Medisoft Case Setup Overview and Definitions

Medisoft utilizes an accounting system known as Case Based Accounting. Case Based accounting groups transactions together based upon the case they are entered into. Different offices have different methods of using cases. Cases include large portions of the information that will appear on a claim. Within the case, you will assign Insurance Carrier and Guarantor values to transactions. These values will be used to determine how and where claims and statements are sent.

Definition of a Case: A case is a unique condition or situation for which a patient seeks treatment or services. There can be multiple visits for service related to a single case and all services related to that malady or condition are contained in the same case.

There is not one “right” way to create new cases but we will give you a few general guidelines for when to create a new case.

In general, you may need or want to create a new case whenever:

1. The number of transactions entered into that case reaches 650. The transaction limitation includes charges, payments, adjustments, and comments as well as any sub-set of these transaction types.

2. The insurance carrier information for that patient changes. You do not want to simply change the insurance carrier information within the existing case, in order to maintain your record of the patient’s insurance history. The transactions entered into that case under the original insurance carrier should not be associated with a case containing a different insurance carrier.

3. Employer information changes. Within the patient setup, you can set up a default employer for use whenever a new case is created. If a patient changes their employer, generally that change will also include a change in benefits, which will change the insurance carrier associated with them. These changes need to be reflected in a new case.

4. Time period changes. Many offices create a new case for a specific time period. You may want to create a new case for each quarter or for each year. This allows you to group transactions together based on when they occurred. The only limitation you will need to note with this is that payments must be entered into the same case as the charge to which the payment will be applied.

5. Visit based cases. Some offices choose to create a new case for each visit a patient makes to the office. This allows you the most detail in grouping transactions together. However, this option is not necessary if the office uses the Document Number or Serialized Superbill features properly.

6. Variations in the billing process for the same patient. If there are different guarantors for different charges for the same patient, you will need to set up a different case for each guarantor. Similarly, if there are charges that you never wish to bill on a patient statement, those transactions will need to be entered into a separate case.

7. Specialty field changes. There are many specialty fields included within the case screen. Whenever any of these fields change, you will want to create a new case. For example, if the patient was a student, and the student status changes, you will want to create a new case for transactions entered since the student status changed.

8. Global Coverage is used. If a Global Surgical Procedure is entered into Transaction Entry for a case, an automatic calculation is done to determine the end date for that Global Surgery. If more than one Global Surgical Procedure is used for the same case, the Global Coverage Until date will change to the latest date.

There are many other reasons to create new cases. You will need to figure out what works best for your office.

Tips and Tricks:
When browsing through the case screen, you may find that you have fields that are “hidden” without the scroll bar that allows you to access the fields. If documentation such as the Knowledge Base, Help Files, or Training Documentation refers to a field that you cannot see, you may have to expand the size of the case screen in order to make the field visible.

 

You will be able to see some of the Patient demographic information at the bottom of the case window. You will also be able to check the eligibility and print a Face Sheet using the buttons available along the right side of the screen.

If you want to switch your case screen to a different case for that same patient, you can do so using the case field in the lower right corner of the screen.

You may find that the Tab labels are missing from your case screen.

This is due to your display settings being set to use large fonts (large size DPI). In order to correct the issue, you must set your font setting (DPI setting) to Normal.

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