• Medisoft Medical Billing Software Tips and Tricks
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  • EMR Software meaninful use accepted
  • Medisoft Medical Billing Software Now Works With EMR Software Practice Partner, Now Called Medisoft Clinical
  • Medical Billing Software Program
  • Medisoft Medical Billing Software - Insurance Company Setup, Part 1
  • Medical Billing Software - Medisoft- Setting up new referring providers Part 3
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The wait is over… the federal Health IT Policy Committee met to discuss public feedback on the Meaningful Use Workgroup’s initial recommendations published in June. You can view the “Meaningful Use Matrix” on the Department of Health and Human Services (HHS) Health IT Policy Committee Web site. The matrix sets forth goals, objectives and measurements for meaningful use beginning in 2011 — the first year physicians are eligible to apply for incentive payments. The Committee also discussed workgroup recommendations for information exchange and certification/adoption requirements.

And of course Medisoft Clinical is an approved CCHIT software program, so this is good news.  Please contact us with any questions you may have on the Stimulus plan or EMR Software.  Medisoft Clinical uses the Bright Note technology to reduce physician time to click on an electronic chart note.

Important news concerning medisoft medical billing software.  Now Medisoft released a new product called Medisoft Clincial.  This new emr software \ practice management software combination brings together two best of breed software programs.  The two programs are Practice Partner EMR Software and Medisoft medical billing software.  As a result, now existing users of Medisoft can transfer all their current patients into the Medisoft clinical database and instantly work with their patients in an EMR software solution.

Over the next several blogs, we are going to be providing you info on How To create a new Referring Provider, To Get Started, Open Medisoft Medical Billing Software Program, Click on the referring provider icon, or click on LISTS: REFERRING PROVIDERS.

Medisoft Referring Provider Entry - Address Tab;
Code: The referring provider code can contain up to five alphanumeric characters and identifies the referring provider in the program.

Inactive: For information on the Inactive check box, click here.

Last Name, First Name, Middle Initial: Enter the provider’s demographic information. A referring provider can be a doctor, nurse, technician, or physician’s aide who deals with patients. Enter the referring provider’s name in the name fields and his or her address and phone numbers in the correct fields.

Credentials: Credentials gives you seven spaces to enter characters indicating the referring provider’s credentials, such as MD, Ph.D., RN, DO, DC, etc., or whatever applies.

Street, City, State, Zip Code: Enter the provider’s demographic information.

NOTE: When entering an address, the focus of the program moves to the Zip Code field after the Street field. Enter the zip code. If that code has already been entered in the program database, the city and state information is automatically entered in their respective fields. If the zip code is not found in the database, the focus of the program returns to the City and State fields for your input. This information is then saved to the database and available the next time the zip code is entered. For more information on this feature, see Program Options - Data Entry Tab.

After entering a Zip Code and auto populating the City and State fields, if you then go back to the Zip Code field and change the value entered without first saving it, the system will not change the City and State value previously entered, producing an inaccurate record. Use care when changing an auto populated City and State field without first saving the initial entry.

E-Mail/Phone Numbers: Enter the referring provider’s E-Mail and other Phone Numbers in the spaces provided.

Medicare Participating: This check box should be clicked if the referring provider is committed to working with Medicare.

License Number: Enter the referring provider’s license number.

Specialty: If you are sending electronic claims, select the referring provider’s special field of practice. If you need to use a specialty code that is different than the usual code, select “Not Listed” and enter your specialty code in the data entry box that appears next to the Specialty field.

NOTE: This field is not used for sending paper claims unless you have modified your claim form to include this information.

Entity Type: The Entity Type field is to identify whether the entity is a Person or a Non-person. This is for sending electronic claims. Read more

Medisoft Medical Billing Software at a Glance - a Brief Description and Links to Key Windows and Features

NOTE: this list does not include all the windows and features of Medisoft, but a few of the key features popular with many users.

Setting up Your Practice

The Provider window contains important information about the providers associated with your practice.  Each provider in the practice needs to have his or her own record set up in the database.  You will use the Provider Class window to enter classes or groups for providers in your practice including group NPI numbers. The Referring Provider window contains important information about the referring providers associated with your practice.

You will use the Insurance Carrier window to enter insurance carrier records, and the Addresses window is used to enter address information important to your practice.

The Diagnosis List window displays all diagnosis codes that have been entered into the database and controls to edit or enter new codes. You will use the Procedure/Payment/Adjustment Code window to enter and edit, etc. procedure codes.

