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AxiUm Payment Plan User Manual

1. Type Claim Code F Amount 0 Description Complete Tx Enabled for in process or planned treatment only indicates to complete the currently selected treatment and create a new claim for it Complete Tx Last Claim Enabled for in process or planned treatment only indicates to complete the currently selected treatment and add it to the last claim created In Process Tx Visit Enabled for in process treatment only Allows the user to indicate that the patient came in for a treatment visit but the currently in process treatment is still not completed Suspend In Process Tx Enabled for in process treatment only Allows the user to suspend the treatment This will prevent anyone from completing the procedure and is most often used when a patient is not expected to return to the clinic Rebill Treatment Allows the user to re bill the currently selected treatment Rebill Treatments Francesco Harry Practice School of Dentistry v4 20 01 D e Dental Medic Both Add Default Fee Guide UGRAD D Facility HD D Add Special an Cl Rebill C Current Policies Subscriber Ins Co Sch Asa Group Deg Des D C Original Policies 241546987 GWL G Policies Effective 241546987 CIGLAM D on Treatment Date Modify Tx DentalCd Medical Cd stef sutace Original Claim Date Prov Code Site St Description 01 05 2006 Excision pericoronal gingiva 01 05 2006 Excision per
2. ccceccceeeeceeeeeeeeeseeeeseeeeseeesaeeseueeseeesseesseeeseneeseees 40 Right Click Menu eme 40 Other WINGOW S re RR DESDE SR er SR MA deen eer A SR E RIR ME RD RR 41 Applying Ins Payment WWumdow e ereeeeere errar rear re arranca aerea arena re ana 41 SOB Ee 41 Right Click Menu GINS fond anssvesecsccuatdaascustncestredhepssveceaseesadeussendincesdtadbeuccvesnnseatad eavendeecesdtedees 42 Treatment Spin ln ele EE 44 RE EE i ME 46 Transactions Reference Manual Modified 10 May 10 1 of 47 PURON S EE 47 FIGIAS SO DUAS freee ete tase nee no ee a eee ee ee ee 47 Rig GC MENU CMS E 47 Transactions Reference Manual Modified 10 May 10 2 of 47 Introduction Transactions Colors Entry lines are displayed in various colors depending on the state of the data Black Entry that has been finalized for example a treatment that has been submitted or a payment that has been fully allocated Blue A sub total or total line Gray A deleted line Green Entry that has not been finalized for example a treatment that has not been submitted or a payment that has not been fully allocated Red An in process or in dispute line In the payment sub tab red indicates that the payment has been adjusted or reversed Salmon An Ortho Monthly charge Purple A reserve held fund Transactions Icons E This icon is available if your axiUm is set up to use patient reserves In Maintenance module Insurance tab Insurance Companies icon Ins
3. Show Allocations Displays a list of payments and or adjustments that have been applied to this charge By default when the window is opened it is listing all types of allocations To filter the list the user can uncheck the Patient Payments Insurance Payments and Adjustments radio buttons at the top of the window Allocations Iw Patient Payments Iw Insurance Payments Iw Adjustments Allocations hallocate IDO TrxDate Description Name User Date 1 Allocated Write Off p gt 2791 04 12 2006 Cashier s Che Harry Schell R 04 12 2006 5 00 0 00 0 00 Close To unallocate an item highlight the line and click on the Unallocate button To view a history for a single allocation line highlight the line and click on the History button EOB Details Opens the Explanation of Benefits EOB Details window where you can enter claim adjustment reasons Also available through Maintenance module System tab Processes icon Processes window EDI Claims button EDI Claims window Unsubmitted Procedures tab there is a right click EOB Details option Transactions Reference Manual Modified 10 May 10 17 of 47 Explanation of Benefits EOB Detai Claim Information Trx 62 Insurance E NCON D Name Doe Jane 258 EOB Treatment Details Total Submitted Deductibles Co Pay Co lns Insurance Paid 36 00 0 00 0 00 0 00 0 00 Adjudication Date 07705 2010 8 Claim Adjustment Reasons A
4. This comment will help when more than one plan exists for a patient and the cashier needs to decide which plan to apply a payment to Only bill fee if patient visit occurred An orthodontic payment plan allows the option of only billing the patient if a visit has occurred This allows setting up the orthodontic schedule ahead of time and letting the patient start payments only after the first treatment appointment has occurred With the Only bill fee if patient visit occurred option checked the system will not generate the fee for a given month if there was no patient visit to the clinic within the specified fee period The following qualifies as a patient visit e A Completed or In Process treatment posted from transactions where the procedure is in the Orthodontics category e A Completed or In Process treatment posted with the Practice s Ortho Visit Procedure Code e An Ortho Visit entered in the Ortho module Note axiUm does not consider this flag on the initial down payment and will always post it axiUm looks for records with a date between the fee posting and the previous regular fee For example if you have monthly fees on the 1 of every month and there was one of the above patient visits with a date between September 2 and October 1 axiUm creates the fee for October 1 Regular Schedule Section Down Payment Enter the amount of the expected down payment This can be left as 0 00 if no down payment is expected T
5. This will default to the current date but Date EE 8 Cancel ifi ance n m ifi Code Type me pe Description Amount 7 00 oo Pace ae E RIE The user can type the adjustment code or select it from the adjustment code list The full description of the code entered selected will default and can also be modified if desired The type and amount fields are disabled and are automatically filled in by the system Amount will be the exact amount of the original payment Type will be either debit or credit depending on which type of adjustment code is selected When reversing a payment the user can choose whether this will affect the bank deposit or not If the refund affects the banks deposit the user must indicate which bank Reversing a payment automatically un allocates all items that are tied to it Print List Prints the full list Transactions Reference Manual Modified 10 May 10 32 of 47 Adjustment Tab Transactions Tse Maria 239 HE Gi General Treatment Charges Prt Plan Payment Ins Pmt Notes lt e di Ki Adjustment Date 22 04 2008 al ID Code Type Description Amount Appl to Current Payment Plan Remaining Affect Bank Deposit Bank Adjustment Imt Date Name Code Description Ana Applied __ Remaining Buttons New Clears all fields sets the Date field to the current date Add Adds a new Adjustment to the database assigns the ID and ena
6. 37 of 47 Sub tabs Ins Payments Sub tab iere Ins Payments for Patient me Ta e TO es aa 1487 10 23 2003 cot Insurance Cheque 123456 00 0 00 123456 00 Figure 7 Insurance Payments Sub tab List This lists the entered insurance payments None of these columns can be sorted The applied and held columns show the amount applied to treatments covered by insurance policies with this company and held the amount remaining for allocation Right Click Menu Items Show History Add Attachment View Attachment Delete Attachment Show Adjustments Disbursement Refund Payment CES Figure 8 Insurance Payments List Right click menu The following right click menu options are available for each insurance payment list item Show History Ins Payment History Ins Payment Pit Date Amount Remaining Code Description Bank 1487 10 23 2003 CD IC Insurance Cheq 399994 0 00 399995 Add Feenstra 107 2372003 1467 10 25 2003 COI IC Insurance Cheg 399393 0 00 3399995 Edit Feenstra 107 2372003 1487 10 23 2003 CDO IC Insurance Cheq 999999 999995 0 00 Alloc Feenstra 107 2372003 1467 10 25 2003 COI IE Insurance Cheq 99999 899907 0 00 Alloc Administrat 08 05 2004 1467 10 23 2003 CDI IC Insurance Cheq 999999 899907 910005 Alloc Burger D 04272007 ECH 10 25 2003 Ui E Insurance Cheq 3993992 0 00 3399993 Alloc Burger D 04
7. By typing all or part of the column entry to look up or an underscore for matching all and then clicking on the column heading all matching entries will be found For example Entering P in the List Insurance field and clicking the T Type column will find all parent companies Entering C and doing the same finds all of the local companies The same can be done with the Code EDI and Name column headings The lookup is case insensitive lf the list is preloaded the non matching companies will be discarded If not preloaded the matching companies will be listed See the Options and Settings Load all Ins Companies in list section below for more details Transactions Reference Manual Modified 10 May 10 36 of 47 The Include Inactive option allows the search to include insurance companies that are marked as inactive Pmt An internally generated unique number identifying the payment Date Intended for the user to record the remittance date This is the date on the check not the date of this entry The transaction entry date is also recorded internally as part of the audit Amount The value of the check The amount as well as the date and the code and description see below can be changed as long as the insurance payment has had no adjustments or allocations made to it and the users security level allows it Remaining Shows the amount left to allocate This value is the amount of the check less the
8. Close By default when the window is opened it is listing all types of allocations To filter the list the user can uncheck the Patient Payments Insurance Payments and Adjustments radio buttons at the top of the window To unallocate an item highlight the line and click on the Unallocate button To view a history for a single allocation line highlight the line and click on the History button Print List Allows the user to print the list of charges that have been added in this tab Pmt Plan Tab i Transactions Tse Maria 239 E Gs A General Treatment Charges Prot Plan Payment Adjustment Ins nt Hotes E W Payment Plan Guarantor ET Plan Total Charged to Date Han for Specific Charges Plan Total Total Received to Date Ww Regular Payment Schedule Balance to Charge Current Total Due Regular Schedule Payment ESA Down Payment Schedule Type Total Total Down Prot Date pO SE Starting Date aa 4 Payment Period Monthly sl of Payments Regular Fee Comment Final Fee Final Date sl M Only bill fee if patient visit occurred Payment Plan User Transactions Reference Manual Modified 10 May 10 24 of 47 Payment plans are used in axiUm to create calculate and manage a system for patient payments on account These payments can be for completed work work in progress or treatments planned for the future Payment Plan Section Buttons New Clears and defaults
