Benefits to using medical emr software in a doctors offic

Medical offices and clinics across the country have long borne the responsibility of keeping extensive paper records that not only consumer valuable office space, but are inefficient by today’s standards. These cumbersome anachronisms are the source of countless wasted employee hours, untold volumes of trees, and probably more than a few missed business opportunities. With the advent of medical EMR software the situation is rapidly changing. This is especially true thanks to initiatives set forth by the Obama administration offering incentives to move away from traditional paper filing systems.
Electronic Medical Records, or EMR for short, is the terminology used to describe the software which not only takes the place of the paper charts, files, and folders that have become a central part of most medical practices. By removing the need to keep a large filing system replete with detailed customer records in an easily accessible area medical EMR software is enabling medical providers to add additional service areas and capacity. Medisoft EMR software only needs the pre-existing office computer network and possibly a few new laptops to convert an office to a paperless (or at least paper-light) facility.
Offices can still keep paper records if they see fit, but they can now be relegated to the basement, or even off-site for security. While on the subject of security, medical EMR software is completely digital, meaning that thousands of records can be stored on something small enough to fit in a pocket. This allows backups that can be easily taken off site for increased security.
Being completely digital using McKesson Practice Choice or Medisoft EMR software means that records are available nearly instantly, and the ability to control which employees can access each record and how. This not only allows dramatic time saving when it comes to retrieving and filing patient records, but offers the ability to hide sensitive data from employees who have no need to see it, while allowing others the access to view/add/change as seen fit by the rules laid forth by the powers that be.
The power to search through patient histories can be a real time saver for highly paid personnel whose best use is seeing as many clients as possible, not sorting through their history trying to figure out when the last time a given patient had similar symptoms was.
With a growing environmental awareness and trend towards customers preferring greener businesses, offices utilizing medical EMR software give the impression that they care about the environment. It is all but inevitable that offices who are late adopters will come off as ‘quaint’ at best, but antiquated and archaic to others. Antiquated and archaic are not exactly the impression that most medical facilities want to leave on potential clients, even if it is over an issue like perceived environmental friendliness.
The increased security and completely digital nature of medical EMR software means that nobody ever has to search for a lost piece of paper this is required for billing purposes. All patient records all easily accessible and perhaps best of all, completely legible.
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Now, you can combine the best medical practice management software with the best cloud based EHR software by selecting McKesson Practice Choice For Medisoft.  This solution allows you to use your popular medical billing software program and your emr software program and pass information between them.



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How To Setup Breaks In Medisoft Office Hours Professional

It is important that you completely set up your schedule prior to actually scheduling appointments for patients. This process includes setting up your breaks.

Breaks can be configured using templates, or the Break List. If you schedule your breaks through the Template setup screen, you will be able to schedule appointments during your breaks if you so choose, and they will not appear as a conflicting appointment. If you set up your breaks using the Break List, you will notice that it is possible to schedule an appointment that conflicts with your break if you so choose, but you have less control over how that appointment appears on the schedule.

If you decide to set up your breaks using templates, follow the process listed under templates to set up a repeating template with a reason code set up for breaks.

If you decide to set up your breaks using the Break List, take the following steps:

  1. The Break List can be accessed by clicking the Lists menu and Break

    If you have previously set up any breaks using the Break List, you will see those breaks listed on the screen.

  2. Click New. You will see the New Break Entry window.
  3. Fill in the fields with the following information:

    Name: If this break was the lunch break for a specific doctor, you would want to specify that information in the name of the break. Make the name as descriptive as possible, in order to avoid confusion when looking at the schedule.

    Date and Time: Similar to the Template setup, the Date and Time fields contain the STARTING dates and times for what is being scheduled.

    Length: The Length field should contain the number of minutes you would like to schedule for the break. This number should be an interval that corresponds with the scheduling intervals set in the Program Options.

