So here’s the problem, in Medisoft, under LISTS menu; Patient Guarantor List window, its split into two sides; the patient list on the left, and their case list on the right.  However, you can put your cursor between the two windows and drag either one to make it bigger, but by doing that, you can completely “Hide” the other list.

Medisoft list window

Medisoft list window

 

 

 

 

So here’s how to get the invisible window back:

 

How to get a window back in medisoft

How to get a window back in medisoft

If that doesn’t work, close out all the windows INSIDE of Medisoft; so all you see is a grey screen , then click on WINDOWS on the Medisoft Menu, and then CLEAR WINDOWS POSITIONS…

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Charge Entry and Edit

Once you have configured your data entry screen, you are now ready to enter charges. In this section we will discuss the methods of entering and editing charges. We will focus on the fields that default into the grid. We will also focus on issues that can arise during the charge entry process.

Column Sorting

To help practices manage your charges, you are able to click on any of the Grid Headers to sort by that column. Medisoft will remember your sort preferences.

Single Charge Entry and Edit

We will begin our discussion with the process for entering or editing a single charge. This process can be repeated in order to enter or edit multiple charges. In order to enter charges, click the New button at the bottom of the charge portion of Transaction Entry. (The top data entry section.) You will see a new line appear in the charge section.



Date: The Date field is the date of service for most charges. If you are entering a charge that requires a beginning and ending date, this field is where you would enter the beginning date.

Tips and Tricks

The Date field will default to the date listed in the lower right corner of the Medisoft screen. This date can be easily changed by clicking on the date. This will bring up the calendar. When you select a date, this will be the default transaction date for all new transactions.

Procedure: This field is where you would enter the actual procedure code for the charge. This code should have been entered into the Procedure/Payment/Adjustment List. Only codes with the Type field set to one of the 5 charge types or Tax can be entered in this portion of the screen. In the flow of office procedures, this should be specified on the superbill that the provider fills out during the patient’s visit.

Units: If multiple units of the same procedure were performed, enter the number of units in this field. After entering the Procedure Code, you may see that the units field automatically populate with a number. This is coming from the Default Units field of the procedure code setup. The Units field also corresponds directly to the Total field within Transaction Entry.

Amount: When entering Amounts you are specifying the amount you would like to BILL to the patient or insurance carrier. It is important to note that this amount is not the same as the amount of money you expect to be paid. This is especially true when dealing with insurance carriers. Most carriers base their payments on Allowed Amounts. We will discuss what an allowed amount is later.

You may see that the Amount field automatically populates with a default amount. This amount is calculated based on two fields:

  1. Case – Price Code: Within the patient’s case, you entered a letter from A to Z into a field labeled Price Code which is located on the Account tab.
  2. Procedure Code – Charge Amounts: On the Procedure Code Setup screen, you will see a tab labeled Amounts. This tab contains fields labeled A through Z. These fields contain default charge amounts that can be sent to Transaction Entry when this procedure code is entered. The amount that is sent will be determined by the value entered in the Case – Price Code field. If you entered the letter A for the Price Code, the value entered into field A on the Charge Amounts tab will be sent as the default charge amount.

You do have the ability to manually change any value that defaults into the Amount field.

Total: You do not have the ability to manually change the value that appears in the Total field. This field will be the amount that is billed for this line item on a claim. The value that is displayed here is based on the numbers entered into the Units field and the Amount field, as well as a setting within Program Options. Within Program Options, if the field labeled Multiply units times amount on the Data Entry tab is checked, the Total field will contain the result of multiplying the Units by the amount. If the program option field is not checked, the Total field will contain the same amount that is entered in the Amount field.

Diag 1 – 4: The Diag 1 – 4 fields are where you specify which diagnoses were identified during the patient’s visit. These codes will be identified on the superbill filled out by the provider during the patient’s visit. Within these fields you should enter ALL the diagnosis codes that were identified during the visit. These fields determine what will print in box 21 of a CMS-1500 form.

1-4: The fields labeled 1-4 are fields known as Diagnosis Pointers. These fields correspond directly to the Diag 1 – 4 fields. These fields indicate which of the diagnosis codes apply to this particular transaction. Place a check mark under the numbers that correspond with the correct applicable diagnosis codes entered in the Diag 1 – 4 fields.

Tips and Tricks:

If you are entering multiple charges, it is critical that you enter exact same diagnosis codes in the exact same order in the Diag 1 – 4 fields. Failure to do so will cause the transactions to appear on different claims. If a diagnosis code doesn’t apply to a particular charge, simply uncheck the corresponding Pointer field.

Additionally, if you change the diagnosis codes for a transaction that has been previously placed on a claim with other transactions, that transaction will be removed from the claim.

Provider: The Provider field in transaction entry is where the attending provider (or provider who performed the procedure) is entered. This field will automatically populate with the provider who was entered into the case as the Assigned Provider. When you are creating claims for transactions entered, if you create based on Attending Provider, the claim will include provider information for the provider entered in this field within Transaction Entry.