If you process electronic claims, you will use the EDI Receivers window to set up/edit EDI receivers.

The Patient List window is the main space for entering/editing patient and case information. Medisoft 14 introduces another method for Medisoft Advanced and Network Professional users, the Patient Quick Entry window, for creating and editing patient and case records that provides custom data entry and display options.

You can also take advantage of Medisoft’s security features and set up different users with varying degrees of permissions to application functions.

Scheduling Appointments

Scheduling appointments is simple using Medisoft’s integrated appointment scheduling application, Office Hours .

Entering Transactions and Payments

You enter charges via the Transaction Entry window and you can also apply payments using this feature. Users of Medisoft Advanced or Network Professional can take advantage of the Deposit List window for entering payments.

Generating Claims and Statements

Claims processing centers on the Claim Management window from which you can create, edit, and print/send claims. New in Medisoft 14 is support for UB-04 claims .  And you can use the Statement Management window (available in Medisoft Advanced or Network Professional) to create billing statements for patients.

Running Reports

You can use the robust reporting capabilities of Medisoft to keep track of your office’s performance. Medisoft offers a rich list of reports to manage office functions and analyze your practice’s performance.

Running Utilities

Medisoft also provides easy automation of several functions via the Task Scheduler and EMR interfacing via the Communications Manager . New in Medisoft 14 for Advanced and Network Professional is the Dashboard , a utility that monitors and displays key functions of the practice.

Referring Provider Entry

To access this screen, click on LISTS: Referring Providers.  This window contains important information about the referring providers associated with your practice.  Each referring provider needs to have his or her own record set up in the database.

Referring Provider Entry - Address Tab

Code: The referring provider code can contain up to five alphanumeric characters and identifies the referring provider in the program.

Inactive: To mark this Referring Provider as inactive, check this box.

Last Name, First Name, Middle Initial: Enter the provider’s demographic information.  A referring provider can be a doctor, nurse, technician, or physician’s aide who deals with patients.  Enter the referring provider’s name in the name fields and his or her address and phone numbers in the correct fields.

Credentials: Credentials gives you seven spaces to enter characters indicating the referring provider’s credentials, such as MD, Ph.D., RN, DO, DC, etc., or whatever applies.

Street, City, State, Zip Code: Enter the provider’s demographic information.

NOTE: When entering an address, the focus of the program moves to the Zip Code field after the Street field.  Enter the zip code.  If that code has already been entered in the program database, the city and state information is automatically entered in their respective fields.  If the zip code is not found in the database, the focus of the program returns to the City and State fields for your input.  This information is then saved to the database and available the next time the zip code is entered. For more information on this feature.

After entering a Zip Code and auto populating the City and State fields, if you then go back to the Zip Code field and change the value entered without first saving it, the system will not change the City and State value previously entered, producing an inaccurate record. Use care when changing an auto populated City and State field without first saving the initial entry.

E-Mail/Phone Numbers: Enter the referring provider’s E-Mail and other Phone Numbers in the spaces provided.

Medicare Participating: This check box should be clicked if the referring provider is committed to working with Medicare.

License Number: Enter the referring provider’s license number.

Specialty: If you are sending electronic claims, select the referring provider’s special field of practice.  If you need to use a specialty code that is different than the usual code, select “Not Listed” and enter your specialty code in the data entry box that appears next to the Specialty field.

NOTE: This field is not used for sending paper claims unless you have modified your claim form to include this information.

Entity Type: The Entity Type field is to identify whether the entity is a Person or a Non-person.  This is for sending electronic claims.

Referring Provider Entry - Default PINs Tab

SSN/Federal Tax ID: Enter the referring provider’s Social Security or Federal Tax ID Number.  This number prints in Box 25 of the insurance claim form.  Choose the radio button to indicate whether the number entered is the Social Security Number or the Federal Tax ID.  If you select Federal Tax ID, an X prints in the EIN box of Box 25 on the insurance claim form.  If you select Social Security Number, an X prints in the SSN box of Box 25 on the insurance claim form.

PIN Fields: In the PIN (Personal Identification Numbers) fields, enter all applicable PINs assigned by each of the major insurance types, e.g., Medicare, Medicaid, Tricare, Blue Cross/Blue Shield, Commercial, PPO, and HMO carriers.

UPIN: If the referring provider is part of a group practice which has been assigned a group number by Medicare, that number is entered in the UPIN field.  The UPIN is necessary for designating a referring provider on the insurance claim form.