    Repeat: Most breaks are going to be regularly occurring breaks. For this reason, you would want to set up most of your breaks as repeating breaks. Refer to the Repeating Appointment Handout for more information on how to configure the Repeating settings.

    Color: This field will let you specify what color you want this break to display on the schedule. This field will default to the value set in Program Options.

    All Columns: Office Hours and Office Hours Professional allow you to set up multiple columns for individual providers. This allows you to double-book time slots. Most breaks would prevent the doctor from seeing ANY patients. For this reason, you would want to place a check mark in this field.

    Providers: Any break can be configured for either specific providers, or all providers. Unless your doctors will all be following the exact same schedule, it is generally recommended that you set up individual breaks for each provider.

    Resource: You can schedule breaks for resources. However, it is not necessary to do so, since the use of the resource will generally require the presence of a provider. If you want to make sure that the break time is set aside for the resource as well, you can do so.

  4. Once you have made you selections on this screen, click Save. If you selected the option to schedule the break for some providers, you will see the following screen:

  5. Click on the provider names of the providers that will be utilizing this break. It is not necessary to hold down the [CTRL] button. Once finished, click OK.
  6. Your break will now appear on your Break List. Notice that if multiple providers were selected, the same break will appear in the list multiple times. It will appear once for each provider.

  7. Repeat this process until all desired breaks are scheduled.


medical office scheduler

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Office Hour Professional Medical Scheduler Software – Program Options – Multi-Views Tab

Multi-Views are only available in Office Hours Professional. Multi-Views allow you to customize your screen to include the schedules for multiple providers and resources. Within the standard Office Hours program, you are only able to view the schedule for one provider at a time.

Within the Multi-Views tab, you will have the opportunity to set up multiple multi-view screens. This gives you the ability to create various schedule views for different workers within the office.

To create a new multi-view, click New. You will see the following screen.

In the Type field, you will be able to specify whether the column you want to create within your scheduler view is for a Provider or Resource. The Code field will contain the code for the Provider or Resource you wish to assign to the column. The Width field will determine how wide that column is.

To add a column, click Insert Column. To delete a column, highlight it, and click Delete Column.

A complete Multi-View setup might look like this:

Once completed, click Close.

At this point, if you click the Multi-View button, you will be given the option to select which multi-view you wish to see.

You will now be able to view the schedules for multiple providers and/or resources at the same time. It is important to note that if you schedule an appointment for both a provider and a resource, that same appointment will appear in both columns.


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Introduction To Medisoft Office Hours Professional Medical Scheduling Software

After completing the data entry outlined in Getting Started, we are ready to begin data entry and use of the Medisoft program. In the normal flow of an office, the first step in the care of a patient is the appointment scheduling process. Medisoft includes an appointment scheduler program called Office Hours Professional.

In previous versions, Office Hours Professional was an additional purchase add-on. The program came with a basic scheduler simply called Office Hours which offered basic appointment viewing options which worked best in offices with no more than one doctor.

Office Hours Professional offers robust and customizable schedule viewing options. Additionally, it offers a more integrated interface to the Medisoft Program.

Office Hours Professional is also sold as a stand-alone product.

Providers and Resources


You will first need to identify the different schedules you need to create. The easiest list to create would be a list of Doctors, Nurses, and PA’s. These are the “Providers” who will be seeing, and treating the patients.

Office Hours and Office Hours Professional will automatically read your provider list from Medisoft. If you are using Office Hours Professional as a stand alone product, you will need to set up the Providers for whom you will need schedules. This process will mirror the Provider Setup from the Getting Started module.

This list is accessed under the Lists menu and Provider List.


After you have set up all the providers you need, you will want to identify the resources within the office for which you would like to create a schedule. Resources could include things like Examination Rooms, Meeting Rooms, and equipment such as X-Ray machines that need to be scheduled.

You can access the Resource List by clicking the Lists menu and Resource List.

When you create a new Resource, you will see that the screen is a fairly simple screen. In the Code field, enter the code you wish to use to identify this resource. The Description field should contain a short description that adequately identifies that resource.


