numbers work number 123 345 6789 cell phone 513 224 1111 fax number 513 531 9766 birth date 1 12 1975 sex Male Social Security Number 012 34 5678 Race Caucasian Ethnicity Non Hispanic Language English Patient Guarantor Smith John Payment Plan Custom Hame Address Other Information IF the Chart Humber is left blank Chart Number the program will assign one Inactive Last Name Smith Suffix Wo First Mame loha Middle Mame Street 246 Center Street City Gibet State az ip Code 85234 Country USA E Mail johnenmthtagibertonline com Home 513 224 4668 whore 123 345 6789 Cell 51 31224 1111 Fax 51 31531 9776 Other Birth Date 1012401975 w Sex Male Ww Birth Weight 0 Units Ww Social Security i 2 34 5676 Entity Type Person e Race Caucasian Ww Ethnicity Non Hispanic e Language English Death Date wt O Save a Cancel Help Set Default Copy Address 4 Click the Other Information tab In the Type field be sure Patient is selected Assign J D Mallard as the provider
126. ed Paid Entries TIP Use the True option on the In Collection Match check box to display only records that meet the criteria of true or in collections Selecting False will not apply the filter A field left blank has no limits placed on it and the program searches the entire database and includes all information that fits the criteria Use the Txn Sort Order list to sort transactions within a statement and to the statements as a group Choices include Entry order Date of Service and Document Number F1 Look up Print Send Statements F1 Look up Data Selection Questions Reprinting Statements If necessary you can reprint statements without regard to their status To reprint an entire batch the status must be changed for the batch F1 Look up Reprinting Statements Listing Statements Click List Only to view only those statements that match a set of criteria that you define In the List Only Statements that Match window use one or more of the options to limit the statements you want to appear in the window 123 Creating Statements List Only Statements That Match Chart Number B a Apply Statement Created yf d amp a Cancel Billing Cate Batch Number a Hel L Help Billing Method Status A Al O Paper O Hold O Electronic O Ready to Send O Sent Submission Count o O Failed O Done E sclude Done Challenge Detaults F1 Look up List Only Statements that Matc
127. elect the Provider Class button and click the magnifying glass to select the provider class 4 Select the All Insurance Carrier or Insurance Class button Select the All button to apply the rule to all insurance carriers associated with the practice To apply the rule to a specific insurance company select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select the Insurance Class button and click the magnifying glass to select the insurance class 5 Select either the All or Facility button Select the All button to apply the rule to all facilities associated with the practice To apply the rule to a specific facility select the Facility button and click the magnifying glass to select the facility 6 Select either the None or National Provider ID button Select the None button to not associate an NPI number with the rule Select the National Provider ID button and enter an NPI number to associate that NPI number with rule TIP if your practice has a group NPI number enter it here Then if providers in your office need to file claims as individuals you can create a rule for that provider using the provider s individual NPI number that you enter on the Provider IDs grid 7 Select either None or Taxonomy Select the None button to not associate a taxonomy number with the rule select the Taxonomy button and enter a taxonomy number to as
128. ement Claim Rejection Message Communication Manager Condition Codes Data Entry Data Options Design Custom Patent Case Data Diagnosis Codes ED Receivers Eligibility Enter Deposits Payments Enter Transactions Facilities File Maintenance Final Draft Help Insurance Carrier List Ledger Login Password Management Multilink Codes 45 Setting up the Practice lt Medisoft Reports Permissions Mame P Aging Power Pack Data Analysis Dymo Label riter Facility Financials Focus On Chiropractic Focus On Collections Focus Un Data Focus On Financials Focus On Managed Care Focus On Marketing and Promotion Insurance Data Analysis MediSoft Reports No Default Plus Pack Mame P Aging Summary by Billing Code All Payor Aging Currently Responsible Date Accurate Patient Aging by Date of Service Date Accurate Patient Aging by Statement Date Patient Aging by Allowed Amount Patient Aging by Date of Service 30 Days and Over Patient Aging by Date of Service 60 Days and Ower Patient Aging by Date of Service 90 Days and Over Patient Aging by Date of Service Extended 180 Patient Aging by Date of Service Sorted by Account Balance Patient Aging by Statement Date Extended 180 Patient Remainder Aging Extended 180 Patient Remainder Aging Extended 180 Medisott 124 Patient Remainder 4ging Detail Sort by Acct Balance v12 Kak Level 1 Level Primary In
129. enerate custom reports tailored to meet specific needs Report forms in this section are categorized into several styles Each style defines basic report characteristics i e List Label Ledger Walkout Receipt Insurance Form Statement and Statement Management To create custom reports go to the Reports menu and select Design Custom Reports and Bills F1 Look up Report Designer and Format Design Reports Report Procedures Printing a Report To print a report complete the following steps 1 On the Reports menu select the report to be run The Print Report Where window appears On the Print Report Where window select the Print the report on the printer button Click Start Depending on the report selected the Data Selection Questions window or the Search window opens On the window select data ranges and then click OK The Print window appears Click OK Viewing a Repot In Medisoft you can view or preview a report before printing or exporting it For example you could preview a Patient Aging report before printing it to make sure that you have selected the most appropriate data criteria After previewing users can export or print the report To view a report complete the following steps 1 On the Reports menu select the report to be run The Print Report Where window appears 152 Running Reports 2 On the Print Report Where window select the Preview the report on the screen button Click Start Depend
130. ent Entry Amounts Tab Allowed Amounts Tab Advanced and above The Allowed Amounts tab keeps track of how much each carrier pays for a particular code The program calculates the allowed amount based on the amount paid any applicable deductible and the service classification This amount is used in calculating the patient portion of any transaction entered in Transaction Entry 80 Setting up the Practice lt Procedure Payment Adjustment App of Finger Splint Static Sele General Amounts Allowed Amounts Insurance Mame Lode Moditiers Amount P Aetna AETOU Blue Cross Blue Shield 225 BLU Blue Cross Blue Shield 231 BLUOU Ligna LIGOO FHP Health Plan FHPOD Medicaid MEDOO Medicare MECO U S Tricare USO00 Workers Compensation DARDO F1 Look up Procedure Payment Adjustment Entry Allowed Amounts Tab MultiLink Codes MultiLinks are groups of procedure codes combined under one access code They are for procedures that are normally performed at the same time e g for a physical exam a routine set of treatments etc The advantages to using MultiLinks include a reduction of time during data entry If you can create several transactions with the entry of a single code name or number there is an obvious time saving MultiLinks also reduce omission errors You won t forget codes that should be included if they are included in a MultiLink When you use the MultiLink code all the codes in the group are entered Enter t
131. ent payments on their accounts create payment plans You can create as many plans as necessary to accommodate your patients Go to the Lists menu and select Patient Payment Plan 132 Managing Collections and Small Balance Write Ofts lt Patient Payment Plan List Code Description Tat Payment Que on Interval in Days Amount Que Date Modified Faa sa 000 10 18 2004 AB Code 4B 10 25 20 00 10 18 2004 1 AE Code AC 15 20 30 00 10 18 2004 1 S Print Grid Once you create a plan open the Patient Guarantor window Payment Plan tab and assign the plan to the patient s record The particulars for the plan appear in fields in this tab lt Patient Payment Plan Code AA 3 EEJ Cancel Description Code BA First Payment Due 5 day of the month Due Every 30 days Amount Due 10 00 The program records and tracks the scheduled date for the next payment and the amount to be applied If the patient follows the payment plan e g the patient pays the required amount by the required date this account is not included when you process collection letters If the patient does not follow the payment plan the account is included when you process collection letters F1 Look up Patient Payment Plan Entry Collection Letters Once you put a patient responsible account in collections you can create collection letters to follow up with the patient To print collection letters go to the Reports menu select Collection Reports
132. es go to the File menu and select New Practice When the first practice is set up in the Medisoft program the program assumes there is only one practice and establishes a default directory for the data for that practice Each time you set up an additional data set with totally unrelated patients and procedure files you must create a different subdirectory In the Create A New Set Of Data window enter the additional practice name and change the data path This establishes a completely separate database for the new practice Once you have set up additional practices you can move easily from one to another by going to the File menu selecting Open Practice and choosing the practice you want from the list presented Changing the Program Date You can change the program date for back dating a large number of transactions This affects all dates in the program except the Date Created setting which always reflects the System date Opening a Practice To change practices or create a new practice database go to the File menu and select the appropriate option To open an existing database go to the File menu and select Open Practice Choose the practice you want to open and click OK 34 Setting up the Program and Setting up the Practice Open Practice Medical E ae a g Cancel Jo Hew w Delete 6d Help 35 Setting up the Practice Setting up the Practice Setting up the Practice Once you have the program set up th
133. es in applying billing charges Be sure these codes are set up if you want to use them Go to the Activities menu and select Billing Charges 106 Entering Transactions Billing Charges NOTE Be sure to back up your data before proceeding Chart Number Range sA to v 2 Billing Codes Range o Case Indicator Match Help Help amp blank held indicates no limitation all records will be included Charges Creation Date 14232010 Transaction charges 30 daps old Monthly Billing Charge Mirian Past Due Balance r Minimum Biling Charge Masimum Billing Charge Check this box if you want to exclude a case that has had a payment made after or during the past due period Use the range limitations to select the records to which you want to apply the billing charges The Charges Creation Date is the date that appears in the ledger with the billing charges This can be whatever date you choose but the transactions created still show on the current day s activity reports Fill out all the requested information then click Start New transactions are added to each patient record that fits the criteria you selected F1 Look up Billing Charges and Procedure Payment Adjustment Entry Quick Ledger NOTE This is an Advanced and above feature The Quick Ledger in Medisoft gives a quick reference for transaction and other information in the patient s account There are
134. es in transaction billing functions Entering Practice Information 1 Click File and select Practice Information Click the Practice tab 47 Setting up the Practice lt Practice Information Happy Valley Medical Clinic 18001333 4747 EJ Save pe cance pz o 2 On the Practice tab enter the contact information for practice including practice name address telephone number etc 3 From the Type list select your practice type Choices include Medical Chiropractic and Anesthesia When you choose Chiropractic or Anesthesia other areas in the program change accordingly Medical is the default practice type and does not add any additional fields When you select Chiropractic the Level of Subluxation field appears in the Diagnosis tab of the Case window for entering the level of subluxation See Case Diagnosis In addition five treatment fields are displayed in the Miscellaneous tab of the Case window electronic claims Treatment Months Years No Treatments Month Nature of Condition Date of Manifestation and Complication Ind See Case Miscellaneous 4 Inthe Federal Tax ID field enter the practice s federal tax ID From Practice Type select Individual or Group From Entity Type select Person or Non Person Choose Person or Non Person depending on whether the practice name consists of a practice name or an individual s name For example if the practice name is Western Associates Clinic you would choose N
135. ever Here are the new values Min Max Usage Loop Values o Repeat Claim 0500 Received Date DTMO1 Date Time an DTMO2 Date EN UU IO UR DAR ERES E DIA This is the date that the claim was received by the payer e The number of repeats for the REF Service Identification Element in Loop 2110 has been increased to 8 for 5010 The 4010 required only 7 e There is a new element for 5010 added to the IG in Loop 2110 Service Payment Information REF Healthcare Policy Identification Here is a table of the values POS Min Max Usage Loop Values Repeat HealthCare 1000 Policy Identification Reference Identification Qualifier REFO2 Healthcare an tso rR 12 Getting Started with Medisoft Policy Identification e Updates to reports e Claim Preview Report now includes e any suffix after the patient s name Segment NM107 in Loop 2100 e the Coverage Expiration Date for an expired policy DTM Coverage Expiration Date in Loop 2100 e the Claim Received Date which shows the date the claim was received by the payer DTM Claim Received Date in Loop 2100 e Claim Details Report now includes e any suffix after the patient s name Segment NM107 in Loop 2100 e the Claim Received Date which shows the date the claim was received by the payer DTM Claim Received Date in Loop 2100 e the specific amounts of a claim REF Healthcare Policy Identification in Loop 2110 e Remit
136. ew Break Entry window is a box marked Repeat The Change button is next to this box Clicking Change opens the Repeat Change window where you can establish the Frequency of the break Repeat Change Frequency O None O Daily O Monthly Every week on hon Tue Year Wed Thu and Fri Choosing any of the radio buttons except None displays different data entry boxes in the middle of the window that give you the repeat options for each frequency Also a written summary of the selected frequency appears in the bottom middle area of the box It is important to note that when you set up a break using the Monthly frequency the date highlighted on the main calendar affects the day or date that is entered in the break note Moving Deleting Appointments Changing Appointment Status NOTE This is a feature of Office Hours Professional feature There are multiple options for marking the status of an appointment The default is Unconfirmed When any change in status occurs edit the appointment or right click on the appointment and choose the appropriate radio button If you choose Cancelled the appointment is removed from the grid display Any other status is reflected by a small icon in the upper right corner of the appointment in the grid Moving an Appointment If you want to move the appointment to another day or time click the appointment and press CTRL X or go to the Edit menu and select Cut Move the cursor to the new day
137. f Birth 171271975 05234 Set Default 14 No fields in the Medicaid and Tricare or Multimedia Advanced and above tabs are necessary for Mr Smith skip these tabs Click Save when finished Tutorial Practice 4 Transactions Transaction Entry 1 To begin go to the Activities menu and select Enter Transactions 2 For this exercise select John Smith in the Chart field to pull up Mr Smith s chart Press ENTER His most recent case opens 3 To create a new transaction click any column in the Charges section or click New Any information contained in the case Allergies and Notes box is popped up for your view Click OK to clear this message and continue 201 Tutorial Activities 4 Enter 99214 Office visit in the Procedure column Press ENTER All available information concerning that procedure code is automatically entered in the appropriate column The charge shows 65 for the visit 5 To create a second charge transaction press the down arrow or click New Now enter a second procedure code for this visit 82954 Glucose Test Note that the Amount field shows 10 00 6 Mr Smith is making a payment of 10 on the account Click any column in the Payments Adjustments and Comments section and then enter the procedure code for a cash co payment COPAY10 In Who Paid select Mr Smith In the Description field enter Co payment Notice that 10 is entered in the Amount field Click Apply 7 The Apply P
138. f the Provider IDs grid you save time and effort since one specific entry could be applied to all the providers at the practice level instead of creating an entry for each provider on the provider level In this second entry you would select the insurance carrier and select all providers Importantly you would need to include your NPI taxonomy and Tax IDs since each grid entry needs to be complete You would also select the legacy number your carrier requires When the application gathers claim data it would select this row for the specific insurance carrier and pull the data for the claim If one of the providers in your practice files claims as an individual with an insurance carrier the other providers do not use you would need to create another rule on the Provider IDs grid for that provider In this grid entry you would specify the insurance carrier You would also change your filing status to Individual and enter the provider s NPI number not the group NPI number You could also include the taxonomy and tax ID social security number in this grid entry 37 Setting up the Practice NPI Setup Considerations Depending on the setup of your practice and your claim submission requirements you can enter the NPI number on the Practice window the Practice IDs grid the Provider window the Providers IDs grid or on both windows Solo Provider file claims as an individual If you are a solo provider file claims as an individual with th
139. f you have Office Hours Professional you can also select if you want to print only those appointments that need referrals In the Data Selection window modify the report by setting Date and Provider ranges if desired Remember if a range is left blank all available records will be included in the report See Data Selection Questions TIP If available select the Print Blank Appointments to include unassigned time slots from the appointment list in the report Including this data provides flexibility for you to quickly review open slots over the examined range and even print out the report and manually enter patients on the printed report This feature provides a quick way to accommodate walk in patients when accessing the application is impractical or not desired F1 Look up Printing the Appointment List Appointment Status NOTE This is an Advanced and above feature The Appointment Status report displays a list of appointments showing their statuses F1 Look up Appointment Status Report Printing Superbills The superbill is designed to be a physician s worksheet At the beginning of the day consider printing a copy of the superbill for each patient with an appointment that day and then attach it to his or her chart In Medisoft the superbill is pre formatted with the patient s name chart number appointment time and the practice name at the top The superbill displays a list of 150 Scheduling Appointments what procedures can
140. field lets you choose which flag to associate with the patient record including None if you want to disable the feature after assigning a flag F1 Look up Patient Guarantor Entry Other Information Tab F1 Look up Program Options Color Coding Tab Advanced and above If the patient s employer record has been set up in the Address file this data is available in the Other Information tab Clicking the arrow or magnifying glass icon to the right of the Employer 88 Setting up the Practice field displays a list of those employer records already stored in the program If the employer record you need is not available press F8 for the new employer setup Use the Payment Plan tab to assign a payment plan to a patient if the patient s account is in collection Create patient payment plans by clicking Lists and selecting Patient Payment Plan lt Patient Guarantor Bordon John E E E Mame Address Other Information Payment Plan Custom Payment Code ho 2 Description Set Default The first payment i due on the jo day of the month Payment i expected every 0 days Copy Address Payment Amount Due Appointments F1 Look up Patient Guarantor Entry Payment Plan Tab F1 Look up Patient Payment Plan Entry Setting up a Case Transactions within the program are generally case based A case is a grouping of procedures or transactions generally sharing a common treatment facility or insurance carrier You c
141. from the clearinghouse and look up the commercial identification number submitter identification numbers assigned to the insurance company by the clearinghouse Option click the Payer ID magnifying glass to look this up using the pre loaded database which contains many payer IDs Option The National Plan ID field is not yet mandated If you have received an ID number enter it in this field If you file secondary claims with the insurance company select enter values on the Secondary Receiver panel for the EDI Receiver Claims Payer ID Eligibility Payer ID and National Plan ID fields If you do not enter an EDI receiver in this section of the window electronic claims will not be created or sent for this insurance company for secondary claims From the Type list select a type for the insurance company from the following options Automobile Blue Cross Shield Central Cert ChampsVA Disability EOP FECA Group HMO Indemnity Liability Library Medical Medicaid Medicare Medicare Part A Mutually Defined No Charge Other Other Federal Other non federal POS PPO Self pay Title V Tricare Champus Unknown and Worker s Compensation Leave Alternate Carrier ID blank The Revenue Management feature will populate this field if needed The NDC Record Code field is also used by the Revenue Management feature If needed select from the EDI Max Transactions list a maximum number of transactions accepted by the carrier This field
142. h Changing Statement Status In the Statement Management window all submitted statements are automatically marked Sent with an indication of the method of submission There may be occasions when you need to change this status Statements sent electronically through BillFlash get a report that marks each statement as either accepted or rejected Entire Batch If the status of an entire batch needs to be changed you can change all the statements at once Highlight one of the statements and note the number listed in the Batch column in the Statement Management window Click Change Status The Change Statement Status Billing Method window is opened 124 Change Statement Status Billing Method Change Status Billing Method of Statements For 2 Batch E O Selected Statement s e DR Status From Status To Hold Hold Sent Failed et ei Failed Challenge Done O Any Status Type Challenge Billing Method Fror Billing Method To C Paper 5 Paper Electronic Electronic Choose the Batch radio button and enter the batch number from the Batch column in the Statement Management window Then choose the appropriate radio buttons in the Status From and Status To sections All statements with that batch number have the status changed when you click OK Selecting Multiple Statements When only one or a few statements within the same batch or statements from multiple batches need a status change ho
143. h Nature of Condition Date of Manifestation and Complication Ind F1 Case Miscellaneous Since we are using tutorial data most of this tab is complete We will however delete and add entries to the Practice IDs grid Entering a Practice IDs Grid Entry You will use the Practice IDs tab and Practice IDs grid to enter or edit key data elements associated with your practice tax ID social security number NPI taxonomy legacy numbers etc This grid contains two elements The first displays all current entries rules The second element the New Edit Practice ID window is used to edit or create entries The grid displays insurance carrier insurance class facility NPI Taxonomy tax ID social security number and legacy data 1 Click Practice IDs tab 2 For this activity the Happy Valley Medical Clinic no longer needs most of their non NPI identifiers legacy numbers at the practice level The supervisor Pat Smith has decided to delete all Practice IDs and enter a general rule for the whole practice along with re entering the one legacy ID the practice still uses for a certain insurance carrier In this case you could select individual rows on the grid and press the delete key for each row or since we want to delete all the rows press the CTRL key and the DELETE 180 Tutorial Activities key to delete all grid entries On the Information window click Yes All the rows are deleted 3 Now click the New button to crea
