Medicare has been giving all doctors a “grace period” on coding to the specific level of specificity for DX codes.  This grace period ends Oct 1, 2016.  Contact us for our Encoder Pro $149 add on program to Medisoft that helps you code correctly.   Call us at 888-691-8058 or 941-743-6666

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We’re happy to announce that Medisoft Version 20 Hotfix has been released.  This Hotfix fixes an intermittent problem with Medisoft Version 20 (V20) freezing on startup with some Windows 10 devices or computers.  To download the hotfix click on this link  This  should not be used if you have Medisoft Clinical.

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List Only

If you click the List Only button the following window will appear.

You can utilize this feature to limit the ticklers that are displayed. Once you have made your selections, click Apply.

 

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Billing Patient Statements

After creating your statements, you are now ready to bill them. When a statement is first created, it is not marked as either a paper statement, or an electronic statement. This gives you the option of sending the statement either way.

Printing Paper Statements

In order to print your paper statements, take the following steps:

  1. Create your statements using the process outlined previously.
  2. Click the Print/Send button.


  3. The following window will appear. Select Paper. You will also see a field labeled Exclude Billed Paid Entries. This field will cause the statements to ignore any transactions that have a balance of zero, regardless of whether the entire statement has been paid or not. We recommend that you check this. Once you have made your selections, click OK.


  4. You will now be asked to select a format for your patient statements. Medisoft comes standard with the formats listed. You also have the ability to modify these formats in order to create your own. If the statements you have created are remainder statements, you MUST select a remainder statement format. If the statements you have created are standard statements, you MUST select one of the other formats. After making your selection, press OK.


  5. The program will now prompt you to select where you would like to output your statements. In order for the statement to be marked as billed, you must select either the option to Print the report on the printer or Export the report to a file. Make your selection and click Start.


  6. You will see the Data Selection Questions screen. This screen will allow you to filter your statements. The Statement Total Range will default to 0.01 to 99999. This means that you will only get statements with a total between 1 cent and $99,999. If you want zero or negative balance statements, you will need to modify this value. You will also see a Statement Number Range. This filter will default to a range including the entire range of statements in statement management. Do not change this filter. Make any other selections you wish to filter on and click OK.


  1. The statements will be sent to the output device previously specified.

You will note that Statement Management works in a much different manner than Claim Management. The statements printed are NOT limited to those statements with a status of Ready to Send and a batch set to 0. You will get any statements that have charges with outstanding balances on them.

Additionally, if the same patient or guarantor has multiple statements created in statement management, those statements will NOT print out on separate forms. They will be combined into one statement when printed. There is one exception to this condition. If you have created statements in both the standard and remainder formats, the statements will not merge with other statements with a different type.

Tips and Tricks:

It is possible that charges appear on a remainder statement prior to being paid by the insurance carrier. This has to do with the allowed amount settings. See the Allowed Amount handout for more information.

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Troubleshooting Creating Statements

It is possible that you expect specific transactions to be created on a statement, and they are not appearing on your new statements. If you are encountering this problem, it could be due to any of the following issues:

  1. The transactions have already been placed on a previous statement. This can easily be checked from within
    Transaction Entry. If you modify the grid, you will have the ability to add a field that shows the Statement Number for each transaction.


  2. The transactions were entered into a case not eligible for patient statements. Open the case containing the transactions and make sure the field labeled Print Patient Statement is checked.


  1. If you are trying to create remainder statements, the transaction has not been paid and marked as complete for all responsible insurance carriers. You can quickly check which carriers have not yet paid on the Transaction Entry window. Highlight the charge in question and click the Charge tab at the top of the screen. There is a section labeled Amount Paid. If this section does not have a check mark next to all 3 insurance carriers, the charge will not appear on a remainder statement. Any carriers without a checkmark need to have a complete payment entered prior to that charge creating on a remainder statement.


If the balance on the charge reaches 0 before the responsibility moves to the guarantor, it will not be created on a statement

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Statement Management

There are two methods for actually printing your patient statements. The first method we will discuss is Statement Management. Statement Management handles statements in a similar manner to the way Claim Management handles claims.