After installation, and setting up your providers and resources, it is important to configure your appointment scheduler prior to doing any appointment entry. You should start your configuration with the setup of your Program Options. It is important to note that the options set in program options are for the entire practice. You cannot make different selections for different providers.

It is important to note, that the Standard Program Options screen does not have any tabs. You will not be able to configure Multi-Views, or the Appointment Display settings within Office Hours. You must have the Professional version in order to have these options.

Professional Program Options

Start Time and End Time: Within program options, you will be able to set the start time and end time for your practice. These are basically the hours of operation, or the hours that are available for appointments or breaks to be scheduled. In a practice with multiple providers, you may have providers that have different hours they are in the office and available. This option should be set from the earliest time that any provider is available for an appointment, to the latest time that any provider is available for an appointment.

Interval: The interval field selects the intervals into which you wish to split your schedule. This interval should be the shortest length of appointment that will be scheduled for the office. Additionally, your interval should fit perfectly within the total amount of time available between your start and end times.

Columns: This field is only available in the Standard Office Hours Program Options. Here you will set how many columns (or appointments) you want to have available for each time of day, for each provider. In Office Hours Professional, you can simply right click on a column, and you will have the option to add or remove the column.

Use Pictures: If you select any of the options within Use Pictures, you will include a picture on the right side of your appointment or break display when certain conditions are met. This feature is only available in Office Hours Professional.

  • Break: The entry will display a coffee cup
  • Repeat: The entry will display one box offset and overlapping another box.
  • Note: The entry will display a paper with the corner folded over.


Appointment Status: The entry will display any of the following pictures for the corresponding appointment status settings.

Unconfirmed: Question Mark


Checked In: Check Mark


Missed: X


Confirmed: Box


Being Seen: Sun


Checked Out: C

Rescheduled: None

Cancelled: None

Default Colors: These three settings will determine what color defaults for appointments, breaks, and appointments in conflict with another appointment or break. In Office Hours Professional, you will be able to select colors for individual appointments.

Use Enter to Move Between Fields: This option will give the enter key the same functionality as the Tab key. This option is especially attractive to users used to DOS programs that had this same functionality.

Remind to Save View: Office Hours Professional gives you the option to modify the scheduler views you are using. If you make changes to a view, and this option is checked, it will remind you to save the views.

Use Automatic Word Capitalization: This option will automatically capitalize the first letter of each word you enter, such as the first letters of the patient’s first and last names.

Automatic Refresh: When using the multi-user version of Medisoft and Office Hours/Professional, you may have multiple people entering appointments at the same time. This option will set how often the program goes back and looks at the database, in order to update the view.

Tips and Tricks:

Some versions of Office Hours may allow you to enter a 0 in this field. DO NOT DO THIS. It will cause the program to go into an endless error loop. You will need data repair to fix this problem if it occurs.


Show Notes on New Appointments: If you check this box, Office Hours or Office Hours Professional will automatically give you a warning if notes are entered into the patient’s case.

Use Automatic Zip Codes: Medisoft and Office Hours both offer you the capability of remembering which City and State belong to a particular Zip Code. If this option is selected, your tab order will skip over the City and State fields, to the Zip Code field, when entering any address information. If you enter a Zip Code that has been previously utilized with a particular City and State, that information will automatically populate those fields.

Use Transaction Entry to make Copays: When integrated with Medisoft, Office Hours Professional will allow you to enter copay information from the scheduler screen. Within Medisoft, it is possible to enter payments either through Transaction Entry, or through the Deposit List. If this option is checked, Medisoft will automatically open Transaction Entry to that patient and case, whenever the Copay option is selected from within Office Hours Professional. If this option is not checked, the copay will be entered directly into the deposit list.