144. h to get more detail and learn how to enroll go to BillFlash Within Medisoft you can control several aspects of what prints on your statements including which credit cards you accept service messages you want to print printing of account summaries and aging and printing up to six messages you want to appear on statements For more information go to Program Options BillFlash tab Options on the Activities Bill Flash menu allow you to enroll with BillFlash view and approve statements that have uploaded to BillFlash see your account settings at BillFlash and view reports such as the Disposition report Each one of these menu options will open a different page at the BillFlash website Several windows in Medisoft have quick access to the eView page of the BillFlash website via a new View eStatements button In addition when a patient is selected and Ctrl F7 is clicked the eView page will open for any statements for that patient These windows are e Patient List Patient Guarantor Bordon John 1420 1972 v 444 55 6666 e New Edit Case e Quick Ledger e Guarantor Ledger e Apply Payments through Transaction Entry e Collection List Tickler e Edit Statements Getting Started with Medisoft Statement 4 Statement 4 Guarantor CATSA000 Remainder 71 00 Statement Created 122222003 Catera Sammy LG Save General Transactions Comment Hold 5 Paper Help Ready to Send e i Electr
145. he All button might need to create other entries to address issues with NPI numbers taxonomy legacy numbers if some insurance carriers require you to file as group or individual opposite of your first entry on the grid you could create a second entry to address this situation on the Providers ID in which you select the insurance company and select group 38 Setting up the Practice Assigning Rules Medisoft claim processing for both print and electronic claims depends on a series of flexible rules that you define on the various ID grids in the application When setting up or updating your practice data you will create a series of grid entries rules on the Practice IDs and Provider IDs grid You may also use the Facility IDs and Referring Provider IDs grids depending on your practice structure These grid entries that you complete contain your basic practice information such group or individual NPI taxonomy tax IDs claim filing status group or individual and connect this information to the insurance carriers that your practice accepts and the doctors in your practice as a series of rules You begin by creating general entries for each provider on the Provider IDs grid and at least one entry on the Practice IDs grid level NOTE the setup for solo providers offers more flexibility Also taxonomy requirements or NPI setup considerations can impact how you create your practice In these general entries you enter information that wo
146. he MultiLinks function by going to the Lists menu and selecting MultiLink Codes 81 Setting up the Practice MultiLink List Sle Code Description MICA THETOOOO Catheterization DIABETOUOO Diabetes Screening LOYOOOUO00 LO TAUCKEQOOO Trucker Physical 99213 87087 97086 36215 97010 99000 Link Code 1 Link Code 2 Link Code 3 Link Cod e WELLCOOUOO tell Check Exam 2 months 36215 4 ilii The list displays all available procedure codes adjustment codes and payment codes You can also set up a new MultiLink or edit or delete an existing MultiLink code by clicking Edit or New MultiLink Code Catheterization Seles Code CATHETOOOO Inactive Description Catheterizat Link Codes 1 99213 Ww Office Visit Est Patient EEL 2187087 v 2 Commercial Kit 3 37056 v 3 Catheterization nm P j _ Bg co a el yal _ mo cdo F1 Look up MultiLink Entry Diagnosis Codes 82 Setting up the Practice Diagnosis codes represent the reason a service is provided In effect the procedure code tells what the doctor did and the diagnosis code tells what the doctor found As with other list functions the diagnosis code setup is accessed by going to the Lists menu and selecting Diagnosis Codes lt Diagnosis List E El EJ Search for Field Description Code 1 Description Lode 2 Achilles Tendonitis 493 9 Allergic Bronchitis 493 9
147. he electronic transmission of specific healthcare transactions including eligibility claim status referrals claims and remittances Covered entities such as health plans healthcare clearinghouses and healthcare providers are required to conform to HIPAA 5010 standards These changes include new windows tabs restructured windows or moved fields menu changes new fields additional options and other changes New Windows or Tabs There are three new windows or tabs Edit Claim window new EDI Note tab for Claim level notes The EDI Note tab has been added to the Edit Claim window Information on this tab is pulled from the Case Window Comment tab This tab allows you to change various note information at the claim level so it does not affect the data in the case record itself be Claim 1 E B Ed AN AA AA a Ce For more information on this tab see EDI Note tab EDI Notes and List windows for Transaction Line Item notes A new EDI Notes window will allow you to enter notes of various types for electronic transmission The corresponding List window will open when the new EDI Notes button is clicked during Transaction Entry Patient or Guarantor Ledger or Unprocessed Transactions Getting Started with Medisoft lt EDI Notes List R Note Type Note Reference Code Text Contract Type Code Contract Amount Contract Percent Contract Code Terms A From this window you can create or edit EDI Note
148. her narrowed by specifying detail in the Select transactions that match Provider and Include transactions if the sum is greater than fields 113 Creating Claims lt Create Claims a Transaction Dates to oe ChattNurbers AA t Select transactions that match Primary Insurance Billing Codes Case Indicator Location Provider Assigned A Attending Include transactions if the claim total 12 greater than Enter Amount F1 Look up Create Claims Editing Claims This function within the program is the watch dog area where you can verify and edit the claims that are ready to be submitted for payment It is a safety net where problems can be solved and information entered in a transaction can be overridden if necessary An override in the Claim edit window changes that claim submission but does not affect the default database As the claim comes up for final verification it may be determined that a change needs to be made such as a different carrier or EDI receiver By highlighting a specific claim and clicking Edit or pressing F9 the Claim edit window appears with the claim details and information concerning all assigned insurance carriers and their pertinent data 114 Creating Claims Claim 6 Claim 6 Claim Created 12572002 Chart YODMI000 Michael C Youngblood Case 14 Carrier 1 Caner 2 Carrier 3 Transactions Comment Claim Status Biling Method Hold Paper
149. his window contains two elements The first displays all current entries rules The second element the New Edit Facility IDs window is used to edit or create entries The grid displays insurance company insurance category NPI Taxonomy CLIA and legacy data Facility new Address Facility IDs Insurance Insurance Carrier Class Legacy 2 Help Set Default Delete Print Grid 2 Click the New button to create a new grid entry OR To edit an entry select the record on the grid and click Edit The New Facility or Edit Facility window opens New Facility ID Seles Send Facility On Claim ID Qualifier O National Provider ID Taxonomy O CELIA O Legacy Identifier 1 Legacy Identifier 2 62 Setting up the Practice 3 Select either All Insurance Carrier or Insurance Class Select the All button to apply the rule to all insurance carriers associated with the facility To apply the rule to a specific insurance carrier select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select the Insurance Class button and click the magnifying glass to select the insurance class 4 To include facility information on a print or electronic claim box 32 CMS 1500 form and Loop 2420D select the Send Facility on Claim box and the select an ID Qualifier Leave the box blank unchecked to not include facili
150. ication Number PERO5 Communication ED EM EX Number FX TE Qualifier PEROG Communication AAABBBCCCC Number PERO7 Communication 2 2 S ED EM EX Number FX TE Qualifier PERO8 Communication AN 1 80 S AAABBBCCCC Number PERO9 Contact Inquiry AN 1 20 N U Reference Revenue Management Configuration and Setup Changes Several changes have been made to Revenue Management to simplify the setup and configuration process Among them are the following Eliminated the Alias table for ERA processing The user will not need to choose the practice or payor information for ERA processing Instead information from the ERA file itself is used to process the ERA file The Pay To field from Loop 1000B practice or provider and the Payer Name field from Loop 1000A Segment N102 payer information directly match the information sent out on the claim and will be used eliminating these steps Allowing the user to edit the Receiver table directly bypassing the wizard Certain sections of the table remain locked however Allow the user to log in to Revenue Management automatically from Medisoft Simplify the setup of ERA Assign Posting codes will be populated by default with the appropriate payment codes that reference carrier specific codes in Medisoft In addition there is a set of default ERA posting defaults in the Remit Posting Code window in Revenue Management If Use Insurance Posting Codes is checked and there are no ca
151. ice Information for a Billing Service 50 Print Receipts_ Create Claims 105 Printing a Report 151 Printing Claims 114 Printing Statements 121 Printing Superbills 149 Procedure_ Payment_ and Adjustment Codes 75 Production Reports Network Professional only 156 Q Quick Balance Advanced and above 108 Quick Ledger Advanced and above 106 Quick Ledger Launch from Collection Shortcut Keystroke 29 R Receive Send Reports Through Medisoft Terminal 135 Referring Provider Records 69 Repeating Appointments 142 Reports in Office Hours 149 Reports Overview 151 Repositioning the CMS 1500 form 219 Reprinting Claims 115 224 Reprinting Statements 122 S Searching for a Specific Detail in a Report 152 Security Setup 148 Selecting a Default Printer 98 Sending Claims 204 Sending Claims to a File 117 Sending Statements 208 Set Up 85 Setting an Appointment 140 Setting Breaks 217 Setting Permissions 43 Setting Program Options 40 Setting up a Case 88 Setting Up a New Insurance Carrier Record 181 Setting Up a New Patient Record 192 Setting up a New Provider Record 183 Setting Up a Referring Provider Record 186 Setting up Case Records 139 Setting up Insurance Carriers and Insurance Classes 52 Setting up Patient Records 139 Setting up Provider Records 139 Setting up Providers and Provider Classes 62 Setting Up Repeating Breaks 144 Setting up Resource Records 1
152. ick this button to edit the selected statement For more information see F1 Look up See Edit Statement Create Statements Click this button to create statements For more information see F1 Create Statements Print Send Click this button to print the statements on paper or send them electronically For more information see F1 Print Send Statements Rebill Statement Click this button to rebill statements For more information see F1 See Rebilling Statements Delete Click this button to delete the statement number and release the transactions bound to the statement You can then put those transactions on a different statement NOTE If you delete electronic statements that have already been billed and decide to recreate them the program will automatically assign a media of Paper to those statements F1 Recreating Electronic Statements Close Click this button to close the window Creating Statements Click Create Statements to gather available transactions onto a statement 120 Creating Statements lt Create Statements Range ot Chart Numbers e to e Select transachons that match Billing Codes Case Indicator Location Provider Create statements if the remalnder total i greater thar Enter Amount Statement Type 2 Standard Remainder _ Create You can create a single statement or an entire batch Enter ranges of transaction dates and or chart numbers to control which state
153. ient Recall List Patient Statements Pre Printed Statement Primary Claim Detail Primary Claim Labels Primary Claim Summary Procedure Code List Provider Staff List Referring Provider List Remainder Statements Remainder Statement Troubleshooter Report Sample Statement with Image Sample Statement with Logo Secondary Claim Labels Security Permissions Grid Superbill Tertiary Claim Labels Transaction List Unbilled Transactions and Walkout Receipts TIP In Medisoft Advanced and Medisoft Network Professional there are two statement types Statement and Statement Management If you are modifying a statement make sure you are modifying one with the correct type You can only print Statement report formats from the Reports menu and Statement Management report formats from Statement Management F1 Look up Modifying an Existing Report Other Report Functions 159 Running Reports Load Saved Reports This option allows you to reopen reports that were prepared earlier and have been saved supports reports and statements that use the qrp extension which is created when an mre extension report is previewed and saved mostly statements and custom reports F1 Look up Load Saved Reports Add Copy User Reports This option allows you to share reports by adding reports to your database that may have been prepared by another practice or copying reports to disk for use by another practice or for disk storage Go to the Tools menu and select
154. ify one of the wild card rows and apply it to a specific insurance carrier or class TIP Press CTRL DELETE to delete all ID entries in the Practice Provider Referring Provider or Facilities IDs grids Use this with caution since all your entries will be removed If you have numerous legacy ID entries that no longer apply and only a few rows that need to be set up you save time by deleting all entries and setting up the few rows you need 1 Click Practice IDs tab Practice Information Practice Practice IDs Practice Pay To Statement Pay To Insurance Insurance Facility G Save Provider Carrier Class Code d Legacy 2 Cancel BCBS Group BCBS Group 2 Click the New button to create a new grid entry OR To edit an entry select the record on the grid and click Edit New Practice ID O Provider ho C Provider Class g Cancel Insurance Carrier al Help Insurance Class O Facility National Provider ID O Taxonomy Tax Identifier Social Security Number Legacy Identifier 1 Legacy Identifier 2 49 Setting up the Practice 3 Select the All Provider or Provider Class button Select the All button to apply the rule to all providers associated with the practice To apply the rule to a specific provider select the Provider button and click the magnifying glass to select the specific provider To apply the rule to a specific provider class s
155. ight Home Phone 434 5777 Address 1742 N 63rd Ave work Phone Phoenix A2 eee Date of Birth 33041 932 O Save a Cancel Help Eligibility Face Sheet Set Default 17 w 2 F1 Look up Case Medicaid and Tricare Tab The Multimedia tab Network Professional only allows you to add bitmaps video or sound to your patient records F1 Look up Case Multimedia Tab and Multimedia Entry The Comment tab Advanced and above is provided for the entry of notes to be printed on statements 97 Setting up the Practice lt Case AGADWOOO Again Dwight Broken Hand El Save a Cancel Help LIBO4 Eligibility re Set Default F1 Look up Case Comment Tab This EDI tab is where you enter information for electronic claims specific to this case If applicable to the claims for this case enter values in the fields 98 Setting up the Practice Case AGDADWUOO Again H migni Br aken Hand Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition Miscellaneous l Medicaid and Tricare Multinnedia Comment EDI Custom One Care Plan Oversight H pO Assignment Indicator E Hospice Number pO Timely Filing Indicator CLA Number pO Homebound Mammography Certification fF Referal Access H O Demo Code boo IDE Number o Vision Claims Condition Indicator Code Category Certification Code Applies Home
156. ilter has been removed as it would return invalid values F1 Look up Patient Aging Patient Remainder Aging Advanced and Network Professional only This report has the same format as the Patient Aging but there is a key difference in how it works A charge does not show up on Patient Remainder Aging until all insurance responsibility has been marked complete F1 Look up Patient Remainder Aging Report Patient Remainder Aging Detail Advanced and Network Professional only 156 Running Reports This report has the same criteria as Patient Remainder Aging Detail however it also lists each insurance company on the patient s account and the date the insurance payment was marked complete F1 Look up Patient Remainder Aging Detail Insurance Aging and Summary These reports Primary Secondary and Tertiary tracks aging of claims filed with insurance carriers The summary versions are similar but no patient information is included F1 Look up Insurance Aging F1 Look up Insurance Aging Summary Production Reports NOTE This is a Network Professional only feature Production by Provider Procedure and Insurance and Summary These reports give incoming revenue information for each provider procedure or insurance carrier respectively The difference between these reports and the summary versions of the reports is that the summary reports do not display as much detailed information as the regular reports The summary reports display o
157. in the Repeat section See the following Repeating Appointments section F1 Look up New Appointment Entry Repeating Appointments When a patient needs to make regular return visits set up repeat appointments through the New Appointment Entry or Edit Appointment window Click Change in the Repeat section at the bottom of the window The Repeat Change window that opens is the same window that appears when creating repeating breaks In the Frequency box select the interval for the repeating appointment Choosing any of the radio buttons except None displays different data entry boxes in the middle of the window that 143 Scheduling Appointments give you the repeat options for each frequency Also a written summary of the selected frequency appears in the bottom middle area of the box It is important to note that when you set up an appointment using the Monthly frequency the date highlighted on the main calendar affects the day or date that is entered in the break note F1 Look up Repeat Change Entering Breaks Entering Breaks You can enter breaks into the appointment schedule as reminders that the time slots are committed Some breaks are a one time occurrence like a vacation or a seminar Others are regularly scheduled times for each month or week Click Lists and select Break List Click New or press F8 in the Break List window Break List Search for A Field Name e 2 Breaks from today forward Show all break
158. ine its HIPAA compliance and then click the HIPAA Approved box in both Procedure Code and Diagnosis Code edit windows Another option is to use a program such as Codes on Disk This program imports current CPT and or ICD 9 codes with all HIPAA compliant codes marked See your local Value Added Reseller or contact McKesson directly at 800 333 4747 Color Coding Tab NOTE This is an Advanced and above feature Transactions If you want to use color coding for transactions in Transaction Entry and Quick Ledger click the Use Color Coding box 166 Select colors for each of six types of transactions Unsaved No Payment Partially Paid Overpaid Charge Unapplied Payment and Overapplied Payment These colors appear in both windows letting you know at a glance the status of the transaction Program Options E Default Colors ss Auto Accident HMO Patient Medicare Patient Capitation Patient Delinquent Account Fuchsia Copay Due Maroon Inactive Patient Green Credit on Account Olive No Insurance Red Navy Guarantor Needs Referral Minor Under 18 Fuchsia Purple Teal Lime Special Needs Silver Tricare Patient i l Patients This feature called patient flagging lets you color code patient records to alert you to various situations when viewing the records the Patient List Transaction Entry Quick Ledger and Deposit List windows of Medisoft and the New Appointment window in Office Hours
159. ing on the report selected the Data Selection Questions window or the Search window opens 3 On the window select data ranges and then click OK The report is displayed Use the controls in the Report Preview window to view or search for details Controls include E T 1L Print Used to print the report on the default system printer using the user specified criteria Zoom Used to increase or decrease the viewing size of the report gt a gt Navigate Used to navigate or browse through the various pages of a multi page report and features jumping to the first or last page moving to the previous or next page or specifying a particular page to view a Search Used to further refine data parameters search criteria Once you have generated a report you can further refine the report and search for a more detailed data element When using this feature you essentially re run a report using more specific data criteria mias Close Used to close the currently displayed report NOTE For some reports that use a different format such as statements the controls in this window are slightly different and include a Save Report to Disk option If you select this option you can save the report in a QRP format and then use the Load Saved Reports command on the Reports menu to load the report Searching for a Specific Detail in a Report Once you have generated a report you can further refine the report and search for
160. inish setting up the provider in Medisoft The Provider IDs tab and grid is not available in any version of Office Hours If you want you can let the program assign the Code for the provider or you can enter a five character code yourself Enter the provider s name and pertinent information Enter NPI information taxonomy and other rules in Medisoft in the Providers window on the Provider IDs tab F1 Look up Provider Entry Setting up Patient Records This can be done in either Medisoft or Office Hours Click Lists and select Patient List You can create a chart number yourself eight alohanumeric characters or let the program create one Enter information in as many of the fields as necessary in both tabs When finished click Save Repeat this process for each patient who visits your practice F1 Look up Patient Entry Setting up Case Records This can be done in either Medisoft or Office Hours Click Lists and select Patient List Click the Case button in the top right corner of the window and click New Case or press F8 to display the Case Patient Name new window Enter information in as many of the fields as necessary When finished click Save Repeat this process for each case you want to enter TIP In the Case window you cannot press F8 or F9 to access records available from lookup fields such as Facility or Attorney The F8 and F9 keys are only available in the Case window from within Medisoft itself 140 Scheduling A
161. insurance company F1 Look up Sending Claims to a File 118 Creating Statements Creating Statements Statement Management NOTE This is an Advanced and above feature This section explains briefly how to manage statements within the Statement Management window and includes creating editing printing reprinting and listing statements as well as changing statement status To perform any statement management functions go to the Activities menu and select Statement Management You can also track patients that do not immediately pay their copay using the Copay Remainder statement This format is only available when processing statements using the Statement Manager feature Before using this statement format you will need to select the Add Copays to Remainder Statements box on the Program Options window Billing tab F1 Look up Program Options window Billing tab F1 Look up Tracking Missed Copays You can use Statement Management to create to bill and to rebill statements all from one place You can also view information about the statement such as the guarantor the status the initial billing date and the type You can also generate statements to track missed copays For more information on setting up and using this feature see the topic Tracking Missed Copays Statement Management Window The Statement Management window has several sections Statement Management A EJ A Say achur v Dona Stmit Guarantor
162. int it or click Cancel 212 Tutorial Activities rsa Apply Payment Adjustments to Charges Aereas Dra Ins 1 AT Insurance Partners 41000 Unapplied Amount 0 00 YT als sh Ins 2 FHP Health Plan FHPOO For k mith Jonn Ins 3 Show Unpaid Only Payment Procedure Codes INSPAY w 2 DEDUC v MCwH v 2 APWRO v P TAKEBE v E 2 Date Procedure Charge Remainder Payment Deductible withhold Allowed Adjustment Take Back Complete Rejection Provider 02 01 2010 99214 65 00 30 00 20 KL I o2012010 02304 10 00 10 00 0 00 35 00 4 25 00 0 00 40 00 0 00 0 00 40 00 I Alert When Claims are Done Alert When Statements Are Done i There are charge entries Bill Remaining Insurances Now Pe Pete Per Print Statement Now Write off Balance Mow ES 8 Let s also assume that you receive a check from the secondary insurance carrier FHP Health Plan Create a new deposit for 10 00 from FHP The check number is 10890 and the bank is Greater Southwest Trust 9 Click the deposit and click Apply Select John Smith s chart Apply 8 00 to the 65 charge and apply 2 00 to the 5 00 charge Click Save Payments Adjustments and click OK on the information window Apply Payment Adjustments to Charges FHP Health Plan Ing 1 Al Insurance Partners 41000 Unapplied Amount 0 00 YT gt Ins 2 FHP Health Plan FHPOO cor a 2 smith John Ins 3 Show Unpaid Only Payment Procedure Codes
163. intment schedule the surest way to work him in is to put him on the Wait List Go to the View menu and click Wait List Click New 2 Select John Smith from the Chart number field Click Save 3 To begin the search for his next appointment highlight his record and click Find to open the Find Open Time window 4 Mr Smith is out of school at 2 p m but has choir practice on Tuesday and Thursday He needs a 15 minute appointment so enter a Start Time of 2 30 p and an End Time of 5 00 p Click Monday Wednesday and Friday Click Search and let it go In a few moments if the program finds a match a Confirm window pops up Open time slot found Do you want to set the appointment If the first time slot it presents is not satisfactory click Retry and let it search further Or click Yes and schedule the appointment 219 Tutorial Activities Tutorial Practice 10 Modifying the CMS 1500 Form Repositioning the CMS 1500 form 1 Let s say your paper claims are printing with text shifted too far to the right and below the spaces provided in the pre printed CMS 1500 forms 2 Go to the Reports menu and select Design Custom Reports and Bills Click the Open speed button the book with the arrow pointing to it and select CMS 1500 Primary Click OK 3 Go to the File menu and select Report Properties 4 It s probably better to make one adjustment at a time so in the Form Offset section and change Left to 05 Click OK Repor
