PRESENTS. User Training. Posting

Transcription

1 PRESENTS Practice Management Suite User Training Posting Chenal Parkway, Suite 301 Little Rock, AR (501) Fax (501) Support Fax (501)

2 Navigation Tips for Posting Ctrl+P Applications Account Posting Display Account Information Tool Bar Move to first or last record Move set number of records forward or backward Move to next record forward or backward Insert new record Save delete Bookmark Transaction Go back to Saved bookmark Account Tree - hover over Patient s name to see account balance; right-click to see addl options 1

3 Control Totals Either select an existing control or click to start a new control. If an existing control is opened, a listing of all posted transactions will appear. This screen allows printing the control details for balancing purposes, voiding transactions, and is ultimately used for closing the control. While the Control is open, the transactions will not appear on reports, insurance forms, statements, etc. Based on personal preferences, the Start Date field usually defaults from the Control Date entered when the Control was first created. This date would match one of the following: Service Date on batch of Superbills Date on check that is being posted Date that check(s) was/were received by office and/or deposited in bank Today s Date 2

4 Starting a New Visit When Case Management has been enabled, it allows for the visit information screen to be populated with certain information which may or may not be from the last visit posted. This feature would be used for multiple accidents where diagnoses/doctors, etc are different or to segregate an accident from regular medical care. It must be activated via the Enterprise Manager before it can be utilized. (see page 4 of this document) Case Window 3

5 Visit Information Screen (used on all methods) Attach the visit to an existing referral to increase the number of visits used. This will also populate the fields in the top portion of the screen. Note: The Prior Authorization is the number that will print in Box 23 on HCFA Right click anywhere in the Referral area to see: New Managed Visit Reset Managed Visit on Patient Visit Ctrl+D to move cursor to Diag1 field from anywhere on the screen. 4

6 Visits/Transactions Visit Grid Transaction Grid S Prov is Service Provider 5

7 Visits/Transactions, cont d Right click in the visit section to get these choices: To post a patient payment without having to post procedure by procedure, use one of the Auto Distribution options. Bookmark the account to easily transport the account number to another posting option. Print a Receipt (Visit Summary Report) Right click in the procedure section to get these choices F8 will toggle between Pay/Adj Mode and Charge Entry Post an unapplied payment (IE: deposit, etc.) and then later activate the transaction. 6

8 Bulk Posting To speed data entry, rearrange the columns by dragging and dropping. To reset, R- click and choose the one that applies: Reset Visit Columns or Reset Transaction Columns. ***Post patient payment immediately following the charge to which it should be applied.*** 7

9 Line Posting Line Posting allows any type of payment or adjustment (P, I, A, PP, II, AA) Payment and Adjustment will always be entered on the charge line in the appropriate column(s). After clicking or or F9, the system will disperse and separate lines will appear below the charge. By entering the Approved amount in the CPT Fees table for the appropriate Fee Schedule, this amount will populate the Approved column. Pressing enter (or tabbing through) at this field and then entering the payment amount will cause the system to calculate the write-off amount and that amount will be placed in the Adjustment1 column. If there is no amount in the Fee Schedule, the full charge amount will default and may be overridden by the user to match the EOB, still auto-calculating the adjustment amount. 8

10 Electronic Remittance Full EOB: lists all transactions Non-Applied EOB: lists transactions that could not be electronically posted. Data in Remittance file is compared to the data in the database and must match all of the following: Patient Account Number Patient Name Patient s Insurance ID number Date of Service CPT Code Units 9

11 Balancing the Control Batch totals appear here. A Visit total and a Patient total appear here. Sort data by clicking on multiple column headings to aid in balancing. 10

12 Printing Control Select Print Control from the bottom of the Control Totals screen. It will automatically print to the default printer. 11

13 Closing the Control After Control is printed, balanced and user is satisfied that all data is correct, select or or F11. The summary screen will appear to allow user to confirm totals:. 12

14 PREFERENCES 13

15 Unapplied Payments For pre-payments, the payment may be posted in Visits/Transactions, after the system generates the appropriate charge line. First, create a visit record, then Ctrl+Alt+U or select from the context menu. Post the payment as usual, creating a credit balance on the visit. Once the service has been provided, select the visit and then Ctrl+Alt+C or select Activate Transaction. Because the code UNAPP was system generated, it allows the line to be modified, even after the original control was closed. Proceed with posting the correct CPT code. 14

16 Posting a Procedure Set During charge posting, enter a procedure set code as above, then arrow down to cause the appropriate procedures to appear. 15

