Medisoft Practice Setup

Introduction

Once the Medisoft program has been installed, the office will need to go through and do a large amount of preliminary data entry before they will be able to begin the billing process.

Medisoft is a flexible program that offers many different ways of doing things.  As a Value Added Reseller, your success will depend on your ability to familiarize yourself with the options that are available within the program, and identify which setup will be most beneficial to a particular office.

This workbook follows the recommended order in setting up a new user’s system.

Tips and Tricks:If you have questions regarding any portion of the Medisoft program, you can press the [F1] button with that screen open.  The help files will open to the section regarding the window you have open at the time.

Practice Setup

The first thing an office would set up after installing Medisoft would be a practice.  A practice is defined as a group of data files related to the operations of one office or group of offices.

A practice shares a common list of patients, insurance carriers, procedure codes, diagnosis codes, and other data files.  A practice also shares a common Accounts Receivable total, although you do have the ability to report on each provider or doctor Accounts Receivable total.  All data files for a particular practice reside in the same sub-directory of your root data directory. (Example:  C:\Medidata\medisoft)

Tips and Tricks:Most medical offices will only need to create one practice.  The most common instance where multiple practices are created is in a Billing Service.  A Billing Service generally has multiple offices as clients, and therefore they need to create separate practices for each office.

 

In the previous section, we briefly discussed creating a practice.  We will review this process and expand the explanation of it.

Practice Creation

In order to create a new practice, take the following steps:

  1. Click the File menu and New Practice.  There is also a New button on the Open Practice screen.  Either of these options will bring you to the same process.
  2. You will see the “Create a new set of data” window.  Enter the name of the practice as you would like it to appear in the practice list.  You will also be asked to enter the data path.  The first portion of the path will be defaulted to the value you entered when initially connecting to the Advantage Database Server.  You will simply need to enter the name of the sub-directory within Medidata that you would like to hold the data for this practice.  Once entered, click Create.

 

  1. You will need to repeat this process for any additional practices you wish to create.


Practice Settings

Practice Tab

After you create a practice, the following screen will appear:

 

This screen is the first place you will begin entering information that will affect the billing process.  We will discuss each field that will have an effect, and what that effect is.

Practice Name and Address:  The Practice name and address information must be entered properly, as this information will be sent on electronic claims.

Type:  There are three options available under the type field.  If you do not choose a type, Medical is the default practice type and does not add any additional fields.

  1. Anesthesia:  This option will enable the ability to bill transactions for a specified number of minutes.  This is only necessary for Anesthesiologists.
  2. Chiropractic:  This option will cause certain fields required for Chiropractic billing to appear within the program.  These fields are as follows:

 

Level of Subluxation

Treatment Months/Years

Nature of Condition

Date of Manifestation

Complication Ind.

  1. Medical:  This setting should be used for all other practice types.

Federal Tax ID:  Enter the Tax ID number assigned to the Practice in this field.  This field may affect electronic claims for group practices.

Tips and Tricks:When entering a Tax ID number, do not enter any formatting such as spaces, dashes, or any other symbols.  Simply enter the 9 digit number. 

 

Extra Fields:  Do not enter anything in these fields unless expressly told to do so by your Electronic Claims Module Documentation.

Practice Type: If you are a solo (individual) provider select the Individual button. If you are a member of a group and use an Organizational NPI, select the Group Practice button.

Entity Type:  This field offers you the option to select either Person or Non-Person.  Select Person if the office is a solo practitioner.  Select Non-Person if the office is a group practice or billing under a company name such as Dr Johnson LLC.


Practice IDs Tab

 

This grid houses practice billing information such as group or individual NPI, taxonomy, tax IDs, claim filing status (group or individual) and connects this information to insurance carriers and the doctors in your practice as a series of rules.  You will want to set up at least one entry (rule) on the grid.  You could associate IDs and codes to all providers, insurance carriers and facilities or you could associate different IDs and codes to each provider, carrier or facility or any combination of these.  Click the Help button and read important information regarding this tab and assigning rules.  Proper configuration of this tab is critical for billing.  Also, be aware that there is a similar grid in provider setup that works in conjunction with this tab which is discussed later in this document.

Tips and Tricks:If converting from a version older than Medisoft 16, it is likely that multiple Legacy IDs will be converted into this grid as Group Provider IDs.  This will not be desirable as most Insurance Companies will reject if these IDs appear on claims.  There is no “NPI Only” setting in Medisoft 17.  Many VARs are careful to delete Group Provider IDs from the older version prior to converting to Medisoft 17.If needed, you can quickly delete all items in this grid by holding down the Ctrl button and then pressing the Delete button.  Once deleted, the action is not reversible.

