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Global Information Systems, Inc.

MDofficeManagerUser Manual – Charge Entry

1. Basic Charge Entry 2. Re‐billing 3. Tab Explanation

01/2009

MDofficeManager User Manual Basic Charge Entry

Charge Entry CEGeneral Tab

Charge Id: Click on the # symbol to assign a new Charge ID. If you would like to look up an existing charge,enter the charge id number. Patient: Enter the patient # or look up the patient by last name by clicking on the ellipsis, or press the F2 key. Coverage/Case: If the patient has only one Coverage/Case, the data will default into the fields. Should the patient have more than one, you will be given the option to select from a list.

Responsible Party: This field populates from the RI screen.

Billing Provider: This field populates from RI screen, but may be changed if any other provider within thepractice preformed the procedure. Serv Provider: This field populates from RI screen, but may be changed if any other provider within the practice preformed the procedure. This field may be used to report services provided by a NP, PA, nurse or other technical personal.

Facility: This field populates from the RI screen, but may be changed if services were rendered at another location.

Accounting Transaction Date: This is the date the charges are being entered. You may press enter to accept the date as it appears or change to the appropriate date. Use the “+” or “-“ key to change the date.

Financial Class: This field populates from the RI screen.

Charge Class: This field is used to select the type of charge classification and is used to group charges in a department for report analysis. Enter the code, click the box or press the F2 key to make your selection, e.g. “D” for Doctors charges, “H” for Hospital charges, etc.

Referring Doctor: This field populates from the RI screen.

Date Pt Last Seen: Certain procedure codes require Last Date Seen.

Hosp - Frm and To Date: Hospital procedures require a From and To Date.

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Optional Fields Supervising Doc: This field populates from the RI screen. Employer Name: This field populates from the RI screen.

Work Status: This field populates from the RI screen.

Marital Sts: This field populates from the RI screen.

Symptoms Date: This will populate with today’s date. This will print in box 14 of a CMS 1500 claim form.

Accident Date: This field populates from the RI screen. This will print in box 14 of a CMS 1500 claim form.

LMP Date: This field populates from the RI screen. This will print in box 14 of a CMS 1500 claim form.

Similar Con Date: This field populates from the RI screen.

Job Related; Oth Acdt; Auto - Accident; Pl: These fields will populate from the RI screen. Patient Co-Pay: This field populates from the RI screen.

Initial Trmt Dte: This field populates from the RI screen. You may also manually enter the date.

Last Xray Date: This field populates from the RI screen. You may also manually enter the date. Work - Last Date: This field populates from the RI screen. This will print in box 16 of a CMS 1500 claim form.

Return Dte: This field populates from the RI screen. You may also manually enter the date.

Disability-Frm and To Date: This field populates from the RI screen. You may also manually enter the date.

Disability Status: This field populates from the RI screen. You may also manually enter the status.

Active Recalls; Patient Alerts; Responsible Party Alerts: These populate from the RI screen, you may also enter a new one at this time.

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Ins Coverage/Service Detail Tab

Insurance Company: This information will populate from the RI screen. Inact: By checking this box, the insurance will not be seen electronically or on paper.

Claim Type: This information will populate from the Insurance Company table.

P/Clm: The field indicates the claim process, “Y” the claim will process, “N” the claim will not process, “H” the claim is on hold. Note: If a patient has dual insurance coverage, the second insurance needs to change to Hold or No.

Form: This field indicates the form type, “E” the claim will process electronically, “P” the claim will print on aCMS 1500 form.

Subscriber/Insured: This information will populate from the RI screen.

R’ltn: This information will populate from the RI screen.

Member No: This information will populate from the RI screen. Employer/Group Name: This information will populate from the RI screen.

Grp Number: This information will populate from the RI screen.

A/A: This information will populate from the Insurance Company table.

Prior Auth/Ref No: Enter in the Prior Authorization number, if any.

PA/Ref No. Qualifier: Prior Authorization Number/Reference Number qualifier indicates the type of numberbeing provided, if left blank Prior Authorization is assumed.

Claim Number: This field is used for Workers Compensation, information entered will print in box 11 of aCMS 1500 claim form. Block 19 - Local Use: The information entered in this field will print in Box 19 of a CMS 1500 claim form.The word EMERGENCY needs to be manually entered when utilizing the EMG box. For Medi-Cal ONLY claims.

Block 10d - Local Use: The information entered in this field will print in Box 10d of a CMS 1500 claim form.

Block 22 - Mcd R/C: Medicaid Resubmission Code only applies to paper claims. The information entered inthis field will print in Box 22 of a CMS 1500 claim form.

Block 22 - Orig R/N: Original Reference Number only applies to paper claims. The information entered inthis field will print in Box 22 of a CMS 1500 claim form.

Delay Reason Code: Used if a particular claim is being transmitted in response for a request for information;required when a claim is submitted late (past contracted date of filing limitations) this field is used for only for electronic claims.

Comment: For internal use.

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Diagnosis Code: Enter the diagnosis code or click on the ellipsis to select from the diagnosis table.

