Patient/Guarantor Setup

After going through the initial setup steps, you are now ready to start entering patient information into Medisoft. There are other lists and entry items that have not yet been discussed, and they will be discussed over the course of this manual.

Patient information is set up in two different screens, the Patient screen, and the Case screen. Historically users have been required to create a patient and then create a case for that patient. Beginning with Medisoft version 14 there is a Patient Quick Entry feature that allows users to quickly enter information into both the Chart and Case at the same time from one screen. This chapter will discuss both ways to enter patient information.

To enter a new patient or guarantor the traditional method, click the New Patient button.


Tips and Tricks:
The New Patient button will only be available if the patient portion of the screen is selected. If you do not see a button labeled New Patient, simply click in the left portion of the Patient List window.

 

 

 

Name, Address


Chart Number: The Chart Number field is the equivalent of the Code field in the other list screens. The Chart Number field will be used to identify this patient or guarantor throughout the Medisoft program. If you leave this field blank, the program will assign one for you. We highly recommend that you let the program assign Chart Numbers for you.

The Chart Numbers assigned by the Medisoft Program will be in either of two formats. These formats are determined by the Program Option field labeled Use Numeric Chart Numbers. If this field is checked, the chart number will be an 8 digit long number. If this field is not checked, the chart number will be Alphanumeric, based on the patient’s name.


Tips and Tricks:
We recommend that you use the alphanumeric chart numbering system. Any patient reports are sorted based on the chart number. If you use the alphanumeric chart numbers, you will be able to find a specific patient in the report more easily.

 

Patient Demographics: The patient name, address, phone, and email information will all be entered on this screen. While we will not go through each field individually, you should enter this information properly, as it can affect statements and other reports.

 

 

 

Tips and Tricks:
The Copy Address button allows you to copy the address information from another patient. This can save you time on your data entry by allowing you to quickly enter address information for members of the same household.

 

Birth Date: It is extremely important that you enter the patient’s birth date correctly. The most common mistake is that the year field is not populated properly. This can cause the birth date to appear as though it occurred after the date of service, resulting in rejected claims.

Sex: Similar to the Birth Date field, you must enter the patient sex properly. There are certain procedure codes that are gender specific. For example, pregnancy codes cannot be used on males. If you set the gender incorrectly, you may receive claim rejections stating that the procedure code you are billing is incorrect.

Birth Weight and Units: The birth weight is only necessary for certain offices. You can enter the birth weight in either English or Metric units. For English units, select Pounds. For English units, select Grams.

Social Security: Enter the patient’s social security number into this field. If the social security number entered is already assigned to a patient in the system, you will receive a warning. This will help you prevent the same patient from being entered multiple times into the system.

Tips and Tricks:
It can occur that social security numbers are entered using different formats. Some people may enter the numbers only, and some people may include dashes.
Medisoft can automatically format the field for you. This will prevent different methods of entry from allowing the same patient to be entered multiple times. In order to activate this feature, you will need to check the Program Option labeled Auto format Soc. Sec. # on the Data Entry tab. At this point, the program will ask you if you want to automatically format the existing social security numbers. You should do this in order to ensure that all numbers are entered using the same format.

 

 

Entity Type: Entity Type is a field that can cause confusion and rejections on electronic insurance claims. In most instances, if you are entering PATIENT information, this field will be set to Person. If you are entering Guarantor information, there are some circumstances where a company is the responsible party for the charges incurred. If this is the case, you would set that Guarantor up as a Non-Person.

Race, Ethnicity and Language: These fields are new to version 17. Select from the drop-down choices.

Death Date: This field is also new to version 17. In prior versions, the patient’s death date had to be input in the To Date of the Total Disability field in the Condition tab of the Case.

Other Information


Type: The Type field will let you enter two different values. You can either select Patient or Guarantor. When making this selection, it is important to keep the following information in mind. A patient CAN be set up on someone’s account as a guarantor. However, a Guarantor CANNOT have transactions entered like a patient would. If there is any chance that this person will ever be seen by the office, you will want to select Patient as the type. If the person will never be seen by this office, such as a parent bringing their child to a pediatric office, you should select Guarantor as the type.

Assigned Provider: When entering the Assigned Provider, remember that this provider will simply serve as the DEFAULT provider for any CASES that are entered for this patient. Changing the provider listed here as the Assigned Provider will not correct any rejections or incorrectly printing claims.

Patient ID #2: This field will allow you to assign an alternate ID number to the patient. It will not generally affect claims sent either on paper or electronically. It is most often used by offices that have converted to Medisoft from another POMIS system, and would like to maintain the identification numbers for those patients as opposed to utilizing the Medisoft standard Chart Number methodology.

Patient Billing Code: Billing Codes are used to filter reports, claims, and statements for patients with similar characteristics. Examples of this might include Cash Patients, Diabetic Patients, Patients who are allergic to penicillin, etc… There are not guidelines that can be given for setting up these codes. Each office will need to determine which billing codes are necessary for their office and business practices.

Tips and Tricks:
The Patient Billing Code will function similar to the Assigned Provider, in that it will determine which Billing Code will default for each case set up for this patient. It is also important to note that the billing code entered in the patient information (the patient billing code) will be the code that is most often utilized and offered as a data selection question on reports.

 

Patient Indicator: The patient indicator field can be used to filter and sort various reports. This field can contain up to 5 characters, and is completely user defined. If you do choose to utilize this field, you should keep a separate list of what values you have entered in different patient records.

Patient Flag: Patient Flags are used to color code a patient’s record within various screens within Medisoft. Flag labels are set up within program options on the Color-Coding tab. You must select the option to Use Flags. You will then need to fill out a description for each color flag you wish to use.


Tips and Tricks:
If you activate the Patient Flag option and then assign flags to patients, you may run into error messages (Access Violations) when trying to access that data from a stand-alone version of Office Hours Professional.

 

Healthcare ID: Initial HIPAA legislation indicated that a national Healthcare ID number would be issued to each patient. This identifier would be standardized and unique to each patient. This field was created to accommodate this requirement. Subsequent implementation guidelines for HIPAA have removed the requirement for a national patient identifier.

Signature on File: This field relates directly to the insurance carrier setup and to the patient and insured signature boxes on a claim form. If the insurance carrier on the claim has the option selected for Signature on File for either the patient or insured AND the signature on file box is checked in the patient (or insured party) setup, the words “Signature on File” will appear on the claim form.

Employer Information: The employer information is the employer that will default for each new case.

Payment Plan

The Payment Plan tab allows you to put your patients on a payment plan schedule. The payment plans are set up in the Lists menu and Patient Payment Plan. Here you can specify different plans for different patients. Each plan consists of a date of first payment, a payment interval, and a payment amount. You also have the ability to assign a description to that payment plan. This description should accurately describe the interval and payment amount.

When entering Payment Plan information for a patient, you are only going to have one field available for you to edit, the Payment Code. All other fields will be reference fields only that will let you know the details of the payment plan the patient is assigned to.

Assigning patients to a payment plan has many benefits. These benefits include the following:

1. The ability to automatically flag accounts for patients not following their payment plan. These flags are visible in Office Hours Professional, Transaction Entry, and the Quick Ledger.

2. Automatic payment plan detail information is displayed when an appointment is selected in Office Hours Professional.

3. If the patient is following their assigned payment plan, they can be excluded from batch collection letters that are generated by Medisoft.

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