9. Submitted Claims Only option will restrict the list to only those treatments that have been submitted to the insurance company otherwise all of the claims will appear Pt Allocate Apply the insurance payment to items for the currently selected patient Select a payment with remaining funds to be allocated and press the Pt Allocate button The Pt Allocate button will not be selectable if there is not a currently selected patient Applying Ins Payment Ins Payment DA Great West Health and Dental Benefits Prat hia Close Owing ooo o Date 10 03 2008 Apply 0 00 Code IP Desc Ins Check 4152 Amount 200 00 E Dm Reason E E Desc O Po l om Reason LI Dec Load A Balance 000 Submitted Claims Only Remaining 0 00 Apply Trt Date Name Code Site Suf Tast Subscriber Ins Other Co Insurance Applied __ Outstanding Figure 4 Patient Allocate Applying Insurance Payment Dialog The information displayed sorting and right click menu is identical to the general allocation dialog list menu The only difference is the addition of a Load All button This button allows the user to load all of the patient s treatments including those not covered by insurance those fully paid and those fully allocated Fields amp Options List Insurance This field is used to look up the insurance company It is used in conjunction with the insurance company list column headings
10. a dental claim that should have been billed to the medical coverage for a patient when the user checks medical the Medical Cd field and Site boxes will become enabled for the user to enter the information required Any entries modifications made in this section must be Saved before the user can proceed to Add Default or Add Special On Add Default the claim entry will be processed using the information filled in on this window and the user will not have an opportunity to modify the fee that gets billed The fee is taken from the schedule of fees indicated by the Fee Guide filed The new claim information will appear at the bottom of the window for the user to review before closing Treatment Split Treatment Split Procedure Doan ee _ On Add Special the user will be presented with the d ps a em pa Gs Treatment Split window This window displays the mes Pose Pan Te eer 40 Im Sep secs calculated split between patient and insurance and 4 00 N 000 oo p Dm 0 00 H SE SE allows the user to override the total charge and or OO zeg insurance PED the coverage amount expected from insurance Notes Policy Co pay Amount applied Rebill Claim Allows the user to re bill all items on the currently selected claim Held in Dispute Used to indicate this item is to be held in dispute Held in dispute amounts are not included in the patients expected total but
11. and review existing treatment information Any treatment entered here will be reflected in the EHR window and any treatment entered via the EHR will be displayed here Claim Section Buttons New Claim Clears the data fields and defaults the entry date to today Submit Enabled after the claim is added allows the user to submit the claim to insurance Fields amp Options Instructor Allows the user to indicate which faculty member has authorized approved the treatment that is being added Practice Indicates the practice address at which this work was performed Date Indicates the entry date for this claim Billing ID Indicates the Billing Doctor Fee Schedule to be used for this claim entry Facility Indicates the facility at which this treatment was performed This field is mandatory for the submission of a medical claim Dental Medical Both Indicates the type of claim being added Transactions Reference Manual Modified 10 May 10 13 of 47 Claim Disabled field displays the internal claim number assigned for this claim Treatment Section Buttons Split Allows the user to view modify the split between patient and insurance Medical Enabled when a procedure is added allows the user to indicate the diagnosis code ICD 9 any applicable modifier codes place of service Anesthesia minutes and referring doctor for the procedure New Clears and defaults any applicable fields Add Adds the
12. are included in overall A R for the institution Assign Tx Status Assign Tx Status Allows the user to assign a Tx Status to Sr E the currently selected line s Status Po a The user can select from a custom list of status codes to GES wa assign to the currently selected treatment Transactions Reference Manual Modified 10 May 10 19 of 47 ES Submit Claim Inquiry Form Claim Inquiry Enabled if the insurance Claim Submittance For DDPSF company accepts claim inquiries Allows Submit For Doctor F537 Schoo of Dentistry the user to print a claim inquiry form to submit to the insurance company Document Control Number TH34265 Comments Remarks ee additional documents that Delta is waiting for in regards to this E or D elt a D ent al an d D enti c al cl aim e only the user can submit a claim inquiry form The user will fill in the document control number and any additional comments or Cancel questions then submit print the inquiry form Unbatch Claim Removes the claim from the EDI submission list or print held area A claim that has been batched must be un batched prior to re billing it Additional Tx Information Additional Tx Info Allows the user to enter additional Tx Info information that is required on a claim form for Claim an Sg Prosthetic or Orthodontic work Procedure Demo a a CS E For Prosthetics the user will need to indicate whether ane
13. dialog Apply Transfer and Write Off The amount to be paid can be adjusted using the Apply Transfer and Write Off amount fields Ins Payment AADAT ATLAS ADMINISTRATORS Pmt H C Owing om Date 01 23 2009 8 Apply om Code ic Desc insChgt Amount kom e om Reason m a E o po Reason Do Desc oo Balance po W Submitted Claims Only Remaining om Figure 20 Applying Insurance Payment Dialog Apply Transfer Write Off Detail Transfer is used to adjust the amount the patient or the insurer pays In the above case an amount owing by the usurer is adjusted by 100 and this amount is transferred to the patient to pay If there is more than one insurer for the patient an amount can be transferred from one insurer to another Transactions Reference Manual Modified 10 May 10 45 of 47 The write off field is used to write off the un remitted portion of the procedure instead of transferring to the patient for payment The Reason field for the write off or the transfer is an adjustment code to indicate why the write off or transfer occurred It is best to sue descriptive reasons like deductible not met not a covered service etc Transfer and write off adjustment codes are always adjustments that apply to charges Transfer adjustment codes are always adjustments that transfer a balance amount Write off adjustment codes are always adjustments that do not transfer a balance amount There is no transfer invo
14. is one of two custom fields that can be placed on Wall the treatment entry window The school can define custom codes with Custom Fields _ any prompt and any type of data required This field and the Custom2 Fe Treatment Notet field are defined in the defined in Maintenance Basic tab Custom Desciiption Location Fields as Treatment Note1 see the dialog below The Maintenance Ae e da Basic tab Custom Codes dialog can also be used to define a list of possible entries that can be used to select the value for this field If Patient the Validate using Custom Code Table option is selected only these Pater GA Testes values will be accepted If off the value can be any user input as well Patient5 Endo Patient as a list selection Patient6 Nervous Patient Confirm Appointments Patient Short Notice Patent Active Payment Plan BCD Session User Faculty Discipline Indicates the discipline of work performed Tx Status Allows the user to identify a custom status for this procedure Commonly used to indicate a treatment was redone Custom2 Session is one of two custom fields that can be defined in Maintenance Basic tab Custom Fields as Treatment Note2 Phase Indicates the phase of treatment performed This field is disabled when adding treatment through the transactions window It displays the phase for treatments that were entered through the EHR module if applicable Seq Indicates the sequen
15. person that will be making the payments If the patient is an adult this will be the selected patient if the patient is a child this will be a parent or guardian Plan is for The Plan is for option sets the plan behavior Payment Plan Guarantor Testing Tom Han is for Specific Changes Specific Charges Pe esoe Orthodontics Down Payment Regular Sched wo 0 UD 0 m Figure 2 Plan Types detail The Plan is for option can be set to Specific Charges This payment plan option is for planned work or a combination of treatments with outstanding balances and work planned for the future Specific Charges is the most commonly used payment plan type Outstanding Balance This is a payment plan for the current overall outstanding balance on the patient account Only one outstanding balance type plan can be created for a patient This type of plan does not require the user to associate the treatment to the plan This is most commonly Transactions Reference Manual Modified 10 May 10 25 of 47 used when a contract is created to allow a discontinued patient to pay their arrears at a mutually agreed upon and contracted amount Orthodontics The payment plan is for current and or future orthodontic work where the patient may have insurance coverage for some or all of the treatments This type REQUIRES that the Maintenance System tab Processes Ortho Billings be run periodically to gene
16. the charges add the payments and then subtract total payments from total charges In this method balances are carried forward and payments applied to the oldest outstanding items first It is similar to First in First out inventory methods For example With treatment in the past that would show up in the Over 30 bucket and current treatment balances when a payment is allocated to the current balance treatment the over 30 bucket is reduced by the amount of the payment and the current balance remains at its original amount e Open Item Indicates to use an open item methodology where the user indicates which bucket to affect when allocating a payment they tie the payment to the treatment specifically For example With treatment in the past that would show Transactions Reference Manual Modified 10 May 10 4 of 47 up in the Over 30 bucket and current treatment balances when a payment is allocated to the current balance treatment the current balance bucket would be reduced and the over 30 would remain at the original balance Age Treatments e From Treatment Date Ages your accounts receivables starting from the treatment day e From Claim Date Ages your accounts receivables starting from the claim date Show Deleted Records There are two different types of deleted lines in axiUm When a user deletes a record using a Delete icon the system records this as a deleted record When a user edits a treatment and mov
