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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Adjustment Definitions

As stated in the introduction, adjustment entry is closely related to payment entry. When applying an EOB from an insurance carrier, you will not only create and apply payments, but you will also create and apply various types of adjustments. We will examine the types of adjustments that can be posted, and when each type should be used.

Disallowed Amount Adjustment: Allowed amounts are defined as the amount insurance companies will base their compensation on. Disallowed amount adjustments are used to reduce the balance on charges that were billed at a rate higher than the allowed amount. If you are using Medisoft Advanced or Higher, this adjustment can be automatically calculated for you through the deposit list. If you are using Medisoft Original, or if you are applying your payments through Transaction Entry, you will need to manually calculate and enter this adjustment amount. The calculation used in determining the amount is (Billed Amount – Allowed Amount) x (-1). If your billed amount is lower than the allowed amount, it is definitely in your best interest to raise your prices.

Withhold Adjustment: Withhold adjustments are used to decrease the AR total on a patient’s account due to money being withheld by the insurance carrier on a previous EOB. Insurance carriers may withhold money due to prior overpayments. These overpayments do not necessarily need are not necessarily going to be for the same patient(s). For this reason, withhold adjustments are often combined with takeback adjustments.

Takeback Adjustment: Takeback adjustments are used to increase the AR total on a patient’s account due to money being withheld by the insurance carrier on a previous EOB. This type of adjustment is applied to the patient(s) who has charges that were overpaid by the insurance carrier. Takebacks are usually entered in conjunction with a withhold adjustment.

Deductible: Deductible entries are used to move the responsibility for a particular charge to the next responsible party without lowering the AR total. If a charge has been applied to a deductible, the patient is responsible to pay for the charge. For this reason you do not want to change the AR amount. You simply want to make sure the charge shows up on the remainder statement.

 

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ERA Adjustment Posting

ERA (Electronic Remittance Advice) Adjustment Posting is an option that works in conjunction with Revenue Management. Revenue Management automatically reads the electronic EOB format returned by the insurance carrier, and applies the payments to the appropriate charges. This is the most efficient way to post payments. The process for posting an electronic EOB will be discussed in the blog posts covering EDI.

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Figure 1 – Medisoft Payment Entry

The entire purpose of billing insurance claims is in anticipation of the payment that will come as a result of the claim. It is important that you go through the process of applying the payments to the charges being paid. This will allow your aging, remainder billing, and collections to function properly.

These payments often require the entry of various types of adjustments. This depends on the insurance carrier making the payment. The adjustments will also require application to specific charges.

The document that will guide you through the payment/adjustment entry and application process is the EOB or Explanation of Benefits. This document is returned by the insurance carrier along with the payment for the services. Often this document is returned electronically to the doctor. In many instances, insurance carriers are moving towards a policy of ONLY returning electronic EOB’s.

Refer to the EOB handout to see what an EOB looks like.

 

When applying payments, there are three main data files you will be modifying.

  1. MWTRN.ADT: The mwtrn.adt table is the table that contains all of the transactions entered into the system. This includes charges, payments, adjustments, and comments. Most accounting reports are based on the mwtrn.adt table.
  2. MWPAX.ADT: This table is often referred to as the “PAX” table. It is used to link payments to the charges to which they are applied. This table plays a critical role in calculating patient balances, and which party is currently responsible for any given charge.
  3. MWDEP.ADT: The mwdep.adt table is the table that holds all deposits.

In the chapters to follow, we will discuss the manner in which the different payment interfaces update these three tables. It is critical that you understand these processes in order to more fully understand the reason different problems might arise in the use of and reporting on your data.

 

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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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Patient/Guarantor Payment Application

If you are applying a patient/guarantor payment, you will follow the same process listed above under Insurance Payment Application with one exception. You will not see a Complete box when applying patient/guarantor payments.


The purpose of the complete box is to allow billing of the next responsible party. The patient/guarantor is the last responsible party. There is nobody to move the balance to. For this reason, there is no complete box on the Apply Payment to Charges screen.

Patient/Guarantor Co-pay Application

If you are applying a patient/guarantor co-payment, the most important thing to remember is to choose a co-payment code and not a regular payment code. When applying the patient/guarantor co-payment, a new button will appear called Apply To Co-pay.


The Apply To Co-pay button will work similarly to the Apply To Oldest button. It will apply the co-payment to the oldest procedure code requiring a co-payment. In most cases, there should only be one procedure code requiring a co-payment, however if there was a missed co-pay for a previous visit, the Apply To Co-pay button will apply to the first record requiring a co-payment.

