Medisoft Medical Billing Software – Create A New Set of Data

NOTE: Medisoft is very unique in that you are not charged for each practice you setup and use.  This makes Medisoft an ideal software for biling services as you are not charged “per practice”.

Use this window to create a new set of data in your Medisoft billing software. Go to the File menu and select New Practice. The Create a new set of data window opens.

Enter the practice or doctor’s name to identify this set of data: Enter a name to identify the practice. You can use up to 35 characters.

Enter the data path: Enter the practice’s data path. The entire data path is restricted to 100 characters.

Browse: Click this button to search for a data directory. This option is available to reinstate a practice that has been removed from the list or to locate a lost data directory.

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New in this Medisoft Version 14

There are many new features in this medical billing software version to help you to manage your practice. Some of the highlights include:

UB-04 Support

Version 14 adds UB-04 claims support. If you need to process these types of claims, you can easily enable UB-04 specific fields in the application on the Program Options, Data Entry tab.  Version 14 also provides UB-04 claim processing. Once you have entered data in the UB-04 fields for a patient, you can enter transactions and then create and print UB-04 claims. You will enter transactions and create UB-04 claims as you would for other insurance claims. You will also print the UB-04 claims the same except for the report format you choose when printing. For more information on this feature, see UB-04 Claims Overview .

Custom Date Entry for ERA Posting

Version 14 now supports a quick method for a entering a custom remittance date. The Program Options window,  Data Entry tab now provides a new option that you can select so that you are prompted to enter a remittance date after selecting a file to post. For more information on selecting this feature, see Program Options, Data Entry Tab .

Global Days

The Global Coverage feature lets you enter multiple charges for follow up visits after a surgery. When you enter a Global Surgical Procedure for a patient in Transaction Entry, all transactions entered during the global coverage period will default to a zero-dollar amount and will not be included on claims. Once the global coverage period expires, the charges default back to the standard amount. For more information on this feature, see Global Coverage Overview .

Patient Quick Entry (Available with Medisoft Advanced and Network Pro)

Version 14 now offers a customized interface for patient entry. Using this feature allows you to set up a method for entering patient data that reflects your work environment, which simplifies data entry and increase efficiency. Patient and case data is easily added to existing records or you can quickly create new records from one window without clicking multiple tabs. Using this feature involves setting up templates which contain fields from the Patient and Case windows.  You can create and customize as many as needed and then when using the Patient Quick Entry feature, you can select which template to build or edit a record from. For more information on this feature, see Patient Quick Entry Overview or Using the Patient Quick Entry Feature .

Dashboard (Available with Medisoft Advanced and Network Pro)

Version 14 introduces the Dashboard feature. This new feature provides a quick method to monitor key data points such as the number of appointments, outstanding claims, etc. along with one-click access to application functions all in one window. Once setup is complete and you have created at least one profile (a basic grouping of data categories and selected settings), you can view the displayed data on the Dashboard window and if needed, click links on the window to further examine the data in greater detail. For more information on this feature, see Medisoft Dashboard Overview or Using the Dashboard .

PowerTools Enhancement

Version 14 adds the Power Tools utility to Medisoft Utilities. PowerTools is also enhanced and now provides a new feature to modify individual procedure codes in a single practice. For more information on this feature, PowerTools .

Data Import/Export

Version 14 adds two new utilities to Medisoft Utilities. The Export Data utility lets you export data from a Medisoft practice. You can pick and choose the tables and records that are exported. The utility then exports the data into an encrypted file that can be imported into another Medisoft practice. The  Import Data Records utility lets you import data into a Medisoft practice. First you have to create an export file using the Export Data Records utility. Then you can import that file using the Import Data Records utility. For more information on this feature, see Export Data Records or Import Data Records .

Multi-Practice  Data Conversion

Version 14 adds the Global Convert utility to Medisoft Utilities. This new utility lets you select and convert multiple practices in the same root directory to the current Medisoft version at the same time. For more information on this feature, see Global Convert .

Scheduled File Maintenance

Version 14 provides a simple method for scheduling file maintenance. You can now select a time  and a interval for these features to run that

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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.

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Participate in our new medical billing software discussion forum. Post questions on medisoft billing software or post questions about medical billing or coding issues. Medisoft Medical Billing Software Discussion Forum

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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.

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Provider Class Entry

Use this window to enter classes or groups for providers in your practice.

Go to the Lists menu, select Provider, and select Class.  In the Provider Class List window, click New or Edit to create a new record or modify an existing one.

Class ID: Enter a unique ID to identify the class.  If you do not enter an ID, the program automatically generates one based on the name.

Class Name: Enter a name for the class.

Description: Enter a description for the class.

National ID: Enter the GROUP NPI # here. If the providers in this class bill insurance companies as part of a group, enter the group National Provider ID in this field  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.

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