164. ion Document Control Humber Insurance Coverage Percents by Service Classification Mame Again Dwight Address 1742 M B3rd Ave Phoenis 42 850 21 o Do E i a o E e0 G jo D feo F feo H feo Home Phone 434 5777 Work Phone Cell Phone Date of Birth 330 1932 a save Jl a Cancel Help UBOA Eligibility Face Sheet Set Default F1 Look up Case Policy 1 2 and 3 Tabs The Medicaid and TRICARE tab includes fields for all submission numbers reference and data for each carrier It also includes branch of service information Within the Medicaid and Tricare tab are EPSDT and Family Planning indicators required submission numbers and reference data for the case TRICARE claims 96 It also includes service information for Setting up the Practice Case AGADWOOO Again Dwight Back Pain Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Medicaid EPSOT Resubmission Number Family Planning Original Reference Semice Authorization Exception Code Special Program Code ka EPSOT Referral Code e Tricare Champus Norndwvalability Indicator Ww Branch of Service 44 Sponsor Status bil Special Program e Sponsor Grade wt Start w End ka Mame Again Dw
165. ion Documentation window activated by pressing F5 or clicking Note in the Charges section of the Transaction Entry window There are various transaction documentation types available and they can be viewed in the Quick Ledger Transaction Documentation Tope Transaction Mote internal use only e OK q Documentation Hotes 3 da Cancel 102 Entering Transactions F1 Look up Transaction Documentation If you need to enter drug prescription information for a charge on the Transaction Entry window you can click the Details button to open the Transaction Details window On this window you can add data which is then included on a custom report or a printed claim You will need to customize a report and modify fields 24A 24H to add National Drug Code NDC data in a charge line electronic claims automatically pulls this data for claims For more information on modifying a report see Report Designer And to view NDC Information on the Transaction Entry you will need to add the NDC fields to the grid F1 Look up Adding NDC Information Report Designer and Grid Columns Entering a Charge in Transaction Entry Once you have selected patient chart and case number in the Transaction Entry window click New or click in any column of the Charges section The current date is automatically entered If you are entering transactions from earlier dates insert the correct date of the entries with which you are working If you have a num
166. is available for those carriers that limit the number of transactions per claim accepted electronically If you submit more than the maximum number of transactions per claim the program automatically splits the claim If the insurance carrier is used as both a primary EDI insurer and a Medigap insurer in the EDI Extra 1 Medigap field enter the Medigap number in this field The number entered is the COBA Medigap claim based identifier received from the national Coordination of Benefits Contractor COBC The EDI Extra 2 field is used by the Revenue Management feature Select the Complimentary Crossover box if you are filing complimentary crossover claims Secondary insurance will not be sent in the claim file However the program will mark the secondary as sent If you are sending Medigap claims do not select this box 98 Setting up the Practice 23 Delay Secondary Billing If there is a secondary insurance company you can delay printing the secondary claim form until a response is recorded from the primary carrier by selecting the Delay Secondary Billing box To print the secondary claim form at the same time the primary is printed leave the box empty which is the default setting 24 Select the Send Ordering Provider in Loop 2420E box to send ordering provider information on an electronic claim 25 Select the Send Practice Taxonomy in Loop 2000A box to send taxonomy in Loop 2000A for electronic claims Loop 2000A is usually use
167. is report shows the status of claims providing a summary of total claims and those that have been filed electronically or by paper It includes the percentage of claims filed electronically In addition it shows detail such as the billing date insurance carrier sequence claim number patient chart and name and the status of the claim It is an ARRA report designed for showing that the practice is verifying eligibility electronically F1 Look up Appointment Eligibility Analysis Detail Report Electronic Claims Analysis Summary Report This report shows the status of claims providing a summary of total claims and those that have been filed electronically or by paper It is an ARRA report designed for showing that the practice is verifying eligibility electronically F1 Look up Appointment Eligibility Analysis Summary Report Aging Reports Patient Aging One of the important tools in collections is the patient aging report This can be printed showing the age of each unpaid transaction for patients Default aging criteria is based upon the number of days between the creation of the transaction or claim and the date of the report you are generating The columns break down the amounts due that are 30 60 and 90 days old Aging is from actual date of the transaction so it reflects the true age of the account The aging criteria and columns can be altered in Program Options This report includes all unapplied amounts in the totals The Date f
168. isoft Sales Department at 800 333 4747 for the name of a qualified Value Added Reseller in your area to give you hands on help or search the Medisoft website at www medisoft com for a reseller in your area Technical Support Call Support at 800 334 4006 between the hours of 8 00 a m and 8 00 p m Eastern Standard Time You will hold for a technical support representative who has specific knowledge about the issue for which you are calling Getting Started with Medisoft Getting Started with Medisoft The topics featured in the Getting Started with Medisoft book are intended to help you set up your practice begin entering transactions create claims and apply payments The topics in this section do not completely document Medisoft For more information look up related information in the Search field of the Help file and access other parts of the Help system New in this Version Enhancement ARRA Reporting Medisoft 17 includes four new reports to help you to remain compliant with upcoming ARRA requirements specifically the requirements for electronically verifying the eligibility of your patients for insurance and for electronically sending claims to insurance providers These include e Appointment Eligibility Analysis Detail e Appointment Eligibility Analysis Summary e Electronic Claims Analysis Detail e Electronic Claims Analysis Summary Each of these reports offers several filters for controlling the information that sh
169. k OK Click OK again 221 Tutorial Activities 8 To make sure the two Zip Code fields are aligned right click over the heading and make note of the value in the Left position field Then right click over the Zip Code field green band and enter the same number in the corresponding field of this window 9 To save you must rename the form Go to the File menu and select Save As In the Report Title box enter Patient List w Zip and click OK Close the Report Designer 10 To test your new report form go to the Reports menu and select Patient List w Zip How To Create a New Report 1 Choose a report style on which to base a completely new form 2 Format the report by going to the File menu and selecting Report Properties Establish the report name margins size of bands and filter the source data needed to provide the information for the report 3 With the report formatted you can begin placing fields on the grid Make the necessary additions and or changes to complete your form then save and exit Report Designer The new report appears in the Custom Report List 4 As you become familiar with the workings of Report Designer formatting and designing become easier 222 Index Index A Activity Reports Network Professional only 156 Add Copy User Reports 159 Adding a Collection List Item 214 Adding Details to the Practice Record 178 Aging Reports 155 Aging Reports Tab 164 Analysis Reports 153 Apply Pa
170. l of these entries would be generic wild card rows without any selection of an insurance carrier These grid entries however need modification since all four would be generic wild card rows in which all is selected for insurance carrier Before filing claims you would need to first examine the legacy numbers and see if all are still needed Then you would begin adding deleting or editing entries to match your claim filling needs For instance you might keep the generic wild card row since this information is needed for most of the insurance carriers you file claims with Then you might select one of the other legacy wild card rows the rows in which All insurance carriers and all insurance classes are selected and apply this rule to a specific insurance carrier or class If needed you could add a second legacy number if the carrier required it You could delete the other entries or apply an insurance carrier or class to the entry If you do not review and modify your ID grid entries you can potentially have problems when filing claims if you leave multiple wild card rows all selected for insurance carriers and insurance classes since the rules engine would not know what rule to select In this case the rules engine might select the correct most complete wild card row row but could also pull one that contained the wrong legacy id resulting in a claim rejection Setting Program Options The Program Options window contains set conditio
171. laim Manager s office before being sent to an insurance carrier The Claim Manager focuses on three principal areas not necessarily sequential review batch and final review Watchdog The Claim Manager is first of all the watchdog of the claims She checks each claim and verifies the numbers She has the authority to edit the claim and make needed changes If she sees that a claim should go to a different carrier than indicated or if the EDI receiver information is incomplete she corrects the record She also has access to the insurance carrier records She checks the billing date and how the claim is to be sent either by paper or electronically And then she can indicate the status of the claim There is a place where she can add any special instructions that need to go with the claim Batch em up The function of creating claims serves to group claims that are headed to the same destination The Claim Manager gathers and sorts by range of dates or chart numbers Transactions can be selected that match by primary carrier Billing Code case indicator or location Random Billing Code numbers can be selected The Claim Manager can also indicate a minimum dollar amount for creating the claims eliminating claims too small to be worth billing Reviewer The Claim Manager has at her fingertips a List Only button that lets her retrieve claims that match a certain criteria that she has determined The List Only Claims That Match window is a
172. ld Setthe Length to 120 The search arrow on the Color field lets you select light yellow as the color for the template on the appointment grid 4 Y ou want to use this template every day so click Change to display the Repeat Change window Choose the Weekly frequency enter the number 1 and click the boxes for Tuesday and Thursday Leave the End on field blank at this time Your entry is confirmed with the message Every week on Tue and Thu Creating Multi Views NOTE This is an Office Hours Professional feature 1 Dr Lee works only with therapy patients and uses Exam Room 2 for consultations Let s create a view where you can see all of these schedules at the same time 2 To create a multi view go to the File menu and select Program Options Open the Multi Views tab Click New 3 Name the new view Dr Lee and press TAB In the Type field click the box and select Provider In the Code field locate and highlight Dr Lee s name Leave the Width at its default setting Click Insert Column 4 In the next line select the Resource type Press TAB Locate Exam Room 2 and highlight it Press TAB Change the Width column to 50 Click Insert Column to create a new line Again select Resource This time locate and select Therapy Click Close Click OK Using the Wait List NOTE This is an Office Hours Professional feature 1 Mr Smith has seen the doctor for his injury but he needs a return visit in a week With the full appo
173. ld down the CTRL key and click each statement that needs the status changed Note that the selected statements do not need to have the same status to begin with but they are all changed to the same status Click Edit In the Change Statement Status Billing Method window choose the Selected Statement s radio button then choose the appropriate radio buttons in the Status From and Status To sections If you have chosen statements with varying statuses choose Any Status Type in the Status From section When finished click OK F1 Look up Change Statement Status Billing Method and Marking Statements Billing Cycles The cycle billing feature lets you print statements every certain number of days If you want to print statements every 30 days you can set up a billing cycle of that length First you set up the billing cycle in Program Options Billing tab Then you process the statements through Statement Management The other ways of printing statements do not offer this feature F1 Look up Cycle Billing Claim Rejection Messages Use this window to enter claim rejection messages received on an EOB Explanation of Benefits These messages can then be attached to transactions and printed on statements to explain why the claim was rejected You connect the message to a transaction in the Rejection field when applying deposits from the insurance company If the EOB shows a code for a certain procedure you can enter or select the code in the Reje
174. le for printing disconnected from the network off line etc the system will prompt you to select another printer or cancel the print job If the printer is permanently no longer available you would need to assign another printer to all reports that were using this resource F1 Default Printer Setup Options F1 Setting a Default Printer 100 Entering Transactions Entering Transactions Transaction Entry Overview The Transaction Entry window is designed for easy transaction entry and to display as much information with as few clicks or keystrokes as possible Not only do you record all patient visits and their charges you also enter payments and adjustments that may be added to the ledger Medisoft is an Open Item Accounting program meaning that transactions entered are marked when paid but remain on the active ledger as long as the case is active There is no clearing of the ledger and bringing up a total to start a new month as with a balance forward program Transaction entry is generally case based Transactions are entered into the patient ledger grouped by case number You can have a case for each transaction or for each diagnosis type Transaction Entry E El Teso0000 vae ems eo Case Number Entry Number PP Claim Number Date Fr Date To Document Number Description Attending Provider ple P EDI Notes Details Description Check Humber Amount Ca onen S bane aae F1 Look up Transactio
175. le for which vou would like to verify and rebuild Depending on the size of the file this process may take a LONG time Press START to begin the process Address Allowed Amount Audit Audit Detail Biling Code Biling Practice Case Clam Claims Condition Codes Contact Credit Card Custom Data Database Password Default Deposit Diagnosis ELI Pack Data EDI Receiver Electronic Remittance Electronic Remittance Trkng Eligibility Eligibility Wenfication Status Group IDs AL Trigger Insurance Carrier Insurance Class Login Management MultiLink Multimedia Decurence Codes Decurence Span Codes Office Hours Option Patient Patient Discharge Status Patient Quick Entry Patient Recall Payment Log Payment Plan Physician Practice Practice Settings Printer Defaults Procedure Procedure Flan Provider Class Retering Provider Rejection Repeat Task Report Tree Report Users Revenue Codes Security C All Files g Cancel Security Statement Superbill Tracking Transactions Treatment Plan Trigger Control Table 0804 Form Fields Unprocessed Invalid Records Unprocessed Transactions User Groups Value Codes Warehouse Wizard Table Work Administrator Work List ip Code Select the Pack Data tab to choose the data files from which you want to remove deleted data Here again you can choose one particular set of files or click All Files to include them all 171 Performing File Maintenan
176. lect claims for only Al Primary Secondar Tertiary That match one or more of these criteria Insurance Carrier yt ED Recerver Billing Method Claim Status al All Paper C Hold Electronic O Ready to Send Sent C Rejected Biling Date 44 Challenge O Alert Batch Number Done Exclude Dore Pending al Help In the List Only Claims that Match window use one or more of the options to limit the claims you want to appear in the window F1 Look up List Only Claims that Match Changing Claim Status In the Claim Management window all submitted claims are automatically marked Sent with an indication of the method of submission There may be occasions when you need to change this status Entire Batch If the status of an entire batch needs to be changed you can change all the claims at once Highlight one of the claims and note the number listed in the Batch 1 column in the Claim Management window Click Change Status The Change Claim Status Billing Method window is opened 117 Creating Claims Change Claim 5tatusfBilling Method Change Status Billing Method of Claims For Batch IE Selected Claims ew OK Status From Status To da Cancel O Hold O Hold C Ready to send O Ready to send Help Sent C Sent O Rejected Rejected Challenge Fleet O Aler Challenge Done Alert 5 Pending Done Any st
177. lenge Alert Done Pending Any status type Biling Method From Paper Electronic For Carrier Status To CO Hold 0 Ready to send e Help O Sent Rejected Challenge Alert Done 5 Pending Biling Method To C Paper Electronic a Cancel Primary Tertiary Secondary Al 3 Click OK You are now ready to send the claims for John Smith again Tutorial Practice 6 Statements Creating Statements 1 Click Activities and select Statement Management Click Create Statements in the Statement Management window to open the Create Statements window 2 Since we created two charge transactions for John Smith in the Transaction Entry portion of this tutorial let s create the statement for these charges Click the first Chart Numbers range field and select John Smith s chart Repeat this process in the second Chart Numbers field 3 Click Create 207 Tutorial Activities lt Create Statements Range of 3 Transaction Dates to Oo M Chart Numbers SMIJO000 w 5 to SMIJOOOD w 2 Select transachons that match Billing Codes Case Indicator Create Provider Create statements if the remalnder total i greater thar Enter Amount Statement Type Standard Remainder 4 When you return to the Statement Management window a new statement has been created for SMIJOOOO Editing Statements
178. les should be done only after careful consideration Data removed cannot be reinstated unless you have a previous backup disk containing the information You have a choice of purging appointment fields closed cases and claims data files In any case select the cutoff date to which you want to clear data All data in the selected file before and including the date specified is deleted 172 Performing File Maintenance File Maintenance Rebuild Indexes Pack Data Purge Data Recalculate Balances Start Purging a data file will remove data records from the file that you no longer need You select the data to be removed by checking the appropriate box then entering a date The date entered is a cutoff date 4 Cancel Closed Cases with outstanding balances will not be purged All data in the selected file before and including date specified will be deleted USE THIS PROCESS WITH CARE Data removed cannot be reinstated Press START to begin the process Cutoff Dates Appointment Purge F NOTE When purging claims or statements each claim or statement must also have a L Claim Purge Done status before it will be removed C Statement Purge Recall Purge Purge Closed Cases C Credit Card Purge Recalculate Balances On occasion account balances or applied amounts may appear to be miscalculated This option recalculates the selected types of balances NOTE
179. lity Verification Results If you access this window from the Activities menu the list will automatically show the last inquiry made for each patient You can also set it to show all inquiries To make a real time eligibility inquiry from the Eligibility Verification Results screen highlight the patient and click Verify Patients To make a real time eligibility inquiry for a specific patient right click the patient s case in the Patient List and select Eligibility Verification The Eligibility Verification Results screen opens for the patient Click the Verify button to make the inquiry You can also open the patient s case and click Eligibility Office Hours To make a real time eligibility inquiry for a specific patient from the appointment grid right click the patient s appointment and select Verify Eligibility The Eligibility Verification Results screen opens for the patient Click the Verify button to make the inquiry Task Scheduler You can use the Scheduled Tasks feature to schedule a daily time to send a batch of eligibility inquiries To schedule the batch go to the Activities menu select Eligibility Verification and then select Schedule The task will automatically make inquiries for patients scheduled in the appointment grid up to a week in advance TIP Press F10 to launch the Eligibility Verification Results window to verify a patient s eligibility 138 Scheduling Appointments Scheduling Appointments Office H
180. lumns that have already been created place your cursor where you want the new column and click Insert These views can be also edited or reverted to default views through the View menu Security Setup If you are using Office Hours in connection with Medisoft the security settings established in Medisoft are applied to Office Hours as well However you can make changes from within Office Hours if needed 149 Scheduling Appointments You can be logged in to the program on only one computer at a time If you are logged in on one computer and try to log in on another a message pops up You have to log out of the first computer before you can log in on another computer F1 Look up Security Setup Reports in Office Hours Reports in Office Hours If you select one of the following reports in the Speed Report box in Program Options Options tab that report prints automatically when you click the Print speed button Office Hours Professional The reports are e Quick Appointment List e Appointment List e Appointment Grid e No Show Report Appointment List Probably the most important report printed in Office Hours is the Appointment Schedule a listing of all the day s scheduled events Generally printing this report is the first order of business Print the list and be sure you are ready to meet the day Go to the Reports menu and select Appointment List In the Report Setup window select how you want the report to print I
181. m that need to be set up before you can start scheduling First set up provider records in Medisoft unless you are using Office Hours Stand Alone NOTE If you create a provider in Office Hours you will need to finish setting up the provider in Medisoft The Provider IDs tab and grid is not available in any version of Office Hours If you are booking appointments for lab work or therapy each of those technicians should have a provider number and schedule and so should each office member whose schedule is included in the Office Hours program Second create your resource records You can include all treatment apparatuses in this list as well as consultation and treatment rooms so that you do not double book a room or equipment Third establish the number of booking columns you want Fourth clarify program options such as establishing appointment length creating whatever views you need for viewing multiple columns at once and deciding how much information you want displayed in your appointment blocks in the appointment grid Fifth set up breaks and recurring breaks to show lunch hour set breaks seminars etc Setting up Provider Records Office Hours must have at least one provider record set up in order to run If no provider record is set up Office Hours automatically prompts you to do so the Providers window is available from the Lists menu in Office Hours NOTE If you create a provider in Office Hours you will need to f
182. ments are created Also you can further limit the statements created by entering information in the Select transactions that match Include statements if the remainder total is greater than and Statement Type areas of the window F1 Look up Create Statements Editing Statements Highlight a specific statement and click Edit or press F9 to edit a statement You can modify general statement information the transactions that appear on the statement and any comments attached to the statement When you make changes in the Statement edit window you modify only that statement and do not affect the defaults for other statements 121 Creating Statements Statement 11 Statement 11 Statement Created 12222003 Guarantor 51M 74000 Tanus J Simpson Remainder 386 00 General Transactions Comment Status Billing Method Hold O Paper z ee aaa Electronic O Failed Type 5 Standard O Challenge Initial Billing Date O Done Batch Submission Count 0 Biling Date The detail also indicates submission method assigned to the statement paper or electronic as well as the statement status Statement status options include Hold Ready to send Sent Failed Challenge or Done You can also see the statement type initial billing date batch number submission count and most current billing date Any time a statement is sent the program assigns the statement a batch number That number shows in the Batch