Tips and Tricks:

If you enter multiple transactions with different Attending Providers, pay attention to how claims are created. If you create based on Attending Provider, you will get a different claim for each different provider listed on eligible transactions.

POS: POS stands for Place of Service. This field is used to specify where the service was performed. There are specific place of service codes that must be entered. A list of eligible codes is available in the Medisoft help file. You may also find information defaulting into this field. You have the ability to set default place of service codes both in the Procedure Code Setup, and the Program Options.

TOS: TOS stands for Type of Service. Similar to the POS field, this field requires entry of one code from a list of specific type of service codes. A list of eligible codes is available in the Medisoft help file. This field may also default a value. These defaults are set in the Procedure Code Setup screen. There is not a program option to default this value.

Allowed: Allowed amounts are only required when an insurance carrier is responsible for a charge. This amount is used by the carrier to calculate the amount of compensation that will be made for that charge. See Allowed Amounts Handout.

M1: The M1 field is used to enter modifiers. Modifiers give the insurance carrier more information regarding the charge. This can affect the amount of compensation. In some instances you will need more than one modifier. If this is the case, you will need to add the additional modifier fields to the grid.

Once you have entered your transaction(s) including all pertinent information, click the Save Transactions button at the bottom of the transaction entry screen.


If you want to edit a charge that has been previously entered, you simply need to make the necessary Chart, Case, Document, and Superbill number selections, and then editing the fields you need to change. Once you have made your changed, you will need to click the Save Transactions button.

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Reference Items, Account Aging, and Account Totals

At the top of the Transaction Entry screen, you are going to see various fields that reference different items in the patient’s account. These items can help you with various parts of the billing process. In this section we will discuss those fields and the information that can be found by using them. The items referenced on the default screen relate to the case that is selected. They do not relate to one particular transaction.

Reference Items


Last Payment Date: This field shows you the last time a payment was made to this patient’s chart. This field will be the same for each case a patient has. Additionally, this field is referring to any payment made to the account. It does not matter whether the payment came from the insurance carrier or from the patient.

Last Payment Amount: Similar to the Last Payment Date field, this field is chart specific. It will show you the amount of the last payment made into the patient’s account.

Last Visit Date: Medisoft will automatically track visits for you. A visit is defined as a calendar day for which one or more CHARGES have been entered for a case. Visits are tracked on a case by case basis, meaning each case will have a different date. This field shows the date of the last visit for the selected case.

Visit: When setting up the patient case, you had the opportunity to specify the number of visits that were authorized by the insurance carrier. Certain carriers will authorize a certain number of visits for certain circumstances. These are done using what is known as authorizations. Each authorization would require a separate case. The visit field automatically tracks how many visits have occurred in that case (and therefore under that authorization). It uses the same definition of a visit that was previously given under Last Payment Date.

This field can prevent the office from seeing patients who have met or exceeded their authorized number of visits, and therefore will not have coverage for that care. Additionally, the office can then let the patients know that they are getting close to their limit, and then let the patients take appropriate action to either obtain another authorization, or find an alternative means of care.

If this field is for some reason showing the wrong number of visits, you can manually change it from this screen. Simply double click the word Visit. The following screen will appear.


You will be able to increase or decrease the Visit Number as needed. Once the changes are made, click OK. This process will change the visit series number listed in the patient’s case information.

Global Coverage Until: If you enter a Global Surgery code for this case the Global Coverage Until field will automatically calculate the date by taking the date that the global procedure was entered and adding the number of days entered in the procedure code.

Account Alerts: Account Alerts are red, two letter codes that are designed to alert you when the customer meets certain conditions. In order to receive some or all of these account alerts you must check them in Program Options, in the General tab, at the bottom in the Account Alert Settings area.

Account Aging

        

Account Aging: Depending on the tab being viewed, it will show the aging of the insurance carrier or the patient. The total will indicate the total amount from the insurance carrier’s or the patient’s aging. On the Patient’s tab it will indicate if there is any copay overdue. On the insurance tab TNB stands for Total Not Billed indicating that the claim needs to be created and sent.

Policy Copay: When entering the information into the case, you have the ability to enter a copay amount. The amount entered into that field will appear in this field. Medisoft will not automatically enter the copay for you, but it will help track missed copays. There is a new report call Outstanding Co-payment Report.

OA: OA is an abbreviation for Other Arrangements. This is a field in the case setup screen that will allow you to enter 4 characters. Whatever is entered into that field will appear in this portion of the screen.

Annual Deductible: Similar to visits, deductibles are handled on a case by case basis. You can enter the annual deductible into the insurance carrier tab of the case screen.

YTD: If you enter deductible type codes into a patient’s account, the amount field is filled out with the amount of the charge that was applied to a deductible. When this is done the accounts receivable for the patient is not affected. You simply move the balance responsibility from the insurance carrier to the guarantor. The amounts entered into deductible type transactions are totaled for the case and displayed in the YTD field.

Tips and Tricks

Medisoft will track deductibles for you on a case by case basis. It is important to note that the only party whose calculation matters is the insurance carrier.