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Transaction Notes

You have the ability to enter notes specific to a certain transaction. When viewing the Transaction Entry screen with the default grid settings, the first field along the left side of the screen is the note indicator.

This field appears blank if there is no note attached to the transaction. If there is a note attached to the transaction, you will see a sheet of paper occupying this field and indicating that a note is attached.


If you would like to view or enter a note for a specific transaction, highlight that transaction and click the Note button.


You will see the following screen:


In the Type field you will need to select the type of note you wish to add. The type of note you select will depend on what you want to do with the note. If you want the note to appear on a patient statement, you would need to select the type labeled Statement Note.

Once you have entered the Type, enter the note into the field labeled Documentation/Notes. When finished, click OK.

If you are simply viewing a previously entered note, the screen will appear with the Type and Documentation/Notes displaying the previously entered values.

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Transaction Entry Display Configuration

Now that you understand the reference fields at the top of transaction entry, you are ready to configure the transaction entry portion of the screen to meet your needs.

Screen Size and Proportions

The transaction entry portion of the screen is divided into two parts. The upper portion is used to enter charges. The lower portion is used to enter payments, adjustments and comments. You have the ability to change the size of the charge and payment portions of the screen. Hold the cursor between the two portions until it shows two arrows pointing up and down. While holding your left mouse button down, drag the window until the proportions meet your needs.

If do not like any changes you have made to the display of your screen, you can click the Window menu and Clear Window Positions. It is important to note that this will clear any custom display settings that have been made anywhere within Medisoft.

Custom Grid Settings

Both the charge and payment portions of Transaction Entry come with fields that default into the display. These fields may meet your needs, or they may not. You have the ability to customize the grid to include or exclude fields according to your needs.

In order to modify the grid settings, take the following steps:

  1. Select a Chart and Case Number. You do not have the ability to modify the grid unless these are selected.
  2. Click the small black dot on the far left of either the charge or payment portion of the screen.



    Earlier versions do not have a black dot. Click the small square button that looks like part of the header.


    The following screen will appear. This screen will allow you to modify the fields and captions that appear in that portion of Transaction Entry. The Field column will give you a list of all the data fields that are currently displayed on that view. The Caption column lists the labels that will appear at the top of that particular column. The Width column indicates how many characters will display in the currently set column width.

    The fields are listed in the order they appear on the display. The first field listed will be along the far left of the display screen, and as you move down, each subsequent field will be directly to the right of the previous field.


Tips and Tricks:

It is important to note that you can change the Caption for any particular field that is being displayed. Use this feature with care. Mislabeling a field could lead to improper data entry and rejected claims.

If you would like to change the order of the fields, you can simply click on a field name and drag it to the position you want it to occupy, or you can use the and buttons to help you set the order for your fields.

If you would like to add fields that are not currently listed, click the Add Fields button. The following screen will appear. The Add Fields screen will give you a list of all fields that you can add to the display. Fields that are already displayed will not be listed on this list. Additionally, it is not possible to add fields to the list. Highlight the field(s) you wish to add, and click OK.

Note: The Windows multi-select functionality will work on this screen. Simply hold the [CTRL] button while clicking the fields you wish to add.


If you would like to remove unneeded fields from the list, highlight the field you wish to remove and click Remove Field. This feature will not work with the Windows multi-select functionality. You must remove the fields one at a time.

If, at any time, you want to restore the defaults for that particular window, click the Restore button.

Once all needed changes have been made, click OK.

Certain fields are used more often than others. The following is a list of the fields that are most often added to the Transaction grid, and the purpose the fields fill.

Claim Number: The claim number field is used to quickly tell the user which claim each transaction is on. This information is also given in the charge tab of the referential information at the top of the screen; however you can only see one transaction at a time in this view. Adding the Claim Number to the grid allows a complete overview of the claims containing the displayed transactions.

Date Created: Many reports are run using the date the transaction was created. This is especially true for the aging and analysis reports. Adding this field to the grid can allow you to quickly see which report filters will cause the displayed transactions to print.

Date To: Some procedures may be performed over the course of more than one day. These procedures require two dates, the beginning and the ending service dates. This field allows you to enter the ending date.

Statement Dates: These fields will allow you to quickly see the dates that statements including this charge were sent to the guarantor.

Document Number: The Document Number field is helpful when using the Serialized Superbills or Document Number features. If you are using these features and you select the Show All field, you will be able to see all transactions regardless of document or superbill number. Adding the Document Number field to the grid will allow you to see the document and serial numbers when multiple numbers are being displayed.