183. menu and select Add Collection List Item Choose the Claims radio button Click the Primary radio button in the Carriers field Click the Rejected radio button Select A1 Insurance Partners for the first Insurances field and FHP Health Plan in the second Insurances field Enter 2 in the Add item if submission count is great than field Assign the item to Pat Smith Check the Add Billing Comment to Office Notes check box Click Add Items Click No Patient Payment Plans 1 A O O N ODO OF fF W N k OO A O OORA a O a ok N 14 Go to the Lists menu and select Patient Payment Plan Click New In the Code field enter A In Description enter 5 30 signifying a plan to pay 5 dollars every 30 days In First Payment Due enter 5 to have payments due on the 5 of every month In Due Every days enter 30 Enter 5 in the Amount Due field Click Save Close the Patient Payment Plan List window Go to the Lists menu and select Patients Guarantors and Cases Find John Smith s record select it and click Edit Patient Open the Payment Plan tab In Payment Code select plan A Click Save Click Close Mr Smith is now assigned to a payment plan If he makes payment of the correct amount and in the prescribed time he will not be receiving collection letters from your practice Collection Letters Collection Letters 1 Goto the Reports menu and select Collection Reports then Patient Collection
184. n Entry Start with a Chart Number From the Activities menu select Enter Transactions or click the Transaction Entry speed button Within Transaction Entry two numbers are of prime importance the chart number and the case number Enter the chart number or click the Chart field and select the chart number from the drop down list You also have the option of entering the superbill number or selecting the superbill number from the drop down list in the Superbill field If the patient record has not yet been set up press F8 to bring up the Patient Guarantor new window See Setting up Patient Records for more information 101 Entering Transactions When you press TAB or ENTER a case number is selected in the Case field if one is available By default the most recently opened case is opened You can change the default in the Program Options window Data Entry tab Case Default field see Data Entry Tab If you want to create a new case the shortcut to bring up the Case window is F8 Another method of selecting a specific case is to click the speed button to the right of the Case description field to open the Select Case by Transaction Date window Cases are sorted on the Case drop down menu based on the case number and appear in descending order for instance case nine would appear at the top of the list followed by case five followed by case four etc F1 Look up Select Case by Transaction Date A document number is automatically
185. n based on statements marked Sent in the Statement Management window showing what has not been paid statement date etc Also select Patient Collection Report Statement Notes to generate the report with statement notes included F1 Look up Patient Collection Report Insurance Collection Reports The Insurance Collection Reports are identical in layout but each reflects the selected insurance level primary secondary or tertiary This report also shows the claim data what amount is outstanding etc These reports also offer variants that include claim notes F1 Look up Insurance Collection Report Patient Collection Letters The Collection Letter Report is printed in preparation of collection letters It contains information from the collection list and is used to help evaluate collections To access this report go to the Reports menu select Collection Reports and then Patient Collection Letters F1 Look up Collection Letter Report Collection Tracer Report The Collection Tracer Report reports how many collection letters have been sent and when Each time collection letters are printed the program by default keeps track of each letter sent F1 Look up Collection Tracer Report Audit Reports Audit Generator The Audit Generator helps create a Data Audit Report that contains only the information you want included in the report The tables available in the Audit Generator are governed by choices made in the Audit tab of the Progr
186. n this case to pull your NPI number in Loop 2010AB If you left the NPI number only on the practice level it would not pull for this loop If you are a solo provider with insurance carriers that require mixed NPI numbers some require individual while some require a group you would enter your group NPI number on the Practice IDs grid You would then create an entry on the Provider IDs grid in which you would enter your individual NPI number on Provider IDs grid and apply it to all insurance carriers an insurance class or a carrier you could create several records if needed to address other issues such as legacy numbers taxonomy etc For those carriers that require the group NPI you would create at least one other separate entry on the Providers IDs grid might need more depending on other issues such as legacy numbers taxonomy etc for that carrier or that insurance class in which you select the From Practice button instead of selecting the National Provider ID button and entering an NPI number If you are a group practice you will complete at least one grid entry on the Practice IDs grid for the practice You will also create at least one grid entry on the Provider IDs grid for each provider If you have a provider that in some instances bills using his ner own NPI number for a specific insurance carrier you can create an extra grid entry for this provider in which you specify the insurance company and select to pull the provider s NPI num
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188. nd selecting Procedure Payment Adjustment Codes The Procedure Payment Adjustment List window shows what codes have been set up 76 Setting up the Practice lt Procedure Payment Adjustment List Code 1 Description Amount Type Description 117110 Procedure charge 29130 App of Finger Splint Static 30 00 Procedure charge 43220 Esophageal Endoscopy 275 00 Procedure charge 0250 Ray Skull 4 Views 55 00 Procedure charge 0360 Ray Neck 45 00 Procedure charge 1020 Ray Chest 2 Views 53 00 Procedure charge 40030 Ray Chest Min 4 Views 65 00 Procedure charge 41040 Contrast lt A ay of Bronchitis 50 00 Procedure charge 2052 Ray Spinal Complete 90 00 Procedure charge Tm ob Print Grid At the top of the window there are two fields to help you find a procedure code Search for and Field Field defaults to Type but can be changed to Code 1 or Description If you are not sure of the complete code description or type enter the first few letters or numbers in the Search for field As you type the list automatically filters to display records that match At the bottom of the window are choices for setting up a new code editing a code or deleting a code If the code you need is not shown in the list click New or press F8 F1 Look up Procedure Payment Adjustment Entry General Tab In this area you can enter a new code number description and type Valid code types can be seen by clicking on the drop d
189. ndow opens 3 Click the Address tab Enter the company s contact information in fields such as Name Address 1 Address 2 City State ZIP Code Telephone and Fax In the Contact field enter a contact name at the insurance carrier In the Plan Name field enter the plan name administered by this carrier From the Class list select an insurance class to assign to the carrier This field lets you assign the carrier to a dynamic list of classes you create yourself Insurance classes are then used by the rules engine for selecting an entry on the various IDs grids in the application For more information on the rules engine and assigning rules see the topic Assigning Rules NOTE Insurance classes are created on the Insurance Class window Lists Insurance Classes For more information see the topic Insurance Class Entry 55 Setting up the Practice Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Code m IF the Code is left blank the FF Inactive program will assign one Carrer Address Mame Phone Extension Street Fax Contact City Shate ip Code Plan Information Plan Name fs Class w E Set Default 4 Click the Options and Codes tab Ery F im 1 Insurance Carrier new Ema lx Address Options and Codes EDI Eligibility Allowed i 5 Options Ql_zave Procedure Code Set Diagnosis Code Sek aa Patient Signat
190. nformation about each claim You can add and remove fields from this section by clicking the grid modification button in the top left corner of the grid F1 Look up Grid Columns Click a column header to sort the grid by that column When you exit the Claim Management window the application saves your currently selected sorting pattern and displays this selection the next time you access the window The column next to the record pointer indicates whether notes are attached to the particular claim If the column contains a page icon highlight the record and press F5 to view the note F1 Look up Claim Comment Buttons Edit Click this button to edit the selected claim F1 Look up Edit Claim Create Claims Click this button to create claims F1 Look up Create Claims Print Send Click this button to print the claims on paper or send them electronically F1 Look up Print Send Claims Reprint Claim Click this button to rebill claims F1 Look up Reprinting Claims Delete Click this button to delete the claim number and release the transactions bound to the claim You can then put those transactions on a different claim Close Click this button to close the window Creating Claims lt is in the creating claims operation that a claim is finally prepared for submission Preparation can involve a single claim or a batch Claims are gathered by range of dates and or chart numbers The selection of claims to be created can be furt
191. ng Started with Medisoft Keystroke Action O Opens the MultiLink window FA Opens Apply Payment to Charges window Opens Transaction Documentation window Keystrokes Eligibility Keystroke Acton III Fo Opens the Eligibility Verification Results window when Eligibility is enabled Keystrokes Report Designer Keystroke Action IO UP ARROW Moves selected components up DOWN Moves selected components down ARROW 32 Setting up the Program and Setting up the Practice Setting up the Program and Setting up the Practice Setting up the Program Before you can use the Medisoft program you have to create a practice You might only need to create one practice but you can create multiple practices if necessary Creating a Practice When you first open the Medisoft program after installation you are required to create a new data set if this is the first time you have ever installed Medisoft or convert previous Medisoft or MS DOS data Create Data Do you want to Create 4 new set of data Convert existing Medisatt Data Add tutorial data to list If you have been using Medisoft Version 5 5x or 5 6x and above and have just installed Version 17 a message displays stating that data must be converted before you can access the program If you have not already performed a backup on your existing data perform a backup now Then click OK to perform the automatic conversion If you work with multiple pr
192. nly a summary of the information available F1 Look up Production by Reports F1 Look up Production Summary Reports NOTE Medisoft Network Professional provides this report on the Reports menu This report is also available when using the Medisoft Reports Print Engine feature for Medisoft Advanced users F1 Look up Medisoft Reports Print Engine Activity Reports NOTE This is a Network Professional only feature Daily Monthly Activity Report This report presents financial activity based on the date range selected The report displays the total number and the total amounts of the charges payments and adjustments entered during a date range The report also details the net effect of the financial information entered on the Accounts Receivable balance for the day month Activity Summary by Provider Insurance and Procedure Activity reports break down financial activity by day or month The summary reports summarize financial information entered for each provider procedure or insurance carrier respectively F1 Look up Activity Reports NOTE Medisoft Network Professional provides this report on the Reports menu This report is also available when using the Medisoft Reports Print Engine feature for Medisoft Advanced users F1 Look up Medisoft Reports Print Engine Collection Reports 157 Running Reports NOTE This is an Advanced and above feature Patient Collection Report The Patient Collection Report contains informatio
193. nnnnnnnrnnnnnnnnnrinnos 16 Medisottatia Glace di 24 Kkeysttokesand SOC e ed de a Ud RS avons 30 Keystrokes Common to Most of the Program occccooccnccccccnnccnncnnconononcononcnnonnncnnonnnncnnonanennnnnneos 30 Keystrokes Formatted Date Edit COnNtrOlS ooonccncccoccnnconccononncnnnnononnnononononnnnnnnnnnnnnnnnnnnnns 31 Keystrokes Grid Control in Various WINdOWS oooccccccccoccconccononcconcnononnconononnnncnnnnnnnnnennnnnnnos 31 Keystrokes EIST VV INGCOWS iia Ad 31 Keystrokes TranSaction Entry ccccssscccecssseeecseeeeeeneeeeeseuseeesseeeeesseeeeeseeeeessseeesseneessaeaeees 31 Kevstroke SEGIB errata 32 KEYVSIFOKES EDOM Desidne Fuiste di 32 Setting up the Program and Setting up the Practice occccocconnnnnninncccnconnnnnnonenconconnnnanonennnncnnns 33 Setting UD TMS Progra eenei a e o 33 Creating a PAC a o duly dC a Leda 33 Other Selp Into alias dais 34 Opening a PAI e dd e 34 Seting Up MO Prachee aii pd 36 a O a kta ieee neead 36 Rules Creation and IDS Grid ROW Selection oooonccnccccconcnnncccnoncnnnonconcconnonnnanennnnnnanncnnnnnnnns 36 NPE SUP CONSIGCKAIONS suas E a ed 38 Claim Filing Setup for Individuals and Groups cccccccocccnncccnonccnncnononncnncnononcnnnononancnnnononanennnnss 38 Assigning RUES ar iia 39 Setup Activities After Data Conversion ooncccccccnonconncccnoncnnnonnnannnnnnononnnnnononnnrnnnononanrnnnnnonanennnos 40 SENA Program OPIO Srs 41 O tapmceleenaaned E NR 42 Medis
194. nnnnnns 207 GREATING State Me iii iia eisii 207 E CITING Statements samaritano iii 208 Sendina Statements sais en 209 Gil er nn ec etl ade aa linr A 210 Teutona Practice Depositada A ommend oia 211 Creating a New Deposit a ees 211 Tutorial Practice 8 Collection S td ieliaiada 214 Creating Collection List ltems ococconcnnccnnccnconcnnnnononnnnnonononncnnnnononnnnnonononnnnnononannnnnononanenns 214 Adding a Colection List MOM it cn 215 Patent Payment Plasma aO 215 Collecion Lener S raei a R A cti online 215 Witing Ol SMaAlleDalaNCeS nia A A 216 Tutonal Practice 9 Office OU Sun Vai 216 Entering TACSOURCES 1 a da bid 216 Entering Appointments ccccoocnnccnoccnnnnnncnncnnncnnnononennnnnncnnnnnnnnnnonnnrnnnnnnrnnnnnnnnnrnnnnrnrrnnnrnnennarininnas 217 Repeating APDOINUMGINS siii is 218 Jo abe a a om wbantuseie ont asain 218 CreatinGguRGasoin CodeS o ed do ca cet heat dae ae 218 67 F511 ale fig Template ld lila 219 Ao An Baa etal cee a 219 USAN Walls ad 219 Tutorial Practice 10 Modifying the CMS 1500 FotMoooccccconocccnncnnnnnccnncnnnnccnnnnnnnnncancnonanncnnnnnnnos 220 Repositioning the CMS 1500 fOrM cooooccnncccconcconccononoconnnononnnonnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnonananannnss 220 How To Revise an Existing Report msssisriraaad 221 HOw To Create a New REDON eisicnaicachisacstedcwatnediic tester a R a a E 222 NETE Cas PE ESE A A E E 223 Preface Preface Where to Find Help Online Help No matter where you
195. nnonnncnnnonnnnnrnnnnnnannrnnnnnnnns 179 Adding Details to the Practice Record ccccccconncnnccccnnccnnccccnononnnnnnncnnnnnnnonnnnnononancnnnnnnnnncnnnnss 179 Setting Up a New Insurance Carrier Record oooocccccccccccconccononcconcnononononononancnnnononannnnnnnnnanenns 182 Setting Up a NEW Provider Record sti a 184 Setting Up a Referring Provider Recorders TT N 187 Creating a New Address RecorO ooccccccccocccnnccccconcnnccononncononononnnononononnnnnnnonannnnnononannnnnenonanens 189 Creating and Editing Procedure Codes ccccccccssessecceceeeseeeeecaeeeceeessaaeeeeessaaseeeseesaaeeeess 190 Creating a MultiLink CONE rreren nanti anaa aaaea a aoaaa aaa Ea ae gaia 192 Creating a New Diagnosis COG sasssa a E 193 Tutorial Practice 3 Patient and Case RecoradS oooooocccccccccconnonaninnnccnnonnnnnnnnennnnnonnnnnnnnennnncnnnnns 193 viii setting Up a New Patient Recodo 193 Opening NCW CS eae assassin cronica coociada 195 TUtoral Practico 4 Transactions iat Bich alc ba tare A ie Rial ntact 201 TAPAS ACTION ENUY a A A ia 201 Transaction Documentation rra A A 203 Tutorial Practice 5 ClalMS ococcoconnnnccnoncnnononnnnononnnnonnnnnnnononcnnonnnnnnnnnncnnnnnnrnnnnnnnrnnnnnnrnrennnrinnnnas 204 creating Clan S secos tres 204 Edn OIM S mena a a R AR 204 SENAN Clas a a T lo E NE asa 205 Changing Claims a a N 206 Tutorial Practice 6 StateMentS cccccconnncnncccnonccnncnononnnnnononancnnnononancnnnnnnnnncnnnnnnnnnrnnnnrnnnncnn
196. ns which affect fields and program operations in different parts of the program Go to the File menu and select Program Options The Program Options window opens Program Options Data Entry Payment Application l Aging Reports HIPAA Color Coding Billing l Audit l BillFlash _ Remind to Backup on Program Exit Max utomatic Backup Count 3 Backup Program MBACKUP EXE Command Line Show Windows on Startup Show Hints _ Patient List Show Shortcuts _ Transaction Entry Enforce Accept Assignment Print Report Title Page _ Enable Electronic Prescribing Data Version Number 28 C Use Server Time Hide Inactive Closed Items Menu T oolbar Options _ Use Guarantor Ledger for Quick Ledger _ Hide Icons in Menus Calculate Patient and Statement Remainder Balance Account Alert Setting O when Medisoft first opens O when Medisoft closes None of the above Patient Remainder Balances may also be recalculated All of the above through File Maintenance TIP During initial setup for most users the default settings on the various tabs on the window are sufficient for initial use You can customize these settings at a later date 41 Setting up the Practice Each tab features settings for different functional elements in the application For more information on the available options and settings see General Tab Data Entry Tab Payment Application Tab Aging Reports Tab HIPAA Tab Color Coding Tab
197. nsurance Responsible Party Assign To Follow Up Date Date Resolved F1 Look up Collection List TIP Use the F7 keyboard shortcut on the Collection List to launch the Quick Ledger Select a line item on the Collection List grid and press F7 to display the patient s record in the Quick Ledger Add Collection List Items The option to add collection items through reports is no longer an option However you can add collection items with the new Add Items option in the Collection List This feature lets you create tickler items based on criteria you enter in the Add Collection List Items window 131 Managing Collections and Small Balance Write Ofts lt Add Collection List Items Add items based on O Statements 2 Claims E Add Items Carriers d amp a Cancel All Primary Secondary Tertiary a Help Clair Status 2 All Rejected Challenge Range of Detaults Insurances w j to ga l Initial Billing Thetis Biling Date Add item if submission count i greater than Enter Humber Add tem if patient remainder balance 12 greater than Enter Amount Add Delinquent Payments Missed Payments for Patient Payment Plarr 2 Assign To ke 2 Add Billing Comment to Office Notes F1 Look up Add Collection List Items Patient Payment Plans To help patients make consist
198. nsurance carrier select the Insurance Carrier button and click the magnifying glass to select the insurance carrier To apply the rule to a specific insurance class select the Insurance Class button and click the magnifying glass to select the insurance category 4 Select either Entity Type Person or Entity Type Non Person Select the Person button if the referring provider is a person and not an organization Select the Non Person button if the referring provider is an organization 5 Select either None or National Provider ID Select the None buiton to not include a referring provider s NPI with the rule Select the National Provider ID button and enter an NPI number to associate that NPI number with the rule 6 Select either None or Taxonomy Select the None button to not include a taxonomy number with the rule Select the Taxonomy button and enter a taxonomy number to associate that taxonomy number with the rule 7 If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s For each entry select either None or Legacy Identifier Select the None button to not associate a legacy number with the rule To associate a legacy number with the rule for instance a Medicare Provider Number 74 Setting up the Practice select the Legacy Identifier button enter
199. nt Aetna Write Off Withhold MCH w E Medicaid withhold Deductible Deductible Take Back Insurance Takeback Payment 9 Open the EDI Eligibility tab Since this tutorial is not dealing with electronic claims you can skip most of the settings on this tab In the Type box select HMO 183 Tutorial Activities Insurance Carrier Best Choice Address Options and Codes EDIE ligitulity Allowed i Primary Receiver Secondary Receiver EDI Receiver EDI Receiver Claims Payer ID MA ce Claims Paper ID MA A Eligibility PayerID EQ Eligibility Payer ID A National Plan ID PO National Plan ID PO Carer ED Settings Type e Complementary Crossover Alternate Carrier ID fe C Delay Secondary Billing NEC Record Code C Send Ordering Provider in Loop 2420E EDI Mas Transactions F Send Practice Taxonomy in Loop 20004 Set Default EDI Extra 1 Medigap EDI Extra 2 9 Click Save Setting up a New Provider Record Dr Kris Lee has just joined the practice You will need to set up Dr Lee s record including creating a general rule for Dr Lee and also associating a specific insurance carrier with Dr Lee s record 1 Click the Lists select Provider and select Providers Click New 2 On the Address tab skip the Code field Enter the following information Name Kris Lee Credentials MD Address 77 Guadalupe Road Gilbert AZ 85234 Office number 123 443 2584 There are no additional numbers
200. nt BillFlash to use when the statements are printed Print Optional Sections Select the checkboxes for Summary and Aging if you want that information to appear at the end of the statement Statement Messages Enter up to six statement messages Entering a message in the Top field will place the text at the top of the statement Other messages will be placed in the Messages section just above the line item detail for the statement If you leave fields 1 5 empty the Messages section will not appear at all on the statement F1 Look up Program Options BillFlash Tab Performing File Maintenance File Maintenance The program puts you in the driver s seat by giving you the ability to rebuild indexes pack data recalculate patient balances and purge data The tools to perform each procedure are contained within separate tabs TIP Each of these file management functions carries the warning that it can take a long time to process Keep that in mind when planning your file maintenance activities Rebuild Indexes 170 Performing File Maintenance The Rebuild Indexes tab provides options to rebuild data indexes and lists the files available for rebuilding Clicking All Files includes them all File Maintenance income ocononoccopdecocacncondeca scada aaaeeeaa re Purge Data ebuild Indexes ES Recalculate Balances Pack Data Start The list below represents the data files used by this program Place a check mark by each fi
201. nt Report shows all patients who have co payment transactions It shows the amount of the required co payment how much was applied and what was left unapplied Ifa patient does not have any co payment transactions he or she is not included in the report F1 Look up Co Payment Report Outstanding Co Payment Report Advanced and above 155 Running Reports This report shows all patients who have outstanding co payment transactions The report shows the Co payment amount expected the actual amount paid and the amount due If a patient has no outstanding co payment transactions he or she is not included in the report F1 Look up Outstanding Co Payment Report Appointment Eligibility Analysis Detail Report This report shows patients with appointments whose eligibility has been checked based on criteria entered It includes detail about the patients their appointment date and time the provider name and reason code It is an ARRA report designed for showing that the practice is verifying eligibility electronically F1 Look up Appointment Eligibility Analysis Detail Report Appointment Eligibility Analysis Summary Report This report shows a summary of appointments whose eligibility has been checked based on criteria entered It is an ARRA report designed for showing that the practice is verifying eligibility electronically F1 Look up Appointment Eligibility Analysis Summary Report Electronic Claims Analysis Detail Report Th
202. nt a Eligibility Face Sheet Set Default Employment Emploper REAO w 2 Really Useful Trucking Ca Status Full time wyt Retirement Date e Work Phone 602 457 3326 Location E stension Patient Information Mame Again Dwight Home Phone 434 5777 Address 1742 N Bard Ave work Phone Phoenix 47 Cell Phone colle Date of Birth 34301 932 F1 Look up Case Personal Tab The Account tab displays the provider referral and attorney information set up in the Address file It also covers billing and price codes and information on visit authorization including the number of visits 91 Setting up the Practice lt Case AGADWOOO Again Dwight Broken Hand Miscellaneous Medicaid and Tricare Comment EDI Custom One Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition Assigned Provider REL vw 6l Robert E Lee M D Referring Provider PIEOO Ww Hawkeye Pierce M D Supervising Provider v E Referal Source w Attore ka Facility DESOD w 2 Desert Valley Hospital Eligibility Face Sheet Set Default Case Billing Code M w Medicare Patient Price Code A Other Arrangements Nef Treatment Authorized Through Visit