17. this is the initial prosthetic placement and if not the initial placement then the date of the original jw Is Prosthetics Is the initial placement Initial Placement Date E For Orthodontics the user will indicate whether the Reise appliance was replaced the appliance placement date Appl Placement Date l the total months of ortho care to be completed and the Bete Wegete number of months left in the ortho care Add Student Eval Allows the user to enter an evaluation of the providers performance Refer to the document Grading_ Staff for details of how to complete the grading information for the provider Tx PreAuthorization EJ PreAuthorization Allows the user to indicate whether a Tx preauthorization has been received from the insurance for Pre utht 547 Ps the currently selected procedure eg KS When preauthorization is received the user will select the EE insurance company that the pre auth came from and will TC Pte Authorization Denied enter the PreAuth Effective and Expiry dates If pre Seen Ta authorization was denied the user can indicate this also er E E EEE and or override the denial with an authorization exception 241546987 Ga G Yes D like Emergency Print List Prints the full list For planned treatments there is the following additional right click menu items Change to In Process Enabled for planned treatment only indicates to ma
18. to add additional fees to the account that are not necessarily treatment specific These are things like records copying fees returned check charges etc Buttons New Clears and defaults any applicable fields Add Adds the record to the list Modify Saves any changes that have been made to the highlighted line Delete Deletes the currently selected highlighted line Fields amp Options Practice Indicates the practice address at which this charge was added Date Indicates the entry date for this charge Code Indicates the charge code Can be typed or selected from the list Quantity Indicates the number of units of lt code gt to charge for Description Description of the charge being added to the account Custom1 lt Location gt Optional field Location in the image above is one of two custom fields that can be placed on the window The school can define custom codes with any prompt and any type of data required Custom21 Optional field To the right of Location in the image above is an area where one of two custom fields can be placed on the window The school can define custom codes with any prompt and any type of data required Transactions Reference Manual Modified 10 May 10 22 of 47 ID Disabled field is the Internal ID assigned to this charge entry Provider Optional field to indicate the provider that requested the charge be added to the account Amount The amount to add to the patient acc
19. 0 May 10 29 of 47 If the user has made some allocations that they now wish to cancel out of in order to make different allocations they can click on the Clear All button This will refresh the list to its non allocated state and allow the user to start over If the treatment is not in the list the user can click on Load All to see all treatments on the patient account even 0 00 items The list will refresh and all treatments will be displayed whether there is an amount expected from the patient or not Pre pay allows the user to reserve funds for a specific purpose Please see the Patient_PrePayments pdf for details on this feature Receipt Allows the user to print a receipt for the payment Receipt Printout Ji es Print receipt for the Date period Fom DEE 8 to 17 04 2008 8 The user can select a date range for the receipt print out and choose whether to include payments only or include both payments and charges that have been added to the patient account Include payments only oo Doe John v Comment E SE Custom comments can also be added Copies 1 Print Cancel Fields amp Options Payor Select the guarantor that payment is being accepted from Select Pt For a payor that has multiple dependents allows the user to select another patient in order to take additional payments without having to leave the transactions window Code Abbreviated code that represents the form of payment
20. 2 72007 ECH 10 23 2003 CDI IC Insurance Cheg 123456 0 00 123456 Edit Burger D 04 27 2007 Figure 9 Insurance Payment History Dialog The Insurance Payment History dialog lists all of the the transactions performed with this insurance payment The Type column shows what was done The first item is always an Add type meaning the initial check entry Edit type history items are changes made to the initial entry These can only be made if there are no allocations or adjustments on the insurance payment amount Transactions Reference Manual Modified 10 May 10 38 of 47 Add Attachment Add Attachment ins Pmt Attachment Date 07705 2010 Company Great west Health and Dental Benefits Cancel Trait i Description Attachment E El Use this window to browse to the file location for the attachment Insurance payment records with an attachment displays on the line below the Trx column heading View Attachment e If you have only one attachment axiUm displays it e lf you have multiple attachments axiUm displays the Select Attachment Ins Pmt window From the list view highlight the attachment you want to see and click the OK button Delete Attachment Removes the attachment on the selected line Show Adjustments Insurance Payment Adjustments Adjustments Close JD Dae Description Amount User 1821 04 27 2007 Payment Refund 1000 00 7 Burg
21. 2008 Guarantor Doe John GDL Home Servic Last Recall 22 12 2008 Emergency Tomas Nicoletti Nest Recall tis Manager Tow Dave UNCON Next Appt d Patient Type GOL Home Servic Last Strt By ty E ee gt 120 7 00 0 00 0 00 0 00 116 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 Custom REVIEW 0 00 eee 16 05 05 73 070 Ee Tx History Pending Unapproved Tm Date Name Prov Code Site Description Patient Insurance o 16 04 2009 Jane Pay Copy UU U UU p 21 16 04 2009 John Cash d UU 0 00 Running Balance 0 00 0 00 Fields amp Options The currently selected Patients name and chart number is displayed at the top left Guarantor Name of the primary guarantor for this patient Emergency Emergency contact name Manager Name of the manager assigned to the patient Patient Type Category given to the patient For example Ortho Typodont Pedo Alert Codes Patient Alert codes used for quick information on patients customizable hover mouse over to get full description of the code Office Codes Quick reference codes used by the Office customizable Custom Codes Additional quick reference codes used by the Office customizable The center of the window displays the primary and secondary insurances for the patient Last Visit Date of last patient appointment Last Recall Date of patient s last recall Next Recall Date of patient s next recall Next Appt Date of next scheduled appointment Last Stm
22. Can be typed in or selected from the list Desc Description of the form of payment For personal checks it is recommended that the user type the check number into this field for auditing purposes Pmt Disabled field displays the internal payment record number Date The date that the payment was received or the date that a post dated payment becomes viable Bank The cash drawer that the payment was taken at Can be typed in or can be selected from a list Amount The amount of the payment Remaining Disabled field displays the amount remaining to be allocated to the patient account This field will be blank until the payment is added Apply to Current Pmt Plan Indicates that this payment is to be applied to one of the current payment plans for this patient If there are multiple active payment plans the system will prompt the user to select one Today s Disabled field displays the amount of charges added to the patient account today Discount Disabled field displays the amount of discount this patient is eligible for This is a discount based on the payment code selected for example if they pay cash they get a 10 discount Today s Due Disabled field displays the amount that is due from today s charges This is the calculation of Today s minus any eligible Discount Balance Disabled field displays the amount of all charges on the patient account excluding expected payment plan fees This is
23. History Payment Plan 0 Cose Guarantor Ton L Ges Lieu Plan is for Specific Charges eet ew Closing Bal Regular Schedule Down Papment of Payment Down Prot Date Regular Fee Starting Date Final Fee Payment Period Monthly Final Date Comment E onp Gi Fee ih patent iet occunmed Trt Name StatDate Regular Fee EndDate Total Type Lise Modified Date 2bb4 D ummy 08 05 2007 102 00 08 04 2008 1234 00 Add Burger Tom 08705 2007 13 11 z664 Dummy 08705 2007 102 00 05 04 2008 1235 00 Edit Burger Tom 0870572007 9 13 22 View Payment History Displays a list of the payments that have been received and applied to this payment plan Transactions Reference Manual Modified 10 May 10 2 of 47 Payment Plan Payments 221022 08 05 2007 44 00 000 WG BEE WE Ut do Ooo S O BE S Print List This option prints the entire list to the selected printer Transactions Reference Manual Modified 10 May 10 28 of 47 Payment Tab Zi Transactions Doe Jane 258 Vite General Treatment Charges Prot Plan Pagment Ins Pmt Notes e a di Ki Payment Doe Mrs Jane Today s DUU 3260 Wilson Ave Discount Parker w i 98939 Today s Due 0 00 Fapor John F35 Bank M Balance 700 Select Dt Amount Fmt Plan Bal 116 00 Code E Remaining Unapproved 0 00 Desc M Apply to Curent Prot Plan Total 123 00 Paym
24. aculty member Discounts e Auto Discount Indicates to automatically write off the patient expected portion of a procedure where the insurance company s fee schedule is higher than the charge for non insured patients and clinic s will be billing the higher fee for patients covered by this company If this is the case then the insurance company will be billed their amount but the patient portion will be automatically written off For example if the regular fee amount is 40 but the insurance will cover 60 of 100 then the insurance company will be billed 60 and the patient billed 0 This flag works in conjunction with the Write Off flag in the patient policy record NOTE In most cases an agreement between the clinic and the insurance company is required before this option may be used In order for this to work the Transactions Options Auto Discount flag must be checked and the Bill Option set to Higher Fee the procedure must NOT have an individual charge the patient policy must be set o Write Off and the patient must NOT have a fee schedule specified in the Patient Information window e Binding Quote Planned The fee is held at planned stage i e when you do not know who is providing treatment Deselecting this checkbox enables the auto selected Binding Quote In Process checkbox e Binding Quote In Process Fee is held at in process stage i e when you know who is providing treatment Th