Facility: Adding this field allows you to specify a different facility for each transaction. It is important to note that transactions with different facilities will never create on the same claim. This field will default to include the value entered into the Facility field of the case. Additionally, changing the facility for a transaction that has already been placed on a claim with other transactions will remove that transaction from the claim. It will be added to a new claim the next time claims are created. This information affects box 32 of a paper claim, and loop 2310D.

Tips and Tricks:

If you are printing paper claims, the default formats pull the facility information from the patient case. If you want the forms to print the facility information from the Transaction Facility field, you will need to customize the form to do so.

Minutes: The Minutes field will automatically be added to the grid if the Practice Type field in the Practice Information screen is set to Anesthesia. This field is only necessary for anesthesiologist billing.

Modifiers: Medisoft only defaults one modifier field into the grid. There are some circumstances when more modifiers are needed. You can add the modifier fields 2 through 4 in order to accommodate the necessary additional modifiers.

Remainder: The remainder field indicates how much money is still owed on that particular transaction.

Copay: When checked, this field indicates that the patient copay should be applied to this procedure. This field is automatically checked if the Require Co-pay field is checked in the procedure code.


Copayment Expected Amount: Adding this field will show the copayment amount expected by the patient according to what was entered in the copayment amount field of Policy 1 in the patient’s case.

Copayment Paid: Indicates when a copay has been applied to the procedure code.

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Program Options

After creating a practice, you will need to set up the program options for that practice.  The program options will govern how the Medisoft program will react in certain situations.  It is usually good to set the program options once, and then only modify them if specific situations require that change.

In this chapter, we will not cover all of the program options, rather the more basic ones.  We will cover the more complex options in the chapters covering the affected portions of Medisoft.

The program options are accessed by clicking the File menu and Program Options.

 

 

Tips and Tricks:The program options settings are specific to the practice that is open when you adjust the settings.  This means that multiple users accessing the same data will be functioning under the same program options.  It is not possible to make these settings user specific, unless each user is accessing a different practice’s data.

 

 

General

 

 

 

 

 

 

 

 

Remind to Backup on Program Exit:  This field will enable or disable the Backup Reminder window that appears when closing the Medisoft program.

 

 

 

 

 

 

 

 

Tips and Tricks:It is generally recommended that you leave the Backup Reminder window enabled.  Backups are extremely important for any office.One possible instance when you might want to disable this reminder is if the office is using the Medisoft Backup Scheduler or another automated backup program such as a tape drive backup.

 

Backup Program:  By default this field is set to mbackup.exe.  This is the executable file that runs the Medisoft Backup Program.  We do not recommend that you change this field.

Command Line:  If you decide to use a third-party backup program, the Command Line field is used to pass parameters to this program.  Refer to the manual for the program you choose for a list of valid parameters.

Show Windows on Startup:  Once you have completed your preliminary data entry, you will spend most of your time in Medisoft within 1 or 2 windows.  These windows are Transaction Entry and Patient List.  Selecting either of these options will cause the windows selected to open automatically when Medisoft is launched.

Show Hints:  This option enables pop up help hints when your cursor is held above an icon for a few seconds.

 

 

 

 

 

 

Show Shortcuts:  If you select the option to Show Shortcuts, the available shortcut keys for the active window will display along the bottom bar of the Medisoft program.

 

Use Server Time:  This option helps you maintain the integrity of your data by ensuring that all computers are working off a central date (the system date and time on the server).

Calculate Patient Remainder Balances:  You can see the Patient Remainder Balances in various places throughout the program.  This field must be recalculated every now and then in order to ensure accuracy.  This option allows you to specify exactly when this amount will be recalculated.

Data Entry

 

 

 

 

 

 

Use Enter to move between fields:  This option changes the function of the Enter key to mirror the Tab key and move the cursor to the next field.

Use zip code to enter city and state:  If this option is enabled, the city and state fields of any address within the program will populate automatically if a zip code is entered which has previously been entered in conjunction with a particular city and state.

Tips and Tricks:If the Zip Code feature is enabled, the tab order of most screens containing an address will be changed.  The tab will move from the street fields to the zip code field.  Once the zip code is entered, if the city and state fill in, the tab will never move to those fields.  If the city and state do not populate, the next time you press tab, the cursor will move to the city field.


HIPAA

 

 

 

 

 

 

Auto Log Off:  This field is designed to help the practice maintain HIPAA compliance.  If you have set up your security profiles, a locked screen will prevent viewing and modifications to the program after the allotted number of minutes go by without activity in Medisoft.

Tips and Tricks:The timer for this feature is timing the use of the actual Medisoft Program.  If you are using other programs on the computer, but Medisoft sits idle for the specified amount of time, the program will lock down.

 

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