203. o the Lists menu and select Insurance Select Classes from the drop down menu The Insurance Class List window appears 53 Setting up the Practice Insurance Class List Class Name Description a INSA Blues Description of Insurance Class 4 INS E Medicare Description of Insurance Class E To create a new insurance class click New or press F8 To edit a class click Edit or press F9 Enter an ID Name and Description for the class Insurance classes are assigned in the Insurance Carrier Entry window Options tab Insurance Class Blues Description Description of Insurance e Help Inactive F1 Look up Insurance Class Entry Insurance Carriers 1 Click Lists click Insurance and select Carriers The Insurance Carrier List window opens 54 Setting up the Practice Insurance Carrier List Code Name Type Street Other 112 Aetna Way BLUOO Blue Cross Blue Shield 231 Blue Cross Shield oo Ww Bell Ad ELUQI Blue Cross Blue Shield 225 Blue Cross Shield oo Ye Bell Ad CIGOO Cigna HMO 2525 Big Bucks Ln FHPUQ FHF Health Flan Other 4576 E Ww Power Ad MEDOO Medicaid Medicaid 9675 Wi Thunderbird MECO Medicare Medicare 1111 Hohokam Cir WOROO Workers Compensation Worker s Comp ff WwW Bethany Home Ad 2 Click New OR Select an entry on the Insurance Carrier List grid and click Edit The Insurance Carrier wi
204. ode and then enter Who Paid a Description and the Amount If the payment is being made by check the check number can be entered in the Description field Apply Payments or Adjustments to Charges WARNING We recommend that you apply all payments and adjustments to charges Failure to do so results in other parts of the program not functioning properly i e 103 Entering Transactions remainder billing and the delay secondary billing feature Advanced and above to name only two In addition some report results will be incomplete or inaccurate You can distribute a payment or an adjustment to a specific charge or charges by clicking Apply The Apply Payment to Charges or Apply Adjustment to Charges window opens depending on whether you are applying a charge or an adjustment and lets you direct that payment or adjustment to the proper charge or charges Besides displaying the source of the payment or adjustment and the patient s name the Apply Payment to Charges or Apply Adjustment to Charges window also displays the number of charges in this case The upper right corner displays the unapplied amount entered in the payment Once the entry is complete and verified click Close to return to Transaction Entry You can then click Print Receipt which gives the patient a Walkout Receipt before leaving the office click Print Claim which prepares entries that have not yet been submitted on an insurance claim and sends them to print o
205. olt Standald SEC Uys sca tecnico eee win E ase eee 42 Login Password Management aii 43 Seta Pr IS a e ri 44 SAA A o e 44 Entering Practice Into A A AO 46 SU e a dao add 46 Billing Service or Different Pay To Address cccccccocccnncccconcconccononccnnnnononcnononnnnancnnnnnnnnnenncnnnnas 47 BETAS IWS A tienes sesaasdvee ie ose Stanmeeuts E EEE 47 Practice LV DC rt pana 47 Enternng Praciico IMOLMMANO Nissan tacita 47 Entering a Practice IDS Gra ENUY es ll ii 48 Entering Practice Information for a Billing Service oooccccccoconncnnccononcnnnononanenonononancnnncnnnanenns 51 A A at teh Le 51 Billing Service or Different Pay To Address cocccooccccccccconccnncncnonccnnnnononnnnncnnnnanonnnnonannnancnnnnns 51 Bill IASI USES a ate al eae oec eid aon tesa wh amen a lat ean a eal 51 EDIheceiWer Records coon Oi soe sete cee iio 52 Setting up Insurance Carriers and Insurance Classes ccoooccnccccccnncoconnnnoconcnnnnonnnnnonanennnnoncnnnnnas 53 Meurance Classes cansar aa 53 NSUTANCS CAMS y a a de cani cid 54 FAcIIityinto mat A AA 59 S t p SENASA a 59 Entering ContactIntorMa lO econo llorando 60 Entering Information on the Facility IDS grid oooccccconncncoconnnnononcnnnnoncnnconanonconancnnononons 61 Setting up Providers and Provider Classes oooccccccccooncnncccconnnnncnonancnnnononancnnnnnnnancnnnnnnnanennnnnnnns 63 Provider Glass Records a ee ae 63 SEP SCCMANOS a eae en ees 64 Entering Provider INTORM A
206. om an insurance carrier open the Deposit List window create the total amount deposit and then apply the payment to the cases as specified in the EOB EOB Payments Part of the payment structure to a healthcare office from an insurance carrier involves a check and an Explanation of Benefits Widely known throughout the industry as the EOB it lists claims for which payment is being made and in some cases an explanation of what is not being paid and why Not every insurance claim that is filed with a carrier is paid in full lt may be that payment is 80 percent of the claim or it may be 50 percent Other times a claim may be totally or partially disallowed The EOB explains in these cases Normally the part that is not paid by the carrier is picked up by a secondary carrier or charged back to the patient When an EOB is received a transaction must be entered to offset the charges This is done by creating a deposit in the Deposit List window If the EOB check covers several charges distributing a payment to specific charges can be handled by clicking Apply The window lets you select the patient records and claims to be paid and designate how much goes to each F1 Look up EOB Payments Managed Care Capitation Payments Managed Care One of the important sources of patients and income in many practices has begun to be managed care organizations In each instance the HMO or PPO provides a list of patients who have selected your practice
207. om setting up the chart numbers to entering percentage amounts for insurance claims the effect of data entry is far reaching It is especially important to set up the guarantor when doing insurance billing F1 Look up Patient Guarantor Entry Setting Up the Chart Number Every patient or guarantor must have a chart number and be set up in the database before transactions can be entered If using the program s default automatic settings each chart number consists of eight alphanumeric characters If you leave the Chart Number field blank the program automatically assigns a unique chart number If you want you can change the default settings and have the program automatically assign numeric chart numbers Go to Program Options open the Data Entry tab and click Use numeric chart numbers in the Patient section If you want to establish your own patient chart numbering system type a number or code as soon as you enter the new patient window There is no need for corresponding numbers within a family the number sequence has little bearing on grouping of patients Each patient is set up individually in the program and individual bills are prepared for each guarantor It is important to understand that once assigned the Chart Number cannot be changed To correct a wrong 86 Setting up the Practice chart number you d have to delete the entire patient record and create a new one with the proper chart number All other data in the patient rec
208. on Medisoft Advanced and above 126 Diagnosis Codes 81 E EDI Receiver Records 51 Editing Claims 113 Editing Statements 120 Electronic Claims Processing 135 Eligibility Verification 135 Entering a Charge in Transaction Entry 102 Entering a Payment or Adjustment in Transaction Entry 102 Entering Appointments 216 Entering Breaks 143 Entering Resources 215 EOB Payments 128 Exporting a Report 152 Facility Information 58 File Maintenance 169 General Tab 160 Getting Started 15 Group Setup 175 Guarantor Quick Balance List Network Professional only 158 H HIPAA Tab 164 How To Create a New Report 221 How To Revise an Existing Report 220 I Initial Program Setup 174 K Keystrokes and Shortcuts 29 L Listing Claims 115 Listing Statements 122 Load Saved Reports 159 Index Login Password Management 177 M Managed Care 128 Moving an Appointment 144 MultiLink Codes 80 Multiple Booking Columns 145 N Navigating in Medisoft 15 O Office Hours Overview 138 Office Hours Setup 138 Opening a New Case 194 Opening a Practice 33 P Patient Ledger 157 Patient Payment Plans 131 Patient Recall Office Hours Professional Integrated 145 Patient Remainder Statements Advanced and above 125 Patient Treatment Plans Network Professional only 105 Payment Application Tab Advanced and above 163 Permissions 176 Practice Information 45 Pract
209. on select a record on the Facility List grid and click Edit 3 Click the Address tab 60 Setting up the Practice Facility new Seji Address Facility De soe Type 8 Facility Laboratory a ee Name hn Extension Street PO Far Set Default IN Cell Phone MI City State Po Office po Zip Code Contact fC Estat 0 Eaz O Ma Purchased Services 4 Enter contact data associated with the facility including a name address telephone number etc If the facility is a lab select the Laboratory button if the facility is not select Facility 5 Click Save if finished or go to the next section for information on entering data on the Facility IDs tab Entering Information on the Facility IDs grid Use the Facility IDs tab and Facility IDs grid to enter or edit key data elements associated with a facility NPI number taxonomy number CLIA number legacy numbers etc If your practice is associated with a facility or a lab you will set up at least one entry rule on the Facility IDs grid and associate this information to all or a specific insurance carrier or an insurance class For more information on entering data on the IDs grid see the topic Assigning Rules When creating or editing a facility IDs record you will first create modify a rule based a combination of all or of a specific insurance carrier or insurance class When proce
210. on Person However if the practice name is Dr John Smith you would choose Person NOTE Extra 1 and Extra 2 are optional fields that may be used if a carrier requires extra data on a claim They can hold up to 30 characters Entering a Practice IDs Grid Entry Use the Practice IDs tab and Practice IDs grid to enter or edit key data elements associated with your practice tax ID social security number NPI taxonomy legacy numbers etc You will set up at least one entry rule on the Practice IDs grid and associate this information to all providers insurance carriers or insurance categories and all facilities or a particular provider or carrier and an insurance category or any combination of these elements For more information on entering data on the IDs grid see the topic Assigning Rules This grid contains two elements The first displays all current entries rules The second element the New Edit Practice ID window is used to edit or create entries The grid displays insurance carrier insurance class facility NPI Taxonomy tax ID social security number and legacy data 48 Setting up the Practice TIP when creating or editing IDs grid entries do not create matching wild card entries all selected for insurance carrier and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case mod
211. onal maintenance For more information see F1 Look up Communications Manager Main Window F1 Look up Creating a New Connection 105 Entering Transactions Patient Treatment Plans NOTE This is a Network Professional only feature When a patient has a choice of options for the treatment he or she can receive a treatment plan can be prepared which sets out the different treatments offered and the cost of each plan F1 Look up Treatment Plan List Print Receipts Create Claims Once a transaction has been entered and saved the transaction can be displayed in the Transaction Entry window By sliding the scroll bar at the bottom of the window a full summary of the transaction is revealed You can now print a receipt for the patient file a claim or close the window F1 Look up Create Claims Billing Charges NOTE This is an Advanced and above feature This feature lets you apply billing charges to accounts that are past due Before you can use this feature you must set up at least one billing charge type of procedure code Do this through the Procedure Payment Adjustment List and Procedure Payment Adjustment new windows Fill in the Code 1 and Description fields Be sure to select Billing charge in the Code Type field Add whatever other information you want and save the code Create as many billing charge codes as you need If desired you can use billing codes which are used to categorize patient records and indicator cod
212. onfirmation box displays Click OK The wizard closes A new collection letter format has been created You will see it the next time you create collection letters It is called WzCollections date For example if today s date were February 2 2010 and you customized the format today the format would be called WzCollections120304 NOTE If you create multiple customized versions of the collection letter format you might want to keep a list somewhere noting the date and a note concerning what was customized Writing off Small Balances 1 2 3 4 5 6 7 8 9 1 Go to the Activities menu and select Small Balance Write off Leave the button set to All in the Patient Selection field Select CABADDEBT in the Write off Code field Enter 1 12 06 in the Cutoff Date field Enter 150 00 in the Maximum Amount field Click Apply Click OK on the Confirm window Select Selected Items in the Write off field Hold down CTRL and click the patient record for Sammy Catera and James Doogan Click Write off O Click Close Tutorial Practice 9 Office Hours Entering Resources 216 Tutorial Activities 1 Go to the Lists menu and select Resource List Click New 2 Leave the Code field blank In the Description field enter Treadmill Click Save Click Close Repeat Change Frequency None Every Month s Repeat by Daily Day Date CO Weekly Monthly The 1t Monday of every O Yearly month
213. onic _ Sent Failed Type A Remainder 4 Challenge Initial Biling Date 4 Done Batch 0 Submission Count 0 Biling D ate 44 e Deposit List e Apply Payments e Transaction Entry note that Calculate Totals has been moved Transaction Entry Chart TESO0000 Ww Test Aetna Patient Charges a mi l y Co pay Overdue 0 00 Adjustments z Case ve Fi O30 31 60 61 90 91 Subtotal il Last Payment Amount 0 00 Total 0 00 Balance mi a see Policy Copay 0 00 OA ERE a al igit o Tele 7 Charges Global Coverage Until A a ad Case Number Entre Number PP Claim Number Date Fr Date To Document Number Description Attending Provider F 4 O hy gt New A MultiLink Payments Adjustments And Comments Date Pay Ad Code Who Paid Description Check Number Amount i x v 0 00 amp Apply eo New Delete Note IM LL E Update All 28 Quick Receipt I Print Receipt ey Print Claim is View eStatements a Close C Save Transactions HIPAA X12 Version 5010 The following are changes made to Medisoft 17 to accommodate the upcoming change from the Health Insurance Portability and Accountability Act HIPAA Accredited Standards Committee Getting Started with Medisoft ASC X12 version 4010A1 to ASC X12 version 5010 and National Council for Prescription Drug Programs NCPDP version 5 1 to NCPDP version D 0 5010 HIPAA X12 version 5010 and NCPDP version D 0 are new sets of standards that regulate t
214. onomy button and enter a taxonomy number to associate that taxonomy number with the rule 7 Select From Practice Tax Identifier or Social Security Number Select the From Practice button to pull the tax ID social security number from the Practice ID grid Select the Tax Identifier button and enter the tax ID number to associate with the rule select the Social Security Number button and enter the social security number to associate with the rule 8 If you file mammography claims select the Mammography Cert button and enter the certificate number to associate with the rule Select the None button to not associate a mammography certificate number with the rule 9 If you file laboratory claims using a CLIA number select the CLIA button and enter the CLIA number to associate with the rule Select the None button to not associate a CLIA number with the rule 10 If your carrier requires a care plan oversight number select the Care Plan Oversight button enter the care plan oversight number and select an ID qualifier to associate with the rule Select the None button to not associate a care plan oversight number with the rule 11 If needed enter up to three legacy and qualifiers to associate with the rule using the Legacy Identifier 1 2 and 3 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s For each entry select either None or Legacy Identifier Select the None button to no
215. ons on the Program Options window Data tab Once enabled you can print a blank Superbill by selecting the Blank Superbill command on the Reports menu and at a later date assign the blank superbill to a chart and case in the Transaction Entry For more information see F1 Printing Blank Superbills F1 Assigning a Blank Superbill to a Patient and a Case F1 Look up Printing the Superbill 151 Running Reports Running Reports Reports Overview Medisoft offers flexible reporting options You can run reports in Medisoft by selecting various reports from the Reports menu Or you can launch the Medisoft Reports engine for Medisoft Advanced and Medisoft Network Professional only and complete all reporting tasks in this window The Medisoft Report window offers several key features not available when running reports off the Reports menu including new reports and features to enhance productivity For more information on using the Medisoft Reports engine see the Medisoft Reports topic The Medisoft application also supports Medisoft Reports Professional a robust report authoring application F1 Look up Reports Overview F1 Medisoft Reports Professional F1 Look up Reports and Printing Reports Report Designer One of the most exciting features of Medisoft is the Report Designer adding flexibility in the creation of reports to best serve your practice or business needs Using the Report Designer and the existing set of reports you can g
216. ord can be modified F1 Look up Chart Number New Patient Setup Window Clicking New Patient or pressing F8 lets you set up a new patient record in the program lt Patient Guarantor Bordon John AE Payment Plan Custom Hame Address Other Information Chart Number BORJO000 Inactive Last Hame First Hame F ohn l Set Default Middle Marne Street 77r Hardaway Ln Copy amp ddress N City Scottsdale State 4 ip Code 85777 Country USA E Mail PO Home 1434 777 1234 Work PO Cell pO Fax MA Other pO Birth Date 1 20 1972 v Sex Birth Weight 0 Units Social Security 44 55 6666 Entity Type Enter all known or necessary information When entering an address the focus moves from the Street fields directly to the Zip Code field The program has a feature that saves city state and zip code information in a table Once you enter a zip code with its associated city and state the next time you enter the zip code the City and State fields are filled in automatically saving you time when entering new records In the Medisoft Advanced and Medisoft Network Professional programs you can establish default information applied to all new patient records Enter that information which is generally the same for all of your patients and then click Set Default To remove your new default settings hold down CTRL and the button name changes to Remove Default 87 Setting up the Pra
217. orm audits on these tables Medizoft Tables Office Hours T ables Update Delete Update Delete Update Delete Help Address Insurance Carriers Appointments Allowed Amount Multilink Reasons Billing Code Patient Guarantor Resources Case Patient Recall Superbills Contact Procedure Code wait Custom Case Data Providers 4 Referring Providers Custom Patient Data Transaction Deposit Treatment Plan Diagnosis Treatment Plan Procedure Electronic Receivers QA d d d E d d ARRA Audit F1 Look up Program Options Audit Tab and Audit Report Generator BillFlash Tab The BillFlash tab allows you to control some of the information that appears on the statements you send electronically via BillFlash the web based company that is set up to process electronic statements in Medisoft 169 Performing File Maintenance Program Options 3 4 Digit Sec Code For Billing Inquines Call 2001333 4747 Cal Credit Cards Accepted Select which credit cards your practice selects and they will appear on the printed statements in the top right hand corner of each statement Also enter a message for the credit card security code Service Message Enter up to three service messages These will appear on the statement just below the address of the practice Paper Color Select the color of the paper that you wa
218. ort Report Type Code Report Transmission Code i Attachment Control Mumber Patient Information Mame Smith John Home Phone 51 3 224 4668 Address 46 Center Street eA Ee work Phone 123 345 6789 E a Cell Phone 513 2241111 Date of Birth 1 12 1975 9 Open the Condition tab 10 In the Injury llliness LMP Date field enter January 15 2010 the Illness Indicator is Injury There have been no similar symptoms This was not related to an auto accident so select No in the Related To field In Nature Of select Injured during recreation No other fields are important for this case so leave them blank 198 Tutorial Activities F Case sMIJUU00 Smith Jr John Back pain Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition El Save Injurytlllness LMP Date 14 322070 Date Similar Symptoms Cancel ance Illness Indicator Injury w _ Same Similar Symptoms 7 Initial Treatment D ate w L Employment Related Help _ Emergency Last Fiay Date a Related To bal State E Mature OF Injured during Recreation e e miii From To Face Sheet Unable to Work Return To Work Indicator _Face Sheet Total Disability v Set Default Partial Disability Percent of Disability Hospitalization Last Worked Date w Pregnant Date Assumed Care Estimated Date of Birth
219. ours Overview Office Hours is an appointment scheduling program that helps keep track of appointments for your practice It is automatically installed with Medisoft If you purchased Office Hours Professional the features of this program are specifically marked as Office Hours Professional features in the documentation Office Hours Professional Medical Group Tutorial Data Column 1 Column 2 Column 3 Sun Mon Tue wed Thu Fri 8 004 Brimlery Elm 94 ef 28 29 30 31 1 8 153 Brimley E 3 4 5 6 7 585 9 3 30a Brimley PaF 1111112113 14 15 16 9 008 9 15a 9 30a E 9 45a 10 00a Catera 3925 10 15 10 303 Jones 1j l 11 00a Ei SO Lunch SO Lunch ooh 11 15a 11 50a 11 45 12 00p 12 15p 12 30p 12 45p 1 00p 1 15p Peters M2 1 30p Peters 2 ap 1 45p 2 00p Bordon ma 7 Starting Office Hours If you are working in Medisoft click the Appointment Book speed button or go to the Activities menu and select Appointment Book Accessing Office Hours from Other Programs You can access Office Hours at the same time as you are working in other Windows based programs Open Office Hours at the beginning of each day and then minimize it Press ALT TAB at the same time to activate Office Hours perform the desired scheduling tasks and then minimize it to return to your previous task Office Hours Setup Office Hours Setup 139 Scheduling Appointments There are several portions of the progra
220. own Code Type list 17 Setting up the Practice Procedure Payment Adjustment new General Amounts Allowed Amounts Code 1 _ Inactive Cj Save Descriptions Code Type Account Code Type of Service Place of Service Time To Do Procedure Service Classification Don t Bill To Insurance Only Bill To Insurance Default Moditiers Revenue Code Default Units National Drug Code MOC Unit Price NDC Unit of Measurement Code IO Qualifier Purchase Service Amount Taxable HIPAA Approved Require Co pay HCPCS Code Procedure charge 4 Help Patient Only Responsible Purchased Service HCPCS Rate Code Accounting Codes can be any configuration of letters or numbers you want to assign to each accounting function e g cash checks etc Procedure codes are used for recording charges for services rendered and Accounting Codes show the payment and adjustment side of the entry process These categories are broken down into codes for specific purposes Valid codes that have unique functions within the program are Adjustment Billing Charge Cash Co payment Cash Payment Check Co payment Check Payment Comment Deductible Inside Lab Charge Insurance Adjustment Insurance Payment Insurance Withhold Adjustment Outside Lab Charge Procedure Charge Credit Card Co payment Product Charge 78 Setting up the Practice Credit Card Payment Tax
221. ows In addition several Summary values appear on each report so that you can see at a glance the information you need to verify that you are meeting ARRA requirements Enhancement ARRA Audit Medisoft 17 includes a feature that allows you to track reporting and exporting for ARRA when you generate audit reports A new option on the Audit tab in Program Options allows you to turn this feature on or off It is turned on by default Certain reports or grids that are printed or saved to disk will be audited Note Previewed reports will not be audited The following types of information are included as part of the ARRA Audit e Data grids e Custom reports including claims and statements When printed from either Transaction Entry or Statement Management but not the Report menu or Report Designer e Medisoft reports e Office Hours data e Final Draft reports or data printed or saved to disk e Internal reports e Statements e Eligibility information BillFlash Medisoft Advanced and Network Professional programs only Statements sent to patients electronically through Medisoft will now use BillFlash You can enroll within Medisoft now as well as upload your statement files directly from Medisoft automatically You can view and approve the uploads at BillFlash by clicking links from within Getting Started with Medisoft Medisoft and BillFlash will print and mail your statements to your patients For more information on BillFlas