25. allocation and adjustments made It cannot be edited Figure 5 Bank Codes Dialog Bank Codes Code EM Inacti ode nactive Bank The payment handling area selected from Name Cashier Station 00 the list of entries defined in the Maintenance Address Transactions Bank Codes list This may a departmental accounting construct or an actual City State E physical cash drawer it does not refer to a financial i County institution Business Office BO Cashier Station 1 Payment Codes Figure 6 Payment Codes Dialog ze Zz a des Code The predefined payment code selection The entry can be typed in or searched for but must be an j yriant Leable entry from the Payment Codes dialog list below This Cole P e e list is created in the Maintenance Transactions Description Cash Payment Codes icon Print Description Cash Bank Defaut T fFiom Patient To geg bank sad a me SE SE SN e e insurance payment bank setting when selected Discount Percent 0 00 E The description can be altered as desired after the eege SEN code is selected but both of the Code and description SE fields in the Insurance Payment dialog must have an entry AE Piece Eanes List Details For Displays the setting for the cut off on Bank Card insurance payments to be displayed This date is CE Cahiers Check defined in Transactions Options and Settings CK Check Transactions Reference Manual Modified 10 May 10
26. and the sub tab currently selected there are different right click options available Show History This menu item displays the Treatment History dialog which shows the edits made to the selected line in both the Treatments and Planned sub tabs Transactions Reference Manual Modified 10 May 10 16 of 47 Treatment History x o SPSS E Deg O Mercal C Eon Comi Dae RT Sbst Tinto sehn Tha Tiom BilinglD DOCTOR Ve ves Faciity MN ooo Treatment Date 04 26 2007 Code po010 Ste H Suface Provider D_TOM Description D0010 with lab and Site Unit Dm Total fi 23 00 Patient 0 00 Insurance fi 23 00 Split Status Ic Location ps Discipline Additional Tx NORMAL Session Phase Seq 0 E Bil on Pmt Plen Status RR TST 3 U Car AQEr LI Ue r CH es 00 123 00 0 00 C Aler re TESE 14 18 Burger D wier O with lab Claim Submission History Claim Submission History Displays a list of Claim Information Close submission dates for the selected claim and Date 01 05 2006 whether the claim was sent electronically or on ld 5742 paper 03 28 2006 mg era Dental ars Loge This window is used to determine how when a claim has been submitted The user cannot perform any action within this window It is for lookup only Tx Consent History Will print out a history of all treatment based consents that have been created that includes this treatment
27. ansactions Reference Manual Modified 10 May 10 34 of 47 Ins Pmt Tab Ki Transactions Doe Jane 258 EEE General Treatment Charges Pmt Plan Payment Adjustment Ins Prat Hotes E Ge ia w Ins Payment List Insurance Include Inactive Fmt New Date sl Add Amount Do F Delta Dental DGA 94776 Delta Dental of GA Dolo CDIA Delta Dental of lowa Remaining 0 00 ET o West Health and Dental Be Cx no United Concordia Tricare Dental Bank Code E Description List Details For 60 Month s Ins Payrnents Ine Payments for Patient 10 05 2003 DU Ins Check 4152 200 00 125 00 Total 200 00 125 00 The insurance payment tab of the axiUm transactions module allows the axiUm user to record an insurance company s payment to the school and allocate disperse apply pay the outstanding insurance balances of patients that have insurance policies with the insurance provider This section of the Transactions module is used to apply bulk insurance payments or individual insurance payments Insurance payments can be applied to the currently selected patient s treatments or a group of patients treatments selected from a list by the user A patient does not need to be selected to use this tab of the Transactions module except for the Insurance Payments for Patient sub tab Considerable effort has gone into making the insurance payment tab as flexible an accounting tool as possible Cha
28. any applicable fields Add Adds the record to the list Modify Saves any changes that have been made to the highlighted line To modify the plan the user can make a change to any of the enabled fields on the main payment plan window and click modify To make changes to the schedule or what s applied to the plan click on Edit Sched or Apply Delete Deletes the currently selected highlighted line You cannot delete a payment plan that currently has a fee due You must first edit the schedule so that nothing is now due before the deletion can be completed Apply Allows the user to apply the currently selected payment plan to treatment or charges Please see the Applying Payment Plan Treatments section below Edit Sched Allows the user to modify the current schedule of payments expected for a payment plan Please see the Editing Payment Plan Fees section below Contract The contract button allows the user to view and get a print out of the payment plan contract This contract can be signed electronically by the patient or the patient can manually sign the paper copy The contract content is customizable and may include coupons that the patient could cut out and return to the dental institution with payment Ortho Billing This begins the ortho billing process and creates any applicable ortho billing fees Fields amp Options Guarantor Name of the responsible party for this payment plan The Guarantor is the
29. ar on the next bank deposit report Do not select this option if the next bank deposit report is not the same bank deposited report that the insurance payment itself appears on If the adjustment does not appear on the same bank deposit report as the insurance payment does this would likely lead to confusion Do not change the Apply to chee Payments E setting to charges before selecting the refund code Charge adjustment codes cannot be selected and cannot be edited from the Refund Insurance Payment dialog interface The user will have to use Maintenance Transactions tab Adjustment Codes to do this Print List This prints everything in the insurance payment list to the selected printer Ins Payments for Patient Sub tab Ins Payments Ins Payments for Patient Tet Date Ins Co Code Description PmtTotal TxAmount Appled Tx Balance 566 03 05 2003 AET IC Insurance Cheque 10000 00 800 00 700 00 0 00 566 03 05 2003 AET IC Insurance Cheque 10000 00 500 00 500 00 0 00 Figure 13 Insurance Payments for Patient Sub tab List This lists the insurance allocations for the currently selected patient None of these columns can be sorted This lists individual allocations to treatments for the current patient The Trx field is the insurance payment entry number The Date field is the date the allocation was made The Pmt Total field is the check amount Tx Amount the original insurance balance of the tre
30. atient Note Codes Code The user can select from a pre defined NAB Alaa list of commonly used notes by either typing the EEN note code here or selecting the note from the Code Im ellipsis button Text E Text The full content of the note Third Party Payment Info Insurance needs additional info from patient Info Insurance needs additional info from dentist Info needed Claim denied for frequency Reason Claim denied due to missing tooth clause Remarks Claim denied due to waiting period Remarks Claim denied because it was not preauthorized Claim denied Patient is not covered Reason Claim denied Procedure not a covered benefit Insurance terminated Date Info required on student status Need denial for secondary insurance Deductible portion of payment Claim denied Other reason Deductible Notes Final paper billing attempt to insurance allow 45 days for a response then tran Insurance Claim Requested for DOS INSURANCE DENIED PAYMENT FOR DOS INS A R Insurance Pre Auth submitted today INS DETAIL DATA Ins Frequencies and Limitations Bill for insurance only Insurance information received Updated acct amp re billed services Right Click Menu Items Show History Displays a history of changes to the currently selected note line Print List Allows the user to print the list of transaction notes Transactions Reference Manual Modified 10 May 10 47 of 47
31. ation Close Date i 2 20 2003 Id H 4890 Date ps Description Submitwia Io User O21 7 2004 AET Aetna Insurance Paper 5 Feenstra Rose 0609 2004 AET Aetna Insurance Paper 5 Administrator Ja 011272005 AET Aetna Insurance Paper 5 Administrator Ja 03142005 AET Aetna Insurance EDI Clair 5 Administrator Ja Show Allocations The allocations and allocation history can be viewed and selected allocations can be reversed using the Unallocate button Transactions Reference Manual Modified 10 May 10 42 of 47 x M Patient Payments IY Insurance Payments M Adjustments Allocations RUSS KE reg Nae se CEET kee Coes History Close Allocation History x Jh Patient Payments WM Insurance Payments M Adjustments Allocations ose Ip Tr Date Description Name Lise Date Allocated write DL Des Do 1467 10 23 2005 Insurance Ch AET Burger D 05 03 2007 0 00 0 00 0 00 p 1487 10 23 2003 Insurance Ch SET Burger D 05 03 2007 0 00 0 00 0 00 The display of patient payments insurance payments or adjustments is selectable for both dialogs Note that separate insurance payment allocations for the same treatment from the same insurance check will be summed and displayed as a single list item Rebill Treatment This menu selection allows the treatment to be completely rebilled The treatment billing details can be changed as well as the treatment billing split between the pa