Tips and Tricks:

In most circumstances, at the time the copay is made, the services for which the patient is paying have not yet been performed. If you enter your copay into Transaction Entry, you will be asked to apply the payment immediately, unless the payment code selected is a prepayment.

For this reason, we suggest entering your copays through Office Hours Professional into the Deposit List.


Speed Report: Office Hours Professional gives you the ability to assign one report to a Speed Report icon that appears at the top of the screen. This option determines which report will print when this icon is selected.







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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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Procedure/Payment/Adjustment Setup

When talking about Procedures, Payments, and Adjustments, we are talking about items that are going to affect your Accounts Receivable in some manner. This chapter will discuss the different types of transactions, the effects they will have on your accounts receivable, and how to accurately set up the different types of codes.

To access the Procedure/Payment/Adjustment list, click the Lists menu and Procedure/Payment/Adjustment Codes.

To create a new code, click the New button.

We will now discuss the different types of codes you will set up, and how each is done.


Charges are codes that will increase the accounts receivable, AND will be billed to either the patient or the insurance carrier or both. Codes that are billed to insurance carrier are also known as CPT codes (Current Procedural Terminology).

The most critical field when setting up any entry into this screen is going to be the Type field. The fields available to you on this screen will vary based on the different types selected. We will now discuss each charge type available, and when you would use each type.

Procedure Charge

Procedure charges are the most commonly used codes used in the Medisoft program. Procedure charges are used to charge patients for services rendered in the office.

General Tab

Code 1: The Code 1 field is unlike the other code fields within Medisoft in that it does not automatically populate for you. This is generally the code that will be submitted to the insurance company on either a paper or electronic claim. Unless the service is one you will never be submitting to an insurance carrier, you need to make sure that the code you are entering is a valid code. Valid codes are available through the Codes on Disk and Encoder Pro programs. There are also books that contain listings of all valid codes.

Alternate Codes 2 and 3: These are the alternate codes that are available to be sent on claims to certain insurance carriers, as discussed in the Insurance Carrier setup.

Tips and Tricks:
If an insurance carrier has a 1 in the field Procedure Code Set, claims sent to that carrier for this procedure code will transmit or print the code entered into Code 1. If a 2 or 3 is entered into the Procedure Code Set field, claims sent to that carrier will transmit or print the code entered into Alternate Code 2 or 3.
If you receive reports of procedure codes not printing or incorrect codes printing, this is the first place you should look.


Description: There are official descriptions available through the Codes on Disk and Encoder Pro Products, as well as the books. Codes that will be sent to insurance carriers should utilize these descriptions, even though the description is not generally sent on electronic claims or printed on paper claims. The description does, however, print and send on Patient Statements. For this reason, it is important to enter accurate and good descriptions of the codes, in order to prevent some patients from calling about their statements.

Account Code: Enter the Account Code from your office’s accounting program (such as Quicken or Quick Books) for recording charges and/or payments. This code is used for grouping procedures in the Practice Analysis report.

Type of Service: This type of service code will set the value that will default into the TOS field in transaction entry when this procedure code is entered. There are standard type of service codes that are available in the Knowledge Base and Medisoft Help Files.

Place of Service: The place of service code in the procedure code setup will set the value that will default into the POS field in transaction entry. Similar to the Type of Service codes, there are standard Place of Service codes that are also available in the Knowledge Base and Medisoft Help Files.

Tips and Tricks:
The Type of Service and Place of Service fields within the procedure code setup screen are only fields that will set default values for transactions entered into Transaction Entry using these codes. If you receive a rejected claim for either of these two fields, correcting it in the procedure code setup will not correct the rejection. You must correct the values that are entered into Transaction Entry.


Time To Do Procedure: In the Time To Do Procedure field, enter the average time, in minutes, required to perform this procedure, if applicable. This is usually determined by the provider. This information is displayed when creating an appointment for this procedure, to help determine the appointment length required.