222. ows as zero and the patient s balance shows as a write off in the Adjustment field in the Transaction Entry window F1 Look up EOB Payments Managed Care Capitation Payments 129 Managing Collections and Small Balance Write Ofts Managing Collections and Small Balance Write Offs Collection List The collection list is a central place where you can manage accounts that are in collections Ticklers or collection reminders are displayed as collection list items Go to the Activities menu and select Collection List NOTE Security must be activated before this feature can be used Collection List Ea lx Date 1 29 2010 we lto 1 29 2010 C Show Al Tickers Search Sort By Date Created ListOmlp C Show Deleted Only Exclude Deleted Responsible T Patient Acti Statement Remainder Insurance Claim Claim Stat Fallow L as Party false ec peal Humber Balance E stimate Number Total as Date Add Items What appears in the collection list depends on the user login The program displays the collection list item for the current user unless the user has administrative access Administrators can choose to view all or selected users collection list items To enter items in the collection list click New while in the collection list Fill in the necessary information 130 Managing Collections and Small Balance Write Ofts Tickler Item new Tickler Office Notes Responsible Party Type gt Patient I
223. portion estimate of any procedure in the Transaction Entry window The existing allowed amount can be changed in the Transaction Entry window by clicking the Allowed Amt column and entering the corrected amount 27 Click Save Facility Information Setup Scenarios 99 Setting up the Practice If you have a facility or a lab attached affiliated with your practice you will need to create a record for it There are two components to the record contact demographic data entered on the Address tab and billing specific information entered on the Facility IDs tab If you have enumerated a separate NPI number for your facility and need to send facility billing information in Loop 2420D or pull data for box 32 of the CMS 1500 form you can specify the type of facility and qualifier 77 service location FA Facility Ll Independent Lab TL Testing Laboratory etc along with including a separate facility NPI number and if this information is sent on the claim by selecting the Send Facility on Claim check box Entering Contact Information 1 Click Lists and select Facilities The Facility List window opens lt Facility List Type Extension MIDESOO Desert Valley Hospital 602 969 5432 Facility J Duckworth Mallard and 602 969 4237 Facility Mesa Community Hospital 60 967 87392 Facility New Age Medical Laborato 60 14 73 2241 Laboratory Desert Diamond Labs 60213331111 Laboratory 2 Click New OR Opti
224. ppointment must be at least 75 minutes long to display five rows of information F1 Look up Program Options 148 Scheduling Appointments Views NOTE This is an Office Hours Professional feature One of the most important features of the Office Hours Professional program is the variety of ways you can display appointments breaks in the appointment grid At the bottom of the main Office Hours window in the Status bar there are four View boxes with different configurations of dot patterns These give quick access to the same functions available through the View menu These correspond to Single Provider View Week View Month View or any combination Multi View Day View The Day View shows a single provider s appointments for a selected day If multiple columns are set up all columns are displayed To display another provider s schedule make a new selection in the provider box in the toolbar This view does not show columns for resources but columns can be added or removed as necessary in this view Week View The Week View also shows only one provider s schedule but with one column for each day of the week If you have multiple appointments scheduled the time slot shows the color for scheduling conflicts You can size the columns to see all the appointments breaks scheduled by placing the cursor on the right column heading boundary line until it takes the shape of a double sided arrow and then drag the boundary line right or lef
225. ppointments F1 Look up Case Entry Setting up Resource Records The Resource List is a tool to help you manage the scheduling of rooms and equipment in the office To create the list click Lists and select Resource List In the Resource List window click New or press F8 Create a code for the resource or let the program create one based on the description Enter a description e g Room 1 Treadmill etc and click Save Repeat this process until all rooms and or equipment are contained in the list F1 Look up Resource Entry Setting an Appointment Setting an Appointment To set an appointment in Office Hours first select the provider from the provider box at the top right of the toolbar In any Multi View Office Hours Professional select the provider by clicking in the appropriate provider s column Select a date for the appointment You can use the Day Week Month and Year selection arrows below the calendar to locate the correct date or use the Go to Date feature available from the Edit menu Next in the appointment grid double click a time slot which is highlighted with a heavy line border You can also right click the time slot and select New Appointments or press F8 or go to the Lists menu and select Appointment List and then click New to open the New Appointment Entry window 141 Scheduling Appointments New Appointment Entry Resource Mote Caze Reason w Length 115 e minutes Date 1 2 20
226. pts o Account disable period o minutes Reset to Defaults F1 Look up Login Password Management Setting Permissions Permissions NOTE This is an Advanced and above feature The Permissions feature provides five levels of access to the program The Security Supervisor who has unlimited access and full control of security can assign or remove rights for any level of security with one exception Level 1 access cannot be removed from any of the three options listed in the Security window settings for the Supervisor Lower level access can be added but the Supervisor must retain rights to these options Go to the File menu and select Permissions to open the Medisoft Security Permissions window or select Report Permissions to open the Medisoft Reports Permission window which is used is to set permissions for most reports available in Medisoft and in the Medisoft Reports engine Permissions for most statements and other reports using the MRE extention however are set in the Medisoft Security Permissions window NOTE These options do not appear on the File menu until the security has been applied to practice with users created in the Security Setup window 44 Setting up the Practice Medisoft Security Permissions Window Process Level 1 Level 2 Level 3 Level 4 Level 5 bl Activities gt Quick Ledger F F Addresses Quick Balance F F Appointment Breaks Biling Charges F F Appointments Biling Codes Claim Manag
227. r eligibility requests NOTE Some carriers require Group NPI numbers instead of Individual NPI numbers for individual practitioners If one of your carriers requires a Group NPI number you will need to set up a separate entry on the Provider IDs grid for handling this type of dual NPI environment For more information F1 Setting up Mixed NPI Numbers for Eligibility Patients Fields in the Patient Guarantor window must be populated for each patient On the Name Address tab enter information in the following fields Last Name First Name Date of Birth Gender and Social Security Number On the Other Information tab enter information in the Assigned Provider field Cases Fields in the Case window must be populated for each patient On the Policy 1 Policy 2 and Policy 3 tabs enter information in the following fields Insurance Policy Holder Relationship to Insured and Policy Number On the Account tab enter information in the Assigned Provider field F1 Look up Patient Guarantor Entry and Look up Case Entry Eligibility Verification Results There are multiple places in the program from which you can make eligibility verification requests the Eligibility Verification Results window the Patient List window Office Hours and the Task Scheduler window The type of eligibility inquiry you make either real time or scheduled depends on the window from which you are making the request 137 Using Electronic Services Eligibi
228. r click Close to exit the window F1 Look up Apply Payment to Charges or Apply Adjustment to Charges Unprocessed Transactions The Unprocessed Charges window provides an interface between an Electronic Medical Records EMR service and Medisoft via Communications Manager This window provides controls to edit and post financial transactions imported from an EMR service to Medisoft Transactions imported into Medisoft from an EMR service through Communications Manager are held as Unprocessed Charges until they can be processed by a Medisoft user From the Activities menu select Unprocessed Transaction and then select Unprocessed EMR Charges The Unprocessed Charges window appears with a list of transactions that have yet to be posted The columns in the list correspond to information from the EMR application Columns such as billing providers diagnosis codes and procedure codes should be reflected in the same manner as found in your practice management software 104 Entering Transactions SES Post Transaction Status Chart Mumber Provider Date From 696c996c837d4001897e520e5fa0721b PALTIOOU 1 JM 2492007 8 47 00 AM a0017adebe264Ebcbed67c1305705621 _ JACTHOOO 1 JM 229 2007 8 56 00 AM 432297019 cc4c dae7602f8fd521786 _ 4640000 1 JM afd 2007 8 50 00 AM 440abDGfea25dfdeabes456d1c2d7tBa PETMO000 18 JM 343942007 8 59 00 AM de7eddEbea25dabb9Se5fbzeci3ebdae BRIJAQ0OQ 3 JM 229 2007 9 01 00 AM 5c16898729d409b8c2bb2a82e7
229. r whatever reason Open the Transactions tab 4 This tab shows that both transactions are included in the selected claim To split the claim highlight the second transaction procedure code 82954 and click Split Click Yes to split the claim The second transaction is removed from the claim 204 Tutorial Activities Claim 11 Claim 11 Claim Created 2 1 2010 Chak SMIJDOOO John Smith Case 20 Carrier Carrier 2 Caries 3 Transactions Comment Diagnosis 1 242 Date From Document Procedure Amount Ins 1 Resp Ing Resp A A120170 1002070000 99214 65 00 27122010 1002010000 g2954 10 00 Confirm a Are you sure you want to move this transaction to a new claim HEr s H Eem SS 5 Click Save When Claim Management is reopened a second claim has been created and displays below the original claim Claim Management Search Sot By Chat Number v Eeee Claim Mumber Chart Num Carter Status 1 Medial Batch BilDate1 ED Receiver Camere Status 2 T AGADWOOO MEDOT Sent Paper T 12 6 2002 3 BRIJ4000 ciang Sent Paper 43 25 2002 BLU Sent 4 BRISUODO CIGOO Done Paper p 12 5 2002 BLUOO Sent 1 SIMTAGOO ETOO Sent Paper 1 12 3 2002 LI Sm tiismuooo0 A1000 Ready ToSendPaper ol E AE gt st2 smuoooo at000 Ready To SendPaper ol E 5 WAGJEODO BLUOO Sent EDI 06 1 2002 NATOD E YODMIODO USODO Ready To Senc Paper O Jim Edit 20 Create Cl
230. ransactions Claim Management E E Statement Management BillFlash b Enter Deposits Payments n E 3 Unprocessed EMR Charges iw Patient Ledger F7 Za4 Guarantor Ledger A Quick Balance Fil Patient Quick Entry ae Billing Charges Small Balance Write off Collection List Add Collection List Item Launch Work Administrator Final Draft Add New Task Yn E om Q ei Fa Y re gt 1 Appointment Book SE 3 de Office Messenger F12 Eligibility Verification Revenue Management r Lists Menu This menu provides access to the various list windows available in the program 20 Getting Started with Medisoft Patients Guarantors and Cases Patient Recall Patient Treatment Plans A Patient Entry Template Procedure Payment Adjustment Codes al MultiLink Codes o S 7 pe Diagnosis Codes Addresses a r ET EDI Receivers Referring Providers Es i Facilities Provider Billing Codes S Contact List Condition Codes wy Claim Rejection Messages Patient Payment Plan eS Reports Menu Reports within Medisoft are accessible through the Reports menu You can also access the Custom Report List and the Report Designer through this menu 21 Getting Started with Medisoft window Analysis Reports Procede Day Sheet Aging Reports Payment Day Sheet Collection Reports l Audit Reports Patient Ledger Standard Patient Lists Patient
231. re removed from the transmission file will be written back to Medisoft and the status in Medisoft changed to Alert Denial information will be written to the History tab in Revenue Management and the Comments tab on the Claim window in Medisoft e Remove the OK button displayed after clicking Send from the Claim file saved message Remove the Transmission has been received buiton that displayed after the file was sent received Revenue Management 5010 ERA Changes Changes have been made to Revenue Management processing to handle the upcoming switch to 5010 ANSI Among these are the following e Updates to the 5010 RelayHealth IG These updates include e For the 835 IG the TRNO2 element has increased size to a maximum of 50 characters e The N407 element Country Subdivision Code in Loop 1000A AND Loop 1000B has been added to the 835 IG It is situational and has a maximum length of 3 characters It is required when the address is not in the United States of America including its territories or Canada and the country in N404 has administrative subdivisions such as but not limited to states provinces cantons etc e Several new elements for Loop 1000A Payer Identification in the 835 IG that are not active yet but must be added In this way if they are received the ERA will not be discarded These are the following Payer Technical Contact Information Payer Technical Contact Name Communication Qualifier 10 Get
232. rent day s activity reports TIP To save time and increase work efficiency you can close a case after applying payment by right clicking the line item in the grid and then selecting Close Case At a later date in File Maintenance closed cases can be deleted from the database Select an entry on the grid and click the Detail button to pull up an information only window that displays all the activity the selected deposit You cannot make changes in this window If needed you can print item details 127 Applying Deposits Deposit Detail Deposit Date 12 22 2003 Deposit Amount 200 00 Hide Charges SS lt _ lt Charge Reference Entry Number Chart Humber Fatient Name Prod Chrg Code Prod Chrg Amount d 0 83 BRIJAOOO Brimley Jay Print Grid F1 Look up Print an Entry from the Deposit List When you highlight a payment and click Apply the Apply Payment Adjustments to Charges window is opened z Apply Payment Adjustments to Charges Aetna Ins 1 Medicare ME DDT List Only Unapplied Amount 15 00 r Ins 2 Aetna AE T00 For Again Dwight i For AGADWDDO w Ing 3 View So Far Show Unpaid Only Payment Procedure Codes AP w 2 DEDUC w APWH vw 2 4PwWRO v 2 Take v 9 2 Date Procedure Charge Remainder Payment Deductible withhold Allowed Adjustment Take Back Complete Rejection Provider 1142122002 395213 60 00 12 00 11721 22002 22052 20 00 17 00
233. resh s seconds Show Motes on Mew Appointment Use Automatic 1p Codes Hide Icons in Menus The following images are from Office Hours Professional Program Options Options Pei alt Views Appointment Display Start Time 2 00 am Lilien ee os Appointment E Silver End Time 5 00 pm Conflict HB Red Interval 115 ba minutes s I Break Gray Use Pictures Use Enter to Move Between Fields Break Remind to Save View Repeat Use Automatic Word Capitalization Note Automatic Refresh ia seconds G tatus Show Notes on Mew Appointments Use Automatic ip Codes Use Transaction Entry to Make Copays _ Hide Icons in Menus Speed Report Quick Appointment List 147 Scheduling Appointments Program Options Options Multiviews Appointment Display Program Options Options Multi Views Appointment Display Information to be displayed in the appointment grid Ma Row 2 v Row 3 v Rom d Aow Er v Appointment Display NOTE This is an Office Hours Professional feature In the Appointment Display tab of Program Options click File and select Program Options you can specify up to five rows of information to display in the grid for an appointment Be aware that the length of the appointment determines how much data is actually displayed on the grid An a
234. rial in the various topics in the Getting Started section of the help file If you are a solo provider you can use two different methods to set up your practice For instance you can enter key elements such as NPI taxonomy and tax ID social security number on the Practice level or in the Practice IDs grid Then you would need to create at least 46 Setting up the Practice one record can create more if you have different requirements from various insurance carriers on the Provider IDs grid in which you select the From Practice button for these data elements Selecting From Practice will pull these values for claims from the Practice IDs grid Or when setting up your practice assuming you do not need to send taxonomy in Loop 20004 you could on the Practice IDs grid select None for NPI taxonomy tax ID social security number and enter a minimal amount of information of Practice IDs grid still need at least one record You would then create at least one record on the Provider IDs grid in which you specify your NPI taxonomy and tax ID social security number If you are a group practice then you will complete at least one grid entry on the Practice IDs grid for the practice You will also create at least one grid entry on the Provider IDs grid for each provider If you have a provider that in some instances bills using his ner own NPI number for a specific insurance carrier you can create an extra grid entry for this provider in whi
235. rid entries For instance if you had an entry in the PINS tab in Medisoft 15 for a Medicare provider number and then at a later date selected the NPI only check box on the Insurance Carrier window for this insurance carrier this legacy number will be converted in Medisoft 17 Before filing a claim with this carrier you would need to remove this from the grid entry in Medisoft 17 In this example you would click Lists select Provider and select Providers On the Provider List window select the provider Click the Provider IDs tab When the data converted the insurance carrier that had required the Medicare provider number will have a specific row on the Provider IDs grid Select that row and click Edit Then in the Legacy Identifier 1 field select the None button Click Save You would repeat this process for any other legacy data that is out of date You will also need to examine each IDs grid Practice Provider Referring Provider and Facility before completing print or electronic claims This step is critical for success especially 40 Setting up the Practice when converting data with multiple legacy numbers For instance if your practice in Medisoft 15 had a referring provider record that had multiple entries on the PINs tab Referring Provider window the conversion process will re create these entries as separate rows for instance four entries in Medisoft 15 would translate into four entries on the Referring Provider IDs grid Al
236. rrier specific codes these new Default Posting Codes will be sent 15 Getting Started with Medisoft Ey Report settings E archive Options B Remit Posting Options Use Insurance Posting Codes Always Match Last Name Default Posting Code O Allow Remittance Edits Match by Full Name and ID Adjustment El Change Negative Payments to Set Primary Denied Claim to Withhold se le Deductible Post Secondary Adjustments Set Secondary Denied Claim to Take Back Never Write Off Patient Responsible PR Post ICN CLPO7 to Claim Comment Office Hours Professional Registration Office Hours Professional is registered at the same time as Medisoft Although there is still a place where you can register Office Hours Professional you do not have to perform a separate registration once you register your Medisoft product Any messages you might receive to register Office Hours Professional can be ignored once Medisoft is registered Medisoft Overview The following topics and links to topics discuss key elements such as new features data conversion accessing and step by step procedures along with offering a brief description of key windows features and links to these features Step By Step Procedures There are a series of step by step procedures in the Help file that give instructions on using Medisoft Open the Contents tab of the help file and click the Step By Step Procedures book to see all the areas in th
237. s Name Date Time Length Provider Resource Reason Repeat Lunch 3282007 11 00 am azole ooo Every week on Mon Tue Wed Thu and Fri 4 iiil To create a break give it a name a date and enter the time that the break starts Using the up and down arrows enter the length of time in minutes The display color of the break should be contrasting to the regular daily appointment schedule the default is gray If the All Columns box is checked all columns in the schedule display will be marked with this break If this box is not checked only one column will contain the break The Provider s field contains three buttons Current Some and All If you select Some the Provider Selection window opens when you save the break so you can select the appropriate providers NOTE If you click New in the Break List to create a break this field does not include Current That is because breaks for all providers are included in the Break List If only one provider is affected by the break click Some and then select only the one provider Select either the Some button or All button to apply the break to providers you select or all providers If you select the Some button when you click Save the Provider Selection window appears Click one or more providers and then click OK The Print Grid feature is available with Office Hours Professional F1 Look up New Break Entry 144 Scheduling Appointments Setting Up Repeating Breaks In the N
238. s been automatically changed to Sent a batch number assigned and the current date entered in the Bill Date 1 column for both claims Changing Claim Status Through Claim Management all submitted claims are automatically marked Sent with an indication of the method of submission The status needs to be changed when the claim is paid completely or if a claim is rejected or put on hold or pending for some reason Time has passed since you printed and sent the claims for John Smith and you have received a rejection notice from the carrier You have already corrected the errors and are ready to resend the claims To locate Mr Smith s claims we will use a different portion of the program Click List Only and select John Smith s chart in the Chart Number field Click Apply In Claim Management make note of the batch number and click Change Status 1 Select the Batch button and make sure the batch number in the box matches that shown in Claim Management NOTE Since we used the List Only Claims that Match window to locate the claims the batch number is automatically entered in the Change Claim Status Billing Method window 2 In the Status From section choose Sent In the Status To section choose Ready to Send 206 Tutorial Activities Change Claim 5tatusfBilling Method Change Status Billing Method of Claims For Batch IE Selected Claim s e OK Status From Hold 5 Ready to send Sent Rejected Chal
239. s left blank the Inactive program will assign one L Carrier Address Marne Al Insurance Partners Phone Exterior Street PO Box 11223 Fax Contact City Harford State CT ip Code m 234 Plan Information Plan Name Class we Set Default 182 Tutorial Activities 5 Click the Options and Codes tab 6 Leave the Procedure Code Set and Diagnosis Code Set fields alone for now 7 What you select in the various Signature on File fields determines what prints in Boxes 12 13 31 and 24J of the CMS 1500 form For now select Signature on File for Patient Signature on File Insured Signature on File and Physician Signature on File Leave blank Print PINs on Forms Leave the Default Billing Method as Paper In the respective default payment application code fields select INSPAY APWROFF MCWH DEDUC and TAKEBACK for the purpose of this tutorial we will not create custom default payment types but use existing ones Insurance Carrier Best Choice Seles Address Options and Codes EDI Eligibility Allowed Options Procedure Code Set Diagnosis Code Set 1 a CMS 1500 Patient Signature on File Signature on file w Box 12 Default Biling Method 1 Paper w Insured Signature on File Box 13 Default Billing Method 2 Physician Signature on File ERE Default Biling Method 3 Print PINS on Forme Leave Blank Box 24 Default Payment Application Codes Insurance Payment Adjustme
240. s up to 12 column check boxes to specify if the code is being used for that procedure Getting Started with Medisoft e Unprocessed Transactions You can now have up to 12 columns for diagnosis codes on the List window as well as the Edit window e Case Window Diagnosis Tab You can now have up to 12 Default Diagnosis fields e Patient Guarantor Name Address Tab Sex field Added the option Unknown e Case Policy 1 2 and 3 tabs Relationship to Insured has several new options Other Changes e Medicaid Referral Access field is now called Referral Access e Case Window Condition Tab First Consultation Date field is now called Initial Treatment Date e Case Window EDI Tab Timely Filing Indicator field is now a drop down instead of a free form text field e Case Window EDI Tab The EPSDT Referral Code field is now a drop down e Insurance Type Code Removed this field from the EDI tab on the Case window e Claim Filing Indicator Code Added four new items to the drop down e Dental Maintenance Organization e Federal Employees Program e Other Federal Program e Commercial Insurance Co e Relationship to Insured items in the list have been rearranged so that values valid for 5010 are on top and legacy values for 4010 are on the bottom e Timely Filing Indicator This is now a drop down with preset values to ensure that a valid value is always selected Revenue Management Click Reduction Several changes have been m
241. s using the EDI Note window EDI Note new Seles Line Note NTE You can use this window to enter four different types of notes Depending on your selection in the Note Type field the fields will change For more information see EDI Notes This change eliminates the need to type notes with delimiters in the Transaction Documentation window On the Transaction Entry and Patient Ledger windows you can see if there is an EDI note associated with a particular line item by adding the EDI Notes column using the Grid Columns window Note This column will NOT display by default When you add it the Caption will be EDINotes and the Width will be 4 however after clicking it the Caption will simply be E with a width of 2 If you attempt to change it back to EDINotes it will return to E automatically Warning You must close any open EDI Notes windows before you can return to Transaction Entry Unprocessed Transactions or the Ledger windows Getting Started with Medisoft Restructured windows and moved fields Several fields have been moved and windows have been restructured and rearranged to accommodate the moved fields e Allergies and Notes as well as EDI notes have been moved to the Comments tab of the Case window Certification Narrative CER w LIBDA peated 06 Eligibility test MEE Set Default 8 e Condition Codes have been moved from the UB04 window FL 4 to 41 tab to the Condition tab of