EDI ID: This field may be required when sending electronic claims.

National Identifier: Enter the provider’s National Provider ID.  This 10-digit number is a standardized identifier that provides each provider with a unique identifier to be used in transactions with all health plans.

CPO Number: This field is for electronic claims. Enter the provider’s care plan oversight number.

Extra 1/Extra 2: These fields may be required when sending electronic claims.

Referring Provider Entry - PINs Tab

Depending on the type of claims you file, you could have separate PINs from each insurance for this referring provider.  This tab provides a PIN matrix where you can store these additional PINs.

PIN

Depending on the type of claims you file, you could have separate PINs from each insurance for this referring physician.  Enter the appropriate PIN for the insurance company.

Qualifier

If you send electronic claims, you may also be required to enter qualifiers for the PINs.  These qualifier codes indicate the type of PIN being sent.  Refer to the implementation guide for your insurance carrier if you are not sure which qualifier to use.  This is not provided by Medisoft but by your carrier.

NOTE: If you converted data from Medisoft 10 or previous, the qualifiers may have been converted as well.  Verify that the qualifiers are correct for each PIN and/or Group ID.

Provider Entry - Eligibility Tab
This tab is where you set up the provider to perform eligibility verification inquiries.

Allow Eligibility Verification: Click this check box to allow eligibility verification for this provider’s patients.

Eligibility Enrollment IDs
Some payers require that individual providers enroll for eligibility verification. To use the online eligibility verification feature, the provider needs to enroll with the payer through the clearinghouse and obtain an enrollment ID. This table is where you enter the enrollment ID, user ID, and/or password. The other columns display read-only information. Also, not all of the payers in the list will require the enrollment ID, user ID, and/or password. Those that do require some extra eligibility verification information may not require information in all three fields.

Eligibility Payer, Payer ID, Receiver ID, Service Type, Payer Type: These columns display information about each payer and are read-only.

Enrollment ID: If applicable, enter the enrollment ID for the corresponding payer.

Enrollment User ID: If applicable, enter the enrollment user ID for the corresponding payer.

Enrollment Password: If applicable, enter the enrollment password for the corresponding payer.

This information is provided for entering and setting up your practice management software program from Medisoft.

Provider Entry - PINs Tab
Depending on the type of claims you file, you could have separate PINs and/or Group IDs for each provider for different insurance carriers.  The PINs tab provides a PIN matrix where you can store these additional PINs and Group IDs.  This matrix is also available in the Insurance Carrier window, PINs tab.  You can enter information through either window.

If you send electronic claims, you are also required to enter qualifiers to the PINs and Group IDs, if applicable.  These qualifier codes indicate the PIN or Group ID type.

NOTE: If you converted data from Medisoft 10 or previous, the qualifiers may have been converted as well.  Verify that the qualifiers are correct for each PIN and/or Group ID.  See Converted EDI Fields for the PIN Matrix.

For a list of valid qualifiers, click here.

0B = State License

1A = Blue Cross Provider Number

1B = Blue Shield Provider Number

1C = Medicare Provider Number

1D = Medicaid Provider Number

1G = Provider UPIN Number

1H = Champus Identification Number

1J = Facility ID Number

B3 = Preferred Provider Organization Number

BQ = Health Maintenance Organization Code Number

EI = Employer’s Identification Number

FH = Clinic Number

G2 = Provider Commercial Number

G5 = Provider Site Number

LU = Location Number

N5 = Provider Plan Network Identification Number

SY = Social Security Number

U3 = Unique Supplier Identification Number

X5 = State Industrial Accident Provider Number

Refer to the implementation guide for your insurance carrier if you are not sure which qualifier to use.  This is not provided by Medisoft practice management software, but by your carrier.

Provider Entry - Default Group IDs Tab
This tab is where you store default group numbers assigned to this provider from various sources.

Provider Class: You can assign a provider to a class or group.  First set up provider classes in the Provider Class List.  Then click the down arrow in this field to select a class for the provider.

Group Number: Enter the provider’s group number.

Medicare Group ID: Enter the provider’s Medicare group number.

Medicaid Group ID: Enter the provider’s Medicaid group number.

BC/BS Group ID: Enter the provider’s Blue Cross/Blue Shield group number.

Other Group ID: Enter the provider’s group number for other insurances.

We hope you appreciate our information concerning setting up our practice management software program.  Please Contact us at 888-691-8058 or 941-743-6666 for all your technical support or medisoft training needs.