 

 

 

 

Click New to enter Practice IDs.

 

 

National Provider ID:  The NPI is the standard unique health identifier for health care providers.  It consists of a 10 digit identifier (9 numbers followed by a check-digit) that standardizes one number for each provider used by every insurance carrier.  This standard was part of the HIPAA legislation to establish a unique identifier to improve the efficiency and effectiveness of electronic health information.  Once established, the provider’s NPI will not change regardless of job or location changes.

Taxonomy Code:  Taxonomy Codes are a 10 character provider specialty code used for electronic billing.  There will be circumstances when submitting electronic claims where you will be asked to supply a Taxonomy Code.  Enter this code here.  Refer to your electronic claims documentation for more information regarding this field.

Tax Identifier:  If the practice name is a business or organization, it would be appropriate to select this radio button and enter the 9 digit Tax ID.

Social Security Number: If the practice name is a person’s name, it would be appropriate to select this radio button and enter the 9 digit Social Security Number.

Legacy Identifiers:  The Legacy Identifiers available on this screen are rarely used.  If an Insurance Carrier requires a legacy ID, it may be input here.  If these IDs are input, they should be specific to one Insurance Carrier or Class.

 

Practice & Statement Pay-To Tabs

 

 

These tabs are identical. Use these tabs when both practice and billing service information is needed.  Practice Pay-To is used for electronic claims.  Statement Pay-To is used for electronic statements.  Use these tabs to create a separate pay-to address location such as a PO Box instead of a physical address.

Open Practice

After setting up multiple practices, you will need to be able to switch between these practices.  This is done by clicking the File menu and Open Practice.

The following screen will appear and will give you a few options:

 

Opening a Practice:  To open a practice on the list, simply highlight the practice and click OK.  You can also double-click the practice you wish to open.

Tips and Tricks:Medisoft will remember the last practice that was opened.  When you start the Medisoft program, it will automatically open this practice.

 

Deleting a Practice: You have the option to delete a practice from the open practice screen.  If you would like to remove the practice from the list, highlight the practice and press the Delete button.

Tips and Tricks:When viewing the open practice window, you are actually viewing the contents of a data file.  The name of that file is mwdblist.adt.  This file is located in your root data directory (usually Medidata).When you delete a practice, you are not actually deleting the data files for that practice.  You are simply deleting the reference to that practice from the mwdblist.adt file.  The name of the practice that appears on the Open Practice window is also stored in the mwdblist.adt file.  If the name is spelled wrong, you will need to delete the practice and create a new one that points at the same data path.

 


Finding the Data Path: Find the data location of any practice by clicking and holding the cursor over the name of any practice on the Open Practice window.

****Remember to do a daily, weekly, monthly, quarterly, yearly backups to multiple locations including a local offsite backup *********

For Medisoft Support Call us at 888-691-8058 or 941-743-6666.

How to start a new practice in medisoft

How To Setup Medisoft

 

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Over the next several blogs, we are going to be providing you info on How To Setup a New Insurance Company, To Get Started, Open Medisoft Medical Billing Software Program, Click on the Blue Cross icon, or click on LISTS: INSURANCE COMPANY.

Medisoft Insurance Carrier Entry – Address Tab
This tab is where you enter this insurance carrier’s demographic information.

Code and Inactive: Each carrier is assigned a unique code. You can assign the code or allow the program to assign it automatically. Click the Inactive check box to mark the insurance carrier inactive.

Name and Address: Enter the insurance carrier’s name and address. Following the name, type the street, city, state, or zip code that helps you identify the right carrier.

Phone, Extension, and Fax: Enter the insurance carrier’s phone and fax numbers.

Contact: Enter a contact person at the insurance carrier. This is for reference only and doesn’t print on a claim form.

Practice ID: Enter the ID assigned to the practice by the insurance carrier.

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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.
Referring Provider Entry – PINs Tab (NOTE: DO NOT ENTER ANYTHING HERE IF YOU ONLY WANT YOUR NPI NUMBER TO TRANSMIT)
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.  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

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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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 – 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.

Note: if you want only the NPI number to transmit, please do not type anything in the following fields except the “National Identifier” field.
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(NPI): 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.

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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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Medical Billing Software is what this blog is all about.  Got questions about medisoft medical billing software, or about what it can do, or what reports it has, or who’s the best place to purchase from, or anything else medical billing relalted- just ask!

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