242. set up new cases Case numbers set by the program are sequential and not one of the numbers is repeated within the program in a single data set An existing case can be edited or reviewed through the Patient List window or accessed from any Case fields in the program by pressing F9 The patient Case window contains tabs that display fields necessary to complete an insurance claim form In Medisoft Advanced and Medisoft Network Professional you can limit the tabs that are displayed If atab is not applicable to your practice or if you would prefer not to have it visible right click the tab In the list that appears click each tab you do not want displayed That tab no longer appears in the Case window To add tabs that are not visible right click the tabs and click the tab you want displayed to remove the check mark The Personal tab establishes the patient and his or her guarantor information marital and student status and employment 90 Setting up the Practice lt Case AGADWOOO Again Dwight Broken Hand Miscellaneous Medicaid and Tricare Comment EDI Custom One Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition Case Number 2 Case Closed Description Broken Hand Cash Case Global Coverage Until v Print Patient Statement Guarantor AGADWODD w 2 Again Dwight Marital Status M amied v Student Status Norrstude
243. sing Electronic Services Using Electronic Services Electronic Claims Processing Electronic claims send your insurance claims online either directly to the insurance carrier or to a Clearinghouse that then sends the claims to the insurance carrier Medisoft currently offers modules that send to a clearinghouse and modules that send directly to insurance carriers via the Revenue Management feature This solution is offered in two forms Revenue Management Advanced and Revenue Management Direct Revenue Management Advanced uses the RelayHealth clearinghouse for electronic claims processing and eligibility verification With Medisoft 17 there is no cost for this software option though there are clearinghouse charges For more information on pricing contact your local value added reseller or Medisoft sales at 800 333 4747 Revenue Management Direct provides pre configured connectivity to the most popular direct payers and also supports adding connections to other payers or clearinghouses This solution is available as an annual subscription with additional fees per direct connection For more information on pricing contact your local value added reseller or Medisoft sales at 800 333 4747 With either option Revenue Management provides a flexible tool that lets you manage your claims processing environment and if necessary make changes without completely replacing your EDI software Revenue Management differs from other EDI solutions by virt
244. sociate that taxonomy number with rule If your carrier requires this taxonomy number on a claim you will also need to select the Send Practice Taxonomy in Loop 2000A box on the EDI Eligibility tab of the Insurance Carrier window 8 Select the None Tax Identifier or Social Security Number bution Select the None button to not associate a tax ID or social security number with the rule Select the Tax Identifier button and enter the tax ID number to associate with the rule Select the Social Security Number button and enter the social security number to associate with the rule 50 Setting up the Practice 9 If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s For each entry select either None or Legacy Identifier Select the None button to not associate a legacy number with the rule To associate a legacy number with the rule for instance a Medicare Provider Number select the Legacy Identifier button enter the legacy number and select an ID qualifier to associate with the rule Entering Practice Information for a Billing Service Billing Services If you are a billing service enter your client s information in the Practice tab Enter your information in the Billing Service tab If you want to use the Medisoft program to keep track of your own accounts re
245. ssing claims the rules engine uses this information to select the correct entry on the grid The second part of creating or editing a facility ID record is to select if facility data will appear on aclaim along with selecting a qualifier for the facility and associating other data elements to pull for a claim including a combination of none or a specific NPI taxonomy number CLIA number and legacy data if you need to send information in Loop 2420D or box 32 of the CMS 1500 form After the rules engine identifies the correct row on the grid this data is used in processing either print or electronic the claim TIP when creating or editing IDs grid entries do not create matching wild card entries all selected for insurance carrier and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case modify one of the wild card rows and apply it to a specific insurance carrier or class TIP Press CTRL DELETE to delete all ID entries in the Practice Provider Referring Provider or Facilities IDs grids Use this with caution since all your entries will be removed If you have numerous legacy ID entries that no longer apply and only a few rows that need 61 Setting up the Practice to be set up you save time by deleting all entries and setting up the few rows you need 1 Click the Facility IDs tab T
246. st of the transactions for the practice are maintained The Claim Management icon opens the Claim Management window where claims are prepared edited and sent for payment The Statement Management icon opens the Statement Management window where statements are prepared edited and sent for payment The Collection List icon opens the Collection List window where you manage collection items The Add Collection List Item icon opens the Add Collection List Items which you can use to create collection items The Appointment Book icon opens the Office Hours Patient Appointment scheduler where appointments for the practice are scheduled The Eligibility icon opens the Eligibility Verification Results window where you can check patient insurance eligibility The Patient Quick Entry icon opens the Patient Quick Entry window This feature provides another method for creating patient and case records For more information on this feature see the topic Patient Quick Entry Overview The Patient List icon opens the Patient List window and access to patient case information The Insurance Carrier List icon opens the Insurance Carrier List window and access to carrier information The Procedure Codes List icon opens the Procedure Payment Adjustment List window The Diagnosis Codes List icon opens the Diagnosis List window 17 Getting Started with Medisoft The Provider List icon opens the Provider List window Clicking the Custom
247. stead of the Provider IDs grid you save time and effort since one specific entry could be applied to all the providers at the practice level instead of creating an entry for each provider on the provider level In this second entry you would select the insurance carrier and select all providers Importantly you would need to include your NPI 39 Setting up the Practice taxonomy and Tax IDs since each grid entry needs to be complete You would also select the legacy number your carrier requires When the application gathers claim data it would select this row for the specific insurance company and pull the data for the claim If one of the providers in your practice files claims as an individual with an insurance carrier the other providers do not use you would need to create another rule on the Provider IDs grid for that provider In this grid entry you would specify the insurance carrier You would also change your filing status to Individual and enter the provider s NPI number not the group NPI number You could also include the taxonomy and tax ID social security number in this grid entry Setup Activities After Data Conversion If you are converting data from an existing Medisoft practice then you will need to review select your claim filing status individual or group for each provider in your practice To select your filing status 1 Click Lists select Provider select Providers On the Provider List window select a provider
248. surance Aging Detail Extended 180 Primary Insurance Aging Summary Extended 180 Primary Insurance Class Aging Procedure Code Aging Extended 150 Secondary Insurance Aging Extended 180 Secondary Insurance Aging Summary 180 Tertiary Insurance Aging Detail Extended 180 Tertiary Insurance Aging Summary Extended 180 D Reset Defaults ee Level 1 is for unlimited access and is designed to be used exclusively by the Supervisor or administrator to restrict access to the program Levels 2 3 4 and 5 can be user defined with the Supervisor deciding what fits in what level and assigning users accordingly Generally the higher the level number the fewer rights are assigned to it Add or remove check marks for level access by clicking the appropriate check box for each process displayed with each listed window name If a task is attempted by a user who does not have rights to that task based on the security level assigned a warning dialog box is displayed stating that the user does not have the authority to perform the requested task Once the security feature is used the File menu contains an additional option Log In As Another User Entering Practice Information Setup Scenarios Before setting up a practice consider reviewing the topic An Overview of Setting up a Practice This topic reviews setup order and has links to other topics with specific instructions for setting up providers Also consider reviewing the mate
249. t ALT DOWN Opens drop down lists ARROW SHIFT F4 This shortcut automatically populates the last accessed patient s 30 Getting Started with Medisoft chart in a new chart number field The system holds in memory the last patient s chart number selected for instance in the Patient List Deposit List Collection List Quick Ledger Quick Balance etc and when you go to another window you can use the shortcut to populate the last record Select the Chart field and press SHIFT F4 to automatically populate the last accessed patient s chart in a new chart number field This feature is supported in many windows throughout the system NOTE Reports that do not use the Data Selection Questions window for data filtering do not support this feature Keystrokes Formatted Date Edit Controls Keystroke Action III Increases date by one day or highlighted section of date by one Decreases date by one day or highlighted section of date by one Keystrokes Grid Control in Various Windows Keystroke Action o LEFT ARROW Moves left one cell RIGHT ARROW When not in edit mode moves right one cell CTRL RIGHT When in edit mode moves right one cell ARROW PAGEUP Movesuponepage 3 3 3 3 3 ENTER Moves to the next cell Keystrokes List Windows Keystroke Action OOOO ra Changes value in Field F3 Saves record F8 Creates new record FO Edits selected record Keystrokes Transaction Entry 31 Getti
250. t Properties General Bands Data Filters Report Title CMS 1500 Primary Margins Inches Lett 0 25 Right 0 25 Paper Size Letter Top 0 25 Bottom 0 25 Page Unentation Portrait v Form Offset Insurance Claim Type Left 0 05 a Inches Primary Claim O Secondary Claim Top 0 08 al Inches Tertiary Claim Export To Text Options Mark Billed E Tracer Lines Per Page E Columns 4 1 Uppercase Test Include title page with data filters Guarantor Statement Grouping Group Transactions by Revenue Code Date Created 5133096 11 04 15 4M Date Last Modified 107 2772009 9 57 26 PM File Name rnin 3 mre Report Style Insurance Form 5 You need to print the form to see if it is adjusted enough Click the Print speed button The Save Report As window is displayed Since you are revising a standard form give this form a different name until you know it is correct In the Report Title box enter CMS 1500 1 220 Tutorial Activities TIP You need to use a name that you can remember but you cannot replace the original form lf you use the same name as the original form the list shows two forms with the same name and it may be difficult to remember which is the form you have revised 6 The program informs you that claims and statements printed through the Report Designer are not marked as billed This is generally a good thing Click OK 7 Inthe
251. t associate a legacy number with the rule To associate a legacy number with the rule for instance a Medicare Provider Number select the Legacy Identifier button enter the legacy number and select an ID qualifier and to associate with the rule 12 Click Save Referring Provider Records 70 Setting up the Practice Many patient visits are the result of a referral from another provider When a patient is referred to your practice add data such as the Unique Physician Identification Number UPIN NPI tax ID etc Go to the Lists menu and select Referring Providers To enter a new referring provider record press F8 or click New Setup Scenarios If you have referring providers affiliated with your practice you will need to create a record for each referring provider In this record you can link the provider to a particular insurance company category if needed and include other billing details such as the referring provider s NPI taxonomy and other legacy IDs Entering Contact Information 1 Click Lists and click Referring Providers The Referring Provider List window opens lt Referring Provider List Belts Search for O Field Last Name First Name we Name Credentials License Number Medicare Part Last Name A Te Pierce Hawkeye M E False Pierce Trapper John M E False Trapper 2 Click New OR Select a record on the Referring Provider List grid and click Edit The Referring Provider window appe
252. t grid and the Speed menu gives you a choice of Add Column or Delete Column If you add a column the Add Column window has a horizontal scroll bar that lets you indicate the provider for whom you are adding a column The number of columns determines how many appointments can be booked in one time slot for one provider There is really no limit as to how many columns can be set up on the appointment grid Program Options Appointment Length Click File and select Program Options Set the starting and ending appointment times for the practice Enter the Starting Time and Ending Time breaking it down by hour and minutes Standard appointment Intervals can be established by scrolling with the up and down arrows You can also set colors to distinguish appointments breaks and conflicts Office Hours Professional Make decisions concerning all the other default settings in this tab Designate one of the reports in the Speed Report box Office Hours Professional and it automatically prints when you click the Print speed button 146 Scheduling Appointments Program Options Start Time 8 00 am End Time 5 00 pm Interval 15 minutes Columns 4 Ss Default Colors Appointment Silver v Conflict Break Use enter to move between fields Use Automatic Word Capitalization Automatic Ref
253. t to increase or decrease the size of the column Columns can be added or removed as necessary in this view Month View The Month View shows up to 31 days with the boxes colored where appointments have been scheduled This is a single provider view The value of this view is that you can get a good overall view of which days are free for appointments or other scheduled items Columns cannot be added or removed in the Month View Multi View Multiple Provider Resource View The Multi View or Multiple Provider Resource View is the most flexible The program provides one Multi View setup which automatically includes all providers and all resources each with its own column You can create as many Multi Views as you need in the Multi Views tab of Program Options click File and select Program Options The open data entry field lists all Multi Views that have been set up This is where you can group providers and or resources rooms or facilities scheduled for appointments in any combination desired or modify or delete existing multiple view setups Click New to set up a new Multi View select a view and click Edit to make changes In the New View window assign a name for the new view For the first column indicate the type Provider or Resource the Code provider number or resource code then the width of the column in pixels Set up each column you want in the view and click Close when finished If you want to add a column between co
254. tance posting includes Coverage Expiration Date in Loop 2100 e 25 Changes to the 5010 Eligibility IG Element Location Modification ISA11 Interchange Control Interchange Control Header Was previously hardcoded to Standards ID U but is now blank ISA12 Interchange Control Interchange Control Header Replaced 00401 with 00501 Version Number for use with 5010 GS08 Function Group Header Updated from 004010X092 Version Release Industry to 005010X279 Identifier Code ST03 Implementation Transaction Set Header This is a new segment Convention Reference added after STO2 and hardcoded to 00510X279 NM112 Name Last or Loop 2100A This is a new element for Organization Name 5010 NM112 Name Last or Loop 2100B This is a new element for Organization Name 5010 REF04 Reference Identifier Loop 2100B This is a new element for 5010 NM107 Name Suffix Loop 2100C The insured person s name Suffix has been made available as a data element NM112 Name Last or Loop 2100C This is a new element for Organization Name 5010 REFO04 Reference Identifier Loop 2100C This is a new element for 13 Getting Started with Medisoft 9010 N407 Country Subdivision Loop 2100C This is a new element for Code 5010 DMG10 Code List Qualifer Loop 2100C This is a new element for Code 5010 DMG11 Industry Code Loop 2100C This is a new element for 5010 DTPO01 Date Time Qualifier Loop 2100C This has changed from 472 to 291
255. te a new general rule for the practice New Practice ID Bele O Provider Provider Class O Insurance Carrier O Insurance Class O Facility ID Qualifier National Provider ID 11234567895 a National Provider Identifier Taxonomy 9988776651 Z2 Provider Taxonomy 2 Tax Identifier 334455667 Employer Idenfication Number O Social Security Number Legacy Identifier 1 Legacy Identifier 2 4 Select the top three All buttons This selection applies the rule to all providers all insurance carriers and all facilities unless you have a more specific grid entry 5 Since Happy Valley Medical Clinic is organized as a group click the National Provider ID button and enter 1234567895 6 Since you file electronic claims and your practice is a group select the Taxonomy button and 998877665Y NOTE setting up taxonomy at the practice level only works if you select the From Practice button for taxonomy on the provider level for each provider and you do not select the Send Practice Taxonomy in Loop 2000A box on the Insurance Carriers window on the EDI Eligibility tab Otherwise you will send taxonomy in loop 2000A solo providers not loop 2310B groups 7 Select the Tax Identifier button and enter your tax ID 334455667 8 Select the None buttons to not associate legacy numbers with the rule 9 Click OK The rule entry appears on the grid 10 Click New to create a second entry for the legacy n
256. tes Claim Billing Note Code CLAIM e 2 Quick Formats Use Statement Management for Quick Statements Receipt Walkout Receipt All Transactions Statement Remainder Statement 0 30 60 Face Sheet Patient Face Sheet kd Quick List w Billing Notes When Create statement billing notes is activated a note is added to statements when printed Be sure to select a default note in the Statement Billing Note Code field When Create claim billing notes is activated a Comment transaction line is added in both Transaction Entry and Quick Ledger whenever a claim is billed The note includes the carrier name date billed claim number and the name of the provider associated with the claim Be sure to select a default Claim Billing Note Code F1 Look up Program Options Billing Tab Quick Formats If the Use Statement Management for Quick Statements check box is checked then the Quick Format options for Statements are the Statement Management statements otherwise the list would include the Report option statement formats Any place that a Quick Statement prints would need to print the appropriate statement type regular statements or Statement Management statements The Receipt format option is tied to the Quick Receipt button in Transaction Entry Select a default quick receipt format here and that receipt is automatically printed when you click the Quick Receipt button in Transaction Entry You can select a default Statement form
257. the database Click the down arrow and select Routine Checkup 5 The date and time have already been selected so click Save See that Mr Smith s name appears in the 11 30 am slot Also notice that it is fuchsia in color which is the color assigned to the Routine Checkup reason A recap of the appointment and Mr Smith s information is also displayed to the left of the Appointment Grid Repeating Appointments 1 Dr Lee wants to follow up on Mr Smith s treadmill results and asks you to make two more appointments a month apart Since 11 30 am is a good time for Mr Smith double click the existing appointment 2 In the bottom left corner of the Edit Appointment window click Change to open the Repeat Change window Choose Monthly In the End on field click the down arrow to show the calendar Click the right arrow twice for two months Then click OK Click Save Repeat Change Frequency e al o Repeat by Ova E oa Week a 2200 2 Monthly The Tet Monday of every Yearly month Setting Breaks 1 Click the Break Entry speed button In the Name field enter Dr Lee Seminar 2 The meeting is scheduled for two hours on June 21 starting at 1 00 pm In the Date field enter 11 20 2009 For Time type in 1 00 p In Length type 120 In Resource enter L for the Lunch room Give it an aqua color using the down arrow to display the color choices Click the All Columns box to be sure everyone participates
258. the topic Assigning Rules The Referring Provider window contains important information about the referring providers associated with your practice 25 Getting Started with Medisoft Referring Provider new Address Referring Provider IDs lf the Code is left blank l O Save Code the program will assign one Inactive 7 da Cancel Ag x Last Name o First Hame o Middle Hame A Credentials at Near o setDefault re City PO State O ip Code o E Mail J Office po Far Pp Home Jo Cell Po LIPIN License Mumber Extra 1 Extra Z Medicare Participating Specialty Mot Listed se You will use the Insurance Carrier window to enter insurance carrier records x E l z Insurance Carrier new Address Options and Codes EDI Eligibility Allowed Cade i If the Code is left blank the O acer program will assign one Hame Phone Extension Street Fax Contact City State Zip Code Plan Name l TR Set Default Note 26 Getting Started with Medisoft You will use the Insurance Class window to enter classes or groups for insurance carriers lt Insurance Class new E ox Class ID fo Class Name fs i Inactive Classes can be used when assigning rules For more information on assigning rules see the topic Assigning Rules The Facility window contains
259. the legacy number and select an ID qualifier to associate with the rule 8 Click Save Attorney Employer or Other Addresses The Address file is your address book within the computer lt keeps the names addresses and phone numbers with extensions of important outside contacts such as attorneys employers referral sources etc Facilities and referring providers are set up in the Facility file and Referring Provider file The Address file should include all important contact persons whose phone fax cell and e mail numbers the practice needs at any time in the future Go to the Lists menu and select Addresses or click the Address List icon When you click New or press F8 the program automatically assigns an address code based upon the Name field The address code is not assigned until all information is entered and saved Use Search for and Field to look up the address code of existing records The addresses maintained in the program are classified by type assigned to facilitate ease of selection in a drop down list These types include Attorney Employer Miscellaneous and Referral Source F1 Look up Address Entry Use the Address window to enter information for attorneys employers and other entities To set up address records click Lists and select Addresses The Address List window opens Address List Sel Lode Mame Extension ORO J R Ewing Attorney ANGOO Angela Mason 601451666 Attorney ARMOO Army
260. the record Multiple records can be selected by pressing the CTRL key and clicking the record Click Write off to write off the selected remainder balances Use the Stmt Submission Count field to define a maximum amount of times that you want to send a statement before writing off the balance Once this number is met the small balance is written off The program selects patients whose statements have been sent Submission count more than the value entered in the field Once this number is met the small balance is written off This field works in conjunction with the other fields on this window and if a value is entered in this field the balance is only written off if it meets the criteria for this field completed the statements and the other fields such as Maximum Amount field For instance if you enter 3 in this field and 10 in the Maximum Amount field small balances would be written off after 3 statements are sent and if the balance is under 10 00 When the program writes off the remainder balances it updates a number of other features Write off entries are created and applied to all patient responsible charges associated with the selected patient The program also updates the associated Collection List items refreshing balances and marking zero balances as deleted After a remainder balance write off statements are changed to the status of Done and a note is added to the write off entries F1 Look up Small Balance Write off 135 U
