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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Referring Provider Setup

After setting up the providers in your provider list, you will need to set up your Referring Provider list. The Referring Provider list contains a list of doctors who refer patients to you. When dealing with HMOs, and in some other circumstances, Referring Providers are required for specialists.

Generally, the Referring Provider list will not contain doctors who are in the same practice as the providers entered into the Provider List. The exception to this is if a supervising provider is required for the claim. This usually occurs when billing claims where the provider is not a doctor, but a Nurse Practitioner or PA under the supervision of a provider in the office. Medisoft v12 and earlier pulls Supervising Provider information from the Referring Provider List. Because of this, you may need to enter some doctors as both Providers and Referring Providers. Since v14 Supervising Provider can be pulled from either the Referring Provider List or from the Provider List.

The referring provider list is accessed by clicking the Lists menu and Referring Providers.

 

 

Within the Referring Provider screens, you will see many of the same fields that exist on the Provider screen. We will focus on the fields that are different or that have unique functionality.

Specialty: If you are sending electronic claims, select the referring provider’s special field of practice from the Specialty list. If you need to use a specialty code that is different than the usual code, select “Not Listed” and enter your specialty code in the data entry box that appears next to the Specialty list.

Referring Provider IDs Tab: The IDs tab available for Referring Providers mirrors the functionality of the grids for Providers. You will need to create a record in the grid for each referring provider. In this record, you can link the referring provider to a particular insurance carrier/class, if needed, and include other billing details such as the referring provider’s NPI, taxonomy, and other legacy IDs.

 

 

 

TIP: If upgrading from a previous version, you may have numerous multiple legacy Referring Provider ID entries that no longer apply and only a few rows that need to be set up. You may save time by deleting all entries and setting up the few rows you need. Press CTRL + DELETE to delete all ID entries in the Practice, Provider, Referring Provider, or Facilities IDs grids. Use this with caution since all your entries will be removed.

 

Once you have entered all applicable information for a Referring Provider, click Save.

Tips and Tricks:
Many Primary Care Providers and some specialty practices that do not participate in HMOs may not have the need to enter or track referrals and referring providers.
When an office first begins their data entry, they may not know which providers to enter into the referring provider list. This list will grow as patients are seen and bring their referrals with them.

 

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Security Profile Setup

WARNING – if you do not setup at least one administrator account with NO expiration date, you will get the following error:

Medisoft Security Login Expired – if this happens, call us for support at 888-691-8058 or 941-743-6666 as we will have to log into your computer and download some files to reset your security (support charges will apply).

After you have made your preliminary program option selections, you will need to create your security profiles.  This is done by clicking the File menu and Security Setup.  The Security Setup window will appear.

 

Once the Security Setup window appears, click the New button.

You will then need to setup each user that will have access to this practice within the Medisoft program.

Below, you will find guidelines for creating the user security profiles.

Administrator Setup

It is crucial to the functionality of the program that the first user set up is an administrator.  If you set up someone with less than administrative access, and then log out of the program without setting up an administrator, you may be unable to perform certain functions including adding and modifying user Security Profiles.

In order to set up the administrator, take the following steps after clicking the New button:

Enter the Login Name, Full Name, Password, and Reconfirm the Password.  (Do not mark the Inactive box)

In the field labeled Access Level, make sure the number 1 (one) is selected.

Tips and Tricks:Access level 1 is the highest level of access available.  It gives you access to all functions within Medisoft.

 

Do not enter anything in the Expire Date field.

Tips and Tricks:The Expire Date field is not used for password reset expiration.  It is used to disable the entire account on a specific date.  It is not the date the user’s password expires.  Only the Administrator can change this date. If no date is selected, the user will never expire.  If your Administrator login becomes disabled, you could lock yourself out of vital system functions. 

 

Click Save.


Permissions Setup

After setting up your Administrator, you will need to log out of the Medisoft program and log back in using your newly created Administrator login.

Only after logging out and back in as the Administrator will you see a Permissions option under the File menu.

When you click this option, the Security Permissions screen will appear:  On the left side of the screen, you will see a listing of the various windows throughout the Medisoft program.  On the right side, you will see a listing of the different options within that window, as well as 5 levels of users.  By default, Level 1 has the most security options available, and Level 5 has the least.

 

You will now be able to go through and assign different levels of control to the different levels of users.  Placing a checkmark in a particular option will enable that option for the Level selected.  Taking the checkmark out of an option will disable the option for that user.

After making all necessary changes, click the Close button.

Tips and Tricks:It is not recommended that you remove any security options from the Level 1 users.  This level is reserved for Administrative users. 

 

Before adding or removing options from levels 2-5, identify which types of users will be added using that level.  For example, Doctors could be either Level 1 or Level 2.  The front desk might be level 5.  Billers might be level 3.  If you identify which uses will be using that level, it will make it easier to decide which options should be available to them.


Login/Password Management

Medisoft has the ability to create standards for the passwords used by people in your office.  This option is available under the File menu and Login/Password Management.

This window gives you the opportunity to set the following standards for your user passwords:

Renewal Interval:  This field sets the number of days a user has before they have to change their password.

Reuse Period:  This field sets the number of days before a user can repeat a password they have previously used.

Minimum Characters:  This field allows you to set a minimum password length.

Maximum Characters:  This field allows you to set a maximum password length.

Require Alphanumeric:  If you select this option, your users will be forced to use both letters and numbers in their password.  This prevents users from selecting simple passwords that are easy to crack.

Maximum allowed attempts:  This field sets the number of times a user login can be unsuccessfully attempted before the account becomes disabled.

Account disable period:  This field sets the number of minutes a user will be disabled after the maximum allowed attempts is reached.

Once you have set up your password requirements, click the Save button.

Tips and Tricks:Proper use of this window can help protect an office from hackers and other security threats to the data.  This in turn will help a practice be more HIPAA compliant.


Permanent Employee Setup

Permanent employee setup will mirror the Administrator setup with the exception of the access level.  You will want to set your employees up with the access level appropriate for the type of employee they are.

Temporary Employee Setup

Temporary employee setup will mirror the Permanent Employee Setup with the exception of the Expire Date.  Any temporary employee logins should be set to Expire on the last date of their contract with the office.

 

 

 

 

 

 

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Medisoft Login Security Expired

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