Service Classification: The Service Classification field is where you designate under which service classification this code belongs. The Medisoft Basic program offers only one option (A), whereas Medisoft Advanced and Medisoft Network Professional offer eight options (A-H). The classifications are established in the Case window, Policy tab, Insurance Coverage Percents by Service Classification field.

The main function of Service Classifications is to provide a more accurate division of the patient and insurance portions when transactions are totaled. It is based on the premise that all similar procedures are reimbursed at the same percentage rate by the majority of carriers.

Because a carrier doesn’t normally pay the same percentage for every type of procedure, it is essential that procedures be divided into service classifications in order to assign the proper percentage to each class. These are set up at the time the procedure codes are created and, although they can be changed, they cannot be deleted.

A common example of the variation is the difference in percentages paid for office visits and those paid for lab work. Normally, office visits are paid at 80%, while lab work is covered at 100%. To handle this difference, when the procedure codes are created, office visits are put in service Class A (paid at 80%) and lab work is put in Class B (paid at 100%). In the Case (Policy 1, 2, and 3) windows, in the Service Classification fields, A shows 80% and B shows 100%.


Tips and Tricks:
Service Classification is also used when automatically calculating the allowed amounts. This will be discussed in the Payment Application chapter.


Don’t Bill To Insurance: This field allows you to exclude transactions entered using this procedure code from claims being sent to a particular insurance carrier. If you wish to utilize this feature, enter the insurance code of the insurance carrier you wish to exclude for.

This feature is also based on pre-HIPAA standards, when different insurance carriers used different codes for the same procedure. If you enter anything into this field, you will likely exclude this procedure code from claims. This can result in lower compensation amounts. For this reason, we do not recommend using this feature.

Only Bill To Insurance: Similar to the Don’t Bill To Insurance Field, this field allows you to specify one insurance carrier which will be the only carrier to receive claims with this procedure code on them. Enter the insurance code of the insurance carrier into this field.

Again, this feature is based on pre-HIPAA standards. For the same reasons, we do not recommend using this feature.

Default Modifiers: Certain procedure codes have modifiers that can change the meaning of the code, and therefore the amount of compensation that will come back from the insurance carriers. Lists of these modifiers are available in Encoder Pro as well as in the CPT Code Books.

Tips and Tricks:
Similar to the Type of Service and Place of Service fields, the Default Modifiers simply set which modifiers will be entered by default when this procedure code is entered into Transaction Entry. If you receive a rejection on a claim for a missing or invalid modifier, you will need to correct it in Transaction Entry in order to correct the rejection. Changing this field will not affect any claims.


Revenue Code: This field is only for use with a UB form. UB forms have a field labeled Revenue Code. This is where you should enter the value you wish to print in this field.

Default Units: If no value is entered into this field, each procedure code will default to 1 unit. If you want this procedure code to default to a larger number of units, enter the number you would like to set as default here.

Most procedure codes should default to 1 unit.

If you receive a rejected claim for a missing or invalid number of units, this is not the field you should modify. You will need to change the number of units in Transaction Entry.

National Drug Code: The National Drug Code (NDC) is used for billing prescribed drugs on electronic claims.

NDC Unit Price: The unit price of the drug is applicable when billing prescribed drugs on electronic claims.

NDC Unit of Measurement: The unit of measurement of the drug is applicable when billing prescribed drugs on electronic claims.

Code ID Qualifier: The Code ID Qualifier tells the insurance carrier what type of code is being sent for electronic claims. This should typically be left blank.

Taxable: If the service you are performing is taxable, check this box in order to charge tax when this procedure code is entered.

Tips and Tricks:
In most states, it is illegal to charge taxes on medical services. This field is used more often for items that are sold through the office such as crutches or vitamins.


HIPAA Approved: The HIPAA tab of the program options screen contains an option labeled Warn on Unapproved Codes. If that option is turned on and you enter a procedure code that does not have the HIPAA Approved box checked into Transaction Entry, you will receive a warning stating the following:

If you click Yes, the code will be saved. If you click no, you will be returned to the Transaction Entry screen and you can make any necessary changes.