Procedure Code: Enter the procedure code or click on the ellipsis to select from the procedure table.

Add’l Mod: Enter any additional modifiers.

POS: The Place of Service information will default according to the procedure code setup.

Fee Schedule: The Fee Schedule information will default according to the procedure code setup.

Start Date: Also known as Date of Service, will default according to the Accounting Transaction Date on the General tab.Makes changes, if necessary by utilizing the drop down arrows or typing in the date.

Qty: Enter the quantity or unit of the procedure.

Dx Line No: The Diagnosis line number will default according to the number of diagnosis specified. Make any changesnecessary.

Profile Amt: The Profile Amount information will default according to the procedure code setup.

Patient Amt: The Patient Amount information will default according to the procedure code setup. This field is generally$0.00, use this field when the patient is responsible for a portion of the procedure and it is NOT co-pay.

Charge Amt: The Charge Amount information will default according to the procedure code setup.

Co-Pay: Check the box if the patient has a co-pay related to the procedure.

Fin Resp Lvl: The Financial Responsibility Level will default to 1 - Insurance. Make changes, if necessary.

100%: Check this box if the procedure is 100% covered by the insurance. Patient will NOT receive a statement if the100% box is checked. Generally used for Medicaid or Workers Comp patients. Note: This box is also used when rebilling individual procedure lines.

N/C: Check this box if the procedure is NOT covered by the insurance.

Epsdt: Early & Periodic Screening, Diagnosis and treatment related services. Check this box to print a Y in Box 24H on a CMS 1500 claim form or equivalent electronic field.

EMG: Emergency indicator, Check this box to print a Y in Box 24C on a CMS 1500 claim form or equivalent electronicfield. The word EMERGENCY needs to be manually entered when utilizing this field. For Medi-Cal ONLY claims. F/Pln: Family Planning Indicator, this field is no longer used; Family Planning is now combined with EPSDT in Box 24H.

COB: Leave blank, this field is no longer used.

P/S: Purchased Services, check this box to print a Y in Box 20 on a CMS 1500 claim form or equivalent electronic field.

P/Svc Amt: Purchased Services Amount, enter the amount of the purchased services; this amount will print in Box 20 on a CMS 1500 claim form or equivalent electronic field.

Additional Description: Information entered in this field will print in the shaded portion on Lines 1 through 6 in Box 24Athough 24G.

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Patient Copay: The patient copay amount information will default according to the information from the RI - Registration Information. If the field is blank and the patient has a copay due, enter the amount and make sure the Co-Pay box on the procedure line is check. CTRL S to Save or click on the Save button, at the bottom right corner. Changes to the Procedure Code may be made, only if;

1. The Charge has not been Posted (CREP - Charge Register Edit/Post)

2. A payment has not been created for the charge.

01/2009

MDofficeManager User Manual Re-Bill

Charge Entry CE

For what ever reason you may have to re-bill a claim, following the instructions below and the charge will besaved and ready to send with your next batch of claims.

1. Bring up the Charge ID2. Under the Ins Coverage/Service Detail Tab3. Change the P/Clm indicator from N to Y, this will re-process the charge4. Save

01/2009

MDofficeManager User Manual Re-Bill One Procedure Line on a Charge

Charge Entry CE

only the unpaid procedure line.

1. Bring up the Charge ID2. Under the Ins Coverage/Service Detail Tab3. Change the P/Clm indicator from N to Y, this will re-process the charge4. Check the N/C Box on the PAID procedure line5. Save

If the unpaid procedure code is incorrect/or wrong, the total charge will need to have an adjusted enteras a billing error. A new correct charge will need to be created and filed to insurance and theinsurance payment posted to the procedure codes that were originally paid and then await theadditional payment.

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Should an insurance company only pay for one procedure on a charge, you may re-bill the charge, sending

MDofficeManager User Manual Charge Entry - Tab Explanation

Charge Entry General Tab

CE

The General Tab has the patient, provider, and facility information.

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Charge Entry Ins Coverage/Service Detail Tab

CE The Ins Coverage/Service Detail Tab has all insurance, diagnosis and procedure information.

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Charge Entry Apply Pymt Tab CE Apply payments from the Responsible Party or Insurance on the Apply Pymt Tab. This Tab also shows the Charge Amount, Contractual Write-off Amount, Paid Amount, Adjustment Amount and the Balance for both the insurance and responsible party.

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Charge Entry Financial Mgmt CE The Financial Management Tab is very useful when researching an issue with the charge balance. This tab shows all insurance and responsible party payment and/or adjustments.

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Charge Entry Claim/Stmts History CE The Claim/Statement History Tab will show the history of the charge; every time the charge has been batched and each time the charge has been listed on a statement to the patient. All time and date stamped for tacking purposes.

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Charge Entry Procedure Pay

CE

The Procedure Pay Tab shows the financial summary of the procedure.

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Charge Entry Appeals/Follow-up CE The Appeals/Follow-up Tab shows all Appeals, Notes and Follow-up for the charge that has been entered by a user. 01/2009 7

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