Did you know you can prevent a call to medisoft support by following these simple instructions? Here is how to “Customize” certain Medisoft screens when you are looking at tables of data such as the Transaction Entry Screen? Look for the black DOT in upper left corner of a table, click on it, and add or subtract fields of information you want or don’t use. I like customizing the main Transaction Entry screen to include, these additional fields: Guarantor Amount Paid; Adjustment: Claim Number; Ins 1 Paid; Ins 2 Paid; Ins 3 paid; Remainder; and sometimes whether the copay amount or copay amount paid. With todays wide screens, you can get alot of useful data on the screen so that you don’t have to go hunting for it.
Step 1, click on the Black Dot;
Step 2, Click on Add fields;
Step 3, Click and select the feilds you want to add;
Step 4, You might need to modify the column width so that
all the fields fit on your monitor and you don’t have to scroll
to the right to see all of them. REMEMBER, Medisoft uses the WIDEST of the text is typed in, OR the column width. So either
abbreviate the text or reduce the column width, but again, if your text is wider than the column width, Medisoft ALWAYS show all the text, even though the column width might be smaller than the text.

tips n tricks magic black dot

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  1. Enter the Payment Amount.
  2. In the field labeled Chart Number, enter the chart number of the patient or guarantor who made the payment. This is NOT always the patient’s chart number. If the payment was made by anyone other than the patient, you should specify that person’s chart number in this field.
  3. The Payment Code, Adjustment Code, and Copayment Code fields determine which procedure codes will be listed in the patient ledgers for payments and adjustments applied through this deposit. These codes will default with values entered into the Program Options window. These fields are located on the Payment Application tab. The default payment code will be determined by your selection made in step 5.


  4. Once you have entered all applicable fields, click Save.


  5. At this point, we have only affected the mwdep.adt file. There are not yet any entries in the patient’s ledger, nor have we changed the patient balance in any way.
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Patient Payments

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

  1. Click the New button.


  2. The following screen will appear.


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


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

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Deposit List

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

Navigation of the Deposit List

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

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

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

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

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

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

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

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

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


 

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

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

 

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

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

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

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

 

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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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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 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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