261. ting Started with Medisoft Communication H PERO5 Communication 2 2 S Number Qualifier 2 PERO6 Payer 1 256 S Technical Contact Communication H PERO7 Communication 2 2 S Number Qualifier 3 PERO8 Payer Contact 1 256 S Communication H AN 1 20 N U PERO9 Contact Inquiry Reference Payer WEB Site PERO1 Contact Function Code PERO2 PERO3 Communication Qualifier PERO4 Payer Contact N U AN 1 256 Communication H PERO5 Not Used Z Z Z N ES N la e O e There are new RDM Remittance Delivery Method elements being added to Loop 1000B These will be ignored in posting but need to be defined in the IG These are the following Min Max Usage Loop Values Req Repeat Remittance Delivery Method Transmission Code 11 Getting Started with Medisoft RDMO3 Communication AN 1 256 Number Romos NotUsed mu e There is a new DTM Coverage Expiration Date element for 5010 This segment explains that coverage was denied because the patient s coverage has expired The new values are below Min Max Usage Loop Values Repeat Coverage 0500 Expiration Date DTMO1 Date Time gt gt DTMo2 Date MEA e pommos lw This is the date on which the patient s coverage expired e There are new Claim Received Date Elements DTM in Loop 2100 These have been added to the IG so that they are recognized if they are received They are not used in posting a remit how
262. tion or type in your own S al ANsier a Kelp Reconfirm OoOo 11 In the Select a question or type in your own field select What is your pet s name 12 In Answer type Ginger 13 Reenter Ginger in the Reconfirm field 14 Click Save Repeat these steps for a second user only this time the user will not have the Administrator box checked Medisoft original For instance repeat steps 1 13 to create an entry for Kelly Cooper a login name of scheduling with an access level of 3 15 Click Close to close the Security Setup window 16 If a message pops up reminding you that user s must relog into the program before the changes take effect click OK to clear this message Exit Medisoft and login using the Supervisor login Group Setup 176 Tutorial Activities 1 2 3 oa OL A 10 11 12 13 14 15 Go to the File menu and select Security Setup This opens the Security Setup window Security Setup Full Name Login Hame Access Level al Kelly Cooper SCHEDULING 3 Pat Smith SUPERY ISOR 1 Click the Group tab Click New to open the Security Group window Security Group New Group ID Group Name Description Help In Group ID enter DCTRS Enter Doctors in the Group Name field Enter All doctors and physician assistants in the Description field Click Save In the Security Setup window click the User tab Select the user information for Pat Smith Click Edit
263. tion would see which entries match the facility on the claim This pattern has a specific order and follows the left to right layout on the IDs grid For instance on the Practice IDs grid the logic looks at provider code first then insurance carrier then facility etc For instance if you are setting up a group practice with three doctors you would need to have at least one rule grid entry on the Practice IDs grid and one rule on the Providers IDs grid for each provider three rules You must include an entry for each provider on the Provider IDs grid since you define your claim filing status individual or group here For this general rule on the Practice IDs grid you could apply it to all providers all insurance carriers and all facilities assuming you have no facilities associated with your practice or all facilities would use the same details In this entry you could include your group NPI taxonomy and tax ID numbers Then on the Providers ID grid you would create one grid entry for each provider Each of these initial entries would be general and could apply to all insurance carriers and facilities You would also select Group for your claim type and could select From Practice to pull NPI taxonomy and Tax IDs from the Practice IDs grid If one of the insurance carriers that your practice accepts requires a legacy identifier you would create a second entry on the Practice IDs grid By creating a second entry on this grid instead o
264. tl ON senansa A da ii 64 Entering Provider IDS Grid Entries cccccoocnccnncccconncnncncnonnnnnonononncnnonononnnnnonononnnonononanncnnnnnnnns 67 Reterring Provider Record ii cis eodavee a a a a aa a war a 70 SS UD cena MOS ip id 71 Entering Contact IMM boi e UL erence 71 Entering Information on the Referring Provider IDS Grid ooccccccoccnncconcnnccnoncncnnoncnnnnnnoos 72 Attorney Employer or Other Addresses ccccccccccccconcccnnncccnonononcconnnnnonnnnnnnnnnnnnnnnnnannennnnnnnnnnnnns 75 To set pAddress Records iS 75 Procedure Payment and Adjustment COdABS cccoooccccccoccnnccconcncoconcnnonnnnnnonanonnononennnnonnnnnonaneness 76 A A 77 AMOUNES KA tri A o 79 Allowed Amounts Tab Advanced and above cocccccccnoocccncccnnncconccnnnncconnnonnnnronnnonnnnconcnonnancanens 80 Mitin ode iia 81 BE a aes a le ae ee 82 Billing CAS eds 83 o o PO O O 84 Setting Up Palent RECOS eiii 86 Setting Up th Chart NUMDET caso e 86 New Patient Setup WIN dado a artnet eases 87 STO MU O AM OR AE E E A TE e 89 Delat PANES O el eet 99 ntenng ans aci Sarita A AA A AA bc 101 Transaction ENURy OVEnIS Wo a ie 101 Start with a Chart NUMDEP cccccccseeeceeeeeeeeeeeeeeeeeeeceeesseeeeeeeesseeseeeeesseaeeeeesseaeeeeeeesaeeeees 101 Entering a Charge in Transaction Entry cccccccssccccccsssseceesceeseceeseeseeeeeeseeeseeesseeaeseeeseaaeeeees 103 Entering a Payment or Adjustment in Transaction Entry ooccccoonncnncccnnnc
265. torial button Then select the practice and click OK The practice name appears in the Title bar of the main Medisoft window User Setup 1 Go to the File menu and select Security Setup This opens the Security Setup window Security Setup Full Name Login Hame Access Level OO OO IESO 2 Click New to open the User Entry window User Entry Question Group Login Hame Inactive Full Name Password Recon NS Access Level Expire Date 3 Inthe Medisoft original program we recommend that the first user be designated the Administrator Click the Administrator box in the middle of the window Then you can 175 Tutorial Activities add more names edit entries or delete entries as necessary In Medisoft Advanced and Medisoft Network Professional after one Level 1 person has been entered you can add more names edit entries or delete entries as necessary 4 In Login Name enter Supervisor as the login name 5 In Full Name enter Pat Smith as the user s full name 6 In Password enter tn872284 as the password 7 Reenter the password in Reconfirm 8 If you are using Medisoft original click the Administrator box if this is the first record you are setting up If you are using Medisoft Advanced or Medisoft Network Professional be sure the Access Level is 1 9 Skip the Expire Date field for now 10 Click the Question tab User Entry Main Question Group Cj Save Selecta ques
266. tting up the Practice In these general entries you enter information that would apply to the most generic situation Then you would create other grid entries that apply to a specific insurance carrier insurance class facility provider etc TIP When creating or editing IDs grid entries do not create matching wild card entries all selected for insurance carrier and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case modify one of the wild card rows and apply it to a specific insurance carrier or class When you create claims the application gathers general data and then selects data from the IDs grids by analyzing the entries rows on the various IDs grids The process of selecting the correct row involves first selecting a row that applies to the insurance carrier provider or provider class If more than one row Is present on the various ID grids the application matches the row on an IDs grid to the data gathered for the claim The logic looks for a specific match on an IDs grid first before moving to a general match All button for instance the application searches for insurance carrier X before looking for a row that applies to all insurance carriers The logic continues matching the other various selections on the grids For instance if one or more entries are on the grid the applica
267. ty information on a claim 5 Select either None or National Provider ID Select the None button to not associate an NPI number with the rule Select the National Provider ID button and enter an NPI number to associate the facility NPI number with rule 6 Select either None or Taxonomy Select the None button to not associate a taxonomy number with the rule Select the Taxonomy button and enter a taxonomy number to associate that taxonomy number with rule 7 Select either None or CLIA Select the None button to not associate a CLIA number with the rule Select the CLIA button and enter a facility CLIA number to associate with rule 8 If needed enter up to two legacy numbers and qualifiers to associate with the rule using the Legacy Identifier 1 and 2 fields Use these fields to customize your rule to meet filing requirements with an insurance carrier s For each entry select either None or Legacy Identifier Select the None button to not associate a legacy number with the rule To associate a legacy number with the rule select the Legacy Identifier button enter the legacy number and select an ID qualifier to associate with the rule 9 Click Save Setting up Providers and Provider Classes The Provider List is accessed by going to the Lists menu and selecting Providers or by clicking the Provider List speed button Specific provider information is accessed by clicking Edit or pressing F9 and the Provider new setup windo
268. ue of its design it is an integrated component of Medisoft which means that the company that produces your practice management solution also produces your EDI solution a complete revenue management solution that seamlessly updates claim status and date sent while also providing ERA electronic remittance advice posting and eligibility verification F1 Look up Electronic Claims Overview Statement Processing You can send statements electronically through BillFlash the web based company that is set up to process Medisoft electronic statements Statements sent electronically through Billflash get an instant response report that tells what information was sent F1 Look up BillFlash Receive Send Reports through Medisoft Terminal Within Medisoft the Medisoft Terminal option can be used to send or receive reports by connecting to various bulletin boards using a modem The BBS Bulletin Board Service is set up through Medisoft Terminal F1 Look up Medisoft Terminal Eligibility Verification The Eligibility Verification feature lets you check a patient s insurance coverage online The Revenue Management feature conducts eligibility verification Contact the Medisoft sales department at 800 333 4747 for information on pricing You must have broadband internet service to make eligibility verification inquiries 136 Using Electronic Services Eligibility Verification Setup To set up Medisoft for eligibility requests you must make
269. uick and easy access to a patient s ledger from almost anywhere in the program press F7 or click the Quick Ledger speed button While no new transactions can be made in the ledger itself it is possible to edit and print the ledger and gain valuable detail on patient accounts You can change responsibility for a selected transaction in the Quick Ledger window Right click a transaction to change its responsibility between insurance carriers or from an insurance 108 Entering Transactions to the patient This feature lets you skip entering the zero dollar insurance payment to indicate that no payment is coming from the insurance carrier F1 Look up Changing Responsibility in Quick Ledger The Quick Ledger detail window is very similar to the Transaction Entry window Use the horizontal scroll bar to reveal additional data fields A navigation bar lets you move quickly through the list of transactions Three buttons open additional data fields Click Edit or press F9 to open the Transaction Entry window where charges payments and adjustments can be reviewed and edited as needed Both the Patient and the Guarantor Ledgers let you view the notes entered for transactions in the grid and also add a note Click the Note button or press F5 to toggle the display any transaction notes attached to the transaction If a note is not yet attached you can enter a note The second column from the left next to the record pointer column displays a note i
270. uld apply to the most generic situation Then you would create other grid entries that apply to a specific insurance carrier insurance class facility provider etc TIP when creating or editing IDs grid entries do not create matching wild card entries all selected for insurance company and insurance class since the rules engine would not know which row to select If you had different legacy numbers for instance in each entry the system might not select the correct row In this case modify one of the wild card rows and apply it to a specific insurance carrier or class When you create claims the application gathers general data and then selects data from the IDs grids by analyzing the entries rows on the various IDs grids The process of selecting the correct row involves first selecting a row that applies to the insurance carrier provider or provider class If more than one row is present on the various ID grids the application matches the row on an IDs grid to the data gathered for the claim The logic looks for a specific match on an IDs grid first before moving to a general match All button for instance the application searches for insurance carrier X before looking for a row that applies to all insurance carriers The logic continues matching the other various selections on the grids For instance if one or more entries are on the grid the application would see which entries match the facility on the claim This pattern has a spe
271. umber for a certain carrier 11 Click the All buttons for provider and facility but select the Insurance Carrier button and select FHP Health Plan from the lookup window 12 Re enter your NPI Taxonomy and Tax Identifier Each rule that you create has to be a complete entry by itself 181 Tutorial Activities 13 Select the Legacy Identifier 1 button and enter 44446688 and from the qualifier list select OB State License Number 14 Click OK Practice Information Practice Practice IDs Practice Pay To Statement Pay To Provider Insurance Insurance Facility Taxonomy Tax ID q Save Provider Class Carrier Class Code NPI Code SSN Legacy 1 Legacy 2 All All All All All 1234567895 9988776657 33 4455667 All All All 1234567895 9988776657 33 4455667 44446668 Help lt This saves the rule and when you generate claims for FHP either print or electronic your state license number will be included 15 Click Save on the Practice Information window Setting Up a New Insurance Carrier Record 1 Click Lists and select Insurance and Insurance Carriers Click New 2 Skip the Code field Enter the following information 3 In the Name field enter A1 Insurance Partners In the other appropriate fields enter PO Box 11223 Hartford CT 01234 4 Enter Best Choice in the Plan Name field Insurance Carrier A1 Insurance Partners Address Options and Codes EDI Eligibility Allowed Code IF the Code t
272. ure on File Leave blank Ww Box 12 Default Billing Method 1 Paper e Insured Signature on File Leave blank w Box 13 Default Biling Method 2 Paper we Physician Signature on File Leave blank Box 31 Default Biling Method 3 Paper we Print PINS on Forme Leave Blank Box 24 Default Payment Application Codes Payment Adjustment withhold Deductible Take Back 5 From the Procedure Code and Diagnosis Code Set lists select a procedure code set 1 2 or 3 and a diagnosis code set 1 2 or 3 to apply to the insurance carrier Medisoft gives you the ability to assign up to three codes to the same procedure By using this field the claims for each carrier can contain the correct code For more information see Procedure Payment Adjustment Entry 6 From the Patient Insured or Physician Signature on File lists for each option select Leave blank Signature on file or Print name 96 Setting up the Practice These fields control what is printed in the signature Boxes 12 13 and 31 respectively on the CMS 1500 claim form These fields do not control whether anything is printed in these boxes but what is printed Whether anything prints is controlled by settings on the Case window Policy tab Accept Assignment and Benefits Assigned field and Provider window Address tab Signature on File field The Signature on file option prints Signature on File if the Signature on file field
273. ut Receipt Claim List O Insurance Form CMS 1500 Primary Medicare Century Statement CMS 1500 Primary O Superbil CMS 1500 Secondary Medicare Century av CMS 1500 Secondary TEMEN eN CMS 1500 Tertiary Collection Letter CMS 1500 HP DJ 500 Primary O UB Insurance Form CMS 1500 HP DJ 500 Secondary Collection Letter C Show Unassigned Only Coparment Remainder LI Select Printer Reset Default You will use the Default Printer Window to assign a printer to superbills claims and statements The window displays available reports and provides controls to select or delete a default printer After selecting a report you can click the Select Printer button to select a printer from the Print window On the Print window standard Windows printer interface window you can further select other available settings You can also select multiple reports to assign to a default printer by holding down the CTRL Key while clicking a report at the start of the range and holding down the CTRL Key while clicking a report at the end of the list Then when you click the Select Printer button you can assign all the selected items to the same default printer using the same default settings The window also features a Delete button to remove a default printer from a report and a Reset Default button to remove all assigned printers from the available reports If you assign a default printer to a report and the printer is not availab
274. vailable in Medisoft 15 is removed This functionality is moved to the Provider window Provider IDs tab On this window you can assign to all insurance carriers an insurance class or a specific insurance carrier per provider whether you file claims as a group or as an individual This change provides greater flexibility since you will no longer need to possibly create two versions of the same receiver to address cases in which you had sent claims as a group and as an individual Now you can create as many records on the Provider IDs grid as needed to address your claim submission needs using the same receiver 92 Setting up the Practice E EDI Receiver new E mix Address Modem ID Estras ERA Code IF the Code is left blank the ga program will assign one Name RelayHealth Street City State ip Code Inactive Phone 1 pO Extension nz Phone e pO Fax Phone PO E Mail Pe Web Address CF Contact Comment o F1 Look up EDI Receiver Entry Setting up Insurance Carriers and Insurance Classes Setting up the insurance carriers correctly is essential to getting claims paid in a timely manner Go to the Lists menu and select Insurance Select Carriers from the drop down menu or click the Insurance Carrier speed button Insurance Classes Use this window to create insurance classes such as Blue Shield or Medicare Use these classes to group insurance carriers for easier reporting Go t
275. w Date Relinquished Care 2 3 4 ap E w 2 w 2 w 8 v 2 w 9 E A 4 10 11 12 sw we we 2 we 2 2 2 3 lt gt Name Smith Jr John Home Phone 51 3 024 4668 Address 246 Center Street Work Phone 123 345 6789 Pu is Cell Phone 513 224 1111 05234 Date of Birth 1121975 27 w 9 11 Open the Policy 1 tab 12 In Insurance 1 select A1 Insurance Partners Mr Smith s Policy Number is 9782XYZ and his Group Number is 98KEY The Policy Start date is January 1 2010 and the End date is December 31 2010 Click Assignment of Benefits Accept Assignment Leave the default information in the rest of the fields in this tab 199 Tutorial Activities Case sMIJUU00 Smith Jr John lest Miscellaneous Medicaid and Tricare Multimedia Comment EDI Custom One Personal Account Diagnosis Policy 1 Policy 2 Policy 3 Condition A Save Insurance 1 41000 e Al Insurance Partners O Caca ance Policy Holder 1 SMIIDODD ka Smith Jr Jahn Relationship to Insured Self wt Help Policy Number 978212 Start 114010 w Group Number S8KEY End 12 31 2010 w usos Group H ame o A Eligibility Claim Number o Eligibility Face Sheet e Assignment of Benefits Accept Assignment Deductible Met Set Default Capitated Plan Annual Deductible 0 00 Copayment Amount 0 00 Treatment Authorization Document Control Humber Insurance Cover
276. w is accessed by clicking New or pressing F8 Provider Class Records 63 Setting up the Practice Use this window to enter classes or groups for providers in your practice Grouping providers into classes is helpful when sending claims or statements electronically Go to the Lists menu and select Provider Select Class from the drop down menu To create a new class of providers click New or press F8 To edit a class click Edit or press F9 The Provider Class List window appears Enter a Class ID Class Name and Description Provider classes are assigned to specific providers in the Providers window Reference tab F1 Look up Provider Class Entry Setup Scenarios If you are a solo provider you can use two different methods to set up your practice If you are a solo provider file claims as an individual with the same pay to as your billing address the Pay To tab is blank you can enter your NPI information on the Practice IDs grid In this case you would select on the Providers IDs grid the From Practice button instead of selecting the National Provider ID button and entering an NPI number If you are a solo provider with different billing information and pay to information the Pay To tab is complete you can enter your NPI information on the Provider IDs grid In this case you would select on the Providers IDs grid the National Provider ID button and enter your NPI number Entering the NPI number on the practice level is required i
277. y change the default setting and then also as needed override this setting Users can apply these settings to these lists Address Billing Codes Claim Rejection Message Cases Contact Diagnosis Codes EDI Receiver Insurance Carriers Insurance Class MultiLink Patient Payment Plans Procedure Codes Provider Class Providers Patients Referring Providers and Security Accounts When users selects the right click menu option of Show Inactive Records to override the setting on the Program Option window a red X appears next to all inactive items in the list The right click menu also provides an option to Hide Inactive Records NOTE The option that is initially displayed depends on the current setting on the Program Options window If the feature is enabled on the window then the right click menu initially displays the Show Inactive Records option if the feature is disabled on the Program Options window then the right click menu initially displays the Hide Inactive Records option NOTE When providers are marked as inactive in either Medisoft or Office Hours Professional Provider window Address tab Inactive box their information does not appear on the Appointment grid until the providers inactive status is updated to active This means that when in day view View Day View if you select an inactive provider from the Provider drop down list on the Toolbar and click an appointment timeslot a message will appear that notes that th
278. y window 5 Click Save Transaction 203 Tutorial Activities Tutorial Practice 5 Claims Creating Claims 1 Click Create Claims in the Claim Management window 2 Since we created two charge transactions for John Smith in the Transaction Entry portion of this tutorial let s create the claim for these charges Click the first Chart Numbers range field and type SMI to set SMIJOOOO in the first Chart Numbers field Repeat this process in the second Chart Numbers field lt Create Claims Siz x Range of v Create Select transactions that match Primary Insurance PO Billing Codes LCase Indicator Pe Location Provider Assigned Po Attending Include transactions if the claim total 12 greater than Enter Amount 3 Click Create 4 When you return to the Claim Management window change the Sort By field to Chart Number and type SMI in the Search field Press Enter A new claim has been created for SMIJOOOO Editing Claims 1 To edit the claim highlight the SMIJO000 claim and then click Edit or press F9 to open the Claim editing window 2 Open the Comment tab Type the following message Notify attorney when claim is paid by primary carrier Press ENTER and then press CTRL T to enter a date time stamp 3 The two transactions we created in Transaction Entry are now part of one claim Suppose you find out that they have to be sent separately fo
279. yments or Adjustments to Charges 102 Appointment Display Office Hours Professional 147 Appointment Length 145 Appointment List 149 Appointment Status Advanced and above 149 Assigning Rules 38 Attorney Employer or Other Addresses 74 Audit Reports 157 Audit Tab 168 Available Reports 153 B Billing Charges Advanced and above 105 Billing Code List 82 Billing Cycles 124 Billing Tab Advanced and above 166 C Changing Appointment Status Office Hours Professional 144 Changing Claim Status 116 Changing Statement Status 123 Chart Number Shortcut Keystroke 29 Claim Management Overview 110 Claim Rejection Messages 124 Collection Letters 132 Collection List 129 Collection Reports Advanced and above 156 Color Coding Tab Advanced and above 165 Contact List Advanced and above 83 Converting Statements 121 Creating a MultiLink Code 191 Creating a New Address Record 188 Creating a New Deposit 210 Creating a New Diagnosis Code 192 Creating a New Procedure Code 189 Creating a Practice 32 Creating Claims 112 Creating Collection List Items 213 Creating Multi Views Office Hours Professional 218 Creating Reason Codes 217 Creating Statements 119 Creating Templates Office Hours Professional 218 Custom Report List 158 Customizing Collection Letters 215 223 D Data Entry Tab 161 Day Sheets 153 Deleting an Appointment 144 Deposit Payment Applicati

Medisoft 17 User Manual

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