Simply because Medisoft states that the deductible has or has not been met, does not mean it is true. If the patient has been seen by any other providers for any reason during that year, they will have made payments that were applied to the deductible. These transactions will not be in your providers system.

Totals


Charges: Shows the total number of charges that appear on the currently displayed Transaction Entry screen. If you are utilizing the Superbill or Document Number fields, this will be the total number of charges that have been entered into that specific superbill or document number.

Adjustments: Shows the total number of adjustments that appear on the currently displayed Transaction Entry
screen.

Subtotal: This field displays the sum of the Charges and Adjustments fields. The reason we state that it displays the sum is because the Adjustments field can contain either positive or negative values.

Payment: Shows the total number of payments that appear on the currently displayed Transaction Entry
screen.

Balance: The Balance field shows the total balance for the transactions currently displayed. These transactions are specific to the case that is currently selected. If you are utilizing the Superbill or Document Number fields, this will be the balance on the transactions entered specifically for that superbill or document number.

Account Total: This field is different from the other total fields that have been previously explained in one very important way. The Account Total field shows the entire balance for that patient’s account. This balance does NOT filter based on Case, Document, or Superbill.

If you delete transactions in the day to day operation of the program, this amount may show an incorrect balance total. In order to recalculate the amount, simply double-click on the amount.

Calculate Totals: The Calculate Totals field is located in the lower left corner of the Transaction Entry screen. If this field is selected, the totals will appear. If it is not checked, the only value that will appear is the Account Total field.

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Medisoft Mobile – Medisoft iPhone App Released (via SBWire)

Medical iPad App allows users to enter medical electronic superbills and check schedules from iPhones. Tampa, FL — (SBWIRE) — 04/01/2013 — http://www.MedicalBillingSoftware.com today announced the release of Medisoft Mobile – A Medisoft iPhone App available for Free, now from the iTunes store. The…

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In an article from the MGMA, they state that the average out of pocket cost for a “commercial health plan” patient, each time they visit the doctors office, is approx $110 per visit.  This is a far cry from the simple days when patients only paid a $5 or $10 copay and that was all.

What does this mean to your medical practice cash flow? Several things, first it means that you need to understand the whole revenue cycle management concept and be aggressive in your patient collections since they are paying a bigger portion of your bill.

I use this analogy all the time when consulting with doctors offices;  You wouldn’t expect to go shopping to your local Grocery store, get to the checkout counter, have them bag your groceries, take the bags and yell out to the cashier as you are leaving “just bill me for these” would you?  No, you go shopping, you pay for your products or services right then and there; medical offices need to have the same philosophy about payment for services.

What can you do? Several things, lets start with a short list:

1- Eligibility verification

2- Collection of Copays, co-insurance, and other fees at time of visit.  (Its a whole lot easier to collect from someone face to face, than for them to leave and try to play “telephone tag” afterwards.)

3- Sending regular statements

4- Calling patients to remind them to pay their bill.

5- For some specialties, consider a financing plan where the patient pays the plan and you get your money up front, and the plan takes the responsibility of collections.

6- Create and follow a collection policy.

 

I will go into further details in subsequent blog posts, so stay tuned.

 

All The Best,

 

Harry Selent, MHA

 

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Medical Billing Software Program

Medical billing software from medisoft is a great way to manage the insurance and medical billing functions of your phsician office or medical billing service.  With hundreds of useful reports to the ease of use of sending claims and statements electronically, Medisoft is the medical practice managment software of choice for todays small 1-5 doctor practices.

Because medisoft medical billing software is so popular with smaller practices, you should have less training time when you have staff turnoever.  When you go to hire new staff, its likely that they will already know how to successfully use our software program for electronic claims submission to a clearinghouse or directly to medicare in some states.

What can you do in these slow economic times to stay afloat?  Collect patient deductible at time of service.  Offer different payment options. With the medical billing software, you can offer different payment options. Deductible is the amount payable by the patient and can’t be claimed from the insurance corporation. The software helps to track that to guarantee prompt collection.

What else can you do?  Be sure to followup on all insurance denials or rejections, do not let the insurance companies cheat you out of cash. Many practices simply give in on insurance claims because they find it too boring to trace the claims. The practice therefore ends up losing cash. With the billing software a prepared  practice does not have to lose cash due to denials or denials any more. Simply identify the bad claims, correct the issues, resubmit, and rake in the money.

Here’s another idea – Schedule efficiently to fill up your schedule efficiently.  Your practice relies on your patient appointments for cash. So it is important to have robust software which will manage all your appointments for you, and you can accomplish this with Office Hours medical appointment scheduling software built in to medisoft.

In short, medisoft medical billing software program is the best solution for small doctor practices to manage your insurance billing and medical practice management software solutions.

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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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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 – Address Tab;
Code: The referring provider code can contain up to five alphanumeric characters and identifies the referring provider in the program.

Inactive: For information on the Inactive check box, click here.

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, see Program Options – Data Entry Tab.

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. Read more

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