17 Medicare Interest Medicare Account Create Medicare Interest account, procedure code and adjustment reason code. 16

18 Medicare Interest Transactions Post as indicated above, noting patient name in Visit Memo or in Description. 17

19 NSF Checks PP = payment reversal, AA = adjustment reversal - both of these will debit (increase) the account balance. Note: NSF checks entered in the method described here will be debit payments. (Refer to OnLine Help or User Manual for posting NSF checks via Debit Adjusments.) Remember that all payments and adjustments posted in Line Posting, are entered on a transaction line with a Type = C. 18

20 Medical Records Fees Patient Name, Insurance Company requesting records, and other pertinent information may be entered in the visit Memo or modify the Description field to contain this information. 19

21 Refunds Refunds done this way will be debit payments. (Refer to OnLine Help or User Manual for posting refunds via Debit Adjusments.) 20

22 AEVCS Fees Create an account, CPT Fee, and adjustment (see instructions for Medicare Interest). Post transactions as indicated. 21

23 Anesthesia Billing is authenticated in the Licensing of the Database. Setup In CPT Fees: The only change in Posting is that when tabbing off the CPT code field that contains a CPT code that has been setup as indicated above, the AB window appears. Code appropriate surgery code to print on the claim (may be left blank) Start/End Time Anesthesia start and end times (the colon does not have to be entered 0805 will become 08:05:00 but each portion of the time must contain 2 digits) Time Factor displays based on the CPT code but allows editing Dollars per unit displays based on the CPT code but allows editing Base Units displays based on the CPT code but allows editing Other Units allows input of additional units that need to be charged Calculation: (Base_Units + Time_Units [actual time divided by Time Factor rounded to nearest tenth]) x Dollars_Per_Unit = Amount_Charged Other notable features: Code in transaction grid and date in visit grid appear blue to designate Anesthesia billing. Visit may not contain Anesthesia code(s) and non-anesthesia codes. HCFA has been modified to reflect Anesthesia information. 22

24 Facility Billing Setup: ASC Location = Financial Location (& default Insurance Type to UB92 if majority of Facility claims are billed on UB92s) Resource=ASC Location name Add revenue codes on CPT codes that are required to bill on UB92 only. Surgeons should be added to the Referring Physician Table Posting ASC Charges (facility fees): Service Location ASC Location Financial Location ASC Location Insurance Provider ASC Resource name Referring Physician Actual Surgeon's referring physician code Service Provider ASC Resource name Confirm 'Insurance Type' is correct (HCFA or UB92) for Primary/Secondary payers on Visit screen. If UB92 is required for either Primary OR Secondary payer, create the UB92 screen. If 'Insurance Type' is UB92 in either Primary or Secondary when the visit is created, the UB92 screen will launch automatically when the visit record is saved. If this doesn't happen, click the UB92 button in the lower left corner of the visit screen. Physician Charges (normal): Service Location ASC Location Financial Location Office Location Insurance Provider Actual Surgeon 23

25 How do I bypass the normal primary insurance and bill another carrier? After posting the charge in either Visits/Transactions or in Bulk Posting, go to Visits/Transaction and r-click. From the context menu, select Set Primary Insurance and highlight the correct plan to bill. This only applies to newly posted charges and only prior to closing the control. After the control is closed, refile the claim to whichever carrier you choose from Account Information. control whether a secondary claim prints after posting a payment from the primary insurance? In the patient s secondary insurance in Account Information, set the Auto File if Secondary as needed. In the Control Options for the batch that contains the primary insurance payment, check or uncheck the Auto File Secondary Insurance. On a claim by claim basis, r-click and select File Secondary Insurance (Ctrl+S) and respond appropriately ( Do Not File Secondary, or select a different secondary carrier to bill). (Note: all of these choices do not have to be manually set on each payment. Most are set once and then claims print (or don t print) from that time forward.) 24

26 A.B.R.I. (ADPContext Bill Review Interface) This module requires an annual subscription based on the number of doctors in the practice, and number of templates required. A Linux server is also required. Contact the Medevolve Marketing Department for complete pricing information. The ABRI module creates an interface between eceno and ADP Context's Bill Review Server. ADP Context's Bill Review Server analyzes claims that are entered and checks for a variety of posting errors that can occur. The ABRI system returns the results of the claims server and reports them in an easy to understand manner relating to the charges the user is currently posting. ABRI appears in Bulk Posting, Control Totals, Visit Transaction, and Account Visit Transactions. Claims can be automatically analyzed every time a transaction is entered, analyzed by visit, or analyzed by control. Here is an example of what ABRI can do for you: More examples on the following page. 25

27 Easily defines missing data Alerts to the need for modifiers Alerts to coding errors and allows for easy editing 26