for new clients you will enter this data when you enroll ... · for new clients you will enter this...
TRANSCRIPT
MARIN WITS
BILLING THE COUNTY
SET-UP
For new clients you will enter this data when you enroll and admit them into WITS and
your program. For existing clients you will just need to update the sections listed below.
DIAGNOSIS
Each Client must have a diagnosis attached to each encounter that you bill for. The easy
way to add this is to add the diagnosis to the Admission. It will then auto populate on
each encounter. The Diagnosis is available in the Admission after the ASAM. You can
either click through the pages using the next button or select diagnosis from the left
navigation bar.
From the dropdown list, select the diagnosis that was indicated by the clinician. The
wording may be slightly different so use the numbers to select the appropriate diagnosis.
You will also need to enroll the client in a program. This is the next section of the
admission and can be accessed by clicking on the NEXT arrow.
MARIN WITS
BILLING THE COUNTY
Once you are on the Program Enrollment page select ADD Enrollment.
Select a program from the drop down list and make sure that the start date corresponds
with their actual start date and not the data entry date.
MARIN WITS
BILLING THE COUNTY
Next you will need to add a Payor Group Enrollment for each funding source you wish to
bill this client to. There is no limit to the number of enrollment plans a client can be
enrolled in, however, duplicate plans (ie: 2 DMC plans) with overlapping dates may
cause bills to be denied.
To add a Payor Group Enrollment select Profile and then Payor Group Enrollment from
the left hand navigation bar.
Select Add Benefit Plan Enrollment.
MARIN WITS
BILLING THE COUNTY
Fill in the enrollment information based on the sources you wish to bill.
You need to fill in the following Fields:
Payor Type = Medicaid (any medi-cal program), Self-pay (non-county funding), Group
Insurance (private insurance- i.e. Kaiser, Blue Cross) and Other (County),
Plan Group = Plan Group will populate choices based on Payor Type. If you do not see a
plan type that seems appropriate review your Payor Type Selection.
Coverage Start Date = Date insurance coverage started on.
Relationship to Subscriber/ Responsible Party = Self unless private insurance is through a
family member such as parents or spouse.
First Name = Name on Admission Form
Last Name = Name on Admission Form
Birth date and Gender = information on Admission Form
Address = Client address on file with insurance company
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BILLING THE COUNTY
Select SAVE when you are finished.
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BILLING THE COUNTY
The first step in adding an encounter is to look-up the client via the CLIENT LIST.
Select the client’s Activity List.
The first time you add encounters (individual or group counseling sessions, dosing, or
bed days) you will need to access the Encounter Summary via the left navigation bar.
On subsequent months you can access the Encounters from the Main Activity list
MARIN WITS
BILLING THE COUNTY
To enter a new encounter (counseling session record) select Add Encounter Record.
A new Encounter will look like the below screenshot.
MARIN WITS
BILLING THE COUNTY
Begin by selecting the Note Type. For most Medi-Cal services the only option is
PROGRESS NOTES. (Only methadone clinics will also bill for MEDICATION
ADMINISTRATION notes). County billing will access note types related to their funding
source such as Detox, JDC or County.
Next select the service code. For individual therapy sessions select H0004 ODF-
Individual Counseling. ODF stands for Outpatient Drug Free. (Methadone clinics should
select H0004 NTP- Individual Counseling. NTP = narcotic treatment program).
Likewise group sessions should be H0005- ODF group counseling. A complete list of
Services and codes is at the end of this chapter.
MARIN WITS
BILLING THE COUNTY
The page will reset after you make this selection. Next enter the start date and time of
the counseling session. Make sure to change the start date as this field auto populates
with today’s date.
The screen will refresh after you have entered the start time. Enter the End time. The
screen will refresh again and populate the duration.
MARIN WITS
BILLING THE COUNTY
Next you will select the visit type. Acceptable codes for individual units are: AS-
Assessment, CL-Collateral, CS-Crisis, IT-Intake, DP-Discharge Planning, or TP-
Treatment Planning. If you select CS-Crisis you must also mark the encounter as an
emergency. (Unless you are a methadone clinic DO NOT select IN-Individual NTP.)
For Medi-Cal Group Counseling units, the only option will be GR-group. After you
select a Visit Type the Medi-Cal billable box should auto populate to YES. If you are
billing the county this should not be selected.
MARIN WITS
BILLING THE COUNTY
The Rendering Staff field automatically populates with your name. If you are not the
clinician you must be sure to select the appropriate rendering staff from the drop down
list
.
Once you have completed this page you may enter the Encounter Progress note on the
next page by clicking the NEXT button. This page is not currently required for billing.
Once you complete this page you can return to the previous page. If you are not entering
this data, remain on the previous page. Review the completed data and ensure that it is
MARIN WITS
BILLING THE COUNTY
correct. If it is, SAVE your data and then click on the Release to Billing link in the
Administrative Actions box.
Review the Group and Plan Enrollment. If they are correct. Select Finish.
MARIN WITS
BILLING THE COUNTY
You may also CLONE encounters if you only have to change minimal data. This is
especially useful for group encounters where the group meets at the same time every
session.
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BILLING THE COUNTY
A Cloned encounter is completely filled out except that the START DATE and
RENDERING STAFF Fields need to be updated as they both reset to the current date and
data entry staff.
Once you have updated these fields you can SAVE and RELEASE to BILLING as you
would with an original encounter.
MARIN WITS
BILLING THE COUNTY
Summary of Terminology and Frequently Asked Questions
Required item What is it FAQ Where is it
Payor Group Enrollment insurance information Clients may have more than one active insurance card.
Under Profile
Authorization Place to keep track of how many units rendered
Required private insurance
Under Profile
Program Enroll You can now enroll clients without admitting them to tx. This is useful for pretreatment readiness groups or services rendered to residential clients at OP facility.
Under Activity List
Diagnosis Place to enter Diagnosis so that it pre-populates billing encounters and Tx plan
Under Admission
Encounters Place to enter Tx notes and the place to create billing units
Under Activity List
Notes Place to print a list of client specific notes
Under Activity List
Encounter Report Review all encounters provided within a specific time period
Data is exported to excel so it can be reviewed by client, clinician, service, etc.
Reports
Other Items:
Treatment Team Associates staff with clients so that you can look for clients based on their assigned staff
Under Admission
Treatment Plan Syncs with encounter notes so can track progress toward treatment goals
Under Activity List
Group List A convenient way to create encounters for groups.
Can create encounters straight from this list. Can also print sign-in sheet and track attendance.
Above Client List on Main menu
Absences Place to track client absences
Under Treatment