32. atment and Applied is the amount applied to this treatment Tx Balance is the remaining insurance balance for the treatment Right Click Menu Items Disbursement Refund QverPayment Reverse Payment Print List e ee Figure 14 Insurance Payments for Patient List Right click menu Transactions Reference Manual Modified 10 May 10 40 of 47 Disbursement This menu option shows the allocations for the selected Insurance Payments for Patient list item These allocations can be unallocated here _ Insurance Disbursement Ins Payment Allocations Unall K k hall ate i pas Description Site Name Ins Co Subscriber Allocated LI Transfer Write OFF Pr rir ae Close Refund Overpayment and Reverse Payment Like the insurance payment refund this menu item allows the payment allocation for this patient s selected treatment to be allocated either in part as in the Refund Overpayment or the entirely with the Reverse Payment menu option The dialogs are identical except that the Refund Overpayment option allows the user to edit the refunded amount Refund Insurance Payment Adjust Insurance Payment Date 056 037 Ins Co Rye o ooo Code Do E Description FO Amount om Affect Bank Deposit Bank RR Figure 15 Refund Insurance Payment Dialog from Refund Overpayment Print List The contents of the currently displayed list are printed to the sel
33. axilUm ni Transactions Reference Manual Version 4 81 Contents Jade ele E aila SE 3 Transactions e e 3 TRAM Sa CHONG ICON E 3 TS NES EE 9 FEIOS SS ODOR casais ente b i a an Gata DE debate Ga E RE EN seia adia EEE 9 Eeer eebe 10 TX TANS LOI GUDA D E 10 Ponding SUD UAB EE 10 Unapproved Sub tab EEN 10 Right Click Menu Hemes 11 Ru E E 13 Clan Kn EE 13 BOUON gato centers acta ne E DERRADEIRA RENA E 13 Bic a Cg a ODNONS assadas ene ar ee een ea ee ee E eee ee eee dE 13 Treatment SCC WO E 14 SAD 16 CMN 14 FNS S en 14 OS ee Ee 15 Treatments SUD ta Disaran et ae ne se pri 15 FAIS Re ME 16 Right Click Menu Hemes 16 Et tegen 22 BE NS EE 22 eebe 22 FeO CCR Nena tado segs hecacss hate saceddonstectata added Lenta dence tioreeeaiqusancodsocacet a E aE 23 Sun a TOD EE 24 Payment Plan 3 CCUON EE 25 BOUIN ONS EEN 25 FEIOS ne E 25 Regular Schedule Section cccccccsecccseeceececeneeceueeceeeceucecaucesaueeseeecaeeseusessusesseeesaeeseueessusesaaes 26 Right Click Menu Hemes 2 Kusel Ke E 29 Si el E 29 Eelere ee EE 30 Right Click Menu Hemes 31 ATO UU o tag si eebe 33 DUNONG RR RE ERR E SR DERRAME DR E SRP PA IRS 33 FIGIOS IS ODHONS ieee ee ee en dao end dn pes Se De pa ssa nE pe E e pe 34 Right Click Menu Hemes 34 BUMS Sonn gi EE 35 DUNORS E 35 SIE 6 6 9 CN 36 SE ebe 38 ins sb doe ING SU TaD r RGE REINER VR EDER O NEON RN 38 Right Click Menu eme 38 Ins Payments for Patient Sub tab
34. bles the Modify Delete and Apply buttons Modify Any changes to the fields within the window are saved to the database and updated when the modify button is clicked Delete Prompts warning message about deletion performs check to see if Adjustment has been applied if so error message is display If everything matches the deletion criteria correctly the item is removed from the list box and all fields are cleared Apply Opens the Apply Adjustment Dialog the user to apply the currently selected adjustment to Applying Adjustment GC Adjustment e po Code ID Ceci Appl Description Type zen Amount Remaining Den _ jo Apply 150 00 Date Name i Code Site Sur 6059 09 25 2006 Kirkland DENT 5D5 D8080 Comprehensive 100 00 0 00 6124 10 10 2006 Kirkland DENT SD5 D8803 Ortho Semi Ann 150 00 0 00 6204 11 10 2006 Kirkland DENT SD5 D8803 Ortho Semi Ann 150 00 0 00 Transactions Reference Manual Modified 10 May 10 33 of 47 Fields amp Options Date Required Date of Adjustment defaults to today s date on New Code Required Type the adjustment code or click the ellipsis button to open the Adjustment Codes list To select a code double click on it in the lower list Description Auto populated if Code is selected or entered and there is an associated description with it It is a free text entry field so it is modifiable even if it is auto populated Apply to Current Paymen
35. ce of treatment performed This field is disabled when adding treatment through the transactions window It displays the sequence for treatments that were entered through the EHR module if applicable Bill on Pmt Plan Indicates that this treatment should be applied to the current payment plan Submit Allows the user to submit the claim for currently selected item s Instructor Allows the user to select the instructor that approved the procedure Sub tabs Treatments Sub tab Treatments Planned Imt Date Prov Code Site Surf Description Patient Insurance Total Claim Total 1425 00 O00 1425 00 41 10 03 2003 D555 LOSS Bact studies 0 00 125 00 125 00 Claim Total 0 00 125 00 125 00 Total 1425 00 126 00 1550 00 a 4 d t The Treatments tab only shows treatments that are in process or completed Transactions Reference Manual Modified 10 May 10 15 of 47 Planned Sub tab Treatments Planned EE The Planned tab only shows treatments that have been planned and approved Right Click Menu Items Show History Claim Submission History Tx Consent History Show Allocations FOR Details Complete Tx Complete Tx Last Claim In Process Tx Visit Suspend In Process Tx Rebill Treatment Rebill Claim Held in Dispute Assign Tx Status UnBatch Claim Claim Inquiry Additional Tx Info Add Student Eval PreAuthorization Print List Depending on the type of record that you select
36. ected printer Other Windows Applying Ins Payment Window Sort Columns The list of treatments with insurance balances in the Applying Ins Payment dialog can be sorted in ascending order only by clicking on any column header This will cause the list to sort on the column clicked and allows the user to sort the list in the same manner as the EOB that they are allocating from Transactions Reference Manual Modified 10 May 10 41 of 47 Right Click Menu Items Select Patient Patient Info Claim Submission History Show Allocations Rebill Treatment Add Sticky Note Transactions Note Print Statement Print List Figure 16 Allocating Insurance Payments List Right click menu Select Patient This menu option makes the patient in the currently selected item the currently selected patient in axiUm Patient Info This menu option displays the patient information dialog If a claim was rejected because of missing information the user can correct the data here and return to the insurance window to re submit the claim Patient Info Boultbee Janice Personal Codes Clinical Guarantor Employer Insurance Oo Save Mame a Status Title Sex Unknown sl hd Patient a last Boutbee Birth 05 02 1350 HAEN T Emergency Claim Submission History This option shows the claim submission history for the selected treatment Claim Submission History Claim Inform
37. electronically or on paper Claim Submission History Claim Information l Cl Date 01 27 2006 ose ld 5750 03 28 2006 GWL Great West Dental EDI Claim Schell Robin Disbursement Displays a list of charges that this payment has been applied to Payment Disbursement To u nal locate an item e ii highlight the line and click Date Pract Description site Prov Discipline Locati Progn Name Allocated 5742 01 05 2006 DENT Excision pericoronal 51 ORSURG T_Clin Harry 30 40 Coe O n th e U n al locate b utto n lt gt Print List Prints the full list Show Adjustments Displays a list of adjustments that have been made to this payment line Patient Payment Adjustments m Allocated Adjustments Unallocate Description fei o To unallocate an adjustment highlight 301 08 17 2005 NSF Check Harry 147 20 the line and click on the Unallocate button Transactions Reference Manual Modified 10 May 10 11 of 47 Show Allocations Displays a list of payments and or adjustments that have been applied to this charge Allocations By default when the SC Iw Patient Payments Iw Insurance Payments Iw Adjustments window IS opened It IS ocations CIS aoa ss Dae Tee Tee wie of listing all types of allocations To filter the list the user can uncheck the Patient Payments Insurance Payments and Adjustments radio buttons at the to
38. ents Tmt Date Name Code Description Amount Appied Pete Hei z 16704 2009 Joke 0 00 0 00 0 00 0 00 The upper left of the window displays the name and address of the currently selected patient Buttons New Clears and defaults any applicable fields This button should be pressed for each new payment entry Add Adds the record to the list Modify Saves any changes that have been made to the highlighted line Allocate Allows the user to apply the payment to specific items Applying Payment pare o es Jet Pmt H To allocate to a specific item in the alabanian Lircie D D D D D SE a a Zei list highlight the item and click on 2 625 Amount TI _ the Apply button Code INTER Description nero o Bank Auto Apply Apply f 1 92 Remaining Tre Date Name Practice Prov Code Site Sut Total Amount Appled Clear Al To have the system automatically gu 01 25 2008 vi DENT Zo Ge 2 64500 44800 A8 Lenia apply the funds to the oldest 5747 01 26 2006 H DENT 599 D4999 68 51 68 51 0 00 an 02 02 2006 Hany DENT 99 INTR us ma 0 00 outstanding balances on the ER a e a atient account click on Auto 6043 08 29 2008 Hay DENT sp D3330 30 258 05 5 00 0 00 A J 6144 10 23 2006 Hary DENT F537 D2150 6 MI 237 00 14200 0 00 pp y Pre payments Ing Date Name Practice Prov 1 Discipline Location Prog Total __Amount Appied Pepe Transactions Reference Manual Modified 1
39. er ODS Delete Figure 10 Insurance Payment Adjustments Dialog The Insurance Payment Adjustments dialog displays only the adjustments made to the insurance payment These will always be payment refunds Adjustments can be selected and deleted Disbursement Insurance Disbursement mt an 1 rins Payment Allocations Ip Date Description is Name Ins Co Subscriber Allocated Transter write OR Pririt Clase Figure 11 Insurance Payment Disbursement Dialog Allocations made with the insurance payment item that is currently selected are displayed in the Insurance Payment Disbursement dialog Each allocation can be reversed by selecting it in the list and pressing the Unallocate button The entire list can also be printed Refund Payment Transactions Reference Manual Modified 10 May 10 39 of 47 Refund Insurance Payment Adjust Insurance Payment Cancel it Description Amount 5877 00 Affect Bank Deposit Bank Figure 12 Refund Insurance Payment Dialog Part or all of an insurance payment can be refunded When the required refund code is selected only the refunds that apply to payments will be displayed None of the refund adjustment s options has any effect on an insurance payment refund entry An adjustment will only refund part or all of a payment it cannot increase the amount The Affect Bank Deposit option will make the adjustment appe