Tips and Tricks:
Simply marking a code as HIPAA Approved does not necessarily mean it is truly a HIPAA Approved code. You will still get rejected claims if you submit codes that are not officially HIPAA Approved.


Require Co-pay: Beginning with Medisoft v12, you are able to track missed co-pays. When a procedure code is entered into Transaction Entry where Require Co-pay is marked and a co-pay amount is entered into the patient’s case, Medisoft expects a co-pay payment to be applied to that procedure code. If co-pay payment has not been applied to the procedure code, then the patient will appear on the Outstanding Co-Payment Report with the amount due.

Patient Only Responsible: If you check this box, this procedure code will never appear on any insurance claims. It will also cause the charge to increase the patient’s remainder balance as soon as it is entered.

Purchased Service: The Purchased Service box, when checked, indicates that the procedure code is used only in connection with a service that the practice purchases; usually from a lab.

Amounts Tab

Charge Amounts A-Z: Medisoft Basic only contains the first Charge Amounts field (A). In Medisoft Advanced and Medisoft Network Professional, you will have access to A-Z. Here you have the ability to set up different amounts that will be defaulted into Transaction Entry. This allows you the ability to charge different amounts for the same procedure code based on the value entered into the Price Code field in the Patient’s case. One example of a situation where you may want to bill a different amount would be for cash patients.

These fields will simply default the amount that will be entered into Transaction Entry whenever this procedure code is entered. You will still have the ability to change that amount when entering the charge.




Tips and Tricks:
An alternative to charging different amounts for different types of patients is to use write-offs. This will allow you to document the exact reason someone was charged less than someone else. This will protect you if you are ever audited.


Cost of Service/Product: Enter the amount that it costs you to perform the procedure into this field. This will allow Medisoft to report on the profitability of different procedure codes, if desired.

Medicare Allowed Amount: This is a reference field only that will let you know what Medicare’s allowed amount for this procedure in your area is. This is not to be confused with the Allowed Amounts fields in the Allowed Amounts tab. This field will not affect payment application.

Allowed Amounts Tab

This tab will allow you to see the allowed amounts for this procedure code and every insurance carrier in your insurance carrier list. You can also change the allowed amounts here in the procedure code as well as in the insurance carrier list. If the Update Allowed Amount is checked in Program Options under the Payment Application tab, this will let the allowed amounts entered from within Transaction Entry or the Deposit List to update these lists every time. We will cover allowed amounts more extensively in the Payment Application chapter.

Add on Products

Medisoft offers two add-on products that can assist you in quickly and accurately enter in your Procedure Charges.

Codes on Disk: Codes on Disk offers you a quick way to import thousands of codes at one time into your Medisoft Program. This will prevent you from having to manually enter your codes, and helps insure that the proper codes are entered. This is an inexpensive option for someone who wants to simply and quickly avoid a large amount of preliminary data entry. Codes on Disk does not, however, assist you with proper BILLING of the codes entered.


Encoder Pro: Encoder Pro is a program designed to replace the CPT Code book. It will allow you to look up any valid procedure code by code or by name. It will list out what the procedure is for, as well as list any modifiers or special conditions that go along with that code. You can also merge individual codes into your procedure code list. You do not have the option to merge all codes or sets of codes into your data.

Encoder Pro is accessed by clicking the Encoder Pro button on your Procedure Code Entry screen.

Product Charge

For product charges and any subsequent charges, we will only discuss the items that are different from Procedure Charges.

Product Charges are generally used to differentiate between products that are sold and services that are rendered by an office. Product Charges will transmit on insurance claims, but unless the product charge is a valid charge from either Encoder Pro, or a CPT Code Book, you will want to check Patient Only Responsible.

You will also want to check your local laws to see if any products you sell are subject to sales tax. If they are, check the Taxable field.

All other fields within this type of code have the same meaning as those within Procedure Charges.