Statement Management
allows you to integrate your statements into your collections module (Collection List). Additionally you will be able to utilize the cycle billing feature.

This section will examine the different processes you will use within Statement Management to effectively bill your patients.

To open Statement Management click the Activities menu and Statement Management.

Statement management is ONLY available in Medisoft Advanced and Medisoft Network Professional.

Creating Statements

In order for a transaction to print on a patient statement, that transaction must be created on a statement. In order to create statements, take the following steps from within Statement Management:

  1. Click the Create Statements button.


  2. The following window will appear. Here you will be have the ability to filter which transactions are created on statements. Leaving these filters blank will look for any ELIGIBLE transactions that have not been placed on a previous statement, and place them on a new statement.


  3. In the Statement Type section you have the option to create either Standard or Remainder
    Statements. If you select Standard, you will create statements for all eligible transactions regardless of the party that is currently responsible for the remaining balance. If you select Remainder, you will create statements for all eligible transactions with balances that are currently part of the Patient Remainder Balance.
Tips and Tricks:

When creating statements, each transaction can only be placed on one statement. If you create a standard statement, you will not be able to create a remainder statement for the same transaction unless you delete the original standard statement.

We suggest that you select one type of statement and ALWAYS create statements using that type.

 

  1. Once you have made your selections, click Create.


  2. If the following screen appears, no eligible transactions were found within the parameters set.


  3. If eligible transactions were found, you will see new statements created on the main statement management screens. These statements will have a Status of Ready to Send and a Batch number
    of 0.
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Family Billing


Medisoft Patient Accounting prints one statement per guarantor. A guarantor is the person listed as financially responsible for charges on a patient account. The guarantor is set on a case by case basis on the Personal tab of the case screen.

If a guarantor has multiple patients with balances eligible to print on a statement, all of those patients and charges will appear on one statement sent to the Guarantor.

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medisoft-statement-management-overview

Introduction

After receiving payment from the insurance carriers, the next step in the billing process is to bill patients for any remaining amounts. This process often includes the need to collect from patients on balances not paid. This chapter will discuss the different methods of billing statements, as well as the ways Medisoft can enable your office to better collect outstanding debts owed by patients. Additionally, we will discuss the process for collecting charges owed but not paid by insurance carriers.

Types of Balances

When billing patients for their outstanding balances, it is crucial that you have an understanding of the different types of balances. Within Medisoft, there are two types of patient balances. There are also 3 insurance balances

  1. Patient Reference Balance: The patient reference balance contains all charges in the patient’s ledger that have any outstanding balances. As soon as a charge is entered it is reflected in the patient reference balance. If a transaction is set to be billed to an insurance carrier, the patient reference balance is the only balance it resides in until the claim is billed. When looking at the Transaction Entry screen, the field labeled Account Total will show you the patient reference balance.
    Standard patient statements will include patient reference balances.

  2. Patient Remainder Balance: Patient remainder balances contain charges for which no insurance carrier is responsible AND charges that have been complete payments made by all responsible insurance carriers. By “complete” we mean that the payments entered for the insurance carriers and that payment has been applied and marked “complete” in the payment application screen.
  3. Primary Insurance Aging Balance: When dealing with primary insurance aging balances, we are looking at the amount that is owed by all primary insurance carriers. A charge enters this balance at the point it is billed to the primary insurance carrier. A charge leaves this balance at the point a payment is applied from the primary carrier AND that payment is marked complete.
  4. Secondary Insurance Aging Balance: This balance functions similar to the primary insurance aging balance. A charge enters this balance when the primary insurance carrier makes a complete payment AND when the secondary claim is billed. A charge leaves this balance at the point a payment is applied from the secondary carrier AND that payment is marked complete.
  5. Tertiary Insurance Aging Balance: The tertiary insurance aging balance functions like the secondary insurance aging balance. A charge enters this balance when the secondary carrier makes a complete payment AND when the tertiary claim is billed. A charge leaves this balance at the point a payment is applied from the tertiary carrier AND that payment is marked complete.
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Patient Payments

To enter a patient payment, take the following steps from within the Deposit List:

  1. Click the New button.


  2. The following screen will appear.


  3. The Deposit Date field specifies the date of payment and adjustment that will be listed in the patient ledgers. This date will default to the computer’s system date. You can manually change this date in order to enter payments that were received on previous dates.
  4. The Payor Type field will default to Insurance. Change it to Patient. You will see the window display change.