40. es it from Planned to In Process Planned to Complete or In Process to Complete the system records this as a strike out record an axiUm internal delete e All Indicates to show both deleted lines and strike out lines in the transactions list windows e None Indicates to hide both deleted lines and strike out lines in the transactions list windows e Strike outs Indicates to show strike out lines in the transactions list windows but not deleted lines Show Treatment Steps Some institutions add steps to procedure codes as a teaching tool or method of performing grading on each individual piece of the procedure that must be done This most often used in an undergraduate area for difficult procedures like a bridge When steps are used the workstation can be set to either show or hide the steps in the transaction module axiUm calls the steps children of the parent procedure the procedure that was broken down into several steps e Yes Indicates to show all steps of a procedure e No Indicates to hide all steps of a procedure and show only the parent code Show Ortho Fees on Treatment List Affects only the Treatment tab e Yes axiUm displays any ortho treatments and billing in the list e No axiUm remove any ortho treatments and billing in the list Sales Tax section Charge Sales Tax e No Do not apply sales tax e Yes use Practice rate Apply sales tax using the practice rate set in Maintenance m
41. g Option e Doctor Fee Indicates to use the institutions fee schedule when treatment is rendered taking in to account any overrides exceptions and discounts as appropriate e Patient Fee Indicates to use the patient s fee schedule when treatment is rendered taking in to account any overrides exceptions and discounts as appropriate e Higher Fee Indicates to use whichever fee is higher the doctors or the patients when treatment is rendered Billing ID Types e Fee Guide Indicates to list only Id s that are defined as fee guide types in the Billing Id field on the transaction window and Check Out Patient window With this option the workstation can have all billing occur under the licensing of the clinic dean for example e Doctor Indicates to list only Id s that are defined as doctor types in the Billing Id field on the transaction window and Check Out Patient window With this option the workstation has all billing occur under the licensing of the specific doctor that rendered care Transactions Reference Manual Modified 10 May 10 6 of 47 e Both Indicates to list Id s that are defined as doctor types or fee guide types in the Billing Id field on the transaction window and Check Out Patient window This allows the workstation to bill under either the clinic dean if for example treatment is performed by an undergraduate or the specific doctors license if for example the treatment is performed by a f
42. icoronal gingiva New Claim Inn Date Prov Code site Surf Description 1 Patient Insurance Total The Rebill Treatments window allows the user to make several modifications to the treatment claim Transactions Reference Manual Modified 10 May 10 18 of 47 Practice The practice address to which the remission should be sent Also used for reporting purposes to determine where the procedure was performed Indicate whether this will be strictly a Dental procedure strictly Medical or can be billed to Both dental and medical coverage s Fee Guide The schedule of fees and licensure information to use for this claim Facility The facility at which this procedure was performed For medical claims this is required for dental it is optional This indicates the place and type of service on a HCFA claim form Rebill with Current Policies use the policy information currently in the patient card to calculate the patient insurance split Original Policies use the policy information that was used when this treatment was first entered in the system to calculate the patient insurance split or Policies Effective on Treatment Date use the policy information in the patient card that was effective on the date of treatment to calculate the patient insurance split The Modify Tx section becomes enabled as needed when changing the Dental Medical Both flags at the top of the window For example if a claim was originally
43. is checkbox is auto selected and is enabled if the Binding Quote Planned checkbox is deselected Payment Options section Payment Adjustments e Include appointment estimate in Today s amount Indicates to include amounts estimated on today s appointments as part of the total due from the patient in the Payment tab of Transactions Estimate amounts are defined in the Maintenance Scheduler Tab Appt Codes window Each appointment code can have an estimated value for the work to be performed when this appointment code is used e Allow entry of negative reverse adjustments Indicates that the institution allows adjustment codes to be entered as negative amounts or as the reverse of how the code was defined For example to use an adjustment code that is defined as a debit but enter a so that it then becomes a credit Insurance Payments Insurance payments can be set to display payments for a period of up to 999 months ago to today s date or for a period beginning and ending with absolute dates Transactions Reference Manual Modified 10 May 10 7 of 47 e List Details For Months Disabled if Between and is checked Indicates how many monihs to display an insurance payment in the Transactions Ins Payment Tab e Between and __ Disabled if List Details For _ Months is checked Indicates a date range for the display of insurance payments in the Transactions Ins Payment Tab Payments entered betwee
44. k as NSF Payment insufficient funds the user can right click on Date 10 20 2006 8 Cree the payment and quickly reverse the credit on Code NSF Type Debit the patient account Description INSFCheck i Amount ba 2 When a check is returned from the bank as insufficient funds the user can right click on the payment and quickly reverse the credit on the patient account The date of the reversal is entered for auditing purposes This will default to the current date but can be modified The user can type the adjustment code or select it from the adjustment code list The full description of the code entered selected will default and can also be modified if desired The type and amount fields are disabled and are automatically filled in by the system Amount will be the exact amount of the original check payment Type will be either debit or credit depending on which type of adjustment code is selected Refund Payment Transactions Reference Manual Modified 10 May 10 31 of 47 Kamera The date of the refund is entered for auditing Refund Payment purposes This will default to the current date Date 10 23 2006 8 Se but can be modified Code REF Type Debt Description Payment Refund Amount mm The user can type the adjustment code or Affect Bank Deposit Bark TI a select it from the adjustment code list The full description of the code entered selected will defa
45. lved with a write off Notes Tab Ki Transactions Tse Maria 239 Ho Il fel DE E General Treatment Charges PmtPlan Payment Adjustment Ins Pmt Notes d Ki Hotes Code PTREF E Date 22 04 2009 sl Text Patient was referred to another service and a financial adjusment was made as treatment could not be completed by resident Delete Transaction Notes Date User Description fefOd2009 Admin Axium Patent was refered to another service and a financial adjusment was made as treatment could Notes that relate to the financial side of a patient record are suggested to be kept separate from the clinical chart notes For this reason axiUm has a Transactions Notes tab Here the user can enter a note and rest assured that only people who have access to the financial data will be able to see it To choose the note to use double click on the note lien in the lower list This will pull the note text into the previous window where you can then edit it add to it or simply add it as is to the patient record Transactions Reference Manual Modified 10 May 10 46 of 47 Buttons New Clears the code and text fields and defaults the date to today s date Add Adds the record to the list Modify Saves any field changes made to the selected item Not pressing this button after making changes will cause them to be discarded Delete Deletes the currently selected item Fields amp Options P
46. n these dates will be displayed payments entered outside the date range will not be displayed List all unallocated payments Used in conjunction with the radio buttons above If the display is limited to certain dates the institution may want to force unallocated payments to stay in the list regardless of the entry date so that the user can find the record and complete the allocation If checked the unallocated records will be displayed until fully allocated if unchecked the date settings will apply Load all Ins companies in list Indicates to list all insurance companies in the Ins Payment tab of the Transactions window If checked all companies will be listed and the user can scroll through them to select a company to work with This method may take a long time if there are thousands of insurance companies on file with the institution If unchecked the user must enter some search criteria and find the insurance company to work with Create Secondary Claims while allocating Ins payments Indicates that the system should prompt the user to submit the claim to the secondary insurance when the primary insurance payment is allocated to the treatment and there is a remaining balance to be paid by secondary Transactions Reference Manual Modified 10 May 10 8 of 47 General Tab Transactions Doe Jane 258 oar Treatment Charges Fmt Plan Payment Adjustment Ins Pmt Notes Ee SEH Doe Jane 258 UNCON Last Visit 26 11
47. nding Quote Planned Show Deleted Records SI e Al C None C Strike outs Show Treatment Steps E e No Payment Options from Treatment Date Show Ortho Fees fon Treatment List Ponci a eters ON ks fo No Include appointment estimate in Today s amount i Allow entry of negative reverse adjustments Sales Tax Insurance Payments Charge Sales Tax No List Details For Custom Tax Rate o op De IG Months Miscellaneous Between sl a sl PAnR List all unallocated payments Workstation Facility Override S Li Load all Ins companies in list i Create Secondary Claims while allocating Ins payments Workstation Practice Override Batch new claims instead of printing immediately Display Options section General Tab View e Date Ledger Indicates to sort the records in the General tab by the date of entry In this method a treatment line will not necessarily be displayed close to the payment that was applied to it as these entries may have occurred on different dates e Claims Owing Indicates to sort the records in the General tab by their claim In this method a treatment will be displayed next to all payments received on it and adjustments made to it with a running balance for the individual claim Patient Balance Methodology e Balance Forward Indicates to use the Balance Forward methodology where you maintain a list of charges and payments for each account To find out the balance at any point in time you add