Inside Lab Charge

Inside Lab Charges are meant to separate Lab charges that are performed in your office, from the other types of charges.

All other fields function as previously mentioned.

Tips and Tricks:
If a code is set as an Inside Lab Charge, it will by default not appear on patient statements if they have been entered into a case with Medicare as an insurance carrier. This is determined by looking at the insurance type. If the type is Medicare, Inside Lab Charges will not print on Patient Statements.
If you need these charges to print on patient statements for Medicare patients, you will need to select the Billable to Medicare Patients field.


Outside Lab Charge

Outside Lab Charges are meant to separate Lab charges that are performed outside your office, but are billed for by you, from the other types of charges. When billing Outside Lab Charges, it’s often necessary to check the Purchased Service field. Outside Lab Charges do not have the same effect on Medicare Patient Statements as Inside Lab Charges.

All other fields function as previously mentioned.

Global Surgical Procedure

This feature is new in Medisoft v14. Global Surgery includes all necessary services performed by the physician before, during, and after a surgical procedure. When a Global Surgical Procedure is entered into Transaction Entry, all other procedures entered subsequently will default to a zero dollar amount if it falls within the global coverage period. If the procedure code entered is outside of the global coverage period, the standard charge amount will appear. Once the Code Type of Global Surgical Procedure is chosen, the Global Period ___ Days field appears.

Billing Charge

Billing charges are used to create interest charges for overdue accounts. It is also used for charges such as no-show charges. Generally, you cannot bill interest or other Billing Charges to insurance carriers. For this reason, you will want to check the Patient Only Responsible field. This also makes most of the other fields irrelevant.

Tips and Tricks:
One common mistake made when entering data into Medisoft is to assign Procedure Charges to the type Billing Charge. This will cause processing errors with both your paper and electronic claims.


When the Code Type field is set to Tax, many of the fields will no longer be available to you. The fields that remain the same will have the same functionality as they did in the other code types.

One different field you will see is the Tax Rate field. Here you can specify the sales tax amount in your area. You will also note that the Patient Only Responsible field will default checked. This is because in most states, it is illegal to charge insurance companies for sales tax.






Tips and Tricks:
You will need to specify the procedure code you wish to use for taxes on taxable transactions within the Program Options on the Data Entry tab.
You will not specify anything in the Amounts tab for taxes, since the amount of the charge will be based on the amount charged to taxable transactions, and the tax rate specified on the General tab.
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Provider Setup

After setting up your security profiles, you will now need to begin entering various items into the Medisoft program. Normally, the first data entered is the Provider information.

When we use the term “Provider” we are generally, but not always referring to doctors. Other examples of employees who must be set up as providers would be Nurse Practitioners and Physician Assistants. In general, anyone whose name will be listed on a claim as the person rendering medical services should be set up as a provider.

The provider information window is accessed by clicking the Lists menu, Provider, and Providers.


You will now see the Provider List window. Click New.

The Provider entry screen will now appear.

Tips and Tricks:
You may find that the Medisoft program has many fields that do not apply to your office. You do not have to enter data in non-applicable fields.



Code: The code field is going to be used to identify this provider throughout the Medisoft program. If you leave this field blank (recommended), the program will assign a value based on the provider’s name.


Tips and Tricks:
Medisoft used what is known as a relational database. This means that there are various data tables that hold different pieces of information. One table for the providers, one for the patients, one for the transactions, etc… When you want to assign a provider to a patient, you will be entering the provider code into the patient record, rather than entering all of the provider information into the patient record as well.

Medisoft Reports generally run based on codes as well. If you assign your own codes, it is possible that the sorting order will not make sense. If you allow the Medisoft program to assign the codes, the codes will be based on the names, and therefore the reports will print in alphabetical order.


Inactive: Because Medisoft uses a relational database, you do not want to delete records that are referenced in different places throughout the program. Additionally, Medisoft will not allow you to delete a record that is referenced somewhere else within the program.