  5. When selecting the Payment Method, you will have the option to select Check, Cash, Credit Card, or Electronic. Make your selection according to the method the patient used when making the payment.

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Deposit List

The Deposit List is a feature that is only available in Medisoft Advanced and Medisoft Network Professional. This feature will allow you to quickly apply an EOB to multiple patients. It will also track payments that have been entered into Transaction Entry. Any payments entered into Transaction Entry will be automatically entered into the Deposit List and will be listed in the Deposit List as applied payments.

Navigation of the Deposit List

Prior to utilizing the Deposit List, it is important to know the different functions it can perform.

It is important to note that items entered into the Deposit List WILL NOT affect accounts receivable totals until they have been applied to specific charges. This is important to note because it has implications on reports. Reports based on the Deposit List will not match reports based on the Transaction Entry file. This is because the accounting reports are based on the mwtrn.adt table. The Deposit List does not update this table until payments have been applied.

When you first open the Deposit List, you will see the following screen:

We will now discuss some of the fields available to you and explain what they are used for.

Deposit Date: When you first open the deposit list, the Deposit Date field in the upper left corner of the screen will default to the system date. Selecting a date in this field will allow you to see all payments made on that particular date. By default, you will see all payments made today.

Show All Deposits: If you want to see all payments regardless of date, place a check mark in this field.

Show Unapplied Only: This option will allow you to only view deposits that have not been applied, or deposits that have only been partially applied. This is useful in determining which deposits still require work.

Sort and Search: The sort and search functions work in the same manner as the sort and search functions discussed in previous chapters.

Detail: In the upper right corner of the deposit list you will see a button labeled Detail. This button will only be available if you have selected an existing patient or insurance payment that has been applied. Clicking this button will show you the patient accounts to which the deposit has been applied.


 

The Deposit List Detail window can be printed by clicking on the Print Grid button on the right side of the window. This can be helpful for finding discrepancies between an EOB and what has been posted by allowing users to print the detail and compare. Additionally, the printed version will show the dates of service and procedures for the charges to which the payment was applied.

Tips and Tricks:
Because you do not apply capitation payments, you will not have access to the Detail button when a capitation payment is highlited.

 

Export: Clicking the Export button will allow you to export your deposit list to either Quicken or Quickbooks.

Through the deposit list you can apply three types of payments.

  1. Patient Payments: Patient payments entered through the deposit list can be applied to any charges regardless of case, document, or superbill number. These payments can also be made to different patient accounts. This allows you to enter payments that come from a guarantor for one of the patients for whom they are responsible. You will be able to quickly enter up to 2 types of transactions into the patient ledgers. (Patient Payment, and Adjustment
  2. Insurance Payments: Insurance payments entered into the deposit list can be entered for any patient. You will receive a warning message if you try to apply a payment to a patient who does not have that insurance carrier listed in their case information. Additionally, you will be able to quickly enter up to 5 types of transactions into the patient ledgers. (Insurance Payment, Disallowed Amount Adjustment, Withhold Adjustment, Takeback Adjustment, and Deductible)
  3. Capitation Payments: Capitation payments entered into the deposit list are not applied. Therefore they will not affect the practices AR totals. They will ONLY be reflected in your Deposit List reports. You will not see these payments on any other major accounting reports.

We will discuss the process for entering and applying all three of these types of payments. We will focus on the fields that have the biggest effect on the process. For information regarding fields not discussed, refer to the Medisoft Help Files.

 

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