Provider Entry - Default Pins Tab
This tab is where you enter default PINs as well as other settings pertaining to this provider.

SSN/Federal Tax ID: Enter the provider’s Social Security or Federal Tax ID number.  This number prints in Box 25 of the CMS- or HCFA-1500 claim form.  Choose a radio button to indicate whether the number entered is the Social Security Number or the Federal Tax ID. If you select Federal Tax ID, an “X” prints in the EIN box (Box 25 of the claim form).  If you select Social Security Number, an “X” prints in the SSN box of Box 25 on the claim form.

PIN Fields: In the PIN (Personal Identification Numbers) fields, enter all applicable PINs assigned by each of the major insurance types, e.g., Medicare, Medicaid, Tricare, Blue Cross/Blue Shield, Commercial, PPO, and HMO carriers.

UPIN: If the provider is part of a group practice which has been assigned a group number by Medicare, that number is entered in the UPIN field.  The UPIN is necessary for designating a referring provider on the CMS- or HCFA-1500 claim form.

EDI ID: This field for electronic claims.  Follow the instructions in your Medisoft EDI instruction book to enter the required information.

CLIA Number: If you are sending electronic claims for lab charges, enter the CLIA number in this field.

TAT Number: If applicable, you receive this number when enrolling in electronic claims.  It has 11 digits. If you receive a TAT number that has less than 11 digits, add leading zeros to complete the 11 spaces (e.g., if you receive the number 1234567, enter “00001234567″).

Hospice Emp: This field is for electronic claims.  Click this box if the provider is a employee of a hospice.

CPO Number: This field is for electronic claims.  Enter the provider’s care plan oversight number.

National Identifier: Enter the provider’s National Provider ID.  This 10-digit number is a standardized identifier that provides each provider with a unique identifier to be used in transactions with all health plans.

Payee Number: This field is for when you send GPNT (IL Medicaid) claims only.  Enter the provider’s payee number.

Taxonomy Code: This field is for electronic claims.  Enter the provider’s taxonomy code in this field.  The taxonomy code replaces the provider’s specialty code.

Mammography Certification: This field is for electronic claims.  If the provider is certified to perform mammography procedures, enter the certification number in this field.

Extra 1 and Extra 2: These fields are for entering miscellaneous information in our practice management software program.

Provider Entry - Address Tab
This tab is where you enter demographic information for the provider.

Code: The provider code can be up to five alphanumeric characters and identifies the provider in the program.  A provider can be a doctor, nurse, technician, or physician’s aide who deals with patients.  Enter the provider’s name, address, and telephone numbers.

Inactive: For information on the Inactive check box, click here.

Last Name, First Name, Middle Initial, Street, City, State, Zip Code: Enter the provider’s demographic information.

When entering a new address, the focus of the program moves to the Zip Code field after the Street field.  Enter the zip code.  If that code has already been entered in the program database, the city and state information is automatically entered in their respective fields.  If the zip code is not found in the database, the focus of the program returns to the City and State fields for your input.  This information is then saved to the database and available the next time the zip code is entered.

After entering a Zip Code and auto populating the City and State fields, if you then go back to the Zip Code field and change the value entered without first saving it, the system will not change the City and State value previously entered, producing an inaccurate record. Use care when changing an auto populated City and State field without first saving the initial entry.

Credentials: Enter up to seven alphanumeric characters to indicate the provider’s credentials.

E-Mail/Phone Numbers: Enter the provider’s E-Mail and other Phone Numbers in the spaces provided.

Signature on File/Signature Date: Signature on File would be checked if the provider has signed an agreement with Medicare to accept its charges and an affidavit is on file.  If it is checked, the Signature Date field becomes active to display the date on which the signature was placed on file.  To enter a date in this field, either type the date or click in the Signature Date field or the down arrow to the right of the field and the calendar opens.  For information on how to use the program calendar, click here.

Medicare Participating: This check box should be clicked if the provider is committed to working with Medicare.

License Number: Enter the provider’s license number in the field by that name.

Specialty: If you are sending electronic claims, select the provider’s special field of practice.  If you need to use a specialty code that is different than the usual code, select “– Not Listed –” and enter your specialty code in the data entry box that appears next to the Specialty field.

NOTE: This field is not used for sending paper claims unless you have modified your claim form to include this information.

Entity Type: The Entity Type field is to identify whether the entity is a Person or a Non-person.  This is for sending electronic claims.

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