Instead of deleting the record, you have the option to make it inactive. This will prevent new entries from being made using this provider. It will also protect the integrity of the data that was previously entered using this provider.

Provider Demographics: Provider demographics include Name, Address, Credentials, Email, and Phone Numbers. Most of these fields are self-explanatory. However, it is crucial that this information be accurate. If the information is not entered properly, you may encounter problems when you bill your insurance claims.

Signature on File: This field will affect both paper and electronic claims. Most insurance carriers do not require an actual signature on a claim. If you check this box, paper claims will print the words “Signature on File” in box 31. Electronic claims will also signify to the insurance carrier that the signature is on file.


Tips and Tricks:
The Signature on File fields work in conjunction with fields that are set up in the individual insurance carriers. This is due to the fact that different carriers can have different requirements. Both the provider and insurance carriers must be set up properly in order for this feature to function properly.


Signature Date: The Signature Date field will only affect paper claims. If you enter a date in this field, and this provider is the provider on a claim, that claim will have this date entered in the Date portion of box 31. If you do not have any date entered in this field, the program will automatically populate box 31 with the date the claim was created.

Medicare Participating: This field will not affect either paper or electronic claims. This is a reference field that will allow you to specify which doctors in the office are Medicare participating, and which are not. The benefit to using this field would be in reporting. For example, if you would like to compare the revenue for participating vs. non-participating providers, this field would help you do so.

License Number: The License Number field is used to hold the doctor’s medical license number. This field will not affect paper claims, but can be transmitted on electronic claims in certain circumstances.


Tips and Tricks:
On the provider setup screen and throughout the Medisoft program, you will see a button labeled Set Default. This button is used to create default values for fields that will generally contain the same values for each record entered into that screen.

On the provider screen, the address fields are fields that often qualify as default fields.

This button can also cause confusion if used improperly. If you press the Set Default button with a provider record open, that information will automatically populate whenever the New button is pressed. Customers may then call and state that when they press the New button, Medisoft brings up a different provider account.

In order to remove previously set default values, hold the CTRL button. You will see that the default button now says Remove Defaults. While holding CTRL, click this button.




The Reference tab displays data converted from the Default Pins and Default Group IDs tabs, which were replaced in Medisoft 16 and above with the Provider IDs tab.

This tab is primarily for reference. The only field with functionality is the Provider Class field.

Provider Class: Provider Class allows you to run more effective reports by grouping providers. Provider classes are designed to let you filter for a group of providers that are not listed consecutively in the provider list.




Provider IDs

All providers should have at least one grid entry on the Provider IDs grid for each provider. This grid works in conjunction with the Practice IDs grid in Practice Maintenance. If you have a provider that in some instances bills using his/her own NPI number for a specific insurance carrier, you can create an extra grid entry for this provider in which you specify the insurance company and select to pull the provider’s NPI number from the Provider IDs grid.

Click New to add an item to the grid.





Tips and Tricks:
Similar to the Tax ID number field in the practice information, you do not want to enter any symbols or spaces along with any ID or Number.



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.

Mammography Certification: If a provider has been issued a Mammography Certification number, enter it here. This will only affect EDI claims in certain circumstances.

Care Plan Oversight: Enter the provider’s Care Plan Oversight number here for electronic claims.

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

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Free Download of Medisoft Billing Program:

One of the most popular medical billing software programs is Medisoft Advanced and Medisoft Network Professional.  You can download a free 30 day, fully functional demo of medisoft for free.  Of course the program itself is not free, only the demo period; after the 30 day demo of this popular medical practice management software is up, you may decide you want to purchase the program for your medical billing service or internal medicine practice, mental health clinic, physical therapy management solution, or for your physician office.

After you download medisoft billing software for free , and the 30 day free demo expires, you can purchase our insurance billing software program, or delete it from your computer.

Free Medical Practice Management Software Demo Download

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