48. nges and adjustments of treatment balances can be made notes can be added histories reviewed current patient selection changed adjustments made and reports can be printed from within the insurance payment tab section Buttons New Clears all entries and adds defaults any applicable fields Add Adds the record to the list Modify Saves any field changes made to the selected item Not pressing this button after making changes will cause them to be discarded Delete Deletes the currently selected item Only unallocated and unadjusted insurance payments can be deleted Allocate Apply the payment to treatments and charges with insurance balances owing Select an insurance payment with remaining funds to be allocated and press the Allocate button The list of patient s treatments with unpaid insurance balances covered by the insurance company will be displayed Transactions Reference Manual Modified 10 May 10 35 of 47 Applying Ins Payment Ins Payment DW Great Wrest Health and Dental Benefits Prt H E E Die oo Date 10 03 2008 E Apply 0 00 Code IF Desc Ins Check 4152 Amount 200 00 MM 0 00 Deason E Desc 0 00 Reason Desc Balance 0 00 Submitted Claims Only Remaining 0 00 Apply Inn Date Name Code Site Sut Total Subscriber Ins Other Co Insurance Applied Outstanding Figure 3 Allocating an Insurance payment Applying Insurance Payment Dialog The
49. odule Office tab Practice Address icon Practice Address Transactions Reference Manual Modified 10 May 10 o Of 47 window Practice button Practices window Practice Options window Transactions Options section there is a Tax Rate __ field new e Yes use Custom rate Apply sales tax using a custom rate Custom Tax Rate sales tax using a custom rate Miscellaneous section Default Bank Indicates which bank cash drawer is the default for this workstation When set the user will not have to select the bank code when entering a payment This can be used to override the default bank code associated with an individual user when they enter records at this workstation Workstation Facility Override Indicates which facility to use as the default when treatment is entered from this workstation The facilities place of service code is printed on HCFA claims Workstation Practice Override Indicates the Practice address to use as a default when treatment is entered from this workstation This overrides the default practice associated with the provider Batch new claims instead of printing immediately Indicates to batch claims to either the Print Held or EDI Claims area of Maintenance System Tab Processes instead of immediately printing them on submit In this way the claims can be processed printed or sent electronically as one large batch instead of individually Treatment Options section Billin
50. otes x Date 05 03 2007 sl Transaction Notes Date Lise Desen O 05 03 2007 Burger DDS Patient was overcharged Figure 18 Notes Dialog These notes can be viewed edited and deleted using the above dialog Print Statement This prints a statement bill for the patient in the selected item Print List The current list is printed to the selected printer Treatment Split Window Select one of the treatments with an unpaid insurance component and no applied amount When an allocation is made the item remains listed and cannot be allocated to again in the same session even if there is still an outstanding insurance balance The Split button allows the user to view the details as to how the treatment cost was split between the user and the insurer Transactions Reference Manual Modified 10 May 10 44 of 47 Treatment Split Procedure D 2140 E Cancel Description i surf amalgam Total 73 00 Balance Subscribert Ins Co Aen Eligible Deduct E Ins Mas Coverage Fee Sch Insurance E UU Treatment Deductibles pe Se Treatment Deductibles zen Procedure 02140 Description f surf amalgam Cancel Balance Subscriber Ing Co Asg Eligible Co pay Pt Chg Cat Ded ltem Ded Pt Ded Fam Ded Deduct 73 00 75693745894375 po Y 73 00 0 00 0 00 0 00 0 00 0 00 DUU 0 00 Maximum Ded 0 00 0 00 Figure 19 The Treatment Spilt Dialog and Treatment Deductibles and Sub
51. ount Is calculated by the system based on the code and quantity but can be manually adjusted Discipline Optional field The discipline of work that the charge applies to Used for reporting purposes Bill on Current Pmt Plan Indicates to apply this charge to the current payment plan for the patient Sales Tax Exempt Indicates that this patient is exempt from paying sales tax Right Click Menu Items Show History Displays a history of changes to the currently selected line The Office Charge History window will display a copy of the original entry and will contain a line for each edit that is performed on the entry Office Charge Histo Office Charge Practice School of Dentiste ID Po Amount FOO Date 16 04 2009 Provider fo Tax Rate 0 00 Code KAFEE Quaritity too Sales Tax Dm Description Ray Copy 0 Discipline hs Total ROO o Location Eos E Tat Can Code Beni em Li Modified Date xH ce Admin Axium 16 04 2003 This is a view only window to allow the user to see some information about the charge and does not allow any modifications within it Show Allocations Displays a list of payments and or adjustments that have been applied to this charge Transactions Reference Manual Modified 10 May 10 23 of 47 Allocations Iw Patient Payments Iw Insurance Payments Iw Adjustments Allocations Unallocate SS ES SS RT ET aT p gt 2791 04 12 2006 Cashier s Che Harry Schell R 04 12 2006 5 00 0 00 0 00
52. p of the window p gt 2791 04 12 2006 Cashier s Che Harry Schell R 04 12 2006 5 00 0 00 0 00 Close To unallocate an item highlight the line and click on the Unallocate button To view a history for a single allocation line highlight the line and click on the History button Show History Displays a history of changes to the currently selected line Transactions Reference Manual Modified 10 May 10 12 of 47 Treatment Tab Zi Transactions Tse Maria 239 EEE Treatment Ing mt Notes a CG di KR Claim Practice School of Dentistry Claim EE Date 3110 2008 a H New Claim Biling ID SUGRAD rsueto Submit Faciity DD Mecht Kaina Treatment Date 31 10 2008 8 Code bo Site m Siez E Surface Do Hew Provider De Description Periodic oral evaluation Unit ooo Total 142500 Parent 1425 00 Insurance Doo Split Medical i Status IC e Location Discipline D Tx Status l Phase E seg 1 Bil on Pmt Plan Statement Treatments Planned Inn Date Prov Code Site Surf Description Patent Insurance Total 223 31 10 2008 D555 D0120 Periodic oral 142500 O00 1425 00 Claim Total 142500 oun 142500 o 10 03 2009 D555 D0415 Bact studies 000 12500 125 00 Claim Total 000 12500 125 00 z 8 2s d m ee dd Figure 1 The axiUm Transaction Treatment Tab Dialog The treatment tab allows the user to add treatments modify treatments
53. ransactions Reference Manual Modified 10 May 10 26 of 47 Down Pmt Date Enter the date on which you expect to receive the down payment indicated above Starting Date Enter the first date on which you expect to receive the first of the regularly scheduled payments Payment Period Enter the expected payment period e Monthly Indicates you expect to receive a payment once a month e Quarterly Indicates you expect to receive a payment once every three months e Semi annually Indicates you expect to receive a payment once every six months of Payments Enter the number of payments that you will allow the patient to spread the plan over or skip to the next field Regular Fee If no entry was made in of payments above enter the actual fee amount that you want paid once per payment period defined above Final Fee The system will auto calculate the final fee based on entries above although this amount can be manually adjusted Final Date The system will auto calculate the final fee date based on entries above although this date can be manually adjusted Right Click Menu Items Payment Plan Tr Name Start Date Regular Fee End Date Total User 16 05 2009 bk ella 15 04 2010 1000 00 Show History View Payment History Print List Depending on the type of record that you select different right click options will be available Show History Displays a history of changes to the currently payment plan Payment Plan
54. rate the claims and create the fees that are currently due An orthodontics payment plan like a specific charges payment plan applies to specific treatments An orthodontics payment plan differs from a specific charges payment plan in that this type of plan will also generate insurance claim submissions each time a payment comes due if the patient has insurance for the treatments applied to the plan Regular Payment Schedule This option is used to set up regular payment schedules Not setting this option means the payment plan is created without a regular schedule of payments and will have to be defined manually This is for patients that are not going to make payments on a regular basis or will pay varying amounts at each pay period Plan Disabled field displays the internal payment plan ID number Plan Total Enter the total amount that the payment plan is for Plan Bal Disabled field indicates the outstanding balance on the payment plan Plan Total Total Chg to Date Total Chg To Date Disabled field indicates the total amount that has been billed to the patient for this plan Total Rec to Date Disabled field indicates the total amount that has been received from the patient and applied to this plan Amount Now Due Disabled field indicates the total amount that is currently due on this plan Payment Schedule Details Displays a list of the scheduled payments Comment Enter a comment about the payment plan
55. record to the list Modify Saves any changes that have been made to the highlighted line Delete Deletes the currently selected highlighted line Statement Allows the user to print a statement for the currently selected patient Fields amp Options Date Indicates the date of service Code Indicates the procedure code that was performed Site Indicates the tooth site that was treated if applicable Surface Indicates the tooth surfaces treated if applicable Provider Indicates the provider that performed the treatment Description Description of the procedure entered in Code above Unit The number of units of this procedure performed if factoring units and if applicable to this treatment Total The total charge for the procedure Patient The portion of the total charge that is expected from the patient Insurance The portion of the total charge that is expected from insurance on behalf of patient Status Indicates the status of treatment being entered e P Planned treatment only available when on the Planned sub tab e In Process treatment only available when on the Treatments sub tab e C Completed treatment only available when on the Treatments sub tab Location Discipline gt Dental School Treatment for pa a ENDO Endo Clinic Hospital Clinic Session Main Clinic Transactions Reference Manual Modified 10 May 10 14 of 47 Custom1 Location
56. rk the currently selected treatment as in process Estimate History Enabled for planned treatment only allows the user to view a history of estimates that have been provided to the patient In Process Tx Visit Enabled for in process treatment only Allows the user to indicate that the patient came in for a treatment visit but the currently in process treatment is still not completed Transactions Reference Manual Modified 10 May 10 20 of 47 Select Planned Treatments 10 17 2006 O 10 17 2006 O 10 17 2006 O Transactions Reference Manual Select All Deselect All Seq Coe Ste Sut Den Piet ime D7110 15 Single tooth 0 00 40 30 D7110 16 Single tooth 0 00 40 30 D7110 19 Single tooth 0 00 40 30 Total Cancel Modified 10 May 10 Print Estimate Enabled for planned treatment only allows the user to print an estimate of the planned charges for the patient 21 of 47 Charges Tab Ki Transactions Doe Jane 258 co IS mE General Treatment Charges Pmt Plan F Adjustment Ins Pmt Notes e e di w Office Charge Practice y Amat 000 Hen Date 10705 2010 sl Provider HF Tax Rate oo Add Code Po Quantity Location E Sales Tas o0 Desc Pe Total o0 Discipline Bill on Current Prot Plan E Office Charges Trait Date Code Description Total Balance Practice f Prov Discipline 16 04 2004 ARFEE x Ray Copy Total The charges tab allows the user
57. t Date the last statement of this patient s account was printed The patient s digital image may be displayed in the upper right of the screen A R Grid Displays the patient s aged A R balances Transactions Reference Manual Modified 10 May 10 9 of 47 Sub tabs Tx History Sub tab The Tx History sub tab shows all treatment that is in process or completed all payments from both patient and insurance all adjustments and all office charges on the patient account This list can be displayed in either claims owing or date ledger format Tabs Pending Unapproved 6043 08 29 2006 Harry D3330 30 Molar 0 00 258 05 258 05 Schell Ro School of Dentistry Claim Total 0 00 258 05 258 05 r gt 947 08 29 2006 Great TRNSFB Transfer balan 5 00 5 00 0 00 Schell Ro Running Balance 1304 51 29 2271 49 E SET TT EN ET on ST PER EE ESS ENG EELS SESS RCTS EEN NTE Running Balance 818 51 t 1785 49 6137 10 16 2006 Harry D4220 Ging curettage 0 00 j 156 00 Schell Ro School of Dentistry ip kr 10 16 2006 Harry D7120 Each add tooth 0 00 37 70 Schell Ro School of Dentistry Claim Total 0 00 193 70 6138 10 16 2006 Harry D4910 Perio maintena 0 00 gt 45 50 Schell Ro School of Dentistry 6138 10 16 2006 Harry D7110 Single tooth 0 00 40 30 Schell Ro School of Dentistry Claim Total 0 00 E 65 80 n 6139 10 16 2006 Harry D2160 3 surf amalgam 0 00 117 00 Schell Ro School of Dentis
58. t Plan Checking this associates the Adjustment to the patient s payment plans Affect Bank Deposit Checking this causes the adjustment to appear on the Bank Deposit for today and enables the Bank field ID Auto generated Internally generated number for the Adjustment non modifiable Indicates whether the adjustment is a debit or credit to the account Type Auto generated Populated by the Code selected Non modifiable Amount Required Numerical amount of the Adjustment modifiable Remaining Shows the remaining unapplied amount for this adjustment As amounts are applied to charges payments the remaining is recalculated to reflect what is as yet unapplied Bank Indicates which cash drawer bank this adjustment applies to Can be typed in or selected form the Bank Codes list Right Click Menu Items Show History Opens the Adjustment History dialog to allow the user to see a history of changes to the currently selected record Disbursement Opens the Adjustment Disbursement dialog Displays a list of items the adjustment has been applied to Adjustment Disbursement Adjustment Allocations Unallacate ID Description Site Name Allocated 5327 07 06 2005 DENT Molar 32 Hany 180 00 sn i f 805 07 06 2005 DENT Bleaching Kit Ham 50 00 To unallocate an adjustment highlig ht the line and click on the Unallocate button Print List Prompis for a printer and prinis the list contenis Tr
59. the calculation of Today s Due plus any outstanding charges Transactions Reference Manual Modified 10 May 10 30 of 47 Pmt Plan Bal Disabled field displays the amount currently expected on the payment plan This can be currently due or can include outstanding balances for the payment plan Unapproved Disabled field displays the amount of charges entered today but as of yet unapproved by a faculty member Total Disabled field displays the grand total for the patient This is the amount that should be collected today to bring the patient record up to date Right Click Menu Items Show History Displays a history of changes to the currently selected line Show Adjustments Displays a list of payments and or adjustments that have been applied to this charge Patient Payment Adjustments Allocated Adjustments Unallocate ID Date Description Name 1 Amount SS To unallocate an adjustment highlight 301 08 17 2005 NSF Check Harry 147 20 the line and click on Unallocate Disbursement Displays a list of charges that this payment has been applied to Payment Disbursement Payment Allocations Unallocate Practi ription gn 5742 01 05 2006 DENT Excision pericorona l si ORSURG T_Clin Harry 30 40 Cose To unallocate an item highlight the line and click on the Unallocate button NSF Payment NSF Payment When a check is returned from the ban
60. tient and the insurer by using the Add Special button Rel Treatments Perae She D Practice School of Dentistry v4 81 sl Dental Medical C Both Add Default Billing ID 04 v Facity Add Special N ae Close Rebill C Curent Policies Subscriber Ins Co Sch Asg Group Cvg C Original Policies v 243 BCBSM PITTSB Yes e Policies Effective on Treatment Date Modify Tx DentalCd Medcaca Site o Swaef Save m Original Claim Treatment Split m Treatment Split Procedure D 7210 Description Surg removal of erupted tooth Cancel Total Do Balance Subscriber Ins Co Asg Eligible Deduct Ins Max Coverage Fee Sch bo pa BEBSM Y Um Um o o Balance Total a Patient Insurance 0 00 Figure 17 Rebill Treatment and Treatment Split Dialogs Add Sticky Note Transactions Reference Manual Modified 10 May 10 43 of 47 This is used to add a sticky note to the Applying Insurance Payment dialog list item To assign the sticky note enter the note text left click on the note and while holding down the mouse key drag the note to anywhere in the dialog and then release The treatment will then display a note icon in the list and the dialog will display a numbered note attachment icon on the upper right when the treatment item is selected Transactions Note A transaction note is a full permanent note that is attached to the treatment E N
61. try Claim Total 0 00 i 117 00 2992 10 16 2006 Harry Cash 97 20 97 20 Schell Ro 2993 10 16 2006 Harry MC MasterCard 500 00 500 00 Schell Ro Running Balance aca We f 1584 79 Pending Sub tab IESSE Sub tab shows all treatment that is currently planned and approved for the patient ERES OE TT User Practice p gt 4556 10 17 2006 Harry D7110 15 Single tooth 0 00 40 30 40 30 Schell Robin School of Dentistry p gt 4556 10 17 2006 Harry D7110 16 Single tooth 0 00 40 30 40 30 Schell Robin School of Dentistry p gt 4556 10 17 2006 Harry D7110 19 Single tooth 0 00 40 30 40 30 Schell Robin School of Dentistry Claim Total 0 00 120 90 120 90 Running Balance 0 00 120 90 120 90 Le T Unapproved Sub tab The Unapproved sub tab shows all treatment that has been added modified but is not yet approved by a faculty member Tx History Pending Unapproved ll a er a ee a 10 17 2006 Harry D7110 16 Single tooth 0 00 40 30 40 30 Schell Robin Total 0 00 40 30 40 30 Transactions Reference Manual Modified 10 May 10 10 of 47 Right Click Menu Items Depending on the type of record that you select different right click options will be available Show History Displays a history of changes to the currently selected line Claim Submission History Displays a list of submission dates for the selected claim and whether the claim was sent
62. ult and can also be modified if desired The type and amount fields are disabled and are automatically filled in by the system Amount will be the exact amount that is held from the original payment Type will be either debit or credit depending on which type of adjustment code is selected When refunding a payment the user can choose whether this will affect the bank deposit or not If the refund affects the banks deposit the user must indicate which bank Full Refund Weess The date of the refund is entered for auditing Refund Payment purposes This will default to the current date Dae 10 23 2006 S carce but can be modified Code REF Type Debt Description Payment Refund Amount 10000 The user can type the adjustment code or Affect Bank Deposit Bark TI A select it from the adjustment code list The full description of the code entered selected will default and can also be modified if desired The type and amount fields are disabled and are automatically filled in by the system Amount will be the exact amount of the original payment Type will be either debit or credit depending on which type of adjustment code is selected When refunding a payment the user can choose whether this will affect the bank deposit or not If the refund affects the banks deposit the user must indicate which bank Reverse Payment Reverse Payment The date of the refund is entered for auditing Reverse Payment purposes
63. urance Companies List window search for and select an insurance company Insurance Company window Advanced button Insurance Company Advanced Options window Patient Reserve Funds that are Tracked checkbox Launches the Manage Patient Reserve Funds window This icon may be displayed in one of three ways e Patient currently has 0 reserve funds Patient has funds remaining credit with this policy s Insurance Company Patient lacks funds debit due to over allocation of reserved funds Launches the Patient Attachment window Please see Attachment_Manager documentation for details as Launches the Patient Contact note window bei Launches the Sticky Note window Sticky notes are used to add unlimited length comments reminders about the patient Sticky notes may also be attached to other records including treatments payments and appointments Launches the Patient Card window Please see Patient_Card documentation for details Launches the Transactions Options window shown below for illustrative purposes 1 a Transactions Reference Manual Modified 10 May 10 3 of 47 Transaction Options Display Options Treatment Options General Tab View Billing Option e Date Ledger f Claims Owing f Doctor Fee C Patient Fee Higher Fee Cancel Patient Balance Methodology Biling ID Types Fee Guide f Doctor e Both Discounts f Balance Forward C Open ltem Age Treatments o